• Title/Summary/Keyword: Cutaneous

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A Retrospective Multicenter Evaluation of Cutaneous Melanomas in Turkey

  • Gamsizkan, Mehmet;Yilmaz, Ismail;Buyukbabani, Nesimi;Demirkesen, Cuyan;Demiriz, Murat;Cetin, Emel Dikicioglu;Ince, Umit;Akalin, Taner;Demirkan, Nese Calli;Lebe, Banu;Erdem, Ozlem;Gokoz, Ozay;Sakiz, Damlanur;Demireli, Peyker Temiz;Astarci, Hesna Muzeyyen;Adim, Saduman Balaban;Zemheri, Itir Ebru;Acikalin, Arbil;Yaman, Banu;Aydin, Ovgu;Bassorgun, Cumhur Ibrahim
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10451-10456
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    • 2015
  • Background: We defined melanoma distribution in a large series of Turkish patients and evaluated the prognostic parameters of melanomas. Materials and Methods: A total of 1574 patients' data was retrospectively collected at 18 centers in Turkey. Demographic characteristics were questioned and noted. Prognostic parametres were evaluated based on sentinel lymph node involvement. Results: Mean age was 56.7 (4-99) years. While 844 (53.6%) cases were male, 730 (46.4%) cases were female. One thousand four hundred forty-seven (92%) cases were invasive melanoma and 127 (8%) cases were in-situ melanoma. The most common histopathological form was the superficial spreading melanoma (SSM) which was found in 549 patients (37.9%). It was followed by nodular melanoma in 379 (26.2%), acral lentiginous melanoma (ALM) in 191 (13.2%) and lentigo maligna melanoma in 132 (9.1%), respectively. On univariate analysis, lymphovascular invasion (p<0.001), tumor thickness (p<0.001), histopathological subtype (p<0.001), Clark level (p=0.001), ulceration (p<0.001), ${\geq}6/mm^2$ mitosis (p=0.005), satellite formation (p=0.001) and gender (p=0.03) were found to be associated with sentinel lymph node positivity. Regression was associated with sentinel lymph node negativity (p=0.017). According to multivariate analysis, lymphovascular invasion and tumor thickness were significant independent predictive factors of SLN positivity. Patient age, tumor localization, precursor lesions, lymphocytic infiltration and neurotropism were not related with sentinel lymph node involvement. Conclusions: In this retrospective analysis, it was found that the prevalence of SSM is at a lower rate while the prevalence of ALM is at a higher rate when compared to western countries. According to Breslow index; most of the melanoma lesions' thickness were greater than 2 mm, corresponding Clark IV. Vascular invasion and tumor thickness are the most important factors for sentinel lymph node involvement.

Electrophysiologic Mechanism of Tail Flick Reflex in Rats (흰쥐 Tail Flick Reflex의 신경생리학적 기전)

  • Seoh, Sang-Ah;Kim, Jun
    • The Korean Journal of Physiology
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    • v.23 no.1
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    • pp.139-149
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    • 1989
  • Although tail flick reflex (TFR) in rats has been used as a classic model of the nociceptive test to evaluate the action of analgesics, there have been few studies on the origin of the latent period of TFR. Present study was performed to elucidate the mechanism of increase in latency of TFR by morphine in anesthetized rats. Tail skin and dorsolateral tail nerve were stimulated electrically and EMG activities were recorded from abductor caudae dorsalis muscle participating in tail flick reflex. In the case of noxious radiant heat stimulation to tail, the tail flick tension was recorded before and after administration of morphine. Then changes in latency and conduction velocity of peripheral nerve were evaluated. The results obtained were as follows: 1) The latencies of TFR evoked by the electrical stimulation of tail skin and dorsolateral tail nerve were all within 40 ms and were elongated by several milliseconds from control after the administration of morphine. Peripheral conduction velocities of tail flick afferent nerve were within the range of 10-25 m/s. 2) The conduction velocity of peripheral nerve was significantly reduced after morphine administration, therefore the afferent time (utilization time+conduction time to spinal cord) was significantly increased. But the time for central delay and efferent time was not affected by morphine. 3) The conduction velocity under room temperature $(20-25^{\circ}C)$ was significantly reduced after morphine while that under vasodilation state $(40{\sim}42^{\circ}C)$ increased, 30 min and 45 min after morphine. The conduction velocity under vasodilation state without treatment of morphine increased continuously 4) The latency in tension response of TFR evoked by electrical stimulation was elongated by several milliseconds from control while the latency evoked by noxious radiant heat was elongated by several seconds compared with that of control. From the above results, it could be concluded that: 1) the increased latency of TFR evoked by electrical stimulation of the tail after morphine administration was due to the reducton in conduction velocity of peripheral nerve, which was the secondry effect of morphine on the peripheral vasomotion and 2) increased latency of TFR evoked by noxious radiant heat was also due to the same effect of morphine and the increase in cutaneous insulation to the noxious heat.

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Preparation of Oligo Hyaluronic Acid by Hydrolysis and Its Application as a Cosmetic Ingredient (저분자량 히알루론산의 제조 및 화장품에의 응용)

  • Kim, Ki-Ho;Kim, Kyoung-Tae;Kim, Young-Heui;Kim, Jin-Guk;Han, Chang-Sung;Park, Sun-Hee;Lee, Bang-Yong
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.33 no.3
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    • pp.189-196
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    • 2007
  • In order to investigate the potential of very low molecular weight hyaluronic acid(oligo HA) as a cosmetic ingredient, we first measured its cytotoxicity in fibroblast, keratinocyte, and SIRC cell lines. For efficacy test, its moisturizing effect and penetration rate were evaluated in an artificial skin system and Caco-2 cells. Oligo HA did not show any cytotoxicity at a concentration of 300 ${\mu}g/mL$ in fibroblasts and 1,000 ${\mu}g/mL$ in keratinocytes but it showed weak proliferation. In vitro ocular test, oligo HA showed negligible cytotoxicity at the maximum concentrations used(2,000 ${\mu}g/mL$) in SIRC cells. In the test of the single and repeated cutaneous applications, oligo HA under occlusive patch did not provoke any cumulative irritation and sensitization. Oligo HA at a concentration of 0.01 % exhibited a more potent moisturizing effect than hyaluronic acid at a concentration of 0.01 %. In the permeability test using artificial skin and Caco-2 cell lines, hyaluronic acid(M.W. $1.1{\times}10^6$) was hardly observed in the down medium of the inserts. On the other hand, oligo HA(M.W. 5,000) was detected in the down medium up to 16.0 % at 6 h in Caco-2 cell culture and up to 90 % at 6 h in an artificial skin system. These results suggest that oligo HA could be useful as an active ingredient for cosmetics.

The Ultrastructure of the Cutaneous Pigment Cells in the Frog, Rana nigromaculata Hallowell, during Hibernating Phases (동면기 개구리 (Rana nigromaculata) 피부색소세포의 미세구조)

  • 김한화;지영득;문영화
    • The Korean Journal of Zoology
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    • v.26 no.4
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    • pp.271-282
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    • 1983
  • The authors observed the ultrastructure of the pigment cells of the frog, Rana nigromaculata Hallowell, during the hibernation. The specimens from the skin were fixed in 2.5% glutaraldehyde-paraform-aldehyde fixative in phosphate buffer at pH 7.2 prior to fixation in 2% osimium tetroxide, dehydrated in graded ethanol and acetone, embedded in Epon 812 mixture, and sectioned with LKB-ultramicrotome. the ultrathin sections were contrasted with uranyl acetate and lead citrate and observed with a JEOL-100B electron microscope. The results were as follows. In hibernating phase, pigment cells of the frog were consisted of the three kinds of chromatophores (xanthophore, iridophore and melanophore) in their dorsal skin. The traits of these cells were as follows. 1. Xanthophores A. Xanthophores were filled with pterinosomes and carotenoid vesicles. Many ribosomes, a few mitochondria and glycogen particles were dispersed in the cytoplasm. B. Pterinosomes were spherical or ellipsoidal in shape. They were divided into 6 types (type I, type II, type III, type IV, type V, type VI pterinosomes) by the their inner structure and especially, type I, type II, type III pterinosomes were well developed.

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Functional outcome predictors following mandibular reconstruction with osteocutaneous fibula free flaps: correlating early postoperative videofluoroscopic swallow studies with long-term clinical results

  • Gonzalez, Santiago R.;Hobbs, Bradley;Vural, Emre;Moreno, Mauricio A.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.30.1-30.8
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    • 2019
  • Background: Advancements in the field of microvascular surgery and the widespread adoption of microvascular surgical techniques have made the use of osteocutaneous fibula free flaps the standard of care in the surgical management of segmental mandibular defects. Although the literature possesses abundant evidence to support the effectiveness of fibula free flaps as a reconstructive method, there are relatively few studies reporting on outcomes as objectively measured by videofluoroscopic swallowing studies (VFSS). The purpose of this study is to explore the potential correlation between early postoperative VFSS and the long-term swallowing outcomes in patients who underwent mandibular reconstruction with fibula free flaps. Methods: We performed a retrospective chart review of 36 patients who underwent mandibular reconstruction with osteocutaneous fibular free flaps between 2009 and 2012. Demographics, clinical variables, VFSS data, and diet information were retrieved. Penetration and aspiration findings on VFSS, long-term oral feeding ability, and the need for gastrostomy tube were statistical endpoints correlated with postoperative clinical outcomes. Results: Thirty-six patients were reviewed (15 females and 21 males) with a mean age of 54 years (7-81). Seventeen cases were treated for malignancy. The size of the bony defect ranged from 3 to 15 cm (mean = 9 cm). The cutaneous paddle, a surrogate for soft tissue defect, ranged from 10 to 125 ㎠ (mean = 52 ㎠). A gastrostomy tube was present in patients preoperatively (n = 8), and postoperatively (n = 14). Seventeen patients had neoadjuvant exposure to radiation. Postoperative VFSS showed penetration in 13 cases (36%) and aspiration in seven (19%). Overall, 29 patients (80.6%) achieved unrestricted diet, and this was statistically correlated with age (p = 0.037), radiation therapy (p = 0.002), and preoperative gastrostomy tube (p = 0.03). The presence of penetration or aspiration on VFSS was a strong predictor for long-term unrestricted oral diet (p < 0.001). Conclusion: Early postoperative VFSS is an excellent predictor for long-term swallowing outcomes in patients undergoing mandibular reconstruction with osteocutaneous fibula free flaps.

FUNCTIONAL RECONSTRUCTION OF DENTO-PALATAL AND MAXILLARY DEFECT USING STAGED OPERATION OF PREFABRICATED SCAPULAR FREE FLAP AND DENTAL IMPLANTS (분층피부와 분말골로 이식 전 처리된 유리견갑골근피판과 임플란트 보철을 이용한 경구개와 상악골의 기능적 재건)

  • Lee, Jong-Ho;Kim, Myung-Jin;Park, Jong-Chul;Kim, Yung-Soo;Ahn, Kang-Min;Paeng, Jun-Young;Kim, Sung-Min;Myoung, Hoon;Hwang, Soon-Jung;Seo, Byoung-Moo;Choi, Jin-Young;Choung, Pill-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.4
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    • pp.301-307
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    • 2004
  • The flap considered at first for the reconstruction of large maxillary defect, especially mid-face defect, is scapular free flap, because it provides ample composite tissue which can be designed 3-dimensionally for orbital, facial and oral reconstruction. In case of maxillary defect involving hard palate, however, this flap has some limitations. First, its bulk prevents oral function and physio-anatomic reconstruction of nasal and oral cavity. Second, mobility and thickness of cutaneous paddle covering the alveolar area reduce retention of tissue-supported denture and give rise to peri-implantitis when implant is installed. Third, lateral border of scapula that is to reconstruct maxillary arch and hold implants is straight, not U-shaped maxillary arch form. To overcome these problems, new concept of step prefabrication technique was provided to a 27-year-old male patient who had been suffering from a complete hard palate and maxillary alveolar ridge defect. In the first stage, scapular osteomuscular flap was elevated, tailored to fit the maxillary defect, particulated autologous bone was placed subperiosteally to simulate U-shaped alveolar process, and then wrapped up with split thickness skin graft(STSG, 0.3mm thickness). Two months later, thus prefabricated new flap was elevated and microtransferred to the palato-maxillary defect. After 6 months, 10 implant fixtures were installed along the reconstructed maxillary alveolus, with following final prosthetic rehabilitation. The procedure was very successful and patient is enjoying normal rigid diet and speech.

NEVOID BASAL CELL CARCINOMA SYNDROME : A REPORT OF CASE (기저세포모반 증후군 환아의 증례보고)

  • Heo, Su-Kyung;Choi, Nam-Ki;Kim, Seon-Mi;Yang, Kyu-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.4
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    • pp.725-730
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    • 2008
  • Nevoid basal cell carcinoma syndrome is an ecto-mesodermal polydysplasia with numerous manifestations that affect multiple organs. The syndrome is an autosomal dominant inherited, with a high penetration and visible expression. The syndrome is characterized by a series of associated anomalies such as cutaneous, dentofacial, skeletal, ophthalmologic, neurological, and genital anomalies. Generally, the jaw cysts are multiple odontogenic keratocysts, affecting any area of maxilla and mandible. Multiple odontogenic keratocysts of this syndrome are more recurrent than the keratocysts of non-syndrome, thus they are treated aggressively for complete removal. We report a case of multiple jaw cysts associated with nevoid basal cell carcinoma syndrome. In clinical and radiological examinations, frontal bossing, hypertelorism, mild mental retardation and two odontogenic keratocysts in both the maxilla and mandible were observed. Two cysts were treated by marsupialization. For the management of eruption of unerupted teeth, periodic recall check and orthodontic treatment are required.

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Mycobacterium Kansasii Disease Presenting As a Lung Mass and Bronchial Anthracofibrosis (폐종괴와 기관지 탄분섬유화로 발현한 Mycobacterium kansasii 감염 1 예)

  • Ra, Seung Won;Lee, Kwang Ha;Jung, Ju Young;Kang, Ho Suk;Park, I Nae;Choi, Hye Sook;Jung, Hoon;Chon, Gyu Rak;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.4
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    • pp.464-468
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    • 2006
  • The incidence of Mycobacterium kansasii pulmonary diseases are on the increase in Korea with the higher probability of occurrence in middle-aged and older men with underlying lung diseases Among nontuberculosus mycobacterial (NTM) infections, the clinical features of M. kansasii pulmonary infection are most similar to those of tuberculosis (TB). The chest radiographic findings of M. kansasii infection are almost indistinguishable from those of M. tuberculosis (predominance of an upper lobe infiltration and cavitary lesions), even though some suggest that cavities are more commonly thin-walled and have less surrounding infiltration than those of typical TB lesions. Although there are reports on the rare manifestations of M. kansasii infections, such as endobronchial ulcer, arthritis, empyema, cutaneous and mediastinal lymphadenitis, cellulites and osteomyelitis, the association with bronchial anthracofibrosis has not yet been reported. This report describes the first case of M. kansasii infection presenting as a lung mass in the right lower lobe with accompanying bronchial anthracofibrosis.

Anatomical Observation on Components Related to Foot Gworeum Meridian Muscle in Human

  • Park, Kyoung-Sik
    • The Journal of Korean Medicine
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    • v.32 no.3
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    • pp.1-9
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    • 2011
  • Objectives: This study was carried out to observe the foot gworeum meridian muscle from a viewpoint of human anatomy on the assumption that the meridian muscle system is basically matched to the meridian vessel system as a part of the meridian system, and further to support the accurate application of acupuncture in clinical practice. Methods: Meridian points corresponding to the foot gworeum meridian muscle at the body surface were labeled with latex, being based on Korean standard acupuncture point locations. In order to expose components related to the foot gworeum meridian muscle, the cadaver was then dissected, being respectively divided into superficial, middle, and deep layers while entering more deeply. Results: Anatomical components related to the foot gworeum meridian muscle in human are composed of muscles, fascia, ligament, nerves, etc. The anatomical components of the foot gworeum meridian muscle in cadaver are as follows: 1. Muscle: Dorsal pedis fascia, crural fascia, flexor digitorum (digit.) longus muscle (m.), soleus m., sartorius m., adductor longus m., and external abdominal oblique m. aponeurosis at the superficial layer, dorsal interosseous m. tendon (tend.), extensor (ext.) hallucis brevis m. tend., ext. hallucis longus m. tend., tibialis anterior m. tend., flexor digit. longus m., and internal abdominal oblique m. at the middle layer, and finally posterior tibialis m., gracilis m. tend., semitendinosus m. tend., semimembranosus m. tend., gastrocnemius m., adductor magnus m. tend., vastus medialis m., adductor brevis m., and intercostal m. at the deep layer. 2. Nerve: Dorsal digital branch (br.) of the deep peroneal nerve (n.), dorsal br. of the proper plantar digital n., medial br. of the deep peroneal n., saphenous n., infrapatellar br. of the saphenous n., cutaneous (cut.) br. of the obturator n., femoral br. of the genitofemoral n., anterior (ant.) cut. br. of the femoral n., ant. cut. br. of the iliohypogastric n., lateral cut. br. of the intercostal n. (T11), and lateral cut. br. of the intercostal n. (T6) at the superficial layer, saphenous n., ant. division of the obturator n., post. division of the obturator n., obturator n., ant. cut. br. of the intercostal n. (T11), and ant. cut. br. of the intercostal n. (T6) at the middle layer, and finally tibialis n. and articular br. of tibial n. at the deep layer. Conclusion: The meridian muscle system seemed to be closely matched to the meridian vessel system as a part of the meridian system. This study shows comparative differences from established studies on anatomical components related to the foot gworeum meridian muscle, and also from the methodical aspect of the analytic process. In addition, the human foot gworeum meridian muscle is composed of the proper muscles, and also may include the relevant nerves, but it is as questionable as ever, and we can guess that there are somewhat conceptual differences between terms (that is, nerves which control muscles in the foot gworeum meridian muscle and those which pass nearby) in human anatomy.

A Case of Subcutaneous Panniculitis-like T Cell Lymphoma in Childhood (소아에서 발생한 Subcutaneous Panniculitis-like T Cell Lymphoma 1례)

  • Choi, Yoon Seok;Shin, Kyung Mi;Won, Sung Chul;Lyu, Chuhl Joo;Yang, Chang Hyun;Kim, Byung Soo;Kim, Moon Kyu
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.1028-1032
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    • 2002
  • Subcutaneous pannicultis-like T cell lymphoma is a rare cutaneous T cell lymphoma. It presents with multiple subcutaneous nodules or plaques involving the extremities or trunk, and with constitutional symptoms that include fever, malaise, fatigue, myalgia, chills and weight loss. Histologically, the lesions of this disease are reminiscent of panniculitis and are composed of a mixture of small and large atypical lymphoid cells infiltrating between adipocytes. The optimal treatment for this disease is undefined and prognosis of this disease is poor, even when treated with multiagent chemotherapy regimens considered optimal for agressive lymphoma of other types. Poor prognosis factors include clinical features such as anemia, leukocytopenia, hepatosplenomegaly, lymphadenopathy and coagulopathy, which are suggestive of hemophagocytosis. Much of the mortality of this disease is due not to disseminated lymphoma with organ failure, but rather to complications of the cytopenias associated with the hemophagocytic syndrome. We report a case of subcutaneous panniculitis-like T cell lymphoma in a 12 year-old boy who presented with initial complaints of fever and multiple subcutaneous nodules, and briefly review the related literature.