BACKGROUND: Interferon alpha-2a has already been shown to be effective in clinical use of virus-originated diseases such as hairy cell leukemia, condyloma acuminatum, and AIDS-related Kaposi's sarcoma. The use of recombinant alpha-interferon may allow common warts to be treated relatively atraumatically and with less incidence of recurrence. OBJECTIVE: We tried to determine the safety and effectiveness of intralesional injections of recombinant alpha-2a interferon in the treatment of patients with common warts. METHODS: A single wart on each patient was weekly injected with 0.75 to 1.5×10(5) IU/25mm2 of interferon for 8 weeks, and the response to treatment was followed up-to 6 months. RESULTS: Clearing of the treated wart at the end of treatment occurred in 5(71%) out of 7 patients and the rest showed no improvement. With evaluation for relapses up-to 6 months after treatment, warts relapsed in 2(40%) out of 5 patients. Therefore, 3(43%) out of 7 patients were completely free of warts 6 months after treatment. CONCLUSION: Intralesional recombinant interferon alpha-2a has a limited therapeutic effect, but may be considered as a therapeutic modality of recalcitrant verruca or when it can be anticipated that destructive techniques or blistering agents will not be tolerated.
Blister ; Humans ; Incidence ; Injections, Intralesional ; Interferon-alpha ; Interferons* ; Leukemia, Hairy Cell ; Recurrence ; Sarcoma, Kaposi ; Warts*

OBJECTIVES: Dysfunctional uterine bleeding(DUB) is defined as abnormal bleeding from the uterine endometrium unrelated to anatomic lesions of the uterus, and its incidence is 10-15% among gynecologic diseases. We conducted this study for understanding correlation between clinical aspecets and pathological findings of DUB. Methods: We conducted a retrospective review of 599 women with DUB who underwent endometrial biopsy with special regard to the relation between pathologic findings and presenting symtoms or complaints from Jan. 1988 to Dec. 1997. RESULTS: Age distribution of DUB was mainly 5th decade, mean age was 44.1years, among various bleeding patterns, intermenstrual bleeding was the most common pattern(31.6%) and the next was menorrhagia(25.0%). Histologic findings of endometrium were proliferative phase, 327 cases(54.6%), hyperplasia, 139 cases(23.2%), secretory phase, 74 cases(12.4%) in order of frequency, and there was no difference in distribution of histologic findings among various bleeding patterns. CONCLUSION: Compared to other previoius studies, our study showed more incidence of endometrial hyperplasia, especially at age group of 40 or more. So patients aged more than this age with abnormal uterine bleeding must undergo emdometrial biopsy for pathologic diagnosis. Patients who are diagnosed endometrial hyperplasia must be carefully followed up because there are possibilities of progression to endometrial carcinoma.
Age Distribution ; Biopsy ; Diagnosis ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Endometrium ; Female ; Genital Diseases, Female ; Hemorrhage ; Humans ; Hyperplasia ; Incidence ; Metrorrhagia* ; Retrospective Studies ; Uterine Hemorrhage ; Uterus

Epilepsy surgery can be a safe, effective treatment for individuals with intractable partial epilepsy. There is increasing evidence that brain abnormalities in focal epilepsy are not restricted to a single area. The longstanding debate around the relationship between structural lesions and the epileptic zone remains unresolved. Patients with DNT (dysembryoplastic neuroepithelial tumor), which is an essentially benign tumor, can be cured by epilepsy surgery-oriented approach. Cortical dysplasia is frequently associated with DNT and seems to contribute to epileptogenic activity of DNT. Surgical treatment should be aimed at removal of the associated cortical dysplasia as well as DNT itself for ideal treatment of the disease. Simple lesionectomy of cavernous angioma would relieve seizures significantly, but not always. The concept of epilepsy surgery needs to be recruited in the treatment of cavernous angioma with seizures because diffusion of hemosiderin into the surrounding brain tissue and formation of cortical scars can make epileptogenic areas. Cortical dysplasia is a highly epileptogenic lesion constituting an important cause of medically intractable epilepsy and surgery is a treatment of choice in a selected group of patients. Identification and complete resection of the lesion and ictal onset zone are necessary to achieve a good surgical results. Intractable epilepsy accompanied by benign brain lesions can be treated surgically using the entire armamentarium of presurgical investigations. Deliberate resective procedures aimed at complete removal of dysplastic tissue and epiletogenically active areas on and around the lesion ensure excellent seizure control without permanent neurologic deficit.
Brain* ; Cicatrix ; Diffusion ; Epilepsies, Partial ; Epilepsy* ; Hemangioma, Cavernous ; Hemosiderin ; Humans ; Malformations of Cortical Development ; Neurologic Manifestations ; Seizures

PURPOSE: The ictal perfusion patterns of cerebellum and basal ganglia have not been systematically investigated in patients with temporal lobe epilepsy (TLE). Their ictal perfusion patterns were analyzed in relation with temporal lobe and frontal lobe hyperperfusion during TLE seizures using SPECT subtraction. MATERIALS AND METHODS: Thirty-three TLE patients had interictal and ictal SPECT, video-EEG monitoring, SPGR MRI, and SPECT subtraction with MRI co-registration. RESULTS: The vermian cerebellar hyperperfusion (CH) was observed in 26 patients (78.8%) and hemispheric CH in 25 (75.8%). Compared to the side of epileptogenic temporal lobe, there were seven ipsilateral hemispheric CH (28.0%), fifteen contralateral hemispheric CH (60.0%) and three bilateral hemispheric CH (12.0%). CH was more frequently observed in patients with additional frontal hyperperfusion (14/15, 93.3%) than in patients without frontal hyperperfusion (11/18, 61.1%). The basal ganglia hyperperfusion (BGH) was seen in 11 of the 15 patients with frontotemporal hyperperfusion (73.3%) and 11 of the 18 with temporal hyperperfusion only (61.1%). In 17 patients with unilateral BGH, contralateral CH to the BGH was observed in 14 (82.5%) and ipsilateral CH to BGH in 2 (11.8%) and bilateral CH in 1 (5.9%). CONCLUSION: The cerebellar hyperperfusion and basal ganglia hyperperfusion during seizures of TLE can be contralateral, ipsilateral or bilateral to the seizure focus. The presence of additional frontal or basal ganglia hyperperfusion was more frequently associated with contralateral hemispheric CH to their sides. However, temporal lobe hyperperfusion appears to be related with both ipsilateral and contralateral hemispheric CH.
Basal Ganglia* ; Cerebellum* ; Epilepsy, Temporal Lobe* ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Perfusion ; Seizures ; Temporal Lobe* ; Tomography, Emission-Computed, Single-Photon

Pneumorrhachis, which involves the entrapment of air or gas within the spinal canal, is a rare clinical entity, and the pathogenesis and etiologies of this uncommon entity are various and can present a diagnostic challenge. Usually, pneumorrhachis represents an asymptomatic epiphenomenon but it can produce symptoms associated with its underlying pathology. Here, we report a rare case of symptomatic epidural pneumorrhachis accompanying pneumothorax. Possible pathogenic mechanisms are discussed and a review of the literature is included.
Pneumorrhachis ; Pneumothorax ; Spinal Canal

We report a case of mycosis fungoides in a 28 year-old female patient who had multiple, bizzare, kidney or annular shaped, erythematous to brownishaly patches and plaques on the trunk, buttock, upper and lower extremities. Histopathologic finclingm showed epidermotropism and Pautrir microabscess in the epidermis and sssatypical lymphocytes infiltration in the dermis. T cell marker in leukocyte common antigen were positively stained in an immunohistochemical study. The skin lesions were reproved markedly after treatment it a total dose of 45 x 10 IU recombinant interferonaiv combination with a total dose of 385 iules/art PUVA.
Adult ; Antigens, CD45 ; Buttocks ; Dermis ; Epidermis ; Female ; Humans ; Interferons* ; Kidney ; Lower Extremity ; Lymphocytes ; Mycosis Fungoides* ; Skin

Hypereosinophilic syndrome represents a heterogenous group filisorders with the common features of idiopathic prolonged eosinophilia of undetectable cause and orgar, system dysfunction. We experienced a case af hypereosinophilic syndrome in a 58 year old man who has been suffered from fever, chilling, generelized exfoliative dermatitis, periorbital sngioedema and oral ulcer for 3 weeks duration. The blood eosinophil count was 7436/mm and skin, liver, bone marrow biopsy revealed marked infiltration of eosinophils. We treated him with co ticosteroid, but 5 months later, he died due to hepatoencephalopathy, hepatorenal syndrome, dissernimted intravascular coagulopathy and acute respiratory distress syndrome.
Biopsy ; Bone Marrow ; Dermatitis, Exfoliative ; Eosinophilia ; Eosinophils ; Fever ; Hepatorenal Syndrome ; Humans ; Hypereosinophilic Syndrome* ; Liver ; Middle Aged ; Oral Ulcer ; Respiratory Distress Syndrome, Adult ; Skin

Juxtaductal coarctation is usually distal to the origin of the left subclavian artery, occasionally the orifice of the subclavian artery is involved in the coarctation and partially obstructed. An anomalous origin of the right subclavian artery from the descending aorta below the coarcted segment is also occasionally encountered. Reversed vertebral artery flow to a subclavian artery arising at or below a coarctation may produce the subclavian steal syndrome. Rarely both subclavian arteries arise beyond the coarctation. These abnormal subclavian arteries are important in clinical diagnosis and treatment. We report a case of Turner syndrome with coarctation, which present as juxtaductal type and the left subclavian artery from the descending aorta below the coarcted segment with reversed vertebral artery flow to a subclavian artery producing the subclavian steal syndrome. Resecton of coarctation segment and end-to-end anastomosis was successfully performed after transfer of left subclavian artery to distal segment of descending aorta.
Aorta, Thoracic* ; Aortic Coarctation ; Diagnosis ; Subclavian Artery* ; Subclavian Steal Syndrome* ; Turner Syndrome* ; Vertebral Artery

PURPOSE: The most common complication of Kawasaki disease(KD) is the development of coronary artery aneurysm. Other cardiac complication include myocarditis, pericarditis, mitral or aortic insufficiency, congestive failure, and arrhythmia. These non- coronary cardiac problems have important role on clinical course in acute phase of KD. Extensive researches have been performed about the pathogenesis, natural course and treatment of coronary artery lesion. But the studies about non-coronary cardiac complication have been limited, so we aimed to study the manifestation, incidence, and clinical predictor of carditis. METHODS: The retrospective studies was performed to the 48 KD patients diagnosed in Chungnam National University Hospital from May 1998 to September 2004. The patients were divided into two groups. Patients with carditis(11 patients) and without carditis(37 patients) before receiving the IVGG infusion were analyzed. RESULTS: There were no differences in age and sex between two groups. Patients with long duration of fever and high Harada score had the significant increase in the incidence of carditis before the initial IVGG infusion. No significant differences were not shown between the two groups in terms of WBC count, hemoglobin, hematocrit, platelet count, total protein, AST/ALT, LDH, CPK, troponin I, total cholesterol, and triglyceride before the initiL IVGG infusion. The incidence of carditis was high in patient with high CRP, low albumin, and high cholesterol and triglyceride. CONCLUSION: The possibility of significant carditis should be considered before the infusion of high dose IVIG, which may worse the caridac dysfunction. Some predictors of significant carditis such as long duration of fever, high Harada score, high levels of CRP, and low levels of albumin can be suggested.
Aneurysm ; Arrhythmias, Cardiac ; Child* ; Cholesterol ; Chungcheongnam-do ; Coronary Vessels ; Estrogens, Conjugated (USP) ; Fever ; Hematocrit ; Humans ; Immunoglobulins, Intravenous ; Incidence ; Mucocutaneous Lymph Node Syndrome* ; Myocarditis* ; Pericarditis ; Platelet Count ; Retrospective Studies ; Risk Factors* ; Triglycerides ; Troponin I

OBJECTIVE AND METHODS: To determine correlations among ambulatory renin activity, ambulatory blood pressure and microalbumin excretion rate, 66 Korean essential hypertensives were studied after 4 week wash-out period. The ambulatory blood pressure was monitored every 30 minutes and mean BP were calculated automatically. Urinary microalbumin excretion rate(UAER) and ambulatory plasma renin activity(aPRA) collected at mid-day were measured by radioimmunoassays. Subjectives were divided into 2 groups by aPRA value(2ng/ml/hr). RESULT: 14 cases were high renin group and 52 cases low renin group. The mean BP were 148.83/94.69mmHg in low renin group, and 146.57/98.07mmHg in high-renin group without difference. UAER were not different also between both groups. 23.07%(4/14) of non-dippers were included in high renin group and 25.58%(12/52) in low renin group without statistical difference. The aPRA was significantly related to UAER and systolic and diastolic mean blood pressure. Also UAER was related significantly to day mean blood pressures. CONCLUSION: Thus aPRA is thought to be a meaningful indicator to predict hypertensive renal target organ damage as well as blood pressure measured with 24-hr ABPM.
Blood Pressure* ; Hypertension* ; Plasma* ; Radioimmunoassay ; Renin*