Generalized pustular psoriasis is the most servere form of psoriasis. This disorder is characterized by pustular skin lesions general symptoms such as high fever, weakness and peripheral blood leukocytosis. We have experienced a case of generalized pustular psoriasis after suffering from chickenpox which was diagnosed by clinical symptoms and pathologic features from a skin biopsy. This 4-year-old male patient was managed by local and oral corticosteroid therapy with excellent outcome. A brief review of the related literature is also included.
Biopsy ; Chickenpox* ; Child, Preschool ; Fever ; Humans ; Leukocytosis ; Male ; Psoriasis* ; Skin

The intubating laryngeal masK airway is a newly available device designed to allow for blind endotracheal intubation and treatment of patients with difficult airways. Emergency tracheostomies are required for oropharyngeal, hypopharyngeal, and laryngeal tumors acutely obstructing the airway. Patients with an airway obstructive tumor maintain their airway by a very active inspiratory effort in a sitting position. In these patients, it may be impossible to position them for a tracheostomy with shoulder extension. We report a case where a patient was tracheostomized successfully under general anesthesia with blind intubation via ILMA insertion in a sitting position.
Anesthesia, General* ; Emergencies ; Equipment Design ; Humans ; Intubation* ; Intubation, Intratracheal ; Laryngeal Masks ; Shoulder ; Tracheostomy*

PURPOSE: Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenic anovulation in women of reproductive age. We investigated the metabolic effects of lean and overweight adolescents with PCOS. METHODS: Anthropometric measurements and biochemical parameters were evaluated in 49 adolescents with PCOS and 40 age- and body mass index (BMI)-matched controls. We further divided both PCOS and control groups into those having BMI within the normal range of less than 85th percentile and those being overweight and obese with a BMI greater than 85th percentile. RESULTS: Hemoglobin, gamma-glutamyl transferase (r-GT), total cholesterol, low-density lipoprotein-cholesterol and 2-hour postglucose load plasma insulin levels were significantly elevated in the lean PCOS group than in the lean control group. In the overweight/obese PCOS group, hemoglobin and r-GT levels were significantly elevated than in the overweight/obese control group. In the normal weight group, none of the subjects had metabolic syndrome according to the Adult Treatment Panel III criteria, but the incidence of metabolic syndrome in the overweight/obese PCOS group was 8.3% and that in the overweight/obese control group was 6.7%. CONCLUSION: PCOS in adolescents causes metabolic abnormalities, underscoring the importance of early diagnosis of PCOS in oligomenorrheic adolescents.
Adolescent* ; Adult ; Anovulation ; Body Mass Index ; Cholesterol ; Early Diagnosis ; Female ; Humans ; Incidence ; Insulin ; Insulin Resistance ; Overweight ; Plasma ; Polycystic Ovary Syndrome* ; Reference Values ; Transferases

PURPOSE: VEGF is thought to be an important angiogenic factor playing significant a role in the aggressiveness of malignant tumor by stimulating neovascularization. We morphologically investicated the tumor angiogenesis in terms of the presence of VEGF expression in advanced gastric carcinoma. MATERIALS AND METHODS: We performed immunohistochemical stains for VEGF, CD 34, and MIB-1 (Ki-67) on the 51 paraffin-embedded tissue sections. The degree of angiogenesis was determined by counting microvessel densities and their Ki-67 labelling indices of endothelial cells within the tumors. We evaluated the correlation between the expression of VEGF, angiogenesis and clinicopathologic factors such as histologic differentiation, depth of invasion, and lymph node metastasis. RESULTS: Immunoreactivity for VEGF revealed positivity in 34 out of 51 cases (66.7%). Microvessel densities and Ki-67 labelling indices of endothelial cells reflecting angiogenesis were higher in VEGF-positive tumors than VEGF-negative tumors. There were no conelations between VEGF expression, histologic differentiation and the depth of invasion. We failed to evaluate the conelation of VEGF expression and lymph node metastasis. CONCLUSION: This study suggests that VEGF expressian is closely related to tumor asso- ciated angiogenesis in advanced gastric carcinoma. Considering that tumor growth depends on angiogenesis, therapies reducing VEGF may be a means of inhibiting angiogenesis and tumor aggressiveness.
Angiogenesis Inducing Agents ; Coloring Agents ; Endothelial Cells ; Lymph Nodes ; Microvessels ; Neoplasm Metastasis ; Vascular Endothelial Growth Factor A*

PURPOSE: We wanted to evaluate the efficacy and toxicity of modified FOLFOX-6 chemotherapy for treating recurrent or inoperable gastric cancer patients. MATERIALS AND METHODS: From April 2006 to August 2007, 35 patients with recurrent gastric cancer after curative resection and 43 patients with inoperable gastric cancer underwent chemotherapy, and the results were retrospectively investigated. RESULTS: 78 patients were assessable for response and toxicity, and they underwent an average of 7.1 cycles of chemotherapy. The response was evaluated according to the RECIST criteria. 11 partial responses (14.1%), 35 cases of stable disease (44.9%), and 32 cases of progressive disease (41%) were observed. The median time to progression was 6 months, and the average overall survival was 13 months. CTCAE grade 1 or 2 anemia (52.6%) was the most prevalent toxicity. Other common toxicities included thrombocytopenia (17.9%) and peripheral neuropathy (30.8%). There were 13 changes in the chemotherapy regimen to S1-cisplatin due to disease progression, but only an average of 1.76 cycles of S1-cisplatin were delivered due to severe toxicities and poor compliance. CONCLUSION: Acceptable efficacy and toxicity were seen as 59% of the patients showed non-progression, and no grade 3 or 4 toxicities were observed. In conclusion, the modified FOLFOX-6 chemotherapy is considered to be the proper 1st-line choice as a palliative treatment for recurrent or inoperable gastric cancer patients.
Anemia ; Disease Progression ; Humans ; Organoplatinum Compounds ; Palliative Care ; Peripheral Nervous System Diseases ; Retrospective Studies ; Stomach Neoplasms ; Thrombocytopenia

PURPOSE: To compare the evaluation results of faculties to those of Standardized Patients (SP) participating in a Clinical Performance Examination (CPX) administered at Ewha Womans University College of Medicine. METHODS: The CPX was taken by 77 fourth year medical students. Cases and checklist were developed by the medical school consortium in capital area. Six cases were used and 24 SPs participated and evaluated the students' performances. The whole session was recorded on videotapes so that 6 medical school faculties could analyze and evaluate the students' performances as well. The results were compared and analyzed by SPSS package. RESULTS: The agreement between the faculties and the SPs was relatively good (r=0.79), but not good enough. In every case, SPs gave higher marks than did the faculties. Clear disease entity cases like "hepatitis" and "anemia" showed better agreement than obscure clinical contexts such as "bad news delivery". Better agreement was seen in the items of physical exam category (r=0.91), but the agreement was very poor in the items of doctor-patient (Dr-Pt) relationship category (r=0.54). The construction of checklist and the character of each evaluation item should influence the differences. CONCLUSION: More detailed guidelines and clear/specific evaluating items are necessary to improve the agreement rate. In certain categories like physical exam and brief history taking, the SP' s evaluation can replace the faculties', but for complex contexts like Dr-Pt relationship.
Checklist ; Female ; Humans ; Schools, Medical ; Students, Medical ; Videotape Recording

The purpose of this study was to find out the relationship between waist circumference, muscular strength, flexibility, and brachial-ankle pulse wave velocity (baPWV). Furthermore, the cut-off values of the physical fitness factors according to the baPWV were also calculated. The study was derived with total of 1,562 males (1,116 middle-aged and 446 old-aged). They were tested participant's baPWV, waist circumference, cardiopulmonary fitness, grip strength and flexibility. The results of this study is that the baPWV of the middle-aged men did not show significant changes in relationship with the waist circumference and physical fitness factors. The old-aged group with normal abdominal fat and high physical fitness level (group 4) showed significant baPWV values in comparison to those with waist circumference and low physical fitness levels (group 1); cardiorespiratory fitness p=0.026, grip strength p=0.000, flexibility p=0.000. The cut-off values of the physical fitness such as cardiorespiratory fitness, grip strength, flexibility according to the baPWV were 31.2 mL/kg/min (area under curve [AUC], 0.692; p=0.027), 37.0 kg (AUC, 0.588; p=0.014), and 1.0 cm (AUC, 0.589; p=0.014), respectively. In conclusion, these results demonstrate that waist circumference, cardiorespiratory fitness as well as muscular strength and flexibility effect inversely on arterial stiffness.
Abdominal Fat ; Hand Strength ; Humans ; Male ; Obesity, Abdominal ; Physical Fitness ; Pliability ; Pulse Wave Analysis ; Vascular Stiffness ; Waist Circumference

The keratinocytes in human epidermis are replaced by a population of stem cells located in the basal layer of the epidermis and one candidate stem cell marker is the transcription factor p63. We studied the expression of p63, immunohistochemically, in various hyperproliferative skin diseases (10 poorly differentiated metastatis squamous cell carcinomas (SCCs), 10 non-metastatic primary cutaneous SCCs, 10 cases of Bowen's diseases, 10 actinic keratosis, and 10 melanomas) and also observed the change of p63 expression in psoriasis after cyclosporine treatment. p63 was normally expressed in basal layer cells. Poorly-differentiated metastatic SCC showed the highest expression in most of the tumor cells, while psoriasis, actinic keratosis, Bowen's disease and primary SCC showed an increased expression in the basal and suprabasal area compared to in normal epidermis. The cyclosporine treatment in psoriasis reduced the expression of p63 to a normal level. This data suggests that p63 expression may influence tumor cell differentiation and proliferation without a direct tumorigenesis effect in epithelial tissue.
Bowen's Disease ; Carcinogenesis ; Carcinoma, Squamous Cell ; Cell Differentiation ; Cyclosporine ; Epidermis ; Humans ; Keratinocytes ; Keratosis, Actinic ; Psoriasis ; Skin Diseases* ; Skin* ; Stem Cells ; Transcription Factors

BACKGROUND: Colonic neoplasm is associated with western diet intake and physical inactivity. These life styles are also risk factors for dyslipidemia and metabolic syndrome. The aim of this study was to evaluate the association between dyslipidemia and the prevalence of colon polyps including colon adenoma as a precancerous lesion of colonic neoplasms. METHODS: We selected subjects undergoing a colonoscopy for health screening at the Health Promotion Center of Eulji General Hospital from January 2006 to June 2010. Subjects with histories of cancers, dyslipidemia treatment, and other intestinal diseases like Crohn's disease and ulcerative colitis were excluded. The total numbers of subjects included in the study was 605. Chi-square test and t-test and were used for the analysis. Additionally we used multivariate logistic regression to adjust for sex, age, smoking, drinking, and other risk factors. RESULTS: The prevalence of colon polyps was 48.70% and 28.05% in males and females, respectively. When adjusting for variables that included age, body mass index, hypertension, diabetes mellitus, smoking, drinking, and exercise, dyslipidemia was not significantly associated with the prevalence of colon polyps. However upon analyzing adenomatous colon polyps in men, dyslipidemias due to triglycerides and high density lipoproteins were significant factors (odds ratio [OR], 2.13; confidence interval [CI], 1.14 to 3.98; OR, 2.24; CI, 1.15 to 4.34, respectively). CONCLUSION: Dyslipidemia was not a significant factor in the prevalence of colon polyps. However it had a significant association with the prevalence of adenomatous colon polyps in men.
Adenoma ; Body Mass Index ; Colitis, Ulcerative ; Colon* ; Colonic Neoplasms ; Colonic Polyps ; Colonoscopy ; Crohn Disease ; Diabetes Mellitus ; Diet ; Drinking ; Dyslipidemias* ; Female ; Health Promotion ; Hospitals, General ; Humans ; Hypertension ; Intestinal Diseases ; Life Style ; Lipoproteins, HDL ; Logistic Models ; Male ; Mass Screening ; Polyps* ; Prevalence* ; Risk Factors ; Smoke ; Smoking ; Triglycerides

A mucinous carcinoma of the breast is an uncommon carcinoma containing mucin that is associated with a mucocele-like tumor or other malignant tumors. We report the MR imagingfindings of two cases, a mucinous carcinoma and ductal carcinoma in situ (DCIS), associated with mucocele-like tumor. The mucinous carcinoma showed a gradually enhancing kinetic pattern on the dynamic MR and high signal intensity on the T2-weighted images. The MR findings were indistinguishable from a common benign mass of the breast.
Adenocarcinoma, Mucinous* ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Magnetic Resonance Imaging* ; Mucins*