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*

To determine the types of metabolic a cidosis using anion gap in acute infantile diarrhea and to correlate it with clinical outcome, we examined 103 infants admitted with acute diarrhea. The serum electrolytes (sodium, potassium, chloride, phosphorus), creatinine, CO2 content and anion gap were measued on first admission day. They were classified group A with normal anion gap (8~16mEq/L) and group B with increased anion gap (>16mEq/L). The results were as follows. 1) The number of group A with normal anion gap (11.6+/-3.3mEq/L) was 62 and the number of group B with incresed anion gap(21.1+/-5.5mEq/L) was 38. 2) The duration of diarrhea was significantly prolonged in group B (9.0+/-2.5 days), compared with group A (5.9+/-1.1 days)(p<0.001). 3) The duration of admission was significantly prolonged in group B(5.6+/-2.2 days), compared with group A (4.+/-01.4days)(p<0.001). 4) Infants in group B, compared with group A, were significantly more severe dehydrated (p.
Acid-Base Equilibrium ; Acidosis* ; Creatinine ; Diarrhea ; Diarrhea, Infantile* ; Electrolytes ; Humans ; Infant ; Potassium

Mayer-Rokitansky-Kuster-Hauser Syndrom is characterized by the absence of the vagina and the uterus, the presence of apparently normal tubes and ovaries, feminine appearance, normal female secondary sexual characteristics, a normal 46, XX karyotypes, and a feminine psychosexual orientation. Absence of the vagina results from an embryological arrest in the development of the lower portion of the Mullerian system. Various methods of surgical treatment for the vaginal absence in this syndrom have been introduced but the ideal method to restore the original dimension and function of the normal vagina was not found. The two cases reviewed in this paper were all treated with modified McIndoe operation using full thickness skin grafts. Postoperatively both women were satisfied without complications, i,e. lack of skin graft, bleeding, urethrovaginal fistula, perforation of the rectum, rectovaginal fistula and significant vaginal stricture. This paper reveals the satisfactory results that were uniformly good.
Constriction, Pathologic ; Female ; Fistula ; Hemorrhage ; Humans ; Karyotype ; Ovary ; Rectovaginal Fistula ; Rectum ; Skin* ; Transplants* ; Uterus ; Vagina

Subcutaneous angiolymphoid hyperplasia is an uncommon disease characterized by eosinophilia, proliferation of the capillary vessels and lymphoid tissue and infiltration of the inflammatory cell, especially eosinophils. The etiology of the disease are obscure, but probably trauma, lower grade infection, nervous factor & hormonal status etc. The predilection sites are face, ears, scalf & neck, but rarely reported in the extremities. We experienced a case of subcutaneous angiolymphoid hyperplasia of the inguinal region and anteromedial side of the proximal thigh in a 10 year-old man who complained pain and tenderness on the above region. The patient was treated by excision with satisfactory result.
Capillaries ; Ear ; Eosinophilia ; Eosinophils ; Extremities ; Humans ; Hyperplasia ; Lymphoid Tissue ; Neck ; Thigh

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

Schonlein-Henoch purpura is a generalized small vessel vasculitis characterized by nonthrombocytopenic purpura, arthritis, abdominal pain and nephritis. In 1914 Osler described an allergic purpura associated with hemiplegia. After then Lewis et al. reported the cases of Schonlein-Henoch purpura associated with convulsion, coma, confusion, intracranial hemorrhage, and chorea, CNS complication has been reported in 1-8% of children and subsided spontaneously in most cases. Headache is a remarkable sympton and appears nonspecific nature. In 1991 Ostergaard and Storm reported that headache occured during the first week following skin rash and frequently showed abnormal EEG findings. We investigated prospectively the presence of a possible cerebral and renal involvement in the case of Schonlein-Henoch purpura. EEG abnormality demonstrated in 52.6% of all cases, and headache or irritability in 47.4% of all cases. A significant association was found between abnormal EEG finding and presence of headache, but was not found between EEG findings and presence of renal involvement and hypertension. Patients with abnormal EEG had no Past or famity history of febrile convulsion or ididopathic epilepsy.
Abdominal Pain ; Arthritis ; Child ; Chorea ; Coma ; Electroencephalography* ; Epilepsy ; Exanthema ; Headache ; Hemiplegia ; Humans ; Hypertension ; Intracranial Hemorrhages ; Nephritis ; Prospective Studies ; Purpura, Schoenlein-Henoch* ; Seizures ; Seizures, Febrile ; Vasculitis

Bilateral coronary artery fistula is very uncommon congenital anomaly which occupy small percentage of all congenital coronary artery fistula. About 20% of the cases associated with additional congenital heart disease. And it may cause congestive heart failure, especially severely in neonate. We experienced a case of neonate who was 1 day-old-male with bilateral coronary artery-right ventricular fistula associated with atrial septal defect and congestive heart failure. The Patient was admitted because dyspnea, cyanosis since birth. 2D ecgicardiogram and cardiac catheterization revealed that a fistulous communicating ; forming a large aneurysm, was noted from bilateral coronary artery emptied into the right ventricle, and there was oxygen step-up in right ventricle.
Aneurysm ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Cyanosis ; Dyspnea ; Fistula* ; Heart Defects, Congenital ; Heart Failure ; Heart Septal Defects, Atrial* ; Heart Ventricles ; Humans ; Infant, Newborn* ; Oxygen ; Parturition

PURPOSE: Kawasaki disease is notorious for coronary arterial complication which is usually developed as a febrile disease in early childhood. Increased polymorphonucleus(PMN) cell levels in acute phases may be associated with the pathophysiology of Kawasaki disease. We studied the relationship between coronary arterial dilatation and elastase activity which was excreted from PMN cell and roles as an important factor for vasculitis. METHODS: Ten patients diagnosed with Kawasaki disease in Yonsei University Medical Center were examined between November, 2001 and January, 2002. In addition, 15 patients with other febrile diseases were also examined. Echocardiography was done in patients with Kawasaki disease on the first day of admission and four weeks after the onset of the disease. At each time, venous samples were drawn and separated into plasma and leukocytes. In patients with other febrile disease, samples were drawn on admission. Elastase activities in plasma and neutrophil extracts were measured. RESULTS: The significant increased plasma elastase activity, 6.19+/-0.74 U/mL, found in Kawasaki disease patients compared with the other febrile disease patients, 4.86+/-1.17 U/mL(P<0.05). And there was no significance between the above two diseases in terms of the elastase activity in neutrophil extracts. The relationship between initial elastase activity and the coronary arterial complication which was shown in subacute phase wasn't significant. CONCLUSION: Plasma elastase activity was increased in Kawasaki disease significantly, but the initial plasma elastase activity in the acute phase could not reflect the range of coronary arterial complication.
Academic Medical Centers ; Dilatation* ; Echocardiography ; Humans* ; Leukocyte Elastase* ; Leukocytes ; Mucocutaneous Lymph Node Syndrome* ; Neutrophils* ; Pancreatic Elastase ; Plasma ; Vasculitis

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