The buttercup is an inportant irritant plant which contairs an unsaturated lactone, protoanemonin, formed by the breakdown of a glucoside in injured plants. We report the three cases of irritant contact dermatitis due to buttercup(Ranunculus sceleratus). These patient developed erythematous and edematous patches with tense vesicles or bullae on t,he application site of pounded buttercup for the treatment of diabetes mellitus, arthralgia, and neuralgia, respectively.
Arthralgia ; Dermatitis, Contact ; Dermatitis, Irritant* ; Diabetes Mellitus ; Humans ; Neuralgia ; Plants ; Transcutaneous Electric Nerve Stimulation

Paraquat(Gramoxone) is the most commonly used herbicide in Korea. But serious paraquat poisoning in human beings has occurred following ingestion or exposure to the skin. Exposure to paraquat through the skin has resulted in local irritation or inflammation of varyiig degree, sometimes severe. We report three cases of primary irritant dermatitis due to paraquat. Two patients developed generalized vesicobullae and necrotirulcer in the scrotum, respectively. The other patient developed painful whitish patch and erosion in ttie tongue after accidental exposure.
Dermatitis, Irritant* ; Eating ; Humans ; Inflammation ; Korea ; Paraquat ; Poisoning ; Scrotum ; Skin ; Tongue

Focal dermal hypoplasia (Goltz syndrome) is a rare genetic mesoectodermal disorder characterized by variable multisystem defects, including anomalies of the skin, skeleton, teeth and eyes. A 22-year-old female patient presented with confluent and disciete, yellowish nodules on the calves, white linear atrophic lesions, hypoand hyper!igmented patches, and telangiectasia scattered over the trunk, neck and extremities. In addition to the skin lesions, this patient showed hypertrophy of the left leg, anomalies of the left foot, fingers and nails, and maloccluded teeth. Histopathological findings of a yellow nodule revealed accumulations of adipose tissue very near to the epidermis that largely replaced the upper dermis.
Adipose Tissue ; Dermis ; Epidermis ; Extremities ; Female ; Fingers ; Focal Dermal Hypoplasia* ; Foot ; Humans ; Hypertrophy ; Leg ; Neck ; Skeleton ; Skin ; Telangiectasis ; Tooth ; Young Adult

Ewing's sarcoma is a highly malignant, small, round cell tumor that usually affects long bones. The acral part of the extremities is a very rare primary site for this neo plasm. A fifteen-year-old girl was seen for a lobulated, dome-shaped, 2.7cm diameter, denuded mass on the distal phalanx of the right middle finger which had increased in size over a 14-month period. The radiological featuies of the hand showed a cortical brick of distal phalanx and surrounding soft tissue mass. Histologically, the biopsy specimen showed sheets of small round to oval cells with scanty cytoplasm, that were closely packed and separated into lobules by trands of fibrous tissue. A periodic acid-Schiff stain demonsirated glycogen in the cytoplasm of the tumor cells. Electron microscopy showed large aggregates of glycogen in the cytoplasm of the neoaplastic cells. Immunohistochemical stains revealed positive staining for vimentin, glial fibrillary acid potein, and neuron specific enolase, stains for S-100, Factor VIII, and cytokeratin were negative.
Biopsy ; Coloring Agents ; Cytoplasm ; Extremities ; Factor VIII ; Female ; Fingers ; Glycogen ; Hand ; Humans ; Keratins ; Microscopy, Electron ; Phosphopyruvate Hydratase ; Sarcoma* ; Sarcoma, Ewing ; Vimentin

Ewing's sarcoma is a highly malignant, small, round cell tumor that usually affects long bones. The acral part of the extremities is a very rare primary site for this neo plasm. A fifteen-year-old girl was seen for a lobulated, dome-shaped, 2.7cm diameter, denuded mass on the distal phalanx of the right middle finger which had increased in size over a 14-month period. The radiological featuies of the hand showed a cortical brick of distal phalanx and surrounding soft tissue mass. Histologically, the biopsy specimen showed sheets of small round to oval cells with scanty cytoplasm, that were closely packed and separated into lobules by trands of fibrous tissue. A periodic acid-Schiff stain demonsirated glycogen in the cytoplasm of the tumor cells. Electron microscopy showed large aggregates of glycogen in the cytoplasm of the neoaplastic cells. Immunohistochemical stains revealed positive staining for vimentin, glial fibrillary acid potein, and neuron specific enolase, stains for S-100, Factor VIII, and cytokeratin were negative.
Biopsy ; Coloring Agents ; Cytoplasm ; Extremities ; Factor VIII ; Female ; Fingers ; Glycogen ; Hand ; Humans ; Keratins ; Microscopy, Electron ; Phosphopyruvate Hydratase ; Sarcoma* ; Sarcoma, Ewing ; Vimentin

A most common site for the isthmic spondylolisthesis is at fifth lumbar vertebra(L5) and far less at fourth(L4). The pathogenic lesion in the pars interarticularis is essentially the same in LA and L5 isthmic spondylolisthesis, but the clinical characteristics may differ each other according to their anatomical and biomechanical differences. A retrospective review of 24 patients of LA(study group) and 27 patients of L5(control group) isthmic spondylolisthesis was undertaken for their medical records and radiographs to compare the clinical characteristics in each groups. Included in each groups were all patients who were surgically treated during the same period and followed for more than two years after surgery. In the study group, 18 of 24 patients were females having an average age of 42.5 years(ranging 34-65), while in the control group, 17 of 27 patients were males having an average age of 38,1 years (ranging 13-59). The symptoms were severe leg pain in most of the study group, but in the control group, the leg pain and back pain were equally complained. The degrees of slip were similar in two groups, but a narrowing of dise space at slip segment was more prominent in study group. The lateral radiographs taken in flexion and extension revealed more changes of slip in study group (4.7mm in study group vs 2.8mm in control group in averages), and more angular motion at slip segment in study group unless the dise space is not severely narrowed. A spinal stenosis in CT findings was disclosed in almost all patients of study group and in 18 patients of control group. The sizes of L5 transeverse process were bigger than twice as those of L4 in 17(70.8%) patients including 9(37.5%) sacralizations of L5 in suty group, while in control group they were only 8(29.6%) patients with no sacralization. The heights of intercreastal line revealed no difference in two groups. The surgical procedures in study group were fusion only in two and decompression with fusion in 22(91.7%) patients and those in control group were fusion only in 11 and decompression with fusion in 16(59.3%) paticnts. The satisfactory results of treatment were in 21(87.5%) patients of study group and 25(92.6%) patients of control group without significant difference between two groups. In conclusion, the L4 spondylolytic spondylolisthesis compared to L5 lesion was more unstable and developed spinal stenosis more often. The surgical treatment and decompression procedure were also more needed in L4 lesions particularly in agend women.
Back Pain ; Decompression ; Female ; Humans ; Leg ; Male ; Medical Records ; Retrospective Studies ; Spinal Stenosis ; Spondylolisthesis

Prostate specific antigen (PSA) has become established as the most useful serological marker for monitoring patients with prostate cancer. However, the benefits of serum PSA values are controversial in screening procedures for prostate cancer due to the rather low specificity of PSA test. To determine if different assays yield comparable results, we compared the IMx PSA enzyme immunoassay and the ELSA PSA monoclonal immunoradiometric assay. We analyzed 72 serum specimens from 68 patients with prostatic disease (12 patients with cancer, 47 benign hyperplasia and 9 prostatitis) and 13 from normal controls by both assays. Results from the assays revealed close linear correlation but the ELSA PSA assay yielded values 1.5 times those of the IMx PSA assay In 13 patients with histologically diagnosed benign prostatic hyperplasia, number of patient with PSA value over l0 ng/ml measured by IMx and ELSA assay were 2(15% ) and 4(31%), respectively. We conclude that the proportional bias between assays demonstrates a need for improved standardization of PSA assays.
Bias (Epidemiology) ; Humans ; Hyperplasia ; Immunoenzyme Techniques* ; Immunoradiometric Assay* ; Mass Screening ; Prostate-Specific Antigen ; Prostatic Diseases ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Sensitivity and Specificity

Thirty-one distal femoral and nine proximal tibial primary bone tumor patients who had prosthetic replacements were reviewed retrospectively. Average follow-up was thirty-eight months(range: 12- 109 months). There were thirty-two(osteosarcoma: 29, chondrosarcoma: 3) stage IIB lesions and eight 1B lesions(giant cell tumor). Twenty-nine patients were surviving at final follow-up. Overall prosthetic survival was 81%, 27% at 2 and 5 year respectively. Eleven prostheses were revised. The causes of revisions were infection(7), metal failure(2), fracture of host bone(1), and loosening(1). Eight revisions were successful, one was fair, and two patients needed an amputation. Prognostic factors which were analyzed for survival of prostheses were age, sex, location of primary lesion, percent of bone resected, and stage. Only the location of primary lesion showed statistical significance and diabolic pattern of survival curve was noted between two groups in resection length(<40% versus >40%). Average functional score was 26. The tibial side had worse prosthetic survival and a major threat to this procedure was due to infection.
Amputation ; Chondrosarcoma ; Follow-Up Studies ; Humans ; Knee Joint* ; Knee* ; Prostheses and Implants ; Prosthesis Failure ; Retrospective Studies ; Sarcoma

To investigate the characteristics of incidental pituitary microadenomas, we examined 120 pituitary glands from Korean forensic autopsy cases, from which eight tumors were identified (incidence 6.7%). The average age of the affected subjects was 50 yr (range: 33-96 yr) with a female predominance. The maximum diameters of the tumors ranged from 0.4 to 5.4 mm (mean: 2.8 mm). Immunohistochemical analysis of pituitary hormones revealed three growth hormone-secreting adenomas, one prolactin-producing adenoma, one gonadotropin-producing adenoma, one plurihormonal adenoma, and two null cell adenomas. MIB-1 staining for Ki-67 antigen showed no positive expression. The microvessel density (MVD) of the pituitary microadenomas ranged from 2.3 to 11.6% (mean: 5.3%) and was significantly lower than that of nonneoplastic pituitary glands (11.9-20.1%, mean: 14.8%). Our study provides reference data on incidental pituitary microadenomas in the Korean population.
Adenoma/blood supply/epidemiology/metabolism/*pathology ; Adult ; Aged ; Aged, 80 and over ; Autopsy ; Female ; Humans ; Immunohistochemistry ; Ki-67 Antigen/metabolism ; Korea/epidemiology ; Male ; Microcirculation/pathology ; Middle Aged ; Pituitary Hormones/metabolism ; Pituitary Neoplasms/blood supply/epidemiology/metabolism/*pathology

Electrocutions are relatively rare. However, the electrocutions are gradually increasing as the increases of the use of electricity. In this study, we diagnosed 46 cases as electrocutions among author's autopsy cases from 1991 to 2002 year and reviewed in aspects of forensic medicine. The results were as follows : 1. All cases were males and average age was 35.6 years. 2. Electrocutions occur most frequently in July and August, which are particularly hot and humid. 3. 38 victims were the worker and 44 cases were accident in the manner of death. Only two cases were suicide. 4. 28 cases showed the typical current mark, especially in the fingers and hands(15 cases). 5. The scene investigation by specialists or policemen were made in 36 cases. 6. Forensic pathologists should consider the thorough investigation of the scene for exact diagnosis, if the victims were suspected of accidental electrocution.
Autopsy ; Diagnosis ; Electric Injuries ; Electricity ; Fingers ; Forensic Medicine ; Humans ; Male ; Specialization ; Suicide