Erythema dyschromicum perstans is a cutaneous pigmentary dermatosis of unknown etiology chararcterizd by asymptomatic macules of an ashy gray color which was first presented by Ramirez. We reported a case of Erythema dyschromicum perstans in 57 year old female patient. The skin lesion were characterized by the presence of discreated or confluented bluish-gray colored pigrnentation on the lateral surface of hoth upper extremities. Histologically, the lesion showed hydropic degeneration of the epidermis witb in continence of pigmcnt and an apperence of malanin-hearing macrophages in upper dermis which are compatible with Erythema dyschromicum perstans.
Dermis ; Epidermis ; Erythema* ; Female ; Humans ; Macrophages ; Middle Aged ; Skin ; Skin Diseases ; Upper Extremity

Multiple lentigines syndrome is characterized by the presence of numerous dark brown macules on the skin but not mucous surfaces and known also by the mnemvnic "LEOPARD syndrome" are, besides the lentigines, electrocardiographic conduction defect, ocular hypertelorism, pulmonary stenosis, abnormalities of the genitalia consisting of gonadal or ovarian hypoplasia, retardation of growth, deafness and inherited by autosomal dominant trait. We experienced a case of multipIe lentigine syrrdrome in 20-year old woman. She had numerous pinhead to pea sized, dark brownish macules on the entire body skin a,nd had no associated anomalies of other organ. On laboratory examinations including the CBC, urinalysis., chest X-ray, EKG; EEG, Hormone assay was all normal except for the slight anemic finding. On histologic examina,tion of biopsied macular skin showed a slight elongation of rete ri.dges, an increase in the concentration of melanocyte in the basal layer and mild inflammatory infiltration in the upper dermis. Treatment was done by cryotherapy on the face with marked improvement.
Cryotherapy ; Deafness ; Dermis ; Electrocardiography ; Electroencephalography ; Female ; Genitalia ; Gonads ; Humans ; Hypertelorism ; Lentigo ; LEOPARD Syndrome* ; Melanocytes ; Peas ; Pulmonary Valve Stenosis ; Skin ; Thorax ; Urinalysis ; Young Adult

Hydroa Vacciniforme is a rare, light sensitive dermatitis characterized by discrete vesicles followed by varioliform scar formation, which was first described by Bazin on 1862. We have expe"ienced three cases of hydroa vacciniforme in childhood. The first case was a 6-year-old boy who had discrete vesicles, crusts and pitting scars on forehead, both cheeks, ears and dorsum of the hands in symmetrical distribution with itching sensation, which had used to recur in every summer since last three years ago. Histologic section of a primary lesion showed necrosis and severe edema in the epidermis and adjacent dermis with the dermal inflammatory cell infiltration. The second case was a 10-year-old girl who had discrete vesicles, crusts, erosive and depigmented patch and scars on face, lip, dorsum of the hand and forearm with itching sensation, which had also developed on last spring. The third case was a 7-year-old boy who had vesiclee, erosive patch, crusts and pitting scars on face, Iower lip, both dorsum of the hand and forearm with itching sensation, which had recurred in every summer since last two years ago, On urine examination, porphyrin, was negative in all three cases. Diagnosis was established by clinical characteristics and laboratory findings and histological pictures. Symptomatic treatment was done in all three cases. The literatures were briefly reviewed.
Cheek ; Child ; Cicatrix ; Dermatitis ; Dermis ; Diagnosis ; Ear ; Edema ; Epidermis ; Female ; Forearm ; Forehead ; Hand ; Humans ; Hydroa Vacciniforme* ; Lip ; Male ; Necrosis ; Pruritus ; Sensation

Unilateral absence of the articular process at a lumbar vertebra is a rare anomaly. The etiology of the congenital absence of articular process is not precisely determined yet, but it was explained as some of the possible embryologic bases. Absence of the articular process at the level of L5-Sl have been reported a few, but anomaly above L4 is rare. We are reporting a case of absence of articular process at the level of the 4th lumbar vertebra.
Spine

PURPOSE: This study was performed for the evaluation of the feasibility and toxicity of hypofractionated radiation therapy for early glottic cancer METHODS AND MATERIALS: From February 1999 to February 2000, 20 patients with histologically confirmed Stage I, II glottic cancer were enrolled into this study. There were 18 males and 2 females, the median age of the patients was 59 years. The distribution of stage distribution was as follows; T1aN0-16 patients, T1bN0-1 patient, T2N0-3 patients. Eighteen patients underwent laryngomicroscopic biopsy only, and two patients underwent laser cordectomy. All patients received radical radiation therapy (2.5 Gy per fraction, 24 fractions, total 60 Gy). Median duration of treatment was 36 days (range 31-45 days). RESULTS: Radiation therapy were well tolerated. Most common acute reactions were odynophagia and hoarseness, and these reactions resolved after radiation therapy. There were one case of RTOG grade 3 odynophagia (5%), six cases of grade 3 hoarseness (30%). Response of radiation therapy was evaluated one month after completion of treatment. All patients revealed complete response. During follow up, total three cases of treatment failure were detected. two cases were local recurrence in 10 and 13 months of radiation therapy and one case was local recurrence and distant metastasis in 2 months of radiation therapy CONCLUSION: This hypofractionated radiation therapy schedule was feasible and effective for control of early glottic cancer. But longer follow up time would be required to assess the long-term disease control and the late complication by shortening radiation therapy duration.
Appointments and Schedules ; Biopsy ; Female ; Follow-Up Studies ; Hoarseness ; Humans ; Male ; Neoplasm Metastasis ; Recurrence ; Treatment Failure

PURPOSE: We investigated the correlations between the expression of claudin-1 and claudin-7 in clear cell renal cell carcinoma (clear cell RCC) and clinical parameters. MATERIALS AND METHODS: The subjects of this study were 119 patients with confirmed clear cell RCC between January 2000 and December 2007. Their RCC tissues were immunohistochemically stained for claudin-1 and claudin-7. The correlations between the expression of claudin and parameters such as sex, age, body mass index (BMI), tumor size, TNM stage, Furhman nuclear grade, postoperative distant metastasis, and cancer-specific survival were analyzed. RESULTS: Among the total 119 subjects, claudin-1 was expressed in 18 (15.1%) and claudin- 7 in 31 (26.1%). Claudin-1 was expressed in patients who were older (p=0.007), who had a greater tumor size (p=0.001), who had a higher pathologic T stage (p=0.009), who had preoperative distant metastasis (p=0.035), and who had a higher Furhman nuclear grade (p=0.004). Claudin-7 was expressed only in patients who had a higher Furhman nuclear grade (p=0.031). The risk of postoperative distant metastasis was associated with the expression of claudin-1 (p<0.001) but not with the expression of claudin-7 (p=0.668). The expression of claudin-1 and -7 was not associated with cancer-specific survival (p>0.05). CONCLUSIONS: In clear cell RCC, claudin-1 was expressed in patients who were older and who had a greater tumor size, who had higher T or M stages, and who had a higher Furhman nuclear grade. The expression of claudin-1 was associated with a higher risk of postoperative distant metastasis.
Body Mass Index ; Carcinoma, Renal Cell ; Claudin-1 ; Humans ; Neoplasm Metastasis

The most common form of joint dislocation is anterior shoulder dislocation. There are a number of available techniques to reduce, but which have a possibility to be happened many kinds of complications like brachial plexus injury, axillary nerve injury and fracture of the humerus. In addition, the drugs we use for the reduction have potential side effects such as cardiovascular complications and respiratory arrest. We are trying to introduce new reduction technique aimed at minimizing the complications and increasing the success rate, which was used in 23 cases and all of them were successfully reduced without complications.
Acromion* ; Brachial Plexus ; Dislocations ; Humerus ; Joints ; Shoulder Dislocation* ; Shoulder*

Pheochromocytoma is originated from chromaffin cell of sympathetic nervous system and associated with other disease, such as neurofibromatosis, duodenal carcinoid, medullary thyroid cancer and parathyroid adenoma. Especially, pheochromocytoma is developed more than 50% in neurofibromatosis associated with hypertension. In such cases, several clinical features documented as more frequent bilateral phochromocytoma, more associated with other neuroendocrine tumors and thus more poor prognosis. We can observe the sustained hypertension despite of surgical resection of tumors in pheochromocytoma cases. One of the possible reason of post operative sustained hypertension is the pheochromocytoma originated from minor organ of Zukerkandl that was not resected during operation. Untreated or delayed treated cases with pheochromocytoma were often expired by complication of hypertension such as cerebrovascular hemorrhage, myocardial infarction, etc. Thus, in neurofibromatosis with hypertension, screening of pheochromocytorna is very important for the early detection of tumor and more favorable prognosis. Recently, We experienced a case of neurofibromatosis associated with bilateral pheochromocy-toma expired by cerebral hemorrhage during operation, so we report the case with literature review.
Carcinoid Tumor ; Cerebral Hemorrhage ; Chromaffin Cells ; Hemorrhage ; Hypertension ; Mass Screening ; Myocardial Infarction ; Neuroendocrine Tumors ; Neurofibromatoses* ; Parathyroid Neoplasms ; Pheochromocytoma* ; Prognosis ; Sympathetic Nervous System ; Thyroid Neoplasms

In the course of immunoscreening of Clonorchis sinensis cDNA library, a cDNA CsRP12 containing a tandem repeat was isolated. The cDNA CsRP12 encodes two putative peptides of open reading frames (ORFs) 1 and 2 (CsRP12-1 and -2). The repetitive region is composed of 15 repeats of 10 amino acids. Of the two putative peptides, CsRP12-1 was proline-rich and found to have homologues in several organisms. Recombinant proteins of the putative peptides were bacterially produced and purified by an affinity chromatography. Recombinant CsRP12-1 protein was recognized by sera of clonorchiasis patients and experimental rabbits, but recombinant CsRP12-2 was not. One of the putative peptide, CsRP12-1, is designated CsPRA, proline-rich antigen of C. sinensis. Both the C-termini of CsRP12-1 and -2 were bacterially produced and analysed to show no antigenicity. Recombinant CsPRA protein showed high sensitivity and specificity. In experimental rabbits, IgG antibodies to CsPRA was produced between 4 and 8 weeks after the infection and decreased thereafter over one year. These results indicate that CsPRA is equivalent to a natural protein and a useful antigenic protein for serodiagnosis of human clonorchiasis.
Amino Acid Sequence ; Animals ; Antigens, Helminth/*genetics/isolation & purification ; Base Sequence ; *Cloning, Molecular ; Clonorchis sinensis/genetics/*immunology ; DNA, Helminth ; Gene Library ; Human ; Molecular Sequence Data ; Rabbits ; Recombinant Proteins ; *Repetitive Sequences, Nucleic Acid ; Support, Non-U.S. Gov't

Intradural lipomatosis is a rare clinical entity characterized by excessive fat deposition in the intradural space. And they occur slightly more frequently in males. It may lead compression of the spinl cord or lumbargo, radiating pain, paresthesia, intermittent claudication and if they involve the cervical and thoracic region, the patients with tumours in these regions most frequently present with a slow ascending monoparesis or paraparesis, cutaneous sensory loss and defective deep sensation. Only 3% of tumours have been reported in the thoraco-lumbar region. The diagnosis should be based on a combination of clinical, imaging, surgical, and histological findings, and especially the diagnostic procedure of choice in patients with progressive myelopathy is MRI scan as it produces accurate imaging without exposure to ionizing radiation. He was treated surgically-removal of excessive fat tissue and decompressive laminectomy. We report a case of intradural lipomatosis that we had removed by surgically.
Diagnosis ; Humans ; Intermittent Claudication ; Laminectomy ; Lipomatosis* ; Magnetic Resonance Imaging ; Male ; Paraparesis ; Paresis ; Paresthesia ; Radiation, Ionizing ; Sensation ; Spinal Cord Diseases