The present study was intended to examine the spectrum of radiographic patterns of the stomach associated withacute and chronic pancreatitis and their complications. Subjects served for the study consisted of 70 cases ofpancreatitis (36 cases in acute stage and 34 cases in chronic stage). Intramural and perigastic permeation ofextravasated pancreatic enzymes and secondary inflammatory reacation that follows are responsible for theardiographic change observed. 1. Generalized rugal thickening and particularly selective mucosal prominences ingreater curvature of body and antrum are characteristically seen in acute(14 of 36 cases
Diagnosis ; Diagnostic Errors ; Pancreatitis, Chronic ; Stomach

Confluent and reticulated papillomatosis(CRP) is a rare dermatosis. The lesions are hyperkeratotic, verrucous papules and plaques, resulting in a confluence of lesions centrally and a reticulated pattern at the periphery. It is more common in women and during puberty. The histopathological findings show papillomatosis, hyperkeratosis and a sparse superficial perivascular lymphocytic infiltrate. We report a case of CRP that responded to oral etretinate in an 18-year-old man.
Acitretin* ; Adolescent ; Etretinate* ; Female ; Humans ; Papilloma* ; Puberty ; Skin Diseases

BACKGROUND: Redundant and wrinkled face is a common finding in patients with long-standing leprosy, which is responsible for the appearance of premature aging. Chemical peeling plays a role in dermal regeneration in the treatment of wrinkles. However, the effect of chemical peeling has rarely been studied in patients with leprosy. OBJECTIVE: To investigate the effect of chemical peeling on dermal connective tissue components and clinical improvement of facial wrinkles in patients with leprosy. METHODS: Five patients with clinically and bacteriologically inactive lepromatous leprosy were treated with 70% glycolic acid plus 35% trichloroacetic acid (GA-TCA). Histologic and clinical changes were evaluated at 0 and 90 days postpeel. RESULTS: Histologically, collagen fibers and ground substance increased significantly but elastic fibers did not change at 90 days postepeel. Clinically, fine wrinkles improved considerably, whereas most deep wrinkles remained unchanged at day 90. CONCLUSION: This study demonstrates that chemical peeling with GA-TCA, or medium-depth peeling, causes an increase in collagen and ground substance but not in elastic fibers. These changes result in limited clinical improvement in the facial wrinkles of leprosy patients. Therefore, medium-depth chemical peeling may be insufficient to improve the premature aging appearance in patients with leprosy.
Aging, Premature ; Collagen ; Connective Tissue* ; Elastic Tissue ; Humans ; Leprosy* ; Leprosy, Lepromatous ; Regeneration ; Trichloroacetic Acid

PURPOSE: In spite of the recognition of hyperfiltration injury after kidney donation, the function of the remaining kidney is considered relatively good. Few published reports have examined donor renal outcome after 10 years or later. We evaluated the effect of donor nephrectomy on donor renal outcome and the safety of the kidney donations. METHODS: From January 1991 to August 1994, 205 living donor nephrectomies were performed. 32 donors were available for evaluation at minimum 10 years after the operation. Preoperative laboratory findings included blood urea nitrogen (BUN), serum creatinine, 24-hour creatinine clearance (CCr) and 24-hour urine protein. The same indices were checked at one month after the operation and at the last follow up and was compared with preoperative indices. The CCr was compared with an age adjusted glomerular filtration rate (AGFR) for normal kidney. Blood pressure was checked and compared with general population. RESULTS: Mean patient follow up period was 11 years (10~15 years). BUN and serum creatinine increased, while CCr decreased from the preoperative levels, although still within normal limits. 24- hour urine protein was significantly increased from the preoperative level, and was higher than normal limits. CCr was not significantly different from AGFR. The incidence of hypertension was not higher than the general population. CONCLUSION: Most of the renal indices are well preserved within normal limits at 10 years after donor nephrectomy. Urinary protein excretion increases with marginal significance but seems to be of no clinical significance in most patients. Prospective and longer term follow-up of the donors after donor nephrectomies are needed to establish the safety for the kidney donation.
Blood Pressure ; Blood Urea Nitrogen ; Creatinine ; Follow-Up Studies* ; Glomerular Filtration Rate ; Humans ; Hypertension ; Incidence ; Kidney ; Kidney Transplantation ; Living Donors ; Nephrectomy* ; Tissue Donors*

OBJECTIVE: To report the efficacy of vaginally administered bromocriptine. MATERIAL AND METHOD: Case report. RESULTS: The prolactin level was significantly decreased after the administration of bromocriptine vaginally. CONCLUSIONS: The vaginal administration of bromocriptine can be an alternative to oral administration in patients with hyperprolactinemia who show severe side effects.
Administration, Intravaginal ; Administration, Oral ; Bromocriptine* ; Humans ; Hyperprolactinemia* ; Prolactin

Paralytic lagophthalmos and ectropion in leprosy are serious complications of facial paralysis, which may lead to expose keratitis, corneal ulceration, further lead to blindness. In 1995, 1997 and 1999, we had reported in this journal on the surgical treatment of paralytic lagophthalmos and ectropion. In the first report of 1995 for lid closing, I(Ahn) performed various method of traditional surgery such as temporal muscle transfer, medial and lateral canthoplasty as well as gold implantation. In the 2nd report of 1997, We(Ahn and Park) presented combination treatment of gold plate with minor change of design and weight in the upper lid and medial canthoplasty with horizontal shortening in the lower lid. In the 3rd report of 1999, We described an additional graft of conchal cartilage in the lower lid. However, the lateral end of the cartilage would warp and create new partial ectropion several months later. Therfore, we shifted from cartilage to Alloderm(R), acellular dermal graft. We applied it to the lower border of the tarsus instead of cartilage and fixed each end to medial and lateral canthal ligaments respectively. We think Alloderm(R) is a good substitute for the cartilage and is an effective volume expander to the atrophic lower lid.
Ankle ; Blindness ; Cartilage ; Corneal Ulcer ; Ectropion* ; Facial Paralysis ; Keratitis ; Leprosy ; Ligaments ; Temporal Muscle ; Transplants

Recently, there has been a strong decrease in the number of temporalis muscle transfer(TMT) operations in cases of lagophthalmos. The primary cause of this decline is patient dissatisfaction with drawbacks of eye clinching in concert with mouth closure, ectropion and ptosis. This is mostly true of patients who are now more commonly exposed to urban social environments. In 1997, I discontinued the use of TMT as part of my combination treatment method reported in this journal. Since 1998, I have removed the fascia in 20 TMT cases due to complications in the upper and lower eyelid areas. I then corrected these complications using my combination method. I still use TMT in cases of lower lip drooping. Lagophthalmos patients are treated using my combination method of gold lid loading in the upper eyelid and Alloderm insertion in the lower eyelid through fixation of both ends to the medial and lateral canthal ligaments respectively. Previously, I recommended the use of conchal cartilage but noted the complication of cartilage warping which caused creating new partial ectropion several months later. Alloderm has shown no complications and the results of its use remain most satisfactory.
Cartilage ; Ectropion* ; Eyelids ; Fascia ; Humans ; Leprosy* ; Ligaments ; Lip ; Mouth ; Social Environment

Acquired tufted angioma is a benign, progressive vascular lesion that has a distinctive histopathologic appearance. We report a 31-year-old man with acquireed tufted angioma. Several reddish papules and plaque were present on the neck. The lesion had been present for 6 months. They had enlarged slowly, and were slightly tender. Histopathologic examination of the biopsy specimen showed round to ovoid cellular tufts of capillaries, most prominent in the middle to lower dermis.
Adult ; Biopsy ; Capillaries ; Dermis ; Hemangioma* ; Humans ; Neck

BACKGROUND: Ulnar nerve palsy in patients with Hansen disease causes hand wasting and atrophy. To masquerade these deformities, patients injected paraffin or silicone into the lesions, which results in paraffinomas. Several years later, painful inflammation, ulceration or abscesses may develop in the paraffinomas. OBJECTIVE: To investigate the clinical characteristics of paraffinomas in patients with Hansen disease, and to evaluate and compare the effects of various surgical treatment methods of paraffinomas. METHODS: Fifty-seven patients with paraffinomas were randomized to receive debridement(curettage) with primary closure, skin graft, skin flap, or second intention at the hospital of Korean Hansen Welfare Association from 1998 to 2012. We analyzed retrospectively the final cosmetic results of three methods, primary closure, skin graft, and skin flap, in 33 patients with more than 6 months follow-up. The final results were classified into 4 grades, excellent, good, fair, and poor. RESULTS: Of 57 patients, the ratio of male and female was 42:15 and the average age was 73 and 71 years repectively. The location of the lesions was the hand and wrist in 54 patients and the face in 3. The total number of procedures was 72 and that of 3 methods was 55. In 33 patients, 19 showed above fair grades and the recurrence rate was 42%(14/33). There were no serious postoperative complications. CONCLUSION: Wide and thorough curettage as debridement was very important to reduce recurrence and the primary closure was most efficient in consideration of an old age of patient, simplicity of procedure and cosmeosis.
Abscess ; Atrophy ; Congenital Abnormalities ; Curettage ; Debridement ; Female ; Follow-Up Studies ; Hand ; Humans ; Inflammation ; Intention ; Leprosy* ; Male ; Paraffin ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Silicones ; Skin ; Transplants ; Ulcer ; Ulnar Neuropathies ; Wrist

Facial nerve paralysis in leprosy adversely affects facial regions from the forehead to the lip. In particular, lagophthalmos in patients with leprosy causes exposure keratitis, corneal and conjunctival dryness which can progress blindness and disfigurement. The function of the eyelids is controlled by the oculomotor nerve and the facial nerve. In leprosy patients the oculomotor nerve continues to function causing the levator muscle to lift the eyelids. However, paralysis of the facial nerve prevents the orbicularis oculi muscle from closing the eyelids, resulting in lagophthalmos. Various methods were developed to correct lagophthalmos, one of which was temporal muscle transfer(TMT) reported in 1934 by Gillies. Since we noted relatively high occurrence of ptosis as a complication in patients treated previously with the TMT, we performed other surgical procedures for laglphthalmos over 15 years, not to make the ptosis. Although most of the patients quite improved post-operatively, partial lid-gap frequently persisted. It may be related to involutional changes and paralyzed orbicularis muscle. Recently, we conducted 4 different TMT methods for last 4 years to reduce ptosis. The methods used included Brown & McDowell, McCord & Codner, modified Gillies & Anderson, and modified Gillies. Seventy-five TMT operations in 60 patients(26 males and 34 females) were done between 2011 and 2014. The age range of the patients was 54~87 years(the mean was 70.1). Fifteen patients had bilateral TMT procedures. As a result, ptosis appeared in 14(18.7%) out of 75 TMT procedures for 4 years. Four technical points should be considered for the initial assessment to prevent or reduce the incidence of ptosis. The first is the increase of the length of temporalis muscle flap to approximately 8cm with a parallel course to the lateral canthus, which will reduce the oblique pull. Second, the width of the fascia sling in the upper eyelid is narrow(3~4mm) to reduce weight on the eyelid. Third, the fascia sling in the upper lid is not tied with that of the lower lid at the medial canthal tendon to reduce tension. Lastly, the fascia sling in the upper eyelid is shallow(subdermal level) in location and as near as possible to the lid margin.
Aged ; Blindness ; Eyelids ; Facial Nerve ; Fascia ; Forehead ; Humans ; Incidence ; Keratitis ; Leprosy* ; Lip ; Male ; Oculomotor Nerve ; Paralysis ; Temporal Muscle* ; Tendons