Midline malignant reticulosis is a relentlessly progressive, localized, destructive inflammatory process of upper respiratory tract including the nose, nasopharynx, palate, paranasal sinuses, and midface. Histologically, it is characterized by a dense aceumulation of pleomorphic mononuclear cells with an admixture of inflammatory cells. We report a case of midline malignant reticulosis developed in a 64-year-old man, who showed a serosanguineous nasal discharge, perforation of nasal septum, persistent ulceration of hard palate, and disseminated lesions on the abdominal skin, which was confirmed by histopathalogical examination. In addition we studied infiltrated cells with atypical nuclei by immunohistochemical staining with a pannel of monoclonal antibodies. The results revealed that the atypical cells expressed the T-cell marker, but not the macrophage and B-cell marker.
Antibodies, Monoclonal ; B-Lymphocytes ; Humans ; Macrophages ; Middle Aged ; Nasal Septum ; Nasopharynx ; Neoplasm Metastasis* ; Nose ; Palate ; Palate, Hard ; Paranasal Sinuses ; Respiratory System ; Skin* ; T-Lymphocytes ; Ulcer

Eczema herpeticum is a herpes simplex virus infection with disseminated skin involvement superimposed on a pre-existing dermatosis. Dariers disease has been reported to be among the dermatoses susceptible to the sudden onset of a widespread vesicular eruption accompanied by high fever known as Kaposis varicelliform eruption. We report a case of eczema herpeticum in a 46-year-old woman associated with Dariers disease.
Darier Disease* ; Eczema* ; Female ; Fever ; Humans ; Kaposi Varicelliform Eruption* ; Middle Aged ; Simplexvirus ; Skin ; Skin Diseases

BACKGROUND: Recently, inireaing numbers of chemotherapeutic agens are being used to treat cancer patients. Mucocutaeous complications are commonly sen in association with the administration of these medicaticins. OBJECTIVE: We conducted a study in cancer chemotherapy patient so determine the suspected chemotherapeutic agents ancl frequency of various mucocutaneous side effects in these patients. METHODS: The study involved 140 patients admitted from Decerrae 1993 to September 1994 for cancer chemot herapy at Korea University Guro Hospital. RESULTS: The mucocutaneous side effects during chemotherapy were alopecia(55%), hyperpig mentation(32.9%), stomatitis(20%), phlebitis(12.9%), flushing(8.6%) descending order. Visual grade II, IV alopecia patients were most common, but as the chemot retpy cycle increased so, the severer the alopecia. Although the onset of the alopecia were variake many patients experienced alopcia within 17 to 24 days after the start of chemotherapy. Serpeitie supravenous fluorouracil hyperpigmentation were commor,(17.9%), Diffuse and longitudinal or horizontal band like nail pigmentation were observed, and, pigmented macules were also observei, epecially on the palms and digits. Stomatitis usually developed within 10 days after the start of chemotherapy and it persist ed for about 7 days and the most of the lesions were resolved spor Laeously. Other clinical manifestations accompanied with chmotherapy were tinea infection(16.4%), acne(7.1%), oral thrush (7%), white nail band(4.3%), pruritus(2.9%) in descending order. CONCLUSION: So, physiciars need to be aware of the widely divergnal cutaneous reactions which may occur with the use of antiancer medications.
Alopecia ; Candidiasis, Oral ; Drug Therapy* ; Fluorouracil ; Humans ; Hyperpigmentation ; Korea ; Pigmentation ; Stomatitis ; Tinea

PURPOSE: To report the clinical, radiological and surgical findings of iliopsoas bursitis, and to suggest an indication for diagnosis and treatment. MATERIALS AND METHODS: We report two patients with iliopsoas bursitis who underwent THA in between June 1998 to June 2003. All presented with late onset hip joint discomfort, and their diagnosis were confirmed after interdepartmental consultations and with the help of investigations such as interventional angiography and MRI. Their signs, symptoms, investigations and surgical findings were reviewed retrospectively. RESULTS: Iliopsoas bursitis presented with hip pain, leg edema, palpable inguinal mass and ecchymosis, femoral nerve irritation and flexion contracture of hip. The radiographs provided no diagnostic clues but the MRI revealed a well marginated cystic lesion filled with fluid signals. Ultrasonography revealed the anatomic location that enabled guided aspiration and even ruled out vascular compromise. Two patients were treated with USG guided aspiration. One aspirate was serosanguinous and the other was old blood tinged fluid. One patient underwent surgical debridement of the cyst. Surgery revealed an intrapelvic hemorrhagic bursa with an ill-defined cystic wall and intramuscular extension into the iliacus. CONCLUSION: It is important for surgeons to rule out iliopsoas bursitis when a patient presents with vague hip pain after total hip arthroplasty without any evidence of infection or loosening. A diagnosis of iliopsoas bursitis can be made from the clinical features and ultrasonography.
Angiography ; Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Bursitis* ; Contracture ; Debridement ; Diagnosis ; Ecchymosis ; Edema ; Femoral Nerve ; Hip ; Hip Joint ; Humans ; Leg ; Magnetic Resonance Imaging ; Referral and Consultation ; Retrospective Studies ; Tolnaftate ; Ultrasonography

Follicular hamartoma is a rare, benign adnexal tumor with varieties of clinical diversity. But, Histological feature is characterized by a proliferation of immature hair follicle in the dermis with multifocal islands and thickened perifollicular sheath. Pili multigemini is also a rare, developmental anomaly of hair growth with multiple hairs from two or more matrices and papillae in a single pilosebaceous unit. Its prevalence and pathogenesis are unknown. We describe herein a rare case of localized follicular hamartoma with pili multigemini suggesting the possibility of association on pathogenesis between them.
Dermis ; Hair ; Hair Follicle ; Hamartoma* ; Islands ; Prevalence

Reiter`s disease can no longer be considerded a rare and relatively benign syndrome, defined by the clinical triad of urethritis, conjunctivitis and arthritis. In the etiology of Reiter`s disease, it can be regarded as a post-infectious syndrome after certain enteric disease or veneral infection and usually occurs in patients between 20 and 40 years old, with a male to female ratio of 10:1 in dysenteric cases and 50:1 in veneral cases. The diagnosis of Reiter`s disease should quite obious when the clinical manifestation of non specific urethritis, conjunctivitis, arthritis and mucocutaneous lesions. Recently, HLA-B27 antigen is strogly associated with Reiter`s syndrome and may be diagnosticlly useful when HLA-B27 is positive. There is no specific therapy for Reiter`s disease, but conservative treatement is aviable of acute stage oir recurrence of the disease. We have experienced a case of Reiter`s syndrome in 27 years old male and reproted with review of some literatures.
Adult ; Arthritis ; Conjunctivitis ; Diagnosis ; Female ; HLA-B27 Antigen ; Humans ; Male ; Recurrence ; Urethritis

Reported herein is a case of recurrent major depression with impulse control difficulty in a 33-year-old man with Dandy-Walker variant. He was diagnosed as having major depressive disorder a year before he presented himself to the authors' hospital, and had a history of three-time admission to a psychiatric unit in the previous 12 months. He was readmitted and treated with sodium valporate 1,500 mg/day, mirtazapine 45 mg/day, and quetiapine 800 mg/day during the three months that he was confined in the authors' hospital, and the symptoms were reduced within three months but remained thereafter. This is the only case so far reporting recurrent depression with impulse control difficulty associated with Dandy-Walker variant. This case implies that any cerebellar lesion may cause the appearance of recurrent depression with impulse control difficulty in major depressive disorder.
Adult ; Aggression ; Cerebellar Diseases ; Cerebellum ; Dandy-Walker Syndrome* ; Depression* ; Depressive Disorder, Major ; Dibenzothiazepines ; Humans ; Impulsive Behavior* ; Mianserin ; Valproic Acid ; Quetiapine Fumarate

OBJECTIVE: This study was performed to determine the anatomical landmarks and optimal dissection points of the facial nerve (FN) and the hypoglossal nerve (HGN) in the submandibular region to provide guidance for hypoglossal-facial nerve anastomosis (HFNA). METHODS: Twenty-nine specimens were obtained from 15 formalin-fixed adult cadavers. Distances were measured based on the mastoid process tip (MPT), common carotid artery bifurcation (CCAB), and the digastric muscle posterior belly (DMPB). RESULTS: The shortest distance from the MPT to the stylomastoid foramen was 14.1+/-2.9 mm. The distance from the MPT to the FN origin was 8.6+/-2.8 mm anteriorly and 5.9+/-2.8 mm superiorly. The distance from the CCAB to the crossing point of the HGN and the internal carotid artery was 18.5+/-6.7 mm, and that to the crossing point of the HGN and the external carotid artery was 15.1+/-5.7 mm. The distance from the CCAB to the HGN bifurcation was 26.6+/-7.5 mm. The distance from the digastric groove to the HGN, which was found under the DMPB, was about 35.8+/-5.7 mm. The distance from the digastric groove to the HGN, which was found under the DMPB, corresponded to about 65.5% of the whole length of the DMPB. CONCLUSION: This study provides useful information regarding the morphometric anatomy of the submandibular region, and the presented morphological data on the nerves and surrounding structures will aid in understanding the anatomical structures more accurately to prevent complications of HFNA.
Adult ; Cadaver ; Carotid Artery, Common ; Carotid Artery, External ; Carotid Artery, Internal ; Facial Nerve ; Humans ; Hypoglossal Nerve ; Mastoid ; Muscles

The treatment of bilateral vertebral artery dissecting aneurysms (VADAs) presenting with subarachnoid hemorrhage (SAH) is still challenging. The authors report a rare case of bilateral VADA treated with coil trapping of ruptured VADA and covered stents implantation after multiple unsuccessful stent assisted coiling of the contralateral unruptured VADA. A 44-year-old woman was admitted to our hospital because of severe headache and sudden stuporous consciousness. Brain CT showed thick SAH and intraventricular hemorrhage. Cerebral angiography demonstrated bilateral VADA. Based on the SAH pattern and aneurysm configurations, the right VADA was considered ruptured. This was trapped with endovascular coils without difficulty. One month later, the contralateral unruptured VADA was protected using a stent-within-a-stent technique, but marked enlargement of the left VADA was detected by 8-months follow-up angiography. Subsequently two times coil packing for pseudosacs resulted in near complete occlusion of left VADA. However, it continued to grow. Covered stents graft below the posterior inferior cerebellar artery (PICA) origin and a coronary stent implantation across the origin of the PICA resulted in near complete obliteration of the VADA. Covered stent graft can be used as a last therapeutic option for the management of VADA, which requires absolute preservation of VA flow.
Adult ; Aneurysm ; Aneurysm, Dissecting ; Angiography ; Arteries ; Brain ; Cerebral Angiography ; Consciousness ; Female ; Follow-Up Studies ; Headache ; Hemorrhage ; Humans ; Pica ; Stents ; Stupor ; Subarachnoid Hemorrhage ; Transplants ; Vertebral Artery