A few cases of a dermatosis characterized by "music box spine" keratotic papules limited to the palms and soles have been reported. There have been several names for this dermatosis The Most commonly incorporated term is porokeratosis, but Osman et at suggested the name "spiny keratoderma of palms and soles" because the clinical, histologic and electron microscopic features of this lesion are distinct from porokeratosis. We report a case of spiny keratoderma on the digit showing a single lesion, as a variant of the classic spiny keratoderma of palms and soles.
Porokeratosis ; Skin Diseases

BACKGROUND: Periungual warts are a therapeutic challenge. Many studies have revealed that intralesional interferon α-2b therapy and pulsed dye laser therapy have numerous advantages over other modalities of theratment. OBJECTIVE: The purpose of this study was to determine if combination therapy with intralesional interferon α-2b and pulsed dye laser might offer an effective treatment for periungual warts. METHODS: Thirty-three patients were randomly assigned to one of three study groups. In group A, the patients received both intralesional interferon α-2b treatment and pulsed dye laser(PDL) therapy (n=13). Group B patients were treated wit intralesional interferon α-2b alone (n=10) and group C was done with PDL therapy only (n=10). RESULTS: The clearance rate was 92.3% for the patients treated with the combination therapy of intralesional interferon α-2b treatment and pulsed dye laser (PDL) therapy. It was 50% for the patients with the intralesional interferon α-2b treatment alone, and 0% for the group with the PDL therpy only. No significant side effects were observed. At 6 months after cessation of the therapy, total 2 cases (one from group A and the other from group B) were recurred. CONCLUSION: The combination therapy with intralesional interferon α-2b treatment and pulsed dye laser therapy was highly effective for the treatment of recalcitrant periungual warts.
Humans ; Interferons* ; Lasers, Dye* ; Warts*

No abstract available.
Humans

PURPOSE: This study addressed the feasibility and effect of surgical treatment of metachronous periampullary carcinoma after resection of the primary extrahepatic bile duct cancer. The performance of this secondary curative surgery is not well-documented. METHODS: We reviewed, retrospectively, the medical records of 10 patients who underwent pancreaticoduodenectomy (PD) for secondary periampullary cancer following extrahepatic bileduct cancer resection from 1995 to 2011. RESULTS: The mean age of the 10 patients at the second operation was 61 years (range, 45-70 years). The primary cancers were 7 hilar cholangiocarcinomas, 2 middle common bile duct cancers, and one cystic duct cancer. The secondary cancers were 8 distal common bile duct cancers and 2 carcinomas of the ampulla of Vater. The second operations were 6 Whipple procedures and 4 pylorus-preserving pancreaticoduodenectomies. The mean interval between primary treatment and metachronous periampullary cancer was 20.6 months (range, 3.4-36.6 months). The distal resection margin after primary resection was positive for high grade dysplasia in one patient. Metachronous tumor was confirmed by periampullary pathology in all cases. Four of the 10 patients had delayed gastric emptying (n = 2) or pancreatic fistula (n = 2) after reoperation. There were no perioperative deaths. Median survival after PD was 44.6 months (range, 8.5-120.5 months). CONCLUSION: Based on the postoperative survival rate, PD may provide an acceptable protocol for resection in patients with metachronous periampullary cancer after resection of the extrahepatic bile duct cancer.
Ampulla of Vater ; Bile Ducts, Extrahepatic* ; Cholangiocarcinoma ; Common Bile Duct ; Cystic Duct ; Gastric Emptying ; Humans ; Medical Records ; Neoplasms, Second Primary ; Pancreatic Fistula ; Pancreaticoduodenectomy* ; Pathology ; Reoperation ; Retrospective Studies ; Survival Rate

Isolated fractures of lower sacrum are commonly treated conservatively in most cases because of low energy damage and stable fracture. However, surgical treatment is required in displaced unstable fracture. But the surgical technique is not established and even case reports are not common. We reported a case of displaced transverse fracture of the lower sacrum that was treated with an open reduction and dual plate fixation.

Yacon is used in folk medicines as a medicinal tea for hypoglycemia. In a recent study described herein, anti-oxidative, -bacterial, -fungal activities and cell protective functions of leaf extract of Smallanthus sonchifolius have been reported. In this study, to evaluate the effect on pancreatitis by using yacon extract (YE), we examined the efficacy of YE on DBTC (8 mg/kg)-induced pancreatitis in rats. After the treatment of DBTC on day 21, highly increased inflammatory cells, necrosis of acinar cells and connective tissues were observed. However, the inflammation was strongly inhibited in YE as compared to control group (CON). As a result of immunoreactions against HSP27, HSP70 and MAC387, weak or no possibilities of normal group (NOR) were observed in pancreas, whereas in immunoreactions against HSP27 and HSP70, strong expression of CON was observed in acinar and duct cells on day 14. However, the expression of HSP27 was decreased in acinar cells for CON treatment on day 21 as compared to 14 days observation, whereas strong expression of HSP27 was observed in duct cells and blood vessels on day 21. As regards the immunoreactions against HSP70, weak or no possibilities of CON were observed in duct cells and blood vessels as well as in acinar cells on day 21. In CON, time-dependent increase of MAC387 was observed. However, the expressions of HSP27 and HSP70 were weakly observed in YE as compared to CON on day 14 with strong positive reaction in acinar cells on day 21. Immunoreactions against MAC387 were decreased in YE on day 14 than day 7, which increased on day 21 as compared to day 14. These results suggested that yacon extract has inhibitory and mitigatory effects against DBTC-induced pancreatitis.
Acinar Cells ; Animals ; Beverages ; Blood Vessels ; Connective Tissue ; Hypoglycemia ; Inflammation ; Necrosis ; Pancreas ; Pancreatitis* ; Rats

Erlotinib (Tarceva(R)) is a new anti-cancer agent which acts by inhibiting epidermal growth factor receptor (EGFR) signal transduction. It is currently used in the treatment of advanced stage non-small cell lung cancer and pancreatic cancer. We report a case of acneiform eruption and paronychia induced by erlotinib in a 69-year-old man. The patient visited our clinic with multiple erythematous papules and pustules on the face, periungual erythema and pus discharge, xerosis, fissures on the sole. He had taken erlotinib for the treatment of recurred lung cancer for 4 weeks. The skin lesions were partially improved with oral pyridoxine, corticosteroid and topical antibiotics.
Acneiform Eruptions* ; Aged ; Anti-Bacterial Agents ; Carcinoma, Non-Small-Cell Lung ; Erythema ; Humans ; Lung Neoplasms ; Pancreatic Neoplasms ; Paronychia* ; Pyridoxine ; Receptor, Epidermal Growth Factor ; Signal Transduction ; Skin ; Suppuration ; Erlotinib Hydrochloride

PURPOSE: The aim of this study is to propose a new, simplified formula using an upper incisor-sternal notch (UI-SN) to predict the airway length of optimal positioning of the endotracheal tube via a midsagittal magnetic resonance imaging (MRI) in pediatric patients. METHODS: Between August 2000 and September 2014, a total of 56 pediatric patients (under 8 years old) who underwent MRI for C-spine or whole spine were included for analysis. Variables, such as curved airway length from upper incisor to carina (UI-C), straight length from upper incisor to sternal notch (UI-SN), and from the clivus to sternal notch (C-SN), were measured. Linear regression was used to analyze the relationship among these variables. RESULTS: The average age was 3.5±2.6, and there were 30 (53.6%) males. The mean airway length for UI-C and UI-SN was 16.0±2.8 and 8.8±2.1 cm, respectively. There was a close linear correlation between UI-C and UI-SN (p<0.001). By linear regression, a formula was obtained as UI-C (cm)=1.26×UI-SN (cm)+5.0 (R²=0.873). CONCLUSION: The airway length from the upper incisor to the carina with the head placed in neutral position can be well predicted by a straight length from the upper incisor to the sternal notch. The proposed simplified formula (UI-C=1.26×UI-SN+5, cm) can provide good guidance in determining the optimal positioning of endotracheal tube in pediatric patients.
Cranial Fossa, Posterior ; Head ; Humans ; Incisor ; Intubation ; Linear Models ; Magnetic Resonance Imaging* ; Male ; Pediatrics ; Spine

The pattern reversal visual evoked potential(PRVEP) and flash electroretinogram(flash ERG) were performed in 22 patients with optic atrophy. Patients with ophthalmologic problems other than optic atrophy or with systemic disorders were excluded from the analysis The results are as follows: 1. In the 41 eyes of patients with optic atrophy, 39 of them showed abnormal PRVEP, in which all the eyes had no consistent waveform except in one patient 2 eyes with delayed P1 latency. 2. 13 eyes were abnormal in both PRVEP and flash ERG but no eye was abnomnal in flash ERG only 3, Regarding the flash ERG examination, 13 eyes were abnomlal. Of these, there was a period of 1 to 2 years for 1 eye's disease, a period of 2 to 5 years for another eye' disease and after 5 years 11 eyes were diseased. Therefore, it showed that the longer the duration of disease lasted, the more flash ERG abnormalities developed. 4. The abnormalities of PRVEP haxe no significant relationship with the duration of the disease.
Evoked Potentials, Visual* ; Humans ; Optic Atrophy*

Eccrine poroma is a benign skin appendage tumor originating from the intradermal part of the sweat duct. It is found commonly on the hairless surface of the feet, although eccrine poroma of the hands, head, trunk, and legs have been reported. Histopathologically, the tumor extends from the lower portion of the epidermis into the dermis as broad, anastomosing bands. The tumor cells are smaller than squamous cells, having a uniform cuboidal appearance and a round, deeply basophilic nucleus, connected by intercellular bridges. In eccrine poromas, narrow ducta1 lumina and occasional cystic spaces are found within the tumor bands, but a large cystic space is very unusual. We report a case of eccrine poroma with a large cystic space extending from epidermis into the reticular dermis.
Basophils ; Dermis ; Epidermis ; Foot ; Hand ; Head ; Leg ; Poroma* ; Skin ; Sweat