An 18-year-old man had suffered from intense burning with redness and an increased temperature of both the lower legs, forearms and hands since the age of 5. Symptoms were exacerbated by exposure to heat or walking. The patient obtained temporary relief by immersing his feet and hands in cold water. We observed the increase of skin temperature in relation to pain by thermography. No specific abnormalities were noted in laboratory studies. Treatment with aspirin was ineffective. We report a rare case of primary erythermalgia with typical features.
Adolescent ; Aspirin ; Burns ; Erythromelalgia* ; Foot ; Forearm ; Hand ; Hot Temperature ; Humans ; Leg ; Skin Temperature ; Thermography ; Walking ; Water

Genital melanosis is an acquired, irregular, brown to black discoloration of the glans or shaft of the penis, or of the vulva and vagina. Although genital melanosis seems similar to malignant melanoma clinically, the histologic findings of genital melanosis show basal layer hyperpigmentation with or without melanocytic hyperplasia and no atypia of the melanocytes. We report a rare case of genital melanosis ; a vulvar melanosis.
Hyperpigmentation ; Hyperplasia ; Male ; Melanocytes ; Melanoma ; Melanosis* ; Penis ; Vagina ; Vulva

BACKGROUND: Psoriasis as one of the relatively common cutaneous disorders, affecting 0.5% to 1.5% of the general popuation in the world. However, it is recorded that the disease is characterized by its highly variable clinical manifestations and incidence influenced by racial, geographic and environmental factors. OBJECTIVE: This study was done to investigate the clinical manifestations and clinical incidence and treatment of psoriasis in the Chinju area. METHODS: This study was based on the analysis of the 208 psoriatics from January, 1991 to December, 1994 at the department of dermatology, Gyeongsang National University Hospital. RESULTS: The results were summarized as follows : 1. Among 208 cases of psoriasis, the number of male and female patients was 110(52.9%) and 98(47.1%), making the sex(male to female) ratio 1: 0.9. 2. The mean age of onset was 31.4 years in males and 30.1 years in females. The peak age group of onset. was between 10 and 19 years. 3. The mean duration of the diseases for the total sample was 5.9 years. 4. Itching was the major subjective symptom in 92 cases(42.3%) of the 208 patients. 5. A family history of psoriasis was noted in 33 cases(15.9%) of the 208 patients. 6. Skin lesions were observed at lower extremities(140 cases; 67.3%), trunk(136 cases; 65.4%), elbow joint(136 cases, 65.4%), upper extremities(132 cases; 63.5%), knee joint(131 cases; 63.0%), scalp(126 cases; 60.5%), palm or sole(43 cases; 20.7%), face(15 cases; 7.2%) in order of frequency. 7. Psoriatic patients were composed of psriasis vulgaris(167 cases, 80.3% ), pustulosis palmoplantaris(26 cases, 12.5%), guttate psoriasis(10 cases, 4.8%), and generalized pustular psoriasis(5 cases, 2.4%). 8. Arthralgia was complained of in 33 cases(15.9%) of the 208 patients. Nail changes were noted in 32 cases(15.4%) of the 208 patients in their finger nails. Toe nails were involved in 13 cases(6.3%) of the 208 patients. 9. We treated psoriatics with topical steroid in 188 cases(90.3%) and emollient in 92 cases(44. 2%). Among them 42 cases(20.2%) were treated with topical therapy only. We treated psoriatics with systemic retinoid in 44 cases(21.1%) and methotrexate in 23 cases(11.1%) and steroid in 13 cases(6.2%), in which all of them received the topical remedies with systemic therapy. In phototherapy, we treated psoriatics with UVB in 65 cases(31.2%) and psoralen plus UVA(PUVA) in 34 cases(16.4%). The 97 cases(46.6%) were treated with topical remedies with phototherapy. CONCLUSION: The clinical analysis of the 208 patients with psoriasis was performed. We could not find the significant difference between our study and other reported studies.
Age of Onset ; Arthralgia ; Dermatology ; Elbow ; Female ; Ficusin ; Fingers ; Gyeongsangnam-do ; Humans ; Incidence ; Knee ; Male ; Methotrexate ; Phototherapy ; Pruritus ; Psoriasis* ; Skin ; Toes

Post-transplant lymphoproliferative disorders (PTLD) are a heterogeneous group of lymphoproliferative disorders associated with immunosuppression and Epstein-Barr virus infection. PTLD is classified into three major categories: early lesions, polymorphic PTLD, and monomorphic PTLD. The majority of monomorphic PTLD cases are non-Hodgkin's lymphoma of B-cell origin. This retrospective study was conducted to investigate the incidence, clinical manifestation, treatment, and outcomes of monomorphic PTLD among 5,817 recipients of solid organ or allogeneic hematopoietic stem cell transplantation from five institutions. Fourteen patients with monomorphic PTLD were identified (male:female 11:3; median age 42.6 yr, range 24-60). The overall incidence rate was 0.24%. The most common disease type was diffuse large B cell lymphoma (n=7). The median time between the transplant and diagnosis of PTLD was 85.8 months. However, all cases of PTLD after allogeneic hematopoietic stem cell transplantation occurred within 1 yr after transplantation. Ten of the 14 patients had EBV-positive tumor. Fourteen patients received combination systemic chemotherapy and four patients were treated with radiation therapy. Ten patients achieved a complete response (CR) and two patients a partial response (PR). The median follow-up period for surviving patients was 36.6 months. Nine patients remain alive (eight CR, one PR). Nine of 11 solid organ transplantations preserved graft function. The present study indicates a lower incidence rate and a longer median time before the development of PTLD than those of previous reports. Careful monitoring was needed after allogeneic hematopoietic stem cell transplantation for PTLD.
Adult ; Epstein-Barr Virus Infections/complications/immunology ; Female ; Herpesvirus 4, Human ; Humans ; Lymphoproliferative Disorders/classification/etiology/immunology/*physiopathology ; Male ; Middle Aged ; Retrospective Studies ; Survival Rate ; Transplantation, Homologous/*adverse effects/immunology ; Treatment Outcome ; Young Adult

Status epilepticus is commonly defined as a condition characterized by an epileptic seizure that is so frequently repeated or so prolonged as to produce a fixed and enduring epileptic condition. Common etiologies are brain tumor, CNS infection, vascular insults, trauma, withdrawal of antiepileptic drug, and metabolic disturbance such as hypoglycemia, hypocalcemia, hyponatremia and hyperosmolarity caused by hyperglycemia, hypernatremia, and uremic encephalopathy etc. Although some cases of epilepsia partialis continua in the patient with nonketotic hyperglycemia were reported in the previous literature, we could hardly find the report that generalized convulsive status epilepticus was the initial symptom of nonketotic hypergycemia. We recently experienced three eases of nonketotic hyperglycemia who manifested generalized convulsive status epilepticus as a initial clinical feature. Two cases were completely controlled within a few hours after the correction of hyperglycemia and intravenous dilantinization. Another case was needed an additional phenobarbital administration to control the status epilepticus. In all cases, afterthen no further seizure occurred under the normal serum glucose level without use of antiepileptics.
Anticonvulsants ; Blood Glucose ; Brain Neoplasms ; Epilepsia Partialis Continua ; Epilepsy ; Humans ; Hyperglycemia* ; Hypernatremia ; Hypocalcemia ; Hypoglycemia ; Hyponatremia ; Phenobarbital ; Phenytoin ; Seizures ; Status Epilepticus*

Ameloblastoma ; Ameloblasts ; Diagnosis ; Mandible ; Odontogenic Cysts ; Radicular Cyst

Objective: : Anterior cervical spine surgery (ACSS) is a common surgical procedure used to treat cervical spinal degenerative diseases. One of the complications associated with ACSS is prevertebral soft tissue swelling (PSTS), which can result in airway obstruction, dysphagia, and other adverse outcomes. This study aims to investigate the correlation between various cervical sagittal parameters and PSTS following single-level ACSS, as well as to identify independent risk factors for PSTS. Methods: : A retrospective study conducted at a single institution. The study population included all patients who underwent single-level ACSS between January 2014 and December 2022. Patients with a history of cervical spine surgery or trauma were excluded from the study. The presence and severity of PSTS was assessed by reviewing pre- and postoperative imaging studies. The potential risk factors for PSTS that were examined include patient age, sex, body mass index, tobacco use, comorbidities, serum albumin levels, operative time, implant type, implanted level, and various cervical spine sagittal parameters. Multivariate linear regression analysis was performed to identify the independent risk factors for PSTS. Results: : A total of 62 consecutive patients who underwent single-level ACSS over a 8-year period at a single institution were enrolled in this study. Only preoperative segmental angle showed positive correlation with PSTS among various cervical spine sagittal parameters (r=0.36, p=0.005). Artificial disc replacement showed a negative correlation with PSTS (β=-0.38, p=0.002), whereas the use of demineralized bone matrix (DBM) had a positive impact on PSTS (β=0.33, p=0.009). We found that male sex, lower preoperative serum albumin, and implantation of upper cervical level (above C5) were independent predictors for PSTS after single-level ACSS (β=1.21; 95% confidence interval [CI], 0.27 to 2.15; p=0.012; β=-1.63; 95% CI, -2.91 to -0.34; p=0.014; β=1.44; 95% CI, 0.38 to 2.49; p=0.008, respectively). Conclusion : Our study identified male sex, lower preoperative serum albumin levels, and upper cervical level involvement as independent risk factors for PSTS after single-level ACSS. These findings can help clinicians monitor high-risk patients and take preventive measures to reduce complications. Further research with larger sample sizes and prospective designs is needed to validate these findings.

Background: Riehl’s melanosis of the face and neck has been reported in middle-aged women who have darker skin types. Recently, cases of Riehl’s melanosis have been on the rise in Korea, which might reflect the increased use of various cosmetic products and procedures. Objective: This study was designed to analyze the clinicopathological characteristics and treatment outcomes of Riehl’s melanosis in Korean patients. Methods: We closely observed 80 patients with Riehl’s melanosis diagnosed in Asan Medical Center and Hanyang University Medical Center between 2005 and 2015. A skin biopsy was analyzed in 51 patients, and a patch test was carried out in 16 patients. Results: Patients with chronic Riehl’s melanosis (＞12 months) had an increased frequency of previous laser treatments. Patients with acute Riehl’s melanosis (＜3 months) reported a previous history of dry skin, itching, or irritation as a result of the use of hair dye. Patients older than 50 years, with darker skin type, and with a longer disease duration (＞12 months) had poor response rates. Chronic Riehl’s melanosis may be preceded by repeated irritation of barrier-compromised skin, and acute Riehl’s melanosis seems to be an allergic form of Riehl’s melanosis. Conclusion Riehl’s melanosis has different clinical manifestations according to disease duration and different treatment responses based on disease duration.

PURPOSE: Mycophenolate mofetil (MMF) is thought to have not only low frequency of adverse side effects but also have equal efficacy to other conventional immunosuppressants (CIS). But It's hard to conclude that CIS may be replaceable with MMF. So we inquired into another aspect of MMF as 'Rescue therapy' in non-transplant renal diseases. METHODS: Twenty nine patients with non-transplant renal diseases received MMF therapy between January 2000 and April 2007. Eighteen patients who had received MMF more than 6 months were included. Sixteen of the 18 patients included were resistant to CIS and two were patients who maintained complete remission (CR) with MMF because of the adverse side effects of CIS. Treatment outcome was evaluated by dip-stick urine test. CR was defined by negative or trace, partial remission (PR) by 1 positive and treatment failure (TF) by more than 1 positive. RESULTS: Eleven of the resistant 16 patients had shown CR (69%) and maintained CR. Two of maintenance therapy with MMF had kept CR more than 12 months. The proportions of the patients who had shown decreased proteinuria in each treatment duration were 69% for 3 months (p=0.005), 81% for 6 months (p=0.001), 86% for 9 months (p=0.002) and 91% for 12 months (p=0.004), respectively. There were few adverse effects. CONCLUSION: We observed the efficacy of MMF in decreasing proteinuria and maintaining CR as 'Rescue therapy' for previously treated non-transplant renal disease patients with CIS. Large controlled clinical trials are expected for defining this effect.
Humans ; Immunosuppressive Agents ; Kidney Diseases ; Mycophenolic Acid ; Proteinuria ; Treatment Failure ; Treatment Outcome

Palliative treatment of malignant biliary obstructions represent the principal indications of endoscopic or percutaneous transhepatic implantation of endoprostheses. Many kinds of biliary stents have been used to maintain patency of the bile ducts obstructed by benign or malignant strictures. However, the biliary stent in current use, has a tendency to become blocked. In order to maintain a long-term stent patency before clogging, biliary stents with large diameters are needed and some kinds of expandable metal stents are proposed. The Hanaro stent (Sooho medi-tech Co. LTD, Seoul, Korea) is a modified Gianturco Z biliary stent, made of 0,01-inch stainless steel wire with a zigzag pattern. It has a spiral, cylindrical configuration and is 10 mm in expanded diameter. It hes been used only with the percutaneous transhepatic technique. In this article, we describe a new method for endoscopic retrograde placement of a modified Gianturco Z biliary stent. This report describes our experience on endoscopic application of a modified Gianturco Z biliary stent in a patient with malignant obstruction of the distal common bile duct.
Bile Ducts ; Common Bile Duct ; Constriction, Pathologic ; Humans ; Palliative Care ; Seoul ; Stainless Steel ; Stents*