We report a case of experimental reproduction of the skin lesion of polymorphous light eruption by potent UVA irradiating instrument, metal halide mercury lamp. A 20-year-old female had complained skin lesion at sun-exposed area since childhood. The skin lesion was reproduced after repetitive exposure of high dose of UVA, and the histologic feaure of the lesion was consistent with polymorphous light eruption. Metal halide mercury lamp used in this patient has hight irradiance and exclusive of UVB and UVC. It can be convenient and precise one in phototest using high doses of UVA.
Female ; Humans ; Reproduction* ; Skin ; Young Adult

Reticulate pigmented anomaly of the Flexures (Dowling-Degos disease) is the rare pigment anomaly characterized by spotted and reticulate pigrnentation of the flexures. We report a case of reticulate pigmented anomaly of flexures in a 37-year-old woman. She had reticulated network of brown-black macules on right infrarnammary region and arm. Histopathological findings showed branching melanized epidermal downward proliferations arising from the lower border of epidermis.
Adult ; Arm ; Epidermis ; Female ; Humans ; Pigmentation

Nonoperative dilatation techniques such as bougination, balloon dilatation, endoscopic laser therapy, and endoscopic electro-coagulation, have been applied to relieve dysphagia due to esophageal strictures, but the most widly used ia peroral dilatation once a guide wire has been passed under direct vision using a fiberoptic endoscope. Some cases of severe and curved esophageal strictures coutd'nt be introduced the conventional steel guide wire. We desecibe a method of cannulation of these difficult strictures guided by torque control angiographic catheter with radiogrphic control. A case of 18 year old man with severe corrosive esophageal stricture ingested HCl was successfully treated with esophageal dilatation with Savary-Gilliard dilator guided by Judkin's right coronary artery catheter.
Adolescent ; Catheterization ; Catheters* ; Constriction, Pathologic ; Coronary Vessels* ; Deglutition Disorders ; Dilatation* ; Endoscopes ; Esophageal Stenosis* ; Humans ; Laser Therapy ; Steel ; Torque

In study of 360 psoriatic patients between June 1982 and May 1987 in Seoul National University Hospital, psoriasis was classified according to the severity based on the extent of involvement. The guideline of the extent of involvement was as follows, 1) mi1d less than 5% involvement of whole surface area 2) moderate : 5% 30% involvement of whole surface area 3) severe: over 30% involvement of whole surface area This study was done to evaluate the distribution and clinical features of psoriasis according to the extent, of involvement. Among 360 psoriatics, 180(50.0%) patients had mild psoriasis, 140(38.9%) patients had moderate psoriasis and 40(11.1%) patients presented as severe psoriasis. The duration of psoriasis seemed longer in moderate and severe groups than in mild group but the difference was not signifcant. There was also a tendency that patients developing psoriasis before the age of 20 were more prevalent in severe group.
Humans ; Psoriasis* ; Seoul

Choledochal cyst of the common bile duct is usually considered to be large cystic dilatation that extends from the wall of the common bile duct. Choledochal cyst is a very rare cond.ition in adult, These cysts are commonly distinctive in childran under the age of ten. Even in this age group they are considered rare. The classicajl triad of a choledochal cyst inclule pain, jaundice and a palpable right upper quadrant mass. This triad was found in only 21~63% and the most common finding is jaundice. Diagnoais of choledochal cyst usually is made during laparotomy, In nonjaundiced patients, oral cholangiogram and/or intravenous cholangiogram may yield the diagnosis. In jaundiced patiente where the diagnosis may be more difficult to make, one may consider doing ERCP and/or percutaneous transhepatic cholangiogram. The percutaneous transhepatic cholangiogram seems to be very helpful in diagnosing jaundiced patients. It is being used more and more in recent years but this method is not without complication. With advent of ERCP, visualization of the biliary tree has become a simple procedure when performed by expert endoscopists. To our knowlege, no previous case of choledochal cyst diagnosed by ERCP has been reported. yet in our country This paper reports 4 cases of choledochal cyst diagnosed by ERCP.
Adult ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Choledochal Cyst ; Common Bile Duct ; Diagnosis ; Dilatation ; Humans ; Jaundice ; Laparotomy

Candida Albicans is a saprophytic organism under normal circumstances and a limited pathogen when presents in large numbers. The common site of infection are the mouth, skin, vagina and respiratory tract. It is a common inhabitant of the G-I tract, where it does not usually cause symptoms. With impared defense mechanism or long-term antibiotic therapy, however it can became a significant pathogen. The clinical symptoms and endoscopic findings present a spectrum of changes depending on the degree of esophageal involvement. Painful awallowing and substernal chest pain are most common symptoms. Esophgeal infection is an unusual but impartant form of the diseases and can easily be confirmed by esophagoscopy. Recently we have experienced 4 cases of esophageal moniliasis confirmed by esophagoscopy and tissue biopay.
Candida albicans ; Candidiasis* ; Chest Pain ; Esophagoscopy* ; Mouth ; Respiratory System ; Skin ; Vagina

Primary cancer af the duodenum is rare. An extensive experience with fiberoptic eaophag-ogastro-duodenoscopy in our institution has indicated that duodenal cancer may be more frequent thsn suspeeted and readily diagnesed by this modality, With this in mied, clinical, pathological, diagnostic and therapeetie aspects of the 26 patients with primary duodenal cancer which had been endoscopically diugnosed were reviewed. The results obtained were as follows: 1) Ages ranged from 16 to 75, with the mean of 55.2 years. Seventeen patients were men and nine patients women being l. 9:1 of male-female ratio. 2) Hndoscoyic findings were 46. 1 percent ulcerative anld 34. 8 per cent ulcerative-infiltrative, 3) The diatribution within the duodenum was 50 per cent suprapapillary, 42. 4 per cent peri- papillary aecl 7. 6 per cent infrapapillary. 4) The twenty-three patients had adenocarcinoma, two patients leiomyosarcoma and 1 patient lymphoma. 5) Twenty patients were confirmed by duodenoseopic biipsies and six patients by operations. 6) The mast common presenting mmyliiints were abdominal pain, chronic blood lais leading anemia, jaundice, anorexia, indigestion, weight lass and palpable abdominal mass. 7) Of the 26 patients, eight patients underwent attempted curative resection, six patients underwent palliative bypasa procedures or exploratory laparotomy.
Abdominal Pain ; Adenocarcinoma ; Anemia ; Anorexia ; Diagnosis* ; Duodenal Neoplasms ; Duodenum ; Dyspepsia ; Female ; Humans ; Jaundice ; Laparotomy ; Leiomyosarcoma ; Lymphoma ; Male ; Ulcer

Isolated pulmonary stenosis, a relatively common congenital anomaly that accounts for about 10 percent of all congenital heart disease, is characterized by stenosis of pulmonary valve itself, infundibulum or both of them. Since cardiac catherterization was applied to man by Cournand and Ranges, pulmonary stenosis had been easily diagnosed and many clinical studies had been investigated. It has a wide clinical spectrum depending on the degree of stenosis. The electrocardiogram, phonocardiogram and chest X-ray have proved useful in estimating the severity of hemodynamic facotrs in individual cases. This series comprises 47 cases in whom the clinical diagnosis of isolated pulmonary stenosis was confirmed by right heart catheterization with cardiac cineangiography at Severance Hospital, Yonsei University. An attempt was made to correlate the electrocardiographic, phonocardiographic, chest X-ray findings, and types of stenosis with the hemodynamic data in these cases. 1. Of 47 patients, 33 were male and 14 female. Their ages ranged from 2 to 42 years: the mean age was 19.1 years. 2. The incidence was 5.9 percent of all 797 catheterized congenital heart disease cases. The pulmonary valvular stenosis was 30 (68.3%), infundibular 7 (14.6%) and combined 10 (21.6%) cases. 3. The correlation between electrocardiogram and hemodynamic data were as follows. i) The regression equation between right ventricular sysytolic pressure (RVSP) and height of R wave in V1 lead (RV1) was RVSP=3.32 RV1+48.2: its correlation coefficient was 0.818 and it was very significant (p=0.000). ii) The higher the RVSP, the more the frontal axis of QRS complex shifted to the right side (r=0.55. p=0.001). iii) The RVSP of the groups with positive ECG findings such as p-pulmonale, right ventricular hypertrophy or right ventricular strain were much higher than the RVSP of the groups without such findings (p=0.032.0.000, 0.000). iv) The group with RV1 higher than 20 mm showed much more elevated mean of RVSP than the group with lower RV1 (p=0.000). v) The groups with the above mentioned positive ECG findings showed good correlation with the severity of RVSP which was arbitrarily classified as 49 or less, 50~100, and 100 mmHg or more (chi-square=8.96, 26.69, 19.06; p=0.011, 0.000, 0.000). 4. The group with late occurrence of the maximum intensity of the ejection systolic murmur showed higher mean of RVSP than the group with early peak of the murmur (p=0.014). 5. The means of RVSP of the groups with chest X-ray findings such as decreased pulmonary vascularity, were much higher than the means of RVSP of the groups without such findings (p=0.000, 0.005, 0.015). The groups with above mentioned positive chest X-ray findings showed good corelations with the severity of RVSP which was classified as above limits (chi-square=7.55, 10.94, 13.36; p=0.022, 0.004, 0.001). 6. Combined pulmonary valvular and infundibular stenosis showed more severe systolic pressure gradient and higher mean of RVSP than the isolated types (p=0.000).
Axis, Cervical Vertebra ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Catheters ; Cineangiography ; Constriction, Pathologic ; Diagnosis ; Electrocardiography ; Female ; Heart Defects, Congenital ; Hemodynamics* ; Humans ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Pulmonary Valve ; Pulmonary Valve Stenosis* ; Systolic Murmurs ; Thorax

Postcholecystectomy syndrome is the persistence or recurrence of symytom complex following cholecystectomy, The majority of the patients have mild symptoms. However, the cause of recurrent symptoms is often obscure and as a consequence, a plan of management is difficult to formulate. Recently ERCP has proved to be increasingly helpful in the investigation of postcholecystectomy patients. The purpose of this study was to test the effectiveness of the ERCP in the evaluation of patients with postcbiolecystectomy syndrorae. The results are as follows 1) 102 postcholecystectomy patients were studied by endoscopic retrograde cholangiopancreatography and successful cannulation with demonstration of at least one duct was achieved in 49 of 50 jaundiced patients and in 49 of 52 non-jaundiced patients. The overall success rate was 96. 1%. 2) The results of ERCP were normal in 26 patients(26.5%) and abnormal in 72 patients (73.5%), Only 3 of 50 jaundiced patients were normal, but 23 of 52 non-jaundiced patients showed no abnormal findings. 3) The most common abnormality was biliary stone in common bile duct and intrahepatic duct which were present in 51 patients(50%). Cholangitis without stone was next common finding which was in 13 patients(13%). Of the remaining patients have air biligram, 2 CBD stricture, 1 CBD aseariasis & 1 chronic pancreatitis. 4) Time lapse between onset of symptoms and cholecystectomy was variable. 31 patients were studied less than 2 years after cholecystectomy. 18 of these patients had jaundice and 13 had no jaundice. Within 2 years afte chklecystectomy, the biliary stone was most common finding which were present in 14 out of 31 patients.
Catheterization ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Cholecystectomy ; Common Bile Duct ; Constriction, Pathologic ; Humans ; Jaundice ; Pancreatitis, Chronic ; Postcholecystectomy Syndrome ; Recurrence

There was no definitive reported cases of urinary calculi. This study is to estate the value of urinary calcium, magnesium, uric acid and magnesium/calcium ratio in cases of urinary calculi. The amount of calcium, uric acid and magnesium in 24 hour urinary excretion was measured by OCPC, Uricase and titan yellow method in 56 cases of upper urinary calculi compared with 35 control group.The results were summerized as follows.l. The mean values of 24 hour urinary excretion of calcium were 193+/-26mg/day in stone formers and 15l+/-25mg/day in control group. The 24 hour urinary excretion of calcium in the stone formers were significantly higher than those of the control group. 2. The mean values of 24 hour urinary excretion of uric acid were 498+/-40mg/day in the stone formers and 371+/-6mg/day in the control group. The 24 hour urinary excretion of uric acid in the stone formers were significantly higher than those of the control group. 3. Urinary magnesium values have not been shown any significant differences between the group with urinary calculi and those of control group. 4. The mean values of 24 hour urine of magnesium to calcium ratio was 1.01+/-0.95 in stone formers and l.42+/-1.31 in the control group. The magnesium to calcium ratio in the stone formers were significantly lower than those of the control group. These results suggest that increased urinary calcium and uric acid level may play some role in the genesis of urinary stone but urinary magnesium value was not different in the two groups. We think that a decrease in the urinary magnesium to calcium ratio was the results of increased excretion of calcium rather than lowered excretion of the magnesium for the stone formers.
Calcium* ; Magnesium* ; Saturn ; Urate Oxidase ; Uric Acid* ; Urinary Calculi* ; Urolithiasis