BACKGROUND: Periungual warts are a therapeutic challenge. Many studies have revealed that intralesional interferon α-2b therapy and pulsed dye laser therapy have numerous advantages over other modalities of theratment. OBJECTIVE: The purpose of this study was to determine if combination therapy with intralesional interferon α-2b and pulsed dye laser might offer an effective treatment for periungual warts. METHODS: Thirty-three patients were randomly assigned to one of three study groups. In group A, the patients received both intralesional interferon α-2b treatment and pulsed dye laser(PDL) therapy (n=13). Group B patients were treated wit intralesional interferon α-2b alone (n=10) and group C was done with PDL therapy only (n=10). RESULTS: The clearance rate was 92.3% for the patients treated with the combination therapy of intralesional interferon α-2b treatment and pulsed dye laser (PDL) therapy. It was 50% for the patients with the intralesional interferon α-2b treatment alone, and 0% for the group with the PDL therpy only. No significant side effects were observed. At 6 months after cessation of the therapy, total 2 cases (one from group A and the other from group B) were recurred. CONCLUSION: The combination therapy with intralesional interferon α-2b treatment and pulsed dye laser therapy was highly effective for the treatment of recalcitrant periungual warts.
Humans ; Interferons* ; Lasers, Dye* ; Warts*

We herein report a case of subcutaneous panniculitic T-cell lymphoma which occurred in a 48-year-old Korean woman. Her disease presented as multiple subcutaneous nodules on the arms, legs, and abdomen, with systemic symptoms and signs. From the results of immunophenotypic studies, we suggest her disease may originate from cytotoxic T-lymphocytes. The patient had a protracted course of multiple dark-red-colored subcutaneous nodules on both arms, legs, and abdomen for 1 year, often with fever, chills, and malaise. Histopathologic findings for the subcutaneous nodule in the lower abdomen revealed diffuse infiltration of atypical lymphocytes in the subcutis, with extensive fat necrosis and karyorrhexis and a bean-bag cell appearance with engulfed lymphocytes in some histiocytes. The immunophenotypic studies showed a cytotoxic T-lymphocyte profile, i. e., LCA+, lysozyme+, UCHL1+, CD8+, CD20-, CD30-, and CD56-. In situ hybridization studies for the Epstein-Barr virus genome resulted in a negative finding. A lymphadenopathy was found in the right upper paratracheal area on the chest CT associated with pancytopenia and abnormal LFT findings. She received high-dose chemotherapy with autologous blood stem cell transplantation, but died after 6 months.
Abdomen ; Arm ; Chills ; Drug Therapy ; Fat Necrosis ; Female ; Fever ; Genome ; Glycogen Storage Disease Type VI ; Herpesvirus 4, Human ; Histiocytes ; Humans ; In Situ Hybridization ; Leg ; Lymphatic Diseases ; Lymphocytes ; Lymphoma, T-Cell* ; Lymphoma, T-Cell, Cutaneous ; Middle Aged ; Pancytopenia ; Stem Cell Transplantation ; T-Lymphocytes* ; T-Lymphocytes, Cytotoxic ; Tomography, X-Ray Computed

OBJECTIVE: This study was to investigate the clinical efficiency of clomiphene citrate/GnRH antagonist protocol comparing with the clomiphene citrate only protocol in infertile women with normal ovulatory cycles. METHOD: Among 116 patients, 43 were received assisted reproductive technologies using natural ovulatory cycle, 38 and 35 were received clomiphene citrate only protocol and clomiphene citrate/GnRH antagonist combined protocol, respectively, and the clinical results were compared and analyzed. RESULTS: In each group, basal levels of LH, FSH, E2 and FSH, E2 on hCG day injected were not different, but LH level and endometrial thickness on hCG injected day were decreased significantly and the pregnancy rate was increased significantly in clomiphene citrate/GnRH antagonist group. CONCLUSION: The pregnancy rate was increased significantly in clomiphene citrate/GnRH antagonist group compared with natural ovulatory cycle and clomiphene citrate only group.
Clomiphene* ; Female ; Humans ; Pregnancy Rate ; Reproductive Techniques, Assisted

Purpose: The purpose is to test and evaluate the physical properties of commonly used temporary restoration materials and newly emerged materials. Materials and Methods: Four groups of polymer materials were evaluated: Polymethyl methacrylate (PMMA) 2 groups, Polyetheretherketone (PEEK), Polycarbonate. Four physical properties were tested: surface hardness, bending strength, abrasion resistance during wear, wear behavior. The 3-axis bending strength and Vickers hardness test were measured using a universal testing machines respectively. The microstructure was observed with a scanning electron microscope and weight comparison was evaluated after 100,000 chewing tests using a chewing simulator. Kruskal wallis test was performed to evaluate statistical significance. Results: The four groups showed the highest flexural strength and Vickers hardness of PEEK, followed by PC, PMMA-H, PMMA-T. Microstructure observation also showed the least surface roughness in the PEEK group, followed by PC, PMMA-H, PMMA-T. Conclusion PC is considered to have sufficient mechanical properties that can be applied to the manufacture of temporary teeth. However, further studies, such as biocompatibility, are considered to be necessary for practical clinical applications.

Eccrine poroma is a benign skin appendage tumor originating from the intradermal part of the sweat duct. It is found commonly on the hairless surface of the feet, although eccrine poroma of the hands, head, trunk, and legs have been reported. Histopathologically, the tumor extends from the lower portion of the epidermis into the dermis as broad, anastomosing bands. The tumor cells are smaller than squamous cells, having a uniform cuboidal appearance and a round, deeply basophilic nucleus, connected by intercellular bridges. In eccrine poromas, narrow ducta1 lumina and occasional cystic spaces are found within the tumor bands, but a large cystic space is very unusual. We report a case of eccrine poroma with a large cystic space extending from epidermis into the reticular dermis.
Basophils ; Dermis ; Epidermis ; Foot ; Hand ; Head ; Leg ; Poroma* ; Skin ; Sweat

Spontaneous intramural hematoma of the esophagus is a very rare disease. Varying degrees of submucosal rupture of the esophagus are caused by intramural hematoma of the esophagus. The causative factors include vomiting, an esophageal foreign body, endoscopic sclerotherapy for esophageal varices, equipment manipulation, drugs (e.g., warfarin and aspirin) and full-body disease (e.g., chronic renal failure, hemophilia and leukemia), and idiopathic causes have also been described. A 68-year-old male taking aspirin, clopidogrel and cilostazol was admitted to our hospital complaining of hematemesis. Spontaneous intramural hematoma of the esophagus was diagnosed by endoscopy. We report here on a case of spontaneous intramural hematoma of the esophagus that occurred after vomiting and the patient showed spontaneous improvement. We also review the relevant literature.
Aged ; Aspirin ; Endoscopy ; Esophageal and Gastric Varices ; Esophagus ; Foreign Bodies ; Hematemesis ; Hematoma ; Hemophilia A ; Humans ; Kidney Failure, Chronic ; Male ; Rare Diseases ; Rupture ; Sclerotherapy ; Tetrazoles ; Ticlopidine ; Vomiting ; Warfarin

BACKGROUND: Currently the most common treatment modality of refractory ascites in patients with liver cirrhosis was large volume paracentesis, but this procedure usually needed albumin infusion and occasionally developed unwanted complications. By reason of albumin shortage in Korea and occasional unfavorable complications, we studied the usefulness of dialytic ultrafiltration as an another treatment modality of refractory ascites. METHODS: Dialytic ultrafiltration was done in 10 patients (total 48 times) with liver cirrhosis or hepatocellular carcinoma. Two drainage conduit (via 16 gauge angio-catheter) of input and output were made by puncture of patient's right and left lower quadrant abdomen. The initial ultrafiltration rate of dialyser was 250mL/min. Ascitic fluid was removed continuously until the filtration rate down at 50mL/min. After ultrafiltration, ascitic fluid contained concentrated albumin and large molecules was reinfused via input conduit. Pre-treatment and post-treatment level of blood chemistry, plasma renin concentration, aldosterone, and electrolytes in serum; total protein and albumin in ascites were measured. During the ultrafiltration, we closely observed the change of blood pressure, heart rates and mental status. RESULTS: The mean ultrafiltration time was 231+/-28min, ultrafiltrated volume was 5.15+/-1.41 L. During dialytic ultrafiltration, patient's blood pressure and heart rate were stable and there was no change of mental status. After dialytic ultrafiltration, blood urea nitrogen level significantly decreased from 30.5+/-23.7mg/dL to 25.7+/-20.2mg/dL; serum aldosterone level decreased from 807.3+/-301.1pg/ml to 431.1+/-187.2pg/ml in serum (P<0.01). The albumin level in the ascitic fluid significantly increased from 0.67+/-0.28g/dL to 1.90+/-1.16g/dL (P<0.01). Plasma renin concentration level tend to decreased (P=0.06). The patient's serum total protein, albumin, electrolytes, and creatinine were not changed. Complications of dialytic ultrafiltration were peritonitis (one case) and hypotension (one case). But these unwanted complications were readily managed by adequate antibiotics and intravenous fluid therapy. CONCLUSION: The dialytic ultrafiltration can be used effectively without albumin infusion in the treatment of refrartory ascites in patients with advanced liver cirrhosis.
Abdomen ; Aldosterone ; Anti-Bacterial Agents ; Ascites* ; Ascitic Fluid ; Blood Pressure ; Blood Urea Nitrogen ; Carcinoma, Hepatocellular ; Chemistry ; Creatinine ; Drainage ; Electrolytes ; Filtration ; Fluid Therapy ; Heart Rate ; Humans ; Hypotension ; Korea ; Liver Cirrhosis* ; Liver* ; Paracentesis ; Patient Rights ; Peritonitis ; Plasma ; Punctures ; Renin ; Ultrafiltration*

Chromhidriosis or the production of colored sweat is a rare clinical finding. Several dyes, when injected intravenously, have been shown to be secreted in eccrine gland, but in most cases the sweat is colored in skin surface, resulting from the contamination by dyes, pigment from microorganisms, or other chemicals. We report a case of eccrine chromhidriosis which revealed blue-green spots on palms, soles, buttocks, and back.
Buttocks ; Coloring Agents ; Eccrine Glands ; Skin ; Sweat

OBJECTIVE: To determine the relations of spinal measurements on magnetic resonance imaging (MRI), myelography and electromyography (EMG) in patients with low back pain. METHOD: We investigated forty four patients who were underwent both imaging and electrodiagnostic evaluation. Spinal geometric measurements in axial MRI included anteroposterior (AP) diameters of canal and thecal sac, interlaminar distance, width of lateral recess, thickness of ligamentum flavum, and the findings of a root deviation. This study investigated: 1) correlation of MRI disc herniation types with EMG and myelogram findings, 2) correlation of EMG findings with axial MRI spinal measurements and myelogram findings, 3) correlation of myelogram with axial MRI spinal measurements. RESULTS: The MRI disc herniation types did not relate to EMG and myelogram findings. Findings of the root compression on myelogram related to the width of lateral recess and thecal sac AP diameter only (p<0.05). There were nonparametric correlations between myelogram findings and the findings of root deviation on MRI (p<0.05). CONCLUSION: There were little correlations between EMG findings and other imaging studies. In addition, we suggest not only the disc herniation type, but also the width of lateral recess and thecal sac AP diameter is helpful in interpreting the axial spinal MRI.
Electromyography ; Humans ; Ligamentum Flavum ; Low Back Pain* ; Magnetic Resonance Imaging ; Myelography

Ischemic colitis is the most common vascular disorder of intestines, and usually affects older patients. Many predisposing conditions have been implicated in the pathogenesis of colonic ischemia, although many occurrences are spontaneous in nature. Ischemic colitis can induce a wide spectrum of radiological or endoscopic features, depending on the site, extend, and timing of its onset. The coexistence of colonic ischemia with carcinoma of large bowel is well documented. However It is less well recognized that a localized segment of ischemic colon can mimic a carcinoma. Here, we report a case of ischemic colitis mimicking colon cancer in a 66 year-old man.
Aged ; Colitis, Ischemic* ; Colon ; Colonic Neoplasms ; Humans ; Intestines ; Ischemia