A case of malignant melanoma is described. The patient, 67 years old male, had thumb tip sized two tumor masses with linear arcuate spread on left upper back near spine of 3 months duration, and metastatic lesion on right axillary lymphnode. Lesions were removed surgically and split skin graft was done.
Aged ; Humans ; Male ; Melanoma* ; Skin ; Spine ; Thumb ; Transplants

6 cases of nevus sebaceus of Jadassohn were reported and its literatures were reviewed. It is thought to be rather rare disease in this country. Two of the cases were seen within the age of 2 years and showed the clinical pictures of early stage. The remaining 4 cases were the clinical pictures of late stage showing verrucous lesions. All cases developed the lesions in the scaIp except case 6 which appeared on anterior neck. One of thc cases was associated with syringocystadenoma papilliferum but none of the cases show any association of basal cell carcinoma.
Carcinoma, Basal Cell ; Dronabinol ; Neck ; Nevus* ; Nevus, Sebaceous of Jadassohn ; Rare Diseases

6 cases of nevus sebaceus of Jadassohn were reported and its literatures were reviewed. It is thought to be rather rare disease in this country. Two of the cases were seen within the age of 2 years and showed the clinical pictures of early stage. The remaining 4 cases were the clinical pictures of late stage showing verrucous lesions. All cases developed the lesions in the scaIp except case 6 which appeared on anterior neck. One of thc cases was associated with syringocystadenoma papilliferum but none of the cases show any association of basal cell carcinoma.
Carcinoma, Basal Cell ; Dronabinol ; Neck ; Nevus* ; Nevus, Sebaceous of Jadassohn ; Rare Diseases

Management of the small lower ureteral stone has been attempted by either transurethral manipulation or expectant therapy. To date, however, the choice of proper method has depended mostly on clinician's preference, and the effectiveness of the transurethral stone manipulation has remained controversial. Herein we evaluated the effectiveness of the transurethral stone manipulation, using with the Dormia dislodger, in 37 patients with lower ureteral stone less than 10mm in greatest diameter. The results are summarized as follows. 1. The overall success rate was 68% (25 of 37 patients); Immediate delivery of the stone was observed in 16 of 37 patients. In another 5 patients the stone was removed at the time when the indwelled ureteral catheter was taken out. In the remaining 4 patients the stone passed spontaneously within a week following the procedure. 2. Higher success rate was observed in smaller stone; 79% in less than 4 mm, 58% in 46 mm, and 33% in 610 mm in it's greatest diameter, respectively. 3. The morbidity rate was 8.1% (3 of 37 patients); In one patient a broken basket was retained in the ureter, which was removed at the time of ureterolithotomy. In another patient a ureteral stricture requiring periodic dilation was complicated. And in the other patient persistent hematuria was observed, which was relieved by conservative management. These results suggest that transurethral manipulation might have to be initially applied to unremittingly painful patients with small lower ureteral stone.
Constriction, Pathologic ; Hematuria ; Humans ; Methods ; Ureter* ; Urinary Catheters

Uric acid, pure or admixed, calculous disease during childhood is uncommon. We recently encountered a case of multiple calcium-uric acid urolithiasis in a l7-month-old male patient presented with anuria owing to bilateral complete obstruction of the ureteropelvic junction in which acute renal failure developed following emergency removal of the stones.
Acute Kidney Injury ; Anuria ; Child* ; Emergencies ; Humans ; Male ; Uric Acid ; Urolithiasis*

Inverted vesical papilloma is an uncommon, probably benign neoplasm with distinctive histologic features. It usually presents with hematuria and lower urinary tract obstruction due to hall-valve effect. We report a case of vesical inverted papilloma, which was proved histologically, causing lower urinary tract obstruction.
Hematuria ; Papilloma ; Papilloma, Inverted* ; Urinary Bladder* ; Urinary Tract

BACKGROUND: Although paclitaxel is a widely used chemotherapeutic agent for the treatment of solid cancers, side effects such as neuropathic pain lead to poor compliance and discontinuation of the therapy. Ethyl pyruvate (EP) is known to have analgesic effects in several pain models and may inhibit apoptosis. The present study was designed to investigate the analgesic effects of EP on mechanical allodynia and apoptosis in dorsal root ganglion (DRG) cells after paclitaxel administration. METHODS: Rats were randomly divided into 3 groups: 1) a control group, which received only vehicle; 2) a paclitaxel group, which received paclitaxel; and 3) an EP group, which received EP after paclitaxel administration. Mechanical allodynia was tested before and at 7 and 14 days after final paclitaxel administration. Fourteen days after paclitaxel treatment, DRG apoptosis was determined by activated caspase-3 immunoreactivity (IR). RESULTS: Post-treatment with EP did not significantly affect paclitaxel-induced allodynia, although it tended to slightly reduce sensitivities to mechanical stimuli after paclitaxel administration. After paclitaxel administration, an increase in caspase-3 IR in DRG cells was observed, which was co-localized with NF200-positive myelinated neurons. Post-treatment with EP decreased the paclitaxel-induced caspase-3 IR. Paclitaxel administration or post-treatment with EP did not alter the glial fibrillary acidic protein IRs in DRG cells. CONCLUSIONS: Inhibition of apoptosis in DRG neurons by EP may not be critical in paclitaxel-induced mechanical allodynia.
Animals ; Apoptosis ; Caspase 3 ; Compliance ; Diagnosis-Related Groups ; Ganglia, Spinal ; Glial Fibrillary Acidic Protein ; Hyperalgesia ; Myelin Sheath ; Neuralgia ; Neurons ; Paclitaxel ; Pyruvates ; Pyruvic Acid ; Rats

We investigated to see whether an altered role of nitric oxide (NO) system is involved in erythropoietin (EPO)-induced hypertension in chronic renal failure (CRF). Male Sprague-Dawley rats were five-sixths nephrectomized to induce CRF. Six weeks after the operation, EPO or vehicle was injected for another 6 weeks. Plasma and urine nitrite/nitrate (NOx) levels were determined. Expression of NO synthase (NOS) proteins in the aortae and kidneys were also determined. In addition, the isometric tension of isolated aorta in response to acetylcholine and nitroprusside was examined. Blood pressure progressively rose in CRF groups, the degree of which was augmented by EPO treatment. Plasma NOx levels did not differ among the groups, while urine NOx levels were lower in CRF groups. Endothelial NOS expression was lower in the kidney and aorta in CRF rats, which was not further affected by EPO-treatment. The inducible NOS expression in the kidney and aorta was not different among the groups. Acetylcholine and sodium nitroprusside caused dose-dependent relaxations of aortic rings, the degree of which was not altered by EPO-treatment. Taken together, EPO-treatment aggravates hypertension in CRF, but altered role of NO system may not be involved.
Acetylcholine/pharmacology ; Anemia/metabolism ; Anemia/etiology ; Anemia/drug therapy* ; Animal ; Aorta, Thoracic/physiology ; Body Weight ; Erythropoietin/pharmacology* ; Hypertension, Renal/metabolism ; Hypertension, Renal/drug therapy ; Isometric Contraction/drug effects ; Kidney/enzymology ; Kidney Failure, Chronic/metabolism* ; Kidney Failure, Chronic/complications ; Male ; Nitrates/urine ; Nitrates/blood ; Nitric Oxide/metabolism* ; Nitric-Oxide Synthase/metabolism ; Nitrites/urine ; Nitrites/blood ; Nitroprusside/pharmacology ; Rats ; Rats, Sprague-Dawley ; Vasoconstriction/drug effects ; Vasoconstrictor Agents/pharmacology ; Vasodilator Agents/pharmacology

Epidural adhesions cause pain by interfering with the free movement of the spinal nerves and increasing neural sensitivity as a consequence of neural compression. To remove adhesions and deliver injected drugs to target sites, percutaneous epidural adhesiolysis (PEA) is performed in patients who are unresponsive to conservative treatments. We describe four patients who were treated with a newly developed inflatable balloon catheter for more effective PEA and relief of stenosis. In the present patients, treatments with repetitive epidural steroid injection and/or PEA with the Racz catheter or the NaviCath did not yield long-lasting effects or functional improvements. However, PEA and decompression with the inflatable balloon catheter led to maintenance of pain relief for more than seven months and improvements in the functional status with increases in the walking distance. The present case series suggests that the inflatable balloon catheter may be an effective alternative to performing PEA when conventional methods fail to remove adhesions or sufficiently relieve stenosis.
Catheters* ; Constriction, Pathologic ; Decompression* ; Humans ; Peas ; Spinal Nerves ; Spinal Stenosis ; Walking

BACKGROUND: There has been a gradual increase in the number of newly diagnosed cases of Mycobacterium avium complex (MAC) pulmonary disease. However, the optimal therapeutic regimen for the disease has not yet established and there is no report about the treatment outcome of MAC pulmonary disease in Korea. This study examined the effect of clarithromycin-based regimen in patients with pulmonary MAC disease without a HIV infection. MATERIALS AND METHODS: Fifty-six patients with pulmonary MAC disease were diagnosed according to the American Thoracic Society criteria from January 2000 to December 2003 at this hospital. Of these patients, 15 were treated with clarithromycin, rifampin, and ethambutol for more than 6 months, together with streptomycin initially (first 6 months) in 8 patients. RESULTS: Six months after the treatment, the sputum cultures converted from positive to negative in 8 patients (53%) and the radiological findings improved in 10 (67%). At 12 months 4 patients (44%) achieved sputum negative conversion and 6 patients out of 9 patients (67%) who were treated for more than 12 months showed radiological improvement. Overall, the sputum findings converted to negative in nine patients (60%) who underwent medical treatment. A pulmonary resection was successfully performed in one patient. Only one patient discontinued the treatment due to side effects such as gastrointestinal intolerance and optic neuritis. CONCLUSION: A combined regimen containing clarithromycin is relatively safe and tolerable even in the elderly outpatients. However, the results of this combined chemotherapy were unsatisfactory and new companion drugs for MAC pulmonary disease are needed. A resection may be considered for localized disease.
Aged ; Clarithromycin ; Drug Therapy ; Ethambutol ; Friends ; HIV Infections ; Humans ; Korea ; Lung Diseases* ; Mycobacterium avium Complex* ; Mycobacterium avium* ; Mycobacterium* ; Nontuberculous Mycobacteria ; Optic Neuritis ; Outpatients ; Rifampin ; Sputum ; Streptomycin ; Treatment Outcome