There are three major type of malignant melanoma which differ in their mode of onset, course; lentigo maligna melanoma, superficial spreading malignant melanoma and nodular malignant melanoma. Malignant melanoma may aris on apparently normal skin, in a junction nevus, rarely in a compound nevus and extremely rately in an intradermal nevus. We presented a case of malignant melanoma arising from compoud nevus in 51 year old male patient. Ulcerated verrucous walnut sized brown-black tumor mass was nticed on the posterolateral surface of right foot. There were no palpable lymph nodes in whole body. Tumor cells were epithelioid type and lie in irregularly alveolar formation histologically. There were also numerous nevus cells in dermis and nevus cell nest in lower epidermis with tumor cells. Surgical excision of tumor mass and skin graft was performed.
Dermis ; Epidermis ; Foot ; Humans ; Hutchinson's Melanotic Freckle ; Juglans ; Lymph Nodes ; Male ; Melanoma ; Middle Aged ; Nevus* ; Nevus, Intradermal ; Skin ; Transplants ; Ulcer

No abstract available.
Postoperative Complications*

OBJECTIVE: To examine the synergistic effects of both computer-assisted cognitive rehabilitation (CACR) and transcranial direct current stimulation (tDCS) on cognitive function in patients with stroke. METHODS: The current double-blind, sham-controlled study enrolled a total of 11 patients who were newly diagnosed with stroke. The patients of the tDCS group (n=6) completed sessions of the Korean computer-assisted cognitive rehabilitation program five times a week for 30 minutes a session during a mean period of 18.5 days concomitantly with the anodal tDCS over the bilateral prefrontal cortex combined with the CACR. The patients of the control group (n=5) also completed sessions of the sham stimulation during a mean period of 17.8 days. Anodal tDCS over bilateral prefrontal cortex (F3 and F4 in 10-20 EEG system) was delivered for 30 minutes at an intensity of 2 mA. Cathode electrodes were applied to the non-dominant arm. All the patients were evaluated using the Seoul Computerized Neuropsychological Test (SCNT) and the Korean Mini-Mental State Examination. RESULTS: Mann-Whitney U test revealed a significant difference between the two groups. The patients of the tDCS group achieved a significant improvement in the post/pre ratio of auditory continuous performance test and visual continuous performance test on the SCNT items. CONCLUSION: Our results indicate that the concomitant use of the tDCS with CACR to the prefrontal cortex may provide additional beneficial effects in improving the cognitive dysfunction for patients with stroke.
Arm ; Electrodes ; Electroencephalography ; Humans ; Neuropsychological Tests ; Pilot Projects* ; Prefrontal Cortex* ; Rehabilitation* ; Seoul ; Stroke*

No abstract available.
Animals ; Cerebrospinal Fluid Pressure* ; Cerebrospinal Fluid* ; Guinea Pigs* ; Guinea*

Widespread use of antimicrobial drugs in the management of otitis media has significantly reduced the incidence of labyrinthitis nowadays. Cases of tympanogenic labyrinthitis following acute otitis media have rarely been reported in recent literature on otolaryngology. We report an unusual case of tympanogenic labyrinthitis that presented with sudden sensorineural hearing loss (SNHL) following acute otitis media in an adult who had no previous otological complaints. An audiogram revealed SNHL with pure tone threshold of 43.7 dB in the left ear. MRI was helpful to identify the inflammatory change of the membranous labyrinth. The patient's hearing returned to normal after treatment. The definite diagnosis of serous labyrinthitis was established retrospectively.
Acute Disease ; Adult ; Audiometry, Pure-Tone ; Female ; Hearing Loss, Sensorineural/diagnosis/*etiology/therapy ; Humans ; Labyrinthitis/*complications/therapy ; Otitis Media, Suppurative/*complications/therapy ; Research Support, Non-U.S. Gov't ; Tympanic Membrane

Confluent and reticulated papillomatosis (CRP) was first described as a relatively rare dermatosis. CRP is characterized by slightly hyperkeratotic pigmented papules that are confluent in the center and reticulated at the periphery, located on the neck, abdomen, intermammary, and interscapular regions. Histopathologically, lesions typically reveal orthohyperkeratosis, papillomatosis, and focal acanthosis. A 20-year-old man presented with a 2-year history of slightly pruritic lesions on the chest, abdomen, back, and upper extremities. The lesions were brownish papules and plaques in a reticulated and coalescing pattern. Histologically, a basket-weave pattern of orthohyperkeratosis and mild acanthosis were seen. However, there was no significant papillomatosis, even in multiple sections. Periodic acid Schiff stain was negative for fungi. The patient was treated with doxycycline, 200 mg daily, for 4 weeks. The lesions completely resolved and did not recur during 12 months of follow-up. We report a rare case of CRP without papillomatosis.
Abdomen ; Doxycycline ; Follow-Up Studies ; Fungi ; Humans ; Neck ; Papilloma ; Periodic Acid ; Skin Diseases ; Thorax ; Upper Extremity ; Young Adult

BACKGROUND: The major limitations of the current therapeutic treatments for onychomycosis are the recurrence of the infection and the duration of the treatment. Recently, photodynamic therapy (PDT) is thought to be a novel alternative method for treatment of onychomycosis. OBJECTIVE: The aim of this study is to investigate the efficacy and safety of PDT with methyl 5-aminolevulinic acid (MAL) for the treatment of onychomycosis. METHODS: We performed MAL-PDT in eight patients with distal subungual onychomycosis on at least one great toenail. After the total three treatments, we observed the clinical and mycological courses for twelve months. RESULTS: For the twelve months of follow-up period, three patients (37.5%) showed continuous clinical improvement, two patients (25%) aggravation after transient improvement, and the rest, three patients (37.5%) resistance to treatment. All subjects complained of quite severe burning pain during irradiation of light source. CONCLUSION: In this study, we observed the highly variable clinical and mycological results of PDT in onychomycosis. We concluded that it is too difficult to consistently achieve the best fungicidal effect by PDT without strictly selected conditions.
Burns ; Follow-Up Studies ; Humans ; Light ; Nails ; Onychomycosis ; Photochemotherapy ; Recurrence ; Triazenes

PURPOSE: Facial paralysis is an uncommon but significant complication of chronic otitis media (COM). Surgical eradication of the disease is the most viable way to overcome facial paralysis therefrom. In an effort to guide treatment of this rare complication, we analyzed the prognosis of facial function after surgical treatment. MATERIALS AND METHODS: A total of 3435 patients with COM, who underwent various otologic surgeries throughout a period of 20 years, were analyzed retrospectively. Forty six patients (1.33%) had facial nerve paralysis caused by COM. We analyzed prognostic factors including delay of surgery, the extent of disease, presence or absence of cholesteatoma and the type of surgery affecting surgical outcomes. RESULTS: Surgical intervention had a good effect on the restoration of facial function in cases of shorter duration of onset of facial paralysis to surgery and cases of sudden onset, without cholesteatoma. No previous ear surgery and healthy bony labyrinth indicated a good postoperative prognosis. CONCLUSION: COM causing facial paralysis is most frequently due to cholesteatoma and the presence of cholesteatoma decreased the effectiveness of surgical treatment and indicated a poor prognosis after surgery. In our experience, early surgical intervention can be crucial to recovery of facial function. To prevent recurrent cholesteatoma, which leads to local destruction of the facial nerve, complete eradication of the disease in one procedure cannot be overemphasized for the treatment of patients with COM.
Adult ; Aged ; Chronic Disease ; Facial Nerve/surgery ; Facial Nerve Diseases/*etiology/*surgery ; Facial Paralysis/*etiology/*surgery ; Female ; Humans ; Male ; Middle Aged ; Otitis Media/*complications ; Retrospective Studies ; Young Adult

Chronic actinic dermatitis was recently proposed as a syndrome including photosensitive eczema, photosensitivity dermatitis, actinic reticuloid, and persistent light reactivity. It is defined on the basis of 3 criteria, including clinically persistent eczematous eruption on sun-exposed skin, histologically consistent with chronic eczema, and photobiologically decreased MED to UVB. We report herein a 61-year-old man presented with 2-year history of erythematous to brownish lichenified papules and plaques on sun-exposed areas and shown decreased minimal erythema doses to both UVB and UVA. Biopsy specimen showed consistent with chronic eczema. He was treated with topical therapies of topical steroids and intralesional injection of triamcinolone, and oral anti-histamine, with avoidance of exposure to sun.
Biopsy ; Eczema ; Erythema ; Humans ; Injections, Intralesional ; Middle Aged ; Photosensitivity Disorders* ; Skin ; Solar System ; Steroids ; Triamcinolone

Fibroepithelioma of Pinkus is generally accepted as a low-risk variant of basal cell carcinoma. A 66-year-old man was presented with a solitary dark red nodule with superficial erosion on his right groin. It tended to bleed, but was otherwise asymptomatic. Histopathologically, the tumor was composed of long, thin, branching and anastomosing strands of basaloid cells, which extends from the epidermis into the fibromucinous stroma. Basaloid tumor cells were palisaded at the periphery of the strands, and small buds were seen projecting from the epithelial strands. Significant amounts of melanin pigment were deposited in the papillary and reticular dermis, and the stroma between the tumor cords and also inside the tumor cells. The lesion was completely excised with clear margin. We report a case of pigmented fibroepithelioma of Pinkus with review of the literature in this communication.
Aged ; Carcinoma, Basal Cell ; Dermis ; Epidermis ; Groin ; Humans ; Melanins