A 51-year-old man had small, tender, skin colored firm nodule on the helix of the both ears for eight months. He was found to have classic features of chondrodermatitis nodularis chronica helicis, namely, tender nodule less than 1 cm in length with central crusting, localization to helix, age, men, and histologic findings. The histologic examination of the biopsy specimen showed the presence of thinned epiderrnis on center. acanthosis on the adjacent epidermis, with hyperkeratosis and parakeratosis, and cleft between epidermis and dermis. In the dermis, highly vascularized connective tissue and chronic inflarnmatory infiltrate were visible with perichondrial fibrosis. Elastic tissue stain showed degeneration of elastic fibers. After complete excision, no recurrence was obsered until now.
Biopsy ; Connective Tissue ; Dermis ; Ear ; Elastic Tissue ; Epidermis ; Fibrosis ; Humans ; Hypertrichosis ; Male ; Middle Aged ; Parakeratosis ; Recurrence ; Skin

Electron microscopic study of two malignant fibrous histiocytomas confirmed the presence of previously described tumor cells in the literature. In addition, there existed intermediate cells with morphologic features of both myofibroblasts and histiocytes, or both histiocytes and smooth muscle cells. Our result supported the idea that malignant fibrous histiocytoma may be derived from the undifferentiated mesenchymal cells that differentiate primarily along a fibroblastic and histiocytic cells.

We presented a case of Ehlers-Danlos syndrome(ED syndrome) in s 21-year- old male, who had hyperextensibility of skin, skin fragility, and cigarette paperlike atrophic scars with no joint problems since infancy. There was a family history which was suggestive of autosomal dominant trait. Microscopic examination of the skin biopsy specimen from the normal appearing skin on the right forearm showed no abnormal appearance. In this case the manifestations of skin including marked hyperextensibility might be in accord with type I (gravis) ED syndrome, but the joint manifestation did not correspond to this type. It might be hard to classify this case according to the eleven types of ED syndrome. Wed rather consider this case as a. mixed form of type I and type Il ED syndrome.
Biopsy ; Cicatrix ; Ehlers-Danlos Syndrome ; Forearm ; Humans ; Joints ; Male ; Skin ; Tobacco Products

Combined spinal epidural block with use of the needle-through-needle technique has become increasingly more popular during recent years because it provides rapidity and density of spinal block, combined with the ability to extend the block and provide postoperative analgesia by use of the extradural catheter. However, the combined spinal epidural block has some disadvantages. Since the spinal needle makes a hole in the dura, the accidental migration of an extradural catheter into the dural opening made previously by the spinal needle is thought to be theoretical risk. We report a case during combined spinal epidural anesthesia for a total hip replacement in which the clear fluid in the epidural catheter was found and tested to confirm the nature of fluid and migration of catheter by the dextrostix test and the immunoelectrophoresis test(prealbumin test).
Analgesia ; Anesthesia, Epidural* ; Anesthetics, Local* ; Arthroplasty, Replacement, Hip ; Catheters ; Immunoelectrophoresis ; Needles

A 51-year-old female had disseminated, symmetrically distributed, brownish black pigmentation and papillary hypertrophy on the intertriginous and flexural areas for 6 months, and gastric adenocarcinoma was confirmed during the evaluation of internal malignancy, The cutaneous finding of acanthosis nigricans was a significant cutaneous marker of internal malignancy in this case.
Acanthosis Nigricans* ; Adenocarcinoma* ; Female ; Humans ; Hypertrophy ; Middle Aged ; Pigmentation

PURPOSE: The purpose of this study was to determine the role of CT and MR imagings in the diagnosis aortic dissection and differentiation between the true and false lumen. MATERIALS AND METHODS: We retrospectively studied forty patients with aortic dissection(AD) diagnosed imagings or surgery. Of the forty patients, 19 were examined with only CT, 14 with CT and MR, and 7 with MI~: Our points of view were(1) the classification of AD according to configuration of intimal flap by cross-sectional imaging, (2) differentiation between the true and false lumens, (3) the course of the false lumen, and (4)! detectability of the origin of major branch vessels of the abdominal aorta. RESULTS: The classification by corss-sectional imaging were crescentic(65%), circumferential(15%), flat(12%), and irregular(8%) type, in which false negative diagnosis was made in 1 case of crescentic and circumferential type, respectively. In 2 case of flat type and 1 case of irregular type, the differentiation between the true and false lumen was impossible with CT. The course of the false lumen in descending thoracic aorta revealed countrclock wise rotation(66%), clockwise rotation(5%) or fixed(29%) apperance. MR imaging was superior to CT in the detection of the origin of major branch vessels of the abdominal aorta. The determination of the origin of major branches of abdominal aorta arising from the true and false lumen were impossible in 2 cases in which only CT was done. CONCLUSION: Diagnosis of crescentic and circumferential types of AD with narrow and thrombosed false lumen was problematic in both CT and MR with no difference of diagnostic accuracy between the two modalities. The differentiation between the true and false lumen was difficult in flat and irregular types with only CT. Therefore, when surgical treatment is considered as in type B aortic dissection, MR imaging is recommended in order to determine the origin of major branch vessels.
Aorta, Abdominal ; Aorta, Thoracic ; Classification ; Diagnosis* ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies

No abstract available.
Vascular Access Devices*

Fibrous histiocytomas are characterized by a variable combination of cells with fibroblastic and histiocytic features. They exhibit a distinctive but inconstant cellular arrangement referred to as a storiform or cartwheel pattern. Considerable corfusion has enveloped these tumors as a result of their various terminology-fibrous histiocytoma, dermatofibroma, sclerosing hemangioma, fibroxanthoma, subepidermal nodular fibrosis, xanthogranuloma, giant cell tumor of tendon sheath. A histologically benign but locally infiltrating, 15 * 20cm sized, fibrous histiocytoma was found in the posterior aspect of left thigh of a 17-year-old man. The tumor was incompletely excised due to adhesion of the tumor mass to sciatic nerve and then radiation therpy was combined, Histogenesis and prognostic aspects of the tumor are discussed.
Adolescent ; Fibroblasts ; Fibrosis ; Giant Cell Tumors ; Histiocytoma ; Histiocytoma, Benign Fibrous* ; Humans ; Sciatic Nerve ; Tendons ; Thigh

One patient is a 6-year old female, who has had intensely pruritic linear papuloplaque.", on the left side of the perineal and perianal areas for three years. The other patient, is a. 23-year old male, who has had iritensely pruritic linear papuloplagues on the left upper extremity. This condition started at 1 month of life. In both cases, microscopie examination of the lesions showed psoriasiform and eczematoid appearance. In the latter case, spongioform pustule and Munro's microabscess were also found. We believe that these cases probably represent instances of the entity that. Altman and Mehregan have called inflammatory linear verrueous epidermal nevus, and unusual clinical feature in our patients was the involvement of the left groin in case 1 and of the left upper extremity in case II, which are somewhat rare sites of involvement.
Child ; Female ; Groin ; Humans ; Male ; Nevus ; Nevus, Sebaceous of Jadassohn* ; Upper Extremity ; Young Adult

Zinc sulfate, which was used as zinc sulfate ophthalmic solution in herpetic keratitis, has been found to have the therapeutic effects in cutaneous and mucosal herpes simplex. We studied ta evaluate the therapeutic effect of zinc sulfate in patients with herpes simplex. Nine patients with primary herpes simplex and twenty five patient with recurrent herpes simplex were included in this study. Twenty five patients(six with primary type and nineteen with recurrent type were treated with topical applicatiion of 0.3% zinc sulfate solutiion seven to eight times a day and nine patients(three with primary type and six with recurrent type)were applied with placebo vehicle in the same way. Maintenance treatment was then given tc all these patients, first once a week for one month, and then twice a month indefinitely. The effect was assessed by the comparison of the duration of disappearance of symptoms, drying of vesicles and crust formation, and desiccation and sloughing-off of cursts, and recurrence rate between zine sulfat,e group and placebo group. The resuilts were summarized as follows : 1. In the average time of the disappearance of symptoms, drying of vesicles and crust formation, a,nd desiccation and sloughing-off of crusts, the resu1t observecl in zinc, sulfate group was shorter than that of placebo group, respectively ( p < 0.01). 2. In recurrence rate, 11.1% observed in zinc sulfate group was much lower than 80.0%i in placebo group(p . 0.01). These findings suggest that topical zinc sulfate is an effective agent for treatment and prevention of recurrence af herpes simplex infection.
Desiccation ; Herpes Simplex* ; Humans ; Keratitis, Herpetic ; Recurrence ; Zinc Sulfate* ; Zinc*