Generalized pustular psoriasis of pregnancy (GPPP) is a rare form of pustular psoriasis that occurs in pregnant women during the third trimester. It is characterized by erythematous plaques, peripheral scale and sterile pustules, and this malady is associated with systemic symptoms such as fever, malaise, diarrhea and pain. A 34-year-old primigravida woman with an intermittent history of plaque psoriasis for 12 years presented with a two week history of increasingly widespread erythematous eruptions and associated peripheral pustules. The histopathologic findings were consistent with pustular psoriasis. She was diagnosed with generalized pustular psoriasis of pregnancy and she was treated with systemic and topical steroid, narrowband ultraviolet B phototherapy and wet dressings. 2 weeks after treatment, the patient demonstrated clinical and symptomatic improvement.
Adult ; Bandages ; Diarrhea ; Female ; Fever ; Humans ; Phototherapy ; Pregnancy ; Pregnancy Trimester, Third ; Pregnant Women ; Psoriasis

Anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin's lymphoma, and this tumor is predominantly composed of large lymphoid cells that have a strong expression of CD30. Two major groups of ALCL have been described. The first is a spectrum of CD30+ lymphoproliferative disorders, including primary cutaneous ALCL and lymphomatoid papulosis. The second is systemic nodal ALCL, which can be subdivided into two groups: anaplastic lymphoma kinase (ALK)-positive and ALK-negative. The relative frequency of ALCL in Korea is about 19% of all cutaneous lymphomas. Solitary or multiple large nodular tumoral lesions confined to one body compartment are the most common presentation. We report here on a case of CD30 (+)/ALK (-) primary systemic ALCL in a 77 year-old-male, and the skin lesion manifested as multiple papules, plaques and tumors on the trunk, buttocks and upper and lower extremities.
Buttocks ; Korea ; Lower Extremity ; Lymphocytes ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, Non-Hodgkin ; Lymphomatoid Papulosis ; Lymphoproliferative Disorders ; Phosphotransferases ; Receptor Protein-Tyrosine Kinases ; Skin

Intravascular papillary endothelial hyperplasia (IPEH), so called Masson's hemangioma, is a benign vascular lesion thought to represent a primary process with a subsequent thrombus formation or an unusual manifestation of a thrombus. The important histologic features for IPEH are endothelial proliferation and papillary projections. IPEH should be distinguished from malignant angiosarcoma due to microscopic similarity. We report on a case of IPEH from inferior turbinate appearing in a 56-year-old woman who presented with unilateral nasal obstruction and epistaxis. To the best of our knowledge, the present study is the first case reported of IPEH in a vascular lesion that originated from the inferior turbinate.
Epistaxis ; Female ; Hemangioma ; Hemangiosarcoma ; Humans ; Hyperplasia* ; Middle Aged ; Nasal Obstruction ; Thrombosis ; Turbinates*

We have experienced a case of pulmonary adenocarcinoma looked like cavitary lesion of pulmonary tuberculosis in 49-year-old male patient. He has taken antituberculous medication for 5 months under the impression of pulmonary tuberculosis with cavity at local hospital. The cavitary lesion was changed nodular mass on follow-up chest X-ray. Transthoracic fine needle aspiration was done and cytologic specimen suggested squamous cell carcinoma. Right middle lobectomy was performed. The nodular mass, which was confirmed as adenocarcinoma on microscopic examination, had central cavity filled with hemorrhage.
Adenocarcinoma ; Biopsy, Fine-Needle ; Carcinoma, Squamous Cell ; Follow-Up Studies ; Hemorrhage ; Humans ; Male ; Middle Aged ; Thorax ; Tuberculosis, Pulmonary

Spinal accessory nerve (SAN) injury mostly occurs during surgical procedures. SAN injury caused by manipulation therapy has been rarely reported. We present a rare case of SAN injury associated with manipulation therapy showing scapular winging and droopy shoulder. A 42-year-old woman visited our outpatient clinic complaining of pain and limited active range of motion (ROM) in right shoulder and scapular winging after manipulation therapy. Needle electromyography and nerve conduction study suggested SAN injury. Physical therapy (PT) three times a week for 2 weeks were prescribed. After a total of 6 sessions of PT and modality, the patient reported that the pain was gradually relieved during shoulder flexion and abduction with improved active ROM of shoulder. Over the course of 2 months follow-up, the patient reported almost recovered shoulder ROM and strength as before. She did not complain of shoulder pain any more.
Accessory Nerve Injuries* ; Accessory Nerve* ; Adult ; Ambulatory Care Facilities ; Electromyography ; Female ; Follow-Up Studies ; Humans ; Musculoskeletal Manipulations* ; Needles ; Neural Conduction ; Range of Motion, Articular ; Shoulder ; Shoulder Pain

Leydig cell tumors are the most common non-germ cell tumors of the testis, and they account for 1-3% of all testicular tumors. They most commonly present as a testicular mass and/or with endocrine symptoms. This tumor is characterized by its endocrine manifestations, which are due to the tumor's capacity to secrete hormones. We report here on one case of a patient with Leydig cell tumor; the patient was without symptoms and the tumor was not detected on the physical examination.
Humans ; Leydig Cell Tumor* ; Physical Examination ; Testicular Neoplasms ; Testis

Lung adenocarcinoma is the cancer originated in terminal bronchiole or alveolar epithelium and its incidence is on the increase. The most common radiologic pattern of lung adenocarcinoma is peripheral nodule or mass, but it can be showed various findings such as hilar mass, consolidation, atelectasis or multicentric lesions. Sometimes it is difficult to differentiate lung adenocarcinoma from other diseases, especially pneumonia. We experienced three patients with lung adenocarcinoma, just only presented as pneumonic consolidation on chest X-ray and CT scan. The clinician should consider seriously lung adenocarcinoma including bronchioloalveolar carcinoma in patients who did not respond to antibiotics. And in such cases, pathologic diagnosis must be perfomed at proper time to confirm disease.
Adenocarcinoma* ; Adenocarcinoma, Bronchiolo-Alveolar ; Anti-Bacterial Agents ; Bronchioles ; Diagnosis ; Epithelium ; Humans ; Incidence ; Lung* ; Pneumonia ; Pulmonary Atelectasis ; Thorax ; Tomography, X-Ray Computed

BACKGROUND/AIMS: Endoscopic variceal ligation (EVL) has been effective modality for esophageal variceal bleeding, but recurrent bleeding occurs 20 to 40% of patients. So there has been an increased interest in the use of vasoactive drugs to lower portal hypertension and help control variceal bleeding before and after endoscopy. We investigated the efficacy of octreotide (OCT) infusion as an adjunct to EVL for preventing early rebleeding from varices. METHODS: From Jan. 1997 to Feb. 1999, fifty four patients with endoscopically documented esophageal variceal bleeding were included. The patients were randomly treated by EVL alone (EVL group, n=30) or EVL plus octreotide (EVL+OCT group, n=24). We evaluated the 5-ay and 6-eek rebleeding rate and 6-eek mortality. RESULTS: Baseline characteristics were similar in two group but hospital stay (p=0.028) and units of transfused blood (p=0.043) were significantly less in EVL+OCT group. There were no significant differences on 5-ay rebleeding rate (EVL group; 7%, EVL+OCT group; 0%) and 6-eek rebleeding rate (EVL group; 20%, EVL+OCT group; 4%). CONCLUSIONS: The combined therapy did not decrease early rebleeding and mortality, but it was superior to EVL alone in hospital course such as requirement of transfusion and duration of hospitalization.
Endoscopy ; Esophageal and Gastric Varices* ; Hemorrhage ; Hospitalization ; Humans ; Hypertension, Portal ; Length of Stay ; Ligation* ; Mortality ; Octreotide* ; Varicose Veins

This study was done to evaluate clinical usefulness of cystatin C levels of serum and urine in predicting renal impairment in normoalbuminuric patients with type 2 diabetes and to evaluate the association between albuminuria and serum/urine cystatin C. Type 2 diabetic patients (n = 332) with normoalbuminuria (n = 210), microalbuminuria (n = 83) and macroalbuminuria (n = 42) were enrolled. Creatinine, urinary albumin levels, serum/urine cystatin C and estimated glomerular filtration rate (eGFR by MDRD [Modification of Diet in Renal Disease] and CKD-EPI [Chronic Kidney Disease Epidemiology Collaboration] equations) were determined. The cystatin C levels of serum and urine increased with increasing degree of albuminuria, reaching higher levels in macroalbuminuric patients (P < 0.001). In multiple regression analysis, serum cystatin C was affected by C-reactive protein (CRP), sex, albumin-creatinine ratio (ACR) and eGFR. Urine cystatin C was affected by triglyceride, age, eGFR and ACR. In multivariate logistic analysis, cystatin C levels of serum and urine were identified as independent factors associated with eGFR < 60 mL/min/1.73 m2 estimated by MDRD equation in patients with normoalbuminuria. On the other hand, eGFR < 60 mL/min/1.73 m2 estimated by CKD-EPI equation was independently associated with low level of high-density lipoprotein in normoalbuminuric patients. The cystatin C levels of serum and urine could be useful markers for renal dysfunction in type 2 diabetic patients with normoalbuminuria.
Aged ; Albuminuria/urine ; *Biological Markers/blood/urine ; Creatinine/blood/urine ; *Cystatin C/blood/urine ; Diabetes Mellitus, Type 2/*blood/physiopathology/*urine ; Diabetic Nephropathies/*blood/physiopathology/*urine ; Female ; Glomerular Filtration Rate ; Humans ; Kidney Function Tests ; Male ; Middle Aged ; ROC Curve ; Retrospective Studies

The aim of this study was to evaluate the association of plasma fibroblast growth factor (FGF)-21 with angiographically significant coronary artery disease (CAD) in patients with type 2 diabetes mellitus. Serum FGF-21 was measured in 120 patients undergoing coronary angiography. Patients were divided into 4 groups based on the presence/absence of type 2 diabetes mellitus and of significant CAD. The atherosclerotic burden was obtained by two angiographic scores: Gensini score (GS) and Extent score (ES). FGF-21 levels were higher in type 2 diabetes mellitus than in non-diabetic patients (P = 0.014). FGF-21 levels were significantly correlated with GS (r = 0.358, P < 0.001) and ES (r = 0.324, P < 0.001) in univariate analysis with all patients. After adjusting for several confounding factors, both GS and ES were associated with FGF-21 in all patients (r = 0.271, P = 0.014; r = 0.217, P = 0.041, respectively). However, FGF-21 lost significant correlation with both GS and ES with type 2 diabetes mellitus in the final model. The patients with type 2 diabetes mellitus and CAD feature had elevated FGF-21 levels. Despite of a limited role in diabetic patients, FGF-21 levels are independently associated with angiographic severity and extent of CAD.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Coronary Angiography ; Coronary Artery Disease/complications/*diagnosis/pathology ; Diabetes Mellitus, Type 2/complications/*diagnosis ; Female ; Fibroblast Growth Factors/*blood ; Humans ; Male ; Middle Aged ; Regression Analysis ; Severity of Illness Index ; Young Adult