Histopathologic and immunohistochemical analysis using antibodies for S-100 protein and keratin has been conducted on 21 cases of malignant schwannomas. The 21 cases were divided into the following three groups Group A: tumors originating from the nerve trunk or neurofibroma; Group B: tumors related to von Recklinghausen's disease; and Group C: other tumors not belonging to the above groups but histologically diagnosed as malignant schwannoma. The commonest histological pattern consisted of either closely packed or loosely arranged interlacing fascicles of slender spindle cells with wavy fibrillar cytoplasm, followed by myxoid change, perithelial pattern, hyaline change of the blood vessels, and hyalinlzed cords or nodules. Nine out of 12 cases of malignant schwannomas in group A and B, and 7 out of 9 cases of group C were positive for S-100 protein. None of the above cases showed positive staining reaction for keratin. Since 7 of 9 malignant schwannomas in Group C stained with S-100 protein, we can conclude that careful histological analysis supplemented by immunohistichemical study can make a conclusive diagnosis in most of the cases of malignant schwannomas even in cases that do not fulfil the traditional strict criteria.

Twenty-nail dystrophy is a rare entity in which all 20 nail are uniformly and simultaneously affected with excess longitudinal ridging and loss of luster. This condition is thought to be idiopathic but, many cases are associated with alopecia areata, lichen planus, psoriasis, and ichthyosis. In such cases, it has been hypothesized that immunplogical disorders could play a role in pathogenesis. A 29-year-old male patient presented with dystrophic nail chatge on his all finger and toe nails for 3 years. On phisical examination, all nails were uniformly affected with longitudinal ridging and loss of luster and all body hairs were lost. Thyroid scan showed a finding of chronic thyroiditis. Herein we report a case of twenty-nail dystrophy associated with chronic thyroiditis and alopecia areata.
Adult ; Alopecia Areata ; Fingers ; Hair ; Humans ; Ichthyosis ; Lichen Planus ; Male ; Psoriasis ; Thyroid Gland* ; Thyroiditis* ; Toes

We reported the two cases of olecranon osteomyelitis secondary to the iatrogenic chronic relapsing septic olecranon bursitis. Infection was well eradicated by excision of the infected bursa and curettage of the eroded olecranon under the coverage of antibiotic therapy.
Bursitis* ; Curettage ; Cytochrome P-450 CYP1A1 ; Olecranon Process* ; Osteomyelitis*

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

Erythema multiforme can be induced by various causes, including infections like virus or fungus, drugs like sulfonamides and penicillins, internal malignences, connective tissue diseases, pregnancy, menstruation, and exoessive sun exposure ramoxone, one of the paraquat dichloride compounds, is the most commonly used weed-kiIler in Korea. It is sometimes used in suicides due to its fatal toxicity, and even weak transutaneous absorption can lead to death. Herein we report a case of erythema multiform in a 46-year-old man induced by accidental contact with the Gramoxone
Absorption ; Connective Tissue Diseases ; Erythema Multiforme* ; Erythema* ; Female ; Fungi ; Humans ; Korea ; Menstruation ; Middle Aged ; Paraquat ; Penicillins ; Pregnancy ; Solar System ; Suicide ; Sulfonamides

BACKGROUND: Intravenous patient-controlled analgesia (IV-PCA) is a safe and effective method for post-operative pain control. But opioids used in IV-PCA result in some side effects such as respiratory depression, nausea, vomiting, itching and urinary retention. Nalbuphine, an agonist-antagonist, has a considerable analgesic effect without serious complications. This study was designed to evaluate the effectiveness of post-operative pain relief in PCA-administered nalbuphine-ketorolac and morphine-fentanyl-ketorolac. METHODS: Patients scheduled for total abdominal hysterectomy were randomly assigned in a double-blind manner into one of two groups. Group 1 (n=24) and Group 2 (n=28) received nalbuphine-ketorolac or morphine-fentanyl-ketorolac, respectively. All patients received same background infusion rate (2 ml/hr), PCA dose (0.5 ml) and lockout interval (15 min) just after peritoneum closure. And post-operative pain scores were recorded with numerical rating scale (NRS) at 1, 2, 6, 12, 24 and 48 hr after operation. RESULTS: The pain control effect in group 1 was more effective than in group 2. The patients' satisfaction was more superior in group 1. And the number of using PCA button was more frequent in group 2. CONCLUSION: This study suggests that intravenous nalbuphine is an excellent alternative to morphine and fentanyl for postopertive pain control.
Analgesia* ; Analgesia, Patient-Controlled ; Analgesics, Opioid ; Fentanyl ; Humans ; Hysterectomy ; Morphine ; Nalbuphine ; Nausea ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Peritoneum ; Pruritus ; Respiratory Insufficiency ; Urinary Retention ; Vomiting

A 50-year-old female, who had been suffered from diabetes rielitus, showed typical cutaneous findinhs of dermatomyositis with only transient and mild proximal muscle weakness at sometime during the course of disease. She had Gottrons papules, Gottrons sign, heliotrope rash, macular violsceous erythema involving neck, anterior chest, back, extensor site of forearms and arms and dorsa of hands. However, he serum CPK, LDH and sGOP levels were within normal limits. Her fasting and 2 hours potprandial blood glucose levels were elevated. There were no histological abnormality in muscle biopsy. Histopathologic findigs of the skin lesion on her back were that of poikiloderma atrophicans vasculare. We diagnosed our patient as Rebeccas type 2 amyopathic dematomyositis which is chracterized by skin disease with subjective myalgias and musle weakness, but without laboratory evidence of muscle disease.
Arm ; Biopsy ; Blood Glucose ; Dermatomyositis* ; Erythema ; Exanthema ; Fasting ; Female ; Forearm ; Hand ; Humans ; Middle Aged ; Muscle Weakness ; Myalgia ; Neck ; Skin ; Skin Diseases ; Thorax

A case of circular eczematous dermatitis around seborrheic keratosis was presented. A 54-year-old man presented with two weeks history of a round pruritic eruption around a preexisting lesion of seborrheic keratosis. Microscopic findings showed central tumor nest composed mainly of basaloid cells with occasional spongtosis and exocytosis. A diffuse, dense, mononuclear cell infiltrate with increased contents of melanophages was seen beneath the tumor. The surrounding lesion of halo dermatitis showed mild dilatation of the capillaries and perivascular infiltration of mononuclear cells in the upper and mid-dermis. The lesion of halo dermatitis disappeared gradually over a three week period following excision of the central lesion. This peculiar phenomenon seemed to be different from that of Suttons halo nevus, and might be a manifestation of an eczematous condition which might have a dermatitis provoking factor.
Capillaries ; Dermatitis* ; Dilatation ; Eczema ; Exocytosis ; Humans ; Keratosis, Seborrheic* ; Middle Aged ; Nevus, Halo

Herniated intervertebral disc(HIVD) of the lumbar spine has been known to be relatively uncommon in the teenager and frequently be associated with trauma. However, with the changing life style and increasing sports activities, and most of all, with the advent of new imaging modalities, the incidence seems to be increasing gradually. In order to define the characteristic pattern of HIVD of teenager in the era of MRI, and to clarify the associated lesions, such as apophyseal ring fractures, authors performed this retrospective study in 55 teenager patients with HIVD(77 discs), in which MRI was used as main diagnostic modality. The following results were obtained 1) The incidence of the HIVD in teenager was 9.6%(55 patients) of total HIVD patients(575 patients) for 4 years from December 1989 to December 1993. 2) According to MRI findings, HIVD of the teenager could be classified into 3 distinct patterns; simple HIVD, lumbar apophyseal ring fracture(LARF), and vertebral rim lesion. 3) In simple HIVD, as for the MRI classification, protruded type was most frequent type and there was no sequestered type 4) In LARF, the incidence was 14.4% of teenager's HIVD and posterocephalad margin of L5 was the most common site of involvement. 5) Exophytic bony protrusion from the posterior margin of vertebral body, which we called vertebral rim lesion, could be defined on MR sagittal view in 6 cases.
Adolescent ; Classification ; Humans ; Incidence ; Intervertebral Disc ; Life Style ; Magnetic Resonance Imaging ; Retrospective Studies ; Spine ; Sports

No abstract available.
Enterotoxigenic Escherichia coli*