Basal cell carcinoma is the most common malignant skin lesion. The major aim in the treatment of basal cell carcinoma is the curative treatment, which is best done by Mohs excision of the neoplastic tissue. Despite the effectiveness of surgical excision, non-surgical treatment modalities may be preferred for large tumor size or poor patient performance status. Imiquimod may offer an alternative to surgical excision. Imiquimod is an immune modulator acting as IFN-alpha and other cytokine inducer, stimulating the innate immune response. Imiquimod's anti-tumor effect may be mediated by IFN-alpha, IFN-gamma, IL-12. At this time, there is no published experience on the treatment of basal cell carcinoma with imiquimod in Korea. We report a case of basal cell carcinoma of the nose successfully treated with topical 5% imiquimod cream.
Carcinoma, Basal Cell* ; Humans ; Immunity, Innate ; Interleukin-12 ; Korea ; Nose* ; Skin

Dariers disease is inherited as an autosomal dominant trait and characterized by follicular pruritic hyperkeratotic papules. The onset is usually in late childhood and the course of the disease is chronic and slowly progressive in most cases. Dariers disease is refractory to treatment with most conventional keratolytics and anti-inflammatory agents. To date, oral and topical retinoid products have been the mainstay therapy for this population, but local as well as systemic side effects often limit their effectiveness. We present a case of localized Dariers disease which responded promptly to the topical application of adapalene 0.1% gel without side effects. A review of treatment for Dariers disease also is presented.
Anti-Inflammatory Agents ; Darier Disease* ; Adapalene

The safety and effectiveness of extraperitoneal C/S are controversial, so it has been performed for the purpose of training for selected cases . But we think this procedure have some benefit in selected cases. This study was based on retrospective investigation of 300 cases of extraperitoneal cesarean section among 332 cases at Eul Ji Medical hospital, during from January, 1995 to December, 1996. The results were as follows: 1. The most prevalent age distribution was seen in the age group of 26~30. 2. The indication for extraperitoneal cesarean section were dystocia(38.3%), previous cesarean section(32.6%), elderly primigravida(12.6%) in orders. 3. In the type of the anesthesia, general anesthesia was 70.7%, epidural anesthesia was 15% and spinal anesthesia was 14.3%. 4. The most common group of operation time was 36~40minute(34.3%). 5. The post operative complications and maternal morbidities were breast engorgement(21%), peritoneal opening(19.6%), endometritis(4.3%) in orders. 6. Of all cases, the blood transfusion rates was 6%. 7. The most common group of hospital stay was 5~6 days(82%). 8. In the body weight distribution of infants, the group of 3,000~3,499gm was the most common(80.7%). 9. Of extraperitoneal cesarean sections, cases of the 5minute Apgar score more than 7 were the most common(99%). 10. The most common failure factor was abdominal and pelvic 11. There was no maternal death case.
Age Distribution ; Aged ; Anesthesia ; Anesthesia, Epidural ; Anesthesia, General ; Anesthesia, Spinal ; Apgar Score ; Blood Transfusion ; Body Weight ; Breast ; Cesarean Section ; Female ; Humans ; Infant ; Length of Stay ; Maternal Death ; Methods ; Pregnancy ; Retrospective Studies

Desmoplastic trichoepithelioma is a rare benign adnexal tumor that usually presents as an asymptomatic, firm, annular plaque. It most commonly occurs on sun-exposed areas in middle-aged women, especially on the face. Patients typically give a history of a single, slow-growing lesion that has been present for several years. The diagnosis of desmoplastic trichoepithelioma can be made when a triad of microscopic findings are observed in combination with a compatible clinical picture. We herein report a case of desmoplastic trichoepithelioma associated with syringomas on the face of a young woman.
Diagnosis ; Female ; Humans ; Syringoma*

Paroxysmal kinesigenic dyskinesia (PKD), previously referred to as movement-provoked seizures, is a rare neurological condition that is characterized by short duration dystonic or choreoathetotic movements precipitated by sudden movement, a change in position or hyperventilation. It can be difficult to distinguish this syndrome from seizures. We reported on three brothers in one family all of whom developed abnormal involuntary dystonic or choreoathetotic movement with a tingling or stiffness sensory aura. Evaluations of the patients included general physical examinations, endoclinologic, metabolic studies, chromosomal analysis, video electroencephalograms and brain MRI imaging. All of these studies were normal except for an arachnoid cyst found in one patient. All symptoms showed excellent response to oxcarbamazepine (Trileptal(R)) or carbamazepine. Use of the video electroencephalogram can help differentiate familial PKD from seizures.
Arachnoid ; Brain ; Carbamazepine ; Dyskinesias* ; Electroencephalography ; Epilepsy ; Humans ; Hyperventilation ; Magnetic Resonance Imaging ; Physical Examination ; Seizures ; Siblings*

Cancers of an unknown primary site are heterogenous with respect to their clinical and pathologic features. They are generally very aggressive, but specific favorable subsets have a better prognosis. For these favorable subsets, taxane based chemotherapy is very effective for a subset of woman with papillary serous peritoneal adenocarcinoma. A 52 year-old woman underwent [18F]-FDG PET/CT for routine health screening. On PET/CT, multiple hypermetabolic lymph nodes were detected in the paraaortic spaces, and there were no other hypermetabolic abnormalities. The patient was diagnosed with an unknown primary cancer that probably originated from the ovary or peritoneum, according to clinical studies and biopsy results. This was not a typical case of a favorable subset of cancer of an unknown primary site, but the tumor showed complete biologic response to taxane based chemotherapy as revealed by PET/CT, and necrotic tumor cells were confirmed by surgery.
Adenocarcinoma ; Biopsy ; Bridged Compounds ; Female ; Humans ; Lymph Nodes ; Mass Screening ; Neoplasms, Unknown Primary ; Ovary ; Peritoneum ; Positron-Emission Tomography ; Prognosis ; Taxoids

Cases of self-inserted foreign bodies in the male urethra and urinary bladder are unusual. In most cases, the type of foreign body can be identified by taking a history or from radiological findings; sometimes, however, it is difficult to identify the foreign body because of decreased mental capacity of the patient or unknown radiological characteristics of the foreign body. We experienced a chronic alcoholic patient with septicemia and penile necrosis in whom a fragment of mirror glass had passed through the urethra into the bladder. The glass, 2 cm in length and 0.7 cm in diameter, was detected by cystoscopy and was removed by using a resectosope.
Alcoholics ; Cystoscopy ; Delayed Diagnosis ; Foreign Bodies ; Glass ; Humans ; Male ; Necrosis ; Sepsis ; Urethra ; Urinary Bladder

Necrotizing fasciitis is a life-threatening soft tissue infection involving skin, subcutaneous tissue, and superficial fascia. We report a case of necrotizing fasciitis that developed in a 76- year-old female patient taking low-dose methotrexate and prednisolone for rheumatoid arthritis (RA). A computed tomography scan of the neck during the initial work-up showed soft tissue swelling, loss of fat planes, and mild heterogeneous enhancement in the right lateral neck, suggesting cellulitis. The lesions were associated with skin necrosis and multiple bullae rapidly expanded to the right anterior chest in spite of empirical antibiotic therapy. Surgical debridement was immediately performed, and soft tissue biopsy from the lesions showed the pathologic finding consistent with necrotizing fasciitis. The skin wound defect was reconstructed by a flap operation with split-thickness skin graft. This case shows the development of necrotizing fasciitis in a elderly patient taking methotrexate and low-dose steroid for RA and highlights early recognition and prompt surgical debridement for successful management.
Aged ; Arthritis, Rheumatoid* ; Biopsy ; Cellulitis ; Debridement ; Fasciitis, Necrotizing* ; Female ; Humans ; Methotrexate ; Neck ; Necrosis ; Prednisolone ; Skin ; Soft Tissue Infections ; Subcutaneous Tissue ; Thorax ; Transplants ; Wounds and Injuries

A feeding gastrostomy tube is used to provide chronic nutritional support for patients who have a swallowing disability. Serious complications associated with feeding gastrostomy are rare. However, dislocation of the gastrostomy tube into the duodenum can lead to serious complications. There have been 7 reports in which the gastrostomy tube used for enteral feeding was associated with acute pancreatitis. But there have been no reports of pancreatitis associated with feeding gastrostomy in Korea. Further, all the reported cases were associated with both pancreatitis and cholangitis secondary to the compression of the major papilla by the percutaneous endoscopic gastrostomy tube. To the best our knowledge, this is the first report of acute pancreatitis, without cholangitis, that was induced by the compression of migrating surgical gastrostomy tube. Herein, we report on a case of a 68-year-old Korean male diagnosed with acute pancreatitis, and this was induced by the migration of a surgical gastrostomy tube.
Aged ; Cholangitis ; Deglutition ; Dislocations ; Duodenum ; Enteral Nutrition ; Gastrostomy ; Humans ; Korea ; Male ; Nutritional Support ; Pancreatitis

The alkylating agent ifosfamide is an anti-neoplastic used to treat various pediatric and adult malignancies. Its potential urologic toxicities include glomerulopathy, tubulopathy and hemorrhagic cystitis. This report describes a case of proximal renal tubular dysfunction and hemorrhagic cystitis in a 67-year-old male given ifosfamide for epitheloid sarcoma. He was also receiving an oral hypoglycemic agent for type 2 diabetes mellitus and had a baseline glomerular filtration rate of 51.5 mL/min/1.73 m2. Despite mesna prophylaxis, the patient experienced dysuria and gross hematuria after a single course of ifosfamide plus adriamycin. The abrupt renal impairment and serum/urine electrolyte imbalances that ensued were consistent with Fanconi's syndrome. However, normal renal function and electrolyte status were restored within 14 days, simply through supportive measures. A score of 8 by Naranjo adverse drug reaction probability scale indicated these complications were most likely treatment-related, although they developed without known predisposing factors. The currently undefined role of diabetic nephropathy in adult ifosfamide nephrotoxicity merits future investigation.
Adult ; Aged ; Cystitis ; Diabetes Mellitus, Type 2 ; Diabetic Nephropathies ; Doxorubicin ; Drug Toxicity ; Dysuria ; Fanconi Syndrome ; Glomerular Filtration Rate ; Hematuria ; Humans ; Ifosfamide ; Kidney Tubules, Proximal ; Male ; Mesna ; Sarcoma