Large cell neuroendocrine carcinoma (LCNEC) of the lung is a newly recognized entity of pulmonary neuroendocrine carcinoma. Histologically, it is very difficult to differentiate LCNEC from other pulmonary carcinomas and the prognosis is significantly poor. The cutaneous metastasis of LCNEC of the lung shares some features with Merkel cell carcinoma of the skin in light microscopy and yet it is negatively stained with cytokeratin 20. We report a case of cutaneous metastasis of LCNEC of the lung, previously misdiagnosed as squamous cell carcinoma. Our patient showed a poor response to the chemotherapy and also revealed a brain metastasis on follow-up brain CT scan.
Brain ; Carcinoma, Merkel Cell* ; Carcinoma, Neuroendocrine* ; Carcinoma, Squamous Cell ; Drug Therapy ; Follow-Up Studies ; Humans ; Keratin-20 ; Lung* ; Microscopy ; Neoplasm Metastasis ; Prognosis ; Skin ; Tomography, X-Ray Computed

No abstract available.
Breast* ; Child* ; Humans

Wilson disease gene (WND) locus is presumed to be located in chromosome 13q. There are studies on the clinical heterogeneities and variations between ethnic groups in Europe, North America, and the Middle East and it requires the study of another ethnic group, especially Asian population for the confirmation. This study was an anlysis of restriction fragment length polymorphism of the Wilson's disease with the probes on D13S26, D13S31, and D13S59, The subject was 34 persons of seven families. The serum ceruloplasmin and the serum copper were also measured. The results were as follows: 1) The Wilson disease gene was also presumed to be located in chromosome 13q area in Korean patients and D13S25, D13S26, D13S31 and D13S59 gene loci were also linked to Wilson disease of Koreans. The lod score of D13S25 was 1.45 (theta =0: D13S59, 1.13 (theta =0): D13S26, 247 (theta =0). 2) Three siblings of Wilson disease patients were diagnosed as carriers by the analysis of restriction fragment length polymorphism. 3) In Wilson disease patients, the serum ceruloplasmin and copper was 6.8+/1.8dl, and 64.7+/-38.6microg/dl respectively and it is 18.8+/-6.1 mg/dl and 65.3+/-10.6microg/dl respectively in heterozygotes.
Asian Continental Ancestry Group ; Ceruloplasmin ; Copper ; Ethnic Groups ; Europe ; Genetic Linkage* ; Hepatolenticular Degeneration* ; Heterozygote ; Humans ; Lod Score ; Middle East ; North America ; Polymorphism, Restriction Fragment Length ; Siblings

BACKGROUND: The efficacy of tumescent liposuction in the treatment of axillary osmidrosis has been widely established. But there have been few studies that have conducted a comparative analysis according to the level of dermal curettage with respect to the efficacy and safety. OBJECTIVE: The aim of this study was to evaluate the clinical efficacy and complications of tumescent liposuction according to the degree of dermal curettage. METHODS: From September 2004 through August 2009, a total of 33 patients with axillary osmidrosis (66 axillae) were included in this study. Twelve patients (24 axillae) were treated by tumescent liposuction with dermal curettage at the level of the mid-dermis (the classical technique group), and the other 21 patients (42 axillae) were treated by tumescent liposuction with dermal curettage at the level of the dermo-subcutis junction (the modified technique group). The preoperative and postoperative disease severity was measured as 0, 1, 2 and 3. The improvement of symptoms was graded by the patient as excellent, good, fair and poor. We also evaluated the postoperative complications, including skin necrosis, scar, hematoma, sensory disturbance and infection. Biopsies of the axillary skin were performed in 7 patients to confirm the level of dermal curettage and the reduction of apocrine glands after treatment. RESULTS: The follow-up ranged from 6 to 60 months. Six months after treatment, 95.8% (23/24) of the axillae in the classical technique group and 95.2% (40/42) of the axillae in the modified technique group had reduced disease severity below 1. Among the 12 patients treated with the classical technique, 11 (91.7%) had excellent to good results, while 95.2% (20/21) of the patients treated with the modified technique had excellent to good results by the patients' own grading. The complications included skin necrosis, scar and hematoma. In the classical technique group and the modified technique group, the incidence of skin necrosis was 12.5% (3/24) and 2.4% (1/42), respectively, the incidence of scar formation was 4.2% (1/24) and 0%, respectively, and the incidence of hematoma was 8.3% (2/24) and 0%, respectively. The postoperative histologic examinations confirmed that the dermal curettage level was at the mid-dermis in the classical technique and at the dermo-subcutis junction in the modified technique. Interestingly, the histologic examination from the classical technique group revealed vacuolar alteration of keratinocytes and partial separation of the dermo-epidermal junction. CONCLUSION: The efficacy of the modified technique is compatible with that of the classical technique, but the modified technique offers fewer complications. So, the modified technique may improve the cosmetic outcome without reducing the treatment efficacy for the patient with axillary osmidrosis.
Apocrine Glands ; Axilla ; Biopsy ; Cicatrix ; Cosmetics ; Curettage ; Follow-Up Studies ; Hematoma ; Humans ; Incidence ; Keratinocytes ; Lipectomy ; Necrosis ; Postoperative Complications ; Skin ; Treatment Outcome

We investigate the serial change of the bone density of the lengthening sites in distraction osteogenesis in long bone lengthening of the lower extremity by measuring the pixel value of the PACS(Picture Archiving Communication System). The purpose of this study was to find the clinical implication of the pixel value in PACS in the distraction osteogenesis. The number of the distraction sites were 22 in tibia and 16 in femur. The average distraction length was 4.5cm ranged between 2.1cm and 7.0cm in femur, 4.1cm ranged hetween 1.9cm and 6.8cm in tibia. When the image were sent to the PACS workstations, they were directly interfaced to the workstation without any processing. The absolute and the relati ve pixel values of cortical bones of the original and the lengthening sites repr sented in workstation of PACS were obtained by average value measuring 3 times by 3 different persons. The average absoiute pixel value of the original cortical bone near distraction site was not significantly changed, maintaining 575+/-6 in femur, and 570+/-7 in tibia. The absolute pixel vaIues in AP and lateral view were not significantly changed until 6 week/cm, but rapidly increased after 7 week/cm hoth in the tibia and the femur. The relative pixel value of the lengthening sites were more than 95% in three of the four cortices at the time of the removal of the external fixators. in conclusion, the pixel value of the PACS can be a rapid, simple and easy method for detection of the change of the bone density in distraction osteogenesis.
Bone Density* ; Bone Lengthening* ; External Fixators ; Femur ; Humans ; Lower Extremity* ; Osteogenesis, Distraction* ; Tibia

Nevus sebaceus of Jadassohn has been referred to as a organoid nevus that classically evolves through three stages and may be associated with a range of skin tumors, and of these, syringocystadenoma papilliferum and basal cell carcinoma have been commonly reported to occur. The occurrence of keratoacanthoma is a very rare event in nevus sebaceus. Herein we report on a 23-year-old man with nevus sebaceus of the cheek. He represents a keratoacanthoma arising within nevus sebaceus.
Carcinoma, Basal Cell ; Cheek ; Humans ; Keratoacanthoma* ; Nevus* ; Nevus, Sebaceous of Jadassohn ; Organoids ; Skin ; Young Adult

No abstract available.
Caroli Disease*

PURPOSE: To determine the efficacy of CarnitilR (acetylcarnitine, Hanmi, Korea) therapy in idiopathic oligoasthenospermic men. MATERIALS AND METHODS: Forty-four subfertile men with abnormal semen parameters were treated between March, 2003 and March, 2004 with 3 g of CarnitilR daily for 3 months. Changes in semen parameters were evaluated 3 months after this therapy. RESULTS: The mean age was 34.2 years and the mean follow-up duration was 3.7 months. In asthenospemic patients (n=28), semen analysis before and after CarnitilR treatment showed an increase in volume (2.64+/-1.65 ml vs. 3.10+/-1.60 ml), motility (35.1+/-17.7% vs. 45.9+/-20.4%) and viability (51.4+/-20.3% vs. 59.3+/-13.6%) respectively. In oligoasthenospermic patients (n=16), semen analysis before and after CarnitilR treatment showed an increase in sperm count (10.7+/-54.4 million/ml vs. 38.4+/-32.5 million/ml) respectively. CONCLUSIONS: These results suggested that in idiopathic oligoasthenospermic men the empirical medical therapy with acetylcarnitine may be considered as primary treatment.
Acetylcarnitine* ; Carnitine ; Follow-Up Studies ; Humans ; Infertility, Male ; Male ; Semen ; Semen Analysis ; Sperm Count

Maffuccis syndrome was first reported by Maffucci, in 1881. This syndrome is manifested by multiple enchondromas and hemangiomas, characterized by non-hereditary mesenchymal neoplasia that has a propensity for malignant transformation. Involvement of long bones, particularly the bones of the hands and feet, is most common. The most important complication of this syndrome is the high frequency of chondr osarcomatous metaplasia. We report a case of Maffuccis syndrome in a 56-year-old woman with multiple hemangioma on both the hands and forearms, left foot and enchondromas of multiple bones. The disease started at the age of 8 and was associated with deformity, but malignant transformation was not found.
Chondroma ; Congenital Abnormalities ; Enchondromatosis ; Female ; Foot ; Forearm ; Hand ; Hemangioma ; Humans ; Metaplasia ; Middle Aged

Thirty-nine patients with fixed drug eruption who visited the Department of Dermatology in National Medical Center from January 1g7g to December 1982 were selected. Among them, twentyseven patients performed skin biopsy and were evaluated histopathologically on the basis of duration. The results were as follows; ].In the early stage less than 1 week of duration, hydropic degeneration of basal cells, necrotic keratinocytes with eosinophilic cytoplasm and pknotic nucleus in the epidermis, and mixed cell infiltration with eosinophlis in the upper dermis were prominently. In the late stage more than 20 days of duration, acanthosis, an increased amount of melanin in the basal cell layer and presence of melanophages were found more prominent, however, hydropic degeneration of basal cells, papillary dermal ederna, inflammatory infiltration of mononuclear cells were found less prounced or absent.
Biopsy ; Cytoplasm ; Dermatology ; Dermis ; Drug Eruptions* ; Eosinophils ; Epidermis ; Humans ; Keratinocytes ; Melanins ; Skin