Daily topical sequential triple therapy(tretinoin, betamethasone valerate and hydroquinone), as proposed by Kligman et al and Gano et al, has been performed on 29 Korean female patients with melasma. After 4 weeks treatment with 2% hydroquinone cream, only three of eight patients (37. 5%) showed good to excellent results. However, after 4 weeks treatment with 4% hydroquinone cream, twelve of twentyone patients (57. 1%) showed good to excellent results and its therapeutic effects appeared more rapidly than the former group. Overall, after 4 weeks treatment. 96.6% of the total group showed fair to excellent results of which 57. 7% had a good to excellent rating. The fair-com- plexioned Koreans had a better response than dark-complexioned.
Betamethasone Valerate* ; Betamethasone* ; Female ; Humans ; Melanosis* ; Tretinoin*

A case of hypohidrotic ectodermal dysplasia was seen at the Dermatological Clinic of Chosun Univeraity Hospital, with a classical symptom triad consisting of hypohidrosis to anhidroais, hypotrichosis and hypodontia, and characteristic facial appearance. He was a 20 year-old male patient who presented, in addition, milium-like papules of sebaceous hyperplasia located on the nose and cheeks, supernumerary nipples of right breast, ceruminosis since childhood, and absence of apocrine glands on the axilla and pubic area, all of which are not frequently observed in hypohidrotic ectodermal dysplasia. Dermatoglyphics of this patient revealed that the axial triradius of the left palm was t, its atd angle was 42 degree, and the total ridge count of finger print was 5. This patient has no relatives showing the symptoms of hypohidrotic ectodermal dysplasia and the genetics was discussed in relation to this disease.
Anodontia ; Apocrine Glands ; Axilla ; Breast ; Cheek ; Dermatoglyphics ; Ectodermal Dysplasia 1, Anhidrotic* ; Fingers ; Genetics ; Humans ; Hyperplasia ; Hypohidrosis ; Hypotrichosis ; Male ; Nipples ; Nose ; Young Adult

Papulonecrotic tuberculid (PNT) and Pityriasis lichenoides et varioliformis acuta (PLEVA) have been in controversy in their pathogeneses and entity itselves. Authors reviewed litera,tures of the two dermatoses with observation of nine casea of PNT from 1979 to 1981 and evaluated whether PNT could be also classified as PLEVA. The results were a,s follows: 1. By the review of literatures PNT and PLEVA showed great similarities in their clinical aspects including shape of cutaneous lesions, course, favorite age and subjecive symptoms. Histopathological overlappings were also found. 2. Of the nine cases of PNT authors observed, seven cases were histopathologically PLEVA and four cases could be thought PLEVA also clinically. But way six cases were treated by anti-tuberculous drugs. 3. The incidence of other tuberculous signs and results of tuberculin skin tests were all significant in the nine cases above. With the above observations it seems that PNT is one of the causes of PLEVA and thus could be a kind of PLEVA.
Child* ; Dermatitis* ; Humans ; Incidence ; Pityriasis Lichenoides ; Skin Diseases ; Skin Tests ; Tuberculin ; Tuberculosis, Cutaneous

DNA isolated from human tumor cells can induce malignant transfarmation of tissue culture cells. The DNA is then called an oncogene. Its protein produets have been detected in animal and human tumors and are considered to play a significant role in carcinogenesis. In order to evaluate whether the oncogenes are involved in development of tumors of epidermis and whether they could be used as tumor markers, immunoperoxidase staining was performed for the ras product in sections of squamous cell carcinoma, Bowen's disease, actinic keratosis, keratoacanthoma and seborrheic keratosis. Three cases of sgamous cell carcinoma showed 10~20 positive cells per high power field(HPF). Three cases of Bowen's disease revealed 1-9 positive cells per HPF, whereas the actinic keratosis 1~9 or no positive cells per 10 HPF in all three cases. The keratoacanthoma and seborrheic keratosis showed 1~9 or no positive cells in all observed cases. The positive staining was observed in the cytoplasm. The increasing positivity in parallel with the increase of malignant potential strongly suggests that the ras oncogene is closely related to development of epidermal malignancy and also point out the possibility of ras as a cancer marker.
Animals ; Bowen's Disease ; Carcinogenesis ; Carcinoma, Squamous Cell ; Cytoplasm ; DNA ; Epidermis* ; Genes, ras* ; Humans ; Keratoacanthoma ; Keratosis, Actinic ; Keratosis, Seborrheic ; Oncogenes ; Biomarkers, Tumor

No abstract available.
Keratosis, Seborrheic*

A case of Ramsay Hunt syndrome, though more often seen at the ENT clinic because of the patients' concern with symptoms in the ear, was seen and treated at the Dermatologic Clinic of Chosun University. A 29 year old male patient presented earache, pinhead to rice sized erythematous vesicular eruption on the external auditory canal, auricle and superior auricular area, and facial paralysis, all involving the right side of the face, duration of which were 7 days, 5 days and 1 day respectiveIy. High doses of prednisolone alone made it possible to remit the otalgia, control the vesicular eruption and resolute the facial paralysis almost completely within 18 days in the order of their appearance, indicating that this is one of the more easily treated diseases for dermatologists, The 22 cases of this syndrome reported in Korean literature were reviewed and the conceptual development of its pathogenesis and definition was described.
Adult ; Ear ; Ear Canal ; Earache ; Facial Paralysis ; Herpes Zoster Oticus* ; Humans ; Male ; Prednisolone

OBJECTIVE: The authors reviewed experience with patients harboring intracerebral hematoma (ICH) treated by stereotactic computed tomography (CT) guided thrombolysis and aspiration and evaluated feasibility, safety and prognostic factors of this procedure. METHODS: One hundred and ten patients with supratentorial ICH >25 ml without underlying structural etiology or coagulopathy were recruited. The patients with Glasgow Coma Scale (GCS) <5 were excluded. A catheter was directed stereotactically into the ICH under CT guidance. Hematoma aspiration was followed by instillation of urokinase. This was repeated every 6 hours until less than half of its initial volume remained. For analysis of prognostic factors, we classified them into two groups;good (Glasgow Outcome Scale (GOS) > or =4) and bad (GOS<4) prognosis group, and performed comparative analysis between two groups. RESULTS: Mean age was 59.8 years. The baseline hematoma size ranged from 15 to 72 mL. ICH volume reduced by an average of 74.2%. At 6 months after the procedure, 56 patients had achieved a good recovery, 29 patients were dependent, and 10 remained vegetative. Fifteen patients died in hospital. The main good prognostic factors were young age, small ICH volume, high GCS, absence of rebleeding, underlying disease and complications. CONCLUSION: CT-guided thrombolysis and aspiration appears safe and effective in the reduction of ICH volume. Patients of ICH presenting with bad prognostic factors should require frequent radiological investigation and more meticulous procedure. Further studies are needed to assess optimal thrombolytic dosage and must include controlled comparisons of mortality, and disability outcome.
Catheters ; Glasgow Coma Scale ; Hematoma* ; Humans ; Mortality ; Prognosis ; Urokinase-Type Plasminogen Activator

No abstract available.
Humans*

We report an unusual case of lateral medullary infarction after successful embolization of the vertebral artery dissecting aneurysm (VADA). A 49-year-old man who had no noteworthy previous medical history was admitted to our hospital with a severe headache. Computed tomography (CT) revealed a subarachnoid hemorrhage, located in the basal cistern and posterior fossa. Cerebral angiography showed a VADA, that did not involve the origin of the posterior inferior cerebellar artery (PICA). We treated this aneurysm via endovascular trapping of the vertebral artery distal to the PICA. After operation, CT revealed post-hemorrhagic hydrocephalus, which we resolved with a permanent ventriculoperitoneal shunt procedure. Postoperatively, the patient experienced transient mild hoarsness and dysphagia. Magnetic resonance image (MRI) showed a small infarction in the right side of the medulla. The patient recovered well, though he still had some residual symptom of dysphagia at discharge. Such an event is uncommon but can be a major clinical concern. Further investigation to reveal risk factors and/or causative mechanisms for the medullary infarction after successful endovascular trapping of the VADA are sorely needed, to minimize such a complication.
Aneurysm ; Aneurysm, Dissecting ; Arteries ; Cerebral Angiography ; Deglutition Disorders ; Headache ; Humans ; Hydrocephalus ; Infarction ; Magnetic Resonance Spectroscopy ; Middle Aged ; Pica ; Risk Factors ; Subarachnoid Hemorrhage ; Ventriculoperitoneal Shunt ; Vertebral Artery

We are reporting an unusual case of dural arteriovenous fistula (AVF) of the superior sagittal sinus (SSS) after tamoxifen treatment for breast cancer. A 30-year-old female arrived at the emergency room with a sudden headache and left sided weakness and sensory loss. In her past medical history, she was diagnosed with breast cancer 1 year prior, and subsequently underwent a breast conserving mastectomy with whole breast radiation and adjuvant chemotherapy with tamoxifen. At the time of admission, computed tomography showed a small acute intracerebral hemorrhage at the right parietal cortex, and magnetic resonance imaging showed that a dural AVF at the SSS with a prominent and tortuous venous enhancement along the centrum semiovale was present. Cerebral angiography showed that the dural AVF at the mid-portion of the SSS with meningeal arterial feeding vessels entering the wall of the SSS, then draining through the dilated cortical veins. Our patient had no signs of active malignancy or any abnormalities in her coagulation profile, so it can be concluded that the tamoxifen was the likely cause of the SSS thrombosis and dural AVF. The dural AVF was treated by an endovascular coil embolization for the arterialized segment of the SSS. The patient dramatically recovered favorably from left side motor and sensory deficit. The best clinical approach is to screen potential patients of tamoxifen hormonal therapy and educate them on the sign and symptoms of life threatening thromboembolic events while taking tamoxifen.
Adult ; Breast ; Breast Neoplasms* ; Central Nervous System Vascular Malformations* ; Cerebral Angiography ; Cerebral Hemorrhage ; Chemotherapy, Adjuvant ; Embolization, Therapeutic ; Emergency Service, Hospital ; Female ; Headache ; Humans ; Magnetic Resonance Imaging ; Mastectomy ; Rabeprazole ; Superior Sagittal Sinus* ; Tamoxifen* ; Thrombosis ; Veins