BACKGROUND: There are prerequisites for fungal nail infection: fungal organism, susceptible host, and environments with damaged nail. OBJECTIVE: The purpose of this study was to evaluate the growth rate of the great toe nail in distal subungual onychomycosis(DSO). MATERIALS AND METHODS:: The subjects are 60 adult patients with DSO and 19 age- and sex-matched controls with tinea pedis but no DSO. The growth rate of the great toe nail was measured. Data were evaluated with Mann-Whitney U-test and regression analysis using the statistical program for PC. RESULTS: The growth rate of the patients group showed a decrease against that of the controls. The equation for expected nail growth rate of specific age and sex was as follows: the expected nail growth rate(mm/day) = 0.07382 + (0.01498 × G) - (0.00033 × Age) - (0.00669 × S): if a person has DSO, G is 1, and if he has no DSO, G is 2; if a person is male, S is 1, and, female, 2. CONCLUSION: Patients with DSO often have a decreased growth rate of the nail compared with that of the controls. The authors propose the equation of expected nail growth rate in persons with or without DSO, and think that the growth rate of the nail is one of factors in the pathogenesis of onychomycosis.
Adult ; Female ; Humans ; Male ; Onychomycosis* ; Tinea Pedis ; Toes*

A Case of pigmented choroid plexus carcinoma is reported. The patient was a 35-year-old woman who had headache of 3-month duration, followed by ataxia for 1month before admission. Brain CT revealed a well enhanced mass at the left cerebello-pontine angle area as well as hydrocephalus. Subtotal removal of the tumor was performed via suboccipital craniectomy under the impression of meningioma because there was a mass only in the extraventricular area. The tumor was diagnosed by light microscopic examination. Pigmented choroid plexus carcinoma, which has been reported as low grade malignancy, is very rare and located always in the ventricles. In the case the tumor was subtotally removed and ventriculo-peritoneal shunt surgery and radiation therapy underwent later. The patient has been followed-up without recurrence for 1 year postoperatively.
Adult ; Ataxia ; Brain ; Choroid Plexus Neoplasms* ; Choroid Plexus* ; Choroid* ; Female ; Headache ; Humans ; Hydrocephalus ; Meningioma ; Recurrence ; Ventriculoperitoneal Shunt

Several reports have described the usefulness of tumor markers detected in pancreatic juice for diagnosis of pancreatic cancer. We performed this study to evaluate the usefulness of tumor markers in pure pancreatic juice collected by duodenoscopic cannulation of pancreatic duct before and after injection of secretin. From April 1993 to July 1995, 8 cases of pancreatic cancer, 5 cases of benign pancreatic lesions, and 5 cases of benign biliary diseases without pancreatic lesion were involved. CEA and CA 19-9 immunoreactivity were measured by radioimmunoassay. Concentrations of CA 19-9 in pure pancreatic juice were significantly higher in patients with pancreatic cancer(median value; 3582, range 88.4-10410 IU/ml) than in control patients(median value 231, range 30.4-682 IU/ml)(p<0.05). Concentrations of CEA in pure pancreatic juice were not significantly different between patients with pancreatic cancer(median value: 6,5, range 1.0-152ng/ml) and control patients(median value: 4.0, range 1-17.2 ng/ml)(p>0.05). There was no significant correlation between levels of CA19-9, CEA in pancreatic juice and those levels in serum. The amounts of juice collected by duodenoscopic cannulation in patients with pancreatic cancer were 1.5+/- 0.9ml during 5 minutes before infusion of secretin, 11.3+/- 3.9ml, 10.8+/- 4.0ml, 10.6+/- 4.0ml in 5 minute interval after infusion of secretin. These results indicated that measurement of CA19-9 in pure pancreatic juice may be used as a marker for pancreatic cancer. Adequate amount of pancreatic juice was collected by duodenoscopic cannulation for evaluation of tumor marker, enzyme studies and cytology.
Catheterization ; Diagnosis ; Humans ; Pancreatic Diseases ; Pancreatic Ducts ; Pancreatic Juice* ; Pancreatic Neoplasms ; Radioimmunoassay ; Secretin ; Biomarkers, Tumor

PURPOSE: The aim of this study was to examine the expression of E-cadherin, beta-catenin, Cdx2, MMP7 in gastric cancer and to evaluate the clinical significance of these molecules in tumor recurrence within 2 years of pT2 and N1/N2 gastric cancer. METHODS: In 122 patients who underwent radical resection of gastric cancer, we investigated the association between the expression of these molecules and clinicopathologic factors by immunohistochemistry. The included criteria were pT2 and N1 or N2 (6th AJCC TNM). RESULTS: The expression of MMP7 was significantly associated with N stage (N1 vs. N2) (P=0.011). The negative expression of beta-catenin was strongly correlated with tumor recurrence within a 2-year period. However, the expression of these molecules was not related with recurrent sites. Multivariate analysis demonstrated that negative expression of beta-catenin was an independent predictor for tumor recurrence within 2 years (OR 2.366; 95% CI 1.056~5.297; P=0.036). CONCLUSION: Negative expression of beta-catenin may serve as a significant indicator for predicting tumor recurrence within a 2-year period in pT2 and N1/N2 gastric cancer.
beta Catenin ; Cadherins ; Humans ; Immunohistochemistry ; Multivariate Analysis ; Recurrence ; Stomach Neoplasms

Retrograde transpapillary cholangioscopy can be safely performed by use of a mother-baby-scope system after endoscopic sphincterotomy. Improved endoscopes are now available and may lead to a better acceptance of this technique. Cholangioscopy is complementary to cholangiography for differential diagnosis of various types of bile duct lesions. From march 1992 to September 1994, we performed 15 cases of peroral cholangioscopy for evaluation of bile duct lesions. Indications of peroral cholangioscopy were 6 cases of benign biliary diseases and 9 cases of malignant biliary diseases. In benign diseases, two cases of extrahepatic bile duct stones, 1 case of intrahepatic duct stone with stricture, 2 cases of benign elevated lesions of bile duct and 1 case of occluded expandable metallic stent were involved. In malignant diseases, 7 cases of primary bile duct cancer, 2 cases of hepatocellular carcinoma with bile duct invasion were involved. By use of peroral cholangioscopy with biopsy, differential diagnosis of bile duct lesion was possible. As a complication, severe abdominal pain and hypotension was developed in one case during the procedure and in another case, cholangitis was developed after the procedure. In conclusion, peroral cholangioscopy is a safe and useful procedure in various types of biliary diseases especially in the differential diagnosis of malignancy.
Abdominal Pain ; Bile Duct Neoplasms ; Bile Ducts ; Bile Ducts, Extrahepatic ; Biopsy ; Carcinoma, Hepatocellular ; Cholangiography ; Cholangitis ; Constriction, Pathologic ; Diagnosis, Differential ; Endoscopes ; Hypotension ; Sphincterotomy, Endoscopic ; Stents

Isotopic response is the occurrence of a new skin disorder at the site of another, unrelated, and already healed skin disease. Various diseases have been reported in terms of isotopic response associated with herpes zoster, but the development of comedones is uncommon. We report a case of comedones that had developed on the site previously affected by herpes zoster in a 59-year-old male, which is thought to be an isotopic response. Eight months ago, he visited with herpes zoster lesions on the left upper eyelid, forehead and scalp(dermatome cranial nerve V1). He had grouped and discrete, slightly elevated, skin colored papules with dark, firm hyperkeratotic plug on the healed site of herpes zoster.
Cranial Nerves ; Eyelids ; Forehead ; Herpes Zoster* ; Humans ; Male ; Middle Aged ; Skin ; Skin Diseases

A 47-year-old man developed chronic alcoholic liver cirrhosis and end-stage renal disease. He underwent blood-type-compatible liver transplantation with a graft from his daughter. After 8 months, sequential ABO-incompatible (ABOi) kidney transplantation was performed, with his brother as the donor (A to O). The patient had anti-A antibody titers (1:256). We performed pretransplant desensitization, including administration of rituximab, mycophenolate mofetil, tacrolimus, and prednisolone 2 weeks before the scheduled transplantation, and plasmaphresis (PP) and administered an intravenous immunoglobulin injection. The patient underwent PP before kidney transplantation until the anti-A antibody titer was <1:8. The patient achieved normal renal function within 4 posttransplantation days. Postoperative bleeding (diffuse hemorrhage) requiring additional blood transfusions and radiological intervention (drainage procedure) occurred 9 days after transplantation. The patient was discharged on day 20 of hospitalization. Nine months after the kidney transplantation, the recipient's and donor's liver and kidney functions were normal. ABOi renal transplantation after liver transplantation can be successfully performed in patients with high baseline anti-ABO antibody titers after preconditioning with rituximab and PP, and quadruple immunosuppressive therapy. However, caution is required regarding an increased risk of bleeding complications.
Blood Transfusion ; Hemorrhage ; Hospitalization ; Humans ; Immunoglobulins ; Kidney ; Kidney Failure, Chronic* ; Kidney Transplantation* ; Liver ; Liver Cirrhosis, Alcoholic* ; Liver Transplantation* ; Middle Aged ; Nuclear Family ; Prednisolone ; Rituximab ; Siblings ; Tacrolimus ; Tissue Donors ; Transplants

A 50-year-old man presented with acute pancreatitis. Abdominal CT showed cystic dilatation of common bile duct and diffuse dilatation of pancreatic duct. ERCP showed pancreas divisum, choledochal cyst and pancreatic duct stones. Minor papilla sphincterotomy and insertion of nasopancreatic tube were performed for drainage of dorsal pancreatic duct. And then, he underwent Whipples operation for excision of choledochal cyst and decompresion of dorsal pancreatic duct.
Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst* ; Common Bile Duct ; Dilatation ; Drainage ; Humans ; Middle Aged* ; Pancreas* ; Pancreatic Ducts ; Pancreatitis ; Tomography, X-Ray Computed

Abdominal compartment syndrome (ACS) is a life-threatening disorder caused by rapidly increasing intraabdominal pressure. ACS can result in multiorgan failure and carries a mortality of 60~70%. The treatment of choice in ACS is surgical decompression. There are very few reports of ACS and experience in Korea. We report 12-year-old male patient who developed an abdominal compartment syndrome due to traffic-accident-induced retroperitoneal hematomas, Which was successfully treated by performing a bedside emergency surgical decompression with open linea alba fasciotomy with intact peritoneum. When patients do not respond to medical therapy, a decompressive laparotomy is the last surgical resort. In patients with severe abdominal compartment syndrome, the use of a linea alba fasciotomy is an effective intervention to lower intra-abdominal hypertension (IAH) without the morbidity of a laparotomy. Use of a linea alba fasciotomy as a first-line intervention before committing to full abdominal decompression in patients with abdominal compartment syndrome improves physiological variables without mortality. Consideration for a linea alba fasciotomy as a bridge before full abdominal decompression needs further evaluation in patients with polytrauma abdominal compartment syndrome.
Child ; Decompression, Surgical ; Emergencies ; Health Resorts ; Hematoma ; Humans ; Intra-Abdominal Hypertension ; Korea ; Laparotomy ; Lower Body Negative Pressure ; Male ; Peritoneum

Pityriasis versicolor is a mild chronic superficial fungal infection, usually involving the seborrheic area of the neck, upper arms, and back. In a few instances, however, the eruption has been confined to highly atypical areas, such as one palm, the soles, the face, the scalp, the penis, and the groin. Inverse pityriasis versicolor refer to clinical disease located predominantly in flexural areas. We report three cases of inverse pityriasis versicolor in a 55-year-old man, in a 47-year-old man, in a 27-year-old man. The lesion were manifested by slightly scaly, brownish macules on the groin. Potassium hydroxide (KOH) prepatation showed numerous short hyphae and spores, and Wood's lamp examination showed yellowish brown fluorescence of involved skins. Fungal culture on Leeming and Notman's media grew out the typical colonies of M. globosa and M. sympodialis after 2 weeks at 34 degrees C. The patients were treated with 200 mg of itraconazole daily for 1 week and topical antifungals.
Adult ; Arm ; Fluorescence ; Groin ; Humans ; Hyphae ; Itraconazole ; Male ; Middle Aged ; Neck ; Penis ; Pityriasis* ; Potassium ; Scalp ; Skin ; Spores ; Tinea Versicolor*