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*

Carcinoma of the uterine cervix is the most common malignant tumor in Korean women. It is well known that carcinogenesis is a multi-step event involoving the inactivation of tumor supressor genes, such as p53 gene and RB gene. The inactivation of the normal functions of the tumor-suppressor proteins pRB and p53 are important steps in human cervical carcinogenesis, either by mutation or from complex formation with the HPV E6 and E7 oncoproteins. The pRB protein regulates early cell cyle progression by controlling transit through the G1 phase of the cell cyle. The p53 tumor suppressor gene product also plays a role in cell cycle control by the transcriptional regulation of cyclin-CDK inhibitor. Cervical carcinoma is an excellent model for studying the stepwise progression of cell transformation because this is reflected morphologically by the increasing dysplasia of the squamous cells before it becomes and invasive squamous cell carcinoma. The aim of this study was to examine the expression of pRB and compared that with overexpression of p53 in a series of cervical lesions including normal tissuess, dysplasias, carcinoma in situ and carcinomas by immunohistochemical staining with monoclonal antibody to elucidate the role of these tumor suppressor genes. The result were as follows: 1. In normal cervical mucosa and CIN I , a few positively stained cells for pRB were seen in basal and parabasal layer. 2. An abnormality of pRB, loss of expression was seen in 23.8% of CIN III and in 10.8% of invasive carcinoma. 3. Overexpression of p53 was demonstrated in 14.3% of CIN III and in 59.5% of invasive carcinoma. 4. The immunoreactivity of p53 was significantly increased (p<0.05) in stage II, III than stage I , whereas downregulation of pRB and tumor stage was not correlated. 5. The immunoreactivity of p53 was significantly increased (p<0.05) in squamous cell carcinoma than in adenocarcinoma, adenosquamous carcinoma and CIN III. These result suggest that an alteration of pRB is more frequently implicated in CIN III than invasive carcinoma, whereas overexpression of p53 may be involevd in late progression of uterine cervical carcinoma.
Adenocarcinoma ; Carcinogenesis ; Carcinoma in Situ ; Carcinoma, Adenosquamous ; Carcinoma, Squamous Cell ; Cell Cycle Checkpoints ; Cervical Intraepithelial Neoplasia* ; Cervix Uteri ; Down-Regulation ; Female ; G1 Phase ; Genes, p53 ; Genes, Retinoblastoma ; Genes, Tumor Suppressor ; Humans ; Mucous Membrane ; Oncogene Proteins ; Retinoblastoma Protein*

No abstract available.
Heat-Shock Proteins* ; Hot Temperature*

No abstract available.
Heat-Shock Proteins* ; Hot Temperature*

Verrucous hemangioma is a variety of capillary, cavernous or mixed hemangioma that can develop into acanthosis, hyperkeratosis, and papillomatosis. Most verrucous hemangiomas appear on the lower extremities, and are present at birth or appear during infancy. It is important, from a prognostic and therapeutic point of view, to make a correct diagnosis between verrucous hemangioma and angiokeratoma circumscriptum. The former needs a large and deep excision, while the latter responds to the common means of physical therapy. We observed two patients who showed typical clinical and histopathological findings of verrucous hemangioma. Treatment was by wide sugical excision and skin graft. The two patients responded positively to this tratment.
Angiokeratoma ; Capillaries ; Diagnosis ; Hemangioma* ; Humans ; Lower Extremity ; Papilloma ; Parturition ; Skin ; Transplants

We report a case of cutaneous calcinosis following extravasation of calcium calcium chloride in a 3-week old neonate, After extravasation of 3% calcium chloride infusion, rapid and marked swelling, erythema, and signs of soft tissue necrosis developed over the extensor surface of both upper extremities. Through the small channels of the destroyed epidermis, tiny white pieces of calcific masses were eliminated spontaneously. Histologically the calcium deposits were found as amorphous masses in the upper dermis and the discharge of calcium deposits also took place by means of transepidermal elimination. The central bone formation and surrounding calcium deposition were present along with dense lymphohistiocytic cell infiltration in the deep dermis. Complications of extravasation of calcium solution during intravenous infusion included localized calcification and, ocasionally necrosis. The incidence of compllcations was about eight percent. This is a case which again emphasises of the danger of using calcium chloride intravenously in the neonate or young infant.
Calcinosis* ; Calcium Chloride* ; Calcium* ; Dermis ; Epidermis ; Erythema ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infusions, Intravenous ; Necrosis ; Osteogenesis ; Upper Extremity

BACKGROUND: Intra-aortic balloon pump (IABP)is well known for its hemodynamic benefit but still has its own complications.Proper use of IABP is the best way t o obt ai n maximum benefit with low complication rate. MATERIALS AND METHOD: Twenty one(men 10,female 11) patients were included in this study among the 100 consecutive adult cardiac surgery patients in our hospital.Eighteen(85.7%)were ischemic heart disease patients.They all received IABP therapy due to postcardiotomy cardiogenic shock according to the well-known indications.Their preoperative conditions,intraoperative factors including hemodynamics, postoperative conditions and IABP-related complications were analyzed. RESULT: Nineteen patients(90.5%)were successfully weaned from IABP.There were 2 patients of operative death and the mortality rate was 9.5%.Duration of IABP use was 40.7+/-24.3 hours.There were 2 cases(9.5%)of IABP-related vascular complications that required surgical intervention. CONCLUSION: We concluded that IABP could be used effectively and safely for postcardiotomy cardiogenic shock patients with low complication rate.
Adult ; Hemodynamics ; Humans ; Mortality ; Myocardial Ischemia ; Shock, Cardiogenic* ; Thoracic Surgery

We present herein a case of pyoderma gangrenosum, which showed good response to cyclosporine therapy. The patient, a 47-year-old man, had suffered from a skin defect on the left anterior chest 2 months before the rapidly spreading pustules and ulcer with an inflammed, irregular undermined border appeared together with a hemorrhagic base which developed on his left anterior chest and upper abdomen. Cyclosporine was given orally in a dose of 150mg three times daily for 2 weeks, and tapering to 100mg three times daily for the next 3 weeks. Clinical improvement was observed after 14 day's treatment and all the skin lesions were replaced by granulation tissue with epithelialization after 35 day's treatment. After the 5-week period of treatment, blood urea nitrogen and creatinine rose to 29 and 1.8 mg/dl. Cyclosporine was stopped and then the patient was given prednisolone (10mg/day) in addition to dapsone(50mg/day) for 1 month. Recurrence has not been observed.
Abdomen ; Blood Urea Nitrogen ; Creatinine ; Cyclosporine* ; Granulation Tissue ; Humans ; Middle Aged ; Prednisolone ; Pyoderma Gangrenosum* ; Pyoderma* ; Recurrence ; Skin ; Thorax ; Ulcer

BACKGROUND: Confluent and reticulated papillomatosis(CRP) is a rare but clinically distinct dermatosis of which the etiology is unknown. The pathomechanisms have been discussed from four different viewpoints: 1) endocrine imbalance 2) abnormal host reaction to colonization by pityrosporum orbiculare 3) disorder of keratinization 4) variant of amyloidosis cutis. However recent reports have shown that defect in the keratinization has become the predominant pathomechanism of CRP. OBJECTIVE: Our purpose was to evaluate 25 cases of CRP clinically, histopathologically and electornimcroscopically, to reviewed the literature, and to commented on the pathogenesis. MEHTODS: The 25 patients were examined clinically and pathologic specimens were obtained from lesions for routine light microdcopy and electron microscopy. RESULTS: 1. There were difference between male(68%) ad female(32%) patients. 2. Age distribution, at first visit were variable, ranging from 13 to 35, with the mean age of 20 years-old.3. Duration of symptoms were variable, ranging from 1 month to 5 years with wean duration of 1.5 years. 4. In the seasonal influence 16 cases showed aggrevation of lesions in the summer. 5. The distribution of lesions were abdomen(18 cases), chest(16 cases), back(12 cases), shoulder(7 cases), and buttock(5 were) 6. Three patients had a concomitant disease such as Graves' disease(1 case) or iron-deficiency anemia(2 cases). 7. There were no familial occurrence in any cases. 8. There were no hyphaes or sppores in KOH mount in any cases. 9. The histopathological finding of the affected tissues were characterized as follow : All cases showed laminated hyperkeratosis, epidermal atrophy, acanthosis, and papillomatosis. 23 cases showed an increase of melanin pigment in the basal layer, minimal perivascular and/or perifollicular infiltration. 20 cases showed a decrease of the granular layer. 16 cases showed mild to moderate papillary edema, and dilated or congested upper dermal vessels. 10. In an electron microscopic studies the transitional cells between the stratum corneum and stratum granulosum contained less electron-dense tonofilament-keratohyaline aggregates with electron-lucent inclusions in their cytoplasm in a thick marginal band and degraded cell organelles. These cell layers were increased to 3 or 4 layers. The sratum corneum was thichened and showed a regular keratin pattern with intracellular and extracellular vacuoles. 11. 8 of the 10 patients treated with oral etretinate for 2 months showed some improvement. 7 of the 12 patients treated with topical scalicylic acid oint and selenium sulfide solution for 2 months showed some improvement. 1 patients with oral minocyclin for 2 months showed a marked improvement. 2 patients treated with oral ketoconazole did not show any improve-showed a marked improvement. CONCLUSION: In an electron microscopic study we found that transitional cell layers between stratum corneum and stratum granulosum were increased to 3 or 4 layers. Therefore we think that CRP may be a disease of defect in the keratinization. Although this abnormal keratinization is distinctive, it is uncertain whether it is primary or secondary.
Acitretin ; Age Distribution ; Amyloidosis ; Atrophy ; Colon ; Cytoplasm ; Edema ; Estrogens, Conjugated (USP) ; Etretinate ; Humans ; Hyphae ; Ketoconazole ; Malassezia ; Melanins ; Microscopy, Electron ; Organelles ; Papilloma ; Seasons ; Selenium ; Skin Diseases ; Vacuoles

BACKGROUND: Mixed venous oxygen saturation (SO2) monitoring turned out to be invaluable in following up systemic cardiovascular status. But balloon-tipped flow-directed thermodilution catheter (Swan-Ganz catheter) insertion carries additional inherent risks other than those of central venous catheterization, and it costs much more expense than simple venous catheter. There has been a lot of papers which argue that central venous catheterization may substitute for the Swan-Ganz catheterization. In addition, it may be very difficult or impossible to insert the Swan-Ganz catheter in pediatric patients. This study was performed to determine whether Swan-Ganz catheterization might be replaced by the central venous catheterization in regards to SO2. METHODS: In 17 pediatric open heart surgery (OHS) patients, from the central venous catheter, the tip of which had been located in the center of right atrium (RA) and pulmonary artery, blood samples were drawn for gas analysis simultaneously, which was done immediately after emergence from cardiopulmonary bypass. RESULTS: There were no significant differences between RA blood and mixed venous blood gas analyses except oxygen saturation. The oxygen saturations of both were linearly correlated with each other. The relation was SO2=17 0.8 SRAO2 (R=0.77, p<0.05) CONCLUSIONS: It may be concluded that RA blood may be used for blood gas analysis in place of mixed venous blood immediately after pediatric open heart surgery.
Blood Gas Analysis ; Cardiopulmonary Bypass* ; Catheterization, Central Venous ; Catheterization, Swan-Ganz ; Catheters ; Central Venous Catheters ; Heart Atria ; Heart* ; Humans ; Oxygen* ; Pulmonary Artery ; Thermodilution ; Thoracic Surgery*