Nevus lipomatosus cutaneous superficialis(NLCB) is a rare condition consisting of ectopic fat tissue in the dermis and having the predilection for the pelvic girdle, especially gluteal region. The patient was a 20 year-old female. About 8 years prior to the first visit she had noticed the rice-sized papules on her lower back, which had been gradually increased in size and coalesced to become two, cerebriform, skin colored to yellowish tumor masses of soft consistency, distributed on both sides of the midline of lower back, and measuring respectively 3.5X7.Qcm and 7.0x11.5cm in size. Jihe biopsy specimen taken from the tumor mass revealed the ectopic presence of fat lobules occupying half of the reticular dermis. The fat lobules consisted of almost mature fat cells with the presence of dilated capillaries in their centers.
Adipocytes ; Biopsy ; Buttocks ; Capillaries ; Dermis ; Female ; Humans ; Nevus* ; Skin ; Young Adult

The majority of injections intended to be intramuscular are actually delivered into fat in the area of thebuttock in most of the patients having a thick gluteal fat layer. Injections of some drugs can cause tissuenecrosis that ensues in scar formation and often in dystrophic calcifiation giving rise to ring-like densities inantero-posterior radiographs of the pelvis. We studied the incidence and characteristics of calcifications in thebuttocks frequently noted in pelvic radiographs and whether they have any relationship with thickness anddistribution pattern of the fat layer in the buttocks. Pelvic radiograms of 220 consecutive patients (110 malesand 110 females) with the age ranging from 16 to 76 years(average 39) were reviewed. The area of buttock was divided arbitrarily into four quadrants by the vertical line crossing the center of the head of each femur and thehorizontal line connecting the summit of each femoral head, and the upper outer quadrant was further divided into four quadrants(Fig. 1). We measured the thickness of the extraperitoneal fat layer at the level where it cross theiliac crest bilaterally. The results were as follows; 1. Thirty out of 220 cases(14%) showed calcifications in thebuttock. 2. Calcifications in the buttock were much more frequent in female than in male (p<0.01). 3. Theincidence of calcifications increased with age(P<0.01) and with increase in fat layer thickness(P<0.01). 4,Calcifications in the buttock were mostly located at the upper outer quadrant of the buttock (78%). 5. Inconclusion, we assume that calcifications in the buttock are result of fat necrosis after injection into fatinstead of muscle.
Buttocks ; Cicatrix ; Fat Necrosis ; Female ; Femur ; Head ; Humans ; Incidence ; Male ; Pelvis

Many factors including social rejection, family problems, loss of educational opportunity, fear, prejudice and ignorance, compound the inherent paychologicaI stress of leprosy. In ligh.t of these problems this present study was undertaken to evaluate the psychologica.l status of 1cprosy patients. The subjects of the present study were 220 patients staying at home and 304 control people living in similar isolated areas to resettlemert villages. A self reprort symptom inventory,, SCL--90 symptom check list 90) was used and the group", were analysed and compand by many factors. The results of this study are follows. -countinue-
Humans ; Leprosy* ; Prejudice ; Social Distance

Autogenous bone-patellar tendon-bone is popular ligament substitute used in anterior cruciate liga- ment(ACL) reconstructions. Fracture of the patella is a rare but serious complication unique to this type of reconstruction. We report 4 cases of patellar fracture after autogenous bone-patellar tendon-bone ACL reconstruction.
Autografts* ; Ligaments ; Patella

PURPOSE: We intended to evaluate the results of arthroscopic anterior cruciate ligament(ACL) reconstruction using Bone-achilles tendon-bone composite allograft by analyzing the results clinically and radiologically. MATERIALS AND METHODS: From May 1996 to June 1999, we followed 23 patients who had arthroscopic ACL reconstruction using bone-achilles tendon-bone composite allograft for minimum 24 months, and measured laxity using KT-2000 arthrometer, Lysholm score and enlargement of tibial tunnel width on plain radiograph. RESULTS: In KT-2000 arthrometer test, there was only side-to-side differences of 1.67 +/-0.7 mm between the involved and contralateral limb. Lysholm score was 61.7 +/-10.2 preoperatively and 89.3 +/-5.1 at the last follow up. And there was no tibial tunnel enlargement more than 5 mm at the last follow up. CONCLUSION: Arthroscopic ACL reconstruction using bone-achilles tendon-bone composite allograft has advantage of preservation of anatomic structure and secure bone-to-bone fixation like the bone-patel-lar tendon-bone graft that bone-achilles tendon-bone composite allograft is a reasonable choice in ACL reconstruction.
Allografts* ; Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Extremities ; Follow-Up Studies ; Humans ; Transplants

BACKGROUND: In the Far East, it is well known that hepatic resection is a best form of treatment for complicated intrahepatic stones (IHS). However, many investigators have reported that the associated intrahepatic biliary stricture is the main cause of treatment failure, requiring additional management because of recurrent cholangitis. PURPOSE: A retrospective comparative study was undertaken to clarify the long term efficacy of hepatic resection in IHS and to investigate the clinical significance of intrahepatic biliary stricture affected on treatment failure after hepatic resection. Patient and METHOD: The clinical records of 44 among 51 consecutive patients with symptomatic IHS who underwent hepatic segmentectomy or lobectomy between July 1986 and October 1996 were reviewed. We excluded 7 patients from study group because of postoperative death or incomplete follow- up. Patients were divided into two study groups: group A with intrahepatic biliary stricture (n=28) and group B without stricture (n=16). Residual or recurrent stones, recurrence of intrahepatic biliary stricture, late cholangitis, and final outcomes were analyzed and compared statistically between group A and B. Patients were followed up for a median duration of 65 months after hepatectomy. RESULTS: The overall incidence of residual or recurrent stones were 36% and 11%, respectively. The initial treatment failure rate was 50% in group A and 31% in group B. Intrahepatic biliary stricture was recurred in 46% of group A, but in none of group B (P=0.001). More than two thirds of restrictures were identified on the primary site. The incidence of late cholangitis was higher in group A (54%) than in group B (6%)(p=0.002). The late cholangitis was severe, recurrent and related to stones and strictures in 11 of the 15patients in group A. Twelve patients (ten in group A and two in group B) needed additional secondary multiple procedures at a median of 12 months after hepatectomy. These consisted of percutaneous fluoroscopic stone retrieval (n=6), postoperative cholangioscopy (POC) or percutaneous transhepatic cholangioscopy (PTCS) with electrohydraulic lithotripsy (EHL)(n=3), balloon dilatation (n=7)choledochotomy (n=3), S4 segmentectomy (n=1), Sphincteroplasty (n=1), drainage of the delayed subphrenic or liver abscess (n=2), and repair of prolonged biliary fistula (n=1). The final outcomes after hepatectomy with or without secondary management were good in 80%, fair in 16%, and poor in 4% of the cases. CONCLUSION: The majority of the recurrent cholangitis after hepatectomy in IHS were related to recurrent intrahepatic ductal strictures. Therefore, hepatic resection should be included the strictured duct. However, with hepatectomy alone, it is difficult to clean the IHS and relieve the ductal strictures completely, particularly in cases of bilateral IHS, so a perioperative team approaches, including both radiologic and cholangioscopic interventions, should be used for effective management of IHS.
Biliary Fistula ; Cholangitis ; Constriction, Pathologic* ; Dilatation ; Drainage ; Far East ; Hepatectomy ; Humans ; Incidence ; Lithotripsy ; Liver Abscess ; Mastectomy, Segmental ; Recurrence ; Research Personnel ; Retrospective Studies ; Treatment Failure

BACKGROUND: Fine Needle Aspiration Cytology (FNAC) is widely accepted as the most accurate procedure to differentiate malignant from benign thyroid nodules. It is a simple, safe, and inexpensive procedure, and the accuracy of FNAC is relatively high; however, its success usually depends upon the skill in using the aspiration technique and the experience and skill of the cytologist. The authors confirmed the diagnostic value of preoperative FNAC in differential diagnosis of thyroid nodules treated by the surgical resection. METHODS: Three hundred fifty specimens were taken in the Department of Surgery, Inje University College of Medicine, from July 1990 to June 1996. Fifty-one males and 299 females with ages ranging from 11 to 73 years were enrolled. The cytology of FNAC was compared to the final histologic diagnosis. RESULTS: The number of inadequate smears (or sampling error) was 15.7%. Preoperative cytologic diagnoses was consisted of 198 cases of benign disease (92 cases of nodular goiters, 96 cases of follicular lesion types III, and 10 cases of thyroiditis), 12 cases of highly suspicious malignant lesions (follicular lesions type II), and 85 cases of malignant disease (71 cases of papillary carcinomas and 14 cases of follicular lesions type I). Histologic diagnoses consisted of nodular goiters in 116 cases, adenomas in 66 cases, thyroiditis in 9 cases, papillary carcinomas in 84 cases, and follicular carcinomas in 20 cases. These results has an 84.6% sensitivity, a 95.2% specificity, a 15.3% false negative rate, and a 4.7% false positive rate. In the fifty-five cases of inadequate sampling, 13 cases (23.6%) were malignant lesions histologically. In the 16 cases proven as false negative, nine cases were papillary carcinomas, and 7 cases were follicular carcinomas histologically. Thirteen cases (16.1% of 27 cases of cystic lesions) of cystic nodules revealed malignant neoplasms histologically. CONCLUSION: FNAC is a single, useful diagnostic procedure for the initial screening for malignancy in thyroid nodules. Performing repeated aspiration in cystic nodules and clinically suspicious cases could reduce inadeguate sampling and the false negative rate.
Adenoma ; Biopsy, Fine-Needle* ; Carcinoma, Papillary ; Diagnosis ; Diagnosis, Differential* ; Female ; Goiter, Nodular ; Humans ; Male ; Mass Screening ; Sensitivity and Specificity ; Thyroid Gland* ; Thyroid Nodule* ; Thyroiditis

Dermal melanocytosis includes Mongolian spot, nevi of Ota and Ito, dermal melanocytic harnartoma, and blue nevus. Nevi of Ota may be respectively associated with Mongolian spot, blue nevi and unilateral or bilateral nevi of Ito. We present a case, a 24 year-old female, who had bilaterally brownish or slatebluish pigmented patches on the face, sclera, neck, anterior chest, deltoid, supraclavicular, scapular, back and sacrococcygeal area. And also she had a bluish, bean-sized nodule on her left mid-back. It is likely that this case may be considered as an extremely extensive case of pig:m.entary anomaly, associating aberrant and persistent mongolian spots, extensive nevus of Ito, bilateral nevus of Ota and blue nevus. To our knowledges it seems that such case has not previously been reported in Korean literature.
Female ; Humans ; Mongolian Spot ; Neck ; Nevus ; Nevus of Ota ; Nevus, Blue ; Sclera ; Thorax ; Young Adult

We experienced a 40-year-old female patient who had vegetating plaques, erosions and a few vesicles on the external genitalia and the oral mucasa, assoeiated with pulmonary tuberculosis. On the skin biopsy specimen of the vegetating plaque, it showed acanthoais, papillomatosis, downward proliferation of the epidermis and eosinophilic microabacess in the epidermis. Direct immunofluorescence of the perilesional skin revealed deposition of IgG, Cq, Cs and C on the intercellular substance of the epidermis. Indirect immunofluorescence disclosed IgCi auto antibody(1: 320) positive to the inter ellular substance of the normal human back skin. The skin lesion had impraved with dapsone therapy.
Adult ; Biopsy ; Dapsone ; Eosinophils ; Epidermis ; Female ; Fluorescent Antibody Technique, Direct ; Fluorescent Antibody Technique, Indirect ; Genitalia ; Humans ; Immunoglobulin G ; Papilloma ; Pemphigus* ; Skin ; Tuberculosis, Pulmonary

No abstract available.
Otitis Media* ; Otitis* ; Tympanoplasty*