The authors studied thirty-three cases of malignant tumors of the skin (24 squamous cell carcinomas, 6 basal cell carcinomas, 2 Paget's diseases and one malignant melanoma) at the department of dermatology, Pusan national university hospital during the period from 1966 to 1971. The results obtained were summarized as follows: 1) There were 21 men(63.6%) and 12 women(36.3%) in this series. 2) The average age of these patients was 56 years with a range of 33 years to 70 years. 3) The ages at onset ranged from 29 to 66 years with the peak incidence in the 50-59 years group. 4) Of the 33 cases, 28 cases were first diagnosed at the age of over 40 years. 5) The ratio of squamous cell carcinoma versus basal cell carcinoma was 4: l. 6) In 29 patients the tumors occurred on the exposed areas of the body and the most common predilection site was on the face (63.6%), of which 6 squamous cell carcinomas occurred on the upper lip. 7) Of the 30 cases of both squamous cell carcinomas and basal cell carcinomas, 20 cases (66.6%) showed ulcerative lesions measuring from less than 1cm to 10cm in diameter. 8) Two cases of the tumors (one squamous cell carcinoma and one malignant melanoma) showed metastasis at the time of diagnosis. 9) The accuracy of clinical diagnosis in this series was 96%. 10) Of the 24 cases of squamous cell carcinomas, 7 cases were treated with radiotherapy, 5 cases with curettage and electrodesiccation followed by radiotherapy. Four squamous cell carcinomas and two basal cell carcinomas that showed relatively superficial and small lesions measuring less than 1.5cm in diameter were treated with electrodesiccation and curettage and are under observation with favorable results for six months to two years.
Busan ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Curettage ; Dermatology ; Diagnosis ; Humans ; Incidence ; Lip ; Neoplasm Metastasis ; Radiotherapy ; Skin* ; Ulcer

Clinical studies on five patients with acrodermatitis enteropathica visited during the period from March 1968 to September 1970 to the department of dermatology, Pusan national University hospital were made and the results obtained were summerized as follows; in addition, the literature was reviewed. 1) All of 5 patients aging from 3 months to 3 years, showed characteristic distributions of the cutaneous lesions which ranged in character from vesicobullous to heavily scaled psoriasiform and moniliasis-like lesions. 2) Of these, the nearly full clinical pictures were presented in two cases with the gradual onset in early infancy, dermatitis predominantly involving the periorficial areas and extremities, which followed by recurrent attacks of greenish yellow-colored diarrhea, partial and diffuse loss of the scalp hairs, stomatitis and monilial infections, whereas the rest thtee cases seemed to be "forme fruste" of this disease with the absence of hair and nail abnormalities. 3) There found no speeific histologic findings in two biopsies performed but showed somewhat the pictures of sub-acute dermatoses. 4) Candida albicans were demonstrated from the skin lesions in two cases, 5) Treatment with local application of gentian violet solution, nystatin ointment for the skin lesions and stomatitis were temporarily favorable in all cases and in case 1 and 5, diodoquin, each 300mg and 600mg were administered orally in divided doses for two weeks, with the result of satisfactory responses. However, the latter died, on the 3rd hospitalized day, of acute glomerulonephritis and upper respiratory infection. 6) Though it is generally accepted that there is definite familial occurrence in this disorder but we recognized no evidence of familial incidence in our five cases.
Acrodermatitis* ; Aging ; Biopsy ; Busan ; Candida albicans ; Dermatitis ; Dermatology ; Diarrhea ; Extremities ; Gentian Violet ; Glomerulonephritis ; Hair ; Humans ; Incidence ; Iodoquinol ; Nails, Malformed ; Nystatin ; Scalp ; Skin ; Skin Diseases ; Stomatitis

PURPOSE: A retroperitoneoscopic adrenalectomy is theoretically the ideal procedure for an adrenalectomy. However, it is not popular due to its technical difficulty. Herein, we report our experience with retroperitoneoscopic adrenalectomies and describe the difficulties encountered during the operations. METHODS: From November 1996 to October 1999, a total of 41 retroperitoneoscopic adrenalectomies were performed. Forty (40) patients had a unilateral adrenal tumor (size: 1-6 cm): 21 aldosteronomas, 12 Cushing adenomas, 3 neurogenic tumors, 2 nonfunctioning adenomas, 1 vascular cyst, and 1 angiomyolipoma of the kidney. One (1) had bilateral hyperplasia. The operations were carried out in prone position in all cases with 3 trochars. RESULTS: Thirty five (35) operations were completed endoscopically. Five were converted to open procedures, and one was converted to a transperitoneal laparoscopic approach. The causes of conversion were 1 severe subcutaneous emphysema, 2 technical difficulties, 1 bleeding, 1 partial nephrectomy, and 1 missing tumor. The average operating time for the complete endoscopic adrenalectomies was 183 minutes in the first 14 cases and 142 minutes in the next 21 cases. There was no operative morbidity or mortality. The average hospital stay was 4.3 days in the first 14 cases and 2.8 days in the next 21cases. CONCLUSION: A retroperitoneoscopic adrenalectomy is a less invasive procedure than any other adrenalectomy procedure, and its only disadvantage is technical difficulty. However, the technical difficulty can be overcome with increasing experience.
Adenoma ; Adrenalectomy* ; Angiomyolipoma ; Hemorrhage ; Humans ; Hyperplasia ; Kidney ; Length of Stay ; Mortality ; Nephrectomy ; Prone Position ; Subcutaneous Emphysema

Neurofibromatosis is a disease which involves both neuroectodermal and mesodermal tissue, and is characterized by cafe-au-lait spot, multiple subcutaneous neurofibromas, elephantiasis neuromatosa, a positive family history, and specific dystrophic osseous changes such as scoliosis, penciling of ribs, vertebral scalloping, a paravertebral soft tissue tumor, and congenital pseudarthrosis. The classic type of scoliosis in neurofibromatosis was known as a sharp localized short curve that is often rapidly progressive and produces severe deformity with dystrophic changes, but another form with long gentle curve is reported. Since conservative treatment is usually unsuccessful, posterior fusion with or without Harrington instrumentation is the treatment of choice even in young age when the curve is progressive. This paper was aimed to review our experience with 11 patients having neurofibromatosis and scoliosis, who were treated with posterior fusion and Harrington instrumentation from Jan. 1971 to Dec. 1980, and the results were as follows: 1. The average age that spinal deformity was observed was 7.7 years old, but the average age at treatment was 14.4. 2. Cafe-au-lait spot was observed in all cases, subcutaneous nodule in 7 cases, local gigantism in 2 cases, and positive family history in 3 cases. 2 cases were combined with congenital spinal anormalies. 3. Specific pattern in spinal deformity was not significant. There were 7 short curves less than 5 vertebrae involved and 6 long curves more than 6 vertebrae involved. 4. There were 5 kyphosis which had more than 50°, and those were usually combined with severe scoliosis. 5. Preoperative average degree of scoliosis was 93.8, and the final correction was 41.2° (43.9%) with loss of correction 5.3°(5.7%) after 3.2 year follow-up in average. 6. It shouid be educated for early detection at home and school, and for the importance of early treatment for the scoliosis, to prevent rapid increase of scoliosis in neurofibromatosis.
Cafe-au-Lait Spots ; Congenital Abnormalities ; Elephantiasis ; Follow-Up Studies ; Gigantism ; Humans ; Kyphosis ; Mesoderm ; Neural Plate ; Neurofibroma ; Neurofibromatoses ; Neurofibromatosis 1 ; Pectinidae ; Pseudarthrosis ; Ribs ; Scoliosis ; Spine

Multiple symmetric lipomatosis is a rare disease and affects almost exclusively middle aged man, usually with a background of excessive a alcohol intake. The disease is characterized by progressive growth of subcutaneous fat masses which are located symmetrically at neck, shoulders, chest, abdomen and groin, and which subsequently penetrate deeply into the surrounding spaces and structures with symptomatic compression of deep organs, such as trachea. A recent survey revealed a high incidence of sometic and autonomic neuropathy. The exact cause of the disease is not known, but a hyperplastic mechanism has been postulated, with in vitro studies demonstrating a defect in adrenergic-stimulated lipolysis of lipomatous tissue. We have experienced two cases of multiple symmetric lipomatosis. Case 1 was a 59-year-old male, complaining of slowly enlarging doughunt ring-shaped mass at his neck. He had a habit of excessive alcohol intake for many years. The subcutaneous mass at the neck was excised. The pathology report described the specimen as "normal adipose tissue". Case 2 was a 49-year-old male, complanining of slowly enlarging multiple symmetric masses at the neck, shoulders, chest, abdomen, flank and groin over a period of 6 years. He also complained of mild muscular weakness. He had a habit of excessive alcohol intake for many years. The subcutaneous mass in the neck was excised. The specimen had a tendency to form globular masses and microscopically indistinguishable from mature adipose tissue.
Incidence

One hundred and four biopsy specimens of various dermatoses were stained with Periodic Acid-Schiff and examined. The lesions were grouped into five groups; A. twenty two cases of vesicob-ullous diseases; B. twenty one cases of maculopapulosquamous diseases; C. eighteen cases of chronic granulomatous infection; D. seventeen cases of precancerosis and benign and malignant neoplasms; and E. twenty six cases of miscellaneous skin diseases. Special attention was given to the morph-ological changes of the dermoepidermal junction and the basement membrane. The results were as follows. 1. Among 10 cases of erythema multiforme, partial fraying appeared in 4 cases, partial thicken-ing in 4 and hyperchromasia in 4. Marked convolution was noted in the thickened basement membrane. PAS-positive material was scattered in the edemateus papillary dermis in some cases. 2. All of 6 cases of pemphigus erythematosus and pemphigus vulgaris showed normal basement membrane. 3, In bullous pemphigoid, partial absence in the areas of bulla formation appeared in 2 cases am-ong 3 cases. PAS positive material was present within the bullae and in the upper dermis. 4. All of 3 cases of dermatitis herpetiformis showed partial absence or fraying, 5. Half of 10 cases of psoriasis showed normal basement membrane. Among the remainder, fraying and partial thickening appeared in 3 and 2 cases respectively. 6. Among 6 cases of lichen planus, almsot total absence appeared in 2 cases and fraying in 3 cases. PAS positive material appeared focally in the upper dermis in some cases. 7. Four of 5 cases of pityriasis rubra pilaris showed diffuse thickening and marked convolution ef the basement membrane. 8. Half of 4 cases of lupus vulgaris showed normal basement membrane. Fraying and partial thickening appeared in 2 and 2 cases respectively. 9. All but 1 among 5 cases of lepromatous leprosy showed poor staining and poor visualization of the basement membrane. 10. One case of tuberculoid leprosy showed partial fraying, partial thickening and hyperchromasia with marked convolution, among 5 cases. il. Among 4 cases of condyloma latum, only one showed partial fraying. 12. One of 3 cases of senile keratosis showed partial fraying of the basemement membrane. 13. One case of Bowens disease showed partial thickening and hyperchromasia among 3 cases. PAS-positive material was present focally in the upper dermis in some cases. 14. All of 6 cases of basal cell carcinoma, showed normal basement membrane. PAS-positive ma-terial were present focally in the uppermoet dermis in some vases. 15. All of 3 cases of squamous cell carcinoma showed total absence of the basement membrane. 16. All of the 2 cases of keratoacanthoma showed partial fraying. 17. Among 10 cases of chronic discoid lupus erythematosus, 9 cases showed partial thickening and hyperchromasia with marked convolution of the basement membrane. Two cases showed partial fraying in areas of marked liquefaction degeneration of the basal cells. PAS positive material appe-ared in the uppermost dermis in some cases. 18. All of 3 cases of fixed drug eruption, 2 cases of seborrheic keratosis and 6 cases of verrucae showed normal basement membrane. 19. One case of poikiloderma atrophicans vasculare showed partial fraying, among 2 cases. 20. All of 2 cases of chronic radiodermatitis showed diffuse thickening and hyperchramasia. The thickened basement membrane showed marked convolution focally.
Basement Membrane* ; Biopsy ; Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermatitis Herpetiformis ; Dermis ; Drug Eruptions ; Erythema Multiforme ; Keratoacanthoma ; Keratosis ; Keratosis, Seborrheic ; Leprosy, Lepromatous ; Leprosy, Tuberculoid ; Lichen Planus ; Lupus Erythematosus, Discoid ; Lupus Vulgaris ; Membranes ; Pemphigoid, Bullous ; Pemphigus ; Pityriasis Rubra Pilaris ; Psoriasis ; Radiodermatitis ; Skin Diseases ; Warts

Post-caval or retrocaval ureter is a congenital anomaly of the vascular system. This anomaly almost. always involve the rt. ureter and occurs more frequently in male We have reported a 36 years male of rt. postcaval ureter that was resulted marked hydronephrosis due to compression of rt. ureter by vena cava. Three months after the operation, excretory urogram showed previous caliectasis and pyelectasis were moderately reduced and previous dislocated ureteral course was corrected.
Humans ; Hydronephrosis ; Male ; Pyelectasis ; Retrocaval Ureter ; Ureter*

No abstract available.
Amniocentesis* ; Cerclage, Cervical* ; Female ; Labor Stage, First* ; Pregnancy

Premature rupture of membranes(PROM) means the rupture of amniotic membranes at any time prior to labor during the gestational period. The dilemma of correctly diagnosing rupture of the fetal membranes is well known as the consequences of management based on an incorrect diagnosis. This study was undertaken to determine if the measurement of B-hCG levels in the vaginal fluid is useful for the diagnosis of premature rupture of membranes. HCG is synthesized and secreted by the placental syncytiotrophoblast and it is normally found in amniotic fluid, maternal urine and blood. We used B-hCG for diagnosis of PROM to exclude the cross reaction with other hormones. After irrigating the posterior vaginal fornix with 3 ml of sterile saline and obtaining vaginal washings, we measured B-hCG levels. The groups were classified normal group(group I), confirmed PROM group(group II ), and suspicious PROM group(groupIII) during the third trimester. The median and 95% confidence intervals(CIS) of vaginal fluid B-hCG in each group(normal, confirmed PROM, suspicious PROM group) were 30.99mIU/ml(range: 0.32-209.89mIU/ml), 188.61mIU/ml(range: 9.65-2095.00mIU/ml), 69.63mIU/ml(range 4.76-349.56mIU/ml). There was significant difference between normal and confirmed PROM group(p<0.05), sensitivity was 95.00%, specificity 80.00%, positive predictive value 82.60%, negative predictive value 94.12%, and accuracy 87.50%, using threshold value of 60mIU/ml. There was significant difference between normal and suspicious PROM group(p<0.05) but the result of the B-hCG was not used in the obstetric decision. In terms of these results, the B-hCG level in vaginal fluid is a useful marker of PROM during the third trimester. A new technic is proposed to confirm the diagnosis of rupture of the membranes based on the introduction of B-hCG in vaginal fluid.
Amnion ; Amniotic Fluid ; Cross Reactions ; Diagnosis ; Extraembryonic Membranes ; Female ; Humans ; Membranes* ; Pregnancy ; Pregnancy Trimester, Third ; Rupture* ; Sensitivity and Specificity ; Trophoblasts

No abstract available