We reviewed two cases of keratosis punctata palmaris et plantaris(KPP) and the scanning electron microscopic findings(SEM). The skin lesions of KPP are multiple, hyperkeratotic on the palms and soles with central pitting. There was no subjective symptoms. The histologic findigs revea,l marked hyperkeratosis, hypergranulosis, and acanthosis with depression of the underlying malpighian layers. The SEM findings reveal one hyperkeratoic plug on punctate lesion(case I ) and three hyperkeratotic plugs on depression of the malpighian layer(case ll ).
Depression ; Keratoderma, Palmoplantar* ; Keratosis* ; Skin

The birth of myelography was presaged by Dandy's classic description of pneumoencephalography in 1919. After then, many contrast media, such as Pantopaque, Lipiodol, Abrodil, Dimer-X, and Conray-60, were developed and myelography was achieved in widespread popularity for diagnosis in low back pain, especially on the syndrome of herniated intervertebral disc. During the past few years, the picture has changed dramatically because of the availability of Metrizamide, a new, less toxic, non-ionic, aqueous medium. So, the authors have seen and studied 165 cases of. low back pain with respect to the diagnostic classification and clinical acceptance of Metrizamide myelographic examination from May, 1982 to April, 1985 at Department of Orthopaedic Surgery, College of Medicine, Soon Chun Hyang University. The results were summerized as followings; l. Among the 165 cases, myelographic finding was classified in 4 groups and 7 types, and showed as group 1(41), group 2 and type a(46), group 2 and type b(21), group 3 and type a(9), group 3 and type 1(15), group 3 and type c(16), and group 4(17). 2. The predominent type in the 57 operative cases was group 4(46, 27.9%). 3. In clinical analysis, tenderness was predominent in most types, but sensory changes in group 4. 4. Step by step in types, anatomical changes was seen more often than funtional changes in plain X-ray. 5. Myelographic accuracy was coincided with operative findings in 75.4% and 7 cases of false negative and 5 cases of false positive. 6. In disc findings, the extruded type was seen predominently in group 4 as 29.4%. 7. Above group 3 and type a, the prognosis of operative treatment was excellent than conservative.
Classification ; Clinical Study ; Contrast Media ; Diagnosis ; Ethiodized Oil ; Intervertebral Disc ; Iophendylate ; Low Back Pain ; Metrizamide ; Myelography ; Parturition ; Pneumoencephalography ; Prognosis

Amyloidosis is a disease complex associated with deposition of insoluble filbrillar protein in various tissues of the body. Cutaneous lesions are present in up to 40 % of patients with primary and myeloma associated systemic amyloidosis. We present a case of systemic amyloidosis associated with multiple myleoma occuring in 54-year-old male who had waxy papules with petechiae on nasola bial fold, postauricular area, and cheek. The diagnosis was confirmed by Congo red stain, electron microscope, immunelectrophoresis, Bence-Jones proteinuria, immunoperoxidase stain, and bone marow biopsy.
Amyloidosis* ; Biopsy ; Cheek ; Congo Red ; Diagnosis ; Humans ; Male ; Middle Aged ; Multiple Myeloma* ; Proteinuria ; Purpura

Twenty seven patients with known rectal cancer were evaluated with CT and CT findings were correlated with surgical and pathologic results on the aspect of perirectal fat infiltration and lymph node involvement. The accuracy in assessment of perirectal fat infiltration was 77.8% (21 of 27); sensitivity, 73.3% (11 of 13); specificity, 83.3% (10 of 12). In the detection of lymph node involvement, lymph nodes were divided into five groups according to the arterial teritories. Overall accuracy in the evaluation of lymph node involvement was 86.7%. Accuracy of peritumoral lymph node involvement was 51.9% (14 of 27); sensitivity, 42.9%(9 of 21); specificity 83.3% (5 of 6). Accuracy of internal iliac lymph node involvement was 88.9% (24 of 27); sensitivity, 85.7% (6 of 7); specificity, 90.0% (18 of 20). Of the common and external iliac lymph node, accuracy was 100% (27 of 27); sensitivity, 100% (2 of 2); specificity, 100% (25 of 25). Of the aortic bifurcation and mid sacral lymph node, accuracy was 92.6% (25 of 27); sensitivity, 50% (2 of 4); specificity, 100% (23 of 23). In regard to the inferior mesenteric lymph node, no lymphadenopathy was found on CT and pathologic results. In conclusion, CT has limited value in evaluating rectal cancer but with the satisfactory outcome in assessment of perirectal fat infiltration and lymph node, involvement except peritumoral node preoperative CT is useful in the evaluation of rectal cancer.
Humans ; Lymph Nodes* ; Lymphatic Diseases ; Rectal Neoplasms* ; Sensitivity and Specificity

OBJECTIVES: The effects of superovulation on the expression of mRNA and protein of TIMP-3 and MMP-9 in murine endometrium were assessed. METHODS: Using murine pregnant uteri of gestation day (g.d.) 4, 5 and 6 after injection of PMSG 5 and 10 IU, the effects of superovulation were assessed and compared with those of natural pregnancy and pseudopregnancy groups using quantitative competitive RT-PCR and immunohistochemical staining. RESULTS: Expression of TIMP-3 mRNA and protein showed an increase in PMSG groups and pseudopregnancy group, while there was no difference in MMP-9 expression between natural pregnancy and PMSG, pseudopregnancy groups on g.d. 4 through g.d. 6. CONCLUSIONS: This study suggests that ovarian hyperstimulation by gonadotropin, which produces many oocytes and embryos, may have a detrimental effect on embryonic implantation and its relevant endometrial remodeling process by increase in expression of TIMP-3 in murine endometrium.
Animals ; Embryonic Structures ; Endometrium* ; Female ; Gonadotropins ; Mice ; Oocytes ; Pregnancy ; Pseudopregnancy ; RNA, Messenger ; Superovulation* ; Tissue Inhibitor of Metalloproteinase-3 ; Uterus

Bone marrow transplantation has become an accepted treatment for malignancy(particulary leukemia and lymphoma), aplastic anemia, and certain inborn errors of metabolism. In addition to the problem of severe, prolonged myelosuppression, bone marrow transplantation is associated with several unusual complications. Among the complications such as GVHD, graft rejection, interstitial pneumonia and veno-occlusive disease, involvement of the gastrointestinal tract by GVHD is associated with high graft failure and mortality. Intestinal GVHD is usually manifest clinically as voluminous secretory diarrhea accompanied by abdominal cramping, ileus, nutritional depletion, and, at times, hemorrhage. We experienced a case of severe intestinal GVHD after allogeneic marrow transplantation for treatment of severe aplastic anemia. He received bone marrow from his elder sister, HLA-matched multiparous woman and suffered from large amount of watery diarrhea with skin rash 34 days after transplantation. 1n spite of prednisolone therapy the symptom was progressed. After sigmoidoscopic mucosal biopsy, intestinal GVHD was confirmed and we tried methylprednisolone pulse therapy. Skin lesion was improved but the amount of diarrhea was increased with intermittent abdominal cramping. We tried ALG(anti-lymphocyte globulin) and conservative management but the patient did not respond the therapy. He succumbed to pneumonia and acute respiratory insufficiency complicated with GVHD, 70days after transplantation.
Anemia, Aplastic* ; Biopsy ; Bone Marrow Transplantation* ; Bone Marrow* ; Colic ; Diarrhea ; Exanthema ; Female ; Gastrointestinal Tract ; Graft Rejection ; Hemorrhage ; Humans ; Ileus ; Leukemia ; Lung Diseases, Interstitial ; Metabolism, Inborn Errors ; Methylprednisolone ; Mortality ; Pneumonia ; Prednisolone ; Respiratory Insufficiency ; Siblings ; Skin ; Transplants

OBJECTIVES: To evaluate MRI findings of non-recurrent hepatocellular carcinomas with lipiodol uptake (LHCCs) treated with transarterial chemoembolization. METHODS: 28 LHCCs were divided into two groups according to amount of lipiodol uptake and tumor size, retrospectively. According to amount of lipiodol uptake, HCCs were classified into group A with dense lipiodol uptake (more than 90%) and group B with partial lipiodol uptake (between 50% and 90%). For HCC size analysis, group I was defined by a longest diameter of less than 2 cm, and group II was defined by a longest diameter of greater than or equal to 2 cm. RESULTS: In group A (n=16), eight LHCCs showed high signal intensity (SI) on T2-weighted images (T2WI), ten LHCCs showed low SI on T1-weighted imaged (T1WI), six LHCCs showed decreased SI at higher b value of diffusion-weighted images (DWI). In group B (n=12), six LHCCs revealed high SI on T2WI, six LHCCs revealed low SI on T1WI, ten LHCCs decreased SI at higher b value of DWI. As compared with tumor size and SI, six of 12 LHCCs in group I and eight of 16 LHCCs in group II showed high SI on T2WI. Six LHCCs in group I and ten LHCCs in group II showed low SI on T1WI. All LHCCs were not enhanced. CONCLUSION: Signal intensities of LHCCs were variable, but more than half of LHCCs showed high SI on T2WI, low SI on T1WI, decreased SI at higher b value of DWI, regardless of lipiodol uptake or tumor size.
Carcinoma, Hepatocellular* ; Ethiodized Oil* ; Magnetic Resonance Imaging* ; Retrospective Studies

Background: To evaluate the degree of deformation in patients with ankle osteoarthritis (OA), it is essential to measure the threedimensional (3D), in other words, stereoscopic alignment of the ankle, subtalar, and foot arches. Generally, measurement of radiological parameters use two-dimensional (2D) anteroposterior and lateral radiographs in a weight-bearing state; however, computeraided 3D analysis (Disior) using weight-bearing cone-beam computed tomography (CBCT) has recently been introduced. Methods: In this study, we compared the 2D human radiographic method with a stereoscopic image in patients with ankle arthritis. We enrolled 57 patients diagnosed with OA (28 left and 29 right) and obtained both standing radiographs and weight-bearing CBCT. Patients were divided by the Takakura stage. The interclass correlation coefficient (ICC) for each result was confirmed. Results: On the ICC between 2D radiographs and 3D analysis, the tibiotalar surface angle and lateral talo-1st metatarsal angle showed a good ICC grade (> 0.6), while other parameters did not have significant ICC results. Three-dimension was superior to radiographs in terms of statistical significance. Conclusions We demonstrated that 2D and stereoscopic images are useful for the diagnosis of OA. Our study also confirmed that the radiographic features affected by ankle OA varied. However, according to the results, the typical radiography is not sufficient to diagnose and determine a treatment plan for ankle OA. Therefore, the method of using 3D images should be considered.

BACKGROUND AND PURPOSE: Restless legs syndrome (RLS) is a sleep disorder that frequently occurs in dialysis patients, which disturbs the sleep and reduces the quality of life. The aim of this study was to determine the risk factors for RLS in dialysis patients. METHODS: Patients who visited any of four outpatient dialysis clinics between September 2005 and May 2006 were included in this study. The diagnosis of RLS and the severity assessment were made using the criteria described by the International Restless Legs Syndrome Study Group. We collected basic demographic data, clinical information, and laboratory findings, and then analyzed their association with various aspects of RLS using univariate and multivariate analyses. RESULTS: RLS was present in 46 (28.0%) of 164 dialysis patients. We found no significant risk factor for inducing RLS. The predialysis serum blood urea nitrogen (BUN) level in the dialysis patients with RLS was significantly correlated with RLS symptom severity. CONCLUSIONS: Predialysis BUN is related to RLS symptom severity. Further studies on the underlying mechanism are needed.
Blood Urea Nitrogen ; Dialysis ; Humans ; Multivariate Analysis ; Outpatients ; Quality of Life ; Renal Dialysis ; Restless Legs Syndrome ; Risk Factors

We describe a 27-year-old man who developed gait disturbance and dysarthria 2 years after the onset of cardinal symptoms of Behcet's disease. Positron emission tomography with 18F-fluorodeoxyglucose revealed severe hypometabolism in the cerebellum, in accordance wih cerebellar symptoms and sign of the patient. However, single-photon emission tomography with Tc-99m-HMPAO and Tc-99m-ECD did not disclose significant perfusion abnormalities in the brain. Routine brain magnetic resonance imaging did not show signal abnormalities. The findings of imaging studies compared with neurological manifestations of the patient are discussed.
Adult ; Brain ; Cerebellum ; Dysarthria ; Gait ; Humans ; Magnetic Resonance Imaging* ; Neurologic Manifestations ; Perfusion ; Positron-Emission Tomography ; Tomography, Emission-Computed, Single-Photon*