We are reporting a case of multiple dermatofibromas which occuired during the treatment of systemic lupus erythematous with prednisolone for 3 years in a 30-yenr-old woman, All of the 26 lesions were 0.5-2cm sized. and had the same appearanes ad usual dermatofibromas coccurring singly. Histopathologic examination showed typical findings of dermatofibroma which were characterized hy proliferation of fibroblasts intermingled with collagen in irregular arrangement and proliferation of small vessels and endothelial cells.
Collagen ; Endothelial Cells ; Female ; Fibroblasts ; Histiocytoma, Benign Fibrous* ; Humans ; Lupus Erythematosus, Systemic* ; Prednisolone

The sonographic findings of Trisomy 18 are varied. Sonographic findings including choroid plexus cyst, hydramnios, enlarged cisterna magna, shortening of femur, micrognathia and clenched hands are observed in our case of genetically confirrned Trisomy 18. A case of sonographically diagnosed Edward syndrome (Trisomy 18) with negative triple marker screening test is presented with a brief case history and review of literatures.
Choroid Plexus ; Cisterna Magna ; Femur ; Hand ; Mass Screening ; Polyhydramnios ; Trisomy* ; Ultrasonography ; Ultrasonography, Prenatal*

No abstract available.
Humans

No abstract available.
Hypertension ; Leigh Disease*

No abstract available.

No abstract available.
Humans ; Biomarkers, Tumor* ; Uterine Cervical Neoplasms*

The use of opioids for chronic noncancer pain has increased in recent years, although evidence for its long-term effectiveness is weak and its potential for harm is significant. Most reports suggest that chronic opioid therapy can be effective for the reduction of chronic pain and for the improvement of functioning and health-related quality of life. However, opioids are also associated with potentially serious harm including pharmacologic adverse effects and socioeconomic problems such as abuse, addiction, and diversion. Physicians should use a structured approach that includes a biopsychosocial evaluation and treatment plan that encourages patients to reach functional goals. There should be a comprehensive evaluation of the cause of pain, assessment for risk of opioid complications (including misuse and addiction), and a detailed treatment history including a review of medical records. Regular monitoring for safety and effectiveness is essential including regular checking of functional improvement and progress towards the pretreatment goals. Ineffective or unsafe opioid therapy should be promptly tapered or stopped. In Korea until now, there are no adequate recommendations for opioid prescription in the management of chronic noncancer pain. A Korean guideline or task force team should be established to provide personalized treatment for carefully selected and monitored patients.
Advisory Committees ; Analgesics, Opioid ; Behavior, Addictive ; Chronic Pain ; Humans ; Korea ; Medical Records ; Prescriptions ; Quality of Life

PURPOSE: Joubert syndrome presents neonatal respiratory abnormalities and other clinical manifestations. Pathologically the patients show hypoplasia or agenesis of cerebellar vermis and other intracranial anomalies. Our purpose is to evaluate the clinical manifestations and MR findings of Joubert syndrome. MATERIALS AND METHODS: Among the patients presenting with clinical stigmata of Joubert syndrome and agenesis of vermis on MR imaging, eight patients who did not satisfied the criteria of Dandy-Walker malformation, tectocerebellar dysraphia and rhombencephalosynapsis were selected. MR findings and clinical manifestation were analyzed. RESULTS: On MR imaging, agenesis of the cerebellar vermis (all cases), hypoplasia of the cerebellar peduncle (6cases), fourth ventricular contour deformity(6cases), tentorial elevation (4cases), deformity of the lateral ventricles (4cases), dysgenesis of the straight sinus (3cases) were demonstrated. Other findings were abnormalities of corpus callosum (3cases), falx anomalies (3 cases), occipital encephalomeningocele (2 cases) and fluid collection in posterior cranial fossa (2cases). Clinical manifestations were developmental delay (5cases), abnormal eyeball movement (3cases), hypotonia (2 cases), neonatal rerspiratoy abnormality (2cases), etc. CONCLUSION: Joubert syndrome showed various clinical manifestations and intracranial anomalies. MR imaging is an useful modality in detection of the cerebellar vermian agenesis and other anomalies of the patients.
Christianity ; Congenital Abnormalities ; Corpus Callosum ; Cranial Fossa, Posterior ; Dandy-Walker Syndrome ; Humans ; Lateral Ventricles ; Magnetic Resonance Imaging* ; Muscle Hypotonia

PURPOSE: To explain hypothesis that there are two types of human retinal capillary pathways. One is simple type and the other is complex type. The former plays a role in blood flow regulation and the latter does capillary function itself. METHODS: We measured the length, tortousity, and flow velocity of human retinal capillaries using Fluorescein Leukocyte Angiography (FLA) with a Scanning Laser Ophthalmoscope (SLO) on two healthy adult male volunteers. We studied distribution and pathways of human retinal capillaries on the posterior pole. RESULTS: The lengths of capillaries were distributed with two peak incidence. One was 70 microgram and the other 240 microgram. There was no relationship between capillary length and tortousity. The correlation between capillary length and leukocyte velocity showed that the shorter capillary group has a wide range of velocity but the longer group has a narrow range of velocity. CONCLUSIONS: Two types of retinal capillary pathways exist on human retina. Compared with two types of capillaries on the cat retina described by Ben-nun et al, we found that the shorter capillary type plays a role in blood flow regulation and the longer type in capillary function itself.
Adult ; Angiography* ; Animals ; Capillaries* ; Cats ; Fluorescein* ; Humans* ; Incidence ; Leukocytes* ; Male ; Ophthalmoscopes ; Retina ; Retinaldehyde* ; Volunteers

OBJECTIVE: To compare the safety and efficacy of intravaginal misoprostol versus oral dinoprostone for labor induction at term. METHODS: One hundred of patients at term were randomized to receive either 50microgram of misoprostol vaginally every 4 hours or dinoprostone 0.5mg orally every 1 hour for the maximum of six doses. Intravenous infusion of oxytocin was administered under such circumferences as the patient did not go into active labor after maximum dose, SROM was developed without an adequate contraction pattern, or the patient had arrest of dilatation(no change in cervical dilatation for 2 hours). We compared the frequency of oxytocin augmentation, administration to delivery interval, vaginal delivery rate within 12 hours and 24 hours, intrapartum complications, induction failure, mode of delivery, neonatal outcomes, and maternal complications between two groups. RESULTS: The average interval from administration to delivery was shorter in the misoprostol group(739.4+/-372.4min vs 1087.7+/-765.1min, p<0.05), but the interval from administration to vaginal delivery of each group was similar(724.3+/-375.4min vs 800.3+/-697.0min). Regarding the frequency of vaginal delivery within 24 hours, however, misoprostol group was higher than dinoprostone group(88% vs 56%, p<0.001). And oxytocin augmentation of labor occurred less commonly in misoprostol group than in dinoprostone group(20% vs 76%, p<0.05). Any statistically significant difference in intrapartum complications, mode of delivery, and neonatal or maternal adverse outcome was not appeared between these two group. CONCLUSION: Vaginal misoprostol is as effective and safe as oral dinoprostone for cervical ripening and induction of labor at term. In addition, vaginal misoprostol contributes the curtailment of labor induction expenditure due to its moderate price; misoprostol costs 100 won per 50microgram.
Cervical Ripening ; Dinoprostone* ; Female ; Health Expenditures ; Humans ; Infusions, Intravenous ; Labor Stage, First ; Misoprostol* ; Oxytocin ; Pregnancy