Disseminated superficial actinic porokeratosis (DSAP) has an autosomal dominant mode of inheritance with reduced penetration at young age, characterized by multiple superficial keratotic lesions surrounded by a slightly raised border. The aggrevation of the lesion by exposing UV light indicates that phenotypic expression of gene regluating DSAP is related to sun light. We observed a family of which 13 members had DSAP in 3 successive generations. They were grandrnother, two sons of her 3 offsprings, 2 grandsons and 8 granddaughters. Lesions of all cases were found on the sun exposed areas, especially, face, extremities and upper trunk but exceptionally one had a lesion on the unex posed area, abdomen below the iliac crest. The number of lesions of the individual patient were 12-116, and there appeared to be increasing number of lesions with age.
Abdomen ; Extremities ; Family Characteristics* ; Humans ; Porokeratosis* ; Solar System ; Ultraviolet Rays ; Wills

The globus symptom is a condition in which a patient, often middle aged women, complains of a lump andchocking sensation in the throat, Functional disturbance of the cricopharyngeal muscle, rendering it incapable ofrelaxing during swallowing, has long been recognized as a cause of globus symptom and dysphagia. We wanted to findout how often and to what extent distrubed relaxation of the cricopharyngeal muscle can be seen in patients withglobus symptom with routine examination and video esophagogram. The results were as follows: 1. Male : femaleratio was 1:2.4. 2. Globus symptom was most frequent in the age group between 30-39 of female. 3. Organic lesionswere seen in 43.6%(24 Pts) of globus patients. 4. Cricopharyngeal muscle was visualized in 29.1%(16Pts), esophageal diverticulum in 3.6%(2 Pts) and degenerative spondylosis in 3.6%(2 Pts). 5. Incidence of visualizationof cricopharyngeal muscle were higher in male group (50%) than female one (20.5%). 6. Cricopharyngeal muscle wasmost frequently visualized on early swallowing phase(12/16 Pts).
Deglutition ; Deglutition Disorders ; Diverticulum, Esophageal ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Pharynx ; Relaxation ; Sensation ; Spondylosis

A 51-year-old female had disseminated, symmetrically distributed, brownish black pigmentation and papillary hypertrophy on the intertriginous and flexural areas for 6 months, and gastric adenocarcinoma was confirmed during the evaluation of internal malignancy, The cutaneous finding of acanthosis nigricans was a significant cutaneous marker of internal malignancy in this case.
Acanthosis Nigricans* ; Adenocarcinoma* ; Female ; Humans ; Hypertrophy ; Middle Aged ; Pigmentation

We experienced a case of generalized granuloma annular e in a 68-year-old man. Many factors have been implicated in the genesis of this disease, but in this case no etiologic factors were identified. He was treated successfully with systemic corticosteroid for about l year.
Aged ; Granuloma Annulare* ; Granuloma* ; Humans

Great difficulty may be encountered in the differentiation of basal cell carcinoma from trichoepithelioma snd, in some cases, it may even be irnpossible. Immunohistochemical methods using peanut agglutinin(PNA) which is glycoprotein of non-immune origin selectively binding to galactose-N-acetyl-galactosa-mine are increasingly used in dermatopathology to improve the diagnosis and differential diagnosis. Using PNA, anti-PNA antibody, and peroxidase antiperoxi-dase(PAP) technique, normal skin specimens, basal cell carcinomas, trichoepitheliiomas, and a variety of different skin tumors were studied, and different PNA Ibinding sites between basal cell carcinomas and trichoepitheliomas were observed. The results were as follows : l. In normal skin, except the basement membrane, epidermis and hair follicle epithelium showed a cell membrane staining of PNA, which stained weakly in the Ibssal cell layer. Sebaceous glands revealed membranous and cytoplasmic staining of PNA, but sweat ducts and duct coi1s were mostly negative. 2. 34 of 36(94.4%) basal cell carcinoma sections demonstrated peritumorous PNA-positive bands, and none of 5 trichoepithelioma sections showed peritumorous PNA-binding. 3. Peritumorous PNA-positive bands were strongly positive in solid and keratotic basal cell carcinomas, but decreased or absent in the vicinity of the ulceration or the dense inflammatory infiltration. 4. None of the other skin tumors(squamous cell carcinoms, keratoscanthoma, Bowens disesse and actinic keratosis} showed a periturnorous PNA-positive band. Therefore, we believe that the PNA staining on paraffin-embedded sections using PAP technique can be a useful probe for the differentiation of basal cell carcinoma from trichoepithelioma.
Actins ; Basement Membrane ; Carcinoma, Basal Cell* ; Cell Membrane ; Cytoplasm ; Diagnosis ; Diagnosis, Differential ; Epidermis ; Epithelium ; Glycoproteins ; Hair Follicle ; Peanut Agglutinin* ; Peroxidase ; Sebaceous Glands ; Skin ; Sweat ; Ulcer

A case of hepatocellular carcinoma (HCC) complicating with secondary biliary cirrhosis due to intrahepatic bile duct growth of the tumor is presented. The patient was 34 years-old male who had been suffered from right upper quadrant pain with intermittent fluctuating jaundice for 4 months. Left lobectomy specimen contained a single, 4 cm sized, relatively well circumscribed and partly protruding nodular HCC in the medial seqment of left lobe. It compressed the left hepatic duct, and the intra and extra-hepatic ducts were completely plugged with tumor casts (extending to the common bile duct at the operating table). Remaining hepatic parenclyma was the seat of advanced secondary biliary cirrhosis in which were abundance of HBsAg-containing hepatocytes possibily representing a HBsAg carrier status. Biliary cirrhosis in HCC is an extremely rare manifestation, reflecting the delayed adequate clinical procedure by unusual pattern of obstructive jaundice. In such a case presenting as persisting and fluctuating obstructive jaundice in HCC, an intrabile duct tumor growth should be suspected.
Male ; Humans ; Carcinoma, Hepatocellular

Letterer-Siwe disease is one of Langerhans cell histiocytosis, with Hand-Schuller-Christian disease and eosinophilic granuloma, characterized by proliferation of Langevha is cell. The clinical course of Letterer-Siwe disease is acute fulmunant of casionally fatal, involving skin and many other internal organs, such as the lymph node, liver, spleen, ung and bone. We present 3 cases of Letterer-Siwe disease with characteristic cutaneous findings and revealed Langerhans granules by imrriunohistochemical stain and electronmicrc scopic examination. All patients died in spite of combined chernotherapy.
Eosinophilic Granuloma ; Histiocytosis, Langerhans-Cell ; Humans ; Liver ; Lymph Nodes ; Skin ; Spleen

The purpose of this study was to examine the frequency of dehiscence bone defect on peri-implant and to compare the difference between resorbable membrane and non-resorbable membrane in bone regeneration on peri-implant. Amomg the patients, 22 patientswho have recieved an implant surgery at the department of Periodontics in Dankook University Dental Hospital showed implant exposure due to the dehiscence defect and 27 implants of these 22 patients were the target of the treatment. Gore-Tex(R) and Bio-mesh(R) were applied to the patients and treated them with antibiotics for five days both preoperatively and postoperatively. Reentry period was 26 weeks on average in maxilla and 14 weeks on average in mandible. The results were as follows: 1. Dehiscence bone defect frequently appeared in premolar in mandible and anterior teeth in maxilla respectively. 2. Among 27 cases, 2 membrane exposures were observed and in these two cases, regenerated area was decreased. 3. In non-resorbable membrane, bone surface area 9.25+/-4.84 preoperatively and significantly increased to 11.48+/-7.52 postoperatively.(P<0.05) 4. In resorbable membrane, bone surface area was 14.80+/-8.25 preoperatively and meaningfully widened to 17.61+/-10.67 postoperatively.(P<0.05) 5. The increase of bone surface area in non-resorbable membrane was 2.23+/-3.38 and the increase of bone surface area in resorbable membrane was 2.80+/-3.00 ;therefore, there was no significant difference between these two membranes(P<0.05). This study implies that the surgical method using DFDB and membrane on peri-implant bone defect is effective in bone regeneration regardless the kind of the membrane, and a similar result was shown when a resorbable membrane was used.
Anti-Bacterial Agents ; Bicuspid ; Bone Regeneration* ; Humans ; Mandible ; Maxilla ; Membranes* ; Periodontics ; Tooth

PURPOSE: To evaluate the accuracy of CT using water as an oral contrast material in a prone position in determining the depth of tumor invasion in gastric cancer patients. MATERIALS AND METHODS: Thirty three patients(19 male, 14 female) with surgically confirmed gastric cancer were studied. We performed CT in a prone position after ingestion of 1 liter of pure water. CT findings were classified into 4 groups by the morphologic appearances of infiltrates in the perigastric fat plane :normal perigastric fat(SO), fine mottled densities(S1), irregular aggregated or linear densities(S2) and direct extension and invasion of tumor into contiguous structures(S3). Also we prospectively compared the CT staging with pathologic T staging according to the TNM systems. RESULTS: The overall accuracy of CT staging in determining the pathologic T factor was 69.6%. As we regarded T1 and T2 lesions as one group on CT, the accuracy of CT staging was increased to 80.2% because of a limitation of CT for distinguishing T1 from T2 lesions. CONCLUSION: Prone position CT using water as an oral contrast agent is quite accurate in determining the T staging of gastric carcinoma.
Eating ; Humans ; Male ; Prone Position* ; Prospective Studies ; Stomach Neoplasms ; Water*

PURPOSE: To evaluate the specific findings of angiography for various causes of gastrointestinal bleeding. MATERIALS AND METHODS: We retrospectively analyzed 35 patients of gastrointestinal bleeding detected by angiography, between April 1987 and July 1993. There were 28 men and 7 women, 19 to 83 years old (mean, 47 years). Of these 35 cases of gastrointestinal bleedings, there were 12 gastric bleedings, 4 duodenal bleedings, 9 small intestinal bleeings, 6 ileocecal bleedings, and 4 large intestinal bleedings. RESULTS: Of 35 cases, we could diagnose the specific cause of bleeing in 13 patients (37%) by angiography. Of these 13 cases, there were 4 cases of gastric ulcers showing contrast pooling in ulcer crater, 5 cases of vascular malformations showing anomalous vascular mass with early dilated venous drainage, 2 cases of direct invasion of hepatocellular carcinoma showing invasion of hypervascular mass into small bowel, one case of pseudoaneurysm at gastroduodenal artery in a patient of acute pancreatitis, and one case of small intestinal lymphoma showing contrast pooling in a irregular dilated small intestinal lumen. CONCLUSION: in gastrointestinal bleeding, angiography is useful not only in detecting the bleeding site, but also for evaluating the specific causes such as gastric ulcers or vascular malformations.
Aged, 80 and over ; Aneurysm, False ; Angiography ; Arteries ; Carcinoma, Hepatocellular ; Diagnosis* ; Drainage ; Female ; Hemorrhage* ; Humans ; Lymphoma ; Male ; Pancreatitis ; Retrospective Studies ; Stomach Ulcer ; Ulcer ; Vascular Malformations