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

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*

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

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

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

BACKGROUND: Damage of the facial nerve, especially buccal and marginal mandibular branches, causes facial palsy and paralytic deformity of the lips such as lower lip ectropion, lip drooping, deviation of the mouth, inability of closing mouth, and the loss of the nasolabial folds. OBJECTIVE: To find out the best surgical method to correct paralytic deformity of the lips. METHODS: We reviewed retrospectively the various surgical treatment modalities of the paralytic deformity of the lips performed in The Institute for Leprosy Research for 13 years. RESULTS: One hundred and twenty five surgical procedures were performed in 80 patients with Hansen's disease. Of these, the static method, dermal suspension flap, was done in 15 cases, the dynamic methods were done in 64 cases, and others were done in 46 cases. All patients showed postoperatively clinical improvement above the average. Two patients received reoperation or additional procedures due to relapse of the condition. CONCLUSIONS: The dynamic method using tensor fascia lata was superior to other treatment modalities.
Congenital Abnormalities ; Ectropion ; Facial Nerve ; Facial Paralysis ; Fascia Lata ; Humans ; Leprosy ; Lip ; Mouth ; Recurrence ; Reoperation ; Retrospective Studies

BACKGROUND: Madarosis or loss of eyebrows is one of the complications in leprosy, which takes expressions out of the face and is considered as a stigma of leprosy in society. So the patients with leprosy are usually eager to have the situation corrected through various methods such as tatoo or surgery including scalp flap or hair transplantation. OBJECTIVE: To describe the use of single hair transplantation for the correction of madarosis in patients with leprosy. METHODS: An elliptical donor strip was removed with a No.10 blade from the occiput. It was sectioned into small slices and subsequently into single hair micrografts. Then these micrografts were inserted into preformed slits of eyebrows using hair implantation device. RESULTS: Excellent cosmetic results and high patient satisfaction were seen in almost all patients. Reoperations were done in 3 patients due to partial sparsity or unnatural shape of the eyebrows. There were no complications except for pruritic papules which developed from the transplanted areas in 2 patients with eyebrow tatoos. CONCLUSIONS: Single hair transplantation proved to be useful in the reconstruction of eyebrows in patients with leprosy and provided superior cosmesis to other grafts despite a technically difficult and time-consuming procedure.
Eyebrows ; Hair* ; Humans ; Leprosy* ; Patient Satisfaction ; Scalp ; Tissue Donors ; Transplants

Changes in the eye resulting from leprosy include lagophthalmos, ectropion and the eyelid retraction. In lagophthalmos, an interpalpebral gap(lid gap) of 2mm or less, which is most preferred after correction, does not have any adverse effect on the vision. However, a gap of 3mm or greater can cause or make the eye susceptible to the dryness of the cornea or other vision problems. Bell's phenomenon will adequately prevent eye damages, especially corneal damage when the lid gap is less than 3mm. Although static methods such as autogenous canthal sling, lateral tarsal strip, medial tarsorrhaphy and gold implant had a positive cosmetic effect when used in combination, the lid gap could hardly reduce to less than 3mm. Frequent recurrence of lagophthalmos and ectropion after static methods required further definite surgical treatment. We applied a dynamic method of modified Gillies to correct lagophthalmos and it was successful in reducing the lid gap to less than 2mm in most cases.
Cornea ; Cosmetics ; Ectropion ; Eye ; Eyelids ; Leprosy ; Recurrence ; Vision, Ocular

BACKGROUND: Eyelash ptosis(ELP) is a common finding in patients with long-standing leprosy. However, it has rarely been reported in the literature previously, because it has been diagnosed as trichiasis or entropion. OBJECTIVE: To determine the prevalence of ELP in Hansen's disease. METHODS: We took both frontal and lateral photographs of eyes in 20 patients and evaluated the degree of ptosis using a 4-point rating scale, in which 0 indicates no ptosis; 1, minimal; 2, moderate; and 3, severe. The evaluation was also performed in 20 normal persons as control group. RESULTS: All patients demonstrated ELP. In general, severity of ptosis in patient group is greater than that in control group. While the mean eyelash ptosis rating was 2.0+/-0.6 in the latter, it was 0.6+/-0.4 in the former, which is statistically significant (p<0.01). CONCLUSIONS: ELP is common in the patients with Hansen's disease and moderate to severe forms occurred more commonly in disease group compared with control group. ELP must be considered as a characteristic ocular finding in long-standing leprosy.
Eye ; Humans ; Leprosy ; Prevalence ; Trichiasis