Chromoblastomycosis is a chronic subcutaneous mycotic infections caused by dermatiaceous fungi. Clinically, chromoblastomycosis presents frequently with erythematous or nodular plaque. In Korea, 10 cases of chromoblastomycosis have been reported and Fonsecaea pedrosoi is the most common agent. A 61-year-old woman who was diagnosed as chronic inflammatory demyelinating polyneuropathy 3 years ago, and had been treated with systemic corticosteroids and azathioprine, presented with pruritic, scaly erythematous plaques on the right forearm for 3 years. She had no history of trauma. Histological examination showed pseudoepitheliomatous hyperplasia, mixed granulomatous inflammatory cell infiltrate and multinucleated giant cells with sclerotic cells in the dermis. Tissue culture showed slowly growing, dark brown, velvety colony. DNA was extracted from the cultured colonies and the DNA sequence of the internal transcribed spacer (ITS) region of the clinical sample was matched for that of Fonsecaea monophora. The patient was treated with local heat therapy and topical terbinafine application.
Adrenal Cortex Hormones ; Azathioprine ; Base Sequence ; Chromoblastomycosis* ; Dermis ; DNA ; Female ; Forearm ; Fungi ; Giant Cells ; Hot Temperature ; Humans ; Hyperplasia ; Korea ; Middle Aged ; Polyneuropathies

No abstract available.
Acinetobacter calcoaceticus* ; Acinetobacter* ; Pneumonia*

OBJECTIVE: The purpose of this research was to investigate the differences of symptoms and neurocognitive functions with good and poor social functioning schizophrenic outpatients. METHOD: 152 schizophrenic outpatients were divided to good social functioning group(n=26) and poor social functioning group(n=126) based on the instrumental role of workers or students. Neurocognitive functions of these patient groups were compared with normal control group, which was composed of 30 healthy persons without a history of psychiatric illness. Schizophrenic symptoms were assessed by the Positive and Negative Syndrome Scale(PANSS). Neurocognitive function tests include the sustained attention, sensory register, executive function, concentration and attention, and verbal memory and learning assessed with Degraded Stimulus Continuous Performance Test(DS-CPT), Span Apprehension Task(SAT), Wisconsin Card Sorting Test(WCST), Digit Span(DS), and Rey Auditory Verbal Learning Test(RAVLT). RESULTS: 1) No significant differences were noted in the symptom subtypes of PANSS between good and poor social functioning patient groups. 2) The poor social functioning patient group showed significant deficits in the sustained attention, sensory register, concentration and attention, and verbal memory and learning as manifested in the data of DS-CPT, SAT, DS, and RAVLT compared with normal control and good social functioning patient groups. But there were no differences in these neurocognitive functions between good social functioning patient group and normal control group. CONCLUSIONS: These results suggested that some neurocognitive deficits such as sustained attention, sensory register, concentration and attention, and verbal memory and learning may be more important factors than symptoms for social functioning in the stable schizophrenic outpatients.
Executive Function ; Humans ; Learning ; Memory ; Outpatients ; Schizophrenia ; Verbal Learning ; Wisconsin

Several reports have described the usefulness of tumor markers detected in pancreatic juice for diagnosis of pancreatic cancer. We performed this study to evaluate the usefulness of tumor markers in pure pancreatic juice collected by duodenoscopic cannulation of pancreatic duct before and after injection of secretin. From April 1993 to July 1995, 8 cases of pancreatic cancer, 5 cases of benign pancreatic lesions, and 5 cases of benign biliary diseases without pancreatic lesion were involved. CEA and CA 19-9 immunoreactivity were measured by radioimmunoassay. Concentrations of CA 19-9 in pure pancreatic juice were significantly higher in patients with pancreatic cancer(median value; 3582, range 88.4-10410 IU/ml) than in control patients(median value 231, range 30.4-682 IU/ml)(p<0.05). Concentrations of CEA in pure pancreatic juice were not significantly different between patients with pancreatic cancer(median value: 6,5, range 1.0-152ng/ml) and control patients(median value: 4.0, range 1-17.2 ng/ml)(p>0.05). There was no significant correlation between levels of CA19-9, CEA in pancreatic juice and those levels in serum. The amounts of juice collected by duodenoscopic cannulation in patients with pancreatic cancer were 1.5+/- 0.9ml during 5 minutes before infusion of secretin, 11.3+/- 3.9ml, 10.8+/- 4.0ml, 10.6+/- 4.0ml in 5 minute interval after infusion of secretin. These results indicated that measurement of CA19-9 in pure pancreatic juice may be used as a marker for pancreatic cancer. Adequate amount of pancreatic juice was collected by duodenoscopic cannulation for evaluation of tumor marker, enzyme studies and cytology.
Catheterization ; Diagnosis ; Humans ; Pancreatic Diseases ; Pancreatic Ducts ; Pancreatic Juice* ; Pancreatic Neoplasms ; Radioimmunoassay ; Secretin ; Biomarkers, Tumor

Liver abscess can be caused by bacterial, parasitic, or fungal infection. Amebic abscesses are more common, but pyogenic abscesses account for three quarters of hepatic abscess in developed countries. Most common pathogens of the pyogenic liver abscess are Escherichia coli, Klebsiella pneumoniae, Bacteroides, Enterococci, Streptococci, and Staphylococci. However, liver abscess caused by Salmonella species has rarely been reported. We experienced a case of Salmonella liver abscess which improved after antibiotic therapy and percutaneous drainage. The patient was 52 years-old man who had an episode of intermittent fever, chills and epigastric pain for 2 weeks. He was diagnosed as liver cirrhosis eight years ago and diabetes three years ago. Salmonella group D, non-typhi was cultured from blood and pus from the liver respectively at the same time. With percutaneous drainage and susceptible antibiotic therapy, liver abscess decreased in size with improvements in fever and abdominal pain.
Humans ; Liver/radiography/ultrasonography ; Liver Abscess, Pyogenic/*diagnosis/microbiology ; Male ; Middle Aged ; Salmonella Infections/*diagnosis

Retrograde transpapillary cholangioscopy can be safely performed by use of a mother-baby-scope system after endoscopic sphincterotomy. Improved endoscopes are now available and may lead to a better acceptance of this technique. Cholangioscopy is complementary to cholangiography for differential diagnosis of various types of bile duct lesions. From march 1992 to September 1994, we performed 15 cases of peroral cholangioscopy for evaluation of bile duct lesions. Indications of peroral cholangioscopy were 6 cases of benign biliary diseases and 9 cases of malignant biliary diseases. In benign diseases, two cases of extrahepatic bile duct stones, 1 case of intrahepatic duct stone with stricture, 2 cases of benign elevated lesions of bile duct and 1 case of occluded expandable metallic stent were involved. In malignant diseases, 7 cases of primary bile duct cancer, 2 cases of hepatocellular carcinoma with bile duct invasion were involved. By use of peroral cholangioscopy with biopsy, differential diagnosis of bile duct lesion was possible. As a complication, severe abdominal pain and hypotension was developed in one case during the procedure and in another case, cholangitis was developed after the procedure. In conclusion, peroral cholangioscopy is a safe and useful procedure in various types of biliary diseases especially in the differential diagnosis of malignancy.
Abdominal Pain ; Bile Duct Neoplasms ; Bile Ducts ; Bile Ducts, Extrahepatic ; Biopsy ; Carcinoma, Hepatocellular ; Cholangiography ; Cholangitis ; Constriction, Pathologic ; Diagnosis, Differential ; Endoscopes ; Hypotension ; Sphincterotomy, Endoscopic ; Stents

BACKGROUND: We wanted to evaluate whether a minimal extrathyroid extension (METE) is associated with the clinicopathological parameters that are indicative of a poor prognosis, including lymph node metastasis, distant metastasis at the time of the initial diagnosis and tumor recurrence, in patients with papillary thyroid carcinoma (PTC), and especially in the patients with papillary thyroid microcarcinoma (PTMC). METHODS: We retrospectively evaluated the medical records of patients with PTC and who had undergone total thyroidectomy with/without subsequent 131I remnant ablation at the Korea Cancer Center Hospital from January 1998 through December 2005. A total of 557 patients with PTC were enrolled in the study. We excluded 13 patients with an unknown status of extension and 29 patients with massive ETE. RESULTS: Of the 515 patients, 401 were found to have a METE. We analyzed the 464 patients who were without distant metastasis at the time of the initial diagnosis and who had a follow-up duration of more than 6 months. METE was not significantly associated with tumor recurrence during the follow-up period (median follow-up period: 122 months, range: 6-142 months): 8% vs. 15% of the patients with and without METE had tumor recurrence, respectively (P = 0.069 by the log-rank test). We analyzed the effect of tumor size in the patients with METE. Size was not significantly associated with tumor recurrence (P = 0.374 by the log-rank test). CONCLUSION: These findings suggest that METE might not be a prognostic factor to predict tumor recurrence in patients with PTC, including PTMC.
Carcinoma ; Carcinoma, Papillary ; Factor IX ; Follow-Up Studies ; Humans ; Korea ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

PURPOSE: Dedicated animal PET is useful equipment for the study of new PET tracer. Recently, microPET R4 was installed in the Korea institute of radiology and medical science. In this study, we measured the characteristics of scanner. MATERIALS AND METHODS: Resolution was measured using a line source (F-18: 65 micro Ci, inner diameter: 0.5 mm). The line source was put in the axial direction and was moved from the center of field of view to outside with 1 mm interval. PET images were reconstructed using a filtered back-projection and ordered subset expectation maximization. Line source (16.5 micro Ci, 78 mm) was put on the center of axial direction to measure the sensitivity when the deadtime was under 1%. Images were acquired during 4 minutes respectively from center to 39 mm outward. Delayed count was subtracted from total count and then decay was corrected for the calculation of sensitivity. Noise equivalent count ratio and scatter fraction were calculated using cylindrical phantom. RESULTS: Spatial resolution of reconstructed image using filtered back-projection was 1.86 mm (radial), 1.95 mm (tangential), 1.95 mm (axial) in the center of field of view, and 2.54 mm, 2.8 mm, 1.61 mm in 2 cm away from the center respectively. Sensitivity was 2.36% at the center of transaxial field of view. Scatter fraction was 20%. Maximal noise equivalent count ratio was 66.4 kcps at 242 kBq/mL. Small animal images were acquired for confirmation of performance. CONCLUSION: Performance characteristics of microPET R4 were similar with reported value. So this will be a useful tool for small animal imaging.
Animals* ; Korea ; Noise

Sporotrichosis is a chronic cutaneous fungal infection caused by Sporothrix (S.) schenckii complex. Fixed cutaneous sporotrichosis is one of the three subtype of sprotrichosis and accounts for 20% of total sporotrichosis cases. However, the incidence of total sporotrichosis cases is decreasing recently due to improvement of personal hygiene and industrialization. A 60-year-old woman presented to the hospital with multiple erythematous papules and ulcers on left cheek for 5 months. Histopathologic examination revealed chronic granulomatous inflammation and immunohistochemical staining was positive for GMS and PAS stain. The fungal culture on Sabouraud dextrose agar showed grayish dark brown colonies and the sequences of ribosomal DNA internal transcribed spacer region of clinical sample was 100% similarity with S. globosa. The patient was treated with oral itraconazole 200 mg daily and topical ketoconazole cream for 3 months. At that time after this treatment, skin lesion was almost cured and recurrence is not observed to date.
Agar ; Cheek ; DNA, Ribosomal ; Female ; Glucose ; Humans ; Hygiene ; Incidence ; Inflammation ; Itraconazole ; Ketoconazole ; Middle Aged ; Recurrence ; Skin ; Sporothrix* ; Sporotrichosis* ; Ulcer

To assess the reproducibility of Sphincter of Oddi(SO) manometry, percutaneous manometry of SO was performed repeatedly in 10 subjects with biliary diseases(9 intrahepatic stone cases and 1 bile duct cancer case). Time interval for measurement of SO manometry was 3 to 7(mean 5) days. Mean manometric parameters of SO phasic contraction in the 1st and 2nd studies were not significantly different. However, as a result of manometric records, a diagnosis of dyskinesia was made in the 1st study from 4 patients(tachyoddia in 3 cases and increased retrograde propagation in one case). Among them, the diagnosis was reproduced in the 2nd study from 2(tachyoddia in 2 cases) out of 4 patients. In conclusion, abnormal manometric findings were poorly reproducible. Thus, more prolonged measurement of SO manometry or a dynamic test which stimuli or inhibit the SO activity may be necessary for accurate diagnosis of biliary dyskinesia and better reproducibility of SO manometry.
Bile Duct Neoplasms ; Biliary Dyskinesia ; Diagnosis ; Dyskinesias ; Humans ; Manometry* ; Sphincter of Oddi*