Herpes zoster involving noncontiguous dual dermatomes is very rare in both immunocompetent and immunocompromised persons. This unique presentation has been referred to as zoster duplex unilateralis or bilateralis, depending whether one or both halves of the body are involved. A 22-year-old woman, who had been treated for acute leukemia, congestive heart failure and chronic disseminated candidiasis, was referred to our department for painful papulovesicular eruptions on the right side of the anterior chest and upper back for 2 days, and the left buttock for 1 day. Tzanck smear revealed multinucleated giant cells with intranuclear inclusion bodies. We report a rare case of zoster duplex bilateralis.
Buttocks ; Candidiasis ; Female ; Giant Cells ; Heart Failure ; Herpes Zoster* ; Humans ; Intranuclear Inclusion Bodies ; Leukemia ; Thorax ; Young Adult

Eosinophilia-myalgia syndrome(EMS) is a systemic illness that occurred as an epidemic by ingestion of over-the counter L-tryptophan preparation in the United States in October 1989. We report a Korean case of EMS not associated with the ingestion of either L-tryptophan or other nutritional supplements such as lysine and niacin.
Eating* ; Eosinophilia-Myalgia Syndrome* ; Lysine ; Niacin ; Tryptophan ; United States

Idiopathic atrophoderma of Pasini and Pierini(IAPP) is an uncommon condition of unknown etiology and typically affects persons in the second and third decades of life. IAPP consists of asymptomatic grey to brown depressed lesions with "cliff drop" borders, which are usually bilateral and located on the trunk. A 40-year-old woman visited our department because of unilateral atrophic lesions on the abdomen, right arm, and posterior aspect of right thigh for 20 years. Laboratory evaluations were normal and histologic examination revealed significantly decreased thickness in dermis. We report an unusual case of idiopathic atrophoderma of Pasini and Pierini presenting unilateral distribution.
Abdomen ; Adult ; Arm ; Dermis ; Female ; Humans ; Thigh

BACKGROUND: Although lack of exercise is well known to be a risk factor of osteoporosis, it is unclear whether weight-bearing exercise has different effects on bone mineral density compared to non weight-bearing exercise, and the amount of exercise needed to prevent osteoporosis is not clearly defined. This study was performed to clarify the relations between the type and the amount of exercise with BMD. METHODS: This was a cross-sectional study of 3,661 women who had undertaken health screening including BMD measurement at Health Promotion Center of SNUH between May 1997 and March 1999. Information on sociodemographic characteristics, menarche, childbirth andexercise were gathered by means of self-reported questionnaire, and BMD was measured using DEXA. RESULTS: The number of women with lumbar osteoporosis were 601 (16.4%) and femoral neck osteoporosis 372 (10.2%). Lumbar osteoporosis occurred more frequently with increasing age and age at menarche, and in menopausal women, but less frequently with increasing fat-free mass in multiple logistic regression analysis. When adjusted for age, age at menarche, menopause and fat-free mass, lumbar osteoporosis was less common in women who exercised, but the type and the amount of exercise had no bearing. Especially, lumbar osteoporosis was least common in women engaging in moderate amount of exercise. Femoral neck osteoporosis decreased significantly only in weight-bearing exercise group and in women engaging in high amount of exercise. CONCLUSION: The results of this study suggest that lumbar osteoporosis can be prevented through exercise regardless of its type and amount, and high amount or weight- bearing exercise is most effective to prevent femoral neck osteoporosis.
Adult* ; Body Composition ; Bone Density* ; Cross-Sectional Studies ; Female ; Femur Neck ; Health Promotion ; Humans ; Logistic Models ; Mass Screening ; Menarche ; Menopause ; Osteoporosis ; Parturition ; Risk Factors ; Weight-Bearing ; Surveys and Questionnaires

Almost all colorectal carcinomas have been thought to develop from pre-existing adenomas. However, some colorectal carcinomas can arise directly from normal flat mucosa, and usually form infiltrative mass at the early stage. The carcinogenesis of this infiltrative carcinoma may be different from the well-known adenoma-carcinoma sequence, which usually forms a polypoid mass. The purpose of this study is to investigate the different expression of various oncogenes in polypoid carcinoma and infiltrative carcinoma. We performed immunohistochemical staining on p53, bcl-2, c-erbB-2 and MIB-1 in 29 polypoid carcinomas arised from adenomas, and 21 infiltrative carcinomas. The average tumor size of infiltrative carcinomas (5.5 cm) was larger than that of polypoid carcinomas (3.1 cm), and the polypoid carcinomas were differentiated more than the infiltrative carcinomas. The results of p53, bcl-2, c-erbB-2, and MIB-1 antisera immunoreactivity in the polypoid carcinoma were 79%, 17%, 21%, and 100%, and those in the infiltrative carcinoma were 71%, 29%, 29%, and 100%, respectively. However the diffuse positivities of p53 and MIB-1 antisera were slightly higher in the infiltraive carcinomas (62%, 76%) than in the polypoid carcinomas (55%, 41%) (p=0.63, 0.01). And the results of p53 and c-erbB-2 immunoreactivity in the adenomas were 52% and 17%, respectively, which is significantly lower than that in the polypoid carcinoma(p=0.03, 0.74). The immunoreactivty of bcl-2 in the adenoma was 72%, which was significantly higher than that in the polypoid carcinoma (17%) (p<0.01). In summary, we did not show the significant difference in expression of p53, bcl-2, c-erbB-2, and MIB-1 proteins between polypoid and infiltrative carcinomas. However, the tendency of infiltrative carcinomas having a more aggressive nature suggests another carcinogenetic mechanism is involved in the colorectal carcinogenesis.
Adenoma ; Carcinogenesis ; Colorectal Neoplasms* ; Immune Sera ; Ki-67 Antigen ; Mucous Membrane ; Oncogenes

Benign symmetric lipomatosis is a rare disease of undetermined cause characterized by massive symmetric depositions of adipose tissue, predominantly on the neck, shoulder, back, and upper extremities. A 60-year-old man with chronic alcoholism was referred to our clinic for symmetric, skin-colored, non-tender masses on the posterior neck, both clavicular areas, abdomen, and back for about 10 years. He had been managed for tingling sensation on both hands in the neurologic department. Nerve conduction velocity studies were consistent with sensorimotor polyneuropathy and histopathologic findings revealed that the reticular dermis was replaced by normal uncapsulated mature fat cells. We report a rare case of benign symmetric lipomatosis associated with polyneuropathy.
Abdomen ; Adipocytes ; Adipose Tissue ; Alcoholism ; Dermis ; Hand ; Humans ; Lipomatosis* ; Middle Aged ; Neck ; Neural Conduction ; Polyneuropathies ; Rare Diseases ; Sensation ; Shoulder ; Upper Extremity

Nevoid basal cell carcinoma syndrome is a rare inherited disorder characterized by multiple cutaneous basal cell carcinoma, pits of the palms and soles, cysts of the jaws, and ectopic calcification of cranial membranes. The patient was a 66 year old female. She complained of multiple, symmetrically distributed black-colored papules on the both sides of the neck. On physical examination, multiple pits were detected in the palms and soles. The histopathologic findings of the papules showed variable shaped and sized tumor nests composed of basaloma cells. On PNS CT for search of metastasis of the cancer, odontogenic keratocyst was detected at the Lt. alveolar process of maxilla by accident. We diagnosed her nevoid basal cell carcinoma syndrome and the lesions on both sides of the neck were removed completely.
Aged ; Alveolar Process ; Basal Cell Nevus Syndrome* ; Carcinoma, Basal Cell* ; Female ; Humans ; Jaw ; Maxilla ; Membranes ; Neck ; Neoplasm Metastasis ; Odontogenic Cysts ; Physical Examination

BACKGROUND: The associations of apolipoprotein E (ApoE) genotypes and cholesterol levels with cognitive decline in Alzheimer's disease (AD) are controversial. The aim of this study is to investigate the individual and combined effects of ApoE epsilon 4 allele (Epsilon4) and cholesterol levels on the progression of AD. METHODS: ApoE genotypes and fasting serum total cholesterol levels were measured in 79 patients with AD. The associations were investigated between Epsilon4, cholesterol level and decline in cognitive function (Korean version of Mini-Mental State Examination) over one year. RESULTS: No prospective individual and combined associations were found between Epsilon4, cholesterol level and decline of cognitive function. Adjustment for age, gender, education, and functional activities of daily living made little difference to the associations. CONCLUSIONS: The cognitive decline of AD might be determined by other factors rather than the impact of Epsilon4 or cholesterol levels.
Activities of Daily Living ; Alleles ; Alzheimer Disease* ; Apolipoproteins E ; Apolipoproteins* ; Cholesterol* ; Education ; Fasting ; Genotype ; Humans

BACKGROUND: With the advance of socioeconomy and medical science, the population of the aged has been significantly increased. Therefore it needs to be studied the fundamental epidemiologic survey of dermatologic disease in the elderly. OBJECTIVES: The purpose of this study is to evaluate the prevalence of common dermatoses in the elderly and to compare these to previous studies. METHOD: 1,916 out-patients over 65 years old who had visited the Department of Dermatology, University Hospital and Yongsan Hospital, College of Medicine, Chung Ang University from January, 1996 to December, 2001 were analyzed retrospectively. RESULTS: 1. The incidence of aged group over 65 years old to total number of out-patients(24,723) was 7.7%(1,916 cases). 2. The ratio of male to female was 1.06 : 1(986:930). 3. The frequent skin diseases were herpes zoster(12.0%), benign tumor(9.0%), pruritus(8.9%), onychomycosis/tinea pedis(7.7%), contact dermatitis(7.2%), seborrheic dermatitis(5.4%). 4. Eczema was the most common disease group which revealed 18.5%. The second most frequent group was viral infection(15.3%), followed by fungal infection(12.7%), tumor(12.0%), urticaria, drug eruption and erythema(9.4%), pruritus(8.9%), papulosquamous disease(2.8%) and bacterial infection(2.6%). 5. The most common disease in each disease group were as follows : contact dermatitis in eczema, herpes zoster in viral infection, onychomycosis and tinea pedis in fungal infection, urticaria in urticaria, drug eruption and erythema group, generalized pruritus in pruritus group, psoriasis in papulosquamous disease and folliculitis in bacterial infection, respectively. 6. Among 235 cases of skin tumor, 175 cases(74.5%) were benign and the remaining 60 cases(25.5%) were premalignant or malignant. The frequency of benign tumor was in order of seborrheic keratosis, epidermal cyst, skin tag and lipoma, respectively. In malignancy, there were basal cell carcinoma, squamous cell carcinoma and cutaneous metastatic carcinoma. CONCLUSION: Compared to previous studies, tumor and pruritus showed a increasing tendency but eczema a decreasing tendency.
Aged* ; Bacterial Infections ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermatitis ; Dermatitis, Contact ; Dermatology ; Drug Eruptions ; Eczema ; Epidermal Cyst ; Erythema ; Female ; Folliculitis ; Herpes Zoster ; Humans ; Incidence ; Keratosis, Seborrheic ; Lipoma ; Male ; Onychomycosis ; Outpatients ; Prevalence ; Pruritus ; Psoriasis ; Retrospective Studies ; Skin Diseases* ; Skin* ; Tinea Pedis ; Urticaria

BACKGROUND: Currently, the incidence of hepatitis A is on the increase in Korea. Although there is emphasis on contact precautions, the nosocomial outbreak of hepatitis A virus (HAV) in healthcare personnel has increased within endemic areas because these workers inevitably come in close contact with patients and work under suboptimal hygiene conditions. In this study, we evaluated the necessity of immunization against HAV for healthcare personnel. METHODS: We investigated the seropositivity of serum immunoglobulin G (IgG) anti-HAV antibody (Ab) in 672 healthcare personnel on the basis of their age-group, sex, and occupation in Soon Chun Hyang University Hospital and Soon Chun Hyang University Bucheon Hospital. RESULTS: The subjects were divided into 6 groups on the basis of their ages to identify differences among the various age groups in the number of cases with HAV Ab seropositivity. Significant intergroup differences were noted in this respect: 21-25 years, 2/152 (1.3%); 26-30 years, 33/245 (13.5%); 31-35 years, 70/148 (47.3%); 36-40 years, 52/79 (65.8%); >40 years, 44/48 (91.7%). CONCLUSION: The number of seropositive cases was low among young healthy personnel: low seropositivity is an emerging risk for vulnerable population. With the increase in the incidence of hepatitis A, healthcare personnel have become a risk population for hepatitis A, as are community residents. Therefore, for healthcare personnel working in hospitals, immunization against HAV should be recommended for personnel younger than 30 years, and serological testing for older personnel.
Delivery of Health Care ; Hepatitis ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis A Vaccines ; Hepatitis A virus ; Humans ; Hygiene ; Immunization ; Immunoglobulin G ; Incidence ; Korea ; Occupations ; Serologic Tests ; Vulnerable Populations