We have analysed 13 patients with malignant obstructive jaundice due to metastasis who were treated with local radiation therapy to the area of porta hepatis at the Radiation Therapy Department of Paik hospital attached to the Inje University between 1984 and 1988. A good response was observed in 6 out of 7 evaluable paitens receiving a total radiation dose ranging from 2600 to 5480 cgy in 2.6 to 6 weeks. A complete response was noted in 5 patients, a partial response in 1 patient, and no response in 1 patient. The overall median survival for 13 patients was 3 months. But two patients lived more than a year without recurrence of jaundice. Moderate dose, localized field radiation therapy appears to the beneficial in relieving obstructive jaundice and gives a good symptomatic relief.
Humans ; Jaundice ; Jaundice, Obstructive* ; Neoplasm Metastasis ; Recurrence

Hereditary angioedema is a rare genetic disease transmitted with a autosomal dominant trait result of a quantitative or functional defect of Cl inhibitor. We report three cases of heriditary angioedema from the same famly respectively the 35-year-old sister, the younger bn)ther of 32, and the younger sister of 20 The older sister died due to her airway being obstructel by acute laryngeal edema, and her you igirbrother and sister experienced recurrent episodes oswelling on the hand and forearm. The ore we examined the two patients serum complement levils to confirm diagnosis. In both, the r;ults showed decreased levels of Cl inhibitor and C4 which are the evidence of hereditary a giedema. The younger sister has been administered danazol (600mg/day) to prevent angioedem or 8 weeks, and we have not yet found a recurrenc of he symptoms. However, well cont ol the dosage of danazol because amenorchea has developec.
Adult ; Angioedema ; Angioedemas, Hereditary* ; Complement System Proteins ; Danazol ; Diagnosis ; Forearm ; Hand ; Humans ; Laryngeal Edema ; Siblings

BACKGROUND: Methods to detect and quanitify Mycobacterium leprae(M. leprae)are needed for studies involving the epidemiology, pathogenesis, and chemotherapy of leprosy. Serological assays and skin tests lack the sensitivity and specificity to serve as diagnostic tool for M. leprae infection. The polymerase chain reaction(PCR) based on the selective amplification of an 530-bp frangment of the gene encoding the proline-rich antigen of M. leprae was performed with sections of fixed or frozen biopsy samples from leprosy patients. OBJECTIVE: This study was done to investigate the applicability of PCR for the detection of low numbers of M. leprae in tissues and peripheral blood. METHODS: The PCR was used to amplify a 530-base-pair M. leprae DNA with the thermoxtable Taq DNA polymerase. RESULTS: The In frozen skin tissues and peripheral blood of leprosy patients. relatively high detection rates of PCR products was achieved by using direct gel analysis as well as Southern blot hybridization. CONCLUSION: These results suggest that PCR amplification for the detection of M. leprae may be useful for the epidemiologic study of large papulations as well as coinical astudies on the individual patients.
Biopsy ; Blotting, Southern ; DNA ; Drug Therapy ; Epidemiologic Studies ; Epidemiology ; Humans ; Leprosy ; Mycobacterium leprae* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Skin ; Skin Tests ; Taq Polymerase

Hepatocellular carcinoma (HCC) has become an important indication for liver transplantation in Korea. Even though the Milan criteria have been accepted as the gold standard in deceased donor liver transplantation, the acceptable indication for living donor liver transplantation is controversial. This review covers several key issues in liver transplantation for advanced HCC: (1) recent developments and published data on expanded criteria, (2) the role of down-staging, (3) an ethical issue in expanding the criteria in living donor liver transplantation, and (4) post-operative management, including the immunosuppressive regimen and post-transplant adjuvant chemotherapy to improve survival after transplantation for advanced HCC. Biological factors, such as AFP, PIVKA-II, and a PET scan, in addition to tumor size and number, may be helpful in selecting eligible patients for liver transplantation among patients with advanced HCC. Low-level immunosuppression with low exposure of calcineurin inhibitor may reduce HCC recurrence after transplantation.
Biological Factors ; Biomarkers ; Calcineurin ; Carcinoma, Hepatocellular ; Chemotherapy, Adjuvant ; Humans ; Immunosuppression ; Korea ; Liver ; Liver Transplantation ; Living Donors ; Positron-Emission Tomography ; Protein Precursors ; Prothrombin ; Recurrence ; Tissue Donors ; Transplants

Despite the therapeutic equivalence between twice-daily and once-daily tacrolimus, patient safety after conversion is still a concern. We reviewed 218 liver transplantation (LT) patients who converted twice-daily to once-daily tacrolimus between May 2011 and January 2014. Thirty (13.8%) patients had adverse events after conversion, with a liver function test (LFT) abnormality being the most common adverse event (n = 17). Despite the decrease in serum tacrolimus of > 30% after conversion, none of the patients who were converted to a dosage ratio (once-daily tacrolimus dosage: twice-daily tacrolimus dosage) > 1 had an LFT abnormality. Most patients with an LFT abnormality improved after increasing the once-daily tacrolimus dosage (n = 2), returned to a previous medication, and/or added another immunosuppressant (n = 15). One patient had acute cellular rejection, which improved after steroid pulse treatment, and another patient had graft failure. In patients with a dosage ratio ≤ 1, the conversion time within 5 years after LT was the only significant risk factor for an LFT abnormality after conversion (odds ratio: 11.850, 95% confidence interval: 1.321–106.325, P = 0.027). In conclusion, the dosage ratio and time after LT should be carefully considered during conversion from twice-daily to once-daily tacrolimus.
Humans ; Liver Function Tests ; Liver Transplantation* ; Liver* ; Patient Safety ; Risk Factors* ; Tacrolimus* ; Transplants

Primary papillary serous carcinoma of the peritoneum is a rare primary tumor involving the peritoneum. Histologically, it is indistinguishable from serous ovarian papillary carcinoma, although it either spares the o-varies or only microscopically involves their surface. The characteristic features of this tumor are extensive peritoneal and omental masses or implants with psammomatous calcification, and ascites. In addition, it can occur focally in the pelvic peritoneum. We report the CT findings, with histopathologic correlation of primary papillary serous carcinoma of the peritoneum occurring in the upper mesorectum.
Ascites ; Carcinoma, Papillary ; Peritoneum*

Cutaneous metastasis from internal malignacy is recognized but infrequently occuring manifestation. The prostatic carcinoma rarely acts as a primary source for cutaneous metastasis. We report a case of cutaneous metstasis from prostatic carcinoma. A 82-year-old male presents multiple painless erythematous nodules on suprapubic area, having an episode of surgical removal of prostate carcinoma two years ago. Histologic finding shows atypical anaplastic cell infiltration at the dermis and subcutaneous tissue, forming dermal tumor island, and have features similar to primary prostatic carcinoma. Immunohistochemical staining for prostate specific antigen shows positive reaction within cells, can assist in localization of the metatatic adenocarcinoma to a prostate origin.
Adenocarcinoma ; Aged, 80 and over ; Dermis ; Humans ; Male ; Neoplasm Metastasis* ; Prostate ; Prostate-Specific Antigen ; Subcutaneous Tissue

Cutaneous metastasis from internal malignacy is recognized but infrequently occuring manifestation. The prostatic carcinoma rarely acts as a primary source for cutaneous metastasis. We report a case of cutaneous metstasis from prostatic carcinoma. A 82-year-old male presents multiple painless erythematous nodules on suprapubic area, having an episode of surgical removal of prostate carcinoma two years ago. Histologic finding shows atypical anaplastic cell infiltration at the dermis and subcutaneous tissue, forming dermal tumor island, and have features similar to primary prostatic carcinoma. Immunohistochemical staining for prostate specific antigen shows positive reaction within cells, can assist in localization of the metatatic adenocarcinoma to a prostate origin.
Adenocarcinoma ; Aged, 80 and over ; Dermis ; Humans ; Male ; Neoplasm Metastasis* ; Prostate ; Prostate-Specific Antigen ; Subcutaneous Tissue

BACKGROUND: Occupational dermatoses are increasing tendency in Korea. But there were only a few reports about occupational dermatoses in Korean dermatologic literatures. OBJECT: For the effective preventive method and having interest in occupational dermatoses, we have done wide ranged basic study about the occupational dermatoses for 3 years in a semiconductor industry. METHODS: The number of workers of the semiconductor industry was 10,500(male 5,000, female 5,500) and finally the number of analysed patients in this survey was 2,736. A dermatologist attended regularly at the clinic in a semiconductor industry once a week for the duration of 3 years from June 1992 to May 1995. Diagnosis was made by clinical findings and investigation about the working environment. RESULTS: 1. The most common dermatoses are contact dermatitis(14.3%), acne(14.0%), seborrheic dermatitis(7.1%) and tinea pedis(6.9%). Urticaria, hand eczerna, abscess, onychomycosis, t.inea versicol or and chemical burn were also observed frequently. 2. Chemical burn(2.0%), contact dermatitis(1.4%) and acne(0.8%) were the most important occupation related dermatoses in this survey. Hydrofluoric acid(1.4%) was the main cause of chemical burn. The occupationa contact dermatitis and acne in this survey were mainly came from the mask, hood and dust preventing clothes which the workers must wear for 8 hours a day at working place. 3. The other dermatoses related to occupation were hand eczema, trauma, nummular eczema, atopic dermatitis, etc.. CONCLUSION: This study regardless of insufficient inspection equipment was done for a relatively long period in the semiconductor industry. In the future, many studies like this will be reported and the studies will give a model of management of occupational dermatoses in Korea.
Abscess ; Acne Vulgaris ; Burns, Chemical ; Dermatitis ; Dermatitis, Atopic ; Dermatitis, Contact ; Diagnosis ; Dust ; Eczema ; Female ; Hand ; Humans ; Korea ; Masks ; Occupations ; Onychomycosis ; Semiconductors* ; Skin Diseases* ; Tinea ; Urticaria

BACKGROUND: The incidence of herpes zoster is higher among patients with impaired cell mediated immunity. Herpes zoster skin lesions frequently become more severe and run a more protracted course in such patients. OBJECTIVE: This study aimed to firstly elucidate whether there are changes in cell mediated immunity, even in immunocompetent, patients with herpes zoster, and secondly to investigate relationships between these change and the clinical appearance of herpes zoster. METHODS: T lymphocyte subsets in peripheral blood and delayed hypersensitivity reactions using the Multitest(R) CMI kit were measured in 33 healthy patients with herpes zoster and 28 controls. RESULTS: As compared with controls, there was a slight decrease in percentages of CD4 lymphocytes, a significant decr eas in percentages of CD8 lyrnphocytes, and a slight increase in CD4/ CD8 ratios in the acute phasr of herpes zoster. The percentages of CD3 lymphocytes were also significantly decreased. Based on the severity of the skin lesion, there was a significant increase in duration of acute herpetic pain. However, there were no signigicant differences in percentages of T lymphocyte subsets based on the severity of skin lesion and duration of acute horpetic pain. In delayed hypersensitivity reations with the Multitest(R)" CMI kit, the intensity and frequencies of positive reactions were significintly decreased in the patients group. CONCLUSIONS: There are significant changes in peripheral blood T lymphocyte subsets and delayed hypersensitivity reactions even in other wise healthy patients.
Herpes Zoster* ; Humans ; Hypersensitivity, Delayed ; Immunity, Cellular ; Incidence ; Lymphocytes ; Skin ; T-Lymphocyte Subsets*