BACKGROUND: Cyclosporin A (CsA), a potent immunosuppressant, has been reported to be effective in the treatment of severe atopic dermatitis (AD). OBJECTIVE: The aim of this study was to evaluate the efficacy and side-effects of CsA in Korean patients with severe AD. MATERIALS AND METHODS: 16 patients with recalcitrant AD took CsA for at least 6 weeks. Among them, 11 patients were followed up for more than 16 weeks. Initial dose was 5mg/kg/day (maximum 300 mg/day) and the dose was reduced according to their therapeutic responses. SCORAD (Scoring AD) was used to evaluate clinical efficacy of CsA. During the 1st month of therapy, the therapeutic efficacy and side-effects were evaluated every 2weeks and after 1 month, every month. We checked blood pressure and laboratory abnormalities including liver function test, blood urea nitrogen (BUN), creatinine (Cr) and urinalysis at each visit in addition to observing clinical adverse effects. RESULTS: Significant reduction of SCORAD was noted in 15 patients after 6 weeks of CsA therapy. Only one patient stopped CsA therapy because of the elevation of blood pressure. Three patients showed albuminuria, which disappeared after CsA dose reduction. CONCLUSION: CsA can be used effectively and safely in severe Korean AD patients. Albuminuria seems to be a peculiar side-effect in Korean patients.
Albuminuria ; Blood Pressure ; Blood Urea Nitrogen ; Creatinine ; Cyclosporine* ; Dermatitis, Atopic* ; Humans ; Liver Function Tests ; Urinalysis

Benign hemangioma of the mediastinum is rare. This slowly growing tumor is described as well circumscribed, cystic, hemorrhagic tumor. Histologically it can be differentiated into capillary or cavernous form. We present a case of mediastinal hemangioma. A 20-year-old-man was presented with a slowly growing posterior mediastinal mass of 6 years duration, 8x6 cm in size. The mass was relatively well defined but focally invasive. Microscopically, it was differentiated into vessels of capillary, cavernous, and venous patterns. A solid cellular proliferation with inconspicuous capillary lumens was focally seen. The stroma between variable-sized vessels showed marked myxoid change associated with some smooth muscle bundles and adipose tissue. Ultrastructurally, areas of solid cellular proliferation showed formation of lumens. These lumens were lined by active endothelial cells showing plasmalemmal vesicles and Weibel-Palade bodies on the abluminal surface.
Adipose Tissue ; Capillaries ; Cell Proliferation ; Endothelial Cells ; Hemangioma* ; Mediastinum ; Muscle, Smooth ; Weibel-Palade Bodies

No abstract available.
Mucocutaneous Lymph Node Syndrome*

PURPOSE: Knee IVIR images were repeatedly obtained after intravenous administration of gadopentetate dimeglumine to evaluate the arthrographic effect and to determine the optimal scan timing and technique. MATERIALS AND METHODS: Sagittal Tl-weighted (650/15) sequences were repeated before and after intravenous gadolinium enhancement in 26 patients who were divided into exercise (14/26) and nonexercise (12/26) groups. Fourteen patients in exercise group were allowed to move the affected knee joint actively for 10 minutes immediately after the first post-enhancement scan and before repeating scans. The signal intensities in central and peripheral portions of the joint were measured and compared between these two groups. RESULTS: In all cases, enhancement of joint fluid began at peripheral portion and progressed toward central portion. The diffusion rate in exercise group was far faster than that in nonexercise group and homogeneous arthrographic image was revealed within 10 minutes after completion of joint movement. The arthrographic effect continued and the rate of signal decrease was quite slow. CONCLUSION: MR arthrographic image of knee joint can be obtained within 10 minutes after completion of a few minute exercise following intravenous injection of gadopentetate dimeglumine. Intravenous MR arthrography is expected to become an useful method as a convenient alternative to direct MR arthrography.
Administration, Intravenous ; Arthrography* ; Diffusion ; Gadolinium ; Gadolinium DTPA ; Humans ; Injections, Intravenous ; Joints ; Knee Joint ; Knee*

BACKGROUND: Pruritus, which is a frequent accompanying symptom of dermatological diseases, is also common during pregnancy, either localized or generalized. It may be related to specific dermatoses of pregnancy. OBJECTIVE: A clinical study was performed to know the exact nature of pruritus in pregnancy. METHODS: Subjects with systemic diseases, or laboratory abnormalities were excluded. People who have had pruritic dermatologic diseases before pregnancy were also excluded. One hundred and fifty five pregnant women were interviewed with physical examinations and followed up to the date of delivery. Pruritus was graded. RESULTS: Pruritus was present in 31.6%. Most affected subjects had mild or moderate severity. The abdomen was the most common site. There was a tendency for the duration of itching to increase with the duration of pregnancy. CONCLUSION: Conclusion: These findings may provide basic and useful data on pruritus during pregnancy.
Abdomen ; Clinical Study* ; Female ; Humans ; Physical Examination ; Pregnancy* ; Pregnant Women ; Pruritus* ; Skin Diseases

Nuclear DNA content of 32 cases of prostate adenocarcinoma diagnosed 1986-1991 was determined by flow cytometry, with the use of paraffin-embedded archival tissue. The present study was done to define the relationship between clinical stage, histopathological grade, and DNA ploidy. Aneuploidy was found in 10(31.3%) cases including 7 cases of near-tetraploidy. Among diploid tumors, 36.4% were localized disease(stage A and B), 13.6% were characterized by invasion outside the prostate(stage C), and 50.0% showed distant metastasis(stage D). Among aneuploid tumors, 10.0% were stage B, 50.0% stage C, and 40.0% stage D. The degree of glandular differentiation was characterized by the Gleason score and the percentage of sampled tissue involved by carcinoma was graded by Dhom's method. Apparent correlation was found between Gleason grade and Dhom grade(P<0.05). All 13 tumors with a Gleason grade I(score of 2 to 5) were diploid. Four of 9 tumors with a Gleason grade II(score of 6 to 7) were aneuploid(near-tetraploidy 33.3%, aneuploidy 11.1%) and 60.0%, of tumors with a Gleason grade III(score of 8 to 10) were aneuploid(near-tetraploidy 40.0%, aneuploidy 20%). The percentage of aneuploid cases increased with advanced clinical stage, but the relationship between aneuploidy versus clinical stage was not significant. However, it can be concluded that DNA ploidy correlates well with Gleason grade(p<0.05), which may have predictive prognostic value for prostate adeno-carcinomas.
Adenocarcinoma

Pyogenic vertebral osteomyelitis is rare. It most commonly occurs at the lumbar area and in the fifth to seventh decades of life. Most individuals present with back pain, abdominal pain, hip pain and meningeal syndrome. We experienced three cases of unusual patterns of pyogenic osteomyelitis. The first case developed after sepsis. The second case developed after open fracture and infection of other site. The third case was misdiagnosed as metastatic cancer. We present these cases with a brief review of literatures.
Abdominal Pain ; Back Pain ; Fractures, Open ; Hip ; Osteomyelitis ; Sepsis ; Spondylitis*

PURPOSE: The purposes of this article are to identify CT findings distinguishing nasal polyps, that are the most common cause of the nasal polypiod lesions, from other nasal cavity masses and to identify differential points between benign and malignant masses of nasal cavity. MATERIALS AND METHODS: We classified 567 cases of pathologically proved nasal cavity masses into 4 different groups on CT according to the sites of origin and surrounding bone changes. RESULT: The nasal polyps were the most common cause of nasal cavity masses(515/567). Group I had a high diagnostic specificity for the nasal polyps (513/515, 99.6%) although inverted papilloma (8/522) and malignant melanoma(1/522) showed similar CT appearances. The representitive nasal mass of Group Ila was the inverted papilloma (15/24, 66.5% of the inverted papilloma). Group III pattern was seen in 3 cases of benign minor salivary gland tumor and 2 cases of pyogenic granuloma. Group IV suggested malignancy and thus was mostly observed in malignant tumors except I case of inverted papilloma and 1 case of granulomatous necrosis. CONCLUSION: The differential diagnosis between nasal polyps and the other nasal cavity masses is possible by characteristic bone changes and their sites of origin revealed on CT. In addition, it is possible to differentiate malignant masses from benign in most cases.
Diagnosis, Differential* ; Granuloma, Pyogenic ; Nasal Cavity* ; Nasal Polyps* ; Necrosis ; Papilloma, Inverted ; Salivary Glands, Minor ; Sensitivity and Specificity

MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes) is one of the mitochondrial encephalomyopathy, A rare disease caused by a disturbance of the mitochondrial chain of respiration. MELAS is confirmed by typical light and electron microscopic findings : "ragged red fibers" by modified Gomori trichrome stain on light microscope and numerous abormal mitochondria on electron microscope. We experienced a boy with the characteristic clinical and pathologic findings of MELAS. Our patient demonstrated bilateral basal ganglia calcifications and infarction at right parieto-occipital and thalamic areas on CT and MR We found that MRI was more sensitive and represented the infarcted lesions better than CT. Detection of cerebral insults of MELAS by MRI is important in making decision on patient treatment and also in predicion of the patient prognosis.
Acidosis, Lactic ; Basal Ganglia ; Brain Diseases ; Child* ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; MELAS Syndrome* ; Mitochondria ; Mitochondrial Encephalomyopathies ; Muscular Diseases ; Rare Diseases ; Respiration

PURPOSE: To illustrate frequently encountered anatomic variations on PNS computed tomography(CT) and to assess their clinical significance. MATERIALS AND METHODS: CT findings of 1523 patients, who underwent PNS CT with no history of sinus surgery, were reviewed, and prevalence of each anatomic variation and its relationship with mucociliary clearance pathway was evaluated. RESULTS: Two categories of anatomic variations were encountered. The first group included variations of the turbinates, such as concha bullosa(28.6% ), paradoxical middle turbinate(31.5%), of the uncinate process, such as medially bent or folded(36.3%), laterally bent(3.7%) or uncinate bulla(0.5%), of the ethmoidal sinus, such as Haller's ce11(28.2%), large agger nasi ce11(9.6%) or large ethmoidal bulla(23.5%) and nasal septal deviation(24. 1%), which might cause obstruction of mucociliary clearance pathway and thus give rise to secondary obstructive sinusitis. The second group included Onodi ce11(1.4%) and medial depression of the lamina papyracea (3.5%), which were not related with obstructive sinusitis. 87 cases of large agger nasi cell were associated with obstruction of nasofrontal recess. Large ethmoidal bulla(452 cases), Haller's ce11(245 cases) and true concha bullosa (25 cases) contributed to narrowing of the infundibulum. Medially bent uncinate process(220 cases), concha bullosa(157 cases), paradoxical middle turbinate(126 cases) and nasal septal deviation(93 cases) were observed in middle meatal obstruction and supreme concha (3 cases) accompanied sphenoethmoidal recess obstruction. CONCLUSION: Recognition of anatomic variations on PNS CT is important to build a treatment plan in patients with obstructive sinusitis as they may represent causes of the disease, and to avoid critical complications during functional endoscopic sinus surgery.
Anatomic Variation ; Depression ; Humans ; Mucociliary Clearance ; Prevalence ; Sinusitis ; Turbinates