Atypical cutaneous fibrous histiocytoma (ACFH) is not well known and only a small number of cases have been reported. Characteristically, ACFH is found on the trunk and limbs of middle-aged women. Although considerable cellular atypia may be present, it occurs focally, the remainder of the tumor representing more classical cutaneous fibrous histiocytoma. A 37-year-old woman presented with a solitary brownish firm nodule on her right forearm. No other abnormalities were found in her personal or family history. Clinically, the tumor simulated a benign fibrous histiocytoma. Histologic examination revealed a poorly delineated intradermal tumor with the usual appearance of benign cutaneous fibrous histiocytoma, but a variable pro-portion of cells in the tumor were scattered atypical cells or bizarre multinucleated giant cells. We report upon a rare case of ACFH.
Adult ; Extremities ; Female ; Forearm ; Giant Cells ; Histiocytoma, Benign Fibrous* ; Humans

Anodic spark deposition method(ASD) surface treated titanium implant possesses a considerable osteoconductive potential that promoting a high level of implant osseointegration in normal bone. The purpose of this study was to observe the ASD implant's osseointegration in the osteoporosis-induced animal model. Twenty four rats, 10 weeks of age, were ovarectomized and 5 weeks later divided into two groups : ASD implant group and control implant group. Titanium screw implants (diameter; 2.0 mm, length, 3.5 mm; pitch-height, 0.4 mm) were designed for this study. Experimental implants were ASD treated and no treatment on control implants. ASD implants and control implants were placed in to left tibiae of rats. The rats were sacrificed at different time interval(1, 2, 4 and 8 weeks after implantation) for histopathologic observation and immunohisto -chemistrical observation, with collagen type I, fibronectin, integrin alpha2beta1 and integrin alpha5beta1 antibodies. The results obtained from this study were as follow: 1. Histopathologic findings, overall tissue response and the pattern of bone formation in both groups were similar. In ASD group, more newly formed bone was seen at 1 week and 2weeks than control group. 2. The levels of type I collagen and fibronectin expression were the most abundant at 2weeks and decreased gradually in both groups. Fibronectin and type I collagen expression in ASD group were stronger than control group but no significance. 3. The levels of integrin alpha2beta1 and Integrin alpha5beta1 expression were most abundant at 2 weeks and decreased gradually in both groups. No significant difference was observed in both groups. From this results, anodic oxidized titanium implants were more advantages in early stage of bone formation than control group, but have no significance in tissue responses and late bone formations. It could be stated that although anodic oxidized titanium implant possesses considerable osteoconductive potential but in osteoporotic bone condition dental implant procedure should performed after improving or treating the osteoporotic bone condition.
Animals ; Antibodies ; Collagen Type I ; Dental Implants ; Fibronectins ; Implants, Experimental ; Integrin alpha2beta1 ; Integrin alpha5beta1 ; Models, Animal ; Osseointegration ; Osteogenesis ; Osteoporosis ; Rats ; Tibia ; Titanium

The purpose of this study is to investigate the clinical and histologic changes in distraction osteogenesis according to different distraction rates in the rat's tibia. Eighteen adult rats underwent open osteotomy and attachment of an external unilateral distraction device in the middle of left tibia. Latency was allowed for 7 days before distracton began. The distraction device was activated with varying distraction rates of 0.5mm, 1mm, 2mm and same rhythm of twice a day until 5mm length gain was achieved. The animals were sacrificed at post-distraction 4, 8 weeks to observe the bony healing states. At each group, clinical, radiographic and histologic studies were done. The results obtained from this study were as follows: 1. The 0.5mm group showed excellent osteogenesis than other groups. The new bone was formed by intramembranous bone formation mostly and endochondral bone formation partly. 2. The 1mm group showed delayed osteogenesis and incomplete bony healing at 8 weeks. 3. The 2mm group showed weak osteogenesis and fibrous union or nonunion at 8 weeks. From these results, it could be stated that distraction rate of 0.5mm per day was most useful in rat's tibia. The rate of 1mm showed delayed bony healing and needed more consolidation period. Distraction osteogenesis is a excellent clinical method for regenerating local bone deficiencies in limbs and craniofacial area. The more studies needed for the higher animals and human about distraction rates and other biomechanical factors on the basis of this study.
Adult ; Animals ; Extremities ; Humans ; Osteogenesis ; Osteogenesis, Distraction* ; Osteotomy ; Rats ; Tibia*

PURPOSE: To evaluate MRI findings of spinal cord according to mechanism in acute cervical spinal injury. MATERIALS AND METHODS: 25 patients under went MRI within 1 month after acute cervical trauma. Axial T1WI (TR/TE :500/20), gradient-echo (TR/TE :300/14), sagittal T1WI (TR/TE:500/20), proton (TR/TE :2000. 20 msec), T2WI (TR/TE :2000/80) were performed. In 11 pateints, post-enhancement T1WI was done. Change of spinal cord signal intensity on MRI in addition to the presence of abnormal changes of vertebral body, intervertebral disc and paraspinal soft tissue were evaluated. RESULTS: 15 patients had flexion injury, seven had extension injury and three had injury of unknon mechanism. Twelve patients showed /so-signal intensity on T1WI and high signal intensity on T2WI. Three patients showed low signal intensity on T1WI and high signal intensity on T2WI. Spinal cord hemorrhage occured in 10 patients. We found cord swelling in nine patients and cord compression in 12 patients. In nine patients with cord swelling, extent of cord injury was more than one segment of vertebral body. Ligamentous injury, disc injury, soft tissue injury occurred in 16(64%), 17(68%), 15(60%) patients respectively. Vertebral body fracture was found in 17 patients (68%). The levels of fracture were C6(eight patients) and C5(five patients). CONCLUSION: MRI is valuable in exaluetion of the spinal cord, intervertebral disc, and soft tissue lesions in acute cervical spinal injury. Prognosis is worse in flexion injury than in extension injury, and is well correlated with cord hemorrhage and lesion extent.
Hemorrhage ; Humans ; Intervertebral Disc ; Ligaments ; Magnetic Resonance Imaging ; Neurologic Manifestations* ; Prognosis ; Protons ; Soft Tissue Injuries ; Spinal Cord ; Spinal Injuries

BACKGROUND: The dysplastic nevus is a rare form of melanocytic nevus, but the clinical criteria and histopathologic finding are still debated. There are no studies of dysplastic nevus in korea except a few case reports. OBJECTIVE: This study was aimed to evaluate the clinical and histopathological characteristics of dysplastic nevus developed in korean. METHODS: We reviewed the clinical and histopathologic finding of 15 patients diagnosed as dysplastic nevus on the biopsy. RESULTS: The result were as follows ; 1. The incidence of dysplastic nevus in our study was 9.9 cases/100,000 population 2. The subjects consisted of 9 males and 6 females. 3. The common onset of age was 11-20. 4. The common site of dysplastic nevus was the trunk. 5. The common pattern of lesional change was asymmetry and color variegation. 6. The common clinical findings of the dysplastic nevus was multiple, 5-12mm size, multipapular surface, ill-demarcated margin and brown/black color. 7. The pathologic findings including shoulder phenomenon, melanocytic nest, patchy lymphohistiocytic infiltration, melanophage, scattered atypical epitheloid cell, random atypia, anisokaryosis and no mitosis was shown in all the patients, but eosinophilic hyperplasia was shown in 13 patients. 8. The mild atypia in the Duke grading system was the most common. There was significant positive correlation between architectural and cytologic scores(Pearson correlation test, P<0.05, r=0.97). CONCLUSION: Although the incidence of the dysplastic nevus in our study was much lower than that of the west, the clinicopathologic findings were not different.
Biopsy ; Dysplastic Nevus Syndrome* ; Eosinophils ; Female ; Humans ; Hyperplasia ; Incidence ; Korea ; Male ; Mitosis ; Nevus, Pigmented ; Shoulder

The most proper antibiotic must be selected after antimicrobial susceptibility test. If difference in antimicrobial susceptibility was significant between oral sampling sites, it is rationale to use the most susceptible antibiotic agent respond to dental procedure and object of treatment. This study examined sampling site variation from saliva, supragingival plaque and subgingival plaque of 16 children's oral microbes. The cultured bacterial isolates, which were Streptococcus viridans and Neisseria, were examined for 10 antimicribial drugs with the Bauer-Kirby agar disk diffusion method. The used drugs were Penicillin, Ampicillin, Oxacillin, Cephalothin, Imipenem, Gentamicin, Erythromycin, Vancomycin, Ciprofloxacin, Clindamycin. There was no significant difference between three sampling sites for antimicrobial susceptibility test of S. viridans and Neisseria and the sequence of susceptibility was agreed among them. In conclusion, it was suggested that antimicrobial susceptibility test from saliva, supragingival plaque and subgingival plaque of children have no significant sampling site variation.
Agar ; Ampicillin ; Cephalothin ; Child* ; Ciprofloxacin ; Clindamycin ; Diffusion ; Erythromycin ; Gentamicins ; Humans ; Imipenem ; Neisseria ; Oxacillin ; Penicillins ; Saliva ; Vancomycin ; Viridans Streptococci

No abstract available.
Primary Health Care*

Paecilomyces lilacinus is an ubiquitous saprophytic fungus and very rarely pathogenic to the human. Although it has been reported to cause endophthalmitis, orbital cellulitis, prosthetic valve endocarditis, and pulmonary infection, cutaneous infection caused by Paecilomyces lilacinus has been rarely reported. A 46-year-old Korean man had asymptomatic slowly growing multiple cutaneous nodules on the left arm and wrist for 8 months. He received a renal transplantation in 1991 because of end-stage renal disease. Postoperatively, he has taken cyclosporin and deflazacort for immunosuppression. Physical examination revealed that the lesions were discrete or confluent, firm, elevated, well-defined fluctuating nodules. Histologic section showed multiple well-encapsulated intradermal abscesses with some foci of chronic granulomatous changes composed of lymphocytes, histiocytes and giant cells. PAS positive fungal hyphae and spores were also found. On the Sabouraud's dextrose agar media, the organism grew rapidly to form velvety lilac-colored colonies with shallow radiating furrows. Slide culture showed brush-like conidiophores ending in flask-shaped phialides carrying chain of conidia. Because of the poor response to the oral antifungal drug for 2 months, all the lesions were completely excised.
Abscess* ; Agar ; Arm ; Cyclosporine ; Endocarditis ; Endophthalmitis ; Fungi ; Giant Cells ; Glucose ; Histiocytes ; Humans ; Hyphae ; Immunosuppression ; Kidney Failure, Chronic ; Kidney Transplantation ; Lymphocytes ; Middle Aged ; Orbital Cellulitis ; Paecilomyces* ; Physical Examination ; Spores ; Spores, Fungal ; Wrist

Cutaneous granulocytic sarcoma are rare extramedullary tumor composed of immature leukemic cells of the myeloid series. It has a characteristic greenish color caused by myeloperoxidase in the granulocytic cells. 58-year-old female patient who had been diagnosed as acute myelocytic leukemia presented multiple, variable sized, tender brown-pigmented nodules, papules and plaques on the abdomen and both upper extremities for about 4 weeks. An incision biopsy of the large subcutaneous nodule on her abdomen showed a dense dermal infiltrate of immature myeloblastic cells with pleomorphic hyperchromatic vesicular nuclei and conspicuous nucleoli. A punch biopsy of the other small papule on her abdomen showed an infiltrate of granulocytic cells with round hyperchromic nuclei and granular acidophilic cytoplasm, between the dermal collagen bundles. We present a case of the cutaneous granulocytic sarcoma (chloroma) with coexistent leukemia cutis in acute myelocytic leukemia developed from myelodysplastic syndrome.
Abdomen ; Biopsy ; Collagen ; Cytoplasm ; Female ; Granulocyte Precursor Cells ; Humans ; Leukemia* ; Leukemia, Myeloid, Acute* ; Middle Aged ; Myelodysplastic Syndromes ; Peroxidase ; Sarcoma, Myeloid* ; Upper Extremity

Cutaneous granulocytic sarcoma are rare extramedullary tumor composed of immature leukemic cells of the myeloid series. It has a characteristic greenish color caused by myeloperoxidase in the granulocytic cells. 58-year-old female patient who had been diagnosed as acute myelocytic leukemia presented multiple, variable sized, tender brown-pigmented nodules, papules and plaques on the abdomen and both upper extremities for about 4 weeks. An incision biopsy of the large subcutaneous nodule on her abdomen showed a dense dermal infiltrate of immature myeloblastic cells with pleomorphic hyperchromatic vesicular nuclei and conspicuous nucleoli. A punch biopsy of the other small papule on her abdomen showed an infiltrate of granulocytic cells with round hyperchromic nuclei and granular acidophilic cytoplasm, between the dermal collagen bundles. We present a case of the cutaneous granulocytic sarcoma (chloroma) with coexistent leukemia cutis in acute myelocytic leukemia developed from myelodysplastic syndrome.
Abdomen ; Biopsy ; Collagen ; Cytoplasm ; Female ; Granulocyte Precursor Cells ; Humans ; Leukemia* ; Leukemia, Myeloid, Acute* ; Middle Aged ; Myelodysplastic Syndromes ; Peroxidase ; Sarcoma, Myeloid* ; Upper Extremity