Solitary morphea profunda is a rare form of scleroderma, characterized clinically by a solitary sclerotic plaque, and histologically by marked dermal and subcutaneous fibrosis with an inflammatory infiltrate. We describe another case of this entity presented with an ulcerative, indurated plaque on the left iliac crest, which histologically revealed a focal incidental acantholysis in the overlying epidermis and a marked eosinophilic infiltration through the dermis to the sub-cutaneous tissue.
Acantholysis* ; Dermis ; Eosinophils ; Epidermis ; Fibrosis ; Scleroderma, Localized* ; Ulcer

No abstract available.
Atrophy* ; Temporal Lobe*

No abstract available.
Cervix Uteri* ; Conization* ; Female ; Pregnancy*

Breast cancer is the most common malignancy of women in industrialized countries and the third in Korean women. There have been a lot of studies on biologic behaviors as well as on the prognostic factors of the breast cancer. In this study, the expression of hormone receptors (estrogen receptor ; ER, progesterone receptor ; PR, and androgen receptor ; AR), bcl-2 and Rb proteins were immunostained on 60 infiltrating ductal carcinomas of the breast. The results were evaluated in relation with the age, histologic grade, tumor size, and status of lymph node metastasis. The expression of ER and PR had a significant inverse correlation with the histologic grade (p<0.001). The expression of AR was significantly correlated with the expression of ER (p=0.039) and PR (p=0.009), but not with other factors such as age, histologic grade, tumor size, and status of lymph node metastasis. There was no relationship between bcl-2 protein expresssion and other prognostic factors, except with the expression of ER. Rb protein expression had a significant positive relationship with PR (p=0.05) and the degree of positivity was correlated with histologic grade (p=0.002). In conclusion, this result suggests that expression of AR is well correlated with ER and PR. bcl-2 has no prognostic value. The significance of Rb protein expression remained to be studied.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Developed Countries ; Female ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Receptors, Androgen* ; Receptors, Progesterone ; Retinoblastoma Protein*

The dual muscle flap (Latissimus dorsi+ Serratus anterior muscle) based on the thoraco-dorsal vascular system for limb reconstruction has been infrequently reported. We have used this flap as a free flap for limb reconstruction in four patients (3 cases in lower linb, 1 in upper limb). A Latissmusi dorsi muscle or musculocutaneous flap and Serratus anterior muscle flap were used and all cases healed satisfactorily. The indications for this flap are to resurface two separate defects simultaneously or to resurface very large defects. It has the advantage of requiring anastomosis of one vascular pedicle only. This flap is particularly suitable for resurfacing defects wider than their length, in relation to the long axis of the limb.
Axis, Cervical Vertebra ; Extremities* ; Free Tissue Flaps ; Humans ; Myocutaneous Flap

Dynamic cardiomyoplasty is a recently introduced surgical method to improve myocardial performance. It consists of a placement of a skeletal muscle flap around the heart and stimulation of the flap in synchrony with ventricular contraction. We experienced a case of cardiomyoplasty in a 25 year old male patient with congestive heart failure. Anesthesia was induced and maintained with fentanyl, midazolam and isoflurane. The operation was performed for 8hrs without cardiopulmonary bypass and the patient was transferred to the intensive care unit. He was mechanically ventilated electively overnight and extubation was done 18hrs postoperatively. The patient was discharged home on the 40days after operation and improved in exercise tolerance. We report the anesthetic management and hemodynamic changes in a patient who underwent dynamic cardiomyoplasty.
Adult ; Anesthesia ; Cardiomyoplasty* ; Cardiopulmonary Bypass ; Exercise Tolerance ; Fentanyl ; Heart ; Heart Failure ; Hemodynamics ; Humans ; Intensive Care Units ; Isoflurane ; Male ; Midazolam ; Muscle, Skeletal

BACKGROUND: Herpes zoster is an important and troublesome disease. OBJECTIVE: The purpose of this study was the elucidation of the epidemiological and clinical characteristics of herpes zoster through patient assessrnent. METHODS: During a 5- Year period, January 1990 to December 1994, 215 patients with herpes zoster were assessed with regard to annual and monthly frequency in occurrence, age and gender incidence. Associated conditions, dermatomic distributions, the relationship of onset of pain and skin lesions, Multi-CMI test and complications were also evaluated. RESULTS: 1. The annual freguency of herpes zoster ranged from 0.88% to 1.78% (mean 1.23%) during the 5-year period. The highest number of herpes zoster patients was observed in winter (p<0.001) especially in January. 2. Herpes zoster was found to most frequently afflict persons aged 50-59 (27.9%). 71% of the patients were over 40 years of age. 3. In 76 patients (41.8%), neuralgia occurred several days (4 days mean) before the development of skin lesions. In 92 patients (50.5%), pain and skin lesions developed simultaneously while skin lesion development occurred before the onset of pain in 14 patients (7.7%). 4. Among the patients, 42.8% had associated conditions such as diabetes mellitus, hypertension, pulmonary tuberculosis, liver diseases, peptic ulcer, hypothyroidism, pharyngitis, fracture, etc. 5. The dermatomic invclvement of herpes zoster patients having one dermatome was most frequent in thoracic dermatome ca. es (52.6%). Others included cervical (16.7%), trigeminal (11.6%), sacral (6. 0%), lumbar (4.2%), facial (0.5%). Cases having two different dermatomes constituted 8.4%. 6. The most common complication of herpes zoster was postherpetic neuralgia although instance of ophthalmologic compiications, secondary bacterial infection, scar formation, Ramsay-Hunt syndrome, keloid formation, and urinary difficulty were also documented. 7. Multi-CMI (Cell-mediated immunity) tests were done on 88 herpes zoster patients. Thirteen of them (14.8%) were found to have comparatively depressed scores. Ten of the 79 single dermatome involvement patients (12.7%) and three of the 9 two dermatome involvement patients (33.3%) exhibited similar scores. CONCLUSION: These results are in accordance with those of previous reports with the exception of the higher incidence ot two different dermatome involvements and seasonal variation.
Bacterial Infections ; Cicatrix ; Diabetes Mellitus ; Herpes Zoster* ; Humans ; Hypertension, Pulmonary ; Hypothyroidism ; Incidence ; Keloid ; Liver Diseases ; Neuralgia ; Neuralgia, Postherpetic ; Peptic Ulcer ; Pharyngitis ; Seasons ; Skin ; Tuberculosis

We report a case of pigmented spindle cell nevus occurred in a 4-year-old girl. The lesion was well-demarcated, 2.5 x 3mm sized black macule on the left thenar area. The histopathologic findings of excisional biopsy specimen revealed the prociferation of uniform spindle-shaped pigmented melanocytes at the dermoepidermal junction and sharply definded lateral margins.
Biopsy ; Child, Preschool ; Female ; Humans ; Melanocytes ; Nevus, Spindle Cell*

No abstract available.
Chondrosarcoma*

BACKGROUND: The main function of melanocyte is known to proiect the skin from hazardous sun-light. But, some investigators have claimed lately that melanocytes are also related to the immunologic role in the epidermis becauase these cells produce IL-1 activity and IL-lb convertase activity, in vitro. OBJECTIVE: Our purposee were to investigate the effects of rIFN-b on the proliferation of melanocytes, melanin content, and the expression of HLA-DR aritign on melanocytes after a rIFN-y exposure. MEHTODS: The number of melanocytes, the melanin content, and the expression of HLA-DR antigen were evaluated on culturect human melanocytes according to a time sequence and various concentrations of rIFN-y. RESULTS: Antiproliferative activity on melanocytes was dependent on the exposure time and the concentration of rIFN-r. According to the exposure time and the concentration of rIFN-r, melanogenic activity was inhibited or stimulated, Normal melanocytes didnt express HLA-DR antigen, but when normal melanocytes were exposed to rIFN-r, the expression of HLA-DR antigen increased in a timeand concentration-dependent fashion. After the removal of rIFN-r fiom the culture media the expression of HLA-DR antigen on melanocytes also disappeared. CONCLUSION: In our study, melanocytes seem to be related to the irnmunologic role in the epidermis because these cells expressed HLA-DR antigen after rIFN-r exposue and we think that study could help to investigate between melanocytes and immunalogic mechanisms in various inflammatory skin diseases.
Culture Media ; Epidermis ; HLA-DR Antigens ; Humans* ; Interleukin-1 ; Melanins ; Melanocytes ; Research Personnel ; Skin ; Skin Diseases