A 54-year-old woman with severe bullous pemphigoid (BP) associated with insulin dependent diabetes mellitus (DM), who showed unresponsiveness to conventional therapy with corticosteroids in combination of either cyclosporme or dapsone, was successfully treated with plasmapheresis followed each time by 3 successive days of pulse therapy of cyclophosphamide (500mg, intravenously). After six times of plasmapheresis, anti-basement membrane zone (BMZ) antibody titer decreased from 1:1280 to 1:40 and no new lesions developed at all. In severe refractory BP patients with uncontrolled DM, plasmapheresis is one of the valuable treatment modalities for a short period and the need for corticosteroids thus avoiding corticosteroid induced side effects. Herein we report a case of BP with uncontrolled DM who showed an excellent response to a low dose of corticosteroid and 150 mg oral azathioprine following plasmapheresis and cyclophosphamide pulse therapy.
Adrenal Cortex Hormones ; Azathioprine ; Cyclophosphamide* ; Dapsone ; Diabetes Mellitus ; Female ; Humans ; Insulin ; Membranes ; Middle Aged ; Pemphigoid, Bullous* ; Plasmapheresis*

Eosinophilic gastroenteritis is characterized by peripheral eosinophilia, eosinophilic infiltration of the bowel and gastrointestinal symptoms. The disease may affect any area of the gastrointestinal tract. Various manifestations are present, corresponding to the predominant layer of the eosinophilic infiltration. We experienced a case of eosinophilic gastroenteritis presenting as protein-losing enteropathy in a 36-year old male patient with acute upper abdominal pain and watery diarrhea. He showed peripheral eosinophilia, hypoalbuminemia, penile., thigh and ankle edema. The patient was treated with oral corticosteroid, and supportive care such as parenteral albumin, fluid and electrolytes. Almost all symptoms resloved within 1 week. The present report concerns a case of eosinophilic gastroenteritis associated with protein loss. Cases, of eosinophilic gastroenteritis with protein-losing enteropathy are not common. To our knowledge, no case has reported in Korea. So we report this case with brief review of the literature.
Abdominal Pain ; Adult ; Ankle ; Diarrhea ; Edema ; Electrolytes ; Eosinophilia ; Eosinophils* ; Gastroenteritis* ; Gastrointestinal Tract ; Humans ; Hypoalbuminemia ; Korea ; Male ; Protein-Losing Enteropathies ; Thigh

No abstract available.
Cryotherapy* ; Leishmaniasis, Cutaneous* ; Metronidazole*

No abstract available.
Myiasis*

Angioma serpiginosum is a rare vascular naevoid disorder due to progressive ectatic dilatation of capillaries in the papillary dermis. We report two cases of angioma serpiginosum. A 24-year-old woman presented with asymptomatic multiple deeply red macules arranged in a serpiginous pattern on the left posterior thigh. In the other case, an 8-year-old girl had asymptomatic red nonpalpable puncta that were grouped closely together in a linear pattern from the left lower abdomen to thigh. On the histopathological examination, both cases commonly showed grouped, dilated, ectatic vessels in the upper dermis. These clinical and histopathological findings were typical of angioma serpiginosum.
Abdomen ; Capillaries ; Child ; Dermis ; Dilatation ; Female ; Hemangioma* ; Humans ; Thigh ; Young Adult

PURPOSE: For the production and evaluation of the tissue-equivalent phantom. MATERIALS AND METHODS: We used agarous gel and oil as a basic component of the mixture and added Tween 80 for the stabilization of phantoms. We did the test for homogeneity and measured T1 and T2 relexation times of each phantom tube. RESULTS: T1 relaxation time ranged from 642 to 2781 msec and T2 relaxation times from 42 to 157 msec. Each phantom was significantly different in T1 relaxation time and T2 relaxation time (p < .0001). CONCLUSION: Tissue equivalent phantom may provide good information on the optimal sequence before MR imaging of patients and may be valuable if it is used with the patients' MR imaging.
Agar ; Humans ; Magnetic Resonance Imaging* ; Polysorbates ; Relaxation

No abstract available.
Nails

The purpose of this study is to describe the magnetic resonance imaging (MR) findings of metastatic brain tumors with emphasis on the signal intensities of the lesion on MR. Thirty four patients with intracranial metastases were studies with MR imaging. The diagnosis was established on the basis of either brain biopsy or combination of brain MR findings and the presence of primary tumors. The primary tumors include lung cancer (n=18), breast cancer (n=3), stomach cancer (n=3), rectal cancer (n=1), renal cell carcinoma (n=1), hepatocellular carcinoma(n=1), ovarian cancer (n=1), thyroid cancer (n=1), melanoma (n=1) and unknown primary sites (n=4). The parenchymal lesions were solitary in 35% (12/34) and multiple in 65% (22/34). The size of the lesions was variable, ranging from several millimeters to 5cm in diameter. The corticomedullar junction of the cerebral heispheres was the most common location of the lesions (68%). The signal intensity of solid portion of the lesions was usually either isointense (44%) or hypointense (29%) on T1-weighted images, whereas it appeared in isointense (47%), hypointense (8%) or hyperintense (11%) on proton density-weighted or T2-weighted images. The remaining cases showed mixed signal intensities. The enhancement patterns were variable including nodular (<1cm) (6%), homogenous (19%), heterogeneous (10%), ring-like enhancement (22%) or mixed pattern(43%). The size of surrounding edema was larger than the tumor diameter in 76%. In conclusion, although there are no specific MR findings of intracranial metastasis except multiplicity, intracranial metastasis should be included in differential diagnosis with high priority, when a solitary mass showing isointensity on boty T1-and T2-weighted images with massive surrounding edema, especially in the corticomedullary junction of the cerebral hemispheres is encountered.
Biopsy ; Brain Neoplasms* ; Brain* ; Breast Neoplasms ; Carcinoma, Renal Cell ; Cerebrum ; Diagnosis ; Diagnosis, Differential ; Edema ; Humans ; Lung Neoplasms ; Magnetic Resonance Imaging ; Melanoma ; Neoplasm Metastasis ; Ovarian Neoplasms ; Protons ; Rectal Neoplasms ; Stomach Neoplasms ; Thyroid Neoplasms

The purpose of this study is to describe the magnetic resonance imaging (MR) findings of metastatic brain tumors with emphasis on the signal intensities of the lesion on MR. Thirty four patients with intracranial metastases were studies with MR imaging. The diagnosis was established on the basis of either brain biopsy or combination of brain MR findings and the presence of primary tumors. The primary tumors include lung cancer (n=18), breast cancer (n=3), stomach cancer (n=3), rectal cancer (n=1), renal cell carcinoma (n=1), hepatocellular carcinoma(n=1), ovarian cancer (n=1), thyroid cancer (n=1), melanoma (n=1) and unknown primary sites (n=4). The parenchymal lesions were solitary in 35% (12/34) and multiple in 65% (22/34). The size of the lesions was variable, ranging from several millimeters to 5cm in diameter. The corticomedullar junction of the cerebral heispheres was the most common location of the lesions (68%). The signal intensity of solid portion of the lesions was usually either isointense (44%) or hypointense (29%) on T1-weighted images, whereas it appeared in isointense (47%), hypointense (8%) or hyperintense (11%) on proton density-weighted or T2-weighted images. The remaining cases showed mixed signal intensities. The enhancement patterns were variable including nodular (<1cm) (6%), homogenous (19%), heterogeneous (10%), ring-like enhancement (22%) or mixed pattern(43%). The size of surrounding edema was larger than the tumor diameter in 76%. In conclusion, although there are no specific MR findings of intracranial metastasis except multiplicity, intracranial metastasis should be included in differential diagnosis with high priority, when a solitary mass showing isointensity on boty T1-and T2-weighted images with massive surrounding edema, especially in the corticomedullary junction of the cerebral hemispheres is encountered.
Biopsy ; Brain Neoplasms* ; Brain* ; Breast Neoplasms ; Carcinoma, Renal Cell ; Cerebrum ; Diagnosis ; Diagnosis, Differential ; Edema ; Humans ; Lung Neoplasms ; Magnetic Resonance Imaging ; Melanoma ; Neoplasm Metastasis ; Ovarian Neoplasms ; Protons ; Rectal Neoplasms ; Stomach Neoplasms ; Thyroid Neoplasms

BACKGROUND: Partial unilateral lentiginosis (PUL) is a rare pigmentary disorder characterized by grouped multiple lentigines on otherwise normal skin that histologically have the typical features of lentigo. This entity has been only rarely reported in the Korean population. OBJECTIVE: The purpose of this study was to evaluate clinical and histopathologic characteristics, association with other disorders, and differential diagnosis of PUL. METHODS: We reviewed our experiences of thirteen cases of PUL which had been collected in our dermatology clinic during the 6-year period between 1993 and 1998. RESULTS: Twelve patients were female and one was male. In 3 patients the lesions appeared after the age of 20 years. Ten patients had the lesions on the upper part of the body, the neck being the most common location. No bias was shown in terms of the side of the body affected. Cafe-au-lait macules (one to three) were found in six patients, axillary freckles were observed in two. Histopathologic examination of biopsy specimens commonly showed hyperpigmentation of the basal layer, elongation of rete ridges, and an increased number of melanocytes. There ,was no evidence of associated disorders or family history. CONCLUSION: Based on this data, we confirmed that PUL is a benign, idiopathic lentiginosis with no commonly associated abnormalities. Furthermore, we believed that PUL is not uncommon in Korean people.
Bias (Epidemiology) ; Biopsy ; Dermatology ; Diagnosis, Differential ; Female ; Humans ; Hyperpigmentation ; Lentigo ; Male ; Melanocytes ; Melanosis ; Neck ; Skin