Etretinate is a synthetic retinoic acid which has been reported effective in hyperkeratotic disorders. Recently, it has also been tried, on a limited number, for the treatment of viral wart. A 33-year-old male patient presented with multiple, tender, confluent, verrucous lesions on the scalp, both hands and feet of 4 years duration. Before coming to us, he had been treated with intralesional injection of bleomycin and electrodesiccation with little effect. We started etretinate therapy in a daily dose of 70mg(1mg /kg). After 3 weeks treatment, most of his skin lesions were flattened and softened: but an abrupt elevation of serum aminotransferases was noticed, which was normalized soon after cessation of medication. Unfortunately, the drug stop page aggravated most of skin lesions. After two weeks of withdrawal we started again the drug in a daily dose of 30mg and observed a good response without hepatic dysfunction.
Acitretin* ; Adult ; Bleomycin ; Etretinate* ; Foot ; Hand ; Humans ; Injections, Intralesional ; Male ; Scalp ; Skin ; Transaminases ; Tretinoin ; Warts*

PURPOSE: Intravesical prostatic protrusion (IPP) is a morphological change of prostate protruded into bladder and might be related to bladder outlet obstruction (BOO) depending on the extent of protrusion. There is a high possibility that lower urinary tract symptoms (LUTS) tends to get worse as IPP grows. Therefore, it is necessary to examine the effect of IPP on LUTS after revision of prostate volume in order to identify the direct effect of IPP on BOO and LUTS. MATERIALS AND METHODS: A retrospective study of 296 male patients diagnosed with benign prostate hyperplasia (BPH) between August 2006 and December 2008 were performed. The patients were evaluated with international prostate symptoms score (IPSS) and quality of life (QoL), uroflowmetry (UFR), post-void residual urine volume (PVR), prostate volume and IPP as measured by transurectal ultrasound (TRUS). The changes of IPSS after 8 weeks of medication treatment and the occurrence rates of transurethral resection of prostate (TURP) and acute urinary retention (AUR) were compared. By checking IPSS and UFR, the improvement of voiding symptom was evaluated. RESULTS: The population of patients with moderate enlargement (30-50gm) of prostate extent was 147 (49.6%) out of 296, the whole examined population. There were correlation between IPP and IPSS (p=0.002) and the storage symptoms score was significantly increased (p=0.014). After 8 weeks of medication treatment, both moderate BPH patients with IPP showed similar improvement in storage symptom compared to non-IPP groups. But, the TURP was significantly performed more with IPP (p=0.040) than non-IPP groups and more AUR has occurred (p=0.013). After TURP, IPP group resulted in improvement of IPSS, storage symptoms score and voiding symptoms score statistically compared to non-IPP group. As the change of UFR and IPSS after TURP had shown, the improvements of voiding volume, maximal flow rate (Qmax), and average flow rate (Qavg) in IPP groups were smaller however, it is no correlation in statistical view. CONCLUSIONS: Moderate BPH group with IPP has a higher possibility of having AUR and surgical treatment while showing significant correlation with storage symptoms. A further prospective study is necessary for identification of improvement of IPSS and UFR after TURP and IPP should be checked carefully during TRUS.
Humans ; Hyperplasia ; Indoles ; Lower Urinary Tract Symptoms ; Male ; Prostate ; Prostatic Hyperplasia ; Quality of Life ; Retrospective Studies ; Transurethral Resection of Prostate ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Retention

No abstract available.
Anti-Bacterial Agents/pharmacology ; DNA, Bacterial/analysis ; Female ; Humans ; Hypertrophy/diagnosis ; Magnetic Resonance Imaging ; Microbial Sensitivity Tests ; Middle Aged ; Mycobacterium/classification/drug effects/*isolation & purification ; Nontuberculous Mycobacteria/classification/drug effects/isolation & purification ; Phylogeny ; RNA, Ribosomal, 16S/chemistry/metabolism ; Real-Time Polymerase Chain Reaction ; Republic of Korea ; Sequence Analysis, RNA ; Sequence Homology, Nucleic Acid ; Tenosynovitis/*diagnosis/microbiology/pathology

PURPOSE: We evaluated the impact of renal tumor size on the oncologic and surgical efficacy of laparoscopic renal cryosurgery (LRC) according to our intermediate-term experience in Korea. MATERIALS AND METHODS: From June 2005 to October 2008, we enrolled 37 patients who underwent LRC for 40 renal tumors. Patients were stratified into four groups according to renal tumor size. Patients who presented with a maximum tumor diameter (MTD) of at least 1 cm but less than 2 cm were assigned to Group 1, those with an MTD equal to or greater than 2 but less than 3 cm were assigned to Group 2, those with an MTD equal to or greater than 3 but less than 4 cm were assigned to Group 3, and those with an MTD equal to or greater than 4 cm were assigned to Group 4. Oncologic and clinical outcomes in each group were compared. RESULTS: The four groups showed no statistically significant differences in preoperative variables, including age, sex, body mass index, American Society of Anesthesiologists scores, baseline renal function and hemoglobin, and length of hospital stay. Regarding surgical aspects, however, operation time, estimated blood loss, and postoperative complications were significantly increased in patients with larger tumors. Three patients in Group 3 required postoperative transfusions, and 1 patient in Group 4 required conversion to open renal cryosurgery. During the mean follow-up period of 31.6 months, radiologic evidence of tumor recurrence was found in only 2 patients in Group 4. CONCLUSIONS: In this series, LRC for renal tumors smaller than 3 cm was conducted safely without radiologic evidence of tumor recurrence during intermediate-term follow-up. For tumors larger than 3 cm, however, the transfusion rate increased, and for renal tumors larger than 4 cm, the tumor recurrence rate increased significantly.
Body Mass Index ; Carcinoma, Renal Cell ; Cryosurgery ; Follow-Up Studies ; Hemoglobins ; Humans ; Korea ; Laparoscopy ; Length of Stay ; Postoperative Complications ; Recurrence

BACKGROUND AND PURPOSE: Hemifacial spasm(HFS) is a chronic and often progressive disorder characterized by unilateral irregular clonic and tonic contractions of one or more muscles of facial expression. Many previous electrophysiologic studies showed characteristic features of HFS differentiating from other involuntary movements of the face. However, there has been no electrophysiologic study for estimating the clinical severity of HFS. This study was prospectively designed to evaluate the relationships between electrophysiologic findings and clinical severity of HFS. METHODS: The authors performed direct facial nerve stimulation, blink reflex, and lateral spread response in 62 patients with HFS, and compared the results of affected side with those of unaffected each other. Clinical severity was graded into seven groups (0-6) by questionnaire and confirmed by a neurologist. RESULTS: The results were as following. 1) The total number of subjects were 62, the number of patients in group 2 was 3 (4.8%), group 3 was 12 (19.3%), group 4 was 25 (40.3%), group 5 was 21 (33.9%), and group 6 was 1(1.6%). 2) The mean age was 54.5+/-9.1years old, the mean duration of the illness was 6.4+/-4.9years, male was 11(17.7%) and female was 51(82.3%), and involved sites were right in 26(41.9%) and left in 36(58.1%) patients. 3) Direct stimulation of facial nerve showed no differences between affected and unaffected sides in HFS. 4) The results of blink reflex showed more increased latencies and larger amplitudes of R1 & R2 responses in affected sides than in unaffected sides of HFS, but no differences among the groups. 5) The lateral spread responses were found in 45 of 62 (72.6%) patients by stimulation of zygomatic branch and recording in mentalis muscle, 26 of 62 (41.9%) patients by stimulation of mandibular branch and recording in orbicularis oculi muscle on affected side. 6) There was a linear correlation between the presence of lateral spread response with zygomatic or mandibular stimulation and the grade of clinical severity. CONCLUSION: We suspected that the lateral spread response was a significant electrophysiological test for estimating the clinical severity of HFS.
Blinking ; Dyskinesias ; Facial Expression ; Facial Nerve ; Female ; Hemifacial Spasm* ; Humans ; Male ; Muscles ; Prospective Studies ; Surveys and Questionnaires

No abstract available.
Classification* ; Wounds and Injuries* ; Wounds, Gunshot*

No abstract available.
Carcinoma, Squamous Cell*

A fracture of the shaft of the humerus in young adults is known to occur as a result of high energy injuries such as traffic accidents and falls from a height. In baseball, which is one of the popular sports in the world, the incidence of a fracture of the shaft of the humerus during pitch motion is increasing even in non-professional players. Over the course of a year, we analyzed four cases of humeral shaft fractures that occurred during pitch motion through the pitch count, type of pitch, duration of playing, and prodromal pain. It was found that these fractures can easily occur through the torsion developed by the uncoordinated contraction of the muscle. The mechanism of the fracture should be recognized in order to prevent this type of fracture while playing baseball.
Accidents, Traffic ; Baseball ; Contracts ; Humans ; Humerus ; Incidence ; Muscles ; Sports ; Young Adult

Dynamic contrast-enhanced MRI (DCE-MRI) is a noninvasive imaging technique used to evaluate tissue vascularity/permeability features through consecutive imaging acquisitions after gadolinium-based contrast agent administration. Over the past several decades, techniques and protocols for DCE-MRI have evolved, leading to growing applications of DCE-MRI for different neurological disorders. Although most established applications of DCE-MRI are for studying tumors, an increasing number of studies have been evaluating the use of this technique for neurodegenerative and other miscellaneous diseases. The purpose of this article was to provide an overview of DCE-MRI and its clinical applications in various neurological diseases.

BACKGROUND: Extracorporeal circulation (ECC) can induce alterations in blood viscoelasticity and cause red blood cell (RBC) aggregation. In this study, the authors evaluated the effects of pump flow pulsatility on blood viscoelasticity and RBC aggregation. METHODS: Mongrel dogs were randomly assigned to two groups: a nonpulsatile pump group (n=6) or a pulsatile pump group (n=6). After ECC was started at a pump flow rate of 80 mL/kg/min, cardiac fibrillation was induced. Blood sampling was performed before and at 1, 2, and 3 hours after ECC commencement. To eliminate bias induced by hematocrit and plasma, all blood samples were adjusted to a hematocrit of 45% using baseline plasma. Blood viscoelasticity, plasma viscosity, hematocrit, arterial blood gas analysis, central venous O2 saturation, and lactate were measured. RESULTS: The blood viscosity and aggregation index decreased abruptly 1 hour after ECC and then remained low during ECC in both groups, but blood elasticity did not change during ECC. Blood viscosity, blood elasticity, plasma viscosity, and the aggregation index were not significantly different in the groups at any time. Hematocrit decreased abruptly 1 hour after ECC in both groups due to dilution by the priming solution used. CONCLUSION: After ECC, blood viscoelasticity and RBC aggregation were not different in the pulsatile and nonpulsatile groups in the adult dog model. Furthermore, pulsatile flow did not have a more harmful effect on blood viscoelasticity or RBC aggregation than nonpulsatile flow.
Adult ; Animals ; Bias (Epidemiology) ; Blood Gas Analysis ; Blood Viscosity ; Cardiopulmonary Bypass ; Dogs ; Elasticity ; Erythrocytes* ; Extracorporeal Circulation* ; Hematocrit ; Hematology ; Humans ; Lactic Acid ; Plasma ; Pulsatile Flow ; Viscosity