We report a rare case of sporadic keratosis punctata palmaris et plantaris in a 49-year-old woman. Thirty years ago, firm semitranslucent papules developed on the middle portion of her palms without any subjective symptom. The lesions had flat-topped smooth surfaces. They were concentrated along the margins of the hands, especially on the lateral surfaces of both index fingers and finger tips/ Ten years ago, similar hyperkeratotic papules with or without central craters developed on the weight bearing portions of her soles. Her family and past histories were negative. The biopsy specimen revealed a dense hyperderatotic stratum corneum which fitted into a cup shaped depression in the stratum malpighii and a turning inward of the rete ridges at the margin. The Masson trichrome and elastic strains showed no peicific dermal changes.
Biopsy ; Depression ; Female ; Fingers ; Hand ; Humans ; Keratosis* ; Middle Aged ; Weight-Bearing

PURPOSE: To evaluate the predictive value of the early response of 18F-flurodeoxyglucose positron emission tomography (FDG PET) during concurrent chemoradiotherapy (CCRT) for locally advanced non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: FDG PET was performed before and during CCRT for 13 NSCLC patients. Maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured and the changes were calculated. These early metabolic changes were compared with the standard tumor response by computed tomograms (CT) one month after CCRT. RESULTS: One month after the completion of CCRT, 9 patients had partial response (PR) of tumor and 4 patients had stable disease. The percent changes of SUVmax (%DeltaSUVmax) were larger in responder group than in non-responder group (55.7% +/- 15.6% vs. 23.1% +/- 19.0%, p = 0.01). The percent changes of SUVmean (%DeltaSUVmean) were also larger in responder group than in non-responder group (54.4% +/- 15.9% vs. 22.3% +/- 23.0%, p = 0.01). The percent changes of MTV (%DeltaMTV) or TLG (%DeltaTLG) had no correlation with the tumor response after treatment. All the 7 patients (100%) with %DeltaSUVmax > or = 50% had PR, but only 2 out of 6 patients (33%) with %DeltaSUVmax < 50% had PR after CCRT (p = 0.009). Likewise, all the 6 patients (100%) with %DeltaSUVmean > or = 50% had PR, but only 3 out of 7 patients (43%) with %DeltaSUVmean < 50% had PR after CCRT (p = 0.026). CONCLUSION: The degree of metabolic changes measured by PET-CT during CCRT was predictive for NSCLC tumor response after CCRT.
Carcinoma, Non-Small-Cell Lung* ; Chemoradiotherapy* ; Glycolysis ; Humans ; Lung Neoplasms ; Positron-Emission Tomography ; Tumor Burden

A 33-year-old man with alopecia totalis presented with facial erythema and flares, conjunctival injection, and dyspnea developed within several minutes following the ninth application of dinitrochlorobenzene (DNCB). A scratch skin test produced positive reactions in concentrations of 0.01, 0.05, 0.1% DNCB showing flares and wheals, whereas concentrations of 0.001, 0.01, 0.05% diphenylcyclopropenone (DPCP) showed negative results. Contact urticaria due to DNCB is very rare, but this complication must be fully noted because of the widespread and frequent use of DNCB in dermatotherapeutic fields. We report herein a rare case of contact urticaria following topieal application of DNCB in the treatment of alopecia totalis.
Adult ; Alopecia ; Dinitrochlorobenzene* ; Dyspnea ; Erythema ; Humans ; Skin Tests ; Urticaria*

A 34-year-old man visited our hospital with alopecia areata on the occipital scalp, which began to develop two months prior to his visit. He was sensitized with 0.2% diphenylcyclopropenone(DPCP) in acetone that was applied to the inner side of his right arm. Two weeks after sensitization, we applied DPCP on his bald lesion once weekly for skin challenge. Following the third application of DPCP, polycyclic erythematous target-like lesions developed around the sensitized area. A clinical diagnosis of erythema multiforme was made. Histologically, the target-like lesion showed few eosinophilic dyskeratosis, exocytosis, and hydropic de-generation of basal layer in the epidermis, and mononuclear infiltration around superficial blood vessels in the dermis. We report herein a rare case of erythema multiforme following topical application of DPCP in the treatment of alopecia areata. This complication must be noted because of the wide-spread and frequent use of DPCP in dermatotherapeutic fields.
Acetone ; Adult ; Alopecia Areata ; Arm ; Blood Vessels ; Dermis ; Diagnosis ; Eosinophils ; Epidermis ; Erythema Multiforme* ; Erythema* ; Exocytosis ; Humans ; Scalp ; Skin

No abstract available.
Acinar Cells* ; Biopsy, Fine-Needle* ; Carcinoma, Acinar Cell* ; Parotid Gland*

BACKGROUND: The diastolic transmitral flow velocity pattern has been commonly used to assess left ventricular(LV) diastolic function. The effects of multiple factors(such as, LV preload, afterload and heart rate, etc.) make difficulties in accurate interpretation. METHODS: In order to investigate the diastolic transmitral filling patterns according to the changes of the proload or heart rate, we studied 27 normal subjects with pulsed Doppler echocardiography after the administration of nitroglycerin(0.6mg/tab.) sublingually or atropine(0.5mg/amp.) intravenously. RESULTS: 1) After nitroglycerin administration, the folowings were obtained. ; The systolic blood pressure and LV diastolic filling time(DFT) decreased by 10.1% and 15.3%, respectively(p<0.001), compared with baseline data. The ratio of peak early to late diastolic transmitral flow velocities (E/A) and time-velocity integrals(TVIE/TVIA) decreased by 10.3% and 14.8%, respectively(p<0.01). The early diastolic filling time(Time E) was unchanged. Therefore, we suggest that time E is helpful, compared with the increments of the preload or the diastolic dysfunction. 2) After atropin administration, the heart rate, peak late diastolic transmitral flow velocity(PA) and percent atrial contribution(%AC) significantly increased by 43.6%, 25.1% and 41.4%, respectively(p<0.001). The E/A, TVIE/TVIA and DFT significantly decreased by 42.9%, 38.9% and 43.0%, respectively(p<0.001) compared to the data before drug administration. 3) The heart rate correlated negatively to the E/A, TVIE/TVIA and DFT. It was correlated positively to %AC(r=+0.63; p<0.001). The normalized E/A ratio by DFT(E/A/DFT) didn't correlate. Therefore, E/A/DFT is helpful on the exclusion of the influences of heart rate by the administration of the atropine. CONCLUSION: The decrement of preload or the increment of heart rate changes the diastolic transmitral flow velocity patterns. Therefore, when the diastolic function is assessed by interpretation of the Doppler transmitral flow velocity pattern with pulsed Doppler echocardiogram, the potential influences of preload and heart rate must be taken into account.
Atropine* ; Blood Pressure ; Echocardiography ; Echocardiography, Doppler* ; Echocardiography, Doppler, Pulsed ; Heart Rate ; Humans* ; Nitroglycerin* ; Time

Halo dermatitis (Meyerson's nevus) is an inflammatory, eczematous eruption usually encircling a preexisting melanocytic nevus. Spontaneous healing occurs within several weeks or months and is never concurrent with regression of the central nevus, in contrast to halo nevus (Sutton's nevus). Although halo dermatitis is often associated with central melanocytic nevi, pathogenesis leading to the morphological change of this disorder remains obscure. Herein, we report a case of a 23-year-old female who developed an eczematous halo reaction surrounding the junctional nevi.
Dermatitis* ; Eczema ; Female ; Humans ; Nevus* ; Nevus, Halo ; Nevus, Pigmented ; Young Adult

Continuous assessment of arterial oxygenation is important in the clinical management of critically ill patients. Analysis of arterial blood gas is reliable but is invasive and only provides intermittent informations. In order to determine the accuracy of pulse oximeters in ICU patients, arterial oxygen saturation was measured in 58 patients in ICU using two kinds of pulse oximeters (Ohmeda, CSI), while simutaneously analyzing arterial blood gases. The relationship between the pulse oximeters saturation (SpO2) and arterial oxygen saturation (SaO2) was evaluated, Group l consisted of 102 samples of SpO2 using an Ohmeda pulse oximter in 45 of 72 patients. Group ll included 102 samples of SpO2 using a CSl pulse oximeter in 45 of 72 patients. Both Ohmeda and CSI pulse oximeters were applied to 32 patients. Group lll had 204 samples, thE Sum of Groups l and ll. The results were as follow ; 1) The correlation coefficients of SpO2 to SaO2 in Groups l, ll and lll were 0.97, 0.90 and 0.96 (p < 0.775). 2) Mean difference between SaO2 and SpO2 in Groups l, ll and lll were almost within the limit of 1%. 3) The correlation coefficient of SpO2 between Ohmeda andcsr pulse oximeter was 0.79, and there was no mean difference between them in the 32 patients who were tested with both the Ohmeda and the CSI pulse oximeters. In conclusion, a pulse oximter is an accurate noninvasive device which assesses arterial oxygenation and provides information continuously. Wider clinical indication will follow.
Critical Illness ; Gases ; Humans ; Oximetry* ; Oxygen

No Abstract Available.
Hepatitis B e Antigens* ; Hepatitis B Surface Antigens*

Supernummerary breast is a rare developmental anomaly occurring along the course of the embryological milk lines, which run from the anterior axillary folds to the inner thighs. Kajava first described the classification of supernumerary tissue in 1915, and this term is still in use. We herein report two cases of supernumerary breast, classified as Kajava classification type 3 and 6.
Breast* ; Classification ; Milk ; Thigh