Weber-Christian disease is a relapsing, febrile, nodular, nonsuppurative inflammation of the subcutaneous fat tissue. Many authors reported these cases which illustrate the great variability of the clinical manifestation, such as acute or chronic, fulminating or transient, febrile or non febrile, systemic or cutaneous. Two of our cases have had recurrent painful subeutaneous nodules without fever for several years. Biopsy showed a nonspecific inflammatory panniculitis with lymphocytes chiefly, and small amount of histiocytes and foamy cells. It should be suggested Weber-Christian disease when subcutaneous nodules appear recurrently same areas of the whole body surface except anterior aspects of tibia even if no fever as systemic manifestation. Treatment with steroid and chloroquine diphosphete produced good improvement.
Biopsy ; Chloroquine ; Fever ; Histiocytes ; Inflammation ; Lymphocytes ; Panniculitis ; Panniculitis, Nodular Nonsuppurative* ; Subcutaneous Fat ; Tibia

PURPOSE: The purpose of this study was to evaluate and compare the scintigraphic findings and diagnostic accuracy of double-phase Tc-99m sestamibi scan in primary and secondary hyperparathyroidism (HPT). MATERIALS AND METHODS: We retrospectively reviewed 16 cases of primary (18 lesions) and 11 cases of secondary HPT (44 lesions) who underwent Tc-99m-sestamibi scan before the surgical intervention. Scan was performed using LEM camera (Siemens, Germany) after the injection of 740MBq of Tc-99m sestamibi. Routine image consisted of baseline and 3-hour delayed images and each image was obtained using both parallel and pine hole collimator. The study population was 27 patients (male/female=5/22, age: 49.1+/-10.8). RESULTS: Eighteen lesions of primary HPT consisted of 13 adenomas and 5 hyperplasias, while all lesions of secondary HPT were hyperplasias. Among the case of primary HPT, we could detect all the lesions of 13 adenomas but only 2 lesions of 5 hyperplasias (40%) could be detected by double phase scintigraphy. Three cases of primary lesion showed decreased uptake in delayed images compared with baseline. The sensitivity, specificity, positive predictive value and accuracy of primary and secondary HPT were 58.8% (10/17), 83.3% (10/12), 83.3% (10/12), 75.9% (22/29), and 37.5% (15/40), 50% (2/4), 88.2% (15/17), 38.6% (17/44), respectively. Overall sensitivity, specificity, positive predictive value and accuracy were 43.9% (25/57), 75% (12/16), 86.2% (25/29), and 53.4% (39/73). There were no statistical difference between the weight of primary and secondary HPT lesion (p>0.05). CONCLUSION: Tc-99m sestamibi scan is fairly good modality to detect parathyroid lesion in patient with primary HPT before the surgical intervention. However, since some of cases may reveal decreased uptake in delayed image, a careful attention to the findings of baseline images may be helpful. Still the low accuracy of sestamibi scan in diagnosis of secondary HPT prohibits routine use of it for this disease.
Adenoma ; Diagnosis ; Humans ; Hyperparathyroidism, Primary ; Hyperparathyroidism, Secondary* ; Hyperplasia ; Parathyroid Glands ; Radionuclide Imaging* ; Retrospective Studies ; Sensitivity and Specificity

Carcinosarcoma is a rare malignant neoplasm consisting of both epithelial and nonepithelial components, that is, carcinoma and sarcoma in the same tumor. Since Queckenstedt reported the case of carcinosarcoma of the stomach in 1904, only 30 cases have been reported. We present a case of carcinosarcoma and adenocarcinoma of the stomach in 63-year-old man with the review of the literature.
Adenocarcinoma* ; Carcinosarcoma* ; Humans ; Middle Aged ; Sarcoma ; Stomach*

PURPOSE: Attention deficit hyperactivity disorder (ADHD) has been known as psychiatric disorder in childhood associated with dopamine dysregulation. In present study, we investigated changes in dopamine transporter (DAT) density of the basal ganglias using I-123 N- (3-iodopropen-2-yl) -2-carbomethoxy-3beta- (4-chlorophenyl) tropane [I-123 IPT] SPECT in children with ADHD before and after methylphenidate treatment. MATERIALS AND METHOD: Nine drug-naive children with ADHD and seven normal children were included in the study. We performed brain SPECT two hours after the intravenous administration of I-123 IPT and made both quantitative and qualitative analyses using the obtained SPECT data, which were reconstructed for the assessment of specific/nonspecific DAT binding ratios in the basal ganglia. All children with ADHD reperformed [123I]IPT SPECT after treatment with methylphenidate (0.7mg/kg/d) during about 8 weeks. SPECT data reconstructed for the assessment of specific/nonspecific DAT binding ratio of the basal ganglia were compared between before and after treatment methylphenidate. We investigated correlation between the change of ADHD symptom severity assessed with ADHD rating scale-IV and specific/nonspecific DAT binding ratio of basal ganglia. RESULTS: Children with ADHD had a significantly greater specific/nonspecific DAT binding ratio of the basal ganglia comparing to normal children (Right: z = 2.057, p = 0.041; Left: z = 2.096, p = 0.032). Under treatment with methylphenidate in all children with ADHD, specific/nonspecific DAT binding ratio of both basal ganglia decreased significantly greater than before treatment with methylphenidate (Right: t = 3.239, p = 0.018; Left: t = 3.133, p = 0.020). However, no significant correlation between the change of ADHD symptom severity scores and specific/nonspecific DAT binding ratio of the basal ganglia were found. CONCLUSIONS: These findings support the complex dysregulation of the dopaminergic neurotransmitter system in children with ADHD.
Administration, Intravenous ; Attention Deficit Disorder with Hyperactivity* ; Basal Ganglia* ; Brain ; Child* ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Humans ; Methylphenidate ; Neurotransmitter Agents ; Tomography, Emission-Computed, Single-Photon

GTPrS-dependent phospholipase D activity in human neutrophils was investigated using exogenous phospholipid as a substrate. Both cytosolic and membrane- associated phospholipase D activities were identified. The previously described 50 kDa cytosolic activating factor was resolved chromatographically from the cytosolic phospholipase D. Using exogenous phospholipid as substrate along with chromatographically resolved 50 kDa factor and recombinant ADP-ribosylation factor 1, plasma membrane was required for activity, indicating that the activity which was previously seen using endogenous phospholipid substrate was due to a phospholipase D located in the plasma membrane. In addition, ADP-ribosylation factor and the 50 kDa factor activated synergistically. Using neutrophil plasma membranes, a third regulator of neutrophil membrane phospholipase D was identified from bovine brain cytosol. This factor was resolved from ADP-ribosylation factor and Rho A by successive column chromatographies. The brain factor showed a synergistic effect with the 50 kDa neutrophil activator but an additive effect with recombinant ADP- ribosylation factor. Whether or not ADP-ribosylation factor or the brain factor were present, high activities were seen only when the 50 kDa factor was present, indicating that the 50 kDa cytosolic factor is a major activating factor for the neutrophil plasma membrane phospholipase D.
ADP-Ribosylation Factor 1 ; ADP-Ribosylation Factors* ; Brain* ; Cell Membrane ; Chromatography ; Cytosol* ; Fibrinogen ; Humans ; Membranes ; Neutrophils* ; Phospholipase D* ; Phospholipases*

BACKGROUD AND OBJECTIVES: Incus erosion with intact stapes head was most common ossicular impairment in chronic otitis media. Here, we aimed to investigate hearing and clinical results of the ossiculoplasties when the stapes head was intact. SUBJECTS AND METHOD: We analyzed 281 patients of ossiculoplasties over stapes head performed from 1990 to 2005. Patients were divided into 3 groups: Si group (n=121) included patients with interposition of prosthesis between malleus and stapes; Sc-PORP group (n=99) included patients with columellarization between tympanic membrane and stapes head with PORP; Sc-SC group (n=61) included patients with columellarization with the autologous materials between tympanic membrane and stapes head. Hearing improvement and extrusion rates of three groups were analyzed. RESULTS: At 6 months after the surgery, the postoperative air-bone gap (ABG) level within 20 dB was 45%, 44%, 25% in Si, Sc-PORP, Sc-Sc, respectively. The closure of ABG was statistically better in Si and Sc-PORP compared with Sc-SC. In canal wall-up mastoidectomy, Sc-PORP showed better hearing results than Si, while Si was better than Sc-PORP in canal wall-down mastoidectomy. At 36 months after the surgery, extrusion-free survival according to the type of ossiculoplasty were 100%, 89.6%, 100% in Si, Sc-PORP, Sc-SC, respectively. CONCLUSION: Si and Sc-PORP provide good hearing results. However, Si has lower extrusion rates than Sc-PORP and remains stable over time.
Head ; Hearing ; Humans ; Incus ; Malleus ; Ossicular Prosthesis ; Ossicular Replacement ; Otitis Media ; Prostheses and Implants ; Stapes ; Tympanic Membrane

OBJECTIVES: This study was conducted to analyze the factors that affected the decision of claims for cerebrovascular disorders and cardiovascular diseases in chronically overworked workers, that submitted their claims after the reformation of approval standards in the Industrial Accident Compensation Insurance Act on 1 July 2008. METHODS: Of 2909 cases, who claimed between January 1. and December 31. 2009, 1046 cases were selected based on their worker's compensation record and investigated following 6 provincial committees for work-related diseases. The approval rate and odds ratio were analyzed with respect to the general characteristics, past medical history and work-related information using a logistical regression and Student t-test. RESULTS: Of the 1046 selected cases, the approval rate was 18.5%(194 cases). In the multivariate logistical regression analysis, the factors for approving cerebrovascular disorders and cardiovascular diseases as work-related diseases were found to be the average working time over the last 1 week, occupational category, gender, age, death or survival, the presence of an associated disease, claimed province, and smoking. CONCLUSION: Factors for approving claims of cerebrovascular disorders and cardiovascular diseases as work-related diseases were the average working time over last 1 week, gender, age, death or survival, claimed disease, presence of associated disease, claimed province, smoking.
Accidents, Occupational ; Cardiovascular Diseases ; Cerebrovascular Disorders ; Compensation and Redress ; Humans ; Insurance ; Odds Ratio ; Smoke ; Smoking ; Workers' Compensation

BACKGROUND AND PURPOSE: The most-common initial manifestation of Miller Fisher syndrome (MFS) is diplopia due to acute ophthalmoplegia. However, few studies have focused on ocular motility findings in MFS. This study aimed to determine the pattern of extraocular muscle (EOM) paresis in MFS patients. METHODS: We consecutively recruited MFS patients who presented with ophthalmoplegia between 2010 and 2015. The involved EOMs and the strabismus pattern in the primary position were analyzed. Antecedent infections, other involved cranial nerves, and laboratory findings were also reviewed. We compared the characteristics of the patients according to the severity of ophthalmoplegia between complete ophthalmoplegia (CO) and incomplete ophthalmoplegia (IO). RESULTS: Twenty-five patients (15 males and 10 females) with bilateral ophthalmoplegia were included in the study. The most-involved and last-to-recover EOM was the lateral rectus muscle. CO and IO were observed in 11 and 14 patients, respectively. The patients were aged 59.0±18.4 years (mean±SD) in the CO group and 24.9±7.4 years in the IO group (p<0.01), and comprised 63.6% and 21.4% females, respectively (p=0.049). Elevated cerebrospinal fluid protein was identified in 60.0% of patients with CO and 7.7% of patients with IO (p=0.019) for a mean follow-up time from the initial symptom onset of 3.7 days. CONCLUSIONS: The lateral rectus muscle is the most-involved and last-to-recover EOM in ophthalmoplegia. The CO patients were much older and were more likely to be female and have an elevation of cerebrospinal fluid protein than the IO patients.
Cerebrospinal Fluid ; Cranial Nerves ; Diplopia ; Female ; Follow-Up Studies ; Guillain-Barre Syndrome ; Humans ; Jupiter ; Male ; Miller Fisher Syndrome ; Ophthalmoplegia ; Paresis ; Strabismus

Background: The number of general cosmetic practitioners impersonating dermatologists in Korea has increased, leading to serious harm that is significant enough to attract the attention of health authorities, which dermatologists are deeply concerned about. Objective: We conducted a survey targeting dermatologists to gather their opinions on the behavior, problems, and countermeasures of general cosmetic practitioners disguising themselves as dermatologists. Methods: A total of 280 dermatologists completed the survey between January and February 2024. The questions covered demographic characteristics, experiences of cosmetic general practitioners falsely introduced themselves as dermatologists, complications experienced by patients who received treatment after being mistaken for a dermatologist, the seriousness of the problem for cosmetic general practitioners impersonating dermatologists, and the relationship between the shortage of essential medical personnel and the phenomenon of cosmetic general practitioners disguising themselves as dermatologists. Results: Despite cases in which cosmetic general practitioners impersonate dermatologists, most dermatologists have not responded appropriately in many instances. Dermatologists have reported many cases of complications after receiving dermatological treatment from such cosmetic general practitioners. Most dermatologists are concerned about the serious problems of general cosmetic practitioners, disguising themselves as dermatologists and anticipating many adverse effects. Conclusion We believe that we need to pool our wisdom to solve these problems and expect that this study will provide valuable basic data for solving these problems in the dermatology and medical environments of Korea.

Background: The number of general cosmetic practitioners impersonating dermatologists in Korea has increased, leading to serious harm that is significant enough to attract the attention of health authorities, which dermatologists are deeply concerned about. Objective: We conducted a survey targeting dermatologists to gather their opinions on the behavior, problems, and countermeasures of general cosmetic practitioners disguising themselves as dermatologists. Methods: A total of 280 dermatologists completed the survey between January and February 2024. The questions covered demographic characteristics, experiences of cosmetic general practitioners falsely introduced themselves as dermatologists, complications experienced by patients who received treatment after being mistaken for a dermatologist, the seriousness of the problem for cosmetic general practitioners impersonating dermatologists, and the relationship between the shortage of essential medical personnel and the phenomenon of cosmetic general practitioners disguising themselves as dermatologists. Results: Despite cases in which cosmetic general practitioners impersonate dermatologists, most dermatologists have not responded appropriately in many instances. Dermatologists have reported many cases of complications after receiving dermatological treatment from such cosmetic general practitioners. Most dermatologists are concerned about the serious problems of general cosmetic practitioners, disguising themselves as dermatologists and anticipating many adverse effects. Conclusion We believe that we need to pool our wisdom to solve these problems and expect that this study will provide valuable basic data for solving these problems in the dermatology and medical environments of Korea.