The nevoid basal cell carcinoma syndrome, or Gorlin-Goltz syndrome, is an autosomal dominant multiple system disorder with high penetrance and variable expressions, although it can also arise spontaneously. The diagnostic criteria for nevoid basal cell carcinoma syndrome include multiple basal cell carcinomas, palmoplantar pits, multiple odontogenic keratocysts, skeletal anomalies, positive family history, ectopic calcification and neurological anomalies. We report a brother and sister who were both diagnosed with nevoid basal cell carcinoma syndrome.
Basal Cell Nevus Syndrome ; Carcinoma, Basal Cell ; Humans ; Odontogenic Cysts ; Penetrance ; Siblings

PURPOSE: To evaluate the role of linac based radiosurgery (RS) in the treatment of meningiomas, we retrospectively analyzed the results of clinical and follow up CT/MRI studies. METHODS AND MATERIALS: From the 1988 July to 1998 April, twenty patients of meningioma had been treated with 6 MV linear accelerator based radiosurgery. Of the 20 patients, four (20%) were male and 16 (80%) were female. Mean age was 51 years old (22~78 years old). Majority of intracranial location of tumor for RS were parasagittal and sphenoid wing area. RS was done for primary treatment in 6 (30%), postoperative residual lesions in 11 (55%) and regrowth after surgery in 3 (15%). Mean tumor volume was 5.72 cm3 (0.78~15.1 cm3) and secondary collimator size was 2.04 cm (1~3 cm). The periphery of tumor margin was prescribed with the mean dose of 19.6 Gy (9~30 Gy) which was 40~90% of the tumor center dose. The follow up duration ranged from 2.5 to 109 months (median 53 months). Annual CT/MRI scan was checked. RESULTS: By the follow up imaging studies, the tumor volume was reduced in 5 cases (25%), arrested growth in 14 cases (70%), and increased size in 1 case (15%). Among these responsive and stable 19 patients by imaging studies, there showed loss of contrast enhancement after CT/MRI in four patients. In clinical response, nine (45%) patients were considered improved condition, 10 (50%) patients were stable and one (5%) was worsened to be operated. This partly resulted in necrosis after surgery. CONCLUSION: The overall control rate of meningiomas with linac based RS was 95% by both imaging follow-up and clinical evaluation. With this results, linac based RS is considered safe and effective treatment method for meningioma.
Female ; Follow-Up Studies ; Humans ; Male ; Meningioma* ; Middle Aged ; Necrosis ; Particle Accelerators ; Radiosurgery* ; Retrospective Studies ; Tumor Burden

PURPOSE: The aim of this retrospective study was to assess the treatment results of 30 patients with pineal region tumors who were underwent radiation therapy under the diagnosis by either CT or MRI. There was no histological verification. We analyzed the prognostic factors that have a significant effect on the overall survival (OS) and disease free survival (DFS) rates. MATERIALS AND METHODS: A total 30 patients with pineal region tumors were treated between March 1983 and August 1995. After a trial radiation therapy of 20~30 Gy/2~3 weeks, the patients were evaluated for their clinical response and radiological response by either CT or MRI and the final treatment direction was then decided. According to their response to the trial radiation therapy and the involved site, radiation treatment was given in various fields i.e., local, ventricle, whole brain and craniospinal field. The radiation dose ranged from 40.8 to 59.4 Gy (Median 50.4 Gy). The median follow up was 36.5 months (4~172 months). RESULTS: An improvement or stability in the clinical symptoms was observed in 28 patients (93.3%) after the trial RT. Nineteen patients (63.3%) showed a partial or complete response by CT or MRI. The two-year and five-year survival rates of the patients were 66.7% and 55.1%, respectively. No significant difference in the survival rates according to the degree of the radiological response was abserved after the trial RT. The results of univariate analysis showed that age, the primary site, the performance status (KPS>or=70), the degree of response after completing RT and the RT field were significant prognostic factors affecting the survival and disease free survival rates (p<0.05). CONCLUSION: The clinical and histological characteristics of pineal region tumors are quite complex and diverse. Therefore, it is difficult to predict the histological diagnosis and the possibility of radiocurability only with the initial response to RT. We think that the development of less invasive histological diagnostic techniques and tailored treatment to the histological type of each tumor are needed.
Brain ; Diagnosis ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Survival Rate

Intense pulsed light (IPL) is a high-intensity polychromatic incoherent light of a determined wavelength spectrum, fluence, and pulse duration. Clinicians can combine these variable factors of IPL for the purpose of selective destruction of target chromophores. Due to these properties, IPL has been widely used for numerous indications including hair removal and treatment of vascular or pigmented lesions. For skilled and experienced clinicians, IPL is a great treatment modality; however it can be a source of serious adverse effects when performed by untrained clinicians. Thus, to promote the proper and safe use of IPL, we summarized the origin, history, basic principles, and clinical application of IPL and discussed qualification factors needed for clinicians who use IPL.
Hair Removal

Primary lymphoma of the kidney is rare, and in most cases is attributable to lymphomatous renal infilitration of systemic non-Hodgkin's lymphoma or an extension from an adjacent site of the disease. Since the renal parenchyma is not a lymphoid organ, the mechanism by which renal lymphoma occur remains poorly understood. We report here a case of primary bilateral B-cell renal lymphoma in 26-year-old man who was treated successfully with combination chemotherapy.
Adult ; B-Lymphocytes* ; Drug Therapy, Combination ; Humans ; Kidney ; Lymphoma* ; Lymphoma, Non-Hodgkin

OBJECTIVE: To evaluate the effect of prophylactic therapy on gout flare during urate lowering treatment. METHODS: We retrospectively examined the data derived from 59 patients who had been treated with allopurinol for more than six months after stopping prophylactic medication at our rheumatology clinic. Demographic data (age, sex, disease duration, tophi and comorbidity), clinical and laboratory features, including presence of gout flare during urate lowering treatment, dose of allopurinol, serum uric acid level and creatinine clearance at initiation and six months later, were collected. For the subgroup analysis, the same data were collected in 46 patients who had been followed up at one year after stopping prophylactic medication. RESULTS: Twenty-eight patients among 59 (47.4%) had experienced at least 1 gouty attack during urate lowering therapy. The mean duration of prophylactic medication was not different between the flare group (3.8 months) and the non-flare group (5.9 months, p=0.617). Six months later, the mean serum uric acid level was 6.3 mg/dL (6.1 mg/dL vs. 6.5 mg/dL). According to the duration of prophylactic treatment (<6 months, > or =6 months), there were more frequent flares in the <6 months group than in the > or =6 months group (51.2% vs. 38.9% in the six month follow-up group, 70.6% vs. 50% in the one year follow-up group). CONCLUSION: Prophylactic medication for more than six months could be a favorable factor for the prevention of recurrent gout flare during urate lowering treatment.
Allopurinol ; Creatinine ; Follow-Up Studies ; Gout ; Humans ; Retrospective Studies ; Rheumatology ; Uric Acid

OBJECTIVE: To evaluate the effect of prophylactic therapy on gout flare during urate lowering treatment. METHODS: We retrospectively examined the data derived from 59 patients who had been treated with allopurinol for more than six months after stopping prophylactic medication at our rheumatology clinic. Demographic data (age, sex, disease duration, tophi and comorbidity), clinical and laboratory features, including presence of gout flare during urate lowering treatment, dose of allopurinol, serum uric acid level and creatinine clearance at initiation and six months later, were collected. For the subgroup analysis, the same data were collected in 46 patients who had been followed up at one year after stopping prophylactic medication. RESULTS: Twenty-eight patients among 59 (47.4%) had experienced at least 1 gouty attack during urate lowering therapy. The mean duration of prophylactic medication was not different between the flare group (3.8 months) and the non-flare group (5.9 months, p=0.617). Six months later, the mean serum uric acid level was 6.3 mg/dL (6.1 mg/dL vs. 6.5 mg/dL). According to the duration of prophylactic treatment (<6 months, > or =6 months), there were more frequent flares in the <6 months group than in the > or =6 months group (51.2% vs. 38.9% in the six month follow-up group, 70.6% vs. 50% in the one year follow-up group). CONCLUSION: Prophylactic medication for more than six months could be a favorable factor for the prevention of recurrent gout flare during urate lowering treatment.
Allopurinol ; Creatinine ; Follow-Up Studies ; Gout ; Humans ; Retrospective Studies ; Rheumatology ; Uric Acid

BACKGROUND: Radiofrequency obliteration and endovenous laser therapy of the greater saphenous vein have recently been introduced as alternative, minimally invasive techniques for the treatment of saphenous vein incompetence. The 7 Fr. VNUS ClosureFAST(R) radiofrequency obliteration system was introduced in Gwang-Ju Veterans hospital. The purpose of this study is to evaluate the efficacy and complications of radiofrequency obliteration using the 7 Fr. VNUS ClosureFAST(R) system. MATERIAL AND METHOD: Between May 2, 2007 and May 31, 2008, we performed radiofrequency obliteration on 90 patients. The number of males was 67 and their mean age was 57.9+/-11.0 (range: 23~78) years old. The patients underwent follow up exams at 3 weeks after the procedures and then every 3 months. The effects of treatment and the complications were reviewed. RESULT: The postoperative complications were ecchymosis (94.4%), pain (27.8%), paresthesia (25.6%), bullous formation (8.9%), edema (6.7%) and phlebitis (2.2%). One patient showed good blood flow after 3 weeks and one patient showed good blood flow after 3 months. The one-year success rate of radiofrequency obliteration in varicose veins was 97.6%. CONCLUSION: Our data showed acceptable operative results and short-term clinical results for treating varicose veins with radio frequency obliteration. Long-term follow-up and comparison of radio frequency obliteration with high ligation and stripping, previous radiofrequency ablation and endovenous laser therapy are needed in the future.
Ecchymosis ; Edema ; Follow-Up Studies ; Hospitals, Veterans ; Humans ; Laser Therapy ; Ligation ; Male ; Paresthesia ; Phlebitis ; Postoperative Complications ; Saphenous Vein ; Varicose Veins ; Veins

Pulmonary embolism is most commonly related to deep vein thrombosis of the lower extremities. However, recent studies show that the thrombosis of superficial veins can also progress to deep vein thrombosis and pulmonary embolism. To our knowledge, there is no Korean report of pulmonary embolism associated with superficial vein thrombosis. We experienced an 82-year-old woman complaining of dyspnea and chest pain. On chest dynamic computed tomography (CT), pulmonary embolism was diagnosed. To evaluate the origin of the pulmonary embolism, abdominal CT, Doppler ultrasonography, and ascending venography of both lower extremities were done. We found no deep vein thrombosis, while thrombus of the proximal left greater saphenous vein was seen. We report a case of pulmonary embolism accompanying greater saphenous vein thrombosis without deep vein thrombosis.
Aged, 80 and over ; Chest Pain ; Dyspnea ; Female ; Humans ; Lower Extremity ; Phlebography ; Pulmonary Embolism* ; Saphenous Vein* ; Thorax ; Thrombosis* ; Tomography, X-Ray Computed ; Ultrasonography, Doppler ; Veins ; Venous Thrombosis

PURPOSE: To evaluate the effect of the simulation method on recurrence among the patients who received radiotherapy after breast-conserving surgery (BCS) for early breast carcinoma. METHODS AND MATERIALS: Between 1995 and 2000, 70 patients with stage I-II breast carcinoma underwent breast-conserving surgery and adjuvant radiotherapy. Twenty nine patients (41.4%) were simulated with the 2D contour-based method (September 1995 to August 1997) and 41 patients (58.6%) were simulated with the 3D CT-based method (September 1997 to February 2000). To analyze the effect of the simulation method, the patient and treatment characteristics were compared. RESULTS: The characteristics were similar for the patients between the 2D contour-based simulation group and the 3D CT-based simulation group. During a median follow-up period of 75 months, 4 (13.8%) of 29 patients who were treated with 2D simulation and 1 (2.4%) of 41 patients who were treated with 3D simulation group devel-oped treatment failure. The five-year survival rates were 89.2% and 95.1% between the 2D and 3D simulation groups (p=0.196). The five-year disease free survival (DFS) rates were 86.2% and 97.5% between the 2D and 3D simulation groups (p=0.0636). On univariate analysis, age > 40 (p= 0.0226) and the number of dissected axillary lymph node > or = 10 (p=0.0435) were independent predictors of improved 5-year DFS. CONCLUSIONS: Although our data showed marginal significance for the DFS between the two groups, it is insufficient, due to the small number of patients in our study, to prove whether 3D CT-based simulation might improve the DFS and reduce the risk of recurrence when compared with 2D contour-based simulation. Further study is needed with a larger group of patients.
Breast Neoplasms ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Lymph Nodes ; Mastectomy, Segmental* ; Radiotherapy* ; Radiotherapy, Adjuvant ; Recurrence* ; Survival Rate ; Treatment Failure