No abstract available.
Lymphoma, Large-Cell, Anaplastic*

Spontaneous fracture of the Silastic shunt catheter is a rare complication of lumboperitoneal shunt. A review of the literature revealed only one case in which spontaneous fracture occurred after this procedure. The authors report a case in which fracture of a lumboperitoneal shunt catheter occurred within the interspinous ligament probably due to repeated tension caused by flexion and extension during lumbar motion. The fractured proximal catheter was located entirely within the intrathecal space exclusively from the level of L1 to S1, and caused incomplete cauda equina syndrome.
Catheters* ; Fractures, Spontaneous* ; Ligaments ; Polyradiculopathy

BACKGROUND: Alopecia areata(AA) is believed to be an autoimmune disease in which a mononuclear cell infiltrate develops in and around anagen hair follicles. There is no clearly superior therapy in the treatment of AA, especially AA with atopic dermatitis and alopecia universalis. The theory of autoimmune pathogenesis of alopecia areata suggests a potential therapeutic effect of cyclosporin-A(CsA). OBJECTIVE: The purpose of this study is to evaluate the effectiveness of CsA in the treatment of AA. METHOD: 12 patients with severe or refractory AA were treated with DPCP for at least 12 months. They showed resistance to treatment using DPCP. CsA was made up as a 0.01M, 0.005M solution in an ethanol preparation. 1cc of 0.01M CsA solution was applied on the Lt. side scalp and 1cc of 0.005M CsA solution was applied on the Rt. side scalp. The drug was applied once per week. Response to treatment was evaluated as follows: complete recovery, more than a 80% extent of hair regrowth; marked recovery, hair regrowth of 60% to 80%, moderate recovery, hair regrowth of 40% to 60%; slight recovery, hair regrowth of 20% to 40%; no response, hair regrowth of 0% to 20%. RESULT: The Six patients with focal type AA showed a moderate recovery. Of the six patients with alopecia totalis, 4 patients showed a moderate recovery, two patients showed no response. CONCLUSION: Topical CsA therapy is recommended in severe and refractory AA.
Alopecia Areata* ; Alopecia* ; Autoimmune Diseases ; Dermatitis, Atopic ; Ethanol ; Hair ; Hair Follicle ; Humans ; Scalp

OBJECTIVE: To identify the prevalence and risk factors for lower limb lymphedema in the patients after gynecologic neoplasms treatment in Korea. METHODS: We retrospectively reviewed the medical records and interviewed 242 gynecologic neoplasms patients who have managed surgically and medically over a 4 year period between January 2003 and December 2006. We identified the patients with lower limb lymphedema as described by the medical records or reported by the interviews. We obtained demographic characteristics, other medical history, cancer type, stage of cancer, lymph node dissection, chemotherapy, radiotherapy, hormone therapy and laboratory findings. Multiple logistic regression analysis was done to evaluate the risk factors for lower limb lymphedema. RESULTS: Forty eight (19.8%) patients out of two hundred forty two had lower limb lymphedema. Those patients with lower limb lymphedema had a higher body mass index, radiotherapy history, chemotherapy history and lymph node dissection history, radical hysterectomy. Multivariate analysis revealed that body mass index, radiotherapy and lymph node dissection were independently risk factors for lower limb lymphedema after gynecologic neoplasms treatment. CONCLUSION: The patients who had radiotherapy, body mass index greater than 25 or lymph node dissection must be considered as potential candidates to have lower limb lymphedema in the patients after gynecologic neoplasms treatment. Therefore, these patients should be informed during the follow-up period about this morbidity, the preventive measures, and the treatments.
Body Mass Index ; Female ; Follow-Up Studies ; Genital Neoplasms, Female ; Humans ; Hysterectomy ; Korea ; Logistic Models ; Lower Extremity ; Lymph Node Excision ; Lymphedema ; Medical Records ; Multivariate Analysis ; Prevalence ; Retrospective Studies ; Risk Factors

Actinic lichen planus is a particular subtype of lichen planus with a distinct photodistribution. This disease has been variously named lichen planus in subtropical countries, such as lichen planus subtropicus annularis, lichen planus tropicus, summertime actinic lichenoid eruption, and lichenoid melanodermatitis. It is a disorder seen most frequently in Africa, the Middle East, and the Indian subcontinent, favoring Asians. This disease presents in the spring or summer and is frequently quiescent during the winter. A 61-year-old man with unusual lichenoid photosensitive eruption is presented. The lesions developed during the late spring, appearing on both dorsa of hands, wrists, and lower legs. We report a case of actinic lichen planus with a review of the literature.
Actins* ; Africa ; Asian Continental Ancestry Group ; Hand ; Humans ; Leg ; Lichen Planus* ; Lichenoid Eruptions ; Lichens* ; Middle Aged ; Middle East ; Wrist

Chilblain lupus erythematosus (CLE) is a subtype of lupus erythematosus. It is characterized by cutaneous lesions located on the fingers, toes, nose, ears, elbows, heels and knees and is induced or aggravated by exposure to a cold or damp climate. Various laboratory alterations including antinuclear antibody (ANA), anti-dsDNA antibody, anti-SSA/SSB antibody, rheumatoid factor, and cryoglobulin have been reported in CLE patients. Especially, SSA/Ro antibodies may be especially associated with CLE. Approximately 20% of patients presenting with CLE later develop systemic lupus erythematosus (SLE). A 28-year-old man diagnosed with SLE presented with a 2-year history of pruritic erythematous plaques on the ears and dorsa of his hands and feet. The lesions developed or were aggravated the cold weather. In the summer, they were reported to improve, but they did not heal. ANA anti- SSA/SSB antibodies, and anti-dsDNA antibodies were found to be present. He was treated with a topical steroid and advised to avoid the cold.
Adult ; Antibodies* ; Antibodies, Antinuclear ; Chilblains* ; Climate ; Ear ; Elbow ; Fingers ; Foot ; Hand ; Heel ; Humans ; Knee ; Lupus Erythematosus, Systemic ; Nose ; Rheumatoid Factor ; Toes ; Weather

SAPHO syndrome is characterized by sternocostoclavicular osteoarthritis and hyperostosis in the anterior chest wall, and skin changes such as palmoplantar pustulosis and acne. Despite the higher frequency of psoriasis in this syndrome, its inclusion in the psoriatic arthropathy spectrum is not yet clearly established to date. According to a familial series of the SAPHO syndrome, both sacroiliac and sternoclavicular joints could be involved. We report a case of SAPHO Syndrome in a palmoplantar pustulosis patient who had on associated osteoarticular manifestation. A 47-year-old woman had been treated for palmoplantar pustulosis for 15 months. Pain and tenderness then developed abruptly on the chest and neck, and multiple erythematous papules and pustules broke our over the whole body. Laboratory tests were negative for serum RA factor and ANA, and positive for HLA-B27. An X-ray showed a hyperostosis, osteolytic and osteosclerotic lesions in the costo-sterno-clavicular junction. 99mTc isotope scan showed the typical "Bull's head sign" in the anterior chest wall due to increased uptake in the manubrium and both sternoclavicular joints.
Acne Vulgaris ; Acquired Hyperostosis Syndrome* ; Arthritis, Psoriatic ; Female ; Head ; HLA-B27 Antigen ; Humans ; Hyperostosis ; Manubrium ; Middle Aged ; Neck ; Osteoarthritis ; Psoriasis ; Skin ; Sternoclavicular Joint ; Thoracic Wall ; Thorax

BACKGROUND: Ambulatory phlebectomy is a cosmetically elegant outpatient procedure for the removal of varicose veins. One of the keys to its success is the ability to perform the procedure under local anesthesia. Tumescent anesthesia is applied in dermatologic surgery and now being expanded for use in phlebectomy. OBJECTIVE: To evaluate the efficacy and safety as well as advantages of 0.1% tumescent anesthesia with epinephrine in ambulatory phlebectomy. METHODS: Twenty-two patients(twenty-seven legs) without reflux at the SFJ were treated with ambulatory phlebectomy using the tumescent(0.1%) technique. In all patients, we monitored blood pressure, heart rate, and O2 saturation before, during, and after procedure. All patients were asked to rate the pain, both intraoperatively and postoperatively. They visited in hospital to record complications at one day, one week, and various monthly intervals (1, 3, 6, 12 months) following the initial treatment. RESULTS: The volume of anesthetic fluid ranged from 90 to 650ml, with an average of 320.7ml of fluid. Blood pressure, heart rate, and O2 saturation measured did not significantly change before, during, or after procedure. The average reported intraoperative pain for all interviewees was from 0 to 2. For postoperative pain, patients reported pain rate less than one. During operation, significant surgical blood loss is eliminated. There were minimal hematoma, purpura, and hyperpigmentation after operation. CONCLUSION: 0.1% Tumescent anesthesia provides a very safe, comfortable technique of anesthetizing patients for ambulatory phlebectomy and may decrease the incidence of complications.
Anesthesia* ; Anesthesia, Local ; Blood Loss, Surgical ; Blood Pressure ; Dermatologic Surgical Procedures ; Epinephrine ; Heart Rate ; Hematoma ; Humans ; Hyperpigmentation ; Incidence ; Outpatients ; Pain, Postoperative ; Purpura ; Varicose Veins

BACKGROUND: Ambulatory phlebectomy is a cosmetically elegant outpatient procedure for the removal of varicose veins. One of the keys to its success is the ability to perform the procedure under local anesthesia. Tumescent anesthesia is applied in dermatologic surgery and now being expanded for use in phlebectomy. OBJECTIVE: To evaluate the efficacy and safety as well as advantages of 0.1% tumescent anesthesia with epinephrine in ambulatory phlebectomy. METHODS: Twenty-two patients(twenty-seven legs) without reflux at the SFJ were treated with ambulatory phlebectomy using the tumescent(0.1%) technique. In all patients, we monitored blood pressure, heart rate, and O2 saturation before, during, and after procedure. All patients were asked to rate the pain, both intraoperatively and postoperatively. They visited in hospital to record complications at one day, one week, and various monthly intervals (1, 3, 6, 12 months) following the initial treatment. RESULTS: The volume of anesthetic fluid ranged from 90 to 650ml, with an average of 320.7ml of fluid. Blood pressure, heart rate, and O2 saturation measured did not significantly change before, during, or after procedure. The average reported intraoperative pain for all interviewees was from 0 to 2. For postoperative pain, patients reported pain rate less than one. During operation, significant surgical blood loss is eliminated. There were minimal hematoma, purpura, and hyperpigmentation after operation. CONCLUSION: 0.1% Tumescent anesthesia provides a very safe, comfortable technique of anesthetizing patients for ambulatory phlebectomy and may decrease the incidence of complications.
Anesthesia* ; Anesthesia, Local ; Blood Loss, Surgical ; Blood Pressure ; Dermatologic Surgical Procedures ; Epinephrine ; Heart Rate ; Hematoma ; Humans ; Hyperpigmentation ; Incidence ; Outpatients ; Pain, Postoperative ; Purpura ; Varicose Veins

BACKGROUND: Chronic actinic dermatitis (CAD) is a rare disease worldwide. It has been defined on the basis of three criteria: 1) clinical - a persistent eczematous eruption on sun- exposed area with possible extension into non-exposed areas, 2) photobiological - a reduction in the minimal erythema dose to UVB irradiation, and possibly longer wavelengths, and 3) histologic - an appearance consistent with chronic eczema, with or without the presence of lymphoma-like changes. However, only a few clinicohistopathologic and photobiological analyses of CAD have been undertaken in Korea. OBJECTIVE: To explore photoallergens and/or allergens causing or thought to be associated with CAD in Korean patients, and to compare the photopatch or patch test results in Korea with those from other countries. METHODS: Thirty-five Korean patients with CAD were enrolled for this study. Photopatch tests were carried out by applying two sets of the Scandinavian photopatch series to each patient. Two days after application, the photopatch tests were analysed, and one set of the photoallergens was irradiated with 50% of the MED-UVA. Both sets of photoallergens were examined 2 days later. A European standard series was used to assess the patch tests. At two and four days after application, patch tests were analysed. RESULT: Twenty-seven of the 35 patients (77.1%) who had photopatch tests showed positive responses; balsam of Peru, promethazine HCl, perfume mix, fentichlor, chlorhexidine digluconate, and chlorpromazine HCl were the common photoallergens that elicited a positive response. Twenty-one of the 35 patients (70%) showed allergy to nickel, chrome, and/or ammoniated mercury. Noticeably, photoallergens such as balsam of Peru, perfume mix, cobalt, and captan revealed positive reactions in the patch tests, too. CONCLUSION: In 77.1% and 74.3% of CAD patients, photoallergens and allergens were identified, respectively. Among them, 57.1% showed positive reactions including both photopatch and patch tests. After the most frequent photoallergens, perfume and spices, and phenothiazines or related antihistamines ranked next and were found to be a unique characteristic to Korea. Photopatch and patchtests are the method for detecting photoallergens and allergens as important initiating agents and are the diagnostic tool for the epidemiologic study of CAD.
Allergens ; Captan ; Chlorhexidine ; Chlorpromazine ; Cobalt ; Eczema ; Epidemiologic Studies ; Erythema ; Histamine Antagonists ; Humans ; Hypersensitivity ; Korea ; Nickel ; Patch Tests* ; Perfume ; Peru ; Phenothiazines ; Photosensitivity Disorders* ; Promethazine ; Rare Diseases ; Spices