Keratosis punctata of palmar creases has been considered an uncommon variant of keratosis punctata, which itself is considered rare condition. Clinically our case, 32-year-old seaman, shows cup-shaped depression of the epidermis of varying size, from 1-3mrn in diameter, limited to the large flexor creases of the palms and digit. The histologic features are hyperkeratotic and slight acanthotic central epidermal depression without parakeratosis and loss of granular layer. A sparse mononuclear infilterate are seen arround the capillaries in the dermal papillas. No relationship to arsenical agents, syphilis, or genetic factors can be ascertained by history.
Adult ; Capillaries ; Depression ; Epidermis ; Humans ; Keratosis* ; Parakeratosis ; Syphilis

No abstract available.
Colitis, Ulcerative* ; Sweet Syndrome* ; Ulcer*

No abstract available
Mycosis Fungoides*

OBJECTIVE: The authors evaluate the differences in the pedicle screw pull-out strength between an unaugmented screw and a screw augmented by high pressurized PMMA in an embalmed human lumbar cadaveric spine. METHODS: Pedicle screws were inserted in the 50 pedicles of cadaver lumbar spine after measuring the bone mineral density(BMD) of the specimens. The pedicle screw was inserted without augmentation on the left pedicle and with augmentation by a vertebral reconstruction with high pressurized PMMA on the right side. The pedicle screw was inserted before the hardening of bone cement on the right side. A computed tomographic scan was done to evaluate the location of the PMMA and PMMA/ screw interface. After that, a screw pullout strength test was performed. RESULTS: There were positive correlations between the pull-out strength and BMD in the control group (r=0.7339). The average pull-out strength of the augmented group was 168% greater than that of the control group(p<0.05). The pull-out strength of the augmented group was correlated with in the volume of the PMMA. CONCLUSION: A pedicle screw that is augmented with PMMA will provide a more rigid fixation than that of an unaugmented screw, especially in the low BMD group of the specimens.
Cadaver* ; Humans ; Polymethyl Methacrylate ; Spine

From Jan. of 1990 to Dec. of 1992, we have experienced three cases of multiple primary malignant neoplasms originated from different histogenesis, in the Department of Orthopedic Surgery of Korea Cancer Center Hospital. Liposarcomas, malignant fibrous histiocytoma were combined with renal cell carcinoma, mucinous cystadenocarcinoma of ovary or prostatic cancer. With Moertel's classification, synchronous tumors were found in 2 cases and metachronous in 1 case. Synchronous tumors were 2 liposarcomas-renal cell carcinoma or mucinous cystadenocarcinoma of ovary. Metachronous tumors were malignant fibrous histiocytoma-prostate cancer. We couldn t find any family history among them. The causes of these multiple malignancies were considered as the individual predilrection to tumors.
Carcinoma, Renal Cell ; Classification ; Cystadenocarcinoma, Mucinous ; Female ; Histiocytoma, Malignant Fibrous ; Humans ; Korea ; Liposarcoma ; Orthopedics ; Ovary ; Prostatic Neoplasms

BACKGROUND: The bcl-2 is an oncogene involved in tumorigenesis by blocking apoptosis, or programmed cell death and over-expression of bcl-2 protein has been reported in several malignant tumors such as lung cancer, basal cell carcinoma, breast cancer and malignant melanoma. However, there have been only a few studies about bcl-2 expression of cutaneous T cell lymphoma. OBJECTIVE: The purpose of this study was to examine whether there is any difference in expression of bcl-2 between mycosis fungoides(MF), angiocentric T cell lymphoma, angioimmunoblastic T cell lymphoma, subcutaneous T cell lymphoma and anaplastic large cell lymphoma. We also evaluated the statistical significance between expression of bcl-2 and the prognosis of the diseases. METHODS: Routine paraffin sections of formalin-fixed 36 tissues (14 MF, 7 angiocentric T cell lymphoma, 5 subcutaneous panniculitic T cell lymphoma, 2 anaplastic large cell lymphoma, 1 angioimmunoblastic T cell lymphoma, 1 unspecified peripheral T cell lymphoma, 2 small plaque parapsoriasis, 2 psoriasis and 2 lichen planus) were labelled with anti-bcl-2 monoclonal antibody using an avidin- biotin-peroxidase complex. Normal skin for bcl-2 served as negative controls. RESULTS: The results were as follows. l. All cases of benign inflammatory diseases, small plaque parapsoriasis and patch stages of MF showed positive staining for bcl-2. Therefore, there were no differences in expression of bcl-2 among these diseases. 2. In the plaque and tumor stages of mycosis fungoides, statistically significancant differences in bcl-2 expression were not found during disease progression. 3. bcl-2 expression in peripheral T cell lymphoma (five in seven cases of angiocentric T cell lymphoma showed positive staining but all other peripheral T cell lymphoma was negative) decreased significantly (p<0.05) than that of MF. 4. No statistical significance was found between bcl-2 expression and prognosis of cutaneous lymphoma (p>0.05). CONCLUSION: These results suggest that the loss of bcl-2 expression may play a significant role in progression of cutaneous T cell lymphoma except in MF and angiocentric T cell lymphoma.
Apoptosis ; Breast Neoplasms ; Carcinogenesis ; Carcinoma, Basal Cell ; Cell Death ; Disease Progression ; Lichens ; Lung Neoplasms ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Cutaneous* ; Lymphoma, T-Cell, Peripheral ; Melanoma ; Mycosis Fungoides ; Oncogenes ; Paraffin ; Parapsoriasis ; Prognosis ; Psoriasis ; Skin

PURPOSE: The purpose of this study was to evaluate and compare the scintigraphic findings and diagnostic accuracy of double-phase Tc-99m sestamibi scan in primary and secondary hyperparathyroidism (HPT). MATERIALS AND METHODS: We retrospectively reviewed 16 cases of primary (18 lesions) and 11 cases of secondary HPT (44 lesions) who underwent Tc-99m-sestamibi scan before the surgical intervention. Scan was performed using LEM camera (Siemens, Germany) after the injection of 740MBq of Tc-99m sestamibi. Routine image consisted of baseline and 3-hour delayed images and each image was obtained using both parallel and pine hole collimator. The study population was 27 patients (male/female=5/22, age: 49.1+/-10.8). RESULTS: Eighteen lesions of primary HPT consisted of 13 adenomas and 5 hyperplasias, while all lesions of secondary HPT were hyperplasias. Among the case of primary HPT, we could detect all the lesions of 13 adenomas but only 2 lesions of 5 hyperplasias (40%) could be detected by double phase scintigraphy. Three cases of primary lesion showed decreased uptake in delayed images compared with baseline. The sensitivity, specificity, positive predictive value and accuracy of primary and secondary HPT were 58.8% (10/17), 83.3% (10/12), 83.3% (10/12), 75.9% (22/29), and 37.5% (15/40), 50% (2/4), 88.2% (15/17), 38.6% (17/44), respectively. Overall sensitivity, specificity, positive predictive value and accuracy were 43.9% (25/57), 75% (12/16), 86.2% (25/29), and 53.4% (39/73). There were no statistical difference between the weight of primary and secondary HPT lesion (p>0.05). CONCLUSION: Tc-99m sestamibi scan is fairly good modality to detect parathyroid lesion in patient with primary HPT before the surgical intervention. However, since some of cases may reveal decreased uptake in delayed image, a careful attention to the findings of baseline images may be helpful. Still the low accuracy of sestamibi scan in diagnosis of secondary HPT prohibits routine use of it for this disease.
Adenoma ; Diagnosis ; Humans ; Hyperparathyroidism, Primary ; Hyperparathyroidism, Secondary* ; Hyperplasia ; Parathyroid Glands ; Radionuclide Imaging* ; Retrospective Studies ; Sensitivity and Specificity

Adenocarcinoma metastatic to the skin usually originates in the lung, breast, large intestine or ovary. Cutaneous metastatic tumors from rectum or colon tend to appear in the abdominal or perineal area, but rarely appear in the perianal and genital skin. A 53-year-old female presented multiple nodules in and near the surgical scars of inguinal, pubie, vulvar, perianal areas and normal skin of left thigh two months after surgical removal of rectal adenocarcinoma. Biopsy specimens from the nodules of the perianal area and left thigh showed adenocarcinoma of well differentiated atruetures like the primary rectal carcinoma.
Adenocarcinoma* ; Biopsy ; Breast ; Cicatrix ; Colon ; Female ; Humans ; Intestine, Large ; Lung ; Middle Aged ; Ovary ; Rectum ; Skin ; Thigh

Cholangiocarcinomas have several histologic types, but intrahepatic cholangiocarcinoma with sarcomatous change is rare. A 71-year-old man was admitted to our hospital because of fever which had lasted two months. Ultrasonography (US) of the upper abdomen demonstrated a huge hepatic mass with central solid and peripheral cystic portions, and computed tomography (CT) revealed a heterogeneous hepatic mass with a central area in which enhancedment was delayed. Magnetic resonance imaging (MRI) disclosed a huge mass of predominantly low signal intensity at T1WI, and peripheral portions of high signal intensity and a central portion of intermediate signal intensity at T2WI. The pathologic diagnosis was cholangiocarcinoma with sarcomatous change.
Abdomen ; Aged ; Cholangiocarcinoma* ; Diagnosis ; Fever ; Humans ; Magnetic Resonance Imaging ; Ultrasonography

No abstract available.
Pre-Eclampsia* ; Proteinuria*