We present a case of pemphigus vulgaris developed during pregnancy. The clinical features of this patient were similar to those of hetpes gestationis. By immunofluorescence studies we found that the patient's serum contained autoantibodies to intercellular substance of epidermis. Direct immunofluorescence microscopy of a perilesional skin also demontrated immunoglobulin deposition in the intercellular areas. Additionally we did in vitro C3 staining for further confirmation of the diagnosis but it was negative in basement membrane zone. This patient was initially treated with corticosteroid and azathioprine. Several months later gold compound was given instead of azathioprine and corticosteroid with good therapeutic response.
Autoantibodies ; Azathioprine ; Basement Membrane ; Diagnosis ; Epidermis ; Fluorescent Antibody Technique ; Fluorescent Antibody Technique, Direct ; Humans ; Immunoglobulins ; Microscopy ; Pemphigus* ; Pregnancy* ; Skin

No abstract available.
Humans ; Hypocalcemia* ; Infant*

Three cases of hydatidiform mole with a coexisting fetus are described. In two cases, flow cytometric analysis of nuclear DNA content from paraffin-embedded, molar tissues and normal-appearing placental tissues showed diploid pattern. One case had karyotypes of 46, XX both in fetal skin fibroblasts and in molar tissues. Microscopically, the villi showed diffuse hydropic swelling with circumferential trophoblastic proliferations and consistent with the diagnosis of complete mole. Two patient had persistent gestational trophoblastic neoplasia on the follow-up. Therefore, in cases of hydatidiform mole with a coexisting fetus, dizygotic twin pregnancies composed of a normal pregnancy from one ovum and a complete mole pregnancy from the other ovum must be considered and the patients should be followed with serum beta-hCG measurements.
Pregnancy ; Female ; Humans

We present 6 patients with systemic lupus erythematosus who had papulosquamous skin lesions. These skin lesions were consistent with the findings of subacute cutaenous lupus erythematosus(SCLE) clinically and histopathologically. The. distribution of the skin lesions were on the face, upper extremities and upper trunk in one group, and the upper and lower extremities in other group of these patients. After confirmation of the skin lesions as a type of SCLE, they were regressed with anti-malarial and/or systemic corticosteroids, within 2 months in all patients. For the better management of the patient with lupus erythematosus, understanding of clinically distinct LE-specific skin lesions, including the papulosquamous cuta-neous manifestation of SCLE, may be necessary.
Adrenal Cortex Hormones ; Humans ; Lower Extremity ; Lupus Erythematosus, Systemic* ; Skin* ; Upper Extremity

No abstract available.
Thioctic Acid*

Ossification of the ligamentum flavum(OLF) is a well recognized cause of acquired spinal canal stenosis resulting in myelopathy, radiculopathy, or a combination of both. OLF is extremely rare in caucasian patients, but is one of the most common causes of compression of the posterior thoracic spinal cord in Japan. In most cases, it has been found in the thoracolumbar regions, and rarely in the cervical region. It is frequently but not alwalys found in association with ossification of the posterior longitudinal ligament(OPLL) and may cause cumulative damage, if comhined with OPLL. We experienced a case of ossification of the ligamentum flavum and posterior longitudinal ligament with sacral radiculopathy, which was treated hy posterior decompressive laminectomy and removal of the ossified ligamentum flavum and posterior longitudinal ligament. The day after operation, the radiating pain and paresthesia dramatically improved.
Constriction, Pathologic ; Humans ; Japan ; Laminectomy ; Ligamentum Flavum* ; Longitudinal Ligaments* ; Paresthesia ; Radiculopathy* ; Spinal Canal ; Spinal Cord ; Spinal Cord Diseases

BACKGROUND AND PURPOSE: Multiple sclerosis (MS) in Asians is characterized by frequent involvement of the spinal cord and optic nerve and low prevalence rates, but even the most fundamental epidemiologic findings and unique clinical features of MS patients in Korea have not been studied extensively. We performed this study to establish the clinical spectrum of MS patients in Korea. METHODS: Sixty-two MS patients (25 men and 37 women) who satisfied the diagnostic criteria for definite MS were reviewed retrospectively using medical records from two university hospitals and one general hospital. The MS patients were classified into the three clinical subtypes according to the involved site (opticospinal, spinal, and conventional MS). RESULTS: The age at MS onset was 35.2+/-13.3 (mean+/-SD) years, and the predominant initial clinical manifestations were myelopathy (54.8%) and optic neuropathy (33.9%). The single most common involved lesion site was the spinal cord (35.5%). Spinal (35.5%) and opticospinal (25.8%) MS were the most common type, and they had a frequent relapsing-remitting course and long lesions extending over two vertebral segments (as assessed using spinal cord MRI). The interval between the first symptom and relapse was 35.6+/-71.1 months, and the number of relapses was 3.8+/-2.6. The spinal form of MS was associated with a higher age at onset and a higher male-to-female ratio than the other types. Positive rates of CSF oligoclonal bands and IgG index and the number of patients with characteristic brain MRI lesions were low. However, the abnormal rate of visual evoked potentials was relatively high (64.4%). CONCLUSION: The clinical features of MS patients in Korea are different from those in Western patients, but similar to those in Far East Asian patients. The value of the various diagnostic tools used for MS should therefore be reevaluated, at least for Korean patients.
Asian Continental Ancestry Group ; Brain ; Evoked Potentials, Visual ; Far East ; Hospitals, General ; Hospitals, University ; Humans ; Immunoglobulin G ; Korea* ; Magnetic Resonance Imaging ; Male ; Medical Records ; Multiple Sclerosis* ; Oligoclonal Bands ; Optic Nerve ; Optic Nerve Diseases ; Optic Neuritis ; Prevalence ; Recurrence ; Retrospective Studies ; Spinal Cord ; Spinal Cord Diseases

No abstract available.
Airway Resistance* ; Respiration*

Retroperitoneal cystic lymphangioma is a rare benign tumor which had previously been difficult to diagnose preoperatively by conventional radiographic technique(1). Recent reports describe the computed tomographic and ultrasonographic findings in cystic lymphangioma(1,2). We report a case of retroperitoneal cystic lymphangioma, accurately diagnosed by lymphography, with computed tomographic findings and percutaneous drainage findings. To the best of out knowledge, this is the most aged case of retroperitoneal cystic lymphangioma of preoperatively diagnosed.
Drainage ; Lymphangioma, Cystic* ; Lymphography

OBJECTIVE: The aims of this study were to evaluate the common gastrointestinal problems, diet and bowel care patterns, and to estimate the colon transit time in spinal cord injury (SCI). METHOD: Fifteen chronic spinal cord injured persons with upper motor neuron type neurogenic bowel were studied by measuring the colonic transit time and interviews. The colon transit time was studied by using radioopaque markers. RESULTS: Mean total colonic transit time was 43.79 h with right colonic transit time 13.71 h, left colonic transit time 20.36 h, and rectosigmoid colonic transit time 9.71 h. The right colonic transit time was delayed in 35.7% of the subjects, left colonic transit time in 64.3%, and rectosigmoid colonic transit time in 21.4%. The common gastrointestinal problem in SCI were constipation (66.7%). The defecation difficulty (73.3%) was the most significant subjective symptom. Delayed colonic transit time was shown in 80% of perceived 'constipation' group. The average time spent for the defecation was 64.7 minutes per day. 73.3% of the subjects did not control the diet. CONCLUSION: Spinal cord injured persons of upper motor neuron type neurogenic bowel in Korea showed significantly delayed colonic transit time than non SCI adults, similar delayed colon transit time as Western SCI persons who consume less fibers in daily diets.
Adult ; Colon* ; Constipation ; Defecation ; Diet ; Humans ; Korea ; Motor Neurons* ; Neurogenic Bowel* ; Spinal Cord Injuries* ; Spinal Cord*