Occult syringoma means a clinically inapparent tumor of the swea gland that are histologically similar but not identical with the common syringoma. They may occur in a variety of inflammatory skin lesions and cutaneous neoplaams as a reactive process. We report herein a case of diffuse alopecia areata associated with occult syringoma in the scalp of a 57-year-old man. Our patient developed progressive, fairly well circ amscribed patches of alopecia and diffuse hair loss over a 1 month period. Histopathological examinaiion revealed non-scaring alopecia and a proliferation of eccrine ductal structures in the upper dermis. These ductal structures resembled syringoma. Only minimal focal fibrosis was occasionally observed arcund the hair follicles. We believe that occult syringona is a reactive process and is secondary to active inflarnmation or dermal fibrosis. It has been most commonly observed in scarring alobiecias but plays no significant role in the etiology of hair loss.
Alopecia Areata ; Alopecia* ; Cicatrix ; Dermis ; Fibrosis ; Hair ; Hair Follicle ; Humans ; Middle Aged ; Scalp ; Skin ; Syringoma*

Partial lipodystrophy is an uncommon disorder primarily affecting women, with onset usually in childhood, characterized by slowly progressive, symrnetrical loss of aubcutaneous fat from the upper half of the body. We present a case of partial lipodystrophy in a 43-year-old woman with multiple depressed lesion on the face and reticulated atrophic lesions on the upper trunk and u]pper extremities. Typically, her face was the first part of the body so affected, giving it a characteristic cadeverous appearance, and gradu ally spreaded to the upper half of t2e body. Sirnultaneously, there was an accumulation of fat over the lower part of the body. She was generally otherwise well, although there had been an association with hyperpigmentation, hirsutism, arthralgia, thyroid disoraer, and low serum CR(45mg/dl), Riopsy specimens of iace and back showed lack of subcutaneous fat, but in the other section of the face showed hydropic degeneration of basal cells and inflammatory infiltrate in the dermis.
Adult ; Arthralgia ; Dermis ; Extremities ; Female ; Hirsutism ; Humans ; Hyperpigmentation ; Lipodystrophy* ; Subcutaneous Fat ; Thyroid Gland

No abstract available.

The clinical investigation was performed regarding cutaneous manifestations in 495 patients with thyroid disorders who had visited Pusan National University Hospital from January, 1979 to April, 1984. The results of this study were as follows: I. Of the 495 patients with thyroid disorders, 417 patients(84. 2%) showed various cutaneous manifestations. Among the cutaneous manifestations presented in the 176 patients with hyperthyroidism, hyperhidrosis was the most common(24. 2%), followed by pruritus (42. O%), chronic urticaria(29, 5%), bronze appearance(21. 6%), sparsity of hair (20. 5%), soft and friable nail(17. 6%). 3. Among the cutaneous manifestations presented in the 57 patients with hypothyroidism, pruritus was the most common(26. 3%), followed by sparsity of hair (21. 1%,), chronic urticaria(19. 3%), soft and friable nail(14. 0%). 4. In patients with Graves disease, cutaneous manifestations were more frequently observed than those of other thyroid disorders. 5, Autoimmune thyroid disorders such as Graves' di ease and Hashimotos thyroiditis were rarely associated with vitiligo(only 2 cases) and alopecia areata(only 1 case).
Alopecia ; Busan ; Graves Disease ; Hair ; Humans ; Hyperhidrosis ; Hyperthyroidism ; Hypothyroidism ; Pruritus ; Thyroid Gland* ; Thyroiditis

BACKGROUND: Relative changes of astroglial volume constitute the major part of brain edema, which is related to delayed neuronal damage. Several factors including glutamate may contribute to astroglial swelling. Intravenous anesthetic, ketamine was known to restore neuronal damage by inhibiting NMDA receptor activity. Therefore, we decided to investigate the effect of ketamine on the astrocyte swelling by glutamate in the present study. METHODS: To analyze cell swelling in vitro, glial cell line, U1242MG was used. The effects of glutamate (1, 2, 3 mM), and glutamate with ketamine (1 mM) on the regulation of astrocyte volume were achieved by flow cytometry system. To eliminate the dead cells from experimental cell suspension and to assess cell viability, fluorescent dye propidium iodide was used. RESULTS: Glutamate addition (1, 2, 3mM) caused astroglial swelling both in calcium present and calcium absent buffer. The difference of cellular swelling dependent on glutamate concentration was only seen in calcium free buffer (p<0.05). Ketamine per se did not affect astroglial volume. However, when it was added to glutamate perfusion, 1 mM ketamine diminished cellular swelling by glutamate during first 10 minutes (p<0.05), and cellular shrinkage by glutamate after 1 hour incubation (p<0.05). CONCLUSIONS: Ketamine (1 mM) is effective in the regulation of astroglial volume alterations induced by glutamate in both short time and long time perfusion.
Astrocytes ; Brain Edema ; Calcium ; Cell Survival ; Flow Cytometry ; Glutamic Acid* ; Ketamine* ; N-Methylaspartate ; Neuroglia ; Neurons ; Perfusion ; Propidium

To estimate the cancer mortality rates among Koreans, a mortality survey was carried out in the province of Kyongsangnam-do. The study population are the beneficiaries of Korea Medical Insurance Corporation (KMIC), Kydngsangnam-do area, among which the 3,867 deaths occurred from January, 1989 to December, 1990, were reviewed to confirm the cancer deaths. These were based upon the death certificates and medical utilization records before dying which were available through the computerized databases on medical care utility of KMIC. The survey was conducted along three steps. At first, the death certificates were examined, as a second step medical utilization records were reviewed, and finally direct contacts to the family members of the deceased were done. As a result, 990 deaths were found due to cancer. Using them, age and sex specific cancer(all sites and several sites) mortality rates were estimated. Overall cancer mortality rate in the area was estimated 138.7 per 100,000 person-years in males, and 65.7 in females, respectively. And the orders of site-specific cancer mortality rates were the cancers of stomach, liver, lung, esophagus, and cancers of the hematopoietic system among males, In females, followed by gastric cancer, cancers of lung and liver are the 2nd and 3rd in rank, respectively and cancers of breast and uterine cervix are the 4th and the 5th in rank.
Breast ; Cervix Uteri ; Death Certificates ; Esophagus ; Female ; Gyeongsangnam-do* ; Hematopoietic System ; Humans ; Insurance ; Korea ; Liver ; Lung ; Male ; Mortality* ; Stomach ; Stomach Neoplasms

BACKGROUND: Neonatal hypocalcemia is not an infrequent condition, especially in the premature neonate. It is effectively treated by intravenous administration of calcium gluconate. Complications of extravasation during intraveous infusion included calcification and, occasionally necrosis. But the exact mechanism of calcinosis cutis following extravasation of calcium gluconate remains unknown and there is no specific mode of treatment except cold packs and skin graft. OBJECTIVE: Our purpose was to evaluate the clinical and histological features in rabbits after subcutaneous injection of 10% calcium gluconate and a mixed solution of gluconate and triamcinolone acetonide. METHODS: Two rabbits were divided into 3 groups and were subcutaneously injected with the following materials on the back; 10% calcium gluconate, a mixed solution of calcium gluconate and triamcinolone acetonide, and 25% normal saline as controls respectively. The injection site including the skin and subcutaneous fat was excised and fixed with natural buffered formalin. The biopsied specimens were stained with Hematolxylin and Eosin. RESULTS: 1) In the 10% calcium gluconate injected group, there was some erthema and induration after three days. By the fifth to the seventh days there was more erythema and firm induration. At 15 days, nodules and large ulcreated lesions developed. Multiple, linear shaped, ulcreative surfaced and indurated masses were noted at 37days.l from 45days to 2months there was progressive healing with decrease in ulceration, and gradual disapppearance of the mass. Histologically, at the 8th day calcium was seen in the walls of the arteries and veins, after 15days, the reaction was at its peak and epidermal necrosis was seen on the injected site. From 30 to 3days, calcium deposition and granuloma formation were seen in the dermis. In addition discharge of calcium deposits began to place by means of transepidermal elimination. After 45days, although the response was subsiding, the calcium and mucin deposition was observed focally in the dermis. 2. In the 10% calcium gluconate and triamcinolone acetonide adjuvant injected group, there was development of some erythema at 8days. After 15days, some erythema and induration were seen of the injected site ad this gradually disappeared. By 37days, the injection site was normal in appearance. Histologically, at 15days calcium deposition was seen on the upper dermis and the injection site was histologically normal after one month. 3. In 25% normal saline injected group, the injection site was clinically normal. Histologically there was no reaction except for focal perivascular eosinophilia after 24horus. CONCLUSION: We conclude that the important mechanism of calcinosis cutis appears to be elevated concentration as well as the tissue damage at the site of the extravasation of calcium gluconate. The final common pathway of calcification is the formation of crystalline and insoluble calcium phosphate mineral, in the form of hydroxyapatite. The intralesional injection of triamcinolone for the treatment of calcinosis cutis in our study was effective due to its antiinflammatory effect and the reabsorption of calcium in the tissues.
Administration, Intravenous ; Arteries ; Bowen's Disease ; Calcinosis* ; Calcium Gluconate* ; Calcium* ; Carcinoma, Squamous Cell ; Crystallins ; Dermis ; Durapatite ; Eosine Yellowish-(YS) ; Eosinophilia ; Erythema ; Formaldehyde ; Granuloma ; Humans ; Hypocalcemia ; Infant, Newborn ; Injections, Intralesional ; Injections, Subcutaneous ; Keratoacanthoma ; Keratosis, Actinic ; Mucins ; Necrosis ; Proliferating Cell Nuclear Antigen ; Rabbits ; Skin ; Subcutaneous Fat ; Transplants ; Triamcinolone ; Triamcinolone Acetonide ; Ulcer ; Veins

BACKGROUND: Neonatal hypocalcemia is not an infrequent condition, especially in the premature neonate. It is effectively treated by intravenous administration of calcium gluconate. Complications of extravasation during intraveous infusion included calcification and, occasionally necrosis. But the exact mechanism of calcinosis cutis following extravasation of calcium gluconate remains unknown and there is no specific mode of treatment except cold packs and skin graft. OBJECTIVE: Our purpose was to evaluate the clinical and histological features in rabbits after subcutaneous injection of 10% calcium gluconate and a mixed solution of gluconate and triamcinolone acetonide. METHODS: Two rabbits were divided into 3 groups and were subcutaneously injected with the following materials on the back; 10% calcium gluconate, a mixed solution of calcium gluconate and triamcinolone acetonide, and 25% normal saline as controls respectively. The injection site including the skin and subcutaneous fat was excised and fixed with natural buffered formalin. The biopsied specimens were stained with Hematolxylin and Eosin. RESULTS: 1) In the 10% calcium gluconate injected group, there was some erthema and induration after three days. By the fifth to the seventh days there was more erythema and firm induration. At 15 days, nodules and large ulcreated lesions developed. Multiple, linear shaped, ulcreative surfaced and indurated masses were noted at 37days.l from 45days to 2months there was progressive healing with decrease in ulceration, and gradual disapppearance of the mass. Histologically, at the 8th day calcium was seen in the walls of the arteries and veins, after 15days, the reaction was at its peak and epidermal necrosis was seen on the injected site. From 30 to 3days, calcium deposition and granuloma formation were seen in the dermis. In addition discharge of calcium deposits began to place by means of transepidermal elimination. After 45days, although the response was subsiding, the calcium and mucin deposition was observed focally in the dermis. 2. In the 10% calcium gluconate and triamcinolone acetonide adjuvant injected group, there was development of some erythema at 8days. After 15days, some erythema and induration were seen of the injected site ad this gradually disappeared. By 37days, the injection site was normal in appearance. Histologically, at 15days calcium deposition was seen on the upper dermis and the injection site was histologically normal after one month. 3. In 25% normal saline injected group, the injection site was clinically normal. Histologically there was no reaction except for focal perivascular eosinophilia after 24horus. CONCLUSION: We conclude that the important mechanism of calcinosis cutis appears to be elevated concentration as well as the tissue damage at the site of the extravasation of calcium gluconate. The final common pathway of calcification is the formation of crystalline and insoluble calcium phosphate mineral, in the form of hydroxyapatite. The intralesional injection of triamcinolone for the treatment of calcinosis cutis in our study was effective due to its antiinflammatory effect and the reabsorption of calcium in the tissues.
Administration, Intravenous ; Arteries ; Bowen's Disease ; Calcinosis* ; Calcium Gluconate* ; Calcium* ; Carcinoma, Squamous Cell ; Crystallins ; Dermis ; Durapatite ; Eosine Yellowish-(YS) ; Eosinophilia ; Erythema ; Formaldehyde ; Granuloma ; Humans ; Hypocalcemia ; Infant, Newborn ; Injections, Intralesional ; Injections, Subcutaneous ; Keratoacanthoma ; Keratosis, Actinic ; Mucins ; Necrosis ; Proliferating Cell Nuclear Antigen ; Rabbits ; Skin ; Subcutaneous Fat ; Transplants ; Triamcinolone ; Triamcinolone Acetonide ; Ulcer ; Veins

The uroflowmetry was accurate, noninvasive method in the assessment of infravesical obstruction, but it was difficult to differentiate normal from obstructed individuals. The use of the flow rate nomogram appeared to differentiate reliably normal from obstructed individuals. The uroflowmetries using flow rate nomogram which was previously reported by our hospital, were performed on 35 BPH patients, 12 patients preoperatively and postoperatively (Group I) and 23 patients postoperatively only due to preoperative urinary retention (Group 2). The following results were obtained. 1. In group 1, the mean preoperative maximal flow rate was 9.4 (ml/sec) and the mean postoperative maximal flow rate was 15.3 (ml/sec). 2. In group 2, the mean postoperative maximal flow rate was 18.3 (ml/sec) 3. In group 1, nine of twelve patients (75%) were improved in the maximal flow rate. But six of twelve patients (50% ) were improved in the flow rate nomogram. 4. In group 2, fourteen of twenty-three patients (70%) were improved in the flow rate nomogram. In summary, this study shows much difference in the results between maximal flow rate and flow nomogram. So uroflowmetry using flow rate nomogram, we consider, will show more objective result in the evaluation of prostatectomized patient.
Humans ; Nomograms* ; Prostatectomy* ; Urinary Retention

The author had experienced 67 cases of blepharoptosis to be operated, such as anterior approach (Berke, 33 cases), posterior appoach (Iliff, 24 cases) and frontalis suspension with 2-0 supramid (10 cases) from March 1967 to Dec. 1978. To obtsurgical results in blepharoptosis, it is necessary to select the appropriate operation for each case according to levator function, degree of ptosis and its etiology and the others. In cases of 5 mm or more levator function, the author attempted to resect the levator muscle through Iliff's posterior approach; but in cases of beween 3 mm and 4 mm, levator resection through Berke's anterior approach for indication of ptosis repair was selected. On the other hand, in cases of 2 mm or less levator function, frontalis suspenion was done with 2-0 supramid. "With levator resection decided upon, how much in to be resected levator muscle considering levator function and condition of its aponeurosis in each case. The results were as follows: 1. The sex distribution was in ratio of 3:2 with 36 females and 24 males. 2. In cases of unilateral ptosis, left lid was higher incidence than right lid. 3. The majority of the patients (72% of all cases) was operated between the second and the third decade. 4. The highest incidence of degree of ptosis was 3-4 mm which comprised 61% of all cases. 5. The levator functions were as follows; below 3 mm ... 34.3% (23 cases), between 4 mm and 7 mm ... 44.8% (30 cases). above 8 mm ... 25% (14 cases). 6. The good and fair surgical results were as follows; Iliff's posterior approach ... 58.3% (14 case), Berke's anterior approach ... 75.5% (25 cases), Frontalis suspension ... 29.1% (7 cases). 7. Undercorrection (12 cases, 18%) was the most common type of postoperative complication. In 12 cases of this complication, the author noted 8 cases in Iliff's posterior approach. 8. It was concluded that good surgical indications for blepharoptosis were Iliff's posterior approach with above 8 mm levator function, Berke's anterior aproach with above 3 mm levator function and frontalis suspension with below 3 mm levator function.
Blepharoptosis* ; Female ; Hand ; Humans ; Incidence ; Male ; Nylons ; Postoperative Complications ; Sex Distribution