BACKGROUND: The differentiation between basal cell carcinoma(BCC) and trichoepithelioma(TE) is sometimes difficult clinically and histologically, and their differentiation is important since their treatment and prognosis are sometimes different. OBJECTIVE: Our purpose was to investigate whether there was a difference in CD34 staining patterns in the stromas (immediate and distant stromas from the tumor lobules) of BCC and TE, since the histopathologic characteristics of the stromas are one of the most important features to differentiate the two tumor. METHOD: We perfomed immunoperoxidase staining(modified ABC technique) by using a monoclonal anti CD34 antibody(QBEND10, IgG1) on the formalin-fixed, paraffin-embedded biopsy specimens of 11 BCC as and 10 TEs. RESULTS: 1. In the immediate strcimas, spindle-shaped cells were stained in 4 out of ll cases of BCC and in 9 out of 10 cases of TE. However, the staining patterns observed in the 4 cases of BCC were all loosely scattered, week staining, while those of the 9 cases of TE were all densely compact, strong staining. CD34 was not expressed in one case of TE. 2. In the distant stromas, all cases of BCC and TE showed staining of loosely scattered spindle-shaped cells, and there was no difference in staining patterns of the two tumors. 3. Papillary mesenchymed bodies were observed in 8 cases of TE and in none of BCC, and they expressed CD34 focally. CONCLUSION: CD34 sta ining patterns of the immediate peritumoral stromas of BCCs and TEs were different and could differentiate the two tumors.
Biopsy ; Carcinoma, Basal Cell* ; Prognosis

No abstract available.
Fistula*

The surgical correction of postburn nose and lips deformities still remains a difficult task domain to be done by plastic surgery. Consequently, the performance of autogenous cartilage graft and ear cartilage graft to maintain a better philtral form were found to raise the problem of a defect in the unnatural form due to consecutive tension in the region. Recently, focus had been placed on composite graft, including auricular cartilage, to obtain a unique dimple in the philtrum, and concurrently with this, part of its natural form has been acknowledged. However, composite graft on scar beds with poor circulation on the recipient site dose not represent safe survival, has increased risk allotment, which laeds to difficult application. From Jan. 1992 to Dec. 1998, the authors have experienced auricular composite graft in 15 patients who had a defect on the philtrum due to postburn scar contractures. As types of this operation, in method I, the subcutaneous pocket is made at the midline of the upper lip. The next step is cartilage insertion into subcutaneous tissue. The cartilage graft is fixed to be overlying skin by the bolus sutures. In Method II, the recipient site is excavated by some excision of the soft tissue in the central upper lip after scar tissue excision. The obtained auricular skin composite graft is placed and fixed to the philtral area. In Method III the auricular skin composite graft is harvested, and 2 or more 2mm-sized multiple holes are made along the midline of cartilage. Then composite graft is fixed to the defects of philtrum. The elongated portion of the distal tip of cartilage is embedded into the vermilion tubercle for sprouting and fullness. The most effective method was Method III, which enhanced the survival of auricular cartilage graft and its overlying skin, by trimming the margin of grafts, and enhancement of the connecting vessels through fenestrated holes of cartilage between the recipient site and composite graft. The authors hereby report the results of the present study along with study findings based on literature surveys.
Burns* ; Cartilage ; Cicatrix* ; Congenital Abnormalities ; Contracture ; Ear Cartilage ; Humans ; Lip ; Nose ; Skin ; Subcutaneous Tissue ; Surgery, Plastic ; Sutures ; Transplants*

Though proper management of hand burns in children is provided, hypertrophic scars frequently cause various hand deformities or functional disturbances in growing hands. When correction principles have not been observed for the long term, contraction of the skin, tendon and joints has a serious influence on hand deformities and bone change occur in growing children and second, to determine when is the proper operative time to minimize hand deformities and recurrences. We reviewed 107 hands in 103 admitted pediatric patients who had postburn hands deformities by scar contracture. The analysis of severity of hand deformities was evaluated by assessment of our hospital scale. According to these data, we performed the operations and compared the final results. The results were as follows: The types of burn hand deformities among 107 involved hands of 103 patients included flexion contracture (39.3%), syndactyly (29.9%), extension contracture (10.3%), Boutonniere deformity (9.3%), claw hand deformity (5.6%), severe hypertrophic scar (3.7%), swan neck deformity (0.9%), and loss of digit (1.9%) etc. On 98 preoperative x-ray examinations, bone changes were common, including angular deformity (19.4%), epiphyseal plate loss(18.4%), osteoporosis (17.3%), bony erosion (17.3%), joint change (15.3%), and ankylosis (9.2%). Thus, early correction of postburn hand deformities is imperative in pediatric patients, even though there is a greater chance of secondary operation due to immature scars. All patients were operated on by our proposed protocol and postoperative results showed greatly improved finger joint motion than before. We concluded that early correction of Grade III to V postburn hand deformities is mandatory in rapidly growing pediatric patients.
Animals ; Ankylosis ; Burns* ; Child* ; Cicatrix* ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Contracture ; Finger Joint ; Growth Plate ; Hand Deformities* ; Hand* ; Hoof and Claw ; Humans ; Joints ; Neck ; Operative Time ; Osteoporosis ; Recurrence ; Skin ; Syndactyly ; Tendons

BACKGROUND: The morphalogy of fibroblast in culture is important in the discrimination of normal and abnormal cells as well as in recogniring general physiologic status of the cells. There have been many reports on the morphologic clialges in various skin diseases and in response to various drugs. However, we couldnt find any report on the time-sequential morphologic changes of normal fibroblasts in early subculture using light microscopy. OBJECTIVE: The purpose of this study is to describe the time-sequential morphologic changes of normal fibroblhst in early subculture. METHODS: The fibroblaats from 4 normal donors were cultured. We observed the morphologic changes of fibrolMasts in the third passage of subculture using light microscopy at 0-, 30-, 60-, 90-, 120-minutes, 3-, 5-, 24-, 72-hours and days after trypsinization, and electron microscopic exarriioation was done at 21 day-culture. RESULTS & CONCLUSION: Just after trypsinization, the cell were small and round, which divided and increased in number as time went by. At 120-minute culture, many cells had long and thin cytoplasmic elongations and they took stellae,shape at 5-hour culture. At 24-hour culture, several spindle-shaped cells were observec with cell-cell contacts. At 72-hour culture, many spindlle-shaped cells were arranged in medirection, with the appearance of parallel or whorl patterns and showed prominent cell-cell contacts. On electron microscopic examination, there were prominent RER, residial bodies and microfilaments.
Actin Cytoskeleton ; Cytoplasm ; Discrimination (Psychology) ; Fibroblasts* ; Humans ; Microscopy ; Skin Diseases ; Skin* ; Tissue Donors ; Trypsin

A consensus of current surgical practice favors external skeletal fixation in the patients with open fractures, where it can be difficult to achieve a good position and fixation by the usual methods and ipsilateral multiple fractures where it is desirable to avoid prolonged immobilization of adjacent joints. From March, 1979 to December, 1981, 34 patients with lower limb fractures were treated by the method of external skeletal fixator. 22 patients had open comminuted fractures with extensive soft tissue injuries and 12 patients had multiple fractures which were difficult to reduce and maintain in alignment. In the 30 patients which could be assessed, the final result was excellent or good in 23 patients, acceptable in 5 patients, and poor in 2 patients.
Consensus ; Fracture Fixation ; Fractures, Comminuted ; Fractures, Multiple ; Fractures, Open ; Humans ; Immobilization ; Joints ; Lower Extremity ; Methods ; Soft Tissue Injuries

No abstract available.
Humans ; Muscle Spasticity*

14 cases of femoral shaft fractures were treated with cast-brace for two years from June, 1974 to June, 1976 at the Department of Orthopedic Surgery, College of Medicine, Seoul National University Hospital. The results were as followings; 1. Of the 14 cases, eleven cases were male and three were female, and they were between 18 to 51 years of ages. 2. The fracture site was accounted that three of 14 cases were at the distal one third of the femur and the other eleven at the mid one third with four cases being comminuted. 3. 7 cases were treated with cast-brace initially, and the other 7 cases were secondarily treated, because of being complicated. 4. The average time of fracture healing was 14 weeks in the cases with cast-brace which is compared with 20 weeks of spica-cast control group in the same period. 5. One of 7 cases treated primarily developed shortening and angulation, which was corrected by open reduction and internal fixation.
Clinical Study ; Female ; Femoral Fractures ; Femur ; Fracture Healing ; Humans ; Male ; Orthopedics ; Seoul

Urinary growth hormone (GH) excretion was quantitated in 12-hr overnight urine collections obtained from 13 children with complete growth hormone deficiency (CGHD). 6 children with partial growth hormone deficiency (PGHD), 5 children with short stature and normal GH provocation tests (NSC), and 5 normal control children (NC) to investigate whether the measurement of urinary GH can clearly separate the PGHD and CGHD groups from the NSC and NC groups. In addition, the urinary excretion of GH was measured in CGHD after sc injections of 0.1 IU/kg GH three times a week and daily in an attempt to determine the optimal replacement dose. The results were as follows. 1) The 12-hr urinary GH excretion cleary separated the CGHD (1.2+/-1.1 ng/12 hr; range, 0.3-3.1, n=13) and PGHD (3.7+/-2.4 ng/12 hr; range, 0.9-6.8 n=6) groups from the NSC (14.0+/-3.6 ng/12 hr; range, 8.5-18.2 n=5) and NC (12.7+/-5.8 ng/12 hr; range, 6.9-20.8, n=5) groups without any overlap. 2) There were significant difference in 12-hr urinary GH excretion between CGHD and PGHD, but the higher values in CGHD groups overlapped some of the lower values in PGHD group. 3) There were no differencies in 12-hr urinary GH excretion between NC and NSC. 4) A 12-hr urinary GH values less than 6.9 ng/12 hr suggested GH deficiency. 5) The CGHD patients who received o.1 IU/kg GH. sc. daily GH levels within the range of the mean +/-SD in NC. but those who received theree times a week had daily variable urinary GH levels. These results suggest that the measurement of 12-hr nocturnal urinary GH excretion monitering of GH therapy response.
Child ; Growth Hormone* ; Humans ; Urine Specimen Collection

BACKGROUND: The CD34(human progenitor cell antigen) is a monomeric, 115 kD glycoprotein which is expressed on hemitopoietic progenitor cells. It is also now known as an immunohistochemical marker of endothelial cell like UEA-I and factor VIII R Ag and its function is thought to be related to endot.helial adhesion, migration, and angiogenesis. OBJECTIVE: This study was aimed to investigate the patterns of CD34 expression during the early and late stages of vascular formation in pyogenic granuloma. METHOD: We performed immuinoperoxidase staining(ABC technique) by using a monoclonal anti-CD34 antibody(QBEND10, IgG1) on the formalin fixed, paraffin embedded sections of 19 cases of pyogenic granulomas. Result : 1. In all cases of pyogenic grinulomas, CD34 was strongly expressed in the endothelial cells of normal vessels in the perilobular stroma and in the endothelial cells of the mature vessels within the lobules of hemangioma. 2. In the foci of immature vessels, most of the endothelial cells located near the small vascular lumina and endothelial cells with intracellular lumen formations expressed CD34, while the endothelial cells far from the vascular lumina and endothelial cells without intracellular lumen formations mostly did not express CD:4. CONCLUSION: The above result. suggested that the expression of CD34 of the endothelial cells vary with the stage of maturation of the vessels.
Endothelial Cells ; Factor VIII ; Formaldehyde ; Glycoproteins ; Granuloma, Pyogenic* ; Hemangioma ; Paraffin ; Stem Cells