Multiple satellite pyogenic granuloma developed on the left upper back of a 14-year-old boy after excision of a hemangioma-like lesion. He has had nevus flammeus on the left upper arm since birth with fine linear telangietasiae around the main lesions. Histopathology showed the capillary proliferation in the dermis, and transmission electron microscopy revealed multiple Weibel-Palade bodies, considered an early endothelial cell marker, in the cytoplasm of the endothelial cells. We believe this patient may have the propensity to develop different angiomatous lesions.
Adolescent ; Arm ; Capillaries ; Cytoplasm ; Dermis ; Endothelial Cells ; Granuloma, Pyogenic* ; Humans ; Male ; Microscopy, Electron, Transmission ; Parturition ; Port-Wine Stain ; Weibel-Palade Bodies

A 62-year-old farmer was admitted to our department because of second degree chemical burns of both buttocks ten days following accidental contact with Gramoxone, a weed killer. He was treated with oral antibiotics and cold compresses and discharged after the burned area were reepithelialized. Laboratory findings were within normal limits for three weeks. Although lung fibrosis, hepatic and renal failure can be caused by repeated absorption of paraquat (Gramoxone) through injuried skin, systemic absorption through normal skin has not been reported. During the four month follow up period there were no systemic problems nor recurrence of skin lesions. We report herein a case of chemical burns induced by Gramoxone, which is probably an occupational dermatosis of farmers handling weed killers.
Absorption ; Anti-Bacterial Agents ; Burns ; Burns, Chemical* ; Buttocks ; Fibrosis ; Follow-Up Studies ; Humans ; Lung ; Middle Aged ; Paraquat ; Recurrence ; Renal Insufficiency ; Skin ; Skin Diseases

Xeroderma pigmentosum is rare autosomal recessive disease, characterized by extreme sensitivity to ultraviolet light and leading to development of multiple malignant skin tumors. Among multiple malignant skin tumors, basal cell carcinoma and squamous cell carcinoma are common. Treatments of xeroderma pigmentosum are palliative or radiation treatment, but surgical resection is necessary if xeroderma pigmentosum is transited to malignant skin tumors. We report a case of a 32-years-old female xeroderma pigmentosum patient, who developed radiation resistant basal cell carcinoma on right alar nasi. Radiaton theraphy(300cGy, fractions: 10, total dose: 3000cGy) was not effective, so surgical excision and local skin flap coverage was made and no specific wound complications occurred. During 11 months follow-up period, no evidence of recurrence was found.
Carcinoma, Basal Cell* ; Carcinoma, Squamous Cell ; Female ; Follow-Up Studies ; Humans ; Ichthyosis* ; Recurrence ; Skin ; Ultraviolet Rays ; Wounds and Injuries ; Xeroderma Pigmentosum*

BACKGROUND: Cytoskeletons, the complex set of protein fibers found in the cytoplasm, have important roles in the movement of cells and subcellular structures and the generation of shapes. Melanocytes have numerous dendritic processes which are in direct contact with many keratinocytes and transfer the melanosomes into the neighboring keratinocytes. Little information is available on the structure and function of cytoskeletons, and the effects of ultraviolet light on the cytoskeletons of the melanocytes. OBJECTIVE: The purpose of this study was to investigate the general cytoskeletal system of cultured melanocytes and to find out the effects of the cytoskeletal antagonists and UVB on the cytoskeletal system of the cultured melanocytes. METHODS: Melanocytes were cultured from adult foreskin and then exposed to various cytoskeletal antagonists and UVB radiation. The changes of the cultured melanocytes were evaluated by using phase contrast microscopy, immunofluorescence staining methods and electron microscopic examinations. RESULTS: Colchicine produced shortening of dendrites, stellate cellular contour and granular fluorescence of the tubulin. Cytochalasin D produced round cellular contour and granular fluorescence of the actin. Acrylamide produced disorganization of cytoplasmic constituents, but no specific fluorescent change was observed. Colchicine also had inhibitory effects on the vimentin. Cellular responses induced by these agents were reversible. UVB caused morphological changes of the melanocytes, but their effects on the organization of the cytoskeletal system could not be detected in this method. CONCLUSION: Microtubules are related to the dendritic movement of the melanocytes. Vimentin may be involved in the transfer of cellular organelles, probably including the melanosomes. Cytoskeletal antagonists produce their characteristic morphological changes to cultured melanocytes.
Acrylamide ; Actins ; Adult ; Colchicine ; Cytochalasin D ; Cytoplasm ; Cytoskeleton* ; Dendrites ; Fluorescence ; Fluorescent Antibody Technique ; Foreskin ; Humans* ; Keratinocytes ; Melanocytes* ; Melanosomes ; Methods ; Microscopy, Phase-Contrast ; Microtubules ; Organelles ; Tubulin ; Ultraviolet Rays ; Vimentin

From January to December of 1990, we have evaluated VDRL reactivity among 17,142 apparently normal Korean adults which consisted of 9,151 blood donors in Seoul area, 2,682 pregnant woman delivered at Severance Hospital, Yonsei University and 5,309 physical examinees. The VDRL-positive rates were 0.3% in the blood donors, 0.1% in the pregnant women and 0.8% in the physical examinees but the rates were higher in the age group of 50 years or older. The VDRL titers were below 1:2 in 94% of the VDRL-positive pregnant women and physical examinees. From the comparison of the results obtained by the present author group since 1977, i.e., 2.5 % in 1977, 1.1 % in 1981, 0.6 % in 1986 and 0.4 % in 1990, it is evident that the prevalence of syphilis in Korea is continually decreasing.
Adult ; Blood Donors ; Female ; Humans ; Korea ; Pregnant Women ; Prevalence* ; Seoul ; Syphilis*

The perforator based flap has been used successfully as a pedicle or free flap and has gained popularity in clinical use. Although Lipo-PGE1 effect on survival rate of musculocutaneous flap is good, but effect on survival rate of perforator based flap is not well known. Therefore, the purpose of this study is to find pharmacological delay effect by using Lipo-PGE1 in abdominal skin perforator flap of rats. Thirty Sprague- Dawley rats were divided into 3 groups. Perforator flaps were designed in rectangular shape, sized 3x7cm to 4x8 cm on abdomen. Flap incision was made deeply enough to the panniculus carnosus, from lateral to medial side and we found four musculocutaneous perforators at each side. Right second cranial perforator was saved, and the others were electrocauterizied. The experimental groups included group I(control): no procedure before the flap elevation; group II(surgical delay): right second cranial perforator was saved, one week before the flap elevation, the others cauterizied. But left four perforators were not injuried.; Group III(pharmacological delay): before the flap elevation, Lipo-PGE1(0.5microgram) was given intraperitoneally for 5 days. On the seventh day after operation, the results were evaluated and compared in terms of flap survival area, vessel counts by Hematoxylin-Eosin stain and Vascular Endothelial Growth Factor (VEGF) protein expression by Western blot. The results were as followings. First, The mean percentages of the flap survival area in Group II(83.75+/-11.07%) and Group III(76.95+/-11.99%) were significantly higher than that in Group I(44.06+/-15.29%)(p<0.05). Second, The vessel counts of Group II(4.4+/-0.84) and Group III(4.3+/-0.82) were significantly higher than that of Group I(2.0+/-0.67) significantly(p<0.05) Third, The VEGF expression is increased in two experimental groups than that of control group. In conclusion, the use of Lipo-PGE1 could increase flap survival area in rat skin perforator flap model, as likely as surgical delay. This phenomenon is thought to be due to choke vessel dilatation and new vessel formation. Therefore, we expect that Lipo-PGE1 can increase rate of flap survivability in perforator based flap as well as that of musculocutaneous flap, only short term use.
Abdomen ; Alprostadil* ; Animals ; Blotting, Western ; Dilatation ; Free Tissue Flaps ; Myocutaneous Flap ; Perforator Flap ; Rats* ; Skin* ; Survival Rate ; Vascular Endothelial Growth Factor A

Erythropoietic protoporphyria (EPP) is an autosomal dominant condition due to decreased activity of ferrochelatase. The disease is characterized by a wide range of photocutaneous changes and occasionally by liver disease. The level of protoporphyin is raised in erythkocytes and it may also be increased in the feces. We report herein a case of EPP present in a family which was diagnosed by a high free erythrocyte protoporphyrin (FEP) count.
Erythrocytes ; Feces ; Ferrochelatase ; Humans ; Liver Diseases ; Protoporphyria, Erythropoietic*

Erythropoietic protoporphyria (EPP) is an autosomal dominant condition due to decreased activity of ferrochelatase. The disease is characterized by a wide range of photocutaneous changes and occasionally by liver disease. The level of protoporphyin is raised in erythkocytes and it may also be increased in the feces. We report herein a case of EPP present in a family which was diagnosed by a high free erythrocyte protoporphyrin (FEP) count.
Erythrocytes ; Feces ; Ferrochelatase ; Humans ; Liver Diseases ; Protoporphyria, Erythropoietic*

OBJECTIVE: The authors undertook a study to compare three intraoperative guidance systems, which are intraoperative ultrasonography, stereotaxy and computer-assisted image-guided surgery (neuronavigation) in terms of time consuming during the preparation of these procedures. In this operative case-based study, we have investigated the ability and benefits of intraoperative grey-scale sonographic examination in the localizing of intracranial hemorrhage (ICH) in the brain. METHODS: We used B-mode ultrasonography (5-MHz, 1.2x2.5 mm sized probe) during 23 procedures (craniotomy or craniectomy ; 17, hematoma aspiration : 6) performed in the acute stage after head injury, hypertensive ICH, ruptured cerebral aneurysm. Seventeen patients who suffered from spontaneous ICH underwent stereotactic hematoma aspiration and fourteen patients underwent hematoma removal using neuronavigation system (spontaneous ICH ; 11, Arteriovenous malformation and aneurysm ; 3). We compared intraoperative ultrasonography-assisted hematoma removal with procedures with stererotaxy or neuronavigation system in respect of detection of the pathology and time consuming for preparation. RESULTS: Mean preparation time for stereotactic hematoma aspiration was 71.2 minutes (50-90 minutes), and mean preparation time for neuronavigation-guided surgery was 52.5 minutes (30-70 minutes). However, only 7.4 minutes (4-20 minutes) were needed for the preparation time of intraoperative ultrasonography. Moreover, intraoperative ultrasonography-guided surgery had many advantages compared to other image-guide surgery, such as capability of real-time monitoring and independency of brain shifting. However, there were several limitations too, which were relatively low resolution, artifact by air bubble during the procedure, and the lower echogenecity of liquified hematomas when a delay of several days was needed. Nevertheless, ultrasound-guided hematoma surgery could serve as minimally invasive treatment whenever hematoma evacuation seems to be advisable, at least as a first attempt. CONCLUSION: Based on this preliminary result, we concluded that intraoperative ultrasonographic examination during the surgical treatment of ICH was a non-invasive, useful, and simple diagnostic tool in the detection of the components and accompanying parts of the lesion. It was more useful than stereotaxy or neuronavigation system in the situation of emergent case such as an impending brain herniation.
Aneurysm ; Arteriovenous Malformations ; Artifacts ; Brain ; Cerebral Hemorrhage* ; Craniocerebral Trauma ; Hematoma ; Humans ; Intracranial Aneurysm ; Intracranial Hemorrhages ; Neuronavigation ; Pathology ; Surgery, Computer-Assisted* ; Ultrasonography*