Angiosarcoma is a rare malignant tumor of endothelial cell origin. Histopathologically, varied differentiation may be observed even within the same tumor. Epithelioid angiosarcoma is one subset of poorly differentiated angiosarcoma which is a rare variant. We report a case of epithelioid angiosarcoma of the scalp in a 59-year-old man. The patient had a painful solitary, 2x3 cm sized, dome-shaped, firm, erythematous to purplish nodule with crust on the vertex of the scalp. Histopathologically, the tumor was chiefly composed of solid sheets of atypical epithelioid cells with prominent eosinophilic cytoplasm, a large vesicular nuclei, and occasional intracytoplasmic vacuoles. Well to moderately differentiated areas with irregular vascular channel-like structures lined by atypical hyperchromatic endothelial cells were also seen in the peripheral areas of the tumor. Immunohistochemically, the tumor cells were positive with CD31 which is sensitive marker of endothelial cell.
Cytoplasm ; Endothelial Cells ; Eosinophils ; Epithelioid Cells ; Hemangiosarcoma* ; Humans ; Middle Aged ; Scalp* ; Vacuoles

PURPOSE: To assess the efficacy of ancillary CT findings other than the obstructive lesion per se for the differential diagnosis of extrahepatic biliary obstruction. MATERIALS AND METHODS:CT findings of 49 patients with extrahepatic bile duct obstruction(22 benign and 27 malignant lesions) were assessed with emphasis on the patterns of ductal dilatation, contrast enhancement, and diffuse thickening of the extrahepatic ductal wall. Degree of central and peripheral intrahepratic ductal dilatation was graded by comparing with the adjacent portal radicles and hepatic parenchymal thickeness. RESULTS: Diffuse circumferential thickening and contrast enhancement of the extrahepatic ductal wall were more frequent in benign cases, but only thickening was statistically significant(p < 0.01). Peripheral intrahepatic ducts were more severely dilated by malignant causes(p < 0.01). With the same degrees of extrahepatic and central ductal dilatations, peripheral intrahepatic ducts were more severely dilated in malignant than in benign cases. CONCLUSION: These results may help to interpret the CT findings of extrahepatic biliary obstruction, particularly when the cause of biliary obstruction is uncertain.
Bile Ducts, Extrahepatic ; Diagnosis, Differential ; Dilatation* ; Humans

Desmoplastic trichilemmoma is a rare variant of trichilemmoma characterized by typical features of trichilemmoma with abundant desmoplastic stroma. We report herein a 54-year-old man presented with 2-year history of a solitary bean sized verrucous nodule on the occipital scalp. Histologically, the tumor showed a well-defined lobular growth extending from the epidermis into the dermis with abundant central desmoplastic stroma. Epithelial lobules at the margins of the neoplasm showed the typical features of trichilemmoma composed of glycogen-rich clear cells and peripheral palisading columnar cells. In contrast, at the center the cells assume a more random pattern of cords and strands traversed by the hyaline stroma, mimicking invasive carcinoma. It was diagnosed desmoplastic trichilemmoma by the distinctive histologic appearance and totally excised.
Dermis ; Epidermis ; Humans ; Hyalin ; Middle Aged ; Scalp

OBJECTIVE: To evaluate the changes of maximum fibrillation potential amplitude and root- mean-square (RMS) value of denervation potential after nerve injury using power spectrum analysis. METHODS: The sciatic nerve was transected in 8 rats, and was compressed in 6 rats. Denervation potentials were collected in gastrocnemius using monopolar needle weekly after nerve injury. The change of RMS value of 1 second epoch of denervation potentials with time was evaluated and compared with the change of maximun fibrillation potential amplitude. RESULTS: In nerve-transected rat, the RMS value declined linearly with time after injury. On the contrary, the amplitude of fibrillation potentials declined much rapidly during first 3 weeks. In nerve-compressed rat, both the RMS value and amplitude of fibrillation potential increased for 2 weeks after injury, and declined thereafter. As the result of simple regression analysis, the changes of RMS value correlated better than changes of fibrillation amplitude in all 8 nerve-transected rat. CONCLUSION: The RMS value of denervation potentials correlated well with time after nerve injury in animal experiments. Measurement of the RMS value might be helpful to evaluate the time after peripheral nerve injury, but long-term human data should be essential for clinical application.
Animal Experimentation ; Animals ; Denervation* ; Evaluation Studies as Topic* ; Humans ; Needles ; Peripheral Nerve Injuries ; Rats* ; Sciatic Nerve ; Spectrum Analysis*

Holoprosencephaly is a rare CNS developmental defect with midline cleavage of embryonal forebrain during the fourth week of fetal development characterized with s single ventricle. Holoprosencephaly is divided into three types by the degree of the brain cleavage : alobar, semilobar, and lobar. Depending on the degree of defected regions, there exist variable clinical symptoms and signs such as stillbirth, hypotonia, apnea, convulsion, delayed development and visual disturbance. It was frequently associated with the deformity of the brain as well as the midline facial structures. Advances in neuroimaging over the past decades have led us to a better understanding of the pathogenesis and the variability of holoprosencephaly. As a result, a lot of cases of holoprosencephaly with various clinical and pathologic findings have been reported. We experienced a case of isolated interhemisphere fusion of frontal lobes with intact septum pellucidum in a child with febrile status epilepticus. Is it a variant of holoprosencephaly?
Apnea ; Brain ; Child ; Congenital Abnormalities ; Fetal Development ; Frontal Lobe* ; Holoprosencephaly* ; Humans ; Muscle Hypotonia ; Neuroimaging ; Prosencephalon ; Seizures ; Septum Pellucidum* ; Status Epilepticus ; Stillbirth

PURPOSE: Out-of-hospital cardiac arrest is an extensive public health problem, so cardiopulmonary resuscitation (CPR) has been widely taught to lay communities. However, little research has been done to assess attitude and reluctance to performing CPR in Korea. The present study clarified the basic factors affecting attitude and reluctance towards resuscitation in Seoul, Korea. METHODS: Using a telephone survey of a randomly selected sample of Seoul citizens, we questioned 1,007 subjects over a 2 week period in November 2006 on their prior training, knowledge, and awareness of resuscitation. The survey questions sought to clarify basic aspects of knowledge and attitude towards CPR, as well as to gather demographic information. RESULTS: Forty-five percent of subjects had previously been taught CPR. Of these, 70% had been taught more than two years previously. While sixty-nine percent indicated a general willingness to performed CPR on a stranger, only 6.8% responded that they definitely would perform CPR. In addition, only 3.3% were able to remember the correct compression- to-ventilations ratio for adult CPR. Of the 314 respondents who were unwilling to performed CPR, 44.3% gave as their reason the risk involved in a deteriorating situation, while 33.1% cited a lack of CPR knowledge. The factors most related to CPR performance and reluctance were male (odds ratio=1.997, p=0.048), prior CPR education (odds ratio=1.798, p=0.001), and accuracy of CPR knowledge (odds ratio=1.983, p=0.001). CONCLUSION: Although general awareness of CPR among the Korean community is high, practical knowledge relating to the performance of basic CPR is poor. This suggests that present community CPR educational strategies had limited efficacy.
Adult ; Cardiopulmonary Resuscitation ; Surveys and Questionnaires ; Humans ; Korea ; Male ; Out-of-Hospital Cardiac Arrest ; Public Health ; Resuscitation ; Telephone

Chondroid syringoma, also known as `mixed tumor of the skin', is a kind of acquired hamartoma of folliculosebaceous-apocrine lineage. Histologically, it is characterized by the biphasic pattern, with epithelial structures enveloped by abundant stroma. We report a case of chondroid syringoma, as an asymptomatic nodule, on the upper lip of a 55-year-old male. Histologically, the tumor had both epithelial components with follicular differentiation and myxochondroid stroma.
Adenoma, Pleomorphic* ; Hamartoma ; Humans ; Lip ; Male ; Middle Aged

We report a case of alopecia neoplastica in a 54-year-old woman, who presented with a 2 month history of a solitary 2X2 cm sized, erythematous hairless plaque on the vertex. Histological findings showed an extensive infiltration of tumor cells in the dermis, resulting in loss of the pilosebaceous structure. Tumor cells infiltrated in sheets or cords of cells, sometimes demonstrating glandular structures, and tumor cells formed small groups or single rows between thickened collagen bundles; the characteristic features of alopecia neoplastica.
Alopecia* ; Breast Neoplasms* ; Breast* ; Collagen ; Dermis ; Female ; Humans ; Middle Aged

BACKGROUND: Scientific and epidemiologic studies have shown that several dermatoses of Vietnam veterans were caused by Agent Orange. Most of the previous studies on Vietnam veterans have been about the relationship between systemic diseases including limited dermatoses and Agent Orange, but there have been no clinical studies of dermatoses of Korean Vietnam veterans exposed to Agent Orange. OBJECTIVE: We conducted this study to find out the distribution and characteristics of dermatoses of Korean Vietnam veterans exposed to Agent Orange. METHODS: A total of 19, 262 Korean Vietnam veterans who received their first dermatological examination at Seoul Veterans Hospital between January 1997 and December 2003 were included in this study, which consisted of a skin examination and 15-item questionnaire. RESULTS: 1. The distribution of dermatoses groups were as follows: pruritus, psychocutaneous disorders, and neurocutaneous dermatoses (36.1%), dermatomycosis and deep mycosis (20.5%), eczema (11.6%), diseases of the skin appendages (3.6%), epidermal and adnexal nevi and tumors (2.1%), drug eruption, erythema, and urticaria (1.8%), and papulosquamous diseases (1.5%). 2. Pruritus (31.6%) was the most frequent dermatosis in all age groups. 3. The frequency of dermatoses related to exposure to Agent Orange were as follows: seborrheic dermatitis (4.8%), chronic urticaria (1.7%), psoriasis vulgaris (1.2%), xerotic eczema (0.5%), photosensitive dermatitis (0.2%), chloracne (0.1%), soft tissue sarcoma (0.1%), and malignant tumors (0.01%). 4. With regard to regional groups of dispatch in Vietnam, QuiNhon (20.1%) was the most frequent area of dispatch. There was no statistically significant difference in frequency of dermatoses related to exposure to Agent Orange between Dian, where larger amounts of Agent Orange were sprayed, and the other regional groups. 5. For duration of dispatch in Vietnam, there was no statistically significant difference in frequency of dermatoses related to exposure to Agent Orange between two groups of duration. CONCLUSION: This study showed the distribution and characteristics of dermatoses of Korean Vietnam veterans exposed to Agent Orange, and may be helpful as the fundamental epidemiologic data of dermatoses of Korean Vietnam veterans for dermatologists to examine.
Chloracne ; Citrus sinensis* ; Dermatitis ; Dermatitis, Seborrheic ; Dermatomycoses ; Drug Eruptions ; Eczema ; Epidemiologic Studies ; Erythema ; Hospitals, Veterans ; Humans ; Nevus ; Pruritus ; Psoriasis ; Sarcoma ; Seoul ; Skin ; Skin Diseases* ; Urticaria ; Veterans* ; Vietnam* ; Surveys and Questionnaires

In the era of coronary artery bypass grafting, the intraaortic balloon pump(IABP) is more widely used and its indication has been expanded. We performed retrospective clinical analysis on the patients who have received IABP pre and/or postoperatively during the course of CABG. From January 1981 to June 1995, total 322 patients have received CABG at the Seoul National University Hospital and among them 50 patients(15.5%) were supported by IABP during the course of the operation. The mean age at the time of the operation was 57.2 years(39-75 years) and the male to female ratio was 33:17. The preoperative diagnosis was unstable angina in 33(66%), stable angina in 7(14%) and postinfarct angina in 8 patients(16%). As for the indications of the IABP, there were 13 cases(26%) with left main disease, 13(26%) with class IV angina, 12(24%) with difficulty in CPB weaning, 6(12%) with postinfarct angina and 3(6%) with severe LV dysfunction. In the remaining 3 cases, one patient was operated on after PTCA failure in emergency basis, another was a patient with AMI, and the other was one who had postoperative low cardiac output syndrome. All IABPs were introduced via femoral artery and among them 45 cases(90%) percutaneously. The mean postoperative assist time was 22.3 hours(0.5-168 hours) and IABP could be removed within 48 hours in most of them(44/50). The operative mortality was 6.1%(3 cases) and postoperative morbidity was only one with lower extremity ischemia. The more general application of the IABP during the course of the CABG ,especially in patients with high preoperative risk factors or difficulty in CPB weaning is a good measure of protecting and recovering myocardial function with minimal risk.
Angina, Stable ; Angina, Unstable ; Cardiac Output, Low ; Coronary Artery Bypass* ; Coronary Vessels* ; Diagnosis ; Emergencies ; Female ; Femoral Artery ; Humans ; Intra-Aortic Balloon Pumping ; Ischemia ; Lower Extremity ; Male ; Mortality ; Retrospective Studies ; Risk Factors ; Seoul ; Weaning