Hypertrophic lichen planus is rare chronic variant of this disease, usually occurs on the lower extremities especially the shins, and associated with severe itching sensation. We report a case of localized hypertrophic lichen planus with bilateral hyperkeratotic polygonal violaceous papuloplaques on both upper eyelids and dorsa of hands and lace-like patches in oral mucosa. The patient had been treated with triamcinolone acetonide intralesional injection at two week intervals, two times and topical steroid after then the lesion had significantly improved.
Eyelids ; Hand ; Humans ; Injections, Intralesional* ; Lichen Planus* ; Lichens* ; Lower Extremity ; Mouth Mucosa ; Pruritus ; Sensation ; Triamcinolone Acetonide ; Triamcinolone*

PURPOSE: The purpose of this study was to evaluate the clinical performance of the BTA TRAK assay and to compare it with that of voided urine cytology in the detection of bladder cancer. MATERIALS AND METHODS: TRAK was evaluated two groups of patients. Bladder cancer group was comprised of patients wit histologically confirmed active bladder cancer. The second group of patients had a history of bladder cancers but were considered to have no evidence of disease on basis of cystoscopic evaluation of bladder and/or biopsy. Sensitivity was determined in urine samples from patients with histologically confirmed bladder cancer. Specificity was determined in samples from patients who had a history of bladder cancer but no current evidence of disease. RESULTS: BTA TRAK assay was positive in 21 of 24 samples from patients with diagnosed bladder cancer. The sensitivity of BTA TRAK assay (87.5%) was significantly higher than that of voided urine cytology (45.8%). According to grade, the sensitivity of BTA TRAK assay was significantly higher than that of voided urine cytology in urine samples from patients with grade 1 bladder cancer. The specificity of BTA TRAK assay was 80% in patients who had a history of bladder cancer but no current evidence of disease. CONCLUSIONS: The BTA TRAK assay is superior to voided urine cytology in the detection of bladder cancer. The difference of the sensitivity was statistically significant(p<0.05). The results of this study indicate that BTA TRAK assay is a useful adjunct to cystoscopy in the detection of bladder cancer and useful monitoring tool of bladder cancer.
Biopsy ; Cystoscopy ; Humans ; Sensitivity and Specificity ; Urinary Bladder Neoplasms* ; Urinary Bladder*

This article presents a description of the ultrasonographic and computed tomographic findings with a discussion on the imaging features in three patients with epigastric hernias, simulating abdominal wall lipomas. Ultrasonogram showed a heterogeneous hypoechoic mass encircled by echogenic rim within subcutaneous space of the abdominal wall. Computed tomographic findings were a localized fatty mass surrounded by a thin capsule in as sociation with a focal discontinuity of the linea alba. Ultrasonogram was not diagnostic, but computed tomogram was suggestive because of the well demonstrated focal defect in linea alba.
Abdominal Wall ; Hernia* ; Humans ; Lipoma ; Ultrasonography*

No abstract available.

OBJECTIVES: We investigated the prevalence and composite score of the neuropsychiatric symptoms in patients with mild cognitive impairment(MCI), and dementia of Alzheimer's type(AD). The aim of this study is to analyze the correlation between the result of Korean Neuropsychiatric Inventory(K-NPI) and cognitive function. METHODS: A total of 163 patients diagnosed with MCI or AD was divided into three groups(55 MCI patients, 56 dementia patients with mild stage, and 52 dementia patients with moderate, severe stage). We examined neuropsychiatric symptoms by K-NPI and compared the prevalence and composite score of each subdomain in K-NPI among three groups. RESULTS: The most common symptoms in the MCI group were depression/dysphoria, sleep/night-time behavior, anxiety, and irritability/lability. In mild AD group, the most frequent disturbance was agitation/aggression, depression/dysphoria, anxiety, apathy/indifference, and sleep/night-time behavior. In moderate to severe AD group, the most frequent disturbance was apathy/indifference, depression/dysphoria, agitation/aggression, and delusion. The frequencies of delusion, hallucination, agitation/aggression, apathy/indifference, aberrant motor behavior, appetite/eating change were statistically significant. The total NPI score showed a negative correlation with MMSE-KC and a positive correlation with GDS. CONCLUSIONS: Neuropsychiatric symptoms are common features of MCI and AD. These symptoms observed in MCI are similar to those of mild AD. Psychosis is most common in moderate to severe AD, leading to a faster rate of cognitive decline. Therefore, proper management according to the neuropsychiatric symptoms of MCI and three stages of dementia is needed.
Anxiety ; Delusions ; Dementia ; Hallucinations ; Humans ; Mild Cognitive Impairment ; Prevalence ; Psychotic Disorders

A retrospective study was conducted on 10 patients who had undergone extended pyelolithotomy for staghorn calculi. There were some complications which were such as retained stones in 3 cases, urine leak 1 case, pneumothorax 1 case, but this surgical technique was relatively simple and easy for patients with staghorn calculi disease.
Calculi* ; Humans ; Pneumothorax ; Retrospective Studies

OBJECTIVES: Mild cognitive impairment(MCI) and dementia of Alzheimer's type(AD) are characterized by progressive decline of cognitive abilities and a wide range of neuropsychiatric symptoms like depression. Among various diagnostic tools of AD, many studies showed that elevated levels of serum total homocysteine are associated with increased risk of developing Alzheimer's disease, depression and other neuropsychiatric disorders. We investigated whether elevated homocysteine concentrations are associated with depressive symptoms in MCI and AD. METHODS: A total of 86 patients diagnosed with MCI or AD participated. Total serum homocysteine levels in fasting blood samples were measured. We examined cognitive symptoms by MMSE-KC, Global Deterioration Scale(GDS), Clinical dementia rating(CDR) and depressive symptoms by Korean version of Geriatric Depression Scale(K-GDS). RESULTS: The total serum homocysteine levels were significantly higher in MCI with depression than in MCI without depression. There was no significant difference in the mean homocysteine levels between AD patients with depression and AD patients without depression. The total homocysteine levels showed a negative correlation with MMSE-KC and a positive correlation with CDR, GDS. CONCLUSIONS: These findings suggest that elevated homocysteine level is a risk factor for the decline of cognitive function and depression. We found a significant relationship between elevated serum homocysteine level and depressive symptoms in MCI. But our study had several limitations, thus more research is needed to confirm this finding.
Alzheimer Disease ; Dementia* ; Depression* ; Fasting ; Homocysteine* ; Humans ; Mild Cognitive Impairment* ; Neurobehavioral Manifestations ; Risk Factors

OBJECTIVE: Although cor pulmonale due to chronic lung disease was not uncommon, there was uncertainty in its diagnosis due to the difficulty in measuring functional and anatomical changes of right heart and pulmonary vascular system. Among various non-invasive diagnostic methods presented so far, no ideal standard diagnostic criterion has been established. The authors attempted to know positive diagnostic ratio of cor pulmonale and to study the presence of the relationship between these diagnostic criteria when electrocardiographic and echocardiographic diagnostic criteria for cor pulmonale were applied to the patients with chronic lung disease. And we investigated the usefulness of echocardiogaphic diagnostic criteria for the diagnosis. METHODS: One electrocardiographic and two echocardiographic diagnostic criteria were applied to 38 patients with chronic lung disease(21 pulmonary emphysema and 17 chronic advanced pulmonary tuberculosis) for the diagnosis of cor pulmonale. Comparison was also made in their relationship. Then pulmonary artery diameter, measurement of pulmonary function test and echocardiographic examination and radio-nuclear right ventricular ejection faction were compared between the groups to ensure each criterion was satisfied. RESULTS: 1) When the three diagnostic criteria for confirming the cor pulmonale, electrocardiographic rriterion(right ventricular hypertrophy), right ventricular dimension criterion(right ventricular end-diastolic dimension>25mm, RVDd>25mm), and right ventricular wall thickness criterion (right ventricular wall thickness>6mm, RVWT>6mm) were applied to the patients, the positive rate were 32%(12/37), 30%(10/33) and 17%(6/36) respectively. A statistically significant correlation between electrocardiographic criterion and right ventricular wall thickness criterion was found to exist. 2) Various parameters of pulmonary function test and echocardiographic examination were compared in the patient groups with and without cor pulmonale when each non-invasive diagnostic criterion was applied to all patients. Followings are the results. (1) In the positive group on electrocardiographic criteria, vital capacity, forced vital capacity, and arterial oxygen tension were significantly smaller than in the negative group on electrocardiographic criterion(p<0.05), and the echocardiographic parameters of right ventricle, ie. end-diastolic area, end-systolic area, end-diastolic dimension, end-systolic dimension, mid-ventricular short axis and maximal short axis in positive group were significantly larger than in the negative group. (2) In the positive group on right ventricular diastolic dimension criterion(RVDd>25mm), percentage forced expiratory volume in 1 second and forced expiratory flow 25-75% were significantly smaller than in the negative group on right ventricular diastolic dimension criterion. (3) In the positive group on right ventricular wall thickness criterion(RVWT>6mm), vital capacity, forced vital capacity, forced expiratory volume in 1 second, forced expiratory flow 25-75% and arterial oxygen tension were significantly smaller than in the negative group on right ventricular wall thickness criterion. CONCLUSION: When several non-invasive diagnostic criteria for cor pulmonale were applied to the patients with chronic lung disease, there were some differences in its positive diagnostic ratio depending on the applied diagnostic criteria. There was also a statistically significant correlation between electrocardiographic criterion and right ventricular wall thickness criterion. When each diagnostic criterion was applied to the patients, significant differences were found in several parameters resulted from pulmonary function test and echocardiographic examination based on presence or nonpresence of cor pulmonale. But no difference in the ejection fraction measured by radio-nuclear method was shown between cor pulmonale group and non cor pulmonale group. Consequently it was suggested that applying echocardiographic criteria in addition to electrocardiographic criterion for the diagnosis of cor pulmonale in the patients with chronic lung disease is clinically useful.
Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Electrocardiography ; Forced Expiratory Volume ; Heart ; Heart Ventricles ; Humans ; Lung ; Lung Diseases ; Oxygen ; Pulmonary Artery ; Pulmonary Emphysema ; Pulmonary Heart Disease* ; Respiratory Function Tests ; Uncertainty ; Vital Capacity

No abstract available.
Temporomandibular Joint*

OBJECTIVES: Alzheimer's disease(AD) and mild cognitive impairment(MCI) affect several nervous structures involved with the autonomic nervous system. Association between neuropsychiatric deficits and heart rate variability has been observed. But cardiac autonomic function in AD has been scarcely studied and the results reported are conflicting. We investigated autonomic function in normal control, MCI, AD using heart rate variabil-ity(HRV) technique. METHODS: Time and frequency-domain variability of 5-min R-R interval series was comparatively evaluated in 26 normal control subjects, 22 MCI subjects and 34 AD subjects. Analysis of variance(ANOVA) was used to compare the differences across groups. Correlations between MMSE-KC and HRV components were performed using Pearson's correlation coefficient. RESULTS: No significant difference was observed among the groups in time, frequency-domain analysis of HRV (p>0.05). HRV were not found to be significantly correlated with the degree of cognitive impairment. CONCLUSIONS: There were no differences in HRV with MCI, AD subjects when compared with normal controls. Further investigation is required to use HRV technique as noninvasive parameters of MCI and AD.
Alzheimer Disease ; Autonomic Nervous System ; Heart ; Heart Rate ; Mild Cognitive Impairment