There have been several reports in the literature of coexistent psoriasis and bullous pemphigoid. In most cases, the bullous pemphigoid lesions have been considered to be induced by antipsoriatic treatments. We describe a patient with psoriasis in whom bullous pemphigoid developed during psoriasis treatment, but the exact etiologic factor was not identified. Recently, some reports have suggested that an immunologic or biochemical association between the two diseases plays a role in the pathogenesis.
Humans ; Pemphigoid, Bullous* ; Psoriasis*

BACKGROUND: Recentliy copper vapor laser(CVL) has been applied with encouraging results in the treatment of port wine stain. The CVL emits yellow light(578nm) in a sequence of about 10,000 to 15,000 pulses/second(10-15kHz) with a pulse duration of 15-50 cases. One of the basic methods of evaluationg the effects of laser lights is to study histologic changes after laser irradiation. OBJECTIVE: The effects of power output and energy density on the histologic change of guinea pig skin following CVL irradiation was evaluted to suggest a way of deciding parameters of CVL to achieve the best clinical results. METHODS: After setting the power output for one of 0.8W, 1.6W and 2.4W, the laser was irradiated with an energy density of 10, 12, 14, 16, 18, 20J/cm. A biopsy was done 15 minutes after irradiation and the biopsy specimens was stained with H&E and NBTC histocberr ical method. RESULTS: 1. At the power of 0.8W, specimens irradiated with an energy density above 14J/cm showed diffuse nonspecific coagulation necrosis of the epidermis and upper dermis. 2. At the power of 1.6W, specimens irradiated with energy density of 14, 16J/cm showed coagulation necrosis of dermal vessel and perivascular collagen. With energe density of 18, 20J/cm, diffuse nonspecific coagulat,ion necrosis of epidermis and upper dermis were observed. 3. At the power of 2.4W, specimens irradiated with an anergy density of 12, 14, 16, 18J/cm showed coagulation necrosis of the dermal vessel and perivascular collagen. With an energy density of 20J/cm, diffuse nonspecific coagulation necrosis of the epidermis and upper dermis was observed. CONCLUSIONS : With the above results it was found that t,he higher power output of CVL enlarged the range of energy density confining thermal damage to the dermal v-ssels and perivascular collagen. Additionally the higher power raised the upper limit of energy density with which t,he epidermis was viable.
Animals ; Biopsy ; Collagen ; Copper* ; Dermis ; Epidermis ; Guinea Pigs* ; Guinea* ; Herpes Zoster ; Humans ; Inpatients ; Lasers, Gas* ; Necrosis ; Port-Wine Stain ; Skin*

BACKGROUND: Recentliy copper vapor laser(CVL) has been applied with encouraging results in the treatment of port wine stain. The CVL emits yellow light(578nm) in a sequence of about 10,000 to 15,000 pulses/second(10-15kHz) with a pulse duration of 15-50 cases. One of the basic methods of evaluationg the effects of laser lights is to study histologic changes after laser irradiation. OBJECTIVE: The effects of power output and energy density on the histologic change of guinea pig skin following CVL irradiation was evaluted to suggest a way of deciding parameters of CVL to achieve the best clinical results. METHODS: After setting the power output for one of 0.8W, 1.6W and 2.4W, the laser was irradiated with an energy density of 10, 12, 14, 16, 18, 20J/cm. A biopsy was done 15 minutes after irradiation and the biopsy specimens was stained with H&E and NBTC histocberr ical method. RESULTS: 1. At the power of 0.8W, specimens irradiated with an energy density above 14J/cm showed diffuse nonspecific coagulation necrosis of the epidermis and upper dermis. 2. At the power of 1.6W, specimens irradiated with energy density of 14, 16J/cm showed coagulation necrosis of dermal vessel and perivascular collagen. With energe density of 18, 20J/cm, diffuse nonspecific coagulat,ion necrosis of epidermis and upper dermis were observed. 3. At the power of 2.4W, specimens irradiated with an anergy density of 12, 14, 16, 18J/cm showed coagulation necrosis of the dermal vessel and perivascular collagen. With an energy density of 20J/cm, diffuse nonspecific coagulation necrosis of the epidermis and upper dermis was observed. CONCLUSIONS : With the above results it was found that t,he higher power output of CVL enlarged the range of energy density confining thermal damage to the dermal v-ssels and perivascular collagen. Additionally the higher power raised the upper limit of energy density with which t,he epidermis was viable.
Animals ; Biopsy ; Collagen ; Copper* ; Dermis ; Epidermis ; Guinea Pigs* ; Guinea* ; Herpes Zoster ; Humans ; Inpatients ; Lasers, Gas* ; Necrosis ; Port-Wine Stain ; Skin*

Diabetic and nondiabetic vascular diseases cause significant foot problems and it frequently progress to osteomyelitis and amputation. Advances in vascular surgical techniques, including distal arterial bypass via synthetic grafts or autogenous vein grafting have opened the way for higher rate of limb salvage. We have experienced patients with ischemic vascular foot disease and combined skin ulceration and varing degree of soft tissue defect. In three patient with major vessel obstruction, we could preserve limb and avoid major amputation using greater saphenous vein graft with or without microvascular free tissue transfer.
Amputation ; Extremities ; Foot Diseases ; Foot* ; Humans ; Limb Salvage ; Osteomyelitis ; Saphenous Vein ; Skin Ulcer ; Transplants ; Vascular Diseases ; Veins

No abstract available.
Adult* ; Humans ; Orbit*

Non-metrical morphologic variations of skull foramina were studied with 250 crania of Korean adults. Studied morphologic variationts were presence of supra-orbital foramen(33.3%), frontal foramen(27.7%), accessory infraorbital foramen(13.2%), accessory lesser palatine foramen(41.0%), Vesalius foramen (16.9%), Huschke foramen(18.8%), condylar canal(62.6%) and parietal foramen(49.8%). The ahsence of posterior ethmoidal foramen(0.2%), zygomaticofacial foramen(7.1%) and mastoid foramen(30.2%) was also observed. The variations were presence of the exsutural location of anterior ethmoidal foramen 30.8%), mastoid foramen(35.9%) and incomplete development of oval foramen(4.9%), foramen spinosum(9.6%), hypoglossal foramen(9.6%). And incidence of these variations were compared with 12 different geographical localitics.
Adult ; Humans ; Incidence ; Mastoid ; Rabeprazole ; Skull*

PURPOSE: MRI is known to be an effective imaging modality of the aorta and its role is steadily increasing in the evaluation of acquired aortic diseases including aortic dissections and aortic aneurysms. However, differentiation of the aortic dissections with thrombosed false lumen from the aortic aneurysm with mural thrombus in MRI has not been easy. Therefore, the authors tried to find the characteristic MR featrses which would to differentiate the two diseases. MATERIALS AND METHODS: MR images of 6 patients with thrombosed aortic dissection and 7 patients with thrombosed aortic aneurysms were reviewed retrospectively and compared in regand to shape and extent of thrombus, dimension of aorta, and luminal flow signal. RESULTS: Thrombosed aortic dissections showed sharply demarcated crescent shaped aortic wall thickening of even thickness involving long segment of the aorta, whereas thrombosed aortic aneurysms showed irregular aortic wall thickening of uneven thickness localized in the short dilated segment of the aorta. Characteristically aortic aneurysm with mural thrombus showed eccentric intraluminal slow flow signal. In contrast to the signal void of the true lumen in aortic dissections, the residual lumen of the aortic aneurysm with mural thrombus revealed intraluminal signal due to slow flow. CONCLUSION: Familiarity to these MRI findings of thrombosed aortic dissections and aortic aneurysms may lead to the accurate differential diagnosis in majority of cases.
Aorta ; Aortic Aneurysm* ; Aortic Diseases ; Diagnosis, Differential* ; Humans ; Magnetic Resonance Imaging* ; Phenobarbital ; Recognition (Psychology) ; Retrospective Studies ; Thrombosis

OBJECTIVES: Posttraumatic stress disorder(PTSD) has devastating effects on multiple aspects of the quality of life(QoL). Therefore, the purpose of this study is to compare the QoL between PTSD group and non-PTSD group, and identify the variables affecting the QoL of the Vietnam War veterans. METHODS: We recruited 39 veterans with PTSD and 43 veterans without PTSD, all of whom had deployed to the Vietnam War. We used the Korean version of Mini International Neuropsychiatric Interview-Plus, the Korean version of Clinician-Administered PTSD Scale, Combat Exposure Scale and the Korean version of World Health Organization Quality of Life Assessment Instrument abbreviated version. We used independent samples t-test to identify the differences between PTSD and non-PTSD group in each domains of the quality of life. We also used stepwise multiple linear regression analysis to figure out the variables affecting the QoL of the Vietnam War veterans. RESULTS: In the PTSD group, all domains of the QoL and the QoL total score(p<0.01) were significantly lower than those in the non-PTSD group. In the Vietnam War veterans, PTSD, major depressive disorder and education levels were the variables affecting the QoL. Among these, PTSD uniquely explained the QoL of the overall and general health(beta=-1.411, R2=0.180), the physical health domain(beta=-2.806, R2=0.089) and the total score (beta=-11.479, R2=0.104). CONCLUSIONS: These results suggest that among the Vietnam War veterans, the QoL of the PTSD group is significantly lower than that of the non-PTSD group. Among the combat exposed veterans, PTSD may be one of the main reasons that affect the multiple domains of the QoL.
Depressive Disorder, Major ; Humans ; Linear Models ; Quality of Life ; Stress Disorders, Post-Traumatic ; Veterans ; Vietnam ; World Health Organization

Self expandable metallic stent is a good alternative of percutaneous transhepatic biliary drainage because it can eliminate numerous problems caused by external drainage catheter, such as tube dislodgement, bile leakage and psychotic problems. Authors analyzed initial results of self expandable metallic stents used in the patients with malignant biliary obstruction to evaluate the efficacy of the procedure and to find the technical problems in the procedure. Self expandable metallic stents were inserted in 14 patients: three with recurrent stomach cancer: there with gallbladder cancer: seven with Klatskin tumor: one with common duct cancer. Gianturco type stent was used in 9 cases ans Wallstent was used in 2 cases. In remaining three cases, both Z-stent and Wallstent were used in the same patient. The average period of follow up was 104 days (4-409). In 13 cases, the patency of the bile duct was restored by the stent (technical success: 92.9%). Occlusions of the stent were found in two cases, after two and 13 months, respectively. Causes of failure and stent occlusion were associated duodenal obstruction, tumor overgrowth and shortening of Wallstent. In remaining 11 patients, one patient was lost to follow up an 10 patients did not show recurrent jaundice until death or last follow up. There was no major complication related to the procedure. The insertion of self expandable metallic stent is a safe procedure and call eliminate major disadvantages of PTBD. Overstenting, overlapping land evaluation of associated GI tract obstruction is crucial for obtaining technical success and long-term patency.
Bile ; Bile Ducts ; Catheters ; Drainage ; Duodenal Obstruction ; Follow-Up Studies ; Gallbladder Neoplasms ; Gastrointestinal Tract ; Humans ; Jaundice ; Klatskin Tumor ; Lost to Follow-Up ; Self Expandable Metallic Stents* ; Stents ; Stomach Neoplasms

Self expandable metallic stent is a good alternative of percutaneous transhepatic biliary drainage because it can eliminate numerous problems caused by external drainage catheter, such as tube dislodgement, bile leakage and psychotic problems. Authors analyzed initial results of self expandable metallic stents used in the patients with malignant biliary obstruction to evaluate the efficacy of the procedure and to find the technical problems in the procedure. Self expandable metallic stents were inserted in 14 patients: three with recurrent stomach cancer: there with gallbladder cancer: seven with Klatskin tumor: one with common duct cancer. Gianturco type stent was used in 9 cases ans Wallstent was used in 2 cases. In remaining three cases, both Z-stent and Wallstent were used in the same patient. The average period of follow up was 104 days (4-409). In 13 cases, the patency of the bile duct was restored by the stent (technical success: 92.9%). Occlusions of the stent were found in two cases, after two and 13 months, respectively. Causes of failure and stent occlusion were associated duodenal obstruction, tumor overgrowth and shortening of Wallstent. In remaining 11 patients, one patient was lost to follow up an 10 patients did not show recurrent jaundice until death or last follow up. There was no major complication related to the procedure. The insertion of self expandable metallic stent is a safe procedure and call eliminate major disadvantages of PTBD. Overstenting, overlapping land evaluation of associated GI tract obstruction is crucial for obtaining technical success and long-term patency.
Bile ; Bile Ducts ; Catheters ; Drainage ; Duodenal Obstruction ; Follow-Up Studies ; Gallbladder Neoplasms ; Gastrointestinal Tract ; Humans ; Jaundice ; Klatskin Tumor ; Lost to Follow-Up ; Self Expandable Metallic Stents* ; Stents ; Stomach Neoplasms