No abstract available.
Denture, Partial, Fixed*

We have experienced a case of neurofibromatosis with unusual giant pigmentation, which presents itself as a 28 cm x 40 cm sized, serrated bordered light brownish patch speckled with small dark hyperpigmented macules on his back. Histopathologic examinations of light brown patch and speckles showed only an increase in basal melanin pigmentation.
Melanins ; Neurofibromatoses* ; Pigmentation*

BACKGROUND: In patients with severe chronic lung diseases even a small pneumothorax can result in life-threatening respiratory distress. It is important to treat the attack by chest tube drainage until the lung expands. Pneumothorax with a persistent air leak that does not resolve under prolonged tube thoracostomy suction is usually treated by open operation to excise or oversew a bulla or cluster of blebs to stop the air leak. Pleurodesis by the instillation of chemical agents is used for the patient who has persistent air leak and is not good candidate for surgical treatment. When the primary trial of pleurodesis with common agent fails, it is uncertain which agent should be used f or stopping the air leak by pleurodesis. It is well known tbat inappropriate drainage of hemothorax results in severe pleural adhesion and thickening. Based on this idea, some reports described a successful treatment with autologous blood instillation for pneumothorax patients with or without residual pleural space. We tried pleurodesis with autologous blood for pneumothorax with persistent air leak and then we evaluated the efficacy and safety. METHODS: Fifteen patients who had persistent air leak in the pneumothorax complicated from the severe chronic lung disease were enrolled. They were not good candidates for surgical treatment and doxycycline pleurodesis failed to stop up their air leaks. We used a mixture of autologous blood and 50% dextrose for pleurodesis. Effect and complications were assessed by clinical outcome, chest radiography and pulmonary function tests. RESULTS: The mean duration of air leak was 18.4 :1:6.16 days before ABP (autologous blood and dextrose pleurodesis) and 5.2 ± 1.68 days after ABP, The mean severity of pain was 2.3 ± 0.70 for DP(doxycycline pleurodesis) and 1.7 ± 0.59 for ABDP (p<0.05). There was no other complication except mild fever. Pleural adhesion grade was a mean of 0.6 ± 0.63. The mean dyspnea scale was 1.7 ± 0.46 before pneumothrax and 2.0 ± 0.59 after ABDP (p>0.05). The mean FEV1 was 1.47 ± 1.01 before pneumothorax and 1.44 ± 1.00 after ABDP (p>0.05). Exɡpt in 1 patient, 14 patients had no recurrent pneumothorax. CONCLUSION: Autologous blood pleurodesis (ABP) was successful for treatment of persistent air leak in the pneumothorax. It was easy and inexpensive and involved less pain than doxycycline pleurodesis. It did not cause complications and severe pleural adhesion. We report that ABP can be considered as a useful treatment for persistent air leak in the pneumothorax complicated from the severe chronic lung disease.
Blister ; Chest Tubes ; Doxycycline ; Drainage ; Dyspnea ; Fever ; Glucose ; Hemothorax ; Humans ; Lung ; Lung Diseases ; Pleurodesis* ; Pneumothorax* ; Radiography ; Respiratory Function Tests ; Suction ; Thoracostomy ; Thorax

PURPOSE: To evaluate changes of pancreatic size with aging in control subjects and in non-insulin-dependent diabetic patients. MATERIALS AND METHODS: Two groups of non-insulin-dependent diabetic patients were examined; one had been treated with an oral hypoglycemic agent(n=59), and the other with insulin(n=56). The CT findings of 175 patients without clinical evidence of pancreatic disease were included as a normal control. RESULTS: In control subjects, pancreatic size and age correlated. The pancreas was smaller in non-insulin-dependent diabetics than incontrol subjects and smaller in insulin- treated non-insulin-dependent diabetics than in non-insulin treated patients. CONCLUSION: The pancreas was smaller in non-insulin-dependent diabetic patients than in control subjects within the same age range.
Aging ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Humans ; Pancreas* ; Pancreatic Diseases

We report two cases of angiokeratoma circumcriptum. One of them was 20 year- old male, who had multiple dark erythematous 0.5 cm to 2 cm sized keratotic papules and nodules surrounding irregular shaped erythema scattered or grouped on the right lower leg. The other case was 36 year-old male, who had Q. 7 cm sized dark erythematous papules and 2 cm sized dark brown colored nodule with central ulceration on the medial part of the left upper thigh, The two patients had skin lesions at birth. Histopathologic finding disclosed markedly dilated vessels containing many red blood cells mainly in the papillary dermis, which in some, were surrounded by elongated rete ridge. Cavernous hemangioma like lesion was present in the lower dermis and subcutaneous fat in case 2.
Adult ; Angiokeratoma* ; Dermis ; Erythema ; Erythrocytes ; Hemangioma, Cavernous ; Humans ; Leg ; Male ; Parturition ; Skin ; Subcutaneous Fat ; Thigh ; Ulcer

Objectives: Cognitive behavioral therapy for insomnia (CBT-I) is the first line treatment for insomnia. However, many patients remain with sleep disturbances even after undergoing CBT-I, and those with short sleep durations have shown fewer gains. Acceptance and commitment therapy (ACT) is one of the third wave of behavioral therapies, and it is useful in helping patients get flexibility of mind. Therefore, we incorporated its components into CBT-I, came up with an advanced CBT-I program that involves cognitive behavior therapy based on ACT, and examined its efficacy in comparison to that of CBT-I. Methods: Patients with chronic primary insomnia were recruited at the memory center of CHA University Hospital from June to August 2020. To examine the efficacy of advanced CBT-I compared to that of CBT-I, the patients (n=16) were assigned to two groups (CBT-I: n=6; advanced CBT-I: n=10). The patients in each group were treated for 4 weeks (8 sessions). The quality of sleep, severity of insomnia, sleepiness, depression, anxiety, acceptance, efforts to sleep, and dysfunctional beliefs concerning sleep were assessed with self-report questionnaires. Results: The severity of insomnia, quality of sleep, depression, anxiety, acceptance, efforts to sleep, and dysfunctional beliefs concerning sleep improved after both CBT-I and advanced CBT-I treatment. Conclusions This study examined the efficacy of advanced CBT-I in improving the severity of insomnia, sleep quality, and other symptoms related to sleep. The results suggest that components of ACT were useful for insomnia.

Objectives: Cognitive behavioral therapy for insomnia (CBT-I) is the first line treatment for insomnia. However, many patients remain with sleep disturbances even after undergoing CBT-I, and those with short sleep durations have shown fewer gains. Acceptance and commitment therapy (ACT) is one of the third wave of behavioral therapies, and it is useful in helping patients get flexibility of mind. Therefore, we incorporated its components into CBT-I, came up with an advanced CBT-I program that involves cognitive behavior therapy based on ACT, and examined its efficacy in comparison to that of CBT-I. Methods: Patients with chronic primary insomnia were recruited at the memory center of CHA University Hospital from June to August 2020. To examine the efficacy of advanced CBT-I compared to that of CBT-I, the patients (n=16) were assigned to two groups (CBT-I: n=6; advanced CBT-I: n=10). The patients in each group were treated for 4 weeks (8 sessions). The quality of sleep, severity of insomnia, sleepiness, depression, anxiety, acceptance, efforts to sleep, and dysfunctional beliefs concerning sleep were assessed with self-report questionnaires. Results: The severity of insomnia, quality of sleep, depression, anxiety, acceptance, efforts to sleep, and dysfunctional beliefs concerning sleep improved after both CBT-I and advanced CBT-I treatment. Conclusions This study examined the efficacy of advanced CBT-I in improving the severity of insomnia, sleep quality, and other symptoms related to sleep. The results suggest that components of ACT were useful for insomnia.

Craniosysostosis syndrome is caused by premature fusion of bones of skull and face during fetal development. It is related to Fibroblast growth factor receptor gene and most common craniosynostosis syndromes are Apert, Pfeiffer and Crouzon. Apert syndrome is one of the severe type of craniosynostosis syndromes which shows mutations in the Fibroblast growth factor receptor 2 (FGFR2) gene. Pfeiffer syndrome is also related with FGFR 1 or 2 gene mutation. We experienced two patients with craniosynostosis syndromes, Apert syndrome and Pfeiffer syndrome. The first baby was a in-born female baby presented with syndactly of the hands and feet and facial dysmorphism including shallow orbit with deep crease above eye brow. Apert syndrome was confirmed by the presence of a mutation in FGFR2. The second patient visited our developmental delay clinic due to developmental delay at seven month old age. He showed facial dysmorphism including cloverleaf-shaped skull, micrognathia, low set ears, low nasal bridge and high-arched palate, but there were no syndactly or limb anomalies. He was suspected of Pfeiffer syndrome, however his FGFR2 gene study was normal. These patients need multidisciplinary team management and regular follow up for visual, auditory, and cognitive development functions Pediatricians have important role on recognizing the patients with facial dysmorphism, planning to evaluate accompanying anomalies and making appropriate decisions about the timing of surgical management to minimize growth and cognitive impairments.
Acrocephalosyndactylia ; Craniosynostoses ; Ear ; Extremities ; Female ; Fetal Development ; Follow-Up Studies ; Foot ; Hand ; Humans ; Orbit ; Palate ; Receptor, Fibroblast Growth Factor, Type 2 ; Receptors, Fibroblast Growth Factor ; Skull

Erythema nodosum has been known to be frequently associated with some kind of drug, infections with streptococci, mycobacteria, lymphogranuloma venerum and certain unknown pathogenic processes such as sarcoidosis, iilcerative colitis and regional enteritis. However, the association of erythema nodosum with leukemia has rarely been reported. Erythema nodosum with leukemia has been divided into leukemia cutis with specific infiltration of atypical leukemic cells and leukemid with non specific infiltration of normal infilammatory cells. We report herein a case of the very rare but typical erythema nodesum showing nonspecific infiltrative panniculitis as an initial manifestation of chronic myelocytic leukemia.
Colitis ; Crohn Disease ; Erythema Nodosum* ; Erythema* ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Panniculitis ; Sarcoidosis

Secondary cutaneous cryptococcosis may occur earlier than other manifestations of disseminated cryptococcosis. A 68-year-old woman presented with multiple ulcerative lesions on the right calf of 2 weeks duration. She had been treated with antibiotics, but the lesions spread rapidly. The initial clinical impression was necrotizing fasciitis, but routine KOH mounting from the ulcerative lesions showed numerous budding yeast cells with peripheral clear zones and further investigations including a skin biopsy, tissue cultures and India ink preparations allowed a rapid and definitive diagnosis of cutaneous cryptococcosis. Studies for other evidence of infection elsewhere revealed an asymptomatic pulmonary lesion. We report a case of secondary cutaneous cryptococcosis clinically mimicking necrotizing fasciitis that occured before other manifestations of disseminated cryptococcosis.
Aged ; Anti-Bacterial Agents ; Biopsy ; Cryptococcosis* ; Diagnosis ; Fasciitis, Necrotizing* ; Female ; Humans ; India ; Ink ; Saccharomycetales ; Skin ; Ulcer