We report a 27-year-old male with rnultiple pruritic papulovesicular eruptions on the whole body without any gluten-sensitive enteric syrnpoms. A skin biopsy specimen showed subepidermal vesicles and papillary microabscesses infiltrated with rnany neutrophils and a few lymphocytes and eosinophils. Direct immunofluorescent study of the perilesional skin revealed linear deposits of immunoglobulin A along the dermo-epidermal junction. The lesion responded rapidly to oral dapsone and topical steroid therapy.
Adult ; Biopsy ; Dapsone ; Eosinophils ; Humans ; Immunoglobulin A* ; Linear IgA Bullous Dermatosis ; Lymphocytes ; Male ; Neutrophils ; Skin ; Skin Diseases*

There has been a few articles dealing with the incidence of congenital anomalies of the hand in Korea. In this paper, we have analyzed patients who have visited the hand clinic of Seoul National University Children s Hospital from March 1993 to February 1995 to study the relative incidence of congenital anomalies of the hand. We regarded more than two visits of the same patients as one. They were categorized into two groups by our classification system. First group consisted of the patients who showed hand anomaly only. The other group consisted of the patients who had anomalies in the other sites as well as in the hand. The first group was divided into two subgroups; the patients who had single entity of hand anomaly, and those who had more than two entities of hand anomalies. From the clinical analysis based on above criteria, following results were obtained. There were 626 anomalies in 547 patients, 319 (58.3%) males and 228 (41.7%) females (1.4: 1). Unilateral involvements of hand anomaly were noted in 385 (70.3%) patients (229 in right, 156 in left) and bilateral in 162 (29.7%). As a whole, the most common anomaly was trigger thumb (16.5%) and the second was polydactyly (16.1%). Other anomalies, in order of frequency, were syndactyly, camptodactyly, hypoplasia, brachydactyly, cleft hand and so on. In the first group who had hand anomaly only, there were 407 patients who had single entity of hand anomaly. Among these, trigger thumb were 25.3%, and polydactyly 16.2%. There were 68 patients who had multiple entities of anomalies. Among these, the syndactyly was the most common anomaly (23.9%) and the polydactyly was the next (16.2%). Fifty eight (10.6%) patients had anomalies in the hand as well as in the other site. Among these, camptodactyly was the most commonly found (36.5%) and polydactyly was the next common variety (19.0%) in the hand. In the anomalies which occurred in other than hand, arthrogryposis multiplex congenita was the most common (30.0%). Syndactyly of the foot (22.9%) and polydactyly of the foot (18.6%) were the next common anomalies.
Arthrogryposis ; Brachydactyly ; Child ; Classification ; Female ; Foot ; Hand* ; Humans ; Incidence* ; Korea ; Male ; Polydactyly ; Seoul ; Syndactyly ; Trigger Finger Disorder

A case of papillary eccrine adenoma on the right hand of a 84-year-old woman is reported. The tumor was 1 cm in diameter, occupying the whole thickness of the dermis. Histologically, the tumor was composed of dilated tubules of various sizes with intraluminal papillary projections, and was surrounded by a fibrous stroma. An immunohistochemical study revealed that the proliferating tubules were composed of the outermost layer of alpha-smooth muscle actin-positive and the inner layer of keratin 14-negative cells. This antigen expression pattern was comparable to that of the normal eccrine secretory coil, which indicates that the tumor differentiated toward the secretory coil of an eccrine sweat gland.
Adenoma* ; Aged, 80 and over ; Dermis ; Female ; Hand ; Humans ; Sweat Glands

The study comprises 13 cases of phenytoin induced drug eruption admitted and treated at Seoul National University Hospital during a 6-year period (1981-1986). The summaries are as follows : 1. The skin lesions were usually pruritic morbilliform maculopapular eruptions on face, trunk, extremites, including palms and soles. However, erythema multiform was observed in one case. 2. Hiistopathologically, the dermis showed perivascular accumulation of mononuclear cells with occasional eosinophils. In some cases, the epidermis showed vacuolar alteration of basaI layer, necrotic keratinocyte with dermal perivascular mononuclear cell infiltrations. 3. The frequencies of the associated features were as follows : fever(61.5%), lymphadenopathy(23.1%), leukocytosis(45.5%), esinophilia(72.7%), and liver function abnormalities(63.6%)
Dermis ; Drug Eruptions* ; Eosinophils ; Epidermis ; Erythema ; Keratinocytes ; Liver ; Phenytoin* ; Seoul ; Skin

We performed experiments using Aplysia neurons to identify the mechanism underlying the changes in the firing patterns in response to temperature changes. When the temperature was gradually increased from 11degrees C to 31degrees C the firing patterns changed sequentially from the silent state to beating, doublets, beating-chaos, bursting-chaos, square-wave bursting, and bursting-oscillation patterns. When the temperature was decreased over the same temperature range, these sequential changes in the firing patterns reappeared in reverse order. To simulate this entire range of spiking patterns we modified nonlinear differential equations that Chay and Lee made using temperature-dependent scaling factors. To refine the equations, we also analyzed the spike pattern changes in the presence of potassium channel blockers. Based on the solutions of these equations and potassium channel blocker experiments, we found that, as temperature increases, the maximum value of the potassium channel relaxation time constant, taun(t) increases, but the maximum value of the probabilities of openings for activation of the potassium channels, n(t) decreases. Accordingly, the voltage-dependent potassium current is likely to play a leading role in the temperature-dependent changes in the firing patterns in Aplysia neurons.
Aplysia ; Computer Simulation ; Fires ; Neurons ; Potassium ; Potassium Channel Blockers ; Potassium Channels ; Relaxation

PURPOSE: Following planned posterior continuous curvilinear capsulorrhexis (PCCC) during cataract surgery in adults, we evaluated the clinical effects of visual acuity and prevention of posterior capsule opacity. METHODS: The clinical results were studied retrospectively by comparing 43 eyes of 43 patients who underwent cataract surgery with PCCC (the experimental group) and 46 eyes of 31 patients who underwent cataract surgery without PCCC (the control group). Preoperative and postoperative best corrected visual acuities (BCVAs) of patients were measured. BCVA (using log MAR) and the occurrence of posterior capsule opacity were closely monitored in both groups preoperatively, two months postoperatively, and at each group's final visit (14.6 months postoperatively for the experimental group and 15.7 months for the control group). One-piece plate intraocular lens was used in cataract surgery. RESULTS: Preoperative BCVA was lower in the control group but not significantly. The 2-month mean postoperative BCVA showed improvement in vision in both the control and experimental groups. In both groups, the BCVA was decreased at the final examination compared with the 2-month postoperative BCVA, and significant differences between the two groups were not observed. Under slit lamp examination, anterior hyaloid opacity was observed in 13 of 43 eyes that underwent PCCC. The decrease in BCVA in 13 eyes with anterior hyaloid opacity was significantly different (p < 0.05) compared with the 2-month postoperative BCVA. CONCLUSIONS: Considering the effort and operation skills required for PCCC, the clinical benefits are negligible. Since cataract surgery with PCCC can cause reduced vision due to anterior hyaloid opacity, side effects should be disclosed before PCCC is performed.
Adult* ; Capsulorhexis* ; Cataract ; Humans ; Lenses, Intraocular ; Retrospective Studies ; Slit Lamp ; Vision, Low ; Visual Acuity

Hyperreactio luteinalis is a rare disease characterized by marked cystic enlargement of the ovary due to multiple benign theca lutein cyst. The cause of this disease is not well known but is believed to be induced by high serum levels of human chorionic gonadotropins (hCG). It occurs usually in gestational trophoblastic disease, multiple pregnancies, and rarely in normal pregnancy. In nature, hyperreactio luteinalis is a benign condition. Therefore, the appropriate management is conservative, but surgical intervention is definitely indicated to remove infarcted tissue, control hemorrhage, or decrease androgen production in virilized patients. Here we report a case of hyperreactio luteinalis which was diagnosed at 11 weeks gestation. Lower abdominal pain was developed and progressed. Emergent right wedge oophorectomy and left salpingoophorectomy was performed due to probable torsion of left ovarian cyst and the pregnancy maintained. Theca lutein cysts were confirmed on pathologic examination.
Abdominal Pain ; Chorionic Gonadotropin ; Female ; Gestational Trophoblastic Disease ; Hemorrhage ; Humans ; Lutein ; Ovarian Cysts ; Ovariectomy ; Ovary ; Pregnancy* ; Pregnancy, Multiple ; Rare Diseases

PURPOSE: To evaluate the results and efficacy of posterior dual plating for distal shaft fractures of the humerus. MATERIALS AND METHODS: We retrospectively analyzed 12 patients, who underwent open reduction and internal fixation using posterior dual plating for distal shaft fractures of the humerus, between July 2007 and July 2015, with at least 6 months of follow-up. After locating the radial nerve without dissection via posterior triceps splitting, the fracture was stabilized using a short 3.5 mm locking compression plate. Then additional fixation, using a long 3.5 mm locking compression plate, was performed. The clinical outcomes were assessed in accordance with the Mayo Elbow Performance Index (MEPI) scoring system, and the radiological outcomes were assessed using serial plain radiographs. RESULTS: Eleven patients (91.7%) had bony union, and the mean union period was 13.9 weeks. In one patient, delayed union was treated by autogenous iliac bone graft at 8 months after surgery, which resulted in bony union. The mean MEPI score was 95.8, and the clinical outcomes were excellent in 9 patients and good in 3 patients. Postoperative complications included 1 elbow stiffness by heterotopic ossification and 1 temporary radial nerve palsy. One patient with temporary radial nerve palsy was completely recovered within the first 4 days after surgery. CONCLUSION: Posterior dual plating for distal shaft fractures of the humerus revealed satisfactory clinical and radiological outcomes. It can be a useful alternative to provide stable fixation without the need for a dissection of the radial nerve.
Elbow ; Follow-Up Studies ; Humans ; Humerus* ; Ossification, Heterotopic ; Paralysis ; Postoperative Complications ; Radial Nerve ; Retrospective Studies ; Transplants

BACKGROUND/AIMS: The rate of diagnosis of gastric adenoma has increased because esophagogastroduodenoscopy is being performed at an increasingly greater frequency. However, there are no treatment guidelines for low-grade dysplasia (LGD). To determine the appropriate treatment for LGD, we evaluated the risk factors associated with the categorical upgrade from LGD to high grade dysplasia (HGD)/early gastric cancer (EGC) and the risk factors for recurrence after endoscopic treatment. METHODS: We compared the complication rates, recurrence rates, and remnant lesions in 196 and 56 patients treated with endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR), respectively, by histologically confi rming low-grade gastric epithelial dysplasia. RESULTS: The en bloc resection rate was significantly lower in the EMR group (31.1%) compared with the ESD group (75.0%) (p<0.001). However, no significant difference was observed in the prevalence of remnant lesions or recurrence rate (p=0.911) of gastric adenoma. The progression of LGD to HGD or EGC caused an increase in the incidence of tumor lesions >1 cm with surface redness and depressions. CONCLUSIONS: For the treatment of LGD, EMR resulted in a higher incidence of uncertain resection margins and a lower en bloc resection rate than ESD. However, there was no signifi cant difference in recurrence rate.
Adenoma ; Endoscopy, Digestive System ; Humans ; Incidence ; Prevalence ; Recurrence ; Risk Factors ; Stomach Neoplasms

Primary serous papillary carcinoma of peritoneum (PSCP) is a tumor of the peritoneum, distinct from malignant mesothelioma, but similar in many ways to primary epithelial ovarian carcinoma (EOC). It seems to be histologically identical to EOC and is differentiated from EOC based on the extent of gross ovarian involvement and microscopic invasion of the cortex. Currently, PSCP is evaluated, staged and treated in the same fashion as EOC, with the Gynecologic Oncology Group trials for the treatment of EOC now open to patients with PSCP. Therefore it is managed surgically in the same way as EOC with shared goal of optimal cytoreduction. Although the preponderance of evidence supports the benefit of maximal cytoreductive efforts for EOC, only limited data are available for debulking in PSCP. Here we report four cases of PSCP with a short literature, in who excisions of all visible implants were performed and residual lesions were measured up to less than 2 cm.
Carcinoma, Papillary* ; Humans ; Mesothelioma ; Peritoneum*