We report a case of linear scleroderrna associated with severe musculoskeletal atrophy of Ieft arm or disabling pansclerotic morphea of children. The patient was 11 year-old girl who has 8 years history of linear violaceoushued atrophic plaques on left arm and anterior chest, left sboulder region in a circumscribed sclerotic lesion. She had a history of injury on left forearrn at 3 years of age. One, month later, erythematous swelling and hardening of skin on left hand were developed and then progressed rapidlyfto other area for one year. However there was no signs of dyspnea, dysphagia, Raynauds phenomenon, myalgia, weakness and photcsensitivity. Diagnosis was confirmed by the characteristics of clinical features and histologic findings of skin and muscle and laboratory findings. As a therapeutic trial, low dose D-penicillamine was attempted.
Arm ; Atrophy* ; Child ; Deglutition Disorders ; Diagnosis ; Dyspnea ; Female ; Hand ; Humans ; Myalgia ; Penicillamine ; Scleroderma, Localized* ; Skin ; Thorax ; Upper Extremity*

PURPOSE: Pigmented villonodular synovitis (PVNS) is a rare soft tissue tumor, which usually arises in larger joints, such as the knee. It has a high recurrence rate after surgical treatment. The purpose of this study is to evaluate and analyze the clinical results of diffuse-type pigmented villonodular synovitis cases that were treated with open total synovectomy. MATERIALS AND METHODS: Between 1994 and 2006, 21 patients who had diffuse-type pigmented villonodular synovitis were selectively reviewed. Among the 21 cases studied, 14 patients presented at the knee, 5 at the ankle, and 2 at the shoulder and elbow. The mean follow up period was 5.5 years (range, 36-157 months). The average age of the patients was 34 years consist of 7 men and 14 women. Clinical outcomes were analyzed retrospectively, including range of motion and complications. RESULTS: Open total synovectomy and adjuvant electrocautrization were done in all cases except one. During the regular follow-up period after the surgery, two patients showed symptoms of recurrence. After re-operation, only one case was pathologically confirmed as a recurrence. The patient who had partial synovectomy and the other patient who had second operation due to recur rence received additional radiation therapy. Clinical outcome scores were improved in every aspect (p<0.0001). 2 out of 14 Patients who had pigmented villonodular synovitis at the knee developed stiff knee after the surgery. CONCLUSION: After the open total synovectomy with electrocautrization, a low recurrence rate and satisfactory clinical outcome was achieved, observed in a minimum of 3 years of follow-up.
Animals ; Ankle ; Elbow ; Female ; Follow-Up Studies ; Humans ; Joints ; Knee ; Male ; Range of Motion, Articular ; Recurrence ; Retrospective Studies ; Shoulder ; Synovitis ; Synovitis, Pigmented Villonodular

PURPOSE: We analyzed disease free survival and the prognostic factors of liposarcoma in the extremity. MATERIALS AND METHODS: Between 1994 and 2005, of 44 patients who were diagnosed and treated for liposarcoma of the extremity, 40 patients were restrospectively analysed. 13 out of 40 patients got postoperative radiotherapy. We examined local recurrence, distant metastasis and disease free 5-year survival rate. We also analyzed clinical prognostic factors, such as age, gender, size of tumor, prior unplanned excision, histologic type, surgical excision margin and postoperative radiotherapy respectively. RESULTS: There were 3 cases of local recurrence and 4 cases of distant metastasis. The disease free 5-year survival rate was 85.0%. 26 patients presented with myxoid, 8 well differentiated, 4 round cell, 1 pleomorphic and 1 dedifferentiated histology. The disease free 5-year survival rate of mixoid, well differentiated and round cell liposarcoma were 100.0%, 84.6% and 75.0% (p=0.419). The 5-year disease free survival rate was 90.6% in negative surgical margin (n=25) and 62.5% in positive surgical margin (n=15) (p=0.003). CONCLUSION: Our study suggests that surgical excision margin is significant prognostic factor for 5-year disease free survival rate.
Disease-Free Survival ; Extremities ; Humans ; Liposarcoma ; Neoplasm Metastasis ; Recurrence ; Survival Rate

In a retrospective study of 21 patients, in whom the acetabular fractures were suspected on initialradiographs, we compared and analysed the CT findings and plain radiographic findings and plain radiographicfindings. The results were as follow: 1. In patients with multiple trauma, no further change in position wasrequeired during CT examinations. 2. CT showed intraarticular loose bodies, which were invisible on plainradiographs. 3. CT was useful in detecting the fractures of acetabular rims, medial wall of acetabulum, andfemoral head. 4. CT permitted better evaluation of shape, extent, and degree of separation of fracture fragments.5. CT was helpful indetecting the associated fractures and soft tissue injuries. 6. CT also demonstrated theadequacy of reduction, the position of metallic fixation devices, and the presence or absence of remainingintraarticular osseous fragments after surgery.
Acetabulum ; Head ; Humans ; Multiple Trauma ; Retrospective Studies ; Soft Tissue Injuries

No abstract available.
Seizures*

Marjolin's ulcer seated upon an old cicatrix, especially old burn scar, which may chiefly degenerated into a squamous cell carcinoma with propensity for metastasis. We are experienced two cases of Marjolins ulcer recently. A 54-year-old male who had a Marjolins ulcer(15x40cm) on his left lower extremity. He was experienced burn at the age of eight and rice sized ulcer was developed at the site of burn scar about 21 years ago. The ulcer progressively enlarged in size to reach 15x40cm for 21 years. The pathologic diagnosia was squamous cell carcinoma grade 1, but cancer cells invaded to deep dermie and subcutaneous tissues. Severe skin lesion and irreversible osteoporotic degeneration on knee joint of affected limb were present. So he was treated by high above knee amputation. Another 58-year-old female who had a Marjolins ulcer(10x20cm) on her right lower extremity. She was experienced burn at the age of forty eight and bean sized ulcer was developed at the site of burn scar about 1 year ago. The pathological diagnosis was squamous cell carcinoma grade 1 and invasian of cancer cells was limited upper dermis. On lymph node biopsy, the histological diagnosis was within normal limit. So she was treated radical surgical excision with split thickness skin graft(Mesh).
Amputation ; Biopsy ; Burns ; Carcinoma, Squamous Cell ; Cicatrix ; Dermis ; Diagnosis ; Extremities ; Female ; Humans ; Knee ; Knee Joint ; Lower Extremity ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis ; Skin ; Subcutaneous Tissue ; Ulcer*

No abstract available.

BACKGROUND: Photodynamic therapy (PDT) with methyl 5-aminolaevulinate (MAL) has proven to be useful for the treatment of a wide variety of benign and malignant dermatologic conditions. More recently, this therapeutic modality has emerged as an alternative therapy for viral wart. OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of PDT for treating viral warts with using a light-emitting diode (LED) device and MAL. METHODS: Fifteen patients with a total of 34 warts were treated with MAL under an occlusive dressing for 3 hours and this was followed by irradiation with a LED device at a wavelength of 633+/-3 nm and a fluence of 37 J/cm2. The treatment was repeated at 1~2 weeks until all the lesions cleared. The side effects, including pain, hyperpigmentation and pruritus, were recorded on a progress chart. The intensity of pain was assessed by using a 5-point verbal rating scale (VRS). RESULTS: A total of 34 warts from 15 patients (9 males and 6 females) were treated with MAL-PDT. The sites of the lesion were classified as periungal (26%), sole (18%) and others (56%). After an average of 2.15+/-0.61 therapeutic sessions (MAL+PDT) for 34 warts, the number of complete, partial and no responses were 27/34 (79.4%), 7/34 (20.6%) and 0/34 (0%), respectively. The overall complete response rates were 66.7% for the periungal warts, 50% for the sole warts and 94.7% for the others. The pain after the first treatment was more intense and deeper as compared with that after the second treatment. There were no recurrences of the warts that had a complete response during the follow-up period (from 6 to 12 months). CONCLUSION: We suggest that MAL-PDT is an effective and safe alternative therapy for viral warts.
Aminolevulinic Acid ; Follow-Up Studies ; Humans ; Hyperpigmentation ; Male ; Occlusive Dressings ; Photochemotherapy ; Pruritus ; Recurrence ; Triazenes ; Warts

The incidence of cutaneous metastases of primary tumor has been reported to be rare, as compared with metastasis of other internal organ. Carcinoma of the breast is most common cause of cutaneous metastasis in women. We report here on a case of telangiectactic metastatic breast carcinoma in a 65-year-old female who had violaceous plaques and vesicles over the right side of the neck. Histopathological examinations of the cutaneous lesion revealed aggregations of tumor cells within the dilated blood vessels in the dermis.
Aged ; Blood Vessels ; Breast ; Dermis ; Female ; Humans ; Incidence ; Neck ; Neoplasm Metastasis

Morphea is a rare, sclerotic connective tissue disorder and is thought to be caused by a decreased collagenase activity. Numerous treatment modalities have been tried, such as infiltration with glucocorticosteroid, D-penicillamine, antimalarial agents and cyclosporine. However, all have shown only limited success. We report a case of a 21 year- old female with localized scleroderma, who showed a marked improvement after localized therapy with high dose UVA-1.
Antimalarials ; Collagenases ; Connective Tissue ; Cyclosporine ; Female ; Humans ; Penicillamine ; Phototherapy* ; Scleroderma, Localized*