Allergic contact dermatitis due to 8-MOP is a rarely known si(ie effect of this widely used drug. Other known adverse reactions due to 8-MOP such as the oallergic dermatitis as well as some isolated cases of exanthema, papular eruptions, and astloma like symptoms are also sporadically reported. A 52-year-old man with vitiligo developed erythema to the UVA exposed 0.3% Oxoralen cream applied area. Prior to this episode, the patient had history of generalized burns after systernic PUVA therapy in 1983. Even after this experience, the patient had few more episodes of erythema at the site of 0.3%. Oxoralen cream application. We performed patch test and photopatch tests with Scandinavian series, 0.3% Oxoraler or am (as is), and diluted 8-MOP, 5-MOP, TMP solution. The result showed positive reactivity to 6-methylcoumarin, 8-MOP, as well as to 0.3% Oxoralen cream. The size of erythema was same in both irradiated areas which indicates an allergic contact dermatitis rather than photoallergic dermatitis or phototoxic dermatitis.
Burns ; Dermatitis ; Dermatitis, Allergic Contact* ; Dermatitis, Photoallergic ; Dermatitis, Phototoxic ; Erythema ; Exanthema ; Humans ; Methoxsalen ; Middle Aged ; Patch Tests ; PUVA Therapy ; Thymidine Monophosphate ; Vitiligo

Serovars of 22 leptospiral field isolates from rats trapped in Korea were identified by cross-agglutinin absorption test (CAAT). Genomic characteristics of 7 selected isolates and 6 antigenically closely related reference serovars of lai, yeonchon, birkini, gem, mwogolo, and canicola were differentiated by arbitrarily primed PCR (AP-PCR) and southern blot hybridization using 16S rRNA gene probe from Borrelia burgdorferi. Among the 22 isolates, 21 strains were identified as serovar lai by CAAT, while the serological reactivity of NR13 did not accord with that of serovar lai. Results of AP-PCR using primers RSP, KF and PB-1 were in general agreement with those obtained by serological identification, and all 7 isolates including NR13 showed the same profile with serovar lai or yeonchon. In the southern blot hybridization with 16S rRNA gene probe, the isolates were divided into two ribotype groups when HindIII and BamHI digests were employed: isolates NR4, NR13, and serovar lai showed the same profile, and isolates JR34, JR57, KR48, JR77, and JR82 were classified as the another ribotype group. Isolate NR13 and serovar yeonchon, which were isolated in Korea and showed serological differences with serovar lai, were indistinguishable from serovar lai in this DNA study using AP-PCR and ribotyping. These results demonstrate that Korean leptospiral isolates were closely related in DNA level, and ribotyping would be useful for subgrouping of field isolates.
Absorption ; Animals ; Blotting, Southern ; Borrelia burgdorferi ; DNA ; Genes, rRNA ; Korea ; Leptospira* ; Polymerase Chain Reaction* ; Rats ; Ribotyping*

Idiopathic thrombocytopenic purpura is an uncommon illness but most common form of thrombocytopema in pregnancy. Corticosteroids, splenectomy, immunosuppressive drugs, and immunoglobulin therapy have been recommended for manaaement. The optimal method of delivery is controversial. We have experienced a case of idiopathic thrombocytopenic purpura diagnosed previously and managed with corticosteroid and vincrstine, which was followed by pregnancy, vaginal delivery and postpiirtum splenectomy.
Adrenal Cortex Hormones ; Immunization, Passive ; Pregnancy* ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy

BACKGROUND: Ethyl crbmate(EC) has been identified at low microgram quantities in various fermented beverages, destiled products and tobacco smoke. EC has long been known as a carcinogen. Oxidation of the ethyl group of EC is followed by dehydration to yield the carcinogen vinyl carbamate (VC). This is further oxidized to vinyl carbamate epoxide(VCO). VC and VCO proved to be much more carcirogenic than EC. OBJECT: The objective of this study is to compare the potency of carcinogenic ability and histologic changes in skin tumors induced by EC, VC, or VCO. METHODS: In this exeriment, the tumor induction was performed by painting the mouse skin once a week for five weeks with EC, VC and VCO solution, and then 12-0-tetradecanoyl-phorbol-13-acetate(TP2) was treated in the same manner twice a week for 35 weeks. We biopsied the skin at B 0, 15, 25, 30 and 35 weeks and stained the specimens with hematoxylineosin. RESULTS: The time period for the first appearance of papilloma was 6 weeks in the VC-TPA and VCO-TPA group, but, 15 weeks in the EC TPA group. The average number of papilloma showed a statistically sign.ficant difference after 15 weeks between the EC-TPA, VC-TPA and VCO-TPA group. The occurrence of keratoacanthoma and squamous cell carcinoma was 16 and 21 weeks respectively. Histologic changes, such as epidermal layers, pseudohorncysts, degree of hyperkeratosis, hypergranulosis, dysplasia and dyskeratotic cells were more prominent in the papil loma than in the non-papilloma lesion. Dermal changes disclosed similiar findings, that is, increased dermal thicknes, proliferation of vessels and hair follicles, and fibrosis of the dermis. Squamous cell carcinomis and keratoacanthomas were produced only in the VCO-TPA group. CONCLUSION: From the above results it is concluded that VC and VCO have a more potent carcinogenic potential than EC. Various skin tumors, such as papilloma, keratoacanthoma or squamous cell carcinoma were prorduced by the above carcinogens.
Animals ; Beverages ; Carcinogens ; Carcinoma, Squamous Cell ; Dehydration ; Dermis ; Fibrosis ; Hair Follicle ; Keratoacanthoma ; Loma ; Mice ; Paint ; Paintings ; Papilloma ; Skin* ; Smoke ; Tobacco ; Urethane*

BACKGROUND: Recent ad vances and innovation in laser technology encourages us to learn and use it experimentally and clinically. The pulsed dye laser(Candela SPTL-1) is a flashlamp excited dye laser, using the princ ples of selective photothermolysis that targets the abnormal microvascu lature of cutaneous lesions while sparing adjacent structures including the epidermis. The laseemits a 585nm wavelength, and has a pulse duration of 450 usec. It is now being widely used in the treatment of vascular diseases in the dermatology field. OBJECTIVE & METHOD : Buring the period of about 3 years from August 1994 to March 1992, at the out patient clinin of Department of Dermatology of Yonsei University. 252 patients who were treated with SPTL was analyzed to evaluate the clinical effects of the pulsed dye laser. Patient di@st.ributition f the cutaneous vascular lesions included 1fil pat.ients with nevui flammeus, 68 with telangcetasia, 15 with spider angima, 5 with strawberry hemangiona and 2 with cavernous hemangior ia. RESULTS: The results and summarized as follows : 1. Nevus flammeus 4b.7% of early childhood, 41.5% of late childhood and 47.3% of adults showed excellent or good results. 2. Telangiectasia 78.1% of patients she wed excellent or good results. 3. Spider angioma 66.7% of patients she wed excellent or good results. 4. Strawberry hemangioma and cavernous hemangioma Most, of the patients,howed fair or poor results. 5. Complications included hyperpigmentation(26.5%), hypopigmentation(1.6%) and atrophic scar(4.5% ). CONCLUSION: Our experince with pulsed dye laser during the last 3 years revealed that it was superior in treating vascular disease than other existing lasers.
Adult ; Dermatology ; Epidermis ; Fragaria ; Hemangioma ; Hemangioma, Cavernous ; Humans ; Lasers, Dye* ; Port-Wine Stain ; Spiders ; Telangiectasis ; Vascular Diseases

Endoscopic injection sclerotherapy(EIS) has been widely used in treating and eradicating acutely bleeding esophageal varies, but may be associated with some undesirable local and systemic complications. Endoscopic variceal ligation(EVL), which consists of mechanicai ligation and thrombosis of varices using elastic o-band, has been recently developed as a non operative alternative to EIS. We performed EVL in 65 patients who had bled from esophageal varices between November 1991 and September 1993. Total 274 sessions were performed and 774 o-bands were used. Six patients were actively bleeding and all of them were successfully controlled by emergency EVL. During the follow-up period, five patients who had combined hepatoma died. Varices were eradicated or reduced grade I in 43(71.6%) of the 60 survivals by 8-36 ligations(mean 15.6 ligation) in 2-13 EVL sessions(mean 5.6 sessions). During follow up period, five patients had recurred from grade 0 to grade 2 or 3 in 106-260 days(mean 182.6 days), and then eradicated by repeated EVL. During or after EVL, there were no complications, except mild substernal distress and mild dysphagia in 17 and 7 patients respectively. These results showed that EVL is a safe and effective method for eradication of bleeding esophageal varices.
Carcinoma, Hepatocellular ; Deglutition Disorders ; Emergencies ; Esophageal and Gastric Varices* ; Follow-Up Studies ; Hemorrhage ; Humans ; Ligation* ; Thrombosis ; Varicose Veins

BACKGROUND: Langerhans cells (LC), keratinocytes and Thy-1+ dendritic epidermal cells(DEC) are epidermal cells which are known to have important roles in inflammatory or immunologic skin disorders. Allergic contact dermatitis(ACD) is a prototype of a delayed hypersensitive reaction in which LC, keratinocytes and T lymphocytes play an important role. The role of LC in ACD is well known, but the role of Thy-1+ DEC is not yet fully revealed. Futhermore, the mechanism of irritant contact dermatitis(ICD) is not known and more study is required on the interaction between these epidermal cells in ICD. OBJECTIVE: The aim of this study is to observe the changes of these cells in ACD and ICD and to discuss their possible roles in the disease precess. MEHTODS: We evoked ACD with DNFB and ICD with croton oil in BALB/c mice and observed the morphologic changes of LC, Ia+ keratinocytes, and Thy-1+ DEC by immunoperoxidase staining when the inflammation was at its peak and at the resolution state. RESULTS: 1. In the control group, LC were evenly distributed and their average number was 1147+/-132/mm*. Thy-1+ DEC were slightly bigger than LC and showed uneven distribution. The average number of Thy-1+ DEC was 57+/-69/mm* Ia+ keratinocytes did not appeared. 2. On the 1st day of DNFB challenge, the number of LC was significantly decreased and their size and dendritic processes were increased when compared to those of the control group. Most of the keratinocytes showed Ia antigen expression on their surfaces. 3. On the 12th day of DNFB challenge, no significant changes in the number and morphologyof LC were noted when compared to the cotrol group, Ia+ keratinocytes were not observed. 4. there were no significant changes in the number and morphology of Thy-1+ DEC in ACD on the 1st and 12th day after DNFB challenge. 5. On the 2nd day after croton oil application, the number of LC was significantly decreased but the morphology not significantly changed. Ia+ keratinocytes were not observed. 6. On the 20th day after croton oil application, the number of LC was significantly increased but the morphology was not significantly changed. Ia+ keratinocytes were not observed. 7. There were no significant changes in th number and morphology of Thy-1+ DEC in ICD on the 2nd and 20th day after application of croton oil. Ia+ keratinocytes were not observed. CONCLUSION: In can be deduced that the LC have important roles in the mechanisms of both ACD and ICD reactions. Ia+ keratinocytes have an important role mainlyin the inflammatory precess of ACD. In addition, since the changes of the number of Langerhans cells in ACD and ICD showed different time courses and Ia+ keratinocytes appeared only in ACD, we hypothesized that different pathways of inflammation exist in ACD and ICD, and different cytokines may be responsible. It is probable that Thy-1+ DEC does not have any significant role in the inflammatory process of both ACD and ICD.
Animals ; Croton Oil ; Cytokines ; Dermatitis, Allergic Contact* ; Dermatitis, Contact* ; Dinitrofluorobenzene ; Histocompatibility Antigens Class II ; Inflammation ; Keratinocytes ; Langerhans Cells ; Mice ; Skin ; T-Lymphocytes

Intramucosal gastric cancer (IGC) is associated with a very low risk of lymph node metastasis; thus it is the main candidate for minimally invasive surgical procedures, such as endoscopic submucosal dissection (ESD). Herein, we document an extraordinary case of IGC, which showed a very aggressive clinical course. A 66-year-old female underwent ESD for early gastric cancer. Histologically, the tumor consisted mainly of moderately differentiated adenocarcinoma measuring 1.6 cm in diameter, and the tumor was confined to the mucosa. Despite annual esophagogastroduodenoscopic follow-up, the tumor recurred, with wide metastasis to multiple lymph nodes and bones throughout the body after three years. Fluorescence in situ hybridization study demonstrated MET gene amplification as well as low grade polysomy 7 in both original and recurrent tumors. The clinical characteristics of metastatic IGCs and the implication of MET amplification are discussed.
Adenocarcinoma ; Aged ; Female ; Fluorescence ; Follow-Up Studies ; Gene Amplification ; Humans ; In Situ Hybridization ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Stomach Neoplasms* ; Surgical Procedures, Minimally Invasive

Glossectomy combined with radiotherapy causes different levels of tongue function disorders and leads to severe malocclusion, with poor periodontal status in cancer survivors. Although affected patients require regular access to orthodontic care, special considerations are crucial for treatment planning. This case report describes the satisfactory orthodontic management for the correction of severe dental crowding in a 43-year-old female 6  years after treatment for tongue cancer with total glossectomy combined with radiotherapy, to envision the possibility of orthodontic care for oral cancer survivors. Extraction was performed to correct dental crowding and establish proper occlusion following alignment, after considering the possibility of osteoradionecrosis. Orthodontic mini-implants were used to provide skeletal anchorage required for closure of the extraction space and intrusion of the anterior teeth. The dental crowding was corrected, and Class I occlusal relationship was established after 36 months of treatment. The treatment outcome was sustained after 15 months of retention, and long-term follow-up was recommended.

Eighty seven cases of ocular adnexal tumors were excised and studied histologically between January 1, 1967 and March 31,1974 at Department of Ophthalmology, Dong San Presbyterian Medical Center. The incidence of ocular adnexal tumors among 22,420 out-patients was 0.38%. The Sexual distribution revealed 49 males (56.3%) and 38 females (43.7%). The benign tumors were more frequent in 2nd and 3rd decades, but the malignant tumors, on the other hand, after 5th decade. Location-wise, the eye-lid was largest in number (38 cases, 43.7%) followed by the conjunctiva (24 cases, 27.6%), orbit (23 cases, 26.4%) and lacrmal apparatus (2 cases, 2.3%) in order. As asingle disease, the nevus, pseudotumor and malignant melanoma were impressively high in incidence. Over all incidence of malignant tumors was 31% (27 cases) and that of benign tumors 69% (60 cases). Of malignant tumors the eye lid tumors were largest in number (12 cases), the orbit 9 cases and conjunctiva 6 cases.
Conjunctiva ; Female ; Hand ; Humans ; Incidence ; Male ; Melanoma ; Nevus ; Ophthalmology ; Orbit ; Outpatients ; Protestantism