Photodynamic therapy(PDT) is a treatment modality by highly reactive oxygen intermediates generated through the interaction of light with a photosensiziter. It has been shown to be an effective treatment for various cutaneous and noncutaneous malignancies. It is efficient for the curative and palliative treatment of epithelial skin tumor in situ or early invasive lesions. In effect, it is a useful alternative treatment for the lesions located on anatomically difficult areas or the large-sized lesions. We treated a case of Bowen's disease arising on the plantar area and 3rd and 4th toewebs of left forefoot in a 61-year-old man with PDT using the hematoporphyrin derivative, porfirmer sodium(Photofrin, Russia) as a photosensitizer and gold vapor laser as a visible light source. The outcome showed partial clinical improvement after about 2 months' follow-up.
Bowen's Disease* ; Follow-Up Studies ; Hematoporphyrin Derivative ; Humans ; Lasers, Gas ; Light ; Middle Aged ; Oxygen ; Palliative Care ; Photochemotherapy* ; Skin

OBJECTIVE: Among risk factors associated with cerebral infarction, cardiac factors are well known to be very important. However there were only few studies related to correlation between cardiac risk factors and stroke recurrence. So we tried to evaluate cardiac disease as a risk factor of recurrent cerebral infarction. METHOD: Subjects were 118 patients (62 male, 56 female) with cerebral infarction and were divided into first attack group as a control and recurred group. We evaluated the results of transesophageal echocardiographic study and other major risk factors and the results were compared in two groups using X2 test. RESULTS: Control group was 75 patients (39 male, 36 female), and recurred group was 43 patients (23 male, 20 female) and the mean ages were 62.8 years and 66.7 years, respectively. General transesophageal echocardiographic abnormalities were shown in 63 cases (84%) in control group and 40 cases (93%) in recurred group. Among the abnormal transesophageal echocardiographic findings, atherosclerosis of aorta was significantly higher in recurred group (49%) compared to control group (25%) (p<0.05), but there were no significant difference in aortic valve calcification, mitral calcification etc. Among the major risk factors of cerebral infarction, hypertension, diabetes, hyperlipidemia, and alcohol intake showed tendency of high incidence in the recurred group. Patients with abnormal EKG findings concurrent with abnormal transesophageal echocardiographic findings showed in 33 cases (44%) in control group, and 24 cases (56%) in recurred group, but there's no statistical significance. CONCLUSION: Our results do not support the hypothesis that TEE would be able to diagnose the cardiac risk factor for recurred cerebral infarction. However, the prevalence of atherosclerosis of aorta was significantly higher in recurrent group, so further studies would be needed.
Aorta ; Aortic Valve ; Atherosclerosis ; Cerebral Infarction* ; Echocardiography ; Echocardiography, Transesophageal* ; Electrocardiography ; Heart Diseases ; Humans ; Hyperlipidemias ; Hypertension ; Incidence ; Male ; Prevalence ; Recurrence ; Risk Factors* ; Stroke

OBJECTIVES: This study was carried out to measure the urinary cotinine concentrations of Korean tobacco harvesters with green tobacco sickness (GTS). METHODS: We conducted a questionnaire survey and measured the urinary cotinine concentrations among the cases who visited six health subcenters and the emergency room in the Health Center and County Hospital after harvesting tobacco leaves in Cheongsong-gun, from Jul 15 to Aug 15, 2002. Ten suspected GTS cases were compared to 10 controls matched for residence, age, and sex. Urinary cotinine was analyzed with a reverse-phase high performance liquid chromatography (HPLC) system and expressed as geometric mean and standard deviation. The data collected were evaluated using the SPSS/win statistical package and the urinary cotinine concentrations between the two groups were analyzed by Mann-Whitney U test. RESULTS: In both the 10 cases and controls, there were 3 males and 7 females. Ages ranged from 22 to 70 years old. Half of the cases were reported within the 6 hours between 12:00 pm and 17:59 pm. The median time from starting work to initially feeling ill was 4.3 hours (min. 2.5; max. 11.0). The GTS symptoms reported were nausea in 10 cases (100.0%), dizziness in 9 (90.0%), weakness in 8 (80.0%), headache in 7 (70.0%) and other symptoms. The geometric mean of urinary cotinine concentrations was significantly higher (p<0.01) in cases at 497.6 +/- 2.5 ng/ml (min. 73.1; max. 2,574.3) than in controls at 32.7 +/- 1.8 ng/ml (min. 13.3; max. 76.9). CONCLUSIONS: Our study suggests that many tobacco harvesters may suffer from GTS in Korea. Therefore, it is very important for doctors to diagnose exactly the GTS. Also we must develop the methods which can prevent GTS, and simple methods of analysis for urinary cotinine.
Aged ; Chromatography, Liquid ; Cotinine* ; Dizziness ; Emergency Service, Hospital ; Female ; Headache ; Hospitals, County ; Humans ; Korea ; Male ; Nausea ; Nicotine ; Questionnaires ; Tobacco*

Reactive perforating collagenosis(RPC) is a kind of perforating disorder characterized by the transepidermal elimination of altered dermal collagen. Two types have been recognized; the childhood or inherited form and the adult or acquired form. Acquired RPC is frequently associated with diabetes, chronic renal failure with nephropathy and liver disease. We describe a case of RPC in a 41-year-old woman of about 2 months' duration. She has had a problem of tricuspid regurgitation for 3 years. Skin lesions showed scattered umbilicated papules with central keratotic plugs, 0.3-0.8cm sized, located on the proximal extremities.
Adult ; Collagen ; Extremities ; Female ; Humans ; Kidney Failure, Chronic ; Liver Diseases ; Skin ; Tricuspid Valve Insufficiency*

A 27-year-old man presented with a 6-month history of a dark-reddish nodule on the dorsal aspect of the right fifth finger. The lesion was a smooth-surfaced asymptomatic polypoid feature, measuring 0.4x0.9x0.5cm. Past and personal history were unremarkable. The excisional biopsy specimen showed numerous nests of spindle cells with some epithelioid cells in the entire dermis. The junctional activity was not present. On immunohistochemical staining, nest cells were strong positive for S-100 protein, but weak positive for HMB-45. No relapse was noted during a period of 6-month follow-up.
Adult ; Biopsy ; Dermis ; Epithelioid Cells ; Fingers* ; Follow-Up Studies ; Humans ; Nevus, Epithelioid and Spindle Cell* ; Recurrence ; S100 Proteins

OBJECTIVES: Infectious diseases are known to be affected by climate change. We investigated if the infectious diseases were related to meteorological factors in Korea. METHODS: Scrub typhus, hemorrhagic fever with renal syndrome (HFRS), leptospirosis, malaria and Vibrio vulnificus sepsis among the National Notifiable Infectious Diseases were selected as the climate change-related infectious diseases. Temperature, relative humidity and precipitation were used as meteorological factors. The study period was from 2001 through 2008. We examined the seasonality of the diseases and those correlations with meteorological factors. We also analyzed the correlations between the incidences of the diseases during the outbreak periods and monthly meteorological factors in the hyper-endemic regions. RESULTS: All of the investigated diseases showed strong seasonality; malaria and V. vulnificus sepsis were prevalent in summer and scrub typhus, HFRS and leptospirosis were prevalent in the autumn. There were significant correlations between the monthly numbers of cases and all the meteorological factors for malaria and V. vulnificus sepsis, but there were no correlation for the other diseases. However, the incidence of scrub typhus in hyper-endemic region during the outbreak period was positively correlated with temperature and humidity during the summer. The incidences of HFRS and leptospirosis had positive correlations with precipitation in November and temperature and humidity in February, respectively. V. vulnificus sepsis showed positive correlations with precipitation in April/May/July. CONCLUSIONS: In Korea, the incidences of the infectious diseases were correlated with meteorological factors, and this implies that the incidences could be influenced by climate change.
Adult ; Aged ; Climate ; Female ; Hemorrhagic Fever with Renal Syndrome/*epidemiology ; Humans ; Leptospirosis/*epidemiology ; Malaria/*epidemiology ; Male ; Meteorological Concepts ; Middle Aged ; Occupations ; Republic of Korea ; Rocky Mountain Spotted Fever/*epidemiology ; Seasons ; Vibrio Infections/*epidemiology

PURPOSE: Galectin 3 is a beta-galactoside binding protein that is involved in various biological processes such as cell adhesion, migration, cell growth, tumor progression and metastasis. Although the precise acting mechanisms of Galectin 3 are unclear, it have been reported that the expression of Galectin 3 may related to tumor progression and metastasis. We investigated the immunohistochemical expression of Galectin 3 in 57 cases of benign and malignant breast neoplasm to evaluate the relation of a Galectin 3 expression to malignancy of breast neoplasm and the acting mechanism of Galectin 3. METHODS: Twenty fibroadenomas, 7 intraductal papillomas, 10 intraductal carcinomas and 20 invasive ductal carcinomas were studied. Immunostaining of Galectin 3 was evaluated in comparison with that of the internal controls, and the intensity of immunostaining was semiquantitatively graded on an intensity scale of 0 to 3. RESULTS: The normal ductal epithelium of the breast showed strong immunoreactivity with an intensity 2 to 3. The staining gradually and significantly decreased in accordance with the histopathological type and tumor progression from a fibroadenoma, intraductal papilloma, ductal carcinoma in situ and invasive ductal carcinoma (P<0.001). In particular, the expression of galection-3 was prominently decreased in invasive ductal carcinoma. CONCLUSION: The galectin-3 expression pattern suggests that progression from benign breast tumor to malignant breast tumor leads to a reduced expression of galectin-3.
Biological Processes ; Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Carrier Proteins ; Cell Adhesion ; Cell Movement ; Epithelium ; Fibroadenoma ; Galectin 3* ; Galectins* ; Neoplasm Metastasis ; Papilloma ; Papilloma, Intraductal

BACKGROUND: An important constituent of normal human oral microflora has long been recognized. The increase in the incidence of candidal infections has been associated with the increase in the number of patients at risk. Especially, diabetic patients have been increased susceptibility to general and local infections, but it is often equivocal whether or not risk factors such as oral-ambient conditions are related to candidal colonization. OBJECTIVE: The isolates of candidal species were evaluated in the oral cavity of diabetic patients in comparison with non-diabetic, non-immunocompromized subjects. Risk factors that could influence candidal colonization in diabetic patients were also studied. METHOD: Candidal species were isolated from the oral mucosa of 205 diabetics and 62 non-diabetics, using oral swab and smear technique. They were identified by germ tube test, Cornmeal-Tween agar and API 20C system. RESULTS: The frequency of oral candidal isolates was more common in 130 isolates (63.4%) in diabetic patients compared with 23 (37.1%) isolates in controls (p<0.05), but insignificantly related in age and sex distribution of both groups (p>0.05). Germ tubes were formed in the 102 species and chlamydospores in the 105 species in diabetic patients. Candida(C) albicans among the species was the most frequent isolates in both groups (80.8% vs 69.6%). The isolated 130 candidal species, identified by API 20C system, in diabetic patients, showed C. albicans (104), C. tropicalis (16), C. parapsilosis (6), C. krusei (1), C. kefyr (1) and unidentified species (2) compared with C. albicans (16), C. tropicalis (2), C. parapsilosis (2), C. krusei (3), C. kefyr (3) in 23 of controls. These results were almost same in both groups except for the relative high frequency of C. kefyr in controls. As for the risk factors, the isolates were increased in diabetic patients who were smokers (p<0.05), but insignificantly associated with sex, age, glycosylated hemoglobin and wearing of denture (p>0.05). Candidal culture rate and diabetic duration were not correlated (p>0.05). The number of colonies in SDA plate was significantly increased in smokers and denture-wearers (p<0.05). CONCLUSION: The frequency of oral candidal isolates in diabetic patients is higher than in that of controls. Oral-ambient factors such as smoking, probably involve in the development of oral candidal colonization, but not being the result of a single factor.
Agar ; Candida ; Colon ; Dentures ; Hemoglobin A, Glycosylated ; Humans ; Incidence ; Mouth ; Mouth Mucosa ; Risk Factors ; Sex Distribution ; Smoke ; Smoking

BACKGROUND: An important constituent of normal human oral microflora has long been recognized. The increase in the incidence of candidal infections has been associated with the increase in the number of patients at risk. Especially, diabetic patients have been increased susceptibility to general and local infections, but it is often equivocal whether or not risk factors such as oral-ambient conditions are related to candidal colonization. OBJECTIVE: The isolates of candidal species were evaluated in the oral cavity of diabetic patients in comparison with non-diabetic, non-immunocompromized subjects. Risk factors that could influence candidal colonization in diabetic patients were also studied. METHOD: Candidal species were isolated from the oral mucosa of 205 diabetics and 62 non-diabetics, using oral swab and smear technique. They were identified by germ tube test, Cornmeal-Tween agar and API 20C system. RESULTS: The frequency of oral candidal isolates was more common in 130 isolates (63.4%) in diabetic patients compared with 23 (37.1%) isolates in controls (p<0.05), but insignificantly related in age and sex distribution of both groups (p>0.05). Germ tubes were formed in the 102 species and chlamydospores in the 105 species in diabetic patients. Candida(C) albicans among the species was the most frequent isolates in both groups (80.8% vs 69.6%). The isolated 130 candidal species, identified by API 20C system, in diabetic patients, showed C. albicans (104), C. tropicalis (16), C. parapsilosis (6), C. krusei (1), C. kefyr (1) and unidentified species (2) compared with C. albicans (16), C. tropicalis (2), C. parapsilosis (2), C. krusei (3), C. kefyr (3) in 23 of controls. These results were almost same in both groups except for the relative high frequency of C. kefyr in controls. As for the risk factors, the isolates were increased in diabetic patients who were smokers (p<0.05), but insignificantly associated with sex, age, glycosylated hemoglobin and wearing of denture (p>0.05). Candidal culture rate and diabetic duration were not correlated (p>0.05). The number of colonies in SDA plate was significantly increased in smokers and denture-wearers (p<0.05). CONCLUSION: The frequency of oral candidal isolates in diabetic patients is higher than in that of controls. Oral-ambient factors such as smoking, probably involve in the development of oral candidal colonization, but not being the result of a single factor.
Agar ; Candida ; Colon ; Dentures ; Hemoglobin A, Glycosylated ; Humans ; Incidence ; Mouth ; Mouth Mucosa ; Risk Factors ; Sex Distribution ; Smoke ; Smoking

Herpes Zoster duplex -zoster affecting 2 separate dermatome simultaneously- is a rare disease. A 65 year old man, healthy in the past, presented with severely painful grouped papulovesicles and hemorrhagic crusts on the erythematous base on the right forehead and nasal bridge(V-I dermatome) and left chest(T4 dermatome) with nearly simultaneous occurrence. Tzanck smear revealed multinucleated giant cells and biopsy taken from the chest lesion showed the features consistent with herpetic viral blister. He was treated with intravenous administration of acyclovir for 5 days and both lesions were markedly improved.
Acyclovir ; Administration, Intravenous ; Aged ; Biopsy ; Blister ; Forehead ; Giant Cells ; Herpes Zoster* ; Humans ; Rare Diseases ; Thorax