Cutaneous metastatic tumors on the scalp from the rectum are very A 66-year-old male presented a nodule and papule an his scalp three months after surgical removal of a rectal adenocarcinorna. Biopsy specien from the scalp showed adenocarcinoma which is similar to the primary rectal carcinoma.
Adenocarcinoma* ; Aged ; Biopsy ; Humans ; Male ; Rectum* ; Scalp*

No abstract available.
Dermatitis, Allergic Contact* ; Rosa*

The paratertiary butylphenol formaldehyde resin(PTBP-FR) is commonly used in neoprene shoe adhesive to provide stability, durability, flexibility, and to stick quickly. We report here a case of allergic contact dermatitis in a 22-year-old female, who had well defined, pruritic, erythematous, and papulovesicular lesions on the lateral side of the left foot and ankle for 3 years. Patch test showed 2+(vesicular) reaction .to PTBP-FR(1% in petrolatum), a piece of leather shoes(as is), and a piece of leather watch strap(as is).
Adhesives ; Ankle ; Dermatitis, Allergic Contact* ; Female ; Foot ; Formaldehyde* ; Humans ; Neoprene ; Patch Tests ; Pliability ; Shoes ; Young Adult

Lymphangiectasia is a rsre occurrence, and may be due to an undgrlying disturbance of the lymph flow following surgery or irrediation. We present an unusual case of an extensive lymphangictasia of the vulva following radical abdominal hysterectomy and irradiation for cervical cancer.
Hysterectomy ; Uterine Cervical Neoplasms ; Vulva*

BACKGROUND: The regional variation in transepidermal water loss(TEWL) is related to the varying skin structure, particularly the epidermis and its horny layer, and the regional distribution of the eccrine sweat glands, which are concentrated on the palms and soles. OBJECTIVE: We tried to evaluate the TEWL values at various anatomic sites and compare of TEWL values between male and female, left and right, dominant and non-dominant forearm. METHODS: In this study 24 healthy volunteers(mean age 26.6 years, range 20-34 years, 14 males and 10 females) with no history of atopic dermatitis were included. Measurements were performed at various anatomical sites of the skin using Tewameter TM 210(R)(Courage+Khazaka, Koln, Germany). Prior to the measurement of TEWL values, subjects stayed still for 30 minutes in the room where the temperature was controlled(18-23degrees C) with a relative humidity of 35-45%. RESULTS: 1. TEWL values at various anatomical sites of the skin ranked as follows ; palm > sole > back = calf = chin > forearm. TEWL values of wrist forearm was statistically higher than those of proximal forearm and mid-forearm. 2. TEWL values at paim and sole were higher in male than in female(p<0.05), although we could not see any statistically significant difference in TEWL values between male and female at other sites of the skin. 3. Comparing TEWL values of right side of forearm, palm, and sole with those of left side, there were no statistical significance in differences. 4. There were no statisically significant differences in TEWL values at forearm between dominant portion(right handed person's right forearm in 20 persons and left handed person's left forearm in 4 persons) and non-dominant portion. CONCLUSION: There were significant variations in TEWL values at various anatomical site of the skin. It may be necessary to consider the anatomical site of the skin, when we compare the TEWL values which studying the irritant contact dermatitis.
Chin ; Dermatitis, Atopic ; Dermatitis, Contact ; Epidermis ; Female ; Forearm ; Hand ; Humans ; Humidity ; Male ; Skin* ; Sweat Glands ; Wrist

Bone Regeneration ; Connective Tissue ; Giant Cells ; Guided Tissue Regeneration ; Membranes ; Rabbits ; Skull

Since the first description of non-small cell lung cancer (NSCLC) with activating epidermal growth factor receptor (EGFR) mutation as a distinct clinical entity, studies have proved EGFR tyrosine kinase inhibitors (TKIs) as a first choice of treatment. The median response duration of TKIs as a first-line treatment for EGFR mutant tumors ranges from 11 to 14 months. However, acquired resistance to EGFR-TKIs is inevitable due to various mechanisms, such as T790M, c-Met amplification, activation of alternative pathways (IGF-1, HGF, PI3CA, AXL), transformation to mesenchymal cell or small cell features, and tumor heterogeneity. Until development of a successful treatment strategy to overcome such acquired resistance, few options are currently available. Here we provide a summary of the therapeutic options after failure of first line EGFR-TKI treatment for NSCLC.
Carcinoma, Non-Small-Cell Lung ; Drug Resistance ; Epidermal Growth Factor ; Lung ; Population Characteristics ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor

X-linked agammaglobulinemia is attributed to the genetic defect for Bruton's tyrosine kinase at Xq22 region and the developmental arrest of pre-B lymphocytes. The characteristics of the disease are as follows; 1) male sex, 2) onset in infancy or early childhood, 3) severe panhypogammaglobulinemia, 4) normal cell mediated immunity, 5) recurrent, hardly controlled infection. The most common sites of infection are the respiratory tract and the gastrointestinal tract. The disease must be suspected when the recurrent, hardly controlled infection or the unusual, multiple sites of infection are present. Regular intravenous immune globulin approved the preventive effect against severe infection and fatal complication. But the final outcome remains grave in spite of intensive care. We report an adult case, 20 years old male patient, of X-linked agammaglobulinemia. He has been suffered from recurrent pneumonia and other sites of infection including meningitis and cellulitis. Pseudomonas aeruginosa was cultured from blood. X-linked agammaglobulinemia was diagnosed based on clinical history, severe panhypogammagloblinemia, lack of the gamma-fraction on the serum protein electrophoresis and absence of B-lymphocytes in peripheral blood. The clinical course waxed and waned until intravenous infusion of immune globulin, which dramatically improved pneumonia.
Adult ; Agammaglobulinemia* ; B-Lymphocytes ; Cellulitis ; Electrophoresis ; Gastrointestinal Tract ; Humans ; Immunity, Cellular ; Immunoglobulins, Intravenous ; Infusions, Intravenous ; Critical Care ; Male ; Meningitis ; Pneumonia ; Precursor Cells, B-Lymphoid ; Protein-Tyrosine Kinases ; Pseudomonas aeruginosa ; Respiratory System ; Young Adult

BACKGROUND: Diffuse panbronchiolitis(DPB) is a chronic inflammatory disease affecting the respiratory bronchioles which was first described in Japan in 1966. DPB is prevalent in Japan and is known to be very rare in western countries. The first cases of DPB were reported in Korea in 1992 and the number of the patients has been increasing. The prognosis of DPR had been very poor because there had been no effective treatment for the disease. Hut it has been dramatically changed since the introduction of low-dose long-term erythromycin therapy. In Korea, there is rare experience of 1ong-term follow-up of DPH patients and we presents the results of mean 21.6 months of follow-up after erythromycin treatment. METHODS: We analyzed the long-term follow-up data of 25 DPH patients who were diagnosed in Seoul National University Hospital during the period from September 1989 to December 1994 and followed up more than 6 months with erythromycin therapy. We tried erythromycin 250mg b.i.d. on all the patients and analyzed the changes of subjective symptoms, physical signs, pulmonary function tests, and chest X-rays. RESULTS: 1) The mean follow-up period was 21.6 months. 2) Subjective symptoms improved in 96% of the patients within 3 months and 76% of the patients showed no symptom after 18 months of treatment. 3) Crackles and wheezing decreased in all patients within 3 months and completely disappeared in 76% of the patients after 18 months of treatment. 4) Diffuse small nodular lesions on chest X-ray decreased in 56% of the patients within 3 months and chest PA was normal in 32% of the patients after 12months of treatment. 5) FVC and FEV1 increased remarkably during the first 3 months and slowly increased thereafter, reaching normal level after 12 months of treatment. FEV1/FVC was 60.4% before treatment and in- creased slowly reaching 76.1% after 24 months of treatment. 6) Erythromycin therapy could be finished in 7 patients. The mean duration of medication was 26 months and no evidence of recurrence was found in 6 months of follow-up. 7) No patients had experienced the side effect of erythromycin, CONCLUSION: The prognosis of DPR is very goad when treated with erythromycin. And at least 2 years of erythromycin treatment seems to be needed for DPB patients.
Bronchioles ; Erythromycin* ; Follow-Up Studies* ; Humans ; Japan ; Korea ; Prognosis ; Recurrence ; Respiratory Function Tests ; Respiratory Sounds ; Seoul ; Thorax

In 1974, Casson et. al. reported midfacial degloving approach to repair the midfacial bone fracture. After then, this approach has been used frequently to treat the lesions on nasal cavity, nasopharynx, facial plastic surgery and midfacial trauma. Midfacial degloving approach consists of 1) bilateral sublabial incision 2) complete transfixion incision/ septocolumellar incision 3) bilateral intercartilaginous incision 4) bilateral pyriform aperature incision. This approach provides proper access for midfacial bone structure without facial scar but has post-operative complications such as transient epistaxis, infraorbital nerve paresthesia and nasal crust. We treated three patients using midfacial degloving approach to correct traumatic deformity in midface area. In two patients, rhinoplasty with autogenous rib graft was done simultaneously. So we report these cases with review of literatures.
Cicatrix ; Congenital Abnormalities ; Epistaxis ; Fractures, Bone* ; Humans ; Nasal Cavity ; Nasopharynx ; Paresthesia ; Rhinoplasty ; Ribs ; Surgery, Plastic ; Transplants