We report herein three cases of vesicular pemphigoid that is a varient of bullous pemphigoid, occuring in 38-year old female, 51-year old male, and 35-year old female patients. They had recurrent and moderate to severe pruritic tense vesicles with symmetrical distribution chiefly on the head and neck areas. The histological findings showed subepidermal bullae which contained a few eosinophils and the direct irnmunofluorescent tests revealed linear deposition of IgG, IgM and C, on the basement mernbrane zone. Futhermore, all the patients showed a good response to dapsone.
Adult ; Dapsone ; Eosinophils ; Female ; Head ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Male ; Middle Aged ; Neck ; Pemphigoid, Bullous* ; Transcutaneous Electric Nerve Stimulation

Bilateral coronary artery fistula is very uncommon congenital anomaly which occupy small percentage of all congenital coronary artery fistula. About 20% of the cases associated with additional congenital heart disease. And it may cause congestive heart failure, especially severely in neonate. We experienced a case of neonate who was 1 day-old-male with bilateral coronary artery-right ventricular fistula associated with atrial septal defect and congestive heart failure. The Patient was admitted because dyspnea, cyanosis since birth. 2D ecgicardiogram and cardiac catheterization revealed that a fistulous communicating ; forming a large aneurysm, was noted from bilateral coronary artery emptied into the right ventricle, and there was oxygen step-up in right ventricle.
Aneurysm ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Cyanosis ; Dyspnea ; Fistula* ; Heart Defects, Congenital ; Heart Failure ; Heart Septal Defects, Atrial* ; Heart Ventricles ; Humans ; Infant, Newborn* ; Oxygen ; Parturition

IgA nephropathy can occur rarely as a complication of D-penicillamine treatment, but it is exact pathogenesis remains unclear. If a patients has gross or microscopic hematuria during D-penicillamine treatment, D-penicillamine induced IgA nephropathy should be suspected as a cause of hematuria. In those cases, renal biopsy should be taken for diagnosis and proper management. We experienced a case of IgA nephropathy confirmed by renal biopsy in a 39-years-old female patient with scleroderma during D-penicillamine therapy and report this case with a review of literature.
Biopsy ; Diagnosis ; Female ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Penicillamine*

No abstract available.
Male ; Penile Erection*

The lipid lowering effects of bezafibrate were evaluated in 18 patients with hyperlipidemia, i.e. over 200mg/dl of cholesterol and/or of cholesterol and/or triglyceride before treatment. The materials were 18 patients(male:8, female:10);7 with diabetes mellitus, 8 with congestive cardiomyopathy, 1 with parkinsonism, The serum lipid concents were measured with enzyme method before and 6 weeks after the treatment with daily 600mg of bezafibrate administered per oral and the differences were observed. 1) The level of serum cholesterol was reduced from 262.8mg/dl(+/-58.9SD) before treatment to 191.3gm/dl(+/-31.3SD) after 6 weeks treatment(p<03.005). 2) The level of serum triglyceride was reduced from 231.8mg/dl(+/-104SD) before treatment to 144.4mg/dl(+/-51SD) after 6 weeks treatment(p<0.005). 3) The level of serum HDL increased from 47.2mg/dl(+/-19.7SD) before treatment to 61.3mg/dl(+/-13.9SD) after 6 weeks treatment(p<0.005). 4) The level of serum LDL was reduced from 169.3mg/dl(+/-52.4SD) before treatment to 101.2mg/dl(+/-29.5SD) after 6 weeks treatment(p<0.05). 5) HDL/Cholesterol ratio was increased from 17.8%(+/-5.4SD) before treatment to 32.6%(+/-7.9SD) after 6 weeks treatment(p<0.005). 6) HDL/LDL ratio was increased from 29.2%(+/-10.8SD) before treatment to 67.2%(+/-30.8SD) after 6 weeks treatment(<0.005). The side effects of bezafibrate such as G-I trouble, myositis, hypersensitivity, elevation of BUN and creatinine were not observed.
Bezafibrate* ; Cardiomyopathy, Dilated ; Cholesterol ; Creatinine ; Diabetes Mellitus ; Humans ; Hyperlipidemias* ; Hypersensitivity ; Myositis ; Parkinsonian Disorders ; Triglycerides

To analyze the clinical and endoscopic features of colonic anisakiasis. A retrospective chart review of 20 patients with colonic anisakiasis, who were diagnosed by colonoscopy at 8 hospitals between January 2002 and December 2011, was performed. Patients’ mean age was 53.6±10.74 years. Seventy percent patients were men. Acute abdominal pain was a common symptom that mostly developed within 48 hr after the ingestion of raw fish, and which lasted for 1–28 days. Sixty percent patients had ingested raw fish before the diagnosis of colonic anisakiasis and 40% patients were incidentally found to have colonic anisakiasis during the screening colonoscopies. Leukocytosis and eosinophilia were each found in 20% of the patients. In all patients who underwent colonoscopy, the worms were removed with biopsy forceps, except in 1 case, and a definite diagnosis of anisakiasis was made. In some cases of colonic anisakiasis, colonoscopy may be helpful in the diagnosis and treatment to avoid surgical intervention.
Abdominal Pain ; Anisakiasis ; Biopsy ; Colon ; Colonoscopy ; Diagnosis ; Eating ; Eosinophilia ; Humans ; Korea ; Leukocytosis ; Male ; Mass Screening ; Retrospective Studies ; Surgical Instruments

BACKGROUND AND OBJECTIVES: Off-thyroxine serum thyroglobulin (Tg) level is important to predict metastatic disease (MD) in papillary thyroid cancer (PTC); however, it is unclear whether a single off-thyroxine Tg level is sufficient for predicting MD. In this study, we determined whether serial measurement of off-thyroxine serum Tg level can predict metastasis in PTC patients after total thyroidectomy. MATERIALS AND METHODS: We enrolled 140 PTC patients in whom serum thyroid-stimulating hormone (TSH) and Tg levels were measured 7 days before radio-iodine (RAI) treatment (TSHA and TgA) and on the day of RAI treatment (TSHB and TgB) with withholding L-thyroxine for 4 weeks before RAI treatment. The values of TSHinc (TSHB-TSHA) and Tginc (TgB-TgA), Tgratio (TgB/TgA), Tginc/TSHinc and Tgratio/TSHinc were calculated. Tginc/TSHinc and Tgratio/TSHinc were tested if those parameters can predict MD in patients with TSHA>30 microIU/mL and TgA<10 ng/mL. RESULTS: Forty-four patients had MD and 96 had no evidence of MD (non-MD). MD group showed higher levels of TgA, TgB, Tginc, Tginc/TSHinc and Tgratio/TSHinc compared with non-MD group. A significant correlation was found between TSHinc and Tgratio (r=0.669) in MD group. In 43 patients with TSHA>30 microIU/mL and TgA<10 ng/mL (MD, 9; non-MD, 34), both Tginc/TSHinc (100%) and Tgratio/TSHinc (89%) had higher sensitivities for predicting MD than TgB (78%). CONCLUSION: With the increment in serum Tg corrected for the increment in serum TSH, serial measurements of off-thyroxine serum TSH and Tg levels can help predict PTC metastasis.
Factor IX ; Humans ; Neoplasm Metastasis ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Thyrotropin ; Thyroxine

We performed a electrophoresis to determine the serum level of isoenzyme of creatine phosphokinase in 30 patients with head injuries. The present study was undertaken to examine whether the measurement of serum level of brain type isoenzyme(CPK-BB) and heart type isoenzyme(CPKMB) were valuable in evaluating the clinical status of head injuries. All patients were diagnosed by Glasgow coma scale score, CT scan and then we performed a serial blood sampling during the first 7days. Brain type creatine phosphokinase(CPK-BB) was detected in the serum in 4 of 30 patientts(13.3%) and heart type creatine phosphokinase(CPK-MB) was detected in the serum in 8 of 30 patients(26.7%). These findings were seen within 48 hours after head injuries. The higher level were associated with severe brain damage; hemorrhagic contusion, subdural hemorrhage, subarachnoid hemorrhage and pneumocephalus.
Brain ; Contusions ; Craniocerebral Trauma* ; Creatine Kinase* ; Creatine* ; Electrophoresis ; Glasgow Coma Scale ; Head* ; Heart ; Hematoma, Subdural ; Humans ; Isoenzymes* ; Pneumocephalus ; Subarachnoid Hemorrhage ; Tomography, X-Ray Computed

Cancer screening is one of the most effective methods for cancer control. The national cancer screening program has provided regular cancer screenings for all people at a certain age, regardless of symptoms. This program covers five major cancers: stomach, colorectal, liver, breast, and cervical cancer. Recently, a research project was performed to develop and revise the guidelines for cancer screening, based on the assessment of effectiveness compared to harm and on the evidence from a systematic review of related studies. Target cancers for screening guideline are not only for five major cancers which are included in national cancer screening program, but also for thyroid cancer and lung cancer, because thyroid cancer is rapidly increased recently and lung cancer has the highest mortality rate among cancers. Multidisciplinary expert committees were composed for developing and revising the guidelines for cancer screening. This process of national cancer screening guideline development and revision comprised three steps. First, an expert committee developed key questions for consideration in revision and development of the guidelines. A systematic literature review related to these key questions was performed. In the second step, the effectiveness of the national cancer screening program for five major cancers was analyzed, including analysis of screening rates, early cancer detection rates, and mortality reduction effects. Through this process, a draft of the revised guidelines was created. The draft was open to the public to gather external expert opinions. After review of the expert opinions, the final guidelines for cancer screening were published. In the third step, based on the revised cancer screening guideline, the national cancer screening program will be modified. In this step, cost-effectiveness and feasibility of the revised guideline will be considered.
Breast ; Early Detection of Cancer* ; Expert Testimony ; Liver ; Lung Neoplasms ; Mass Screening ; Mortality ; Stomach ; Thyroid Neoplasms ; Uterine Cervical Neoplasms

After von Rokitansky's description in 1984 of a calcified chronic subdural hematoma, the number of such lesions has reached so far a total of 108. The majority of patients reported have been children and young adults. On review of the literature, elderly patients reported over the age of sixty five years are only 5, so far as we know. A 68-year-old Korean male with a calcified chronic subdural hematoma is reported. He was admitted to our department because of a status epilepticus. During Korean war (1950), abut 37 years before admission, he had been suffered from a blunt head injury, but mistreated then, and afterwards th had several episodes of convulsion. Neurological examination on admission revealed only a drowsy consciousness and mild papilledema on the left. Plain skull X-ray films and brain CT scan demonstrated a left sided biconvex type of intracranial calcification. A left frentoparietal craniotomy was performed. After opening the dura mater, the thickened outer membrane, the subdural hematoma and the thin bone like plate were removed thoroughly. Content of the subdural hematoma was brown muddy substance. In the eight months following the operation, the generalized seizure did not appear. Postoperative CT scan demonstrated complete re-expansion of the brain parenchyme.
Aged* ; Brain ; Child ; Consciousness ; Craniotomy ; Dura Mater ; Head Injuries, Closed ; Hematoma, Subdural ; Hematoma, Subdural, Chronic* ; Humans ; Korean War ; Male ; Membranes ; Neurologic Examination ; Papilledema ; Seizures ; Skull ; Status Epilepticus ; Tomography, X-Ray Computed ; X-Ray Film ; Young Adult