We reviewed two cases of keratosis punctata palmaris et plantaris(KPP) and the scanning electron microscopic findings(SEM). The skin lesions of KPP are multiple, hyperkeratotic on the palms and soles with central pitting. There was no subjective symptoms. The histologic findigs revea,l marked hyperkeratosis, hypergranulosis, and acanthosis with depression of the underlying malpighian layers. The SEM findings reveal one hyperkeratoic plug on punctate lesion(case I ) and three hyperkeratotic plugs on depression of the malpighian layer(case ll ).
Depression ; Keratoderma, Palmoplantar* ; Keratosis* ; Skin

A case of low-grade endometrial stromal sarcoma resembling ovarian sex-cord tumor in the uterus of a 43-year-old woman is described. This tumor belongs to the group II category of uterine tumors resembling ovarian sex-cord tumor described by Clement and Scully, and the epithelial-like elements show prominent smooth muscle differentiation, proved by immunoreactivity for desmin and actin. The patient did not receive any adjuvant therapy; she is alive and well without recurrence 8 months postoperatively.
Female ; Humans

Primary renal lymphoma is a rare tumor of the kidney that typically presents with bilateral nodular enlargement in the absence of extrarenal masses. We describe MR findings of a case of primary renal lymphoma along with ultrasound and CT findings. MR imaging demonstrated globular enlargement of both kidneys with multilobulated contour and multiple masses which had isosignal intensity on T1WI and low signal intensity on T2WI. The masses enhanced slightly on dynamic contrast enhanced scan.
Kidney ; Lymphoma* ; Magnetic Resonance Imaging ; Ultrasonography

A 7-month-old boy was presented with growth retardation. The brain CT scan and the cerebral angiography revealed hydrocephalus resulting from venous hypertension and a high-flow direct arteriovenous fistula at the distal M2 segmnt of the middle cerebral artery which was drained into the sphenoparietal sinus. The echocardiogram disclosed a ventricular hypertrophy. The patient was treated by gradual ligation of fistulous portion in ten minutes to prevent sudden increase of peripheral resistance and cardiac overloading. It is stressed that slow obliteration of an arteriovenous fistula is a paramount procedure to prevent congestive heart failure.
Arteriovenous Fistula ; Brain ; Cerebral Angiography ; Fistula* ; Heart Failure ; Humans ; Hydrocephalus ; Hypertension ; Hypertrophy ; Infant ; Ligation ; Male ; Middle Cerebral Artery ; Tomography, X-Ray Computed ; Vascular Resistance

This study was carried out to reveal the epidemiologic characteristics of psoriasis in Korea. Seventeen university hospitals were engaged in this study, and the results were as follows : 1. The number of psoriasis patients during the 10 years from January 1977 to March 1987 was 1.05% of all the outpatients; the male to female-ratio was 1.08:1. 2. In the prospective study, the number of psoriasis patients was 2.3% of all the outpatients in 1987, 2.8% of all the outpatients in 1988 and the male to female ratio was 1.26:1. 3. The most prevalent age of onset was 20-29 years ; 81.1% were living in urban areas; and a family history was obtainable in 19.8% with parents holding the highest rank of 7.8%. 4. The most frequent duration of disease activity was under 5 years in 63.3%; the most common age for the worst condition was 20-29 yrs. The most common area size of skin involvement at the peak of the worst condition was less than 10%. 5. The most common initiating skin lesion began on the scalp in 20.2%, on the nail in 17.2%, pruritus in 63.0% with joint symptoms in 10.8%, and Koebner phenomena in 50.6%. 6. Emotional stress was the most common aggravating factor in 34.4%. The method of treatment that attained the best result was the combination therapy of oral medication and a topical agent. The best treatment modality was said to be the application of ointment with p.o.medication by as many as 28.4% of patients who took the leading rank. Photo-chemotherapy, effective with few complications, was not used much as it was not well-known in Korea until after 1980. Most people had an accurate knowledge of psoriasis.
Age of Onset ; Epidemiologic Studies* ; Epidemiology ; Female ; Hospitals, University ; Humans ; Joints ; Korea ; Male ; Methods ; Outpatients ; Parents ; Prospective Studies ; Pruritus ; Psoriasis* ; Scalp ; Skin ; Stress, Psychological

A 36-year-old female patient with aplastic anemia developed massive hemoptysis and was placed on ventilator support. However, airway obstruction by blood clots triggered desaturation and ventilator malfunction. Manual ventilation was initiated to improve oxy-genation, and emergency flexible bronchoscopy was performed to clear the airway. Nevertheless, the patient developed extensive subcutaneous emphysema, pneumothorax, and pneumomediastinum.
Adult ; Airway Obstruction ; Anemia, Aplastic ; Barotrauma* ; Bronchoscopy ; Emergencies ; Female ; Hemoptysis* ; Humans ; Mediastinal Emphysema ; Pneumothorax ; Subcutaneous Emphysema ; Ventilation* ; Ventilators, Mechanical

PURPOSE: We report a case of inadvertent staining of the vitreous with Trypan Blue during cataract surgery. CASE SUMMARY: We performed cataract surgery in a 44-year-old male patient on an eye with mature cataract. Preoperatively, he had no zonular weakness or lens subluxation. We used trypan blue to stain the anterior capsule to facilitate capsulorhexis. We observed zonular weakness during surgery. During phacoemulsification, the dye entered into the vitreous cavity through the area of zonular weakness and a sudden loss of the red fundus reflex developed. However, we did not perform any specific procedure to correct the problem and finished phacoemulsification and intraocular lens insertion. After surgery, slit lamp examination showed a blue fundal glow, which persisted for 1 week. As expected, the patient's BCVA was better than before the operation. CONCLUSIONS: Use of trypan blue is relatively safe for use in cataract surgery. But to use trypan blue or other dye during cataract surgery, it is necessary to have careful pre operative ocular examination. And if some risk factors like zonular weakness or lens subluxation exists, more caution during surgery is needed.
Adult ; Capsulorhexis ; Cataract ; Diminazene ; Eye ; Humans ; Lens Subluxation ; Lenses, Intraocular ; Male ; Phacoemulsification ; Reflex ; Risk Factors ; Trypan Blue

BACKGROUND: The diagnosis of hepatitis C virus (HCV) infection is screened by anti-HCV enzymelinked immunosorbant assay (ELISA) and confirmed by recombinant immunoblotting assay (RIBA) or HCV RT-PCR. We attempted to evaluate the results between anti-HCV ELISA and a qualitative HCV RT-PCR. METHODS: Four hundred and twenty patients who were tested with anti-HCV ELISA and HCV RTPCR, simultaneously, from January 2002 to June 2005 were enrolled in this study. Anti-HCV ELISA was performed by AxSYM HCV version 3.0 (Abbott Laboratories, USA). HCV RT-PCR was performed using in-house RT-nested PCR methods from January 2002 to October 2004 and HCV Genotype Amplification Kit (LiPA) (Bayer Healthcare, USA) from November 2004 to June 2005. RESULTS: Of the 420 patients tested, 321 were positive for anti-HCV ELISA, and 204 were positive for RT-PCR. The positive predictability of anti-HCV ELISA was 63.6%. Among anti-HCV positive patients, RT-PCR was positive in 7.3% of the patients with sample/cut-off (S/CO)<6, compared with 82.8% of the patients with S/CO> or =6. Among the 117 patients with positive anti-HCV, but with negative HCV RT-PCR, 64 had liver diseases such as chronic hepatitis C, chronic hepatitis B, or hepatocellular carcinoma. Twelve patients showed positive HCV RT-PCR, but negative anti-HCV results; of these 9 had hepatic dysfunction. CONCLUSIONS: In the patients who were positive for anti-HCV ELISA with a low S/CO, HCV RT-PCR positivity was shown in a low proportion. Therefore, in such cases, the results should be confirmed by RIBA or HCV RT-PCR. The liver function test showed increased levels of hepatic enzymes in patients with positive HCV RT-PCR, but negative anti-HCV. Such findings correlate to an early phase of chronic hepatitis C, suggesting the necessity of continuous follow up.
Carcinoma, Hepatocellular ; Delivery of Health Care ; Diagnosis* ; Enzyme-Linked Immunosorbent Assay* ; Follow-Up Studies ; Genotype ; Hepacivirus ; Hepatitis B, Chronic ; Hepatitis C ; Hepatitis C, Chronic ; Humans ; Immunoblotting ; Liver Diseases ; Liver Function Tests ; Polymerase Chain Reaction

OBJECTIVE: To investigate whether polymorphism of Catechol-O-methyltransferase (COMT) gene is associated with the risk of polycystic ovary syndrome (PCOS) in Korean women. METHODS: One hundred and thirty-six PCOS patients and eighty four controls were enrolled. Blood samples were collected from the patients diagnosed according to the 2003 revised criteria of the Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group. Age matched women with regular menstruation from same geographic region were recruited as control subject. Polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) of PCR products were done to determine all individuals' genotype. RESULTS: In women with COMT(LL) genotype, there was decreased PCOS risk and this difference was statistically significant (OR 0.24, 95% CI 0.11~0.51). CONCLUSION: The results suggest that the COMT(LL) genetic polymorphism might be associated with PCOS risk in Korean women.
Catechol O-Methyltransferase ; Consensus Development Conferences as Topic ; Female ; Genotype ; Humans ; Menstruation ; Polycystic Ovary Syndrome ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length

PURPOSE: To evaluate whether soft tissue surrounding the celiac axis, as seen on abdominal CT imaging after gastrectomy for gastric carcinoma, should be considered as the recurrence of carcinoma or postoperative change. MATERIALS AND METHODS: One hundred and forty-one abdominal CT examinations of 71 patients who had undergone subtotal or total gastrectomy for gastric carcinoma were included in our study. Conventional CT scans were obtained with 1 cm thickness and interval from the diaphragm to the kidneys after contrast enhancement. It was considered that carcinoma had not recurred if findings were negative on UGI series, endoscopy with biopsy and a normal level of carcinoembryonic antigen except for soft tissue surrounding the celiac axis on abdominal CT. We then divided subjects into a recurrence group (N = 20) and normal group (N = 51) and on initial follow-up CT (FU-CT), analyzed the incidence, margin, shape, extent, degree and pattern of attenuation of the soft tissue surrounding the celiac axis in both groups. Since the second FU-CT examination, we observed changes in the soft tissue surrounding the celiac axis. RESULTS: On initial follow-up CT, at mean 308 days after surgery, fifty-five percent(39/71) of total patients (70% (14/20) of the recurrence group and 49% (25/51) of the normal group) showed soft tissue surrounding the celiac axis. The margin was distinct in 12 (86%) of the recurrence group and indistinct in 21 (84%) of the normal group (P < 0.001). Twelve (86%) of the recurrence group showed a nodular or confluent nodular shape and 21 (84%) of the normal group showed a permeative shape (P < 0.001). Extent was unilateral in eight (57%) of the recurrence group and bilateral in 16 (64%) of the normal group. Attenuation was similar to that of the spleen and muscle in seven (50%) of the recurrence group and was similar to that of muscle in 18 (72%) of the normal group. The pattern of attenuation was homogeneous in 13 (93%) of the recurrence group and 21 (84%) of the normal group. There was no significant difference in extent, degree and pattern of attenuation between the two groups. Since the second FU-CT examination, soft tissue surrounding the celiac axis was seen to have changed. In one patient in the recurrence group it had a distinct margin, was nodular in shape, unilateral in extent and showed attenuation similar to that of the spleen. In one patient in the normal group, it had changed and had an indistinct margin, three patients showed a decrease in the amount of soft tissue and eight showed decreased attenuation. CONCLUSION: Follow-up abdominal CT is useful in the differentiation of cancer recurrence and postoperative change, and for observing changes in soft tissue surrounding the celiac axis.
Axis, Cervical Vertebra* ; Biopsy ; Carcinoembryonic Antigen ; Diaphragm ; Endoscopy ; Follow-Up Studies ; Gastrectomy* ; Humans ; Incidence ; Kidney ; Recurrence ; Spleen ; Tomography, X-Ray Computed