BACKGROUND: For the treatment of generalized vitiligo patients with oral PUVA, we can use two different methods; one is to treat the lesions while the whole body is exposed. Another one is to treat the lesions while only the lesions are exposed. PURPOSE: This study was performed to determine whether lesional and whole body exposure in oral PUVA for generalized vitiligo show any therapeutic differences in effectiveness. METHODS: The vitiligo lesions were distributed over the whole body skin of the subjects and the lesion area was less than 6% of the whole skin area. PUVA was done to the subjects more than 20 times after oral administration of psoralen. The patients were classified into two different groups. One is the lesional exposure group in which the patient exposed only the vitiligo lesion. The other is the whole body exposure group in which the patient exposed almost their whole body. RESULTS: Our results show that there is no statistical difference of the therapeutic effectiveness between the two methods. CONCLUSIONS: We recommend lesional treatment rather than whole body treatment to prevent the oral PUVA side effects.
Administration, Oral ; Ficusin ; Humans ; Skin ; Vitiligo*

Volvulus of the colon is a twisting of a redundant segment of the colon about it's narrow mesentery and sigmoid volvulus is the most common type. In many developing counteries this disorder is a common cause of obstruction of the intestine and in the western hemisphere it occurs in elderly patients who often have significant coexisting disease. This disorder may spontaneously reduce and recur as a chronic problem, but more frequently it becomes acute by obstruction, which may lead to strangulation and gangrene with high mortality if not treated promptly. Recently We have experienced 5 cases of signmoid volvulus, which were all in their twenties and had surgical operation. They had the triad of abdominal pain, distention, and absolute constipation. Plain abdominal roentgenogram was diagnostic in all cases The first line of treatment was nonoperative decompression with rigid sigmoidoscopy and successful in four of five. One Patient had emergency Hartman operation and other four had elective sigmoid resection with primary anastomosis.
Abdominal Pain ; Aged ; Colon ; Colon, Sigmoid* ; Constipation ; Decompression ; Emergencies ; Gangrene ; Humans ; Intestinal Volvulus* ; Intestines ; Male* ; Mesentery ; Mortality ; Sigmoidoscopy

Diffuse alopecia due to occult syringoma of the scalp has rarely been reported but the authors of the cases presented different opinions about which one is the primary event between the two conditions and if the syringoma is true or a reactive ductal proliferation. We have found a case whose diffuse alopecia is believed to be due to true syringoma of the scalp. A 43-year old woman showed simultaneous and gradual development of diffuse alopecia and multiple papular elevations on the face and neck adjoining the frontal and temporal hair lines. Histopathology of the scalp and the facial papular elevations all revealed typical syringomatous infiltrations with epithelial comma-tails and sclerotic stroma. All of the clinicopathological findings supported that the diffuse alopecia of the patient was due to the occult syringoma of the scalp.
Adult ; Alopecia* ; Female ; Hair ; Humans ; Neck ; Scalp ; Syringoma*

A nine year old boy presented asymptomatic multiple papular lesions for 6 months. Biopsy revealed typical features of xanthogranuloma with Touton type giant cells. Authors observed natural course of the lesions for about 2 years thereafter, which showed shrinkage of the existing papules in general in spite of newly appearing lesions. Review of the previous cases reported by the name of juvenile xanthogranuloma showed that the age of the onset of the most of the cases with multiple lesions was before one year after birth, but adolescent cases were rare. It was also noted that previous cases with such multiple lesions had a course of spontaneous regression regardless of the onset of its age.
Adolescent* ; Biopsy ; Giant Cells ; Humans ; Male ; Parturition ; Xanthogranuloma, Juvenile

Sebaceous trichofolliculoma, which is a variant of trichofolliculoma, is a rare disease that clinically show a centrally depressed lesion usually singly on the nose, and histologically a centrally located cavity, lined by squamous epithelium, with numerous sebaceous lobules connected to them. We describe a case of sebaceous trichofolliculoma in a 27-year-old woman who had several brown papules on the nose. We think that this is the first report of sebaceous trichofolliculloma in Korean literature.
Adult ; Epithelium ; Female ; Humans ; Nose ; Rare Diseases

Carcinosarcoma of gallbladder (CSGB) is a rare malignancy characterized by malignant epithelial and mesenchymal components. Its pathogenesis is unknown and most CSGBs are associated with poor survival because the disease normally presents at an advanced stage, and as a result, curative resection is uncommon. This report describes a case that underwent curative resection. A 77-year-old woman presented with right upper quadrant pain. The preoperative diagnosis was gallbladder (GB) cancer, and thus, curative radical cholecystectomy was performed. However, pathologic examination of the surgical specimen revealed that the tumor was composed of two histologic components of squamous cell carcinoma and spindle cell sarcoma, which was consistent with a diagnosis of carcinosarcoma. The tumor was found to extend to the perimuscular connective tissue and to have metastasized to one lymph node (LN). The prognosis of CSGB remains poor despite curative resection, and thus, the authors recommend that effort be made to improve surgical outcomes.
Aged ; Carcinoma, Squamous Cell ; Carcinosarcoma ; Cholecystectomy ; Connective Tissue ; Female ; Gallbladder ; Humans ; Lymph Nodes ; Prognosis ; Sarcoma

BACKGROUND: In contrast to childhood intussusception, the clinical features in adults are not typical, and the incidence of adult intussusception is low. This study was to evaluate the clinical features, diagnosis, and management of adult intussusception. METHODS: Thirty-seven cases of adult intussusception occurring between 1981 and 1996 in individuals older than 16 were investigated retrospectively. RESULTS: The most common age was in the 3rd decade (24.3%). Abdominal pain, nausea and vomiting, abdominal tenderness and palpable abdominal mass were common symptoms and physical findings in order of frequency. The duration of symptoms was less than 7 days in 54% of the cases. Correct preoperative diagnosis was made in 13.3% from 1981 to 1990 versus 72.7% from 1991 to 1996. This difference was caused by common use of abdominal ultrasound (US) and computed tomography (CT) during recent years. On exploration there were 27 cases of enteric (73%) and 10 cases of colonic (27%) intussusceptions and there were underlying lesions in 30 cases (81%). Two manual reductions only, 7 manual reductions and resections, including one reoperation after manual reduction only, 28 resections without manual reduction, and 1 ileocolostomy were performed. While only 2 cases (7.4%) of malignancy were identified among the enteric intussusceptions, there were 7 cases (70%) of malignancy among the colonic intussusceptions. CONCLUSIONS: With the advance of abdominal US and CT, preoperative diagnosis of adult intussusception was not so difficult. Because of high prevalence of underlying lesions in adult intussusception, operative management is mandatory. Resection without reduction is the most common method of operation and is recommended in edematous and ischemic enteric intussusceptions and in all colonic intussusceptions which have high malignant rate.
Abdominal Pain ; Adult* ; Colon ; Diagnosis* ; Humans ; Incidence ; Intussusception* ; Nausea ; Prevalence ; Reoperation ; Retrospective Studies ; Ultrasonography ; Vomiting

Merkel cell carcinoma is a rapidly growing malignant neuroendocrine tumor with a high rate of recurrence and metastasis for which wide excision is recommended. About 10 cases of spontaneous regression have been reported in the world. We report a case of Merkel cell carcinoma which showed spontaneous regression. The patient was a 68-year-old woman with a two-month history of a rapidly enlarging dusky red tumor on her right cheek. Microscopically, the tumor cells were uniform with round to oval shaped nucleus and scanty cytoplasm, and showed trabecular arrangement. Ultrastructually, dense core neurosecretory granules 100 to 200nm in diameter were found in the cytoplasm of tumor cells. As far as we know, this is the first case of the spontaneous regression of the tumor in the country.
Aged ; Carcinoma, Merkel Cell* ; Cheek ; Cytoplasm ; Female ; Humans ; Neoplasm Metastasis ; Neuroendocrine Tumors ; Recurrence

Nevus sebaceus is a congenital cutaneous hamartoma which has a potential to develop both benign and malignant neoplasm in late life. The most common benign tumor developed within the nevus is syringocystadenoma papilliferum and the most common malignant tumor basal cell epithelioma. Although two different tumors often develop simultaneously on the lesion, it is rare to see more than two different tumors developing on the lesion of nevus sebaceus. In Korean literatures only three such cases were reported. We report an additional case of nevus sebaceus developing three different tumors, syringocystadenoma papilliferum, sebaceous epithelioma, and basal cell carcinoma, in a 67-year-old female patient.
Aged ; Carcinoma* ; Carcinoma, Basal Cell* ; Female ; Hamartoma ; Humans ; Nevus*

We present a case in which an arterial rupture occurring during embolization of an arteriovenous malformation of the left occipital lobe with a flow-directed micro-catheter,was successfully sealed with a small amount of glue. We navigated a 1.8-Fr Magic catheter through the posterior cerebral artery, and during superse-lective test injection, extravasation was observed at the parieto-occipital branch. The catheter was not removed and the perforation site was successfully sealed with a small amount of glue injected through the same catheter. Prompt recogni-tion and closure of the perforation site is essential for good prognosis.
Adult ; Case Report ; Cerebral Arteries/*injuries ; Embolization, Therapeutic/*adverse effects ; *Enbucrilate ; Human ; Intracranial Arteriovenous Malformations/*therapy ; *Iodized Oil ; Male ; Rupture