Cowden syndrome is a rare autosomal dominant disorder characterized by mucocutaneous alterations including multiple facial trichilemmomas, oral mucosal papillomatosis, and acral keratoses. Extracutaneous lesions include polyposis of the gastrointestinal tract, and other multiple hamartoma of the internal organs. A 39 year-old man presented with multiple verruca-like papules and lichenified patches on the face, one year ago. He had been treated for atopic dermatitis for more than 10 years. Although he had been treated in accordance with atopic dermatitis for 1 year, his skin lesions had not improved, so a skin biopsy was performed. The skin biopsy specimen revealed the typical finding of trichilemmoma. Colonoscopy diagnosed diffuse colorectal polyposis. The clinical and hisopathologic findings were consistent with Cowden syndrome. We, herein, report a case of Cowden syndrome with atopic dermatitis.
Adult ; Biopsy ; Colonoscopy ; Dermatitis, Atopic ; Gastrointestinal Tract ; Hamartoma ; Hamartoma Syndrome, Multiple* ; Humans ; Keratosis ; Papilloma ; Skin

Acrosyringeal nevus is a rare condition, which includes proliferation of acrosyringeal keratinocytes, and the proliferation extends from the undersurface of the epidermis down into the dermis as thin anastomosing cords. It is, however, controversial whether acrosyringeal nevus is the same lesion as eccrine syringofibroadenoma, because of several clinicopathological differences. We report a case of benign tumor, consisting of eccrine structures, which occurred in a 60-year-old man. The histopathological features of the excisional biopsy were consistent with acrosyringeal nevus.
Biopsy ; Dermis ; Epidermis ; Humans ; Keratinocytes ; Middle Aged ; Nevus*

PURPOSE: We compared the calculated percent depth dose curves of 6 MeV electron beam to that of measured to evaluate the usefulness of Monte-Carlo simulation method in radiation physics. MATERIALS AND METHODS: The radiation dose values of 6 MeV electron beam using EGS4 code with one million histories in water were compared values that were measured form the depth dose curve of electron beam irradiated by medical accelerator ML6M. The central exis dose values were calculated according the changing field size, such as 5 X 5, 10 X 10, 15 X 15, 20 X 20 cm2. RESULTS: The value calculated showed a very similar shape to depth dose curve. The calculated and measured value of Dmax at 10 X 10cm2 cone is 15mm and 14mm respectively. The calculated value of the surface radiation dose rate is 65.52% and measured one is 76.94%. The surface radiation dose rate has vaied from 64.43% to 66.99. The calculated values of Dmax are in the range between 15mm and 18mm. The calculated value was fitted well with measured value around the Dmax area, excluding build up range and below the 90% depth dose area. CONCLUSION: This result suggested that the calculation of dose value can be replace the direct measurement of the dose for radiation therapy. Also, EGS4 may be a very convenient program to assess the effect of radiation dose using by personal computers.
Microcomputers ; Water

The incidence, type arid distribution of polyneuropathy in patients with chronic obstructive pulmonary disease (COPD) were assessed and also analyzed the causative factors. Forty-four patients, mean age 66.1 years (42 male, 2 female), have been investigated with arterial gas analysis, pulmonary function test, clinical and electrodiagnostic studies. None of them had conditions known to affect the peripheral nervous system such as metabolic disorders or drugs. In a selected group of 44 patients, electrophysiological findings of polyneuropathy were found in 22 patients(50%), clinical polyneurtpathy were diagnosed in 13 patients(9 patients were diagnosed by electrophysiological studies, 4 patients were normal by electrophysiological studies). These findings indicate that subclinical polyneuropathy( 13 patisnts, 30%) more conimorily occurs than clinical polyneuropathy( 9 patients, 20%) in associated with COPD. In the patients with polyneuropathy, the lesions were predominant axonal degeneration, the changes were more involved in leg than arm, more frequently affected sensory fibers. We could not find etiologic factor to cause polyneuropathy in COPD patients.
Arm ; Axons ; Humans ; Incidence ; Leg ; Male ; Peripheral Nervous System ; Polyneuropathies* ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Function Tests

BACKGROUND/AIMS: Many patients with acute paraquat (PQ) intoxication die even at low PQ concentrations, whereas others with similar concentrations recover. Therefore, it is possible that individual differences in antioxidant capacity are responsible for the variable clinical outcome in patients with acute PQ intoxication. METHODS: We investigated whether there was a relationship between the genetic polymorphisms of SOD (V16A), catalase (C262T), and GPX1 (C593T) in 62 patients with acute PQ intoxication and the clinical outcomes of these patients. RESULTS: The frequency of the Mn-SOD V/V, V/A, and A/A genotypes were 56.3, 43.5, and 0% in survivors and 86.9, 13.1, and 0% in non-survivors (p > 0.05). The GPX1 C/C, C/T, and T/T genotypes were present in 100, 0, and 0% of all subjects. The catalase C/C, C/T, and T/T genotypes were present in 100, 0, and 0% of survivors, and in 82.6, 17.4, and 0% of non-survivors. Neither erythrocyte SOD activity nor catalase activity were significantly different between survivors and non-survivors. CONCLUSIONS: No association was found between clinical outcome of acute PQ intoxication and the genetic polymorphism of GPX1 (C593T) or the genetic polymorphisms or enzyme activity of superoxide dismutase (V16A) or catalase (C262T).
Acute Disease ; Adult ; Aged ; Catalase/*genetics ; Female ; Genotype ; Glutathione Peroxidase/genetics ; Humans ; Male ; Middle Aged ; Paraquat/*poisoning ; Poisoning/mortality ; *Polymorphism, Genetic ; Superoxide Dismutase/*genetics

An elastofibroma, which is a rare soft tissue tumor, was excised from the left subscapular region of a 82-year-old woman. An elastofibroma is a slow-growing, pseudotumoral lesion of the soft tissues of the chest wall with peculiar radiological (CT, MR) and ultrasonographic images, and histological patterns. All cases need to undergo a biopsy in order to rule out a sarcoma. An elastofibroma is a benign tumor. If left untreated, it can grow to a considerable size and become symptomatic. Therefore it needs to be closely observed and its nature confirmed by a biopsy. This condition is rarely encountered in Korea. However, more patients could be diagnosed if more careful attention to elastofibroma is paid.
Aged, 80 and over ; Biopsy ; Female ; Humans ; Korea ; Sarcoma ; Thoracic Wall

BACKGROUND/AIMS: We assessed twelve cases of suspected chronic pesticide intoxication, with medically unexplained physical symptoms. METHODS: Complete blood cell count (CBC), blood chemistry, routine urinalysis, chest X-ray, ECG, gastrofiberscopy, abdominal ultrasonography, neuroselective sensory nerve conduction threshold, and psychological assessment were performed on 12 farmers who believe themselves to have suffered from chronic pesticide intoxication. RESULTS: No specific abnormalities were observed on CBC, routine urinalysis, chest X-ray, ECG, gastroscopy, abdominal ultrasonography, or peripheral nerve conduction velocity test. They persistently manifested helplessness, depression, and anxiety. The results of both psychological assessment and general physical examination revealed the following clinical features: depression (8 cases), multiple chemical hypersensitivity syndrome (2 cases), alcoholism (1 case), and religious preoccupation (1 case). CONCLUSION: In those living in the western rural area of South Korea, depression is a prominent ongoing presentation in pesticide-exposed farmers, in addition to unexplainable physical symptoms.
Aged ; Agricultural Workers' Diseases/*diagnosis/psychology ; Chronic Disease ; Environmental Illness/*diagnosis/psychology ; Female ; Humans ; Korea ; Male ; Middle Aged ; Observation ; *Occupational Exposure ; Pesticides/*poisoning ; Psychological Tests

Background: Although few studies have reported improved clinical outcomes with the administration of vitamin B1 and C in critically ill patients with septic shock or severe pneumonia, its clinical impact on patients with sepsis-related acute respiratory distress syndrome (ARDS) remains unclear. The purpose of this study was to evaluate the association with vitamin B and C supplementation and clinical outcomes in patients with ARDS. Methods: Patients with ARDS requiring invasive mechanical ventilation, admitted to the medical intensive care unit (ICU) were included in this study. Clinical outcomes were compared between patients administered with vitamin B1 (200 mg/day) and C (2 g/day) June 2018–May 2019 (the supplementation group) and those who did not receive vitamin B1 and C administration June 2017–May 2018 (the control group). Results: Seventy-nine patients were included. Thirty-three patients received vitamin B1 and C whereas 46 patients did not. Steroid administration was more frequent in patients receiving vitamin B1 and C supplementation than in those without it. There were no significant differences in the mortality between the patients who received vitamin B1 and C and those who did not. There were not significant differences in ventilator and ICU-free days between each of the 21 matched patients. Conclusion Vitamin B1 and C supplementation was not associated with reduced mortality rates, and ventilator and ICU-free days in patients with sepsis-related ARDS requiring invasive mechanical ventilation.

This study was designed to examine how such factors as hemodialysis parameters, body mass index, renin and aldosterone concentrations, sympathetic nervous activity, and parathyroid hormone concentrations are associated with the control of hypertension in hemodialysis patients. Hemodialysis patients (n=114) were grouped into four categories. Group 1 had normal BP without antihypertensive medication. Group 2 needed one antihypertensive drug, Group 3 needed combination of two or three categories of antihypertensive drugs without minoxidil. Group 4 needed more than three categories of antihypertensive drugs including minoxidil. Parathyroid hormone, beta2-microglobulin, renin and aldosterone, epinephrine, norepinephrine, and hemodialysis parameters were measured. The fractional clearance of urea as Kt/V urea was significantly lower in Group 3 and Group 4 than in Group 2 (p<0.01). Concentrations of parathyroid hormone were significantly higher in Group 4 than the other groups (p<0.01). Pre-hemodialysis norepinephrine concentrations were significantly higher in Group 4 than the other groups (p<0.05). Traditional factors associated with hypertension did not seem to be relevant to the degree of hypertension in hemodialysis patients in the present study. In conclusion, poor Kt/V urea, elevated parathyroid hormone concentrations, and elevated concentrations of plasma norepinephrine seemed to be the factors that might be associated with control of hypertension in hemodialysis patients.
Adult ; Aged ; Aldosterone/*blood ; Analysis of Variance ; Antihypertensive Agents/therapeutic use ; Blood Pressure/drug effects/*physiology ; Epinephrine/blood ; Female ; Humans ; Hypertension/blood/drug therapy/physiopathology ; Kidney Failure, Chronic/blood/physiopathology/therapy ; Male ; Middle Aged ; Norepinephrine/blood ; Parathyroid Hormone/*blood ; *Renal Dialysis ; Renin/*blood ; Sympathetic Nervous System/*physiology ; Urea/metabolism

Solid and papillary epithelial neoplasm (SPEN) of the pancreas is a rare tumor with low malignant potentiality that usually occurs in young females. Preoperative evaluation, especially radiologic tests, including ultrasonography and CT scan, is helpful in the diagnosis. These studies demonstrate a well-demarcated large mass with solid and cystic portions, frequently in the tail or body of the pancreas. Complete resection is usually curative, however local invasion and/or metastasis may occur. The authors report a case of a solid and papillary epithelial neoplasm of the pancreatic body in a 14-year old child at St. Benedict Hospital and review the literature.
Adolescent ; Child* ; Diagnosis ; Female ; Humans ; Neoplasm Metastasis ; Neoplasms, Glandular and Epithelial* ; Pancreas* ; Tomography, X-Ray Computed ; Ultrasonography