A 25-year-old man had been intermittently treated with topical steroid ointment for his eczematous lesions on the scrotum. One year later, a few hard nontender nodules were found with surrounding thickened lichenified skin on the previous lesions. Histopathologic examination of the skin revealed moderate acanthosis of the epidermis and multiple scattered calcified materials in the upper demis and within the hair follicle. We present this case, being considered a dystrophic calcinosis cutis due to local injury.
Adult ; Calcinosis* ; Epidermis ; Hair Follicle ; Humans ; Lupus Erythematosus, Discoid* ; Scrotum ; Skin

Hemorrhagic radiation proctitis is infrequently seen in patients receiving pelvic irradiation. The treatment of hemorrhagic ralation proctitis is often difficult. Many patients need reyeated hospitalizations and blood transfusions. Occasionally patiets will develop severe or recurrent rectal bleeding. In case of massive bleeding requiring excessive transfusion, colonic diversion by construction of a colostomy or excision of the diseased segment may be inevitable. However, surgical procedures in these patients are associated with a high mortality and morbidity. Moreover, medical therapy is usually ineffective. Recently formalin therapy has been introduced as a simple and effective treatment for hemorrhagic radiation proctitis. We experienced a 69 year-old woman patient who developed severe homorrhagic proctitis 1 year after radiotherapy for carcinoma of the cervix. She had not improved by conservative management and required blood tranafusions and repetitive hospitalizations. After local application of a 4% formalin solution in the diseased rectum under caudal anesthesia, the bleeding immediately stopped and the patient was discharged from the hospital, and no recurrence has been observed until now.
Aged ; Anesthesia, Caudal ; Blood Transfusion ; Cervix Uteri ; Colon ; Colostomy ; Female ; Formaldehyde* ; Hemorrhage ; Hospitalization ; Humans ; Mortality ; Proctitis* ; Radiotherapy ; Rectum ; Recurrence

BACKGROUND: To reduce surgical stress, fentanyl is frequently used for neurosurgical procedure where focal and/or global ischemia may occur. However, the effect of fentanyl on the cytokine level during ischemia/reperfusion is still uncertain. The goal of this study was to evaluate the effect of fentanyl infusion on the proinflammatory cytokine, TNF-alpha and IL-1beta, levels during global cerebral ischemia/reperfusion (I/R) in rats using the intracerebral microdialysis technique. METHODS: Forty male S-D rats weighing 280 320 g were randomly assigned to four groups. Group 1: no fentanyl infusion and only I/R, Group 2: 1.5 ng/ml of fentanyl infusion during I/R, Group 3: 3.0 ng/ml of fentanyl infusion during I/R (n = 10 in each group). Rats were anesthetized with a intraperitoneal injection of pentobarbital (50 mg/kg), intubated and ventilated with room air using an animal ventilator. Two femoral arteries and one femoral vein were cannulated with PE-50 tubing for hemorrhagic hypotension, drug infusion and hydration. Both carotid arteries were dissected and a sling was placed for brain ischemia. The head was fixed on a stereotaxic device and a small burrhole was made for probe insertion. A CMA-12 probe was inserted into the left hippocampal CA-1 region according to the guidelines. Artificial CSF was run from the inserted microdialysis probe and infused with or without fentanyl at 3 microliter/min using a microinjection syringe pump during I/R. Ischemia was induced by clamping the carotid arteries while hemorrhagic hypotension for 17 min via the femoral artery and reperfusion were accomplished by the unclamping of the sling and reinfusing the blood via the femoral artery. Nasopharyngeal and rectal temperatures were maintained within the normal range during the whole procedure. After 2 hours of stabilization, the microdialysate was collected every 17 min just before (control) and during I/R and stored at 80oC until analysis using HPLC. RESULTS: During global I/R, TNF-alpha and IL-1 beta significantly increased at reperfusion (R5) compared to the control value (P < 0.05). However, in both cases of fentanyl infusion, TNF-alpha and IL-1 beta did not increase compared to the control value. CONCLUSIONS: Fentanyl inhibited the increase of proinflammatory cytokine TNF-alpha and IL-1 beta levels during global cerebral ischemia/reperfusion in rats.
Animals ; Brain Ischemia ; Carotid Arteries ; Chromatography, High Pressure Liquid ; Constriction ; Femoral Artery ; Femoral Vein ; Fentanyl* ; Head ; Humans ; Hypotension ; Injections, Intraperitoneal ; Interleukin-1beta ; Ischemia ; Male ; Microdialysis ; Microinjections ; Neurosurgical Procedures ; Pentobarbital ; Rats* ; Reference Values ; Reperfusion ; Syringes ; Tumor Necrosis Factor-alpha* ; Ventilators, Mechanical

No abstract available.

Sleep disturbance and restless legs syndrome (RLS) among uremic patients is known to be high, but data on the prevalence, clinical significance, and causative factors are limited. A semiquantitative sleep and RLS questionnaire was distributed to 62 chronic hemodialysis(HD) patients. 74.5N had sleep complaints and frequent awakening was the most frequent specific sleep complaints followed by daytime sleepiness. Presence of diabetes mellitus(DM), RLS, depres- sion, high CRP level, low intact parathyroid hormone level, low subjective global assessment score, and short HD duration were associated with more sleep complaints. 58.3N had RLS and presence of DM, low serum albumin level were also associated with more severe RLS. But Kt/V, protein catabolic rate, hematocrit, plasma bicarbonate level, use of erythropoietin and sleep medication were not associated with sleep complaints and RLS. Sleep problems and RLS are comrnon in HD patients and seem to be associated with malnutrition. Presence of DM, de- pression, and RLS are likely to contribute the high prevalence of sleep disturbance.
Erythropoietin ; Hematocrit ; Humans ; Malnutrition ; Parathyroid Hormone ; Plasma ; Prevalence ; Renal Dialysis* ; Restless Legs Syndrome ; Serum Albumin ; Surveys and Questionnaires

Maxillofacial injuries are less common in children than in adolescents and adults. This lower incidence is a result of the relatively small size of mandible, the resilient nature of the bones, and a relatively protected environment, which distinguish the treatment principles of pediatric mandibular fractures from those of the adult. The bone of child is malleable, so pediatric fractures tend to be less displaced and rarely comminuted. Moreover, high regeneration potential of the wound allows more conservative treatment modalities for the pediatric mandibular fracture. High risk of damaging unerupted tooth bud renders many clinicians to resort to more conservative treatment modality for the reduction of displaced segments. This case report describes two successful treatment cases using the circummandibular wiring which was applicated to the fracture on parasymphysis of mandible. Circummandibular wiring can protect the tooth buds, and there is no need for intermaxillary fixation so that it prevents the possible complications of intermaxillary fixation such as the temporomandibular joint ankylosis and the facial growth disturbances. The acrylic splint was removed after 3 weeks, which showed clinically good union across the fracture line without complications. They showed complete clinical and radiological bone healing with an optimum occlusion.
Adolescent ; Adult ; Ankylosis ; Child ; Health Resorts ; Humans ; Incidence ; Mandible ; Mandibular Fractures ; Maxillofacial Injuries ; Regeneration ; Splints ; Temporomandibular Joint ; Tooth ; Tooth, Unerupted

BACKGROUND: The HPV28 Detection test (Seegene) is a real-time polymerase chain reaction assay that is designed for testing a total of 28 human papillomavirus (HPV) genotypes and estimating the approximate HPV viral load. The aim of this study was to evaluate the clinical applicability of the HPV28 Detection test with regard to the prevalence of HPV infection and distribution of HPV genotypes by using the HPV28 Detection and HPV DNA Chip tests (Biomedlab). METHODS: HPV DNA Chip and HPV28 Detection tests were performed for 500 cervical swab specimens. HPV genotype results were confirmed by sequencing analysis of the specimens that showed discordant results in the 2 test methods. RESULTS: The positive rate of HPV detection determined by using HPV28 Detection and HPV DNA Chip tests were 43.8% and 40.6%, respectively. The sequencing results in 64 discordant specimens that showed single HPV infection in the 2 test methods were in complete agreement with the test results obtained with the HPV28 Detection test. The genotyping results of the HPV28 Detection test were 100% concordant in repeated experiments with HPV-infected specimens that have 12 different HPV genotypes, i.e., types 16, 31, 33, 39, 42, 51, 52, 53, 58, 66, 68, and 70. The HPV28 Detection test was 100-fold more sensitive than the HPV DNA Chip test with serially diluted HPV DNAs. CONCLUSIONS: The HPV28 Detection test can be applied in the clinical field as an HPV genotyping test can accurately identify various HPV genotypes with high specificity and low detection limit.
DNA ; Genotype ; Humans ; Limit of Detection ; Oligonucleotide Array Sequence Analysis ; Prevalence ; Real-Time Polymerase Chain Reaction ; Sensitivity and Specificity ; Viral Load

Osteoma is a slow growing benign osteogenic lesion characterized by proliferation of compact or cancellous bone. Osteomas may be classified as peripheral, central, or extraskeletal. Central osteoma arise from the endosteum, pheripheral osteoma from the periosteum, and extraskeletal soft tissue osteoma within a muscle. Peripheral osteoma of the mandible is uncommon. They manifest as asymptomatic, fixed tumors of bony-hard consistency that may be sessile or pedunculated. Radiographically, a well circumscribed round or oval radiopaque mass is seen. Here, we report a case of a huge solitary peripheral osteoma of the buccal posterior mandible in a 40-year-old woman who was otherwise in good health. The patient visited at the dental clinic because the lesion makes esthetic problem. Treatment was performed by surgical esthetic recontouring and histological examination. The patient remains free of recurrence after surgical esthetic recontouring operation
Adult ; Dental Clinics ; Durapatite ; Female ; Humans ; Mandible ; Muscles ; Osteoma ; Periosteum ; Recurrence

Bisphosphonates are compounds widely used in the treatment of various metabolic and malignant bone disease. Recently, an association between bisphosphonate use and a rare dental condition termed 'osteonecrosis of the jaw(ONJ)' has been reported. Bisphosphonate-related osteonecrosis of the jaw(BRONJ) is rare, but serious, side effect of bisphosphonate therapy in affected patients. It is characterized by poor wound healing and spontaneous intra-oral soft tissue break down, which lead to exposure of necrotic maxillary and mandibular bone. We reviewed 11 patients of BRONJ visited Ajou University Hospital Dental clinic from May 2007 to November 2008. The management of the patients included cessation of bisphosphonate therapy and various surgical restorative procedures and conservative care there after. Aggressive debridement is contraindicated. A new complication of bisphosphonate therapy administration, osteonecrosis of jaws, seems to be developing. The improved results after cessation of the medication should make clinicians reconsider the merits of the rampant use of bisphosphonates, while further investigation is needed to completely elucidate this complication.
Bone Diseases ; Debridement ; Dental Clinics ; Diphosphonates ; Humans ; Jaw ; Maxilla ; Osteonecrosis ; Osteoporosis ; Wound Healing

Human anthrax has been a zoonotic disease affecting those who have close contact with animals or animal products contaminated with the spore-forming bacterium Bacillus anthracis. Now the incidence of anthrax in herbivores and human are rare, but it remains an important health problem in Korea because anthrax is seen as one of the most likely biological weapon. The B. anthracis forms a spore, which is resistant to drought, heat and numerous disinfectants, and the spore can remain viable and infective in the environment for decades. There are three major forms of human disease depending on how infection is contracted, cutaneous, inhalation and ingestion. Inhalational anthrax is the most common form, but the events in the Korea show that gastrointestinal anthrax is the most common. Several cases of anthrax have been reported in Korea. In recent years, 2 cases of bovine anthrax and 5 cases of human anthrax occurred in Changnyeong-gun, 2000, but it haven't occurred any more so far. The most useful microbiological test remains the standard blood culture. Confirmatory diagnostic tests such as polymerase chain reaction can also be used and may help in early diagnosis. Prompt clinical suspicion and rapid administration of effective antimicrobials are essential for treatment of anthrax. Ciprofloxacin or doxycycline should be used for initial intravenous therapy until antimicrobial susceptibility results are known. The best measure to eliminate human anthrax is control in domestic animals by effective surveillance and by immunization of animals in endemic areas. Also, the government must establish countplan for knowledge and rational policies in dealing with potential bioterrorism attacks.
Animals ; Animals, Domestic ; Anthrax* ; Bacillus anthracis ; Biological Warfare Agents ; Bioterrorism ; Ciprofloxacin ; Diagnostic Tests, Routine ; Disinfectants ; Doxycycline ; Droughts ; Early Diagnosis ; Eating ; Herbivory ; Hot Temperature ; Humans ; Immunization ; Incidence ; Inhalation ; Korea ; Polymerase Chain Reaction ; Spores ; Zoonoses