Generalized plane xanthoma is less common and usually involves the eyelids, lateral side of the neck, upper trunk, and extremities. Lesions, however, may appear on any portion of the body. Cutaneous xanthomas may occur in hyperlipidemic and in normolipidemic states. Generalized normolipidemic plane xanthoma is often associated with multiple myeloma, other reticulo-endothelial malignancies and monoclonal gammopathy with unknown significance(MGUS). We wish to report two eases of generalized plane xanthoma associated with IgG monoclonal gammopathy of unknown significance.
Extremities ; Eyelids ; Immunoglobulin G ; Multiple Myeloma ; Neck ; Paraproteinemias* ; Xanthomatosis*

Pseudocyst of the auricle presents as a non-inflammatory, fluctuant swelling on the upper half or third section of the ear, due to intracartilaginous accumulation of fluid. Histological examination shows an intracartilaginous cavity without an epithelial lining. The etilogy and pathogenesis of this disorder remains unknown, but the lesion is likely to be due to localized de-generation of cartilage. The degenerated cartilage is replaced by a vascular fibrous tissue from which there is serious exudation, and a clinical cystic swelling is formed. We describe in this report three cases of pseudocyst of the auricle, of which one was treated successfully by surgical excision and a pressure dressing, and the others by aspiration and steroid injection therapy. In all cases, the skin lesions had not recurred, and the patients were left with an excellent cosmetic result.
Bandages ; Cartilage ; Ear ; Humans ; Skin

Ureteroscopic management of ureteral calculi is an established successful technique with low complication. We performed 140 ureteroscopies for stone removal from January 1990 to April 1995. The stone were removed successfully in 131 cases (94%), and complication occurred in 37 cases (27%). In 9 cases, complete removal of stone was failed due to upward migration of stone (3 cases), not mobilization of stone (3 cases), inability to introduce ureteroscope into the intramural ureter (2 cases), inadequate illumination due to bleeding (1 case). Complications of ureteroscopic removal of stone were ureteral perforation (8 cases), tearing of ureteral mucosa (5 cases), gross hematuria (19 cases), infection (3 cases) and fever (2 cases). All complications were treated successfully with conservative treatment. We conclude that ureteroscopic removal of stone is still primary useful treatment of middle and lower ureteral stones and can be done safely if certain guide lines such as proper selection of patient, adequate use of lithotriptor, careful dilatation of ureteral orifice are kept strictly.
Dilatation ; Fever ; Hematuria ; Hemorrhage ; Humans ; Lighting ; Mucous Membrane ; Ureter ; Ureteral Calculi ; Ureteroscopes ; Ureteroscopy

Microcystic meningioma is a rare variant of meningiomas. This unusual variant was originally described by Masson, who labeled it "humid". The computed tomographic scan or magnetic resonance images of these tumors resemble those of a glial or metastatic tumor with cystic or necrotic changes. There is no definitive method for differentiating cystic meningiomas from these more common tumors. But immunohistochemically, they share a similar pattern of positive staining for epithelial membrane antigen and vimentin with other meningiomas. Our case was a 34-year-old woman with a tumor mass on the right frontal area. She was admitted to hospital because of generalized tonic seizure. Grossly all of the tumor could be removed, and histopathologically this tumor was revealed to be a microcystic meningioma.
Adult ; Female ; Humans ; Meningioma* ; Mucin-1 ; Seizures ; Vimentin

A total of 150women with singleton pregnancies who were delivered between 37 and 42weeks gestation had ultrasound scans on elective cesarean section day. The biparietal diameter(BPD), head circumference(HC), abdominal circumference(AC) and femur length(FL) were measured in all cases. Equations of estimated fetal body weight(BWT) for Korean term fetuses using AC alone, BPD/AC, AC/FL, HC/AC/FL, BPD/AC/FL, BPD/HC/AC/FL were made by stepwise multiple regression analysis and were compared with foreign equations such as Campbell(AC), Shepard(BPD/AC), Hadlock I(AC/FL), Hadlock II(HC/AC/FL), Hadlock III(BPD/AC/FL), and Hadlock IV(BPD/HC/AC/FL). The results were as follows. 1. The equations of BWT by sonographic measurement were Equation1 (AC) logeBWT=6.105936+0.005957X(AC) (R=0.876) Equation2 (BPD,AC)logeBWT=6.53614548+0.00004963X(ACXBPD) (R=0.929) Equation3 (AC,FL) logeBWT=6.25336442+0.00751602X(FL)+0.00005155X(ACXFL) (R=0.950) Equation4(HC,AC,FL) logeBWT=6.39631346+0.00004823X(ACXFL)+0.00002023X(FLXHC) (R=0.953) Equation5(BPD,AC,FL) logeBWT=5.99934074+0.00871394X(BPD)+0.00005132X(ACXFL) (R=0.960) 2. When BPD, AC and FL were measured, the addition of HC didn,t affected to accuracy of EFW 3. The best results of all equations were obtained with our equation 5(Mean error=2.36gm, Mean absolute error=96.39gm, Mean deviation + SD(%)=0.07+0.37) and among foreign equations, the best results were with Hadlock III equation(Mean error=18.35gm, Mean absolute error=107.82gm, Mean deviation + SD(%)=-0.46+0.42) 4. The equations using AC/FL (our equation 3, Hadlock I) are more accurate than those using BPD/AC (our equatione 2, Shepard) when utilizing two parameters. Therefore, equation using AC/FL is recommended when the BPD is unobtainable at term or labor 5. The percentage of cases in which the EFW was within +5% and +200gm of the actual birth weight was highest at our equation 5 for 82% and 89%, Hadlock IV equation for 79%, 88%. 6. Our equations had relatively an equal tendency to under- and overestimate fetal weight, but foreign equations, especially Campbell and Hadlock II equations tended to underestimate. 7. Analysing according to actual birth weight, our all equations gave the most accurate estimates of fetal weigh for birth weight group between 3000-3499gm, but for birth weight group above 3500gm, that was not. At birthweight group above 3500gm, the equations depend on femur length are more accurate than the equations independ on fumr length.
Birth Weight ; Cesarean Section ; Female ; Femur ; Fetal Weight* ; Fetus ; Head ; Pregnancy ; Ultrasonography

PURPOSE: To determine the usefulness of carbon dioxide(CO2) indirect portography during TIPS procedure. MATERIALS AND METHODS: We evalvated eight patients who had undergone TIPS due to variceal hemorrhage or ascites caused by portal hypertension. All patients but one with complete situs inversus underwent wedged right hepatic venography for visualization of the portal vein using CO2. For CO2 indirect portal venography, 50cc of CO2 was injected by hand without prior injection of a small amount of CO2. In three patients a 5-F angiographic catheter was wedged into the right hepatic vein, and in the other five a 9-F sheath from a Ring 's transjugular access set was adjunctively wedged into the right hepatic vein over the 5-F catheter. The time required for portal vein puncture was defined as the time between the indirect portal venography procedure and the first procedure after successful portal vein puncture. RESULTS: All patients successfully underwent TIPS without any immediate complication. The portal vein was visualized by CO2 in 7 of 8 patients (87.5 %). Two of three patients who underwent indirect portography with only a 5-F catheter wedging demonstrated opacification of the right portal vein; in the remaining patient the portal venous system was not visualized. Of the five patients who underwent indirect portography with an adjunctive 9-F sheath wedged in the right hepatic vein, four showed opacification from the peripheral to the main portal vein, and in the other, the only right peripheral portal vein was opacified. The mean time for portal vein puncture was 20.5 minutes. CONCLUSION: For visualization of the portal venous system during TIPS procedure, the use of CO2 indirect portography is feasible.
Ascites ; Carbon ; Carbon Dioxide ; Catheters ; Hand ; Hemorrhage ; Hepatic Veins ; Humans ; Hypertension, Portal ; Phlebography ; Portal Vein ; Portasystemic Shunt, Surgical ; Portography* ; Punctures ; Situs Inversus

This study was aimed to investigate the possible correlations between International Prostate Symptom Score (IPSS), volume of total and transition zone of prostate, and serum prostate specific antigen (PSA) level in 42 patients diagnosed and treated as benign prostatic hyperplasia. We got IPSS by interview and calculated the volume of the total and the transition zone (TZ vol) of prostate by transrectal ultrasonography. The size of the total prostate was 37.35+/-12.9 cc (mean+/-standard deviation) and that of the transition zone was 17.72 +/- 10.04 cc. Transition zone index(transition zone volume/total prostate volume, TZ index) was calculated and its value was 0.45 +/- 0.14. Symptom score was not correlated with total prostate volume, TZ volume or 72 index (r=0.27, p>0.05; r=0.23, p>0.05; r=0.16, p>0.05, respectively). Either it did not show correlation with serum PSA level (r=0.16, p>0.05). However, there were statistically significant correlations among serum PSA, total volume, TZ volume, TZ index (r=0.66, p<0.05; r=0.64, p<0.05; r=0.47, p<0.05). From these results, it is difficult to find significant correlations between symptom severity easured by IPSS and several clinical indices such as total prostate volume, transitional volume, TZ index or serum PSA level. Prospective study including developing a more objective symptom scoring system is needed to get a more useful clinical index reflecting the symptom severity of the BPH patients as well as clinical status of them.
Humans ; Prostate* ; Prostate-Specific Antigen ; Prostatic Hyperplasia* ; Ultrasonography*

The treatment for full thickness skin defect with the full or split-thickness autograft was often associated with aesthetically poor result, hypertrophic scar or extensive injury on donor site. Because of this donor morbidity, the use of artificial dermis was considered, which was the substrate of collagen or collagen cross-linked with polyglactin or polylactin. Unfortunately this substrate was void of advantages for the artificial dermis but was of easy biodegradability, antigenicity, or cytotoxic property. Currently chitosan is given attention by many investigators for its biochemical properties in wound healing process. Chitosan is the deacetylated derivative of chitin, which is a polymer of 2-amino-2-deoxy glucose with chemically active free amino group. Chitosan facilitates wound healing process, and then stimulates migration of polymorphonuclear cell(PMN) and macrophage, release of IL-8 and accelerates collagen synthesis surely with vascularization. Indeed chitosan supplies the resistance against bacterial infection of the wound. In this study, we have investigated the clinical applicability of the artificial dermal substrate which is cross-linked of collagen and GAG with chitosan, which we have applied on the full thickness skin defect in Fisher rat. The conclusions are as the follows: 1. There was sufficient vascularization in the grafted dermal substrate for STSG after 2 weeks of artificial dermis grafting. 2. Four 4 weeks after artificial dermis grafting, the architecture of the dermal substrate was maintained in about half amounts and the half of dermal skeleton was replaced with the newly formed dermis(neodermis). In conclusion, the dermal substrate used in this study is available enough for wound of full thickness skin defect.
Animals ; Autografts ; Bacterial Infections ; Chitin ; Chitosan ; Cicatrix, Hypertrophic ; Collagen ; Dermis ; Equipment and Supplies ; Glucose ; Humans ; Interleukin-8 ; Macrophages ; Polyglactin 910 ; Polymers ; Rats ; Research Personnel ; Skeleton ; Skin ; Tissue Donors ; Transplants ; Wound Healing ; Wounds and Injuries

BACKGROUND/AIMS: The treatment strategy for hepatitis C virus (HCV) has been changing rapidly since the introduction of direct-acting antivirals such as daclatasvir (DCV) and asunaprevir (ASV). We evaluated the efficacy and safety of DCV and ASV for HCV in real-life practice. METHODS: Patients were treated with 60 mg of DCV once daily plus 200 mg of ASV twice daily for 24 weeks, and followed for 12 weeks. The primary endpoint was a sustained virological response at 12 weeks after treatment (SVR12) and safety. RESULTS: This retrospective study included eight patients with chronic HCV genotype 1b infection. All of the enrolled patients were diagnosed with liver cirrhosis, and their mean age was 65.75 years. One patient was a nonresponder and two patients relapsed with previous pegylated interferon (PegIFN) and ribavirin (RBV) treatment. None of the patient showed NS5A mutation. An SVR12 was achieved in 88% of cases by the DCV and ASV combination therapy. The serum transaminase level and the aspartate-aminotransferase-to-platelet ratio were improved after the treatment. DCV and ASV were well tolerated in most of the patients, with treatment discontinuation due to adverse events (elevated liver enzyme and decompensation) occurring in two patients. CONCLUSIONS: In this study, combination of DCV and ASV treatment achieved a high sustained virological response with few adverse events even in those with cirrhosis, advanced age, and nonresponse/relapse to previous interferon-based therapy. Close monitoring of safety issues may be necessary when treating chronic HCV patients receiving DCV and ASV, especially in older patient and those with cirrhosis.
Aged ; Alanine Transaminase/blood ; Antiviral Agents/*therapeutic use ; Aspartate Aminotransferases/blood ; Drug Administration Schedule ; Drug Resistance, Viral ; Drug Therapy, Combination ; Female ; Genotype ; Hepacivirus/*genetics/isolation & purification ; Hepatitis C, Chronic/complications/*drug therapy/virology ; Humans ; Imidazoles/*therapeutic use ; Isoquinolines/*therapeutic use ; Liver/diagnostic imaging ; Liver Cirrhosis/complications ; Male ; Middle Aged ; RNA, Viral/blood ; Retrospective Studies ; Sulfonamides/*therapeutic use ; Treatment Outcome