Porokeratosis (mibelli's disease) is a chronic, heritable disorder of the skin, which has a regular dominant limitation to the male sex. This is characterized by localized areas of faulty keratinization resulting in the cornoid lamella, the morphologic and histologic hallmakr of the disease process. Histogenesis is best explained as a mutant clonal keratosis of epidermis, these clonal cells are probably ingerited. A case of porokeratosis Mibelli is reported with its clinical, histological evaluation and review of articles.
Epidermis ; Humans ; Keratosis ; Male ; Porokeratosis* ; Skin

Percutaneous transhepatic cholangiography(PTC) is of value in differential diagnosis of cholestatic diseases. Authors had performed PTC in 120 patients with flexible needle of 23 gauge at the Department of Radiology, KangNam St, Mary's Hospital and Myung Dong St. Mary's Hospital during the period from Jan. 1976 to April 1980. PTC was accomplished successfully in 112 of 120 patients. Diagnoses included cholangiocarcinomas (27 cases), arcinomas ofpancreas head (21 cases), ampullary carcinomas (4 cases), metastatic carcinomas(4 cases), metastatic carcinomas (5cases), bile duct stones(27 cases), sclerosing cholangitis(6 cases), hepatitis(6 cases), liver cirrhosis(6 cases), post operative adhesions(5 cases), chronic pancreatitis(3 cases), stomach carcinomas(3 cases), clonorchiasis(2cases), blood clot (1 case), and remaining normal 4 cases. Some characteristic PTC findings were (1) segmentalannular narrowing and abrupt complete obstruction and polypoid filling defects of the bile duct incholangiocarcinoma, (2) typical nipple or rat-tail appearance of the distal commmon bile duct in pancreatic headcarcinoma, (3) single or multiple sharply and smoothly outlined filling defects whthin bile duct in all cases ofstones, (4) complete obstruction with shallow concavity in ampullary carcinoma, (5) diffuse or segmental narrowingof the intrahepatic bile duct and common bile duct in sclerosing cholangitis, (6) multiple tiny polypoid fillingdefects of gallbladder, common hepatic duct, and common bile duct in clonorchiasis, (7) normal appearance inhepatitis. The overall diagnostic accuracy of PTC in 66 operated cases was 89.4%, and complications following the examination were signficantly reduced by using a fine flexible needle(23 gauge). From the present study it is concluded as follows; 1. To evaluate obstructed or stenosed site accurately, aspiration of bile juice must bepreceded by a 23 gauge needle connected to either 10mo or 5ml syringe. 2. To diagose carcinoma of hte ampullaryportion, serial spot filmings were indispensible ot demonstrated modified appearance of obstructive lesions due tocontraction of Oddi sphincter. 3. In contrast to other reports, the most common site of cholangiocarcinomas wasthe common hepatic duct (12 of 27 cases) in our series. Rat-tail appearance was seen in both pancreatic headcarcinoma and carcinoma involving the distal end of the common bile duct. 4. PTC was a more valuable method for diagnosis of clonorchiasis.
Bile ; Bile Ducts ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; Cholangiography ; Cholangitis, Sclerosing ; Clonorchiasis ; Common Bile Duct ; Diagnosis ; Diagnosis, Differential ; Gallbladder ; Head ; Hepatic Duct, Common ; Humans ; Liver ; Methods ; Needles ; Nipples ; Sphincter of Oddi ; Stomach ; Syringes

No abstract available.
Humans

Recently, we experienced two cases of tuberous sclerosis, in 4-year-4-month-old female and 17-month-old male patient. The diagnoses were established by typical clinical manifestations and brain CAT. Especially, in latter case, calcific density was successfully detected by brain CAT, while plain radiographs of the skull revealed still no evidence of calcification. A brief review of related literatures was made.
Animals ; Brain ; Cats ; Diagnosis ; Female ; Humans ; Infant ; Male ; Skull ; Tuberous Sclerosis*

PURPOSE: Many patients rely on the Internet for medical information. In Korea, there are many websites providing medical information, but the quality of these websites relating to colorectal cancer remains to be clarified. This study was performed to evaluate the quality of websites providing information on colorectal cancer. METHODS: Firstly, sites were identified using four major domestic search engines and were classified according to the administrator. Then, two surgical oncologists used the 'DISCERN' instrument to assess 12 sites (including 2 foreign sites) for the reliability and the quality of the information on treatment choice. RESULTS: Total 297 sites were identified using the search term 'colorectal cancer'. Excluding dead links or duplicated sites, 148 sites were identified. When the sites had been classified according to the administrator of the websites, 115 (77.7%) were identified as local clinic or hospital sites, 8 (5.4%) as medical school sites, 7 (4.7%) as institute or public health sites, 11 (7.4%) as commercial sites, and 7 (4.7%) as private sites. The results of the evaluations by the two examiners showed moderate inter-examiner reliability (K=0.41). The evaluations of the domestic sites by using DISCERN showed serious or important shortcomings in the quality of information on treatment choices and in reliability. Among these domestic websites, the quality of information provided at private or local hospital sites was poorer than that provided at institute or public health sites. CONCLUSIONS: About 80% of the websites providing medical information on colorectal cancer were identified as private or local hospital sites. Evaluations of the information provided at domestic sites showed serious or important shortcomings.
Administrative Personnel ; Colorectal Neoplasms* ; Humans ; Internet ; Korea ; Public Health ; Schools, Medical ; Search Engine

No abstract available.
Diabetic Ketoacidosis* ; Lung Abscess* ; Lung* ; Mucormycosis*

BACKGROUND: Both carotid intima-media thickness (IMT) and global risk score of cardiovascular disease were independent risk factors of stroke and heart disease. We assessed the correlation between the 10-year risk of Korean Stroke Risk Prediction model (KSRP) and carotid intima-media thickness. Additionally, from a perspective of carotid IMT measurement following KSRP risk stratification, we analyzed the difference of carotid IMT and plaque according to the KSRP risk strata. METHODS: Subjects were 282 persons who visited one hospital for the screening of stroke. The 10-year risk was calculated automatically based on the equation of KSRP model. The maximal carotid IMT and the plaque were adopted as the study variables. The sensitivity and the positive predictive value of the KSRP risk categories were calculated. RESULTS: The correlation coefficient between the KSRP risk and the maximal carotid IMT was 0.29 (p<0.01). The mean (+/-standard deviation) of KSRP risk of the group with carotid plaque was statistically significantly higher, 5.3 (+/-4.1), than that of the group without plaque, 3.3 (+/-3.1) (p< or =0.01). The sensitivity of the risk stratum with more than 6% of KSRP risk for the plaque was 28.2%. The positive predictive value of the above cut-point was 48.8%. CONCLUSIONS: The 6% of KSRP risk may be considered as the beginning point of intermediate risk stratum to recommend the carotid ultrasonography. However, generalization needs further studies for various populations.
Cardiovascular Diseases ; Carotid Intima-Media Thickness ; Generalization (Psychology) ; Heart Diseases ; Humans ; Mass Screening ; Risk Factors ; Stroke

PURPOSE: This study was designed to determine the frequency of MMR defective sporadic colorectal cancer (CRC) by using immunohistochemistry and to investigate the correlation between the MMR status and the metastatic potential. METHODS: The study included 249 patients with sporadic colorectal cancer who underwent surgical resection. The MMR status was determined by using an immunohistochemical analysis of MLH1 and MSH2 expression. RESULTS: Twenty seven (10.8%) carcinomas showed abnormal MMR protein expression (18 MLH1 negative and 9 MSH2 negative) and were classified as MMR defective tumors whereas 222 tumors demonstrated normal MLH1/MSH2 immunoreactivity (MMR intact tumor). MMR defective tumors developed at significantly higher frequencies in a proximal site (59.3% vs. 27.5%, P=0.001) and tended to be larger in size (6.3+/-2.4 cm vs. 5.1+/-2.1 cm, P=0.026). They showed significantly lower overall stage, N stage, and M stage at the time of diagnosis (P=0.002, P=0.014, P=0.010, respectively). In patients who had MMR defective tumors, lymphocytic infiltration (40.7% vs. 8.7%, P<0.001) and poor differentiation (22.2% vs. 11.7%, P=0.012) were more frequently observed. Less frequently MMR defective tumors displayed lymphatic invasion (40.7% vs. 67.1%, P=0.007) and infiltrative borders (22.2% vs. 51.8%, P=0.004). The MMR defect was strongly associated with a decreased likelihood of lymph node (odds ratio: 0.34, 95% CI: 0.13~0.95) and distant organ metastases at diagnosis (odds ratio: 0.09, 95% CI: 0.01~0.94), independent of the clinicopathologic features. CONCLUSIONS: mmunohistochemical analysis revealed that 10.8% of sporadic CRC cases showed no staining for MLH1 or MSH2. Lymphatic invasion and distant metastases were found at lower rates in these MMR defective tumors.
Colorectal Neoplasms ; Humans ; Immunohistochemistry ; Lymph Nodes ; Microsatellite Instability ; Neoplasm Metastasis

PURPOSE: Minimizing the polyp miss rate during colonoscopy is important for patients at high risk for colorectal polyps. We investigated the polyp miss rate and the factors associated with it in high-risk patients. METHODS: The medical records of 163 patients who underwent follow-up colonoscopy between January 2001 and April 2010, which was within 9 months after a polypectomy, because the index colonoscopy had shown multiple (more than 3) adenomas or advanced adenoma were retrospectively reviewed. Miss rates were calculated for all polyps, for neoplastic polyps and for advanced adenomas. Factors associated with the miss rates in these patients, such as the location, shape and size of the polyp, were analyzed. RESULTS: The miss rates for polyps, adenomas, adenomas <5 mm, adenomas > or =5 mm and advanced adenomas were 32.6%, 20.9%, 17.7%, 3.2%, and 0.9%, respectively. No carcinoma, except for one small carcinoid tumor, was missed. Flat shape and small size (<5 mm) were significantly associated with adenoma miss rate. The miss rate was significantly higher for flat-type advanced adenomas than for protruded-type advanced adenomas (27.7% vs 4.1%). CONCLUSION: The polyp miss rate in patients at high risk for colorectal polyps was higher than expected. Efforts are needed to reduce miss rates and improve the quality of colonoscopy. Also, early follow-up colonoscopy is mandatory, especially in patients at high risk.
Adenoma ; Carcinoid Tumor ; Colonoscopy* ; Colorectal Neoplasms ; Follow-Up Studies* ; Humans ; Medical Records ; Polyps* ; Retrospective Studies

CATCH 22 Syndrome is caused by chromosome 22q11.2 microdeletion, characterized by developmental abnormalities of the third and fourth pharyngeal pouches. It has a prevalence estimated at 1:3,000-1:9,000. Most deletions occurs sporadic, but autosomal dominant inheritance observed in 6-10% of cases. CATCH22 often diagnosed due to hypocalcemia during neonatal period or decreased immunity or facial defect, so it is very rare being diagnosed CATCH22 in adulthood. We report a 57 year old female who referred to mental change due to hypocalcemia and is diagnosed CATCH22. She was presented with hypoparathyroidism, single kidney due to renal agenesis, and mild facial defect. Our patient responded well to calcium and vitamin D treatment and she is on follow-up in outpatient clinic.
Ambulatory Care Facilities ; Calcium ; Congenital Abnormalities ; DiGeorge Syndrome ; Female ; Follow-Up Studies ; Humans ; Hypocalcemia ; Hypoparathyroidism ; Kidney ; Kidney Diseases ; Prevalence ; Vitamin D ; Wills