We report a case of infantile digital fibromatosis in a 34 month-old boy, who presented with a painless subcutaneous tumor on the medial aspect of the left third toe. A histological examination showed scattered small, round eosinophilic inclusion bodies in the cytoplasm of the tumor cells, which was consistent with infantile digital fibromatosis. A'immunohistochemical study revealed that desmin, a-smooth muscle actin, and vimentin were clearly positive in the cytoplasm of the tumor cells, but the inclusions themselves showed negative staining, thus indicating a hollow-like staining pattern. Electron microscopy showed either well-defined or ill-demarcated dense bodies in the cytoplasm of the tumor cells. In some areas, small vesicles and intracellular organells were observed' in the inclusions. In the course of conservative treatment, a new lesion developed on the lateral aspect of the left third toe, seven months after the appearance of the initial lesion.
Actins ; Cytoplasm ; Desmin ; Eosinophils ; Fibroma* ; Humans ; Inclusion Bodies ; Male ; Microscopy, Electron ; Negative Staining ; Toes ; Vimentin

A case of a 21-year old female with Maffucci's syndrome is presented where the patient developed multiple cutaneous spindle-cell hemangioendotheliomas. She had multiple pea to walnut sized, non-tender, normal skin colored or slight bluish nodules and bony mass-like lesions on the left upper extremity and hand. A histological examination of the lesions showed that they were composed of irregularly dilated, thin walled cavernous blood spaces containing phleboliths and collapsed vascular spaces separated by spindled fibroblastic cells. Radiologically, the bony lesions showed radiolucent densities with calcified spots within the second proximal phalanx and metacarpal bone of the left hand, which were consistent with enchondromas.
Chondroma ; Female ; Fibroblasts ; Hand ; Hemangioendothelioma* ; Humans ; Juglans ; Peas ; Skin Pigmentation ; Upper Extremity

Pretibial myxedema, which consists of localized cutaneous accumulations of acid mucopolysaccharides, oceurs in a few patients with hyperthyroidi';m after its correction by surgery or radioactive iodine therapy. We report a case of pretibial myxedema with exophthalmos in a 36 year old male. He has suffered from hyperthyroidism with bilateral pretibial myxedema for a period of 4 years. He was treated with a subtotal thyroidectomy and excision of both pletibia lesions 1 year ago. The lesions recurred on t,he left pretibial area, as a 11 X 16cm sized, non pitting, non tender, swollen, brownish plaque. The histopathologic findings showed epidermal hyperkeratosis and a considerable arnount of mucin in the mid-dermis. We treat.ed him with intralesional injection of triamcinolone acetonide with marked improvement.
Adult ; Exophthalmos ; Glycosaminoglycans ; Humans ; Hyperthyroidism ; Injections, Intralesional ; Iodine ; Male ; Mucins ; Myxedema* ; Thyroidectomy ; Triamcinolone Acetonide

BACKGROUND: The regular use of soaps and synthetic detergents has been associated with skin dryness and aggravation of dermatological conditions. OBJECTIVE: Our purpose was to investigate the irritancy of 10 hand dishwashing liquids on normal skin. METHODS: The skin changes, responding to repeat patch testing with 10 hand dishwashing liquids, were measured by visual scoring. RESULTS: The results are summarized as follows; 1. Of the 16 healthy volunteers 8 had reactions. 5 women and 3 men, but there was no significant difference in irritancy between men and women. 2. The mean irritancy scores of the 10 hand dishwashing liquids ranged from 0.06 to 0.88. 3. A prominent increase in the degree of erythema in the first 24 hour patch test did not persist beyond exposure day 5, but after day 5, augmented responses of the erythema and scales, even fissuring occurred. 4. The pH of the test solutions of the hand dishwashing liquids ranged from 5.0 to 6.0, but there appeared to be no correlation between pH and irritancy in the dishwashing liquids tested. CONCLUSION: Our data suggests that regular exposure to hand dishwashing liquids may cause disturbances of the skin in a substantial proportion of individuals, and workers should use hand dishwashing liquids in lower concentrations than recommended and only for short periods with protective measures.
Detergents ; Erythema ; Female ; Hand* ; Healthy Volunteers ; Humans ; Hydrogen-Ion Concentration ; Male ; Patch Tests ; Skin* ; Soaps ; Weights and Measures

BACKGROUND/AIMS: The endoscopic mucosal resection has now been adopted for a useful modality in both curative therapy and accurate diagnosis of early gastric cancer. A retrospective study was done to evaluate the indication and the limitation of endoscopic mucosal resection of early gastric cancer. METHODS: We studied 20 cases of early gastric cancer treated by endoscopic mucosal resection in Chungnam National University Hospital from November, 1995 to July, 1997. RESULTS: 1) The size affected the curability: 83. 3% of lesions less than 2 cm and 50. 0% of those larger than 2 cm were resected completely. 2) The depth of cancer invasion affected the curability: 87. 5% of lesion confined to mucosa were resected completely, while all of submucosal cancers were resected incompletely. 3) Among fourteen cases resected completely, three cases of lesions larger than 2 cm were residual cancer and two of those less than 2 cm were recurred locally. CONCLUSIONS: To be a curative therapy by endoscopic mucosal resection of early gastric cancer, we think that careful selection of the lesion, that is lesion less than 2cm and confined to mucosa, is necessary
Chungcheongnam-do ; Diagnosis ; Mucous Membrane ; Neoplasm, Residual ; Retrospective Studies ; Stomach Neoplasms*

We report a case of disseminated cutaneous metastatic carcinoma from stomach carcinoma in a 66-year-old male who complained chiefly of widespread cutaneous nodules. He had been admitted to the Department of Internal Medicine for stomach carcinoma. A radiological examination revealed a diffuse stomach wall thickening from the fundus to the antrum, and enlargement of paraaortic and pericaval lymph nodes during an abodominal CT scan. The clinical findings manifested above may suggest cutaneous metastasis from stomach carcinoma. A histological examination of the skin and stomach biopsies showed atypical cells with pleomorphic, hyperchromatic nuclei and bubble-like cytoplasm, which are consistent with poorly differentiated adenocarcinoma. Immunohistochemical stainings showed that these cells were positive for epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA) and low molecular weight cytokeratin.
Adenocarcinoma ; Aged ; Biopsy ; Carcinoembryonic Antigen ; Cytoplasm ; Humans ; Internal Medicine ; Keratins ; Lymph Nodes ; Male ; Molecular Weight ; Mucin-1 ; Neoplasm Metastasis ; Skin ; Stomach* ; Tomography, X-Ray Computed

We conducted this cohort analytic study to determine whether women with unexplained elevations of maternal serum hCG at 15-18 weeks' gestation are at increased risk for pregnancy complications and adverse perinatal outcomes. The inclusion criteria were a singleton gestation, a confirmed gestational age, and an hCG level greater than 2.0 multiples of the median (MoM). The exclusion criteria were fetal anomalies, an abnormal karyotype, molar pregnancy, and an MSAFP level greater than 2.5 multiples of the median (MoM). A group of randomly selected women with hCG levels under 2.0 MoM served as controls. Patients with elevated levels of hCG had a significantly higher risk for PIH (17.9% versus 4.5%; P <.05) and preterm delivery (17.9% versus 3.5%; P<, 05) than control. But no significant differences were observed in the incidence of intrauterine growth restriction and low birth weight and in the newborn weight. We suggested that pregnancies with unexplained elevated hCG levels should be regarded as high-risk pregnancies. And these patients require careful monitoring with adequate obstetric management.
Abnormal Karyotype ; Chorionic Gonadotropin* ; Cohort Studies ; Female ; Gestational Age ; Humans* ; Hydatidiform Mole ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome* ; Pregnancy* ; Pregnancy, High-Risk

We evaluated the relationship between the surgical success of idiopathic macular hole and sex, age, duration, epiretinal membrane, preoperative visual acuity, size of the hole, and surgical method. Of all 25 eyes in 23 patients, 14 eyes(56%)showed anatomical success(disappearance of the hole), and 17 eyes(68%)functional success(the final visual acuity of 0.15 or more with more than one line improvement). There were statistically significant differences of anatomical(p=0.001)and functional success(p=0.020)between the Group I where its macular hole was less than one-fourth of the optic disc in size and the other group, and anatomical success(p=0.039)between the group with the age of less than 70 years(Group A)and the other group. In Group I, anatomical and functional success were both 92%(11 eyes/12 eyes). In Group A, anatomical and functional success were 72%(13 eyes/18 eyes)and 77%(14 eyes/18 eyes), respectively, and there was statistically significant relationship between size of the hole and anatomical success(p=0.024), and difference of anatomical success between the group with duration of less than 6 months and the other group(p=0.023). Good surgical result may be expected in the idiopathic macular hole of the age of less than 70 years with about 350 micrometer or less in size and duration of less than 6 months.
Epiretinal Membrane ; Humans ; Retinal Perforations* ; Visual Acuity

Cutaneous horns of the penis are rare. We report a case associated with squamous cell carcinoma in a 56-year-old male. A gradually enlarging nodule had been on the glans penis for four years. He had suffered from an erythematous crusted tumor mass and horny excrescence on the glans penis which recurred and was aggravated after excision of the nodule seven months ago. Histopathologic findings of the lesions showed characteristic findings of squamous cell carcinoma and cutaneous horn. In situ DNA hybridization for human papillomavirus types 6, 11, 16, 18, 32, and 33 were all negative. The tumor mass were surgically excised and we have not found any sign of recurrence since then.
Animals ; Carcinoma, Squamous Cell* ; DNA ; Epithelial Cells* ; Horns* ; Humans ; Male ; Middle Aged ; Penis* ; Recurrence

Twenty-nail dystrophy is an idiopathic nail dystrophy in which all twenty nails are uniformly and simultaneously affected with excess longitudinal ridging and loss of lustre. The pathogenesis is controversial, and the treatment is unsuccessful. It is thought to have a self-limiting and reversible nature when it develops in childhood, but in adults, it is unusual and exists persistently. We re-port here two cases of adult patients with dystrophy of all twenty nails, whose ages were 58 and 55. The disease had been present for one year and may be associated with alopecia areata in the 58 year old and an idiopathic condition in the 55 year old. Negative results were obtained on mycological studies. Biopsies taken from the nail bed revealed marked hyperkeratosis consistent with nail dystrophy.
Adult ; Alopecia ; Alopecia Areata ; Biopsy ; Humans