Dyschromatosis universalis hereditaria was reported in 1933 by Ichikawa and Hiraga in Japan. This disease is characterized by small pigmented and depigmented mottled macules on the trunk and extremities. We report two cases of dyschromatosis universalis. Case one is a 47-year-old man presented with hypoand hyperpigmented spots on the trunk and extrexities. At about 30 years of age, he started to show pigmentary changes on the back, which became progressively spread to the other parts of the trunk and extremities. Case two is a 27-year-old man with numerous mottled hypo-and hyperpigmented spots on the trunk and extremities. He started to show pigmentary changes on the back about 12 years ago. This pigmentary changes also became progressively spread to the other part of the trunk and extrimities. There were no family history of similar disease. On physical exminations, both patients had hrown rice-grain sized pigmented and depigmented macules without scales and atropy on the trunk and extremites. Fontana-Masson stains revealed decreased and increased melar in granules in the basal cell layers in the hypopigrnented and hyperpigmented lesions respectively.
Adult ; Coloring Agents ; Extremities ; Humans ; Japan ; Middle Aged ; Weights and Measures

No abstract available.
Blood Platelets* ; Blood Transfusion*

PURPOSE: The purpose of this study was to evaluate the utility of two-phase dynamic CT, early and equilibrium pahse, in the preoperative staging of rectal cancers. MATERIALS AND METHODS: We performed incremental dynamic CT after rectal infusion of water in 34 patients with pathologically proved rectal cancers. Two-phase dynamic CT findings were prospectively analyzed and correlated with surgical and histopathologic findings. A total of 150ml of nonionic contrast medium was intravenously administered with a power injector at a flow rate of 5ml/sec for 30 sec, and two-phase images were obtained at 30 sec(early phase) and 2 min (equilibrium phase) after bolus injection. Local tumor staging and regional lymph node were classified by TNM staging. RESULTS: All 34 rectal cancers showed a moderate to marked enhancement in the early phase and a homogeneous and prolonged enhancement of the entire lesion in the equilibrium phase. T-staging of primary tumors were 85.3%(29/34) in early phase and 70.6%(24/34) in equilibrium phase. The accuracy in determining the perirectal fat invasion of rectal cancer was 92%(23/25) in early phase, and 72%(18/25) in equilibrium phase. The sensitivity & specificity of the regional lymph node metastasis were 63.6% and 79.1% in early phase, and 54.5% and 65.2% in equilibrium phase, respectively. CONCLUSION: Early phase dynamic CT was more accurate for the preoperative staging of rectal cancer than that at equilibrium phase.
Humans ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Staging ; Prospective Studies ; Rectal Neoplasms* ; Sensitivity and Specificity ; Water

PURPOSE: A sensitive assay to detect minimal residual disease in neuroblastoma is necessary for accurate assessment of disease status and optimal treatment. In this study, we compared the usefulness of sensitive methods, flow cytometry and RT-PCR for the detection of minimal residual disease in neuroblastoma. METHODS: Eighteen patients who were newly diagnosed and treated at Severance Hospital since 1999 were included in this study. Samples from bone marrow, peripheral blood, and peripheral blood stem cell product were examined for tumor cell contamination by RT-PCR (TH RT-PCR) to detect tyrosine hydroxylase mRNA and by flow cytometry identifying CD9+/CD56+/CD45- cells. RESULTS: We analyzed 20 cases from 18 patients, which were assayed by both methods at the same time. Among 20 cases, 16 cases showed same results, which were compatible with histologic results and clinical course, and 4 cases showed different results. One case of them showed positive result in histology and flow cytometry, but negative result in TH RT-PCR. The other 3 cases showed negative results in flow cytometry, but positive results in TH RT-PCR, and 1 patient of them relapsed. Among 16 patients, 2 patients, showing positive results in only TH RT-PCR, relapsed. CONCLUSION: Detection of minimal residual disease using TH RT-PCR and flow cytometry was effective and useful in evaluating disease status and deciding for proper treatment.
Bone Marrow ; Flow Cytometry* ; Humans ; Neoplasm, Residual* ; Neuroblastoma* ; RNA, Messenger ; Stem Cells ; Tyrosine 3-Monooxygenase

No abstract available.
Animals ; Muscle, Smooth, Vascular* ; Nitric Oxide* ; Rats*

No abstract available.
Mesenteric Cyst*

As the frequency of radiation exposure by fluoroscopy continues to increase in orthopaedic fields, the level of hazard for the orthopaedic surgeon increases at the same time. Exposure of the clinician's hand is highest during performance of surgery or procedures within the actual clinics. Studies on radiation exposure on thyroid, eye or whole body, or reports on radiation treatment of cancer or for dermal lesions occurring from therapeutic intervention on the body such as heart and liver, and studies on radioactive damage to hands derived from radioactive material handlers have been reported; however, no studies on radioactive damage to a clinician's hand have been reported. Therefore, we report on a case of chronic radiation dermatitis and necrosis of an orthopaedic surgeon's hand as well as its soft tissue defect.
Dermatitis ; Fluoroscopy ; Hand* ; Heart ; Humans ; Liver ; Necrosis* ; Spine* ; Thyroid Gland

Protein losing enteropathy is described as a diverse group of disorders associated with excessive loss of serum proteins into the gastrointestinal (GI) tract. The etiology of protein losing enteropathy is various. Increased mucosal permeability to protein as a result of cell damage, mucosal erosion, or lymphatic obstruction may develop protein losing enteropathy. Celiac disease is a common cause of protein losing enteropathy associated with small bowel villous atrophy in Europe. We experienced a case of protein losing enteropathy associated with small bowel villous atrophy of unknown origin. A 36-year-old woman was admitted due to chronic watery diarrhea and weight loss. Laboratory findings showed total protein 4.7 g/dL, albumin 2.7 g/dL, cholesterol 100 mg/dL, WBC 6,000/mm(3) (lymphocyte 13.6%) with the absence of proteinuria. On esophagogastroduodenoscopic examination, duodenal ulcer scar was noted on the bulb and colonoscopic finding was nonspecific. On small bowel enteroscopy, jejunal and ileal villi was scantly noticed. Small bowel biopsy showed marked villous atrophy. Her symptoms did not improve after supportive care. Gluten free diet was tried because celiac disease could not be ruled out completely. Diarrhea ceased and body weight regained after gluten free diet.
Adult ; Atrophy ; Celiac Disease/*pathology ; Colonoscopy ; Female ; Humans ; Ileum/*pathology ; Immunohistochemistry ; Intestinal Mucosa/pathology ; Jejunum/*pathology ; Protein-Losing Enteropathies/*etiology ; Serum Albumin/diagnostic use ; Technetium Tc 99m Aggregated Albumin/diagnostic use ; Tomography, X-Ray Computed

Cognitive impairment and depression are the most common symptoms affecting the elderly on physical and mental states. Studies have shown that these symptoms in mild cases are improved by psychosocial intervention, emphasizing the importance of therapeutic intervention provided in the community. The purpose of this study was to investigate whether the psychosocial program at a geriatric day care service has any therapeutic effect on the cognitive function and depressive symptoms in the elderly and whether such effect can be maintained. The experimental group was composed of 37 elderly patients attending the day care service at the mental health center located in Kwangju county, Kyonggi province. The control group was composed of 22 elderly patients who either refused intervention or who dropped out of the program. Cognitive function was assessed with the Korean version of the Mini-Mental State Exam(MMSE-K) and depressive symptoms were assessed with the Short-form Geriatric Depression Scale(SGDS) The experimental group and the control group were compared on the score of on each test, which was administered before and after the program and 10 weeks after discontinuation of program. In the experimental group, the scores acquired immediately after the program and at 10 weeks of follow-up were also compared. The results showed that psychosocial intervention at a geriatric day care service was significantly associated with the change in SGDS scores dependent on time but not significantly associated with the change in MMSE-K scores. In the experimental group whose follow-up assessment was possible, it was further shown that 43% of patients had increased SGDS scores 10 weeks after the program ended, indicating that depressive symptoms had worsened. This study suggests that psychosocial therapeutic intervention in the geriatric day care service improve depressive symptoms but not cognitive functions in the elderly. In addition, for a considerable percentage of subjects in the experimental group, the improvements in depressive symptoms were not sustained after the intervention was withdrawn. These findings proposes a need of strengthening therapeutic intervention to maintain such effect.
Aged* ; Day Care, Medical* ; Depression* ; Follow-Up Studies ; Gwangju ; Gyeonggi-do ; Humans ; Mental Health

OBJECTIVE: This study was designed to evaluate the efficacy and safety of tianeptine and sertraline in the treatment of patients with depression. METHOD: The study was done on the patients with major depression diagnosed by DSM-IV, who had a Hamilton Rating Scale for Depression(HAM-D) score > OR =14 on the first 17 items of the HAM-D. A total of 40 patients were randomly assigned to tianeptine group and sertraline group. Tianeptine and sertraline were prescribed to each group. 6 weeks of each medication was carried out after 7 days of drug excretion period. Evaluation using 17 item HAM-D, Montgomery and {0c5}sberg Depression Rating Scale(MADRS), Clinical Global Impression Scale(CGI), and Covi Scale was done on the baseline and after 1 week, 2 weeks, 4 weeks, and 6 weeks. Regarding all side effects that had occurred during the period of our study such as their developed/disappeared time, severities, incidences, managements and results have been recorded. RESULTS: A total of 30 patients(tianeptine group 15;sertraline group 15) finished the 6 weeks of research. 37.5mg of the daily dose was regularly prescribed to the tianeptine group, the average amount of 64.0+/-22.5mg of the final daily dose was prescribed to the sertraline group. Total 17 item HAM-D scores, total points of MADRS and CGI showed significant decrease after 1 week in each treatment group and continous decrease after 2, 4 and 6 weeks;and no difference was found between tianeptine group and sertraline group in the antidepressant efficacy. Also there were no significant changes in vital sign, CBC, chemistry, and EKG in each treatment group. The common reported side effects of tianeptine were nausea(33.3%), epigastic distress(26.7%), dry mouth(20.0%), headache(13.3%) and those of sertraline were dry mouth(53.3%), headache(46.7%), nausea(33.3%), anorexia(33.3%). CONCLULSION: According to the results, tianeptine was effective in improvement of depressive symptoms and was well tolerated and safe in patients with depression.
Chemistry ; Depression* ; Diagnostic and Statistical Manual of Mental Disorders ; Electrocardiography ; Humans ; Incidence ; Sertraline* ; Vital Signs