Few cases of ichthyosis bullosa of Siemens(IBS) have been reported since 1939, as a distinct entity from bullous congenital ichthyosiform erythroderma(BCIE). IBS can be differentiated from BCIE by the absence of congenital erythroderma and a different distribution of involved skin area. It's characteristic features include blistering, superficial erosion or moulting of the outer skin. Histological features are tonofilaments aggregation confined to the granular and upper spinous layer of the epidermis. However, in BCIE these findings are present in the whole suprabasal compartment. The original reports of Siemens and cases from other authors showed an autosomal dominant inheritance. Our patient developed IBS sporadically without a familial background.
Blister ; Dermatitis, Exfoliative ; Epidermis ; Humans ; Ichthyosis Bullosa of Siemens* ; Ichthyosis* ; Intermediate Filaments ; Molting ; Skin ; Wills

PURPOSE: The staging of bladder carcinoma is a major determinant of operative management. CT of bladder carcinoma has been widely used to diagnose external extension (pT3b and over), but tumors confined to the bladder wall (from pT1 to pT3a) are poorly delineated. The authors describe CT findings of the superficial bladder carcinoma (below T1, stage A) in thin section CT with air insufflation technique (air insufflation-CT) to facilitate early detection and to aid correct staging of the superficial bladder carcinoma. MATERIALS AND METHODS: The materials consisted of proved 24 cases (1'9 patients, single tumor: 16 patients, multiple tumors :3 patients) of stage A bladder carcinomas. Air insufflation-CT was performed by the infusion of approximately 200 mL of air into the bladder via a Foley catheter. After the routine pelvic CT, bladder tumors were re-scanned with 1.5 to 5 mm thickness and intervals. RESULTS: The superficial bladder carcinomas were detected as nodular(5 cases, 20.8%), papillary(15 cases, 62.5%), pyramidal(2 cases, 8.3%), and domed(2 cases, 8.3%) forms on air insufflation CT. These tumors were classified into three types according to the size of the tumoral neck:type I(pedundulated polypold tumor:4 cases, 16.6%), type II(polypid tumor with short neck :13 cases, 54.2%), and type Ill(sessile tumor :7 cases, 29. 2%). The mean size(tumoral width x height x base o, neck/stalk) of the tumors was 22 x 20 x 16mm. The average tumoral sizes according to each type of the superficial tumors were type 1:22 x 25 x 6mm, type 11:23 x 22 x 18mm, and type III :18 x 15 x 18mm. The mean width of the type I--II tumoral necks was 15mm. The mean length of the type I tumoral neck(pedicle) was 2.5mm. Papillary fronds of the tumors were seen in 10 cases(41.7%) of 24 superficial tumors. Outer margin of the involved bladder wall was smooth in all cases. CONCLUSION: Thin-sectin CT with air insufflation technique for bladder carcinoma was useful in tumoral demonstration, and characteristics of the superficial bladder carcinomas were small polypold tumors had a short neck mostly and smooth outer wall of the involved bladder wall.
Catheters ; Humans ; Insufflation* ; Neck ; Urinary Bladder Neoplasms ; Urinary Bladder*

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

PURPOSE: The aim of this study is to explore the individual traits needed for the successful performance of a doctor's duties as well as to establish primary criteria for the Medical Education Eligibility Test. METHODS: This study conducted qualitatively by interviewing 43 persons: medical school professors, residents, and medical reporters. The analysis of data were applied a content analysis. RESULTS: 1) The important intelligent abilities revealed were problem solving, verbal expression, and memory. 2) The personality traits included sincerity, sociability, respectability, gentleness, and reflective thinking. 3) The biology, chemistry, and physics were important in the natural science background knowledge, and 4) linguistics, philosophy, and social science were important in human and social science background knowledge. CONCLUSION: The medical aptitude could be constructed intelligent ability, personality trits, and background knowledges, and include specific aspects depended on Korean context.
Aptitude* ; Biology ; Chemistry ; Education, Medical ; Humans ; Linguistics ; Memory ; Natural Science Disciplines ; Philosophy ; Problem Solving ; Schools, Medical ; Social Sciences ; Thinking

Many factors have been identified which to affect the rate of propagation of impulses along motor fibers. These include temperature changes around the nerve, diameter of the axon, degree of myelinization, age of infants, and local environment of the nerve. Motor nerve conduction velocity and Hoffman's reflex latency have been used to assess the degree of myelination and maturation of the nervous system. The conduction velocities in infants of a short gestational age are significantly lower than those of the fullterm infants. The extrauterine myelination and maturation might increase nerve conduction velocity. We measure the median motor nerve conduction velocity, compound muscle action potentials amplitude and H-reflex latency of premature infants to determine the neurological maturation after birth. The premature infants with gestational age above 37 weeks have a significantly higher conduction velocity and a shorter H-reflex latency than those of gestational age below 37 weeks. The premature infants with weight over 2.5 kg have a significantly higher conduction velocity, larger compound muscle action potentials amplitude and a shorter H-reflex latency than those of weight below 2.5 kg. And there is a statistically significant negative correlation of the H-reflex latency with the postmenstrual age. The determination of motor nerve conduction velocities and H-reflex latencies seem to be an additional method in assessing the degree of maturity in infants after birth.
Action Potentials ; Axons ; Gestational Age ; H-Reflex* ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Median Nerve ; Myelin Sheath ; Nervous System ; Neural Conduction* ; Parturition ; Reflex, Abnormal

PURPOSE: Measurement of testicular volume is useful for the evaluation of puberty and testicular development in boys. Four mililiter of testicular volume means Tanner stage 2, the beginning of puberty, and its ethnic differences were reported. However, there is no reference value for Korean children. We tried to establish the standard testicular volume for Korean boys. METHODS: The subjects were selected among the children who visited the out-patient clinic of Kangdong Sacred Heart Hospital and Korea Cancer Center Hospital for the evaluation of growth from 2003 to 2008. Three hundred seventy two healthy Korean boys, 3 to 17 years of age, were included. We excluded the patients who were diagnosed as precocious puberty, delayed puberty, hypopituitarism, adrenal disorder and other endocrinologic disorder. The testicular volume was determined with Prader orchidometer. Clinical data were collected from patient's chart retrospectively. RESULTS: Right and left testicular volumes were 3.65 +/- 1.82 mL and 3.55 +/- 1.80 mL at 10 (10.0 - 10.9) year of age (n = 53), 6.17 +/- 3.60 mL and 6.13 +/- 3.69 mL at 11 (11.0 - 11.9) year of age (n = 52), respectively. There was no significant difference between right and left testicular volumes. CONCLUSION: The time when testicular volume reached 4 mL seemed to be not changed than previous Korean data. However, further study will be required to determine the secular trend of pubertal timing in Korean boys.
Child ; Heart ; Humans ; Hypopituitarism ; Korea ; Outpatients ; Puberty ; Puberty, Delayed ; Puberty, Precocious ; Reference Values ; Retrospective Studies

No abstract available.
Perfusion* ; Stomach Neoplasms* ; Stomach*

A 42-year-old male was hospitalized with abdominal pain, dyspnea, and turbid peritoneal fluid. He was diagnosed with hypertension, diabetes and started continuous ambulatory peritoneal dialysis (CAPD) 11 months ago. He was treated with intraperitoneal cefazolin and ceftazidime, and then white blood cell counts of dialysate decreased. Incidentally, liver abscess was found in chest CT performed for the evaluation of dyspnea, and patient was febrile persistently. So percutaneous abscess drainage was done by pigtail catheter. We changed the antibiotics to ceftriaxone and metronidazole, and hemodialysis was started. Klebsiella pneumoniae was cultured from peritoneal fluid and blood simultaneously. We concluded that liver abscess is a primary cause of CAPD peritonitis.
Abdominal Pain ; Abscess ; Adult ; Anti-Bacterial Agents ; Ascitic Fluid ; Catheters ; Cefazolin ; Ceftazidime ; Ceftriaxone ; Drainage ; Dyspnea ; Humans ; Hypertension ; Klebsiella ; Klebsiella pneumoniae ; Leukocyte Count ; Liver ; Liver Abscess ; Male ; Metronidazole ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Renal Dialysis ; Thorax

The appearance of a tumor in the chest wall is rare compared to that in any other part of the body. It can be classified into benign and malignant types and can be located in the rib, clavicle, sternum, cartilage and soft tissues. Tumors that are metastatic are commonly located in the lung, breast, bone and pleura. But, the soft tissue mass of anterior chest wall is rarely metastasized from a distant organ that is not confined to the thoracic cavity. This and thus has rarely been described. A 68-year-old man was admitted to our hospital with a chief complaint of resting dyspnea. A huge non-tender mass of about 10*15 cm in size was visible on his left lower anterior chest wall. We pathologically confirmed that the mass was a metastatic renal cell carcinoma of clear cell type by incision biopsy. Through an incision biopsy, the mass was pathologically confirmed as a metastatic renal cell carcinoma of the clear cell type.
Aged ; Biopsy ; Breast ; Carcinoma, Renal Cell* ; Cartilage ; Clavicle ; Dyspnea ; Humans ; Lung ; Neoplasm Metastasis* ; Pleura ; Ribs ; Sternum ; Thoracic Cavity ; Thoracic Wall* ; Thorax*

BACKGROUND: Fas and Fas ligand (FasL) are cell surface proteins that mediate apoptosis. Fas and FasL are expressed in normal epidermal cells, but are different in the expression patterns in epidermal layers. OBJECTIVE: The purpose of this study was to evaluate the expression of Fas and FasL in various skin diseases including non-tumorous diseases and tumors. METHOD: We performed immunohistochemical staining for Fas and FasL with monoclonal or polyclonal antibodies using frozen skin tissues from 29 patients. RESULTS: 1. In normal skin, Fas and FasL were expressed as intercellular and intracellular patterns. Fas was expressed in the basal and spinous layers, and FasL was expressed in the upper spinous and granular layers. 2. In psoriasis vulgaris and lichen planus, FasL expression was proportional to the degree of epidermal hyperplasia, such a relationship was not found in Fas expression. 3. In verruca vulgaris and herpes zoster, the upregulation of Fas and FasL expression was observed in lesional epidermis. 4. In skin tumors, Fas and FasL expression were observed in most tumor cells of Bowen's disease, keratoacanthoma, and squamous cell carcinoma. In basal cell carcinoma, FasL was expressed strongly and diffusely in the infiltrating tumor cells, but Fas was not expressed at all. CONCLUSION: Fas and FasL play an important role in the differentiating process of the epidermis by coordinate expression between them. In non-tumorous conditions and skin tumors, Fas and FasL might function as essential mediators of cellular turnover in pathogenesis of the skin diseases.
Antibodies ; Apoptosis ; Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Epidermis ; Fas Ligand Protein* ; Herpes Zoster ; Humans ; Hyperplasia ; Keratoacanthoma ; Lichen Planus ; Membrane Proteins ; Psoriasis ; Skin Diseases* ; Skin* ; Up-Regulation ; Warts