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

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

Aureobasidium pullulans is classified among dematiaceous fungi, characterized by the production of melanin pigments. It is widely distributed throughout the environment. It has occasionally been infected on the skin and nails of humans. We report a case of onychomycosis due to Aureobasidium pullulans developed in an 49-year-old female after trauma.
Female ; Fungi ; Humans ; Melanins ; Middle Aged ; Onychomycosis* ; Skin

PURPOSE: Although the mechanism of virus-induced, aspirin-exacerbated respiratory disease (AERD) is not known fully, direct activation of viral components through Toll-like receptor 3 (TLR3) has been suggested. TLR3 recognizes double-stranded RNA (dsRNA), and activates nuclear factor-kappaB and increases interferon-gamma, which signals other cells to induce airway inflammation in asthma. Considering the association of TLR3 in viral infections and AERD, we investigated whether promoter and non-synonymous variants of TLR3 were associated with AERD. METHODS: The three study groups, 203 with AERD, 254 with aspirin-tolerant asthma (ATA), and 274 normal healthy controls (NC) were recruited from Ajou University Hospital, Korea. Two polymorphisms, -299698G>T and 293391G>A [Leu412Phe], were genotyped using primer extension methods. RESULTS: Genetic associations were examined between two genetic polymorphisms of TLR3 (-299698G>T and 293391G>A [Leu412Phe]) in the three study groups. AERD patients that carried the GG genotype of 293391G>A showed a significantly lower frequency compared with ATA in both co-dominant (P=0.025) and dominant models (P=0.036). Similarly, in the minor allele frequency, the A allele was significantly higher (P=0.023) in AERD compared with ATA for this polymorphism. AERD patients who carried HT2 [GA] showed a significantly higher frequency than other haplotypes in co-dominant (P=0.02) and recessive (P=0.026) models. CONCLUSIONS: Our findings suggest that the -299698G>T and 293391G>A [Leu412Phe] polymorphisms of the TLR3 gene are associated with the AERD phenotype.
Alleles ; Asthma ; Gene Frequency ; Genotype ; Haplotypes ; Humans ; Inflammation ; Interferon-gamma ; Korea ; Phenotype ; Polymorphism, Genetic ; RNA, Double-Stranded ; Toll-Like Receptor 3 ; Toll-Like Receptors ; Viral Structures

Chromoblastomycosis is a chronic fungal infection of the skin and subcutaneous tissues caused by pigmented or dematiaceous fungi that are implanted into the dermis from the external environment. The vast majority of infections are caused by Fonsecaea pedrosoi and Cladosporium carrionii. Several drugs, such as itraconazole, amphotericin B, terbinafine, have been tried with variable success and various therapeutic techniques, including radiotherapy, cryosurgery, electrodesiccation and surgical excision, can be applied as a further treatment. So far, there are five cases filed as chromoblastomycosis in Korea. Four of them are reported from the southern part of the Korea. Intralesional injection or occlusive dressing of Amphotericin B, and oral administration of intraconazole have been used for the treatment in reported cases. Now, we report firstly a case of chromoblastomycosis treated with terbinafine. A 54-year-old Korean teacher had 10 x 5.5 cm sized dark purple colored plaque with crusts 4 years earlier as a linear plaque after an injury by the thorns of wooden chair. A skin biopsy revealed pseudoepitheliomatous hyperplasia and dermal infiltration of mixed inflammatory cells and Touton type multinucleated giant cells with numerous sclerotic cells. Several clusters of sclerotic bodies were observed also within the giant cells. On the fungus culture, the colony showed slowly growing dark-brown colored heaped appearance in 4 weeks. Isolated fungus was identified as Fonsecaea pedrosoi. Because of partial response to 10 months' itraconazole treatment, the treatment regimen was changed to terbinafine 500 mg/d with marked improvement after 4 months.
Administration, Oral ; Amphotericin B ; Biopsy ; Chromoblastomycosis* ; Cladosporium ; Cryosurgery ; Dermis ; Fungi ; Giant Cells ; Humans ; Hyperplasia ; Injections, Intralesional ; Itraconazole ; Korea ; Middle Aged ; Occlusive Dressings ; Radiotherapy ; Skin ; Subcutaneous Tissue

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

Guanine aminohydrolase(GAH;EC 3. 5. 4. 3.) was partially purified 122-fold from rat cerebrum to a specific activity of 7.22 in its per mg protein with a recovery of 7.47% by fractionation with ammonium sulfate, chromatography on DEAE-cellulose and hydroxyapatite, gel filtration on Sephadex G-200, and isoelectric focusing(pH4-6). The molecular weight of partially purified rat cerebral guanine aminohydrolase was estimated to be 110,000. But, in the cerebral cytosol, a rather higher molecular weight form of the enzyme was identified. The activity of the higher molecular weight form of guanine aminohydrolase was increased by dialyzing the cytosol, and it was converted into the lower molecular weight form(M.W.110,000) by addition of 2-mercaptoethanol. The reaction velocity of partially purified guanine aminohydrolase of rat cerebrum disclosed a hyperbolic curve, with its KM being 6.0uM at pH 8.0. The preparation showed high substrate specificity:among the purine nucleotides, nucleosides and bases with amino group, only guanosine and guanine were deaminated by the enzyme, and the reaction rate of the enzyme displayed by guanosine was less than 10% of that by guanine. When observed under the equimolar concentration of the substrate, hypoxanthine as well as inosine inhibited the activity of the rat cerebral guanine aminohydrolase by 9.4 and 7.8%, respectively, while 5-aminoimidazole-4-carboxamide inhibited the activity of it by 38%. The activity was inhibited by p-hydroxymercuric benzoate as well. Complete loss of its activity was observed after 30 minutes incubation at 60 degrees C, suggesting the preparation was heat labile.
Ammonium Sulfate ; Animals ; Benzoates ; Cerebrum* ; Chromatography ; Chromatography, Gel ; Cytosol ; DEAE-Cellulose ; Durapatite ; Filtration ; Guanine Deaminase* ; Guanine* ; Guanosine ; Hot Temperature ; Hydrogen-Ion Concentration ; Hypoxanthine ; Inosine ; Mercaptoethanol ; Molecular Weight ; Nucleosides ; Purine Nucleotides ; Rats* ; Xanthine Oxidase

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