Extramammary Paget disease (EMPD) is a rare disease, especially in Asian populations. Surgical resection is considered the primary treatment option. Recently, radiotherapy has been suggested as an EMPD treatment, either as an alternative to surgical resection or in combination with surgical resection. This report reviewed a patient with EMPD who was treated with wide excision of the EMPD site followed by radiotherapy for remaining gross lymph node metastases. The aim of this report was to determine the optimal treatment for advanced EMPD.
Asian Continental Ancestry Group ; Drug Therapy ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Paget Disease, Extramammary* ; Radiotherapy* ; Rare Diseases

We performed dual color fluorescence in situ hybridization (FISH) for the bcr/abl fusion in CML using the peripheral blood smears without destruction of cell morphology to determine the bcr/abl fusion. Two patients of CML, one patient in accelerated phase and one patient in chronic phase, were selected. The blood smears were fixed in absolute methanol. FISH was performed with the Mbcr/abl translocation DNA probe mixture and the slides were stained with Wright's stain after FISH. The blood smears of both cases revealed distinct signals without destruction of cellular morphology. The normoblasts and lymphocytes revealed beautiful fused bcr/abl signals as well as granulocytes in both cases. The results provide a novel finding that the normoblasts and lymphocytes in CML are also neoplastic clonal cells which has not been demonstrated with a single-cell approach before.
DNA ; Erythroblasts* ; Fluorescence* ; Granulocytes ; Humans ; In Situ Hybridization ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Lymphocytes* ; Methanol

BACKGROUND: The incidence of fungal urinary tract infections has increased in the immunocompromized patients. We analyzed urine culture results of St. Mary's Hospital during 28 month period between October 1993 and January 1996 to evaluate the frequency of yeast isolates and to survey the distribution of departments from where yeasts isolated. METHODS: We performed a retrospective analysis of urine culture results. Yeasts were identified by the examination of germ tube production in human serum at 37degrees C and API2OC (BioMerieux, France) yeast strip. RESULT: A total of 1,387 urine cultures were reviewed, of which 164 (11.8%) were isolated as fungi. Candida albicans occurred in 36.5% of the total yeast isolates, C. tropicalis in 35.3%, C. glabrata in 10.9% and Trichosporon beigelii in 0.6%. The incidence of urinary fungal infection increased in 1995 (13.0%) than 1994 (9.1%) (P=0.047). Fifty two percents (85/164) of urinary fungi were isolated from patients in Neurosurgery (NS), where isolation of C. tropicalis was significantly more increased than other departments. In four patients, candiduria progressed to candidemia, which were caused by C. albicans (three patients) and C. glabrata (1 patient). CONCLUSIONS: The isolation rate of yeast species was different in NS and non-NS department. The frequency of isolation of C. albicans increased in non-NS department than NS department, while the frequency of isolation of C. tropicalis increased in NS department than non-NS department. The most common organism was C. albicans and department was Neurosurgery.
Candida albicans ; Candidemia ; Fungemia ; Fungi ; Humans ; Incidence ; Neurosurgery ; Retrospective Studies* ; Trichosporon ; Urinary Tract Infections ; Yeasts

Ganglion is the most common soft tissue tumor which occurs mainly in hand, but it can also occur in any part of the extremity. It is not always necessary to excise the tumor because it seldom cause symptoms severe enough to take operation. We reviewed the patients with ganglion treated surgically. Exculding the cases which were operated under local anesthesia and Bakers cyst, 42 patients were treated surgically from 1983 to 1992. Females were 33, and males 9. Average age at the time of operation, was 40 years (16 to 67). All the cases were analysed retrospectively in terms of surgical indication, anatomical location, size, duration of symptoms, relationship between recurrence and size, and complication. The average duration of follow-up was 1 year 7 months, ranging from 1 year to 4 years. The causes of operation were, cosmetic problem in 6996 (29 cases); pain in 19% (8 cases); and both comesis and pain in 12% (5 cases). The locations were, wrist in 4696 (19 cases); knee 29% (12 cases); foot 12% (5 cases); hand 7% (3 cases); forearm 2% (1 case); ankle 2% (1 case); and elbow 296 (1 case). The size of mass was less than 2.5 cm in 30 cases (71%), and more than 2.5 cm in 12 (29%). (Total average of size was 2.4 cm)The average duration of symptoms were 28 months (1 month 15 years). The recurrence was found in 7 cases: 3 of them (10%) occurred among 30 cases the diameter of which was less than 2.5 cm, and other four (33%) occurred among 12 cases, larger than 2.5 cm. There were no other complications.
Anesthesia, Local ; Ankle ; Elbow ; Extremities ; Female ; Follow-Up Studies ; Foot ; Forearm ; Ganglion Cysts ; Hand ; Humans ; Knee ; Male ; Recurrence ; Retrospective Studies ; Wrist

PURPOSE: Ubiqutin-proteasome-mediated proteolysis is an important pathway of nonlysosomal protein degradation, which controls the timed destruction of cellular regulatory proteins of the p21, p27, p53 gene (p53), Retinoblastoma gene (Rb), E2F-1, E2F-4 and cyclin etc. The deubiqutination (DUB) gene prevents ubiquitin-proteasome- mediated proteolysis by removal of ubiquitin from ubiqutinated proteins. We investigated the role of the DUB gene (DFFRY or DFFRX) in the progression of a bladder tumor associated with Rb and p53, which follows ubiquitin-proteasome-mediated proteolysis. MATERIALS AND METHODS: RT4 (bladder pailloma cell line), 5637 (superficial bladder transitional cell carcinoma cell line), and HT1376 (invasive bladder transitional cell carcinoma cell line) were cultured. mRNA was extracted from each cell line by the Poly-A tract mRNA isolation system. Relative quantitative RT-PCR (reverse transcription-polymerase chain reaction) for the DUB gene (DFFRY or DFFRX) was performed. Northern blotting for the DUB gene, p53 and Rb were performed. Proteins were harvested at 80% confluence from each cell line. Western blotting for the p53 and Rb were performed. RESULTS: The relative quantitative RT-PCR for the DUB gene showed it to be expressed most strongly in RT4, and most weakly in HT1376, which were identical to the findings of the Northern blotting. The p53 was expressed at similar levels on the Northern blots of all three cell lines, whereas on Western blotting, it was expressed most strongly in 5637, most weakly in RT4, and moderately in HT1376. The Rb was expressed only in RT4 on Northern and Western blotting. CONCLUSIONS: The DUB gene might be related to the inhibition of the progression of bladder tumors associated with Rb and p53, which follows ubiquitin-proteasome- mediated proteolysis.
Blotting, Northern ; Blotting, Western ; Carcinoma, Transitional Cell ; Cell Line ; Cyclins ; Genes, p53 ; Genes, Retinoblastoma ; Proteolysis ; RNA, Messenger ; Ubiquitin ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Lipoma arborescens is a rare intra articular lesion consisting of a villous lipomatous proliferation of the synovial lining and occurs mainly in the knee joint. It is mostly found in older patients with joint trauma, meniscal lesions or chronic synovitis. The authors describe one case of a 29-year-old male with multiple lipomas in the right knee joint who has a history of joint trauma. He had joint effusion, pain, giving way and restricted terminal extension of the right knee. Histology and gross findings are consistent with the lipoma arborescens. After arthroscopic excision of the masses, symptom was relieved completely and the patient had gained full range of motion of the right knee joint.
Adult ; Humans ; Joints ; Knee Joint* ; Knee* ; Lipoma* ; Male ; Range of Motion, Articular ; Synovitis

No abstract available.
Mandibular Condyle

PURPOSE: Speech and language development is an useful indicator of the overall development of children. Since speech and language delay can lead to emotional, social, and learning problems, the early intervention is very important. We examined 137 children with speech or language problems including 22 children of functional articulation disorders of their clinical features. METHODS: 137 children with speech or language problems in the Department of Pediatrics, Uijeongbu St. Mary's Hospital from January 2004 to December 2007 were reviewed for sex, age, developmental and language test findings retrospectively. Especially, in 22 children diagnosed with functional articulation disorders, articulation test findings were analyzed. RESULTS: 1) The mean age of 137 children was 46.8 months, the ratio of male to female was 2.5:1, and the most frequent age group was 24-35 months. The chief complaints included language delay(67.2%), mispronouncing speech sound(27%), stuttering(3.6%), learning disability(2.2%). The diagnoses of them were developmental language disorder(70.8%), functional articulation disorders(16.1%), mental retardation(5.8%), stuttering(2.9%), tongue tie(0.7%), normal language pattern(3.6%). 2) The mean age of 22 patients with functional articulation disorders was 63 months, the ratio of male to female was 1.4:1, and the most frequent age group was 60-71 months. The mean percentage of consonant correct of Picture Consonant Articulation Test was higher in older age group. In the types of phonetic errors substitutions were most common. Distortions, omissions, and additions were followed in the order of frequency. Substitutions and distortions were common in word initial and medial but omissions in word final. It is appeared that the patients had the difficulties in pronouncing alveolar fricative, palatal affricate, liquid, and velar plosive which mature lately in older children. Mainly palatal affricate, alveolar fricative, and velar plosive were substituted for alveolar plosive and the liquid and alveolar fricative were distorted as gliding. CONCLUSION: Categorizing the cause of language and speech delay is essential to make an adequate treatment plans and decrease the late complications. The future studies for the early screening, more suitable tests in Korean, treatment guidelines or prognosis are needed.
Articulation Disorders ; Child ; Early Intervention (Education) ; Female ; Humans ; Language Development ; Language Development Disorders ; Language Tests ; Learning ; Male ; Mass Screening ; Pediatrics ; Prognosis ; Retrospective Studies ; Tongue

No abstract available.
Cardiotocography* ; Meconium* ; Pregnancy*

BACKGROUND: Skin injuries, such as lacerations due to trauma, are relatively common, and patients are very concerned about the resulting scars. Recently, the use of ablative and non-ablative lasers based on the fractional approach has been used to treat scars. In this study, the authors demonstrated the efficacy and safety of ablative fractional resurfacing (AFR) for traumatic scars using a 2,940-nm erbium: yttrium-aluminum-garnet (Er:YAG) laser for traumatic scars after primary repair during the early posttraumatic period. METHODS: Twelve patients with fifteen scars were enrolled. All had a history of facial laceration and primary repair by suturing on the day of trauma. Laser therapy was initiated at least 4 weeks after the primary repair. Each patient was treated four times at 1-month intervals with a fractional ablative 2,940-nm Er:YAG laser using the same parameters. Post-treatment evaluations were performed 1 month after the fourth treatment session. RESULTS: All 12 patients completed the study. After ablative fractional laser treatment, all treated portions of the scars showed improvements, as demonstrated by the Vancouver Scar Scale and the overall cosmetic scale as evaluated by 10 independent physicians, 10 independent non-physicians, and the patients themselves. CONCLUSIONS: This study shows that ablative fractional Er:YAG laser treatment of scars reduces scars fairly according to both objective results and patient satisfaction rates. The authors suggest that early scar treatment using AFR can be one adjuvant scar management method for improving the quality of life of patients with traumatic scars.
Aluminum ; Cicatrix ; Cosmetics ; Humans ; Lacerations ; Laser Therapy ; Lasers, Solid-State ; Patient Satisfaction ; Quality of Life ; Skin ; Yttrium