A 54-year-old man had a 1.0 *0.8cm sized, reddish, slightly firm tumor mass on the right side of his tongue. Some 30 years ago, he bit his tongue with considerable bleeding. Since then, he has experienced irritation at the previous bit site, particularly after eating irritaible foods or smoking. About 5 years ago, he felt a pea sized mass exactly at the bit site which gradually increased in size. The histopathologic findings of skin biopsy specimen show typical features of neurilemmoma consisted of Antony type A and type B tissue.
Biopsy ; Eating ; Hemorrhage ; Humans ; Middle Aged ; Neurilemmoma* ; Peas ; Skin ; Smoke ; Smoking ; Tongue*

No abstract available.
Dermatitis, Contact*

From January 1985, to June 1986, 7 cases in which supracondylar and intercondylar fractures of the femur were treated at our orthopaedic department using the Extensile Approach for an anatomical reduction and firm internal fixstion, show successful results in follow up stuides. l. All 7 cases were type III fractures of Neers classification. 2. Among the 7 cases treated surgically using the Extensile Approach, 5 cases showed excellent and good results and the remaining 2 csses showed one fair and one failed results. 3. Probably due to the additional open proximal tibia and patella fracture and delayed surgery from trauma one case had a fair results. The case which failed wss due to ipsilsteral ligamentous injuries and a nerve injury in addition to the femur fracture and slso the impossibility of early knee joint exercise due to associated injuries. 4. None of the results of the 7 csses had any relationship with the patients age. 5. One case of postoperative skin necrosis developed around the tibial tuberosity and was treated successfully by a cross leg flap. 6. In comminuted supracondylar and intercondylar fractures of the femur, the Extensile Approach is thought to be an excellent surgical technique by means of a wide surgical field for an anatomical reduction and firm internal fixation with the repair of associated ligamentous injuries.
Adult ; Classification ; Femur ; Follow-Up Studies ; Humans ; Knee Joint ; Leg ; Ligaments ; Necrosis ; Patella ; Skin ; Tibia

Congenital pseudarthrosis of the tibia was accepted as one of the most difficult disease in respect of the frequency and treatment for the orthopaedists. Since April, 1984, we experienced 3 cases of congenital pseudarthrosis of the tibia, one 2 year-old boy involved left tibia only and the other 4 year-old female involved bilaterally, obtained solid bony union in all which were treated by massive surgical management that contained vascularized bone graft and electric stimulation. Several complications were faced such as refracture, valgus deformities of the ankle, skin irritation sign, angular deformities. But refracture was healed without delayed or nonunion by simple plaster cast immobilization. The vascularized bone graft snd electric stimulation is thought to be more improved methods for the treatment of congenital pseudarthrosis of the tibia. Althought solid bony union was obtained in congenital pseudarthrosis of the tibia, periodic follow-up and adequste management must be mandatory up to the end of the bony growth.
Ankle ; Casts, Surgical ; Congenital Abnormalities ; Electric Stimulation ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Male ; Pseudarthrosis ; Skin ; Tibia ; Transplants

The intravenous administration of midazolam is widely used as sedative premedication for upper gastrointestinal endoscopy. We performed a study to evaluate the effectiveness and safety of midazoiam as premedication for upper gastrointestinal endoscopy. Between June 1995 and October 1995, 112 patients of diagnostic esophago-gastroduodenoseopy were enrolled in the study. The patients were recieved a bolus midazolam 0.~03mg/kg or placebo, followed by typical anesthesia. The blood pressure, pulse and oximeter values were monitored. The systolic blood pressure and heart rate were increased during endoscopy in compared with before premedication, and normalized immediately. There was no significant change of arterial oxygen saturation. Midazolam induced amnesia completely in 49.2% and partially in 27.2%, and all patients were recovered completely in 1 hour. The tolerance score is higher in the midazolam group as compared with the placebo group(p<0.05), and midazolam group would accept the same sedation for repeated endoscopies(p<0.01). We conclude that midazolam has beneficial effects as premedication for upper gastrointastinal endoscopy without significant altteration in cardiopulmonary parameters. This suggest that midazolam may be used more frequently as premedication, especially in the cases of repeated endoscopy.
Administration, Intravenous ; Amnesia ; Anesthesia ; Blood Pressure ; Endoscopy ; Endoscopy, Digestive System ; Endoscopy, Gastrointestinal* ; Heart Rate ; Humans ; Midazolam* ; Oxygen ; Premedication*

Occult syringoma means a clinically inapparent tumor of the swea gland that are histologically similar but not identical with the common syringoma. They may occur in a variety of inflammatory skin lesions and cutaneous neoplaams as a reactive process. We report herein a case of diffuse alopecia areata associated with occult syringoma in the scalp of a 57-year-old man. Our patient developed progressive, fairly well circ amscribed patches of alopecia and diffuse hair loss over a 1 month period. Histopathological examinaiion revealed non-scaring alopecia and a proliferation of eccrine ductal structures in the upper dermis. These ductal structures resembled syringoma. Only minimal focal fibrosis was occasionally observed arcund the hair follicles. We believe that occult syringona is a reactive process and is secondary to active inflarnmation or dermal fibrosis. It has been most commonly observed in scarring alobiecias but plays no significant role in the etiology of hair loss.
Alopecia Areata ; Alopecia* ; Cicatrix ; Dermis ; Fibrosis ; Hair ; Hair Follicle ; Humans ; Middle Aged ; Scalp ; Skin ; Syringoma*

Phakomatosis pigmentovascularis is characterized by the coexistence of pigmentary nevus and hemangioma. Since the term was first described by Ota et al in 1947, about 80 cases have been reported in the literature. In 1979, Hasegawa et al subclsssified the disorder into eight types : type I, nevus flammeus and nevus pigmentosus et verrucosus, type II, nevus flamme is and dermal melanocytosis, type III nevus flammeus and nev.us spilus, type IV, nevus flammeus, dermal melanocytosis and nevus spilus. Each type is subdivided into localized(a) and systemic(b) types, A 25-year-old male had brown papules on the left knee and thigh and purple patches on the left leg that had been present for approximately 7 years. He had no concon ittant systemic disease. The histopathologic findings on brown papules and purple patches are compatible with epidermal nevus and nevus flammeus respectively. We herein report a case of phakomatosis pigmentovascularis type I a.
Adult ; Down Syndrome ; Hemangioma ; Humans ; Knee ; Leg ; Male ; Neurocutaneous Syndromes* ; Nevus ; Port-Wine Stain ; Thigh

A 21-year-old male visited our clinic with an erythematous plaque studded with papulovesicules on the right thigh and calf which had been noticed at 3 months after birth. Moving the limb caused intermittent pain. He was diagnosed with lymphangioma circumscriptum which involved muscle layers after checking the skin biopsy and magnetic resonance imaging (MRI). Partial removal of mass resulted in relieving pain on motion.
Biopsy ; Extremities ; Humans ; Lymphangioma* ; Magnetic Resonance Imaging* ; Male ; Parturition ; Skin ; Thigh ; Young Adult

Aplasia cutie congenita is a rare congenital disease showing focal abscence of skin. In the msjority of instances it is limited ta the scalp especially on the vertex although other areas of the body may also be involved. Other congenital malformation have been reported to ccur with ACC odcasionally. Diagnosis depends on primarily clinical findings. The histologic finding virious from an absence of appendages to the involvement of varying layers of skin, occasionally extending to the bane or dura. Healed lesions often demonstrate a flattened epidermis, a proliferation of fibrobasts in a loose connective tissue stroma, newly formed capillaries, and a complete absence of adnexa stuctures. We observed a newborn infant with aplssia cutis congenita. The akir, defect was found on the posterior fontanelle. No associating cangenital anomalies were found in this case.
Capillaries ; Connective Tissue ; Cranial Fontanelles ; Diagnosis ; Ectodermal Dysplasia* ; Epidermis ; Humans ; Infant, Newborn ; Scalp ; Skin

BACKGROUND: Primary targit injured from the immunologic mechanism of alopecia areata is not definitely confirmed although alopecia areata is regarded as a disease occuring from certain im munologic process. Recently, par ticular interest has been focused on the follicular keratinocytes which show morphologic and anigenic alterations in active lesions. Another important point is the subclinical state hypothesi. It is based upon the observation that the patterns of T lymphocytes infiltration and ultrastructural changes of dermal papilla cells are nearly identical in active lesions and in non-lesional areas of alopecia areata. OBJECTIVE: The purpose of this study is to determine and to compare the aberrant expression of HLA-DR, CD1 and ICAM-1 on the follicular keratinocytes from the active alopecia areata lesion, stationary lesion and non-lesional scalp. METHODS: We performed a n immunohistochemical study, using the streptavidin system to compare the patterns of HLA-DR, CD1 and ICAM-1 immunoreactivity in the follicular keratinocytes in five active alopecia lesions two stationary lesions and non-lesional scalp specimens among four active and two stationary patients, and two normal control scalp specimens. RESULTS: In the active aloecia lesions, the HLA-DR and ICAM-1 immunoreactivity was observed in some patients while CD1 immunoreactivity was observed in all the patients. In the sta tionary alopecia lesions, none of the HLA-DR or CD1 or ICAM-1 immunoreactivity was observed as was the case in the norrial control scalp specimens. In the non-lesional normal scalp specimens, the HLA-DR, CD1 and ICAM-1 immunoreactivity showed nearly the same patterns as those in the acute alopecia leions. CONCLUSION: The aberrant antigenic alterations, especially CD1 expression of follicular keratinocytes are likely to be asociated with the active progress of alopecia areata lesions. These antigenic alterations were also observed in non-lesional scalp as well as alopecia areata lesions in the very similar patterns.
Alopecia Areata* ; Alopecia* ; HLA-DR Antigens ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes* ; Scalp* ; Streptavidin ; T-Lymphocytes