Benign symmetric lipomatosis is characterised by diffuse symmetric deposits of adipose tissue, predominantly on the neck, shoulder, back and upper extremities. We report a case of benign symmetric lipomatosis in a 61-year-old-man, which was first noted one year previously. It began growing rapidly about 3 months ago and was associated with alcoholic liver disease. Histopathological findings showed that the reticular dermis had been replaced by normal uncapsulated mature fat cells that were slightly increased in number in the fibrous connective tissue. He was treated with theophylline 300mg/day for two months.
Adipocytes ; Adipose Tissue ; Connective Tissue ; Dermis ; Lipomatosis* ; Liver Diseases, Alcoholic ; Neck ; Shoulder ; Theophylline ; Upper Extremity

Eosinophilic pustular folliculitis (EPF) or Ofuji's disease is a cutaneous inflammatory follicular disorder of unknown etiology. It usually affects adults and is clinically characterized by recurrent crops of sterile and pruritic papulopustules grouped in an annular or polycyclic pattern involving preferably the seborrheic areas. Histopathologic examination reveals eosinophilic follicular abscesses. We report a case of eosinophilic pustular folliculitis in a 21-year-old man who showed pruritic erythematous plaques with follicular papules and pustules on the face, back, upper arms, and thigh. Laboratory test showed blood eosinophilia and histopathologic study revealed numerous eosinophilic infiltration in and around the hair follicle. The patient relatively responded well to dapsone and topical steroid.
Abscess ; Adult ; Arm ; Dapsone ; Eosinophilia ; Eosinophils ; Folliculitis* ; Hair Follicle ; Humans ; Thigh ; Young Adult

Recently, there were several epidemiological studies demonstrating that reproductive and menstrual factors are associated with the risk of colorectal cancer in women. A hospital-based case-control study has been conducted to investigate whether the histories of childbearing, menstruation, and breast-feeding are associated with colorectal cancer risk. The cases were consecutively diagnosed, histologically confirmed, incident patients with cancers of the colon and rectum aged 30-79 who were admitted to three tertiary hospitals in Seoul, Korea between March 1995 and August 1997. Controls were selected in the same hospitals as the cases during the same periods. Finally, a total of 151 cases and 110 controls were selected and interviewed on their reproductive and menstrual characteristics using a structured questionnaire. Earlier age at first birth appears to be related with increased risk of colorectal cancer (multivariate relative risk[RR] of colorectal cancer for <21 vs 25 > or = 2.33; 95% confidence interval[CI] 1.1-5.1, p for trend 0.03). Compared with women who experienced menarche at age 16 or older, women whose menarche occurred at age 14 or less appeared at significantly higher risk of rectal cancer(multivariate RR of colorectal cancer for < or = 14 vs > or =16 = 2.26; 95% CI 1.0-3.4, p for trend 0.03). We found no associations for parity, incomplete pregnancies, menopause, use of oral contraceptives, and hormone replacement therapy. These findings suggest that events of reproductive life may have a bearing on female subsequent risk of colon and rectal cancer
Birth Order ; Case-Control Studies ; Colon* ; Colonic Neoplasms ; Colorectal Neoplasms ; Contraceptives, Oral ; Epidemiologic Studies ; Female ; Hormone Replacement Therapy ; Humans ; Korea ; Menarche ; Menopause ; Menstruation ; Parity ; Pregnancy ; Rectal Neoplasms* ; Rectum ; Seoul ; Tertiary Care Centers ; Surveys and Questionnaires

Intimal hyperplasia is the universal response to endothelial denudation and occur after a variety of vascular procedures. In a proportion of cases the smooth muscle cell proliferation may lead to stenosis of the blood vessels. The precise pathophysiologic pathways leading to the development of intimal hyperplasia have not been characterized. This study was undertaken to examine the effect of drugs on the development of proliferative intimal lesion after experimental arterial injury in a rat model. Aortic denudation was performed by balloon catheter in 20 rats. The rats were divided into three group: 1) control group, normal feeding, 2) heparin group, heparin 1200 U/kg/day subcutaneously, 3) ACE inhibitor group, ramipril 10 mg/kg/day subcutaneously. The rat were sacrificed and aortas were perfused and fixed at 21 days after denudation. Microscopic findings were observed and cross sectional intima-to-media ratio were calculated. To evaluate the effects of various drugs on gene expression of aortic smooth muscle cell, semiquantitative reverse transcription polymerase chain reaction(RT-PCR) was done. After reverse transcription, PCR was done to evaluate the change of gene expression in platelet-derived growth factor(PDGF-B), transforming growth factor-beta(TGF-beta). The results were as follows: 1) Normal aorta with intima to media ratio was 0.38+/-0.06. 2) Marked intimal thickening with a mean I-M ratio of 1.35+/-0.45 in the control group. 3) In contrast, the I-M ratio in the heparin group was 0.54+/-0.23, ramipril group was 0.71+/-0.27(P<0.05). 4) mRNA expression of PDGF-B did show significantly increased in control group compared to normal group(0.97+/-0.34 vs 1.60+/-0.21), treatment with heparin and ACE inhibitor shows a tendency to downregulation of mRNA expression to control group(1.04+/-0.31 in heparin group, 1.23+/-0.41 in ACE inhibitor treated group). 5) mRNA expression of TGF-beta was decreased in control group compared to normal group(2.80+/-0.74 vs 1.97+/ 0.24), treatment with heparin and ACE inhibitor shows a tendency to downregulation of mRNA expression to control group(1.36+/-0.40 in heparin group, 1.65+/- 0.45 in ACE inhibitor treated group). In summary, this study shows that repair in even the simplest model of vascular injury is an exceedingly complex, including upregulation of PDGF gene expression. Treatment with heparin and ACE inhibitor revealed a downregulation of each mRAN expression to control group. There results suggest that dysregulation of there gene expression may be involved in the pathogenesis of intimal hyperplasia after endothelial injury.
Animals ; Aorta ; Blood Vessels ; Catheters ; Constriction, Pathologic ; Down-Regulation ; Gene Expression ; Heparin ; Hyperplasia ; Models, Animal ; Myocytes, Smooth Muscle ; Polymerase Chain Reaction ; Ramipril ; Rats ; Reverse Transcription ; RNA, Messenger ; Transforming Growth Factor beta ; Up-Regulation ; Vascular System Injuries

OBJECTIVE: To evaluate the causes, methods of delivery, and maternal complications in cases of fetal death in utero(FDIU) at Samsung Medical Center. METHODS: There were 92 cases of FDIU among 25,195 deliveries at Samsung Medical Center during 7 years from 1994 to 2001. In these cases, perinatal autopsy and placental biopsy was performed in 35 and 71 cases, respectively. All the clinical informations were obtained by reviewing medical records retrospectively. RESULTS: The overall incidence of FDIU was 0.37%. Most of FDIU occurred in 25 to 29 years old group(43.5%). Recurrence rate of FDIU was 3.3%. Most of FDIU were low birth weight(79.3%) and preterm(79.6%). The modes of delivery were induced labor(68.5%), laparotomy(18.5%), and the spontaneous delivery(13.0%). The causes of FDIU were chorioamnionitis(15.2%), placental abruption(14.1%), severe preeclampsia(11.9%), congenital and chromosomal anomaly(6.5%), but it was unexplained in 27.2%. There were 25 cases with maternal complications and the most common complications were intra-/postpartum fever(18.5%), postpartum hemorrhage(8.7%) and DIC(8.7%). CONCLUSION: The causes of FDIU could not be determined in only about 1/4 cases at Samsung Medical Center. Since FDIU recurred in 3.3%, thorough studies including perinatal autopsy and chromosomal study must be made on stillborn infants and placenta to determine the recurrent causes.
Adult ; Autopsy ; Biopsy ; Fetal Death* ; Humans ; Incidence ; Infant ; Medical Records ; Parturition ; Placenta ; Postpartum Period ; Recurrence ; Retrospective Studies

PURPOSE: Pancreatic cancer is a devastating disease and the complete resection is difficult due to its the aggressive histologic behavior. Among the possible treatments for the unresectable pancreatic cancer, intraoperative radiation therapy (IORT) has the several advantages. But the impacts of the IORT on survival and local control are not clear. We analyzed the effects of the IORT on pain control, survival duration and local control in patients with unresectable pancreatic cancer. METHODS: We reviewed 6 years of the medical records of 94 patients who had undergone operations involving the pancreatic adenocarcinoma (33 patient IORTs, 39 palliative surgerys only and 22 curative resections involving a curative resection). The clinicopathologic factors and outcomes of the 33 patients treated with the IORT were compared with those of the palliative surgery groups. RESULTS: The age and sex distribution and tumor stage were same for the two groups. The average tumor size in the IORT group was larger than those of the palliative surgery group. The preoperative serum CA19-9 level in the IORT group was higher than the other group. The most common reason for unresectability in the IORT group was local invasion to the adjacent organs including of the great vessels. On the contrary, distant metastasis was a more common cause unresectability in the palliative surgery group. The postoperative complications and operative times were similar in both groups. Pain relief after treatment was observed in 12 cases of the 26 patients in the IORT group, and 5 of 29 patients in the palliative surgery group (P<0.05). The cases of minor and partial remission were more common in the IORT group than the palliative surgery group. However, the survival rate of the IORT group was no better than the palliative surgery group. CONCLUSION: This study suggests that IORT may have an important palliative role especially in ameliorating visceral pain in patients with unresectable pancreatic cancer. However, IORT appears to have no significant effect on overall survival.
Adenocarcinoma ; Humans ; Medical Records ; Neoplasm Metastasis ; Operative Time ; Palliative Care ; Pancreatic Neoplasms* ; Postoperative Complications ; Sex Distribution ; Survival Rate ; Visceral Pain

OBJECTIVE: To evaluate the status of cone margins and severity of cervical neoplasia as predictors of residual lesions in the remaining cervices, and provide guideline for further treatment or close follow-up. METHOD: We performed a 3-year retrospective study and reviewed 95 patients who had undergone cervical conization followed by subsequent hysterectomy. RESULT: The prevalence rates of positive cone margins were 33, 50, 44, 71 and 88% respectively in patients with cervical intraepithelial neoplasia(CIN)II, CIN III, cervical cancer stage Ia1, Ia2 and Ib1. The prevalence rates of positive residual lesions in postcone hy-sterectomy specimens were 0, 31, 19, 29 and 59% respectively in patient with CIN II, CIN III, cervical cancer Ia1, Ia2 and Ib1. Residual lesions were significantly more frequently found in patients with positive cone margins(51%) than in those with negative margins(4.8%). Positive predictive values of margin status for the presence of residual lesions were 0, 56, 36, 40 and 67% respectively. Negative predictive values of margin status for the absence of residual lesions were 100, 94, 94, 100 and 100% respectively. CONCLUSIONS: (1) The prevalence of positive cone margin and residual lesion increased with more severe cervical neoplasia. (2) Positive cone margins had significantly higher risks of residual lesion than negative cone margins. (3) Positive cone margin does not invariably indicate the presence of residual lesion. (4) Negative cone margin does not ensure the absence of residual lesion. Subsequent hysterectomy may be reserved for the patient with CIN III or cervix cancer having positive cone margin or invasive lesion, or the patient who is not reliable for continuous follow-up.
Conization* ; Follow-Up Studies ; Humans ; Hysterectomy ; Prevalence ; Retrospective Studies ; Uterine Cervical Neoplasms

The purpose of this study was to evaluate the reliability of 6-axis model surgery simulator (6AMSS) for orthognathic surgery. A rectangular parallelepiped plastic block was assembled to model-mounting plate of 6AMSS. Left-right (X), anterior-posterior (Y), up-down (Z) translation and pitching (empty set X), rolling (empty set Y) and yawing (empty set Z) rotation was planned and performed using 6AMSS. The actual translation and rotation were measured with dial gauge and precisional protractor, respectively. Comparison between the planned and actual movements of plastic block for each variable were made using paired t- test. Statistical analysis for X, Y, Z, empty set X, empty set Y and empty set Z movement have shown no significant differences between planned and actual movement (P > 0.05). This indicate that model surgery performed with the aid of the 6AMSS is accurate in 3D translation and rotation. The 6AMSS is practically useful for accurate fabrication of surgical splint for orthognathic surgery.
Orthognathic Surgery ; Plastics ; Splints

PURPOSE: Smoking and high-risk occupation are known to be the risk factors of bladder cancer. The carcinogen-metabolizing enzymes in human body such as GSTM1 and GSTT1 have also been regarded as risk factors in many cancers because the activities of those enzymes play a role in metabolizing the carcinogen. A case control study was conducted to evaluate the role of known risk factors (smoking and high-risk occupational history) and the genetic polymorphism of GSTM1 and GSIT1 in blader carcinogenesis in Korean men. MATERIALS AND METHODS: The pathologically proven bladder cancer cases were selected from three hospitals in Seoul (Seoul National University Hospital, Boramae Hospital, and Sam-Sung Medical Center) and the patients older than 40 years of age with the nonmalig nant urinary tract diseases were selected as the controls from the same hospitals. The informations of demographical characteristics, smoking, and occupational history was obtained by the trained interviewer and the genetic polymorphisms of GSTM1 and GSTT1 were assayed by multiplex PCR. The statistical analysis was performed by multiple logistic regression. RESULTS: Neither smoking nor high-risk occupational history was statistically significant risk factor of the bladder cancer. However, the GSTM1 null-type showed borderline significance (OR 1.49; 95% CI 0.92-2.41) and both GSTM1 and GSlT1 null-type was statistically significant risk factor of bladder cancer when compared with both normal genotype (OR-2.43; 95% CI 1.13-5.24) after age and smoking history were adjusted. CONCLUSION: The concurrent null-type of GSTM1 and GSTT1 increases the risk of bladder cancer in Korean men.
Carcinogenesis ; Case-Control Studies ; Genotype ; Glutathione Transferase ; Human Body ; Humans ; Logistic Models ; Male ; Multiplex Polymerase Chain Reaction ; Occupations ; Polymorphism, Genetic* ; Risk Factors ; Seoul ; Smoke ; Smoking ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urologic Diseases

Two cases are herein reported involving patients with ectopic gallstones which were discharged into the stomach and duodenum through a cholecystoduodenal fistula and successfully removed by endoscopic therapy. In the first case, a 75-year-old man was admitted with epigastric pain. Simple abdomen film demonstrated a round laminated calcification and air biliarygram in the RUQ. Endoscopic examination revealed a fistula on the posterior wall of the duodenal bulb and a brown stone (about 5 cm in diameter) was found in the second portion of the duodenum, It was demolished through endoscopic electrohydraulic lithotripsy (EEH1) and discharged with the stool. In the second case, a 55-year-old man was admitted with epigastric pain. A CT scan revealed an ovoid laminated calcification in the dependent portion of the stomach. Endoscopic examination revealed a fistula on the anterior wa11 of' the duodenal bulb and a black pigmented stone (about 2.5 cm in diameter) was found in the stomach. This stone was removed orally by an endoscopic snare. These patients were discharged and remained asymptomatic.
Abdomen ; Aged ; Duodenum ; Fistula ; Gallstones* ; Humans ; Intestinal Fistula ; Lithotripsy ; Middle Aged ; SNARE Proteins ; Stomach ; Tomography, X-Ray Computed