We present a case of transient acantholytic dermatosis which developed on the face of a 19-year-old Korean girl. Asyrnptomatic pinhead to miliary-grain sized brownish papules arranged in a somewhat band-like outbreak along the left side of the nose for about 3 months. Histopathologic findings were similar to Dariers disease. Immunoperoxidase staining showed that IgG was deposited on the intercellular area of keratinocytes around the suprabasal clefts. Skin lesions disappeared spontaneously in 5 weeks after a skin biopsy.
Biopsy ; Darier Disease ; Female ; Humans ; Immunoglobulin G ; Keratinocytes ; Nose ; Skin ; Skin Diseases* ; Young Adult

Median raphe cyst is known as congenital lesion of the perineum and genitalia, but its etiology is unclear. Most investigators believe that the median raphe cyst represent defects in the embryologic developenient bf the male genitalia. Simple surgical excision is effective in most cases. We report our experience with two cases of median raphe cyst without specific symptoms. Even though median raphe cyst is asymptomatic, surgical therapy is worth applicable because it relieve a patient from cosmetic and psychotic problem.
Genitalia ; Genitalia, Male ; Humans ; Male ; Perineum ; Research Personnel

Early diagnosis of persistent abnormal reflexes may be of great significance to a more effective functioning of the cerebral palsied child. It is important to know the normal and abnormal reflex responses and their effect upon motor development for providing a basis for evaluation in the diagnosis and treatment of the cerebral palsied child. We studied 28 cerebral palsied children, between 1 to 12 years old, who were treated at Sam Yook Childrens Rehabilitation Center from May 1975 to December 1977. The pathologic reflexes were checked, and the relationship between pathologic reflexes and walking was compared. The following results were obtained. 1. The following were the most important pathologic reflexes in non-walking fgroup: a. Positive supporting reaction b. Protective extensor thrust c. Moro reflex 2. If they are present, the prognosis for walking ambulation was bad and surgery will not improve for the chances of walking.
Child ; Diagnosis ; Early Diagnosis ; Humans ; Prognosis ; Reflex ; Reflex, Abnormal ; Reflex, Startle ; Rehabilitation Centers ; Walking

PURPOSE: This study was tried to evaluate the potential benefits of concurrent chemoradiation therapy (low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation therapy alone in stage III non-small cell lung cancer. The end points of analyses were response rate, overall survival, survival without locoregional failure, survival without distant metastasis, prognostic factors affecting survival and treatment related toxicities. MATERIAL AND METHODS: Between April 1992 and March 1994, 32 patients who had stage III non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300cGy given 10 times up to 3000cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks (250cGy given 10 times up to 2500cGy) was combined with 6mg/M2 of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months. Historical control group consisted of 32 patients who had stage III non-small cell lung cancer were received conventionally fractionated (daily 170-200cGy) radiation therapy alone. Total radiation dose ranged from 5580cGy to 7000cGy with median of 5940 cGy. Follow-up period ranged from 36 months to 105 months with median of 62 months. RESULTS: Complete reponse rate was higher in chemoradiation therapy (CRT) group than radiation therapy (RT) group (18.8% vs. 6.3%). CRT group showed lower in-field failure rate compared with RT group (25% vs. 47%). The overall survival rate had no significant differences in between CRT group and RT group (17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastasis (17% vs. 4.6% at 2 years) also had no significant differences. In subgroup analyses for patients with good performance status (Karnofsky performance scale 80), CRT group showed significantly higher overall survival rate compared with RT group (62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype (squamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (IIIa vs IIIb) were identified as a prognostic factors. RTOG/EORTC grade 2-3 nausea and vomiting (22% vs. 6%) and bone marrow toxicities (25% vs. 15.6%) were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmonary toxicity had no significant differences in between CRT group and RT group (16% vs. 6%). The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group (38% vs. 25%). In analyses for relationship of field size and pulmonary toxicity, the patients who treated with field size beyond 200cm2 had significantly higher rates of pulmonary toxicities. CONCLUSION: The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performance status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good performance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group. Therefore, to evaluate the accurate effect on survival of concurrent chemoradiation therapy, systematic follow-up for long term survivors are needed.
Bone Marrow ; Carcinoma, Non-Small-Cell Lung* ; Cisplatin ; Follow-Up Studies ; Humans ; Incidence ; Nausea ; Neoplasm Metastasis ; Pulmonary Fibrosis ; Survival Rate ; Survivors ; Vomiting

PURPOSE: To investigate the effect of amniotic membrane transplantation (AMT) on recurrent herpetic keratitis with unhealed corneal epithelial erosion. METHODS: We performed AMT on 5 cases of herpetic keratitis from February 2004 to August 2005. We had applied two layers of fresh amniotic membrane over the corneal lesion and anchored by running suture technique with 10-0 nylon. RESULTS: After AMT, visual acuity improved in 5 eyes of 5 herpetic keratitis patients. In all patients the persistent epithelial erosion was healed and pain was subsided after surgery. CONCLUSIONS: The AMT shortened the usage of antiviral agents and antibiotics, increased compliance, and decreased corneal opacity and neovascularization. The AMT is an effective method for managing recurrent herpetic keratitis with unhealed corneal epithelial erosion that are refractory to conventional treatment.
Amnion* ; Anti-Bacterial Agents ; Antiviral Agents ; Compliance ; Corneal Opacity ; Humans ; Keratitis, Herpetic* ; Nylons ; Running ; Suture Techniques ; Visual Acuity

Paraganglioma is a tumor from the extra adrenal paraganglion system and is rarely observed in the mediastinum. The authors experienced a case of nonfunctioning paraganglioma of the posterior mediastinum. The patient was 34-years-old male in whom abnormal mass lesion was nites in chest radiograph with hemoptysis. His blood pressure and serologic examination were within normal range upon admission to our hospital. Chest CT revealed a tumor in the left lower lobe. Diagnostic thoracoscopy was performed and diagnosed a posterior mediastinal mass. Surgical resection was them performed. Posterior mediastinal mass was removed successfully and histological examination of the surgical specimen diagnosed paraganglioma. He received radiotherapy after surgery and was followed up. Related literature are reviewed.
Blood Pressure ; Hemoptysis ; Humans ; Male ; Mediastinum* ; Paraganglioma* ; Radiography, Thoracic ; Radiotherapy ; Reference Values ; Thoracoscopy ; Tomography, X-Ray Computed

PURPOSE: To assess the patterns of myelodysplastic syndrome(MDS) and aplastic anemia(AA) on MRI of the spinal bone marrow and to find the differential points between the two groups. MATERIALS AND METHODS: Fourteen patients with MDS(n=7) and AA(n=7) were studied using magnetic resonance imaging. Sagittal images from the lower thoracic and lumbar vertebral marrow were evaluated on Tl-weighted and STIR images. Five distinct patterns of signal intensity of the Tl-weighted and STIR images were classified. T1 and T2 relaxation times and T1 marrow/fat signal intensity ratio were measured and analyzed (t-test). The cellularity of bone marrow was evaluated on histologic slides. RESULTS: MDS showed homogeneously low signal intensity on T1WI and high signal intensity on STIR image, indicating hypercellular marrow, whereas AA showed relative high signal intensity on T1WI and low signal intensity on STIR image, representing fatty marrow. T1 and T2 relaxation time(T1 for MDS=750.26msec +/- 177.50, T1 for AA= 413.21 msec +/- 167.39 (p<0.000), T2 for MDS=91.86 msec +/- 14.16, T2 for AA=81.44msec +/- 15.31 (p< 0.001) and T1 marrow/fat signal intensity ratio(0.22 +/- 0.048 in MDS, 0.30 +/- 0.083 in AA(p<0.000)) revealed statistically significant difference between the two groups. CONCLUSION: Although the marrow aspiration and needle biopsy are mandatory in hematologic disease for diagnosis, there are limited in assessing the change of total marrow mass. Therefore MRI of bone marrow might be useful in distinguishing MDS from AA because of its ability of representation of total marrow mass.
Anemia, Aplastic* ; Biopsy, Needle ; Bone Marrow ; Diagnosis ; Diagnosis, Differential* ; Hematologic Diseases ; Humans ; Magnetic Resonance Imaging* ; Myelodysplastic Syndromes* ; Relaxation

PURPOSE: To assess the patterns of myelodysplastic syndrome(MDS) and aplastic anemia(AA) on MRI of the spinal bone marrow and to find the differential points between the two groups. MATERIALS AND METHODS: Fourteen patients with MDS(n=7) and AA(n=7) were studied using magnetic resonance imaging. Sagittal images from the lower thoracic and lumbar vertebral marrow were evaluated on Tl-weighted and STIR images. Five distinct patterns of signal intensity of the Tl-weighted and STIR images were classified. T1 and T2 relaxation times and T1 marrow/fat signal intensity ratio were measured and analyzed (t-test). The cellularity of bone marrow was evaluated on histologic slides. RESULTS: MDS showed homogeneously low signal intensity on T1WI and high signal intensity on STIR image, indicating hypercellular marrow, whereas AA showed relative high signal intensity on T1WI and low signal intensity on STIR image, representing fatty marrow. T1 and T2 relaxation time(T1 for MDS=750.26msec +/- 177.50, T1 for AA= 413.21 msec +/- 167.39 (p<0.000), T2 for MDS=91.86 msec +/- 14.16, T2 for AA=81.44msec +/- 15.31 (p< 0.001) and T1 marrow/fat signal intensity ratio(0.22 +/- 0.048 in MDS, 0.30 +/- 0.083 in AA(p<0.000)) revealed statistically significant difference between the two groups. CONCLUSION: Although the marrow aspiration and needle biopsy are mandatory in hematologic disease for diagnosis, there are limited in assessing the change of total marrow mass. Therefore MRI of bone marrow might be useful in distinguishing MDS from AA because of its ability of representation of total marrow mass.
Anemia, Aplastic* ; Biopsy, Needle ; Bone Marrow ; Diagnosis ; Diagnosis, Differential* ; Hematologic Diseases ; Humans ; Magnetic Resonance Imaging* ; Myelodysplastic Syndromes* ; Relaxation

Actinomycosis is a chronic, granulomatous suppurative disease caused by Actinomyces species. Actinomyces is an anaerobic, gram positive organism that requires special techniques for culture and isolation. Actinomycosis is characterized by formation of multiple abscesses, draining sinuses, abundant granulations (sulfur granule) and dense fibrous tissue. The three major clinical presentations include the cervicofacial, thoracic, and abdominal regions. Since A. israelii is a normal inhabitant of the oral cavity, to make a definitive diagnosis it must be recovered from closed tissue spaces, draining sinuses, or abscesses, or it must be shown to be invasive in histopathologic sections. The drug of choice is penicillin. Because of the dense fibrous tissue surrounding the colonies of organisms and the concentration of organisms in clusters, high doses of pharmacologic agents must be used for long periods, and radical surgical excision should accompany antibiotic therapy if possible. We report three cases of abdominal actinomycosis, preoperatively impressed as appendicitis and pelvic abscess, which was diagnosed by a histological study of operative specimens. The possible pathogenic mechanisms causing clinical symptoms are discussed.
Abscess ; Actinomyces ; Actinomycosis* ; Appendicitis ; Diagnosis ; Mouth ; Penicillins

Sparganum is a parasite infesting principally in the cats or dogs, but human infestation was also not uncommonly reported. In Korea, the reported cases of sparganosis are over 70. We experienced a case of sparganosis in scrotum. This patient, 47 year-old man, had had episodes of intake raw snakes for 6 years as a tonic since 12 years before. The removed larvae of the parasite revealed milkish-white color, flat, and glistening appearance. Life cycle and route of infection of sparganum mansoni are discussed with review of the literatures.
Animals ; Cats ; Dogs ; Humans ; Korea ; Larva ; Life Cycle Stages ; Middle Aged ; Parasites ; Scrotum* ; Snakes ; Sparganosis* ; Sparganum