Patients with idiopathic erythroderma have often been regarded to have a pre-Sezary syndrome because some of them have developed a cutaneous T-cell lymphoma during follow-up. Sezary syndrome is a form of leukemia-lymphoma characterized clinically by erythroderma, pruritus, adenopathy, and circulating atypical cells with cerebriform nuclei. We describe a case of Sezary syndrome in a 40-year-old man, who suffered from idiopathic erythroderma for 3 years. We suggest that close and long-term follow-up should be performed on patients with idiopathic erythroderma.
Adult ; Dermatitis, Exfoliative ; Follow-Up Studies ; Humans ; Lymphoma, T-Cell, Cutaneous ; Pruritus ; Sezary Syndrome*

Trichoblastic fibroma is a rare, benign trichogenic tumor that has both an epithelial and mesenchymal component. This tumor may be confused clinically and/or histologically with basal cell carcinoma and other tumors with hair follicle differentiation. We describe here a patient with trichoblastic fibroma on the nose. For further characterization of the tumor, we studied the bcl-2 expression in this case and compared it with those of trichoepitheliomas and basal cell carcinomas. The bcl-2 expression in this case and trichoepitheliomas were positive at the periphery of the tumor nest only, whereas those of basal cell carcinomas were positive diffusely throughout the tumor nest.
Carcinoma, Basal Cell ; Fibroma* ; Hair Follicle ; Humans ; Nose

BACKGROUND: For Neer type IIB fracture of distal clavicle with coracoclavicular ligament injury, various surgical treatments have been used in literatures. However, there was no consensus on the optimal treatment. The aim of this study is to report the clinical and radiological results of open reduction and internal fixation of unstable distal clavicle fracture and suture augmentation of disrupted coracoclavicular ligament. METHODS: A prospective study was performed in 23 patients with Neer type IIB distal clavicle fracture in Seoul Medical Center, Eulji Hospital, and National Medical Center. Firstly, suture anchors are inserted in the base of coracoid process and preliminary reduction was achieved by tie-off of three suture limbs around the clavicle. Then, the final fixation was completed with anatomical locking plate. Bony union and the distance between coracoclavicular ligaments were evaluated. Clinical results and complications including stiffness and secondary procedures were evaluated. RESULTS: Bony union was achieved in all cases except one (22 of 23). At mean 14.9 months, no significant difference in the mean coracoclavicular distance was observed compared to uninjured shoulder (8.2 +/- 7.9 mm versus 7.3 +/- 3.4 mm, p=0.14). Pain visual analogue scale, American Shoulder and Elbow Surgeons score, Constant score, and Disabilities of the Arm, Shoulder and Hand score were 0.5, 83.4, 78.5, and 6.2, respectively. Revision surgery was performed in one case of nonunion. Four patients who complained of skin irritation underwent implant removal. CONCLUSIONS: In cases of an unstable distal clavicle fracture with coracoclavicular ligament disruption, satisfactory clinical results were obtained by locking plate fixation and coracoclavicular ligament suture augmentation concurrently.
Arm ; Clavicle* ; Consensus ; Elbow ; Extremities ; Hand ; Humans ; Ligaments* ; Prospective Studies ; Seoul ; Shoulder ; Shoulder Fractures ; Skin ; Suture Anchors ; Sutures*

The Cronkhite-Canada syndrome is a rare, non-neoplastic, non-hereditary condition which consists of gastrointestinal polyposis associated with alopecia, onychodystrophy and hyperpigmentation of the skin. It usually encountered with severe diarrhea, weight loss and other malabsorption symptoms. The etiology of the condition is unknown. Usually, this syndrome is associated with a poor prognosis due to the effect of malabsorption and generalized debility. We report a case of this syndrome showing unusually rapid improvement after 3-month following only conservative treatment. To our knowledge, this is the first case report of Cronkhite-Canada syndrome in the Karean dermatologic literature.
Alopecia ; Diarrhea ; Hyperpigmentation ; Intestinal Polyposis* ; Prognosis ; Skin ; Weight Loss

A case of primary cutaneous CD30(Ki-1)-positive pleomorphic large cell lymphoma in a 51-year-old woman with generalized lichen myxedematosus is presented. Histopathological findings of the biopsy specimens from the lichenoid papules of the left forearm and the dorsum of the right hand were compatible with papular mucinosis. The mucinous material in the papillary dermis stained with alcian blue at pH 2.5 and was susceptible to hyaturonidase, but serum protein electrophoresis showed no abnormal bands and an abnormal paraprotein was not detected in our patient. Histopathological examination of a solitary, firm, purplish nodule on the right popliteal area showed diffuse and extensive infiltration in the reticular dermis composed of large, atypical, often hyperchromatic, sometimes multinucleated and markedly pleomorphic cells. The majority of the large atypical cells were CD30(Ki-1) positive. The TCR gene re-arrangement analysis demonstrated the presence of a monoclonal rearrangement of the y-TCR gene in the skin biopsy specimen of our patient. The organ-system survey revealed no evidence of internal organ involvement. We concluded that this was primary cutaneous CD30(Ki-1)-positive pleomorphic large cell lymphoma developing in a patient with generalized lichen myxedematosus.
Alcian Blue ; Biopsy ; Dermis ; Electrophoresis ; Female ; Forearm ; Genes, T-Cell Receptor ; Hand ; Humans ; Hydrogen-Ion Concentration ; Lichens* ; Lymphoma* ; Middle Aged ; Mucins ; Scleromyxedema* ; Skin

The functional derangement of skeletal muscles which may be attributed to chronic hypoxia has been accepted as a possible mechanism of exercise impairment in patients with chronic obstructive pulmonary disease (COPD). The metabolc changes in skeletal muscle in patients with COPD are characterized by impaired oxidative phosphorylation early activation of anaerobic glycolysis and excessive lactate and hydrogen ion production with exercise. But the cause of exercise limitation in patients with chronic lung disease without hypoxia has not been known. In order to evaluate the change in the skeletal muscle metabolism as a possible cause of the exercise limitation in chronic lung disease patients without hypoxia, we compared the muscular metabolic data of seven male patients which had been derived from noninvasive 31P magnetic resonance spectroscopy(MRS) with those of five age-matched normal male control persons. 31P MRS was studied during the sustained isometric contraction of the dominant forearm flexor muscles up to the exhaustion state and the recovery period. Maximal voluntatry contraction(MVC) force of the muscle was measured before the isometric exercise, and the 30% of MVC force was constantly loaded to each patient during the isometric exercise. There were no differences of intracellular pH (pHi) and inorganic phosphate/phosphocreatine (Pi/PCr) at baseline, exhaustion state and recovery period between two groups. But pHi during the exercise was lower in patients group than the control group (p<0.05). Pi/PCr during the exercise did not show significant difference between two groups. These results suggest that the exercise limitation in chronic lung disease patients without hypoxia also could be attributed to the abnormalities in the skeletal muscle metabolism.
Anoxia ; Exercise ; Forearm ; Glycolysis ; Humans ; Hydrogen-Ion Concentration ; Isometric Contraction ; Lactic Acid ; Lung Diseases ; Lung* ; Magnetic Resonance Spectroscopy* ; Male ; Metabolism* ; Muscle, Skeletal* ; Muscles ; Oxidative Phosphorylation ; Protons ; Pulmonary Disease, Chronic Obstructive

The dose response of the number of micronuclei in cytokinesis-blocked (CB) lymphocytes after in vitro irradiation with -rays and neutrons in the 5 dose ranges was studied for a heterogeneous population of 4 donors. One thousand binucleated cells were systematically scored for micronuclei. Measurements performed after irradiation showed a dose-dependent increase in micronuclei(MN) frequency in each of the doctors studied. The dose-response curves were analyzed by a linear-quadratic model, frequencies per 1000 CB cells were (0.31+/-0.049) D+(0.0022+/-0.0002) D2+(13.19+/-1.854) (r2=1.000, X2=0.7074, p=0.95) following irradiation, and (0.99+/-0.528) D+(0.0093+/-0.0047) D2+(13.31+/-7.309) (r2=0.996, X2=7.6834, p=0.11) following neutrons irradiation (D is irradiation dose in cGy). The relative biological effectiveness (RBE) of neutrons compared with -rays was estimated by best fitting linear-quadratic model. In the micronuclei frequency between 0.05 and 0.8 per cell, the RBE of neutrons was 2.37+/-0.17. Since the MN assay is simple and rapid, it may be a good tool for evaluating the y-ray and neutron response.
Humans ; Lymphocytes* ; Neutrons ; Relative Biological Effectiveness ; Tissue Donors

BACKGROUND: The purpose of this study was to report outcomes of congenital hallux varus deformity after surgical treatment. METHODS: We evaluated ten feet of eight patients with a congenital hallux varus deformity, including four feet combined with a longitudinal epiphyseal bracket (LEB). There were seven male patients and one female patient with a mean age of 33 months (range, 7 to 103 months) at the time of surgery. Two patients were bilaterally involved. The mean duration of follow-up was 5.9 years (range, 2.3 to 13.8 years). Clinical outcomes were assessed according to the criteria of Phelps and Grogan. Surgical procedures included the Farmer procedure, the McElvenny procedure or an osteotomy at the first metatarsal or proximal phalanx. RESULTS: The clinical results were excellent in two feet, good in six and poor in two feet. The LEB was associated with hallux varus in four feet and were treated by osteotomy alone or in conjunction with soft tissue procedure. CONCLUSIONS: Congenital hallux varus was successfully corrected by surgery with overall favorable outcome. Preoperatively, a LEB should be considered as a possible cause of the deformity in order to prevent recurrent or residual varus after surgery.
Child ; Child, Preschool ; Female ; Foot Deformities, Congenital/radiography/*surgery ; Hallux Varus/radiography/*surgery ; Humans ; Infant ; Male ; Osteotomy

BACKGROUND: Many stu iies focused on the distribution of skin tumors, but none of them included the data refered from primat y physicians in Korea. OBJECTIVE: This study was to investigate the incidence and distribution of skin tumors among Korean people. METHODS: A Total of 3738 cases of skin tumor biopsy specimens referred from primary physicians nationwide to Ewon Reference Laboratory(EWON) from July 1989 to June 1992 were reviewed with a microscope, and classified. The result was compared with the data of skin tumor cases biopsied during the same period at the department of dermatology of Asan Medical Center (AMC). RESULTS: 1. Of all skin turnors reviewed, malignant tumors were 3.9% at EWON and 11.0% at Asan Medical Center. 2. The most common primary malignant tumors of the skin were in the order of basal cell carcinoma, squamous cell carcinoma, and malignant melanoma in both centers. 3. The most common benign tumors were in the order of epidermal cyst, lipoma, pilomatricoma, hemangioma, and dermatofibroma at EWON, and epidermal cyst, seborrheic keratosis, syringoma, pyogenic granuloma, derr iatofibroma and lipoma at AMC. 4. While the prevalence of benign skin tumors were highest in the fourth & fifth decades, that of malignant skin tumorware highest in the sixth & seventh decades. CONCLUSION: Our study shows that the data obtained from tertiary hospitals can be quite different from those of primaiy physicians and the incidence of malignant skin tumors can be overestirnated when only data from large university hospitals were included.
Biopsy ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Chungcheongnam-do ; Dermatology ; Epidermal Cyst ; Granuloma, Pyogenic ; Hemangioma ; Histiocytoma, Benign Fibrous ; Hospitals, University ; Incidence ; Keratosis, Seborrheic ; Korea ; Lipoma ; Melanoma ; Pilomatrixoma ; Prevalence ; Skin* ; Syringoma ; Tertiary Care Centers

PURPOSE: This study was to investigate the effect on early visual outcome of corneal cap attachment with brushing after LASIK. METHOD: We studied 40 eyes of 20 patients who received LASIK from April, 1998 to March, 1999. Early visual acuity was measured in the first, second and third day after LASIK between the group that received brushing procedure and the group that didn't. RESULT: The consecutive group that received brushing procedure showed considerable increase in recovery rate of visual acuity compared to the control group that did not receive brushing procedure on the first day (P<0.001), second day (P<0.004) and third day (P<0.005) after LASIK. However, there was no difference of visual acuity between the two groups in one month, three months and six months (P>0.05) after LASIK. CONCLUSION: We think that corneal cap attatchment with brushing helps early visual recovery and further investigation in this study is needed.
Humans ; Keratomileusis, Laser In Situ* ; Visual Acuity