The nevus of Ota is a benign dermal melanocytic lesion that most commonly occurs unilaterally in areas innervated by the first and second division of the trigeminal nerve. Acquired bilateral nevus of Ota-like macules(ABNOM) are located bilaterally on the forehead, temples, eyelids, cheeks, and/or nose. They usually occur in the fourth or fifth decade of life in women(rarely in men). In contrast to the nevus of Ota, ABNOM have not been observed in the mucous membranes of the oral cavity, nose, or eyes. Traditional treatments were palliative, risky electrocautery, or cryotherapy. These methods resulted in permanent pigmentary changes and/or scarring. Recently utilizing the principle of selective photothermolysis, the Q-switched Alexandrite laser has been reported to be successful in treating benign pigmentary lesions and tattoos. Our study evaluated the treatment of 127 patients with nevus of Ota and ABNOM with the Q-switched Alexandrite laser(755 nm, 100 nsec). Nevi were treated up to 7 times with 7-8 J/cm2 at a minimum of 6 weeks interval. Good therapeutic effects were gained (up to 50% improvement was seen in 89% of patients.) and our patients were very satisfied. No patients had permanent textural change or scarring. Treatment with on Alexandrite laser for nevus of Ota & ABNOM is considered to be a safe and effective method.
Cheek ; Cicatrix ; Cryotherapy ; Electrocoagulation ; Eyelids ; Forehead ; Humans ; Lasers, Solid-State* ; Mouth ; Mucous Membrane ; Nevus of Ota ; Nevus* ; Nose ; Trigeminal Nerve

A various type of hairline and height of forehead is considered as a result of genetic effect. The conventional corrective surgical operation of low hairline in forehead has been too complicated and painful to apply, and also has many disadvantages such as scar, bleeding, risks of anesthesia. Recently four classes of devices are designed to remove hair with intense light beam : Nd-Yag lasers with carbon cream, the Ruby lasers, the Alexandrite lasers, and the polychromic broad band light source of flashlamp technology. The goal of these therapeutic modality is to destroy the melanin pigment selectively in hair follicle without injuring the skin for permanent epilation. We have been used long pulse infrared Alexandrite laser for treat low hair line in 27 patients from Dec. 1997 to Dec. 1998. We experienced 3 cases of temporary hyperpigmentation and 1 case of bulla, and the most of patients were satisfied in 89%. The average lengthening of forehead was 2.2cm (median line) and 2.3cm (paramedian line). We achieved successful result without permanent hyperpigmentation or scarring
Anesthesia ; Carbon ; Cicatrix ; Forehead ; Hair Follicle ; Hair Removal ; Hair* ; Hemorrhage ; Humans ; Hyperpigmentation ; Lasers, Solid-State* ; Melanins ; Skin

OBJECTIVE: To test if the intake of H2 receptor antagonists (H2-RAs) increases the risk of gastric cancer in the elderly. METHODS: The source population for this study was drawn from the responders to a questionnaire survey administered to the Korea Elderly Pharmacoepidemiological Cohort (KEPEC), who were beneficiaries of the Korean Medical Insurance Corporation, were at least 65 years old, and residing in Busan in 1993. The information on H2-RAs exposure was obtained from a drug prescription database compiled between Jan. 1993 and Dec. 1994. The cases consisted of 76 gastric cancer patients, as confirmed from the KMIC claims data, the National Cancer Registry and the Busan Cancer Registry. The follow-up period was from Jan. 1993 to Dec. 1998. Cancer free controls were randomly selected by 1:4 individual matching, which took in to consideration the year of birth and gender. Information on confounders was collected by a mail questionnaire survey. The odds ratios, and their 95% confidence intervals, were calculated using a conditional logistic regression model. RESULTS: After adjusting for a history of gastric ulcer symptoms, medication history, and body mass index, the adjusted OR (aOR) was 4.6 (95% CI=1.72-12.49). The odds ratio of long term use (more than 7 days) was 2.3 (95% CI=1.07-4.82). The odds ratio of short term use was 4.6 (95% CI=1.26-16.50). The odds ratio of parenteral use was 4.4 (95% CI=1.16-17.05) and combination use between the oral and parenteral routes (aOR, 16.8; 95% CI=1.21-233.24) had the high risk of gastric cancer. The aOR of cimetidine was 1.7 (95% CI=1.04-2.95). The aOR of ranitidine was 2.0 (95% CI=1.21-3.40). The aOR of famotidine was 1.7 (95% CI=0.98-2.80). CONCLUSION: The intake of H2-RAs might increase the risk of gastric cancer through achlorhydria in the elderly.
Achlorhydria ; Aged* ; Body Mass Index ; Busan ; Case-Control Studies* ; Cimetidine ; Cohort Studies ; Drug Prescriptions ; Famotidine ; Follow-Up Studies ; Humans ; Insurance ; Korea ; Logistic Models ; Odds Ratio ; Parturition ; Pharmacoepidemiology ; Postal Service ; Surveys and Questionnaires ; Ranitidine ; Stomach Neoplasms* ; Stomach Ulcer

PURPOSE: In recent studies, the presence of lymphocytic infiltration in patients with papillary thyroid carcinoma (PTC) was reported to be associated with a favorable prognosis. The prognostic significance of Hashimoto's thyroiditis (HT) in patients with PTC remains unclear. The aim of our study was to determine the frequency and prognostic significance of HT in patients with PTC. METHODS: From January 2005 to December 2007, 367 patients who underwent thyroid surgery for PTC were included in this study. They were divided into two groups: Group A (n=71; 19.4%) included the patients diagnosed as having PTC with HT and Group B (n=296; 80.6%) included the patients who had PTC without HT. The clinicopathologic features between Groups A and B were retrospectively reviewed via the medical records. RESULTS: Lymph node metastasis was less frequent in Group A than that in Group B (25.5% versus 41.0%, respectively, P=0.033). However, both groups had similar clinicopathologic features in terms of age, gender, the tumor size, multifocality, extrathyroidal invasion, the TNM stage and the AMES and MACIS scores. Also, the operative method did not differ significantly between the two groups. CONCLUSION: These results suggest that the presence of HT is not associated with the prognostic factors of PTC.
Humans ; Lymph Nodes ; Medical Records ; Methods ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroiditis*

PURPOSE: In 1970, the Berlin-Frankfurt-Munster(BFM) group introduced an intensification therapy after remission induction to reduce relapse of acute lymphoblastic leukemia(ALL) in childhood. Delayed intensification(DI) phase has been included for treatment of ALL in our hospital since the mid-1990s. The purpose of this study is to evaluate the outcome with vs. without DI phase and the outcome with two vs. one DI phase for intermediate risk patients. METHODS: One hundred and thirty nine children with ALL who were treated at the Department of Pediatrics of Wonju Christian Hospital and Yonsei University Medical Center between March, 1990 and July, 2002 were analysed retrospectively. RESULTS: Thirty-eight patients were treated with a DI phase, and 101 patients were treated without a DI phase. Among the DI patients, seven patients were treated with a double DI phase. Five-year overall survival(OS) in the low, intermediate, and high risk groups were 68%, 66% and 58%, respectively. 5-year OS in DDI, DI, and control were 95%, 86% and 40%, espectively. In the low risk group, 5-year event free survival(EFS) in DI, and control were 94% and 58%, respectively. CONCLUSIONS: Delayed intensification improved EFS on childhood ALL in all risk groups.
Academic Medical Centers ; Child ; Gangwon-do ; Humans ; Pediatrics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; Remission Induction ; Retrospective Studies

Intracranial ependymal cysts are rare, congenital, benign lesions. These commonly occur in the supratentorial regions and usually generate no symptoms. The cerebellopontine angle (CPA) is an extremely rare site for ependymal cysts. Furthermore, there are no previous reports of CPA ependymal cysts related to syncope. We report a case of ependymal cyst in the left CPA with syncope. The patient underwent a cardiologic evaluation for syncope after admission, but there were no definite cardiologic abnormal findings. He underwent fenestration into the subarachnoid space, and the pathologic diagnosis revealed an ependymal cyst. We analyzed this case with review of other literatures.
Cerebellopontine Angle ; Diagnosis ; Humans ; Subarachnoid Space ; Syncope*

PURPOSE: To compare the accuracy of central true net corneal power (cTNP) and mean true net corneal power (mTNP) of the Pentacam system to give a keratometry (K) reading for calculating IOL (intraocular lens) power in eyes following refractive surgery. METHODS: Refraction, an automated K-reading (Km), cTNP and mTNP were measured for 15 eyes that required cataract surgery and had previously undergone refractive surgery. The difference between postoperative manifest refraction values and target refraction values calculated with the SRK/T formula using cTNP were compared with the one using mTNP. RESULTS: The mean deviation from the desired post-cataract refractive outcome was 0.60 diopter (D) +/-0.47 (standard deviation) using cTNP; 0.75+/-0.54 using mTNP (p=0.386). The actual refraction was within +/-0.50D of the intended refraction for 60% (cTNP) and 33.3% (mTNP) of eyes, and within +/-1.00D for 93% (cTNP) and 66.7% (mTNP) of eyes. CONCLUSIONS: Although not statistically significant, the cTNP showed better accuracy than mTNP to give a keratometry (K) reading for post-refractive surgery eyes requiring cataract surgery.
Adult ; Cornea/*pathology/physiopathology/surgery ; Corneal Topography/*methods ; Female ; Humans ; *Lenses, Intraocular ; Male ; Middle Aged ; Myopia/*surgery ; Prosthesis Design ; *Refraction, Ocular ; *Refractive Surgical Procedures

Hyperplasia of Brunner's glands is considered an uncommon finding; its wide range of morphological variation has led to confusing identifying terminology which includes: hyperplasia, adenoma, and hamartoma. Some investigators have suggested that hyperplasia of Brunner's glands is hamartomatous in nature, whereas others have favored a causative relationship that results from gastric acid hypersecretion. Although most commonly an incidental finding, that appears as multiple small submucosal sessile nodules, usually located in the duodenal bulb, it can lead to clinically significant symptoms including gastrointestinal bleeding, abdominal pain, and intestinal obstruction. Here, we report a case of hyperplasia of multiple cystic Brunner's glands on the duodenal bulb in a patient with acute pancreatitis; they were discovered incidentally on abdominal CT and duodenoscopy. This is the first report of hyperplasia of Brunner's glands with these morphological characteristics.
Abdominal Pain ; Adenoma ; Brunner Glands ; Duodenoscopy ; Gastric Acid ; Hamartoma ; Hemorrhage ; Humans ; Hyperplasia* ; Incidental Findings ; Intestinal Obstruction ; Pancreatitis ; Research Personnel ; Tomography, X-Ray Computed

OBJECTIVE: Intracranial hemangiopericytomas (HPCs) are rare tumors with aggressive behavior, including local recurrence and distant metastasis. We conducted this retrospective study to evaluate the efficacy of grossly total resection and adjuvant radiotherapy (RT) for these tumors. METHODS: A total of 13 patients treated for intracranial HPC from January 1995 through May 2013 were included in this retrospective study. We analyzed the clinical presentations, radiologic appearances, treatment results, and follow-up outcomes, as well as reviewed other studies. RESULTS: The ages of the patients at the time of diagnosis ranged from 26 to 73 years (mean : 48 years). The majority of the patients were male (92.3%), and the majority of the tumors were located in the parasagittal and falx. The ratio of intracranial HPCs to meningiomas was 13 : 598 in same period, or 2.2%. Seven patients (53.8%) had anaplastic HPCs. Nine patients (69.2%) underwent gross total tumor resection in the first operation without mortality. Eleven patients (84.6%) underwent postoperative adjuvant RT. Follow-up period ranged from 13 to 185 months (mean : 54.3 months). The local recurrence rate was 46.2% (6/13), and there were no distant metastases. The 10-year survival rate after initial surgery was 83.9%. The initial mean Karnofsky performance scale (KPS) was 70.8 and the final mean KPS was 64.6. CONCLUSION: Gross total tumor resection upon initial surgery is very important. We believe that adjuvant RT is helpful even with maximal tumor resection. Molecular biologic analyses and chemotherapy studies are required to achieve better outcomes in recurrent intracranial HPCs.
Diagnosis ; Drug Therapy ; Follow-Up Studies ; General Surgery ; Hemangiopericytoma* ; Humans ; Male ; Meningioma ; Mortality ; Neoplasm Metastasis ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Survival Rate

PURPOSE: The goal of this study was to evaluate the clinicopathologic characteristics and to investigate the expression of p53, c-erbB2, and nm23 protein in gastric remnant cancer. MATERIALS AND METHODS: We evaluated the clinicopathologic characteristics and expression of p53, c-erbB2, and nm23 protein in 37 cases gastric remnant cancer (GRC) that detected at least 5 years after initial surgery, and compare them with adenocarcinoma from intact stomach. Twenty-seven patients among the 37 patients of GRC and 271 patients of primary gastric cancer (PGC) were chosen for immunohistochemical staining against p53, c-erbB2, and nm23. RESULTS: The median age was 59 years, male was predominant and median time interval between operations were 15 years. GRC initially operated for benign disease were detected later after initial gastrectomy and had a tendency toward lymph node metastasis than those initially operated for malignant disease. Resection was performed in 31 patients (81.0%) in whom 28 patient (71.0%) with curative intent. The overall 5-year survival rate was 44.8%. Multivariate analysis had revealed that depth of invasion was the most significant prognostic factor. p53, c-erbB2, and nm23 protein expression rates of GRC were 44.4%, 14.8%, and 66.7%, respectively and those of PGC were 45.4%, 16.2%, and 85.1%, respectively. p53 protein was more frequently expressed in well differentiated, Laurens intestinal carcinoma in both GRC and PGC. p53 protein expression and depth of invasion had an inverse relationship only in GRC. c-erbB2 protein was more frequently expressed in well differentiated, Laurens intestinal carcinoma in PGC. nm23 protein expression was more frequently expressed in the group of positive lymph node metastasis in GRC. CONCLUSION: Early detection by periodic endoscopic follow-up and radical resection is a reasonable treatment policy for GRC. The results of p53, c-erbB2, and nm23 expression suggest that they might have somewhat different roles in the pathogenesis and progression in GRC and PGC, so further study may be of benefit hereafter.
Adenocarcinoma ; Gastrectomy ; Gastric Stump* ; Humans ; Lymph Nodes ; Male ; Multivariate Analysis ; Neoplasm Metastasis ; Stomach ; Stomach Neoplasms ; Survival Rate