Erythema nodosum leprsum(ENL) is a painful, erythematous subcutaneous and dermal nodules which occurs mainly in lepromatous leprosy. Usually, it starts about 1 year after onset of treatment and lasts from a few days to weeks or months. Rarely it lasts for years. Although the lesions of ENL develop any part of the body, the favorite sites are extensor sites of the extremities, medial thigh, and face. We report a case of ENL which showed about 20 times recurrences for 3 years from 15months after initial treatment because of its widespread inflammatory lesions and duration of the disease. The ENL lesions recurred repeatedly with 2 weeks to 3months interval for 3 years and the tender reddish nodules developed not only in extremities but also on the trunk. During treatment course, he developed diabetes mellitus, Cushings syndrome as complications of long term use of corticosteroid and also developed xanthoma, hyperpigmentation, and ichthyosis.
Diabetes Mellitus ; Erythema Nodosum* ; Erythema* ; Extremities ; Hyperpigmentation ; Ichthyosis ; Leprosy, Lepromatous ; Recurrence ; Thigh ; Xanthomatosis

PURPOSE: This retrospective study was aimed to determine prognostic factors after radical resection of an ampullary carcinoma. METHODS: Medical records of patients with adenocarcinoma of the ampulla of Vater who had undergone pancreaticoduodenectomy between Dec. 1994 and May 2002 were reviewed. This study included 59 men and 40 women with a mean age of 58.9 years. 62 patients underwent Whipple procedures, 36 patients, pylorus preserving pancreaticoduodenectomy and 1 patient, total pancreatectomy. Actuarial survival rates were calculated using the Kaplan-Meier method. A Cox proportional hazards model was used to test the independent predictors of survival. P<0.05 was considered statistically significant. RESULTS: The overall 5-year survival rate was 45.4% with 3% mortality and 34.3% morbidity. According to the pTNM stage, the 5-year survival rates were 91.7%, 54.3%, 28.5% and 0% at stages I, II, III, and IV (P<0.01), respectively. The patient survival was significantly impaired by the depth of invasion, lymph node metastasis and intraoperative transfusion (P<0.05). In a multivariate analysis, only lymph node metastasis was a statistically independent prognostic factor. CONCLUSION: pTNM stage is a good prognostic indicator for an ampullary carcinoma after pancreaticoduodenectomy and patients with lymph node metastasis should be identified as high risk and considered as candidates for further adjuvant therapy.
Adenocarcinoma ; Ampulla of Vater ; Female ; Humans ; Lymph Nodes ; Male ; Medical Records ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Pancreatectomy ; Pancreaticoduodenectomy ; Proportional Hazards Models ; Pylorus ; Retrospective Studies ; Survival Rate

BACKGROUND: Occurrence of dermatoses are influenced by various environmental factors in the area people live. Jeonbuk province, as well as other parts of Korea, has developed industrially for the past three decades. Until now, no statistical survey on dermatoses in Jeonbuk province has been made. OBJECTIVE: To compare the prevalence and trend of dermatoses by patients' age and time in Jeonbuk province over last 30 years. METHODS: The survey was conducted via the medical records of 55, 335 patients seen in Chonbuk National University Hospital from 1979 to 2002. RESULTS: The study results are summarized as follows: 1. Among the 55, 335 new patients (male 47.2%, female 52.8%), the 15 most common dermatoses were as follows (in order of frequency): dermatophytosis (7.8%), urticaria (7.7%), acne (5.2%), atopic dermatitis (4.9%), alopecia (4.4%), seborrheic dermatitis (4.3%), herpes zoster (4.0%), other eczema (3.9%), vitiligo (3.8%), psoriasis (2.6%), pruritus (2.5%), benign epidermal tumor (2.4%), verruca (2.2%), allergic contact dermatitis (1.7%), and irritant contact dermatitis (1.5%). These comprise 58.9% of the total outpatients. 2. The incidences of atopic dermatitis, alopecia, vitiligo and benign epidermal tumor had increase d (about 5 times), while dermatophytosis and urticaria had decreased (about 0.64 times) during the period. 3. The most frequent dermatoses during the summer season were dermatophytosis and vitiligo. In winter season, they were acne, atopic dermatitis, seborrheic dermatitis, psoriasis, pruritus, benign epidermal tumor and verruca. 4. The occurrence of scabies decreased rapidly from the early 90's and remained at a decreased level. Leprosy and tuberculosis had often occurred during the 80's and then became rare from the 90's. 5. The distribution of patients' age was as follows: The 3rd decade (22.0%), 2nd decade (15.8%), 1st decade (15.5%), 4th decade (14.7%), 5th decade (12.0%), 6th decade (10.3%), 7th decade (2.6%), 8th and above (0.4%). 6. Atopic dermatitis was found to be the most frequent dermatosis in the 1st decade. Vitiligo, benign epidermal tumor, and verruca were the most frequent in the 2nd decade, and urticaria, acne, alopecia, seborrheic dermatitis, psoriasis, allergic contact dermatitis and irritant contact dermatitis in the 3rd decade. Herpes zoster and pruritus were the most frequent in the 6th and 7th decade. CONCLUSION: From medical records between 1979 and 2002, we surveyed kinds, prevalence rates and trends of dermatoses in the Jeonbuk Province. During this period we observed changes in the incidence of the dermatoses with years and seasons. We also found that prevalence rates of the dermatoses were influenced by the time, environment and living conditions of the patients. To the best of our knowledge, this is the first survey on the occurrence of dermatoses Jeonbuk Province of Korea.
Acne Vulgaris ; Alopecia ; Dermatitis, Allergic Contact ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Eczema ; Epidemiology ; Female ; Herpes Zoster ; Humans ; Incidence ; Jeollabuk-do* ; Korea ; Leprosy ; Medical Records ; Outpatients ; Prevalence ; Pruritus ; Psoriasis ; Scabies ; Seasons ; Skin Diseases* ; Social Conditions ; Statistics as Topic* ; Tinea ; Tuberculosis ; Urticaria ; Vitiligo ; Warts

No abstract available.

Poor control of bowel movement in some bed-ridden patients with various causes such as stroke or spinal cord injury which causes fecal leakage and diarrhea, increases the risk of perianal excoriation, bed sores and is a burden on caregivers. PURPOSE: To evaluate the efficacy of fecal evacuation, prevention and treatment of skin complications in intractable diarrhea patients employing a new device. METHODS: A continent anal plug (CAP: US Patent No. 5,569,216: Join Ent. Seoul, Korea) comprises an inner balloon surrounded by an external balloon both of which are mounted on a silicone tube containing a pair of air passages and an enema fluid inlet. The tube is secured in place in the rectum by the inflatable external balloon and is designed to drain fecal matter through a thin collapsible hose situated in the anal canal. Thirty two patients (21 male, median age 61 years, range; 28~76) were evaluated after fully informed consent. Median duration (range) was 12 (3~37) days. RESULTS: CAP evacuated efficiently in those with loose or watery stools who only required once daily irrigation or not. Skin excoriations improved in 3~7 days. Minimal leakage was seen around the anus. There was no anorectal mucosal injury noted over 37 days. Conclusions: The CAP was an efficient method of treating patients with loss of bowel control and incontinence because it enabled controlled fecal evacuation and helped reduction of skin complications without causing anorectal mucosal injury.
Anal Canal ; Bays ; Caregivers ; Diarrhea* ; Enema ; Humans ; Informed Consent ; Male ; Pressure Ulcer ; Rectum ; Seoul ; Silicones ; Skin ; Spinal Cord Injuries ; Stroke

BACKGROUND: Topical diphenylcyclopropenone (DPCP) application on a daily or weekly basis has been used for the treatment of warts that affect different sites of the body. The concentration of DPCP for the treatment of warts needs to be determined according to the body site. In addition, the therapeutic response to DPCP application intervals needs to be evaluated for the treatment of warts. OBJECTIVE: The purpose of this study was to determine the minimal DPCP concentration required to induce an elicitation reaction in different body sites of patients with warts and to assess the therapeutic response of wart treatment with daily and weekly applications of DPCP. METHODS: Thirty patients with warts were divided into two groups. Each patient in the two groups was sensitized with 0.1% or 0.2% DPCP. After sensitization, in the first group of patients, DPCP was applied to warts daily. In the second group of patients, DPCP was applied to warts weekly. The initial concentration of DPCP was 0.01% for warts located on the palmoplantar area, periungual area and the dorsum of the hand, knee and upper arm. The initial concentration of DPCP was 0.004% for warts on the face. If no reaction was observed, the DPCP concentration (0.01%, 0.025%, 0.05%, 0.1%, 0.25%, 0.5%, 1% and 2%) was increased stepwise. The minimal concentration of DPCP to induce an elicitation reaction and treatment results were evaluated. RESULTS: The minimal concentrations of DPCP to induce an elicitation reaction were as follows: 0.004~0.01% for the face, 0.01~0.025% for the dorsum of the hand, 0.25~1% for the periungual area and 0.5~2% for the palmoplantar area. The results of weekly application of DPCP were similar as compared to the daily application of DPCP for the treatment of warts. CONCLUSION: Although further studies are needed, our study suggests that the DPCP concentration needs to be adjusted according to the body site and that the weekly use of DPCP may be a convenient alternative to daily use to treat warts.
Arm ; Cyclopropanes ; Hand ; Humans ; Knee ; Warts

PURPOSE: Kawasaki disease is the most common cause of systemic vasculitis in children less than 5 years of age. Recent immunohistochemistry findings suggest that many vascular growth factors play a role in the formation of the coronary artery lesions. Active remodeling of the coronary artery lesions in Kawasaki disease continues in the form of intimal proliferation and neoangiogenesis for several years after the onset of the disease. Intravenous immunoglobulin (IVIG) and corticosteroid have been used in the treatment of Kawasaki disease but the exact mechanism is not clear. We have investigated that IVIG and corticosteroid inhibited vascular endothelial growth factor (VEGF)- induced tube formation of endothelial cells in vitro on Matrigel assay. METHODS: Human umbilical vein endothelial cells (HUVECs) were cultured and seeded on Matrigel coated 24 well plates in medium with or without the following agents: VEGF, VEGF plus IVIG, VEGF plus VEGF antibody, VEGF plus methylprednisolone, VEGF, IVIG plus methylprednisolone for 18 hours. The total length of tube structures in each photograph was quantified. RESULTS: IVIG significantly inhibited the proliferation of HUVECs. The inhibitory effect of IVIG was also reversible. In the meantime, VEGF induced the differentiation of HUVECs into capillary like structures on Matrigel, which was inhibited by VEGF antibody in a dose-dependent manner. Interestingly, IVIG and methylprednisolone inhibited VEGF-induced tube formation of HUVECs. IVIG was more effective in inhibition than methylprednisolone alone. CONCLUSION: We revealed that VEGF induced the differentiation of HUVECs and this effect was inhibited by IVIG and methylprednisolone.
Capillaries ; Child ; Coronary Vessels ; Endothelial Cells* ; Human Umbilical Vein Endothelial Cells ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; Methylprednisolone* ; Mucocutaneous Lymph Node Syndrome ; Systemic Vasculitis ; Vascular Endothelial Growth Factor A

Papillary eccrine adenoma is a rare benign sweat gland neoplasm. It occurs most often as a solitary nodule in women and is located predominantly on the distal portion of the extremities. This tumor is similar to tubular apocrine adenoma in histological and clinical aspects, so distinction of these tumors is still controversial. We report a case of two papillary eccrine adenomas developed on the left popliteal and calf area of a 58-year-old-man, this is the first report of the multiple papillary eccrine adenomas in Korea.
Adenoma* ; Extremities ; Female ; Humans ; Korea ; Sweat Gland Neoplasms

PURPOSE: Currently, the two most influential gastric stem cell marker candidates are CD44 and CD133. The aim of this study was to make a comparison and determine the appropriate marker for use in gastric cancer stem cell research. MATERIALS AND METHODS: We analyzed the expressions of CD44, CD133, and CD24 from the gastric cancer cell lines MKN45, MKN74, KATO-III, NCI-N87, SNU-1, SNU-216, SNU-601, SNU-638, and SNU-688 using flow cytometry. In addition, we measured the change in viability after applying 5 fluorouracil (5-FU) to the MKN45, MKN74, KATO-III, and NCI-N87 cell lines using a Cell Counting Kit 8. RESULTS: CD133 expression was above moderate in the KATO-III, SNU-216, SNU-601 cell lines, whereas it was below 1% in the remaining cell lines. CD44 was expressed at levels above 5% in all gastric cancer cell lines. The effect of 5-FU on viability and CD133 or CD44 expression in the cell lines were not related. CONCLUSIONS: Expression of CD133 positive cells was insufficient in the gastric cancer cell lines. Therefore, of the cell lines tested, CD44 was the most appropriate tumor maker for research on gastric cancer stem cells.
Cell Count ; Cell Line ; Flow Cytometry ; Fluorouracil ; Neoplastic Stem Cells ; Stem Cell Research ; Stem Cells ; Stomach Neoplasms

Actinomycosis is a chronic bacterial infection characterized by suppurative, fibrosing inflammation, and sinus tracts draining sulfur granules. It usually involves the head, neck, thorax and abdomen. Actinomycosis involving the inguinal area is extremely rare. A 55-year-old man presented with an asymptomatic, erythematous, hard, nontender nodule in his left inguinal area. A biopsy taken from the nodule showed an abscess and sulfur granules in the dermis. Gram staining and methenamine silver staining demonstrated a mesh of branching rods. Cultures of the pus and tissue specimens failed to grow any organisms. Based on the histopathologic findings, we diagnosed this case as actinomycosis of the inguinal area and treated it with a surgical method.
Abdomen ; Abscess ; Actinomycosis* ; Bacterial Infections ; Biopsy ; Dermis ; Head ; Humans ; Inflammation ; Methenamine ; Middle Aged ; Neck ; Sulfur ; Suppuration ; Thorax