Erythrasma is a chronic, superficial bacterial skin infection involving the body folds and toewebs, and sametimes it may be generalized. The causative organism of this disease is Corynebacterium minutissimum. But, in Korea, there are few reported case about this common condition. We experienced a case of erythrasma on 39-year-old male who have had well defined, brownish fine scaly patches on both crural areas for 15 years. We had treated this patient with topical antifungal agent for 1 month under impression of tinea cruris, But skin lesion was not improved. So, we reexamined the lesion and diagnosed it as genitocrural form of erythrasma with it's clinical appearance, red fluorescence under Wood's light. And we treated it with oral erythromycin.
Adult ; Corynebacterium ; Erythrasma* ; Erythromycin ; Fluorescence ; Humans ; Korea ; Male ; Skin ; Tinea

Vitiligo is a common acquired Thypornelanotic disease but the pathogenesis is still unknown and also the traatment is still unsatisfactory. The introduction in 1947 of psoralen therapy in vitiligo by El Mofty announced a new era in the treatment of this cosmetically disfiguring disease. Many investigators have developed therapeutic regimens for both topical and systemic poralen using various ligbt sources. The erythema action spectrum in UVA range of psoralen were defined, which consequently enabled the development of a more accurate regimen, namely psoralen and UVA(FUVA, exposure. The present study was undertaken to evaluate the efficacy of topical PUVA therapy in patients with vitiligo and to compare the result of PUVA therapy according to the age, sex, type of disease, total exposure dose, duration of disease nd involved site. Twenty one patients selected in the Department of Dermatology of Kyung hee University Hospital with various clinical types of vitiligo were treated with 03% 8-MOP ointment followed by exposure to longwave ultraviolet energy. Clinical response was graded as follows: Grade 0: No repigmentation Grade 1; Up to 25% repigmentaton Grade 2; 25% to 50% repigmentation Grade 3; 50% to 90% repigmentation Grade 4; Greater than 90% repigmentation A responsive case wss defined as a case with greater than 25% repigmentation. A effective case was defined as a case with greater than 50;o repigmentation.
Dermatology ; Erythema ; Ficusin ; Humans ; Methoxsalen* ; Photochemotherapy* ; PUVA Therapy ; Research Personnel ; Ultraviolet Rays* ; Vitiligo*

Marjolin's ulcer seated upon an old cicatrix, especially old burn scar, which may chiefly degenerated into a squamous cell carcinoma with propensity for metastasis. We are experienced two cases of Marjolins ulcer recently. A 54-year-old male who had a Marjolins ulcer(15x40cm) on his left lower extremity. He was experienced burn at the age of eight and rice sized ulcer was developed at the site of burn scar about 21 years ago. The ulcer progressively enlarged in size to reach 15x40cm for 21 years. The pathologic diagnosia was squamous cell carcinoma grade 1, but cancer cells invaded to deep dermie and subcutaneous tissues. Severe skin lesion and irreversible osteoporotic degeneration on knee joint of affected limb were present. So he was treated by high above knee amputation. Another 58-year-old female who had a Marjolins ulcer(10x20cm) on her right lower extremity. She was experienced burn at the age of forty eight and bean sized ulcer was developed at the site of burn scar about 1 year ago. The pathological diagnosis was squamous cell carcinoma grade 1 and invasian of cancer cells was limited upper dermis. On lymph node biopsy, the histological diagnosis was within normal limit. So she was treated radical surgical excision with split thickness skin graft(Mesh).
Amputation ; Biopsy ; Burns ; Carcinoma, Squamous Cell ; Cicatrix ; Dermis ; Diagnosis ; Extremities ; Female ; Humans ; Knee ; Knee Joint ; Lower Extremity ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis ; Skin ; Subcutaneous Tissue ; Ulcer*

PURPOSE: Acute pyelonephritis in children may lead to permanent renal scarring with a risk of later hypertension and renal failure and so needs prompt diagnosis and appropriate treatment. The main aim of this study was to evaluate the value of 99mTc-dimercaptosuccinic acid(DMSA) renal scan in detecting renal involvement of acute urinary tract infection(UTI) and determining the sensitivity to find coexisting vesicoureteral reflux(VUR) in children. MATERIALS AND METHODS: A total of 192 children(97 males, 95 females) admitted with bacteriologically proven and symptomatic UTI between May 1994 and April 1997 were analysed. DMSA renal scan was performed in all cases. 70 children underwent VCUG. Findings of DMSA renal scan were analysed according to age, sex, previous history of UTI and VUR. RESULTS: 89 children(46%) were under the age of 1 year. There was a preponderance of UTI in boys under the age of 1 year(66.3%) and in girls over the age of 1 year(63.1%). Of the 192 children studied, 155 children(80.7%, 81 males, 74 females) had first episode and the remaining 37 children(19%, 16 males, 21 females) had previous history of symptomatic UTI. Abnormalities in DMSA renal scan were found in 67(43.2%) of 155 children with the first UTI and in 30(89%) of 37 children with recurrent UTI. Bilateral DMSA abnormalities were noted in 8(5.2%) of 155 children with the first UTI and in 11(29.7%) of 37 children with recurrent UTI. Of the 70 children who underwent VCUG, VUR was seen in 41(58.6%) children. Of the 41 children with VUR, 31(90.2%) children had abnormal DMSA images. VUR was demonstrated in 37(75.5%) of 49 children with abnormal DMSA images and especially in 100% of 14 children with bilateral abnormal DMSA images. CONCLUSIONS: A high proportion of abnormal DMSA images was found in children with recurrent UTI and children with VUR, especially high grade or bilateral reflux. DMSA renal scan is a sensitive method for evaluating the functional defect of involved kidney and predicting coexistent VUR according to its image appearance in patients with UTI.
Child* ; Cicatrix ; Diagnosis ; Female ; Humans ; Hypertension ; Kidney ; Male ; Pyelonephritis ; Renal Insufficiency ; Succimer ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

PURPOSE: Acute pyelonephritis in children may lead to permanent renal scarring with a risk of later hypertension and renal failure and so needs prompt diagnosis and appropriate treatment. The main aim of this study was to evaluate the value of 99mTc-dimercaptosuccinic acid(DMSA) renal scan in detecting renal involvement of acute urinary tract infection(UTI) and determining the sensitivity to find coexisting vesicoureteral reflux(VUR) in children. MATERIALS AND METHODS: A total of 192 children(97 males, 95 females) admitted with bacteriologically proven and symptomatic UTI between May 1994 and April 1997 were analysed. DMSA renal scan was performed in all cases. 70 children underwent VCUG. Findings of DMSA renal scan were analysed according to age, sex, previous history of UTI and VUR. RESULTS: 89 children(46%) were under the age of 1 year. There was a preponderance of UTI in boys under the age of 1 year(66.3%) and in girls over the age of 1 year(63.1%). Of the 192 children studied, 155 children(80.7%, 81 males, 74 females) had first episode and the remaining 37 children(19%, 16 males, 21 females) had previous history of symptomatic UTI. Abnormalities in DMSA renal scan were found in 67(43.2%) of 155 children with the first UTI and in 30(89%) of 37 children with recurrent UTI. Bilateral DMSA abnormalities were noted in 8(5.2%) of 155 children with the first UTI and in 11(29.7%) of 37 children with recurrent UTI. Of the 70 children who underwent VCUG, VUR was seen in 41(58.6%) children. Of the 41 children with VUR, 31(90.2%) children had abnormal DMSA images. VUR was demonstrated in 37(75.5%) of 49 children with abnormal DMSA images and especially in 100% of 14 children with bilateral abnormal DMSA images. CONCLUSIONS: A high proportion of abnormal DMSA images was found in children with recurrent UTI and children with VUR, especially high grade or bilateral reflux. DMSA renal scan is a sensitive method for evaluating the functional defect of involved kidney and predicting coexistent VUR according to its image appearance in patients with UTI.
Child* ; Cicatrix ; Diagnosis ; Female ; Humans ; Hypertension ; Kidney ; Male ; Pyelonephritis ; Renal Insufficiency ; Succimer ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

We reviewed retrospectively 23 patients treated with M-VAC (Methotrexate. Vinblastine, Doxorubicin, Cisplatin) from October 1987 to June 1990 at our hospital to evaluate predictive variables for response to chemotherapy and long term survival free of disease. Treatment consisted of monthly cycles of 30mg. per m2 methotrexate, followed 24 hours later by 3mg. per m2. vinblastine, 30mg. per m2. doxorubicin and 70mg. per m2. cisplatin and concluded with repeat vinblastine and methotrexate on days 15 and 22. The Median number of cycles was 3 (range 2 to 5). Complete plus partial remission were observed in 13 of 23 patients (57%) with a median survival or 13 months (range 7+ to 32+ months). Stabilization occurred in 3 patients (14%) and progression in 7 patients (29%) with median survivals of 10 months (range 7+ to 11 months) and 8 months(4 to 12+ months). 1 year survival rate was 77% in complete puls partial remission and 66% in stabilization and 28% in progression. 10 patients with a complete plus partial remission are alive with a median follow up of 15 months ( range 4 to 32+ months), of whom 1 is surviving for more than 2 years. Toxicity included moderately severe myelosuppression that resulted in nadir sepsis in 1 patient mild to moderate anorexia, vomiting, alopecia and renal dysfunction. Though the number of availuable patients are limited, these preliminary results suggest that treatment with M-VAC is effective against disseminated urothelial transitional cell tumors.
Alopecia ; Anorexia ; Cisplatin ; Doxorubicin* ; Drug Therapy* ; Follow-Up Studies ; Humans ; Methotrexate ; Retrospective Studies ; Sepsis ; Survival Rate ; Urothelium* ; Vinblastine* ; Vomiting

Neurilemmoma is wel1 encapsulated tumor of Schwann cell origin. It is more often solid than cystic and. usually solitary and may be benign. The treatment is surgical excision. We report a 42-year-old man hospitalized with complaints of RUQ pain and palpable mass. There was no endocrinological abnormality. Ultrasonography, computerized tomography and angiography revealed right huge extrarenal mass without metastatic evidence. The patient underwent surgical excision.
Adult ; Angiography ; Humans ; Neurilemmoma* ; Ultrasonography

The purpose of this study was to develop the respiratory training system using individual characteristic guiding waveform to reduce the impact of respiratory motion that causes artifact in radiotherapy. In order to evaluate the improvement of respiratory regularity, 5 volunteers were included and their respiratory signals were acquired using the in-house developed belt-type sensor. Respiratory training system needs 10 free breathing cycles of each volunteer to make individual characteristic guiding waveform based on Fourier series and it guides patient's next breathing. For each volunteer, free breathing and guided breathing which uses individual characteristic guiding waveform were performed to acquire the respiratory cycles for 3 min. The root mean square error (RMSE) was computed to analyze improvement of respiratory regularity in period and displacement. It was found that respiratory regularity was improved by using respiratory training system. RMSE of guided breathing decreased up to 40% in displacement and 76% in period compared with free breathing. In conclusion, since the guiding waveform was easy to follow for the volunteers, the respiratory regularity was significantly improved by using in-house developed respiratory training system. So it would be helpful to improve accuracy and efficiency during 4D-RT, 4D-CT.
Artifacts ; Displacement (Psychology) ; Fourier Analysis ; Respiration

Patient's respiration can have an effect on movement of tumor range and peripheral organs. Therefore, the respiratory signal was acquired by relation between external markers and movement of patient's abdomen during radiational therapy in order to minimize the effect of respiration. Based on this technique, many studies of rational therapy to irradiate at particular part of stable respiratory signals have executed and they have been clinically applied. Nevertheless, the phase-based method is preferred to the amplitude-based method for the rational therapy related to respiration. Because stabilization of the respiratory signal are limited. In this study, a in-house respiratory signal analysis program was developed for the phase reassignment and the analysis of the irregular respiratory signals. Various irregular respiratory patterns was obtained from clinical experimental volunteers. After then, the in-house program analyzed the factors affecting to phase assignment which is directly related to irradiated sector. Subsequently, accuracy of phase assignment was improved with removement of irregular signals by self-developed algorithm. This study is considered to be useful for not only image reconstruction and elevation of irradiating accuracy through phase assignment of RPM system but also analysis of respiratory signals. Moreover, development of 4D CT image is planed with phantom researches or clinical experiments based on this program.
Abdomen ; Four-Dimensional Computed Tomography ; Image Processing, Computer-Assisted ; Respiration

Collecting duct carcinoma is an unusual variant of renal cell carcinoma, which is originated from the collecting tubules of the kidney. The typical histological appearance is that of a papillary adenocarcinoma with infiltrating tubules and desmoplastic reaction. And there is mainly tubulo-papillary. structure in histologic examination. We report a case of collecting duct carcinoma of kidney in a 47 years old female, which was managed by radical nephrectomy.
Adenocarcinoma, Papillary ; Carcinoma, Renal Cell* ; Female ; Humans ; Kidney ; Middle Aged ; Nephrectomy