We report a case of mycosis fungoides with small follicular papules and plaques on the trunk. Histopathological findings showed lymphocytic infiltration within and around the follicular epithelium and Pautrier's microabscess in the epidermis. Immunohistochemical studies showed atypical T lymphocytes infiltrating the follicles and electron microscopic examination revealed the presence of lymphocytes with large convoluted nuclei around the follicles. These findings suggest that the follicular lesions were specific for a special variant of mycosis fungoides.
Epidermis ; Epithelium ; Lymphocytes ; Mycosis Fungoides* ; T-Lymphocytes

No abstract available.
Hand*

Autism Spectrum Disorder (ASD) is characterized by persistent deficits in social communication and restricted, repetitive patterns of behavior and interest. Sleep problems are not uncommon in children with autism spectrum disorders. Symptoms of insomnia are the most frequent sleep problems in individuals with ASD. Sleep problems can cause significant difficulties in the daily life of children with ASD and their families. Genetic factor, deregulations of melatonin synthesis, extraneous environmental stimuli and psychiatric and medical conditions may cause sleep problems. The first line treatment of sleep problems in ASD includes managements for potential contributing factors and parent education about sleep hygiene care for child and behavioral therapy. Supplementation with melatonin may be effective before considering other medications, such as risperidone, clonidine, and mirtazapine.
Autistic Disorder* ; Child ; Autism Spectrum Disorder* ; Clonidine ; Education ; Genetics ; Humans ; Hygiene ; Melatonin ; Parents ; Risperidone ; Sleep Initiation and Maintenance Disorders

No abstract available.
Scalp* ; Superficial Back Muscles*

No abstract available.

Cavernous hemangioma is the most common primary tumor occurred in adults' orbit. This tumor has symptoms characteristically developing over several years with slowly progressive proptosis, eyeball deviation, hyperopia, diplopia and optic nerve compression. It's removal, necessary when there is progressive exophthalmos and visual deficit, is best performed en bloc to avoid intraoperative vleeding, the risk of residue, and potential further growth. In principle, surgical approach to the orbit must provide maximum safety and optimal visualization. The noncompressibility of the globe imposes greater demand on the need for some removal of the osseous orbit for surgical approach. This also must permit immediate functional and aesthetic reconstruction. The authors have experienced a case of large cavernous hemangioma in the orbit inferomedially. The surgical treatment of tumor was achieved by inferomedial approach combined with inferolateral orbitotomy. This surgical approach allows better visualization of the tumor and greater protection of essential anatomic structures. This also permits immediate functional and aesthetic reconstruction. So we present our case with a brief review of the literature related to orbital cavernous hemangioma.
Diplopia ; Exophthalmos ; Hemangioma, Cavernous* ; Hyperopia ; Optic Nerve ; Orbit*

Many plastic surgeons have been tried to attain ultimate goal lies in restoring the original shape and function of the facial aesthetics, in reconstruction of deformities resulting from facial hypertrophic scar and skin defects. This would require consideration in terms of hanmony in color match, skin texture and thickness. Various forms of skin graft, local flap, distant flaps, free flap and tissue expander have been employed in restoring skin defects and deformities of the cheek and submental area, and the use of large local flaps utilizing the cervicofacial skin flaps or tissue expander have brought about improved aesthetic results. the authers have obtained satisfactory results in treating 2 cases of wide hypertrophic scar of the cheek and submental area with combination of wide cervical flap and intraoperative tissue expansion using foley catheter. the merits of this combined operative methods are as follows : 1. It is not necessory to keep tissue expander for a long period. 2. This technique is able to diminish the cost of multistage operation and using of tissue expander. 3. There is no psychologic problems due to undesirable facial appearance during tissue expansion period. 4. Rapid intraoperative tissue expansion by foley catheter during elevating wide cervical flap can allow to dissect one, preserving the perforators without bleeding in a short time. 5. Wide cervical flap and additional expanded tissue by means of intraoperative tissue expansion could brought into suturing avoiding tension of oral commissure and lip eversion. 6. Preservation of perforators of cervical flap above the platysma muscle raised flap's survival rate and then this result could prevent distal ischemic necrosis after flap coverage.
Catheters ; Cheek ; Cicatrix, Hypertrophic* ; Congenital Abnormalities ; Esthetics ; Free Tissue Flaps ; Hemorrhage ; Lip ; Necrosis ; Skin ; Survival Rate ; Tissue Expansion Devices ; Tissue Expansion* ; Transplants

We report a case of subclavian artery laceration caused by the removal of a pigtail pleural drainage catheter in a patient with a pneumothorax. The patient was successfully resuscitated through diagnostic angiography with subsequent balloon occlusion and primary repair of the injured subclavian artery. Although pigtail drainage of a pneumothorax is known to be safe and effective, proper insertion and removal techniques should be emphasized to reduce the risk of complications.
Angiography ; Balloon Occlusion ; Catheters* ; Drainage ; Hemothorax ; Humans ; Lacerations* ; Pneumothorax* ; Subclavian Artery* ; Thoracostomy

We present a case which seems identical to REM(Reticular Erythematous Mucinosis) syndrome in 26 year-old male. The lesion was initiated about 2 years ago and waxed and waned. The clinical findings were localized, grouped, erythematous papules and vesicles on the anterior middle chest with intermittent mild itching. Histopathology showed normal epidermis, extensive mucin deposition, telangiectasia and mild perivascular round cell infiltrations on the upper dermis. The mucin was stainable with alcian blue at pH 2. 5, but was not stained by either PAS or mucicarmine. Skin lesions were not responded to the oral steroid, but improved slowly after topical application of 5% para-aminobenzoic acid in ethanol for 9 months. The lesion does not recur until present time.
4-Aminobenzoic Acid ; Adult ; Alcian Blue ; Dermis ; Epidermis ; Ethanol ; Humans ; Hydrogen-Ion Concentration ; Male ; Mucins ; Pruritus ; Skin ; Telangiectasis ; Thorax

To analyse the age of onset, etiologic microorganisms, clinical manifestations, managements and genetic variation of chromic granulomatous disease, the authors reviewed four patients who were diagnosed as CGD at Department of Pediatrics, Seoul National Univesity Children's Hospital. They were siblings in relationship-two of them were brothers, the others were brother-sister. @ES The results were as follows; 1) Initial manifestations developed within 1 year old, and lymphadenopathy associated with BCG vaccination was the most common. 2) In culture study of micro-organism, catalase positive microorganisms such as Staphylococcus aureus, Serratia marcescens, Coagulase (-) Staphylococcus, Enterococcus, Proleus vulgaris, Klebsiella pneumoniae, E. coli and fungus such as Candida albicans were isolated. In 2 cases, culture study revealed no growth. 3) Fever, lymphadenopathy, hepatomegaly, suppurative dermatitis and pneumonia were the most common manifestations. In most of cases, antituberculous medications were administered under the impression of tuberculosis without response. 4) Immunologic screening tests including B-cell system, T-cell system, and complement system were within normal limit except NBT test. 5) In spite of severe infections, NBT scores of all the cases were less than those of controls. Liver biopsies of 3 cases showed granuloma formation with characteristic yellow brown pigment-laden macrophages.
Age of Onset ; B-Lymphocytes ; Biopsy ; Candida albicans ; Catalase ; Coagulase ; Complement System Proteins ; Dermatitis ; Enterococcus ; Fever ; Fungi ; Genetic Variation ; Granuloma ; Hepatomegaly ; Humans ; Klebsiella pneumoniae ; Liver ; Lymphatic Diseases ; Macrophages ; Mass Screening ; Mycobacterium bovis ; Pediatrics ; Pneumonia ; Seoul ; Serratia marcescens ; Siblings ; Staphylococcus ; Staphylococcus aureus ; T-Lymphocytes ; Tuberculosis ; Vaccination