Familial lichen planus is an uncommon disease, and there are 104 cases reported in the English literature. Several theories regarding the etiopathogenesis of lichen planus have been proposed. However, immunological mechanisms and genetic susceptibility have been emphasized the most. Several reports showed HLA analysis in lichen planus patients, and recently 2 cases have revealed an increased frequency of DR1 antigen in patients with lichen planus compared to a control group. We observed two brothers with typical skin lesions of lichen planus of almost simultaneous onset. We confirmed lichen planus by skin biopsies in both brothers and analyzed HLA typing. We also observed the occurrence of DR1 antigen in both of them.
Biopsy ; Genetic Predisposition to Disease ; Histocompatibility Testing ; Humans ; Lichen Planus* ; Lichens* ; Siblings ; Skin

Cutaneous metastasis from renal cell carcinoma is not unusual, occurring in 3 to 7%, although it may be overlooked. We report a case of metastatic renal cell carcinoma in a 74-year-old man who was presented with a 1.5 x 1.5 x 0.5 cm-sized nodule on the right zygoma for 3 months. A skin biopsy demonstrated the typical clear cell adenocarcinoma with PAS(+) granules in the cytoplasm and honeycombed or glandular configuration, compatible with metastatic renal cell carcinoma. Kidney ultrasonogram and abdomina1 CT scanning showed a large cystic mass on the upper pole of the left kidney. Furthermore radiologic studies revealed multiple metastatic lesions in the lung, liver and brain. He died 4 months later.
Adenocarcinoma, Clear Cell ; Aged ; Biopsy ; Brain ; Carcinoma, Renal Cell* ; Cytoplasm ; Humans ; Kidney ; Liver ; Lung ; Neoplasm Metastasis ; Skin ; Tomography, X-Ray Computed ; Ultrasonography ; Zygoma*

Dystrophic epidermolysis bullosa is a rare, chronic non-inflammatory bullous disease, which easily forms bullae by minor mechanical trauma or spontaneously, is inherited either in an autosomal dominant or autosomal recessive fashion. We report herein two cases which presented with bullae, erosions and ulcers on extremities, buttock, chest, abdomen and face and loss of all nail since birth in two sisters. Bulla occured bencath the basal lamina histopathologically, anchoring fibrils were almost absent on electron miaoscopy in both cases. The two sisters represented dystrophic epidermolysis bullosa considering the absence of family history inheritcd in an autosomal dominant fashion and the clinical, histological and electronmicroscopic findings.
Abdomen ; Basement Membrane ; Buttocks ; Epidermolysis Bullosa Dystrophica* ; Extremities ; Humans ; Parturition ; Siblings* ; Thorax ; Ulcer

Anti-E and anti-c is one of the clinical significant irregular antibodies developing a delayed hemolytic transfusion reaction and hemolytic disease of the newborn. Since anti-c occurs frequently with anti-E in immunized people whosoe cells are E-and c-, it has been recommended to select blood of the patient's own R1 phenotype for transfusion, even when the presence of anti-c cannot be demonstrated in his/her serum. To determine the utility of this approach, we reviewed the blood bank laboratory records of patients identified anti-E and anti-c in his/her serum in Severance hospital over a 12 year period (1985-1996). During the 12-year period of study, 53 patients were identified with anti-E and/or anti-c; 30(56.6%) patients had anti-E alone, 6(11.3%) had anti-c, and 17(32.1%) had both. Thirty eight of forty two patients whose Rh-hr phenotypes were tested were R1R1. Of these 38 R1R1 patients, 16 patients (42.1%) presented with anti-c concomitant with anti-E. Ouru study showed that the incidence of antni-c in R1R1 patients with anti-E is similar to that of studies reported in Caucasian groups. We highly suggest the transfusion protocol of prophylactic use of c negative blood for R1R1 patients with anti-E. Furthermore, because anti-c may be present in concentrations too low to be detected, the enzyme technique is recommended in parallel with standard serologic methods for the identification of irregular antibodies.
Antibodies ; Blood Banks ; Blood Group Incompatibility ; Humans ; Incidence ; Infant, Newborn ; Phenotype

communicable diseases. The purposes of the study is to estimate reporting proportion of National Notifiable Infectious Diseases(NNIDs) and investigate characteristics related to reporting using KAP(knowledge, attitude, practice) model. METHOD: We surveyed randomly selected 2,185 physicians (speciality: internal medicine, family medicine, pediatrics, dermatology, general physicians) of their knowledge, attitude, and practice of NNIDs reporting through self-administered mail questionnaires. Of them, 231 physicians responded (response proportion: 10.6%). RESULT: The reporting proportion was estimated to 27.0%. Recognition level (knowledge) of NNIDs was relatively high with proportion of 69.4%, and attitude (public health importance) of reporting was 65.8%. Multiple logistic regression analysis showed that knowledge, attitude significantly affected physicians' reporting in a positive direction (O.R. 6.2, 6.2 respectively). Whereas, senior age group, specialty (family medicine, pediatrics, dermatology) showed significantly lower reporting. General (tertiary care) hospital level of care showed significantly higher reporting practice (alpha=0.05). CONCLUSION: The NNIDs reporting proportion, 27.0% is similar with those studied recently. Continuous efforts to increase the performance level of communicable diseases surveillance system. Of those, restructuring surveillance systems considering characteristics of notifiable diseases classes must be stressed. Educational approach of physicians needs to be tailored specially to newly-designated diseases such as Group II, Designated Group NNIDs.
Communicable Diseases* ; Dermatology ; Humans ; Internal Medicine ; Logistic Models ; Pediatrics ; Postal Service ; Surveys and Questionnaires

Congenital Abnormalities ; Female ; Humans ; Jaw ; Jeollabuk-do ; Male ; Orthognathic Surgery ; Osteotomy ; Osteotomy, Sagittal Split Ramus ; Rehabilitation ; Surgery, Oral

OBJECTIVE: To test the hypothesis that a safety margin may affect local tumor recurrence (LTR) in subsegmental chemoembolization. MATERIALS AND METHODS: In 101 patients with 128 hepatocellular carcinoma (HCC) nodules (1-3 cm in size and < or = 3 in number), cone-beam CT-assisted subsegmental lipiodol chemoembolization was performed. Immediately thereafter, a non-contrast thin-section CT image was obtained to evaluate the presence or absence of intra-tumoral lipiodol uptake defect and safety margin. The effect of lipiodol uptake defect and safety margin on LTR was evaluated. Univariate and multivariate analyses were performed to indentify determinant factors of LTR. RESULTS: Of the 128 HCC nodules in 101 patients, 49 (38.3%) nodules in 40 patients showed LTR during follow-up period (median, 34.1 months). Cumulative 1- and 2-year LTR rates of nodules with lipiodol uptake defect (n = 27) and those without defect (n = 101) were 58.1% vs. 10.1% and 72.1% vs. 19.5%, respectively (p < 0.001). Among the 101 nodules without a defect, the 1- and 2-year cumulative LTR rates for nodules with complete safety margin (n = 52) and those with incomplete safety margin (n = 49) were 9.8% vs. 12.8% and 18.9% vs. 19.0% (p = 0.912). In multivariate analyses, ascites (p = 0.035), indistinct tumor margin on cone-beam CT (p = 0.039), heterogeneous lipiodol uptake (p = 0.023), and intra-tumoral lipiodol uptake defect (p < 0.001) were determinant factors of higher LTR. CONCLUSION: In lipiodol chemoembolization, the safety margin in completely lipiodolized nodule without defect will not affect LTR in small nodular HCCs.
Adult ; Aged ; Carcinoma, Hepatocellular/radiography/*therapy ; Chemoembolization, Therapeutic ; Cone-Beam Computed Tomography ; Ethiodized Oil/*administration & dosage ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms/radiography/*therapy ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local/radiography

PURPOSE: Asthma has been known as a chronic inflammatory disease to cause airway obstruction by allergens, viral infections and other factors. Nowdays infantile asthma is increasing markedly. However, to date the enough study for predicting its long term prognosis was not performed. This study aimed to estimate the long term prognosis of infantile asthma. METHODS: In pediatric allergy clinic of Hanyang University Hospital, 84 asmatics younger than 24 months of age were included from January 1986 to December 1992, who had no abnormality in the airway. Infantile asthma was diagnosed on the basis of chronic cough, episodic wheezing more than three times and reversibility of clinical symptoms by using inhaled bronchodilators. Forty four asthmatics could have been followed and divided into two groups, symptomatic and resolved by analyzinng their medical records and performing follow- up examination with blood and skin prick tests to common allergens. RESULTS: 1) The two study groups included resolved 28 children (63.6%) and symptomatic 16 children (36.4%) with the ratio of male 3.9 to female 1. 2) There were no significant differences the age of first wheezing episode (9.6+/-5.6 mo. vs. 9.9+/-3.5 mo.) as well as diagnosis (14.3+/-5.7 mo. vs. 16.2+/-5.1 mo.) between two study groups, respectively (P>0.05). 3) For history of atopic dermatitis, there was significant difference between the resolved group 6 of 28 children and the symptomatic group 12 of 16 (P<0.05). 4) For laboratory examination, no significant difference was observed, between the levels of PB eosinophil count (310.4+/-282.2/mm3 vs. 368.1+/-465.9/mm3 at diagnosis; 294.3+/-205.3/mm3 vs. 457.7+/-511.2/mm3 at follow-up) and serum IgE (107.2+/-126.5 IU/ml vs. 157.6+/-246.3IU/ml at diagnosis; 267.3+/-700.5IU/ml vs. 442.6+/-546.0IU/ml at follow-up). 5) The frequency of asthmatic attack per year was 3.3+/-1.6 vs. 3.7+/-1.7; the duration of clinical symptom was 2.6+/-1.4 vs. 5.7+/-2.0 years, respectively. 6) The results of skin prick test showed that more frequent positivity to common inhalants in symptomatic group than in resolved was observed. CONCLUSIONS: In the long term follow-up for infantile asthma, the resolved 28 of 44 asthmatics were observed. The positive history of atopic dermatitis might be one of the important predictors for their persistent clinical symptoms.
Airway Obstruction ; Allergens ; Asthma* ; Bronchodilator Agents ; Child ; Cough ; Dermatitis, Atopic ; Diagnosis ; Eosinophils ; Female ; Follow-Up Studies* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Male ; Medical Records ; Prognosis ; Respiratory Sounds ; Skin

This study was conducted to compare the date on knowledge, attitude and motivation toward blood donation between donors and non-donors. The study population included 622 donors and 322 non-donors who visited the mobile blood donation car of Taegu Red Cross Blood Center and participated the group appointed blood donation campaign managed by the center from March 1 to March 31, 1989. The donors and non-donors were questioned above mentioned items with a formulated questionnaire. Among the general characteristics of the subjects in the study, male predominance (84.1% in donors and 73.6% in non-donors) in young age group (16-24 years) was the outstanding feature. As a medium of information about blood donation, “television” was playing a dominant role (donors; 75.2%, non-donors; 78.9%), while “magazine” played more important roles among donors. Of the donors, 70.6% and of the non-donors, 58.1 replied that they had ever been induced to donate blood (p<0.01). Major inducers were friend and personnel of mobile blood donation vehicle. On the measuring of knowledge level, the average rates of correct answer was higher in donors (62.6%) than in non-donors (54.1%) (p<0.01). Higher the education level was presented, higher the knowledge level (p<0.05). There have been noticeable difference between donors and non-donors in blood replying the questionnaire set to measure their attitude toward blood donation, especially in the items such as “impression toward blood”, “selection of transfusion blood source” and “view on the situation of blood shortage.” The major motivation toward blood donation of the groups were “possible future need” and “altruism or humanitarian interest”. The major reasons for not donation blood in both groups were “fear of the needle” and “dread to visit to mobile car or center”.
Blood Donors* ; Daegu ; Education ; Friends ; Humans ; Male ; Motivation* ; Red Cross ; Tissue Donors

PURPOSE: Recently, as the number of transobturator tape (TOT) procedures has increased, recurrence after this procedure has been frequently reported. However, there are no standard guidelines for treatment. We describe our experience with shortening the previously implanted tape in patients with recurrent stress urinary incontinence after the TOT procedure. MATERIALS AND METHODS: We enrolled 10 women who underwent shortening of the previously implanted tape and were followed up for 3 years. Shortening of the previously implanted tape was done by a figure-eight suture with 1-0 Prolene. One year after TOT shortening, we investigated continence status, patient satisfaction by means of a questionnaire, maximal flow rate (Qmax), and postvoid residual urine volume. Three years after TOT shortening, we evaluated continence status and patient satisfaction. RESULTS: The mean period of TOT shortening was 4.2 months (range, 1-12 months) after the TOT procedure. One year after TOT shortening, 7 patients showed complete dryness, 2 patients showed improvement, and 1 patient reported failure. Eight patients were very satisfied or satisfied with the 1-year result after TOT shortening. The mean preoperative and postoperative Qmax were 23.8 and 26.7ml/s, respectively, and there was no significant difference. Three years after TOT shortening, 6 patients showed complete dryness, 2 patients showed improvement, and 2 patients reported failure. Among them,1 had failed from 1 year after TOT shortening and the other had shown 1 year of complete dryness. Eight patients were very satisfied or satisfied and 2 patients were dissatisfied with the 3-year result after TOT shortening. CONCLUSION: Most of the patients who underwent TOT shortening reported satisfaction as well as improvement of incontinence after a 3-year follow up. Therefore, we suggest that TOT shortening may be recommended primarily in patients with recurrent stress urinary incontinence after the TOT sling procedure.
Female ; Follow-Up Studies ; Humans ; Patient Satisfaction ; Polypropylenes ; Recurrence ; Suburethral Slings ; Sutures ; Urinary Incontinence ; Urinary Incontinence, Stress