Pigmented Bowen's disease (PBD) is a rare variant of Bowen's disease(BD). Most of the reported cases showed pigmented patches or thin plaques. Thus its clinical manifestations may simulated other various pigmented skin lesions. We experienced 2 cases of PBD in patients with multiple BD developed after taking Korean proprietary pills (KPP, "Hwan-Yak"), which were suspected to contain certain amount of arsenics. Both patients also showed arsenical keratosis on their palms and soles. The darker pigmentation of the PBL led us to differentiated them from melanoma.
Bowen's Disease* ; Humans ; Keratosis ; Melanoma ; Pigmentation ; Skin

The shortage of available organ donors is a significant problem and various efforts have been made to avoid the loss of organ donors. Among these, extracorporeal membrane oxygenation (ECMO) has been introduced to help support and manage potential donors. Many traumatic brain injury patients have healthy organs that might be eligible for donation for transplantation. However, the condition of a donor with a fatal brain injury may rapidly deteriorate prior to brain death determination; this frequently results in the loss of eligible donors. Here, we report the use of venoarterial ECMO to support a potential donor with a fatal brain injury before brain death determination, and thereby preserve donor organs. The patient successfully donated his liver and kidneys after brain death determination.
Brain Death* ; Brain Injuries* ; Brain* ; Extracorporeal Membrane Oxygenation* ; Humans ; Kidney ; Liver ; Tissue and Organ Procurement ; Tissue Donors*

We observed 2 cases of occupational radiodermatitis which occurred during the radioisotope transpierce test. Patient 1, a 40-year-old man, noticed swelling, erythema, and stiffness on his left 2nd, 3rd, 4th, and 5th fingers 5 days after the exposure to about 2700 rem. Patient 2, a 32-year-old man, noticed painful swelling, erythema, bullae and necrosis on his right palm and thumb 1 week after the exposure to about 5500 rem. Clinicopathologically, patient 1 and 2 came under 2 and 3 burns respectively. The symptoms have been improving after treatment with systemic and topical corticosteroids and antibiotics.
Adrenal Cortex Hormones ; Adult ; Anti-Bacterial Agents ; Burns ; Erythema ; Fingers ; Humans ; Necrosis ; Radiodermatitis* ; Thumb

We observed a family with 12 members in four consecutive generations affected by hereditary epidermolytic palmoplantar keratoderma(HEPPK). The affected family members demonstrated not only autosomal dominant inheritance, but also a high penetrance and constant expression. The lesion of all affected person had developed at birth or within the first few weeks of life. The lesions of three members(the proband, her sister and mother) were biopsed, and all of them showed the characteristic features of epidermolytic hyperkeratosis. Two of family members(the proband, her nephew-not affected by HEPPK) had vitiligo, but we concluded that this coexistance was accidental.
Family Characteristics* ; Humans ; Hyperkeratosis, Epidermolytic ; Keratoderma, Palmoplantar, Epidermolytic* ; Parturition ; Penetrance ; Siblings ; Vitiligo ; Wills

Anterior glenohumeral instability is mainly due to the Bankart lesion and capsular stretch. The differentiation between the Bankart lesion and capsular laxity may not be readily apparent on clinical examination. So, increasing attention has been directed toward preoperative evaluation of the labral lesion and capsular laxity. MRI and MR Arthrogram of 55 shoulders, 40 stable shoulders and 15 unstable shoulders that were confirmed by arthroscopic surgery, were reviewed to evaluate the labral and capsular shapes, especially the lesions of labroligamentous complex. To evaluate and compare the capsular laxity, we measured the anterior capsular insertion type, capsular ballooning, capsular insertion angle and anterior band of inferior glenohumeral ligament. And the following results were obtained; 1) The shape of anterior labrum was varied in the superior, middle and inferior potions in 40 stable shoulders. The anterior labral lesions were shown as torn(eight cases), displaced(six cases) and no detectable labrum(one case), in 15 unstable shoulders. Also, there were a significant di fference in the evaluation of the anteior labrum shape between MRI and MR arthrography. 2) There were not a significant difference in the type III capsular insertion type, capsular ballooning and capsular insertion angle between the stable and unstable shoulders. However, it was found that the shape of the anterior band of the inferior glenohumeral ligament had definite difference between the two groups. And so, more experience and attention should be given for the accurate preoperative evaluation of the anterior labroligamentous complex in shoulder instability.
Arthrography* ; Arthroscopy ; Ligaments ; Magnetic Resonance Imaging ; Shoulder

OBJECTIVES: To determine differences of common personality profiles and coping mechanisms of medical students who prefer specific specialties (medicine and surgery), the authors evaluated the defense mechanisms of the medical students by using Ewha Defense Mechanisms Test. METHODS: The authors compared the defense mechanisms between two groups (medicine selection group and surgery selection group) who are in the senior year of the Soonchunhyang University School of Medicine. RESULTS: There were no significant differences in mean scores of the each defense mechanism and 4 groups of defense mechanisms divided by maturity level between the groups of students who selected medicine and surgery. But, frequency of major defense mechanisms were as follows; For the surgery selection group, the passive-aggression in the Immature defense mechanism and show-off in the Neurotic defense mechanism were significantly higher than in the medicine selection group. Contrarily, in the medicine selection group, humor in the mature defense mechanism as the major defense mechanism was significantly higher than in the surgery selection group. CONCLUSION: After analysis of the differences of frequency of major defense mechanisms between the two groups, there were no significant differences between the two groups in personality. However, the students of the medicine selection group used humor of the mature defense mechanism as a major defense mechanism in higher frequency than the surgery selection group. In situations of complications, anxiety and suffering, the use of the humor defense mechanism gave the students strength to endure these situations. Among these students, there is a high probability that many of them possess strong ego strength. Contrarily, the students of the surgery selection group did not express aggression directly, rather, they expressed these feelings indirectly through passive opposition. There was a high frequency of passive-aggression defense mechanism in dealing with feelings of aggression. Also, in the neurotic defense mechanism, compared to ability, excessive goals were set as was the resulting behavior. Especially, behavior was extremely sensitive to how others would evaluate those actions resulting in using show-off mechanism as a major defense mechanism in higher frequency by the surgery selection group. The results seem to be useful in understanding the student's optimal character for specific specialities that were selected by evaluating the differences of the common characteristics and coping mechanisms of each specialty group.
Aggression ; Anxiety ; Defense Mechanisms* ; Ego ; Humans ; Students, Medical*

BACKGROUND: Nail abnormalities may be associated with alopecia areata and nail abnormalities in alopecia areata are reported to range from 10%-66%. OBJECTIVES: This study investigates the clinical characteristics of nail abnormalities in alopecia areata, such as prevalence depending on sex, age and severities of hair loss. METHODS: Prospective analysis was undertaken by examining the finger nails of 424 alopecia areata patients and the nails of 465 non-alopecic patients were examined as controls. RESULTS: The number of the patients was 424(214 males, 210 females) and their mean age was 28.6 years (range 1-69). Nail abnormalities were noted in 98 (23.1%) out of 424 patients and in 24 (5.1%) out of 465 controls. According to age group, the prevalence of nail abnormalities was high at age under 9(31.7%) and at age of 10-19 (31.6%). The incidence according to severity of hair loss was 20.8% in below 50% of hair loss on scalp, 27.8% in 51%-100% of hair loss on scalp and 41.5% in 51%-100% of hair loss on the scalp and also involving body hair. The Frequent nail abnormalities were leukonychia punctata (8.5%) and pitting nail(8.0%). The other minor nail abnormalities were onychorrhexis, transverse ridging, trachyonychia, melanonychia, abnormality of lunula, onycholysis and koilonychia. CONCLUSIONS: The incidence of nail abnormalities in alopecia areata was significantly higher than in controls and the nail abnormalities were more common in children. The more severe was the degree of alopecia, the higher was the prevalence of nail abnormalities. Leukonychia punctata and pitting nail were frequently found in alopeica areata in Korea. The examination of nail in alopecia areata patients may be helpful in expectation of prognosis.
Alopecia Areata* ; Alopecia* ; Child ; Fingers ; Hair ; Humans ; Incidence ; Korea ; Male ; Nails, Malformed* ; Onycholysis ; Prevalence ; Prognosis ; Prospective Studies ; Scalp

PURPOSE: Prader-Willi syndrome (PWS) is a complex genetic disorder, caused by the deletion of the paternally derived 15q11-13 region or the maternal uniparental disomy of chromosome 15 (mUPD(15)). In this study, we compared phenotypic differences between those patients whose disease was caused by microdeletion and those caused by mUPD(15). In addition, a comparison of the efficacy of growth hormone (GH) therapy between these two PWS genotypes was analyzed. METHODS: Fifty-three patients were diagnosed as having PWS based on molecular and cytogenetic analyses and clinical features. Data that included maternal age, birth weight, a feeding problem in the neonatal period, cryptorchidism, developmental delay or mental retardation, short stature, hypopigmentation, changes in height, weight, and body mass indexes (BMI) before and after GH treatment were obtained by a retrospective review of medical records. The data from the patients with microdeletion were compared with those from the patients with mUPD(15). RESULTS: Of the 53 patients with genetically confirmed PWS, 39 cases had microdeletion and 14 mUPD(15). Maternal ages were significantly higher in the mUPD(15) group, and hypopigmentation and a feeding problem in the neonatal period were more frequent in the microdeletion group. Growth hormone was administered to 20 patients [14 with microdeletion, 6 with mUPD(15)]. There were no differences between the two groups in height velocity, weight and height SDS, and BMI after GH therapy. CONCLUSION: Phenotype and genotype correlations were observed in Korean PWS patients, such as more advanced maternal ages in the mUPD(15) group and more feeding problems and hypopigmentations in the microdeletion group. Further long-term prospective studies are needed to correlate other aspects of the phenotypes.
Birth Weight ; Body Mass Index ; Child ; Chromosomes, Human, Pair 15 ; Cryptorchidism ; Cytogenetic Analysis ; Genotype ; Growth Hormone ; Humans ; Hypopigmentation ; Intellectual Disability ; Male ; Maternal Age ; Medical Records ; Phenotype ; Prader-Willi Syndrome ; Retrospective Studies ; Uniparental Disomy

The shortage of available organ donors is a significant problem and various efforts have been made to avoid the loss of organ donors. Among these, extracorporeal membrane oxygenation (ECMO) has been introduced to help support and manage potential donors. Many traumatic brain injury patients have healthy organs that might be eligible for donation for transplantation. However, the condition of a donor with a fatal brain injury may rapidly deteriorate prior to brain death determination; this frequently results in the loss of eligible donors. Here, we report the use of venoarterial ECMO to support a potential donor with a fatal brain injury before brain death determination, and thereby preserve donor organs. The patient successfully donated his liver and kidneys after brain death determination.
Brain Death ; Brain Injuries ; Brain ; Extracorporeal Membrane Oxygenation ; Humans ; Kidney ; Liver ; Tissue and Organ Procurement ; Tissue Donors

Basal cell carcinoma(BCC) is a most common malignant tumor of the skin and has many different clinical and histological appearances. Polypoid BCC is a new clinicopathological variant of BCC. Polypoid BCC is clinically distinguished by being pedunculated and having a stalk that connects it to the skin surface. Histologically, it is distinctive in that the tumor aggregations are restricted to the exophytic polypoid zone. We herein report a case of polypoid BCC in a 39-year-old man who had a single, asymptomatic, black-brownish, pedunculated mass on his right temple.
Adult ; Carcinoma, Basal Cell* ; Humans ; Skin