Periumbilical perforating pseudoxanthoma elasticum (PPPXE) is a localized acquired disorder found most frequently in obese, multiparous, middle-aged women. It is characterized clinically by yellowish, lax, well-circumscribed, reticulated or cobblestoned patches or plaques in the periumbilical region. Multiparity, obesity, massive ascites, and abdominal surgery are thought to the initiating factors. There is controversy about the etiology of PPPXE. Some authors have classified it as a separate entity from hereditary pseudoxanthoma elasticum (PXE), while others speculate that this condition merely represents a variable expression of PXE in which systemic associations are likely. We report a case of periumbilical perforating pseudoxanthoma elasticum associated with a clinical PXE lesion on the anterior neck.
Ascites ; Female ; Humans ; Neck ; Obesity ; Parity ; Pseudoxanthoma Elasticum*

The authors analysed the CT findings in 75 cases diagnosed as gastric carcinoma by U.G. I.S. or endoscopy in a 3)1, year period. The comparative analysis betw~en CT findings and surgical pathologic findings was done in 55 cases who underwent surgery. 20 cases could not be operated upon because of distant metastasis. The gastric carcinoma was devided into 4′ stages according to the staging system of the American joint Committee on Cancer. The CT findings were then compared and the following results noted : 1. The relationship with gastric wall thickening and penetratioil degree of tumori no thickening (Iesser than 1.0 cm) of 3 cases showed all of T1, 11 of localized thickening (1. 0.1 .5cm) showed 7 of T2, 38 of localized thickening (more than 1.5 cm) showed 37 of T3 and 3 of diffuse thickening showed all of T4a. 2. The accuracy of Iymph node detection by CT scan, 1) Regionaf tymph node showed 86% in operative f in ding and 73% in pathologic. 2) Extragastric Iymph node showed 87% in operative finding and 89% in pathologic. 3) Retro-peritoneallymph node showed 96% in operative finding and 95% in pathologic. ic. 3. In operated cases, there was one case of false positive distant metastasis and three false negative cases. 20 cases of non-operated cases showed distant metastasis such as liver, lung or kidney. 4. 55 cases were classified as stage 1 in 4 cases, 11 in 18, 111 in 23 and IV in 10 by pathologic findings, and 1 in 3, 11 in 24, 111 in 19 and IV in 9 by CT. The overall accuracy by CT stagi ng is 75%. 5. Among a total of 75 cases, there were 46 operable cases by CT finding an d 43 operabl e cases by pathologic staging. There we re 29 inoperable cases by CT finding and 27 cases by pathologic staging. Therefore, there was a 93% overall accuracy by CT stagi ng in terms of determination of operability. 6. The accuracy of adhesion into adjacent structure by CT finding was 69%. compared with operable finding.
Endoscopy ; Joints ; Kidney ; Liver ; Lung ; Neoplasm Metastasis ; Tomography, X-Ray Computed

BACKGROUND: We have already shown that a new vitamin D3 analogue, calcipotriol is a potent growth inhibitor for human keratinocytes, indicating the close relationship between the in vitro inhibitory effect of calciipotriol and its therapeutic effectiveness or psoriasis. OBJECTIVE: Our purpose was to evaluste the clinical efficscy, safety and tolerability of calcipotriol (50ug/g) ointment twice daily in the treatment of psoriasis. MEHTODS: We treated 31 patients with calcipotriol for 6 weeks. Patients were provided with a maximum of 100g of ointment per week. Efficacy, as measured by the Psoriasis Area and Severity Index(PASI), and safety were assessed at 2,4, and 6 weeks. RESULTS: Reduction of PASI was stastistically significant at all time points for treatments (p<0.01). At the completian of 6 weeks of treatment, the mean PASI reduction was 3.61. An analysis of patient overall self-assessment, at 6 weeks showed clearance or marked improvement in 61%. Some patients developed minimal irriltation of lesional or perilesional skin(6.5%). Laboratory tests did not show any significant changes, in particular there was no change in serum calcium levels. CONCLUSIONS: Calcipotriol ointment was effective as measured by the PASI and the self-assessment in patients with psoriaeis. This treatrnent was well tolerated.
Calcium ; Cholecalciferol ; Humans ; Keratinocytes ; Psoriasis* ; Self-Assessment

Phosphodiesterases (PDEs) play a key role in the regulation of cyclic adenosine monophosphate (cAMP), which in turn mediates various cellular functions including learning and memory. We previously cloned and characterized three PDE4 isoforms (ApPDE4) from Aplysia kurodai. Using reverse transcription polymerase chain reaction (RT-PCR), we found that ApPDE4 isoforms are primarily expressed in the central nervous system. However, the detailed distribution of ApPDE4 mRNA in Aplysia individual ganglions was not evident. In this study, to determine the distribution of ApPDE4 mRNAs in Aplysia ganglions, we performed in situ hybridization (ISH) using a probe targeting ApPDE4, including the PDE catalytic domain. Interestingly, we found the strongest ISH-positive signals in the symmetrical bag cell clusters of the abdominal ganglion. The R2, R14, L7, L2 and L11 neurons in the abdominal ganglion, LP1 neuron in pleural ganglion, and metacerebral (MCC) neurons were ISH-positive. Mechanosensory neurons of the sensory cluster were also stained on the ventral aspect of the right and left pleural ganglia. Taken together, we found the detailed distribution of ApPDE4 mRNA in Aplysia ganglion and support their roles in serotonin (5-HT)-induced synaptic facilitation of Aplysia mechanosensory neurons.
Adenosine Monophosphate ; Aplysia* ; Catalytic Domain ; Central Nervous System ; Clone Cells ; Cyclic Nucleotide Phosphodiesterases, Type 4* ; Ganglia ; Ganglion Cysts ; In Situ Hybridization* ; Learning ; Memory ; Neurons ; Phosphoric Diester Hydrolases ; Polymerase Chain Reaction ; Protein Isoforms ; Reverse Transcription ; RNA, Messenger ; Serotonin

Direct coronal CT scans of the body have been carried out in 78 cases of the thoracic and abdnominal diseases. The results are as follows: 1. Among total 78 patients, 66 cases were successfully scanned by the direct coronal CT. 2. Direct co ronal CT scan most accurately detected retroperitoneal diseases, especially renal diseases. 3. In comparison with multiplanar reformating (MPR) image, direct coronal CT of the body has three advantages: (a) improved image quality: (b) improved definition of the coronal anatomy : (c) shorter examination time. 4. Direct coronal CT has advantages in evaluation of the mass nature and relationship with other organs. 5. Disadvantages or limitations of the direct coronal CT are as follows: in creased radiation exposure and insufficient positioning for disabled patients. 6. In our experience, direct coronal CT is considered as helpful method for presurgical evaluation and the rapeutic management of various diseases, especially gross tumor of the retroperitoneum.
Humans ; Methods ; Radiation Exposure ; Tomography, X-Ray Computed

Adult-onset Still's disease (AOSD) is a multi-systemic inflammatory disorder characterized by high spiking fever, evanescent salmon-colored rash, arthralgia or arthritis, leukocytosis and the involvement of various organs. However, leukopenia is rarely associated with AOSD. It may be due to hemophagocytic syndrome, which usually present with acute febrile illness, pancytopenia, hepatosplenomegaly, and hyperferritinemia. We report a case of 28-year-old man with AOSD and leukopenia. There is no evidence of other causes of cytopenia and hemophagocytosis in bone marrow examination. Leukopenia can be the initial presentation of AOSD.
Adult ; Arthralgia ; Arthritis ; Bone Marrow Examination ; Exanthema ; Fever ; Humans ; Leukocytosis ; Leukopenia* ; Lymphohistiocytosis, Hemophagocytic ; Pancytopenia ; Still's Disease, Adult-Onset*

Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis affecting medium- or small-sized arteries. Its diagnosis may be delayed because it is a rare disease, and patients presenting with PAN demonstrate variable clinical manifestations and non-specific laboratory abnormalities. Gastrointestinal involvement occurs in 14~65% of patients with PAN and is a significant cause of morbidity and mortality. Thus, early diagnosis is very important in PAN with gastrointestinal involvement. We report two cases of rapidly progressive PAN presenting with abdominal pain, having failed conservative treatment.
Abdominal Pain* ; Arteries ; Diagnosis ; Early Diagnosis ; Humans ; Mesenteric Artery, Superior* ; Mortality ; Polyarteritis Nodosa* ; Rare Diseases ; Vasculitis

OBJECTIVE: To compare plasma protein expression between patients with squamous cell carcinoma (SCC) of the cervix and normal controls. METHODS: Plasma samples from patients with benign gynecological disease (normal cervix, n=6) and cervical cancer (SCC, n=6) were subjected to plasma proteomic analysis using two dimensional gel electrophoresis (2-DE) and matrix-assisted laser desorption/ionization mass spectroscopy (MALDI-MS). Western blotting and immunoturbidimetric assay were performed to validate the results of 2-DE. RESULTS: Eight proteins showed differential expression between controls and SCC patients; six (ceruloplasmin, complement C3, afamin precursor, alpha-1-B-glycoprotein, transferrin, alpha-fibrinogen precursor) were up-regulated, while two (chain A, crystal structure of antithrombin and apolipoprotein A-IV precursor) were down-regulated in the plasma of SCC patients. Western blotting analysis revealed significant elevation of ceruloplasmin, complement C3, afamin, and alpha-1-B-glycoprotein in the plasma of SCC patients in comparison to controls. Immunoturbidimetric assay of a larger group confirmed the results of 2-DE and Western blotting, and showed that ceruloplasmin and complement C3 were significantly elevated in the plasma of SCC patients in comparison with controls and patients with carcinoma in situ (CIS) of the uterine cervix. CONCLUSION: Plasma protein expression determined using 2-DE and MALDI-MS will give a chance to identify tumor-specific biomarkers for SCC of the cervix.
Apolipoproteins ; Apolipoproteins A ; Biomarkers ; Blood Proteins ; Blotting, Western ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Ceruloplasmin ; Cervix Uteri ; Complement C3 ; Electrophoresis, Gel, Two-Dimensional ; Female ; Humans ; Mass Spectrometry ; Plasma ; Proteins ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Transferrin ; Uterine Cervical Neoplasms

PURPOSE: The purpose of this study was to compare clinical manifestations of human bocavirus (hBoV), respiratory syncytial virus (RSV), and human rhinovirus (hRV) in children with acute wheezing. METHODS: We retrospectively investigated 549 virus-positive throat swabs obtained between January 2006 and December 2008 from pediatric inpatients with acute respiratory tract disease at Kwangju Christian Hospital. Among them, 109 patients, who had lower respiratory tract infections with wheezing, were enrolled in this study. The medical records of patients with positive results were reviewed for clinical data. RESULTS: The mean age of the patients with RSV was 7.15 months, 15.66 months in those with hRV, and 15.04 months in those with hBoV. The mean fever duration and frequency of patients with fever was 2.43 days and 47.9% for RSV, 2.86 days and 51.7% for hRV, and 3.75 days and 69.6% for hBoV. The frequency of patients with acute otitis media was 20.8% in the RSV, 20.7% in the hRV, and 13.0% in the hBoV groups. The frequency of lung infiltration on chest X-ray was 12.5% in the RSV, 20.7% in the hRV, and 47.8% in the hBoV groups. CONCLUSION: We compared the clinical manifestations of respiratory viral infections in infants and children with wheezing. However, further surveillance will be necessary to clarify the clinical manifestations of the viruses.
Bocavirus ; Child ; Fever ; Human bocavirus ; Humans ; Infant ; Inpatients ; Korea ; Lung ; Medical Records ; Otitis Media ; Pharynx ; Respiratory Sounds ; Respiratory Syncytial Viruses ; Respiratory Tract Diseases ; Respiratory Tract Infections ; Retrospective Studies ; Rhinovirus ; Thorax

Episodic angioedema with eosinophilia is characterized by recurrent angioedema, urticaria, fever, weight gain and hypereosinophilia. Although this syndrome shows similarities to idiopathic hypereosinophilic syndrome, it differs in that it has good prognosis and has no organ involvement. The pathogenesis is unclear, but IL-5 is thought to be major cytokine of pathogenesis. It has benign course with spontaneous remission or low-dose prednisolone treatment. Here, we describe a patient whose clinical and laboratory features are similar to those observed in episodic angioedema with eosinophilia.
Angioedema* ; Eosinophilia* ; Fever ; Humans ; Hypereosinophilic Syndrome ; Interleukin-5 ; Prednisolone ; Prognosis ; Remission, Spontaneous ; Urticaria ; Weight Gain