BACKGROUND: Osteoporosis is becoming major health problem in old age and menopausal women, and osteoarthritis is most common joint disease in both ages. The inverse relationship between osteoporosis and osteoarthritis was first noticed 20years ago. However the subject had not been studied in korea. Thus, our objectives is to examine the influence of osteoarthritis on bone density measurements. METHODS: The study group consisted of 120 women, aged over 40 years, who visited for health examination in Health Center of Poondang Jesaeng general hospital from October 1998 to April 1999. Bone mineral density(BMD) of the lumar spine was measured, using dual energy X ray absorptiometry(Lunar, Expert XL), and lateal lumbar spine radiograph was taken. Severity of osteoarthritis were scored on osteophytes, disk space narrowing and vertebral body sclerosis. RESULTS: Postmenopausal women had signifcantly lower BMD than premenopausal women(p<0.001). Age(r= 0.545, p<0.001), body mass index(r=0.264, p<0.01) and education(r=0.284, p<0.01) were significantly correlated with BMD, but smoking, exercise, radiogrphic OA variables not correlated. However, stepwise multiple regression analysis using osteoporosis related variables and OA variables is indicated that menopausal status, body mass index, age, osteophytes were significantly associated factor with BMD, and lumbar osteophytes explained 2.7% of variation in lumbar spine BMD. CONCLUSION: We conclude that, among women, lumbar BMD is highier in those with osteophytosis of the lumbar spine. The effect is largely directed by osteophytes being included in the BMD measurement.
Body Mass Index ; Bone Density* ; Female ; Hospitals, General ; Humans ; Joint Diseases ; Korea ; Osteoarthritis* ; Osteophyte ; Osteoporosis ; Sclerosis ; Smoke ; Smoking ; Spine*

A 65-year-old male was admitted to our hospital complaining of painful swelling of right sternocostoclavicular area. In the past history, he had no specific disease including trauma. After admission, chest CT and neck CT showed right empyema and right cervical abscess. Empyemectomy was performed through open thoracotomy and fistulous tract was detected on right parietal pleura and right sternocostoclavicular area. Ostomyelitis was also detected on right sternocostoclavicular area and removal of right cervical abscess, partial resection of proximal clavicle, resection of chondral portion of 1st rib, and partial resection of manubrium were performed. Empyema that extends from sternocostoclavicular osteomyelits, as in this case, is rare. Herein we report a case of loculated empyema with sternocostoclavicular osteomyelitis and neck abscess.
Abscess* ; Aged ; Clavicle ; Empyema* ; Humans ; Male ; Manubrium ; Neck* ; Osteomyelitis* ; Pleura ; Ribs ; Thoracotomy ; Tomography, X-Ray Computed

Two patients with gustatory hyperhidrosis complaining of discomfort during usual activities were relieved of sweating by using anticholinergic benztropine. Herein, we report two cases of gustatory hyperhidrosis treated with benztropine.
Benztropine* ; Humans ; Hyperhidrosis ; Sweat ; Sweating ; Sweating, Gustatory*

It has long been known that Vasopressin could increase the urinary sodium and chloride excretion. The exact mechanism and site of action, however, have not yet been explained. Experiments were performed whether the renal effects were the same in both cortical and juxtamedullary nephron in decorticated kiddney model. Heat-decortication was car ried out in the left kidney immersed in water kept at 52oC for 5 minutes. In 90% of cases, outer 2/3 of the cortex was necrotized as revealedd at the time of experiment on 8th day. The right kidney underwent the same procedure except that the temperature of water was kept at 39oC, and served as control. Urine flow and fractional excretion of urine were increased by the arginine vasopressin infusion in both kidney, but the diffferences were not significant. There were no signifficant changes in glomerular filtration rate and rrenal plasma flow in doses of 5 and 10 mu/kg/minute. Responsiveness of decorticated kidney was less than the control kidney. Increments of fractional excretion of potassium were not significantly different. From thhese results, it is suggested that the responsiveness of the cortical and juxtamedullarry nephron to the arginine vasopressin may not be the same. The mechanisms of the differences were discussed.
Arginine Vasopressin* ; Arginine* ; Glomerular Filtration Rate ; Kidney ; Nephrons ; Plasma ; Potassium ; Sodium ; Vasopressins ; Water

BACKGROUND/AIMS: Portal hypertension in cirrhosis is associated with a hyperdynamic circulation, which is characterized by hypervolemia, high cardiac output, arterial hypotension and low peripheral vascular resistance. These circulatory abnormalities are thought to be secondary to a splanchnic arteriolar vasodilation related to the increase in portal pressure. Studies assessing regional hemodynamics in patients of cirrhosis with ascites have shown vasoconstriction in the renal circulation and in peripheral vascular territory. This study was designed to assess the cerebral vascular resistance in cirrhotic patients with ascites. METHODS: The resistive index in the middle cerebral artery and in a renal interlobar artery were measured by Doppler ultrasonography in 12 cirrhotic subjects without ascites, 23 cirrhotic subjects with ascites, and 8 healthy subjects. The arterial blood pressure and plasma renin and norepinephrine concentration, which reflect the activity of the renin-ngiotensin and sympathetic nervous systems respectively, were also measured. RESULTS: The resistive index in the middle cerebral artery were significantly higher in cirrhotic patients with ascites (0.58 +/- 0.04, mean +/- standard deviation) than in cirrhotic patients without ascites (0.53 +/- 0.02, p<0.01) and in control subjects (0.50 +/- 0.05, p<0.01). The resistive index in the middle cerebral artery showed direct correlation with renal resistive index (r = 0.52, p<0.01), plasma renin activity (r = 0.44, p<0.01) and norepinephrine (r = 0.33, p<0.05). The resistive index in the middle cerebral artery showed an inverse correlation with mean arterial pressure (r = -.59, p<0.01). CONCLUSION: The results suggest that in patients of cirrhosis with ascites, independent of the amount of ascites, there is a cerebral vasoconstriction which is related with the arterial hypotension and the overactivity of vasoconstrictor systems.
Arterial Pressure ; Arteries ; Ascites* ; Cardiac Output, High ; Fibrosis ; Hemodynamics ; Humans ; Hypertension, Portal ; Hypotension ; Liver Cirrhosis* ; Liver* ; Middle Cerebral Artery ; Norepinephrine ; Plasma ; Portal Pressure ; Renal Circulation ; Renin ; Sympathetic Nervous System ; Ultrasonography, Doppler ; Vascular Resistance ; Vasoconstriction ; Vasodilation

A 19-month-old boy suffered from stridor and dysphagia. He was taking asthma medication for a few months, but symptoms did not improve. After admission, a chest CT showed a posterior mediastinal mass, which compressed the trachea and esophagus. The removed mass via open thoracotomy was a bronchogenic cyst on histopathology. Postoperatively, stridor and dysphagia disappeared. In case of persistent and refractory stridor or dysphagia in children, congenital lesions including bronchogenic cyst need to be ruled out.
Asthma ; Bronchogenic Cyst ; Child ; Deglutition Disorders ; Esophagus ; Humans ; Infant ; Mediastinum ; Respiratory Sounds ; Thoracotomy ; Thorax ; Trachea

Gefitinib (Iressa(R), AstraZeneca) is an oral form of an anticancer drug called epidermal growth factor receptor-tyrosine kinase inhibitor. It is widely used for various solid cancers, including lung cancer. Cutaneous adverse reactions induced by gefitinib have recently been reported with an incidence ranging from 49% to 100%, and they include acneiform skin rash, hyperpigmentation, xerotic skin, pruritus, skin fissures, nail change and disorders of the mucous membranes, eyes and hair. To the best of our knowledge, no cases of leukocytoclastic vasculitis associated with gefitinib have ever been published in the Korean medical literature, and there have been only four such reported cases in other countries. Herein, we report on a case of leukocytoclastic vasulitis induced by gefitinib in a patient with lung cancer.
Epidermal Growth Factor ; Exanthema ; Eye ; Hair ; Humans ; Hyperpigmentation ; Incidence ; Lung Neoplasms ; Mucous Membrane ; Nails ; Phosphotransferases ; Pruritus ; Quinazolines ; Skin ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous

OBJECTIVE: A subdural drain using urokinase after a burr hole hematoma evacuation was performed for subacute subdural hematoma (SASDH), and its effectiveness and safety in elderly patients were evaluated. METHODS: Between January 2013 and May 2015, subdural drains using urokinase after burr hole hematoma evacuation were performed in 19 elderly patients. The inclusion criteria were as follows: 1) a subdural hematoma occurring between 4 and 20 days after injury; 2) worsening neurological symptoms, from mild to moderate or severe, due to injury during the subacute stage; 3) a mix of solid clots (high-density lighter shadow) and fluid hematoma (low-density darker shadow) on the computed tomography (CT) scan; 4) a score of ≥9 on the Glasgow Coma Scale (GCS) assessed immediately before surgery; and 5) an age of ≥65 years. When the majority of the hematoma was evacuated on the CT, we removed the catheter. RESULTS: Under local anesthesia, a catheter was inserted into the hematoma through a burr hole. The mean age of the patients was 73.7 years (range, 65-87 years). The mean preoperative GCS score was 11.2 (range, 10-13), and the mean Glasgow Outcome Scale score for all patients was 5 at discharge. No recurrences of hematomas or surgical complications were observed. CONCLUSION: A subdural drain using urokinase after burr hole hematoma evacuation under local anesthesia is thought to be an effective and safe method of blood clot removal with low morbidity. This surgical method is less invasive for treating elderly patients with SASDH.
Aged* ; Anesthesia, Local ; Catheters ; Drainage ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Hematoma ; Hematoma, Subdural* ; Humans ; Methods ; Recurrence ; Urokinase-Type Plasminogen Activator*

CD20 positive T cell lymphoma is a rare condition that is associated with the coexpressions of CD20 and T cell markers, such as, CD3, CD5, or UCHL-1. Positivity for CD20 in this tumor represents an aberrant immunophenotype, but the presence of monoclonal T cell receptor (TCR) gene rearrangements and negativity for immunoglobulin heavy chain gene rearrangement indicate that this tumor is a T cell lymphoma. The majority of cases of CD20 positive T cell lymphoma have been reported as immature peripheral T cell lymphoma not otherwise specified. However, we believe that this disease is likely to be re-listed as a new disease entity after its pathogenesis has been elucidated and more cases have been evaluated. Here, we present a case of peripheral T cell lymphoma coexpressing CD20 and T cell markers with a demonstrable TCR gene rearrangement, in a patient who had been misdiagnosed as having B cell type lymphoma 4 years previously. We hypothesize that in this case initially circulating normal CD20+ T cell subsets underwent neoplastic transformation and CD20 positive T cell lymphoma subsequently developed in the lymph node, and then recurred in the skin due to systemic disease or metastasized from the nodal disease.
Gene Rearrangement ; Genes, T-Cell Receptor ; Humans ; Immunoglobulin Heavy Chains ; Lymph Nodes ; Lymphoma ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Receptors, Antigen, T-Cell ; Skin ; T-Lymphocyte Subsets

Malassezia yeasts are lipophilic fungi that are regarded as normal flora of the skin. They are associated with a number of diseases affecting human skin, such as pityriasis versicolor, Malassezia folliculitis, and seborrheic dermatitis, and less commonly with other dermatologic disorders, such as confluent and reticulated papillomatosis and transient acantholytic dermatosis. Clinically, Malassezia folliculitis shows erythematous papules, sometimes pustules. Here, mutiple erythematous papules and pustules over the trunk and upper arms developed in a 37-year-old man. The skin lesions became enlarged and confluent, resulting in the formation of an annular configuration. They spread gradually to form a large plaque with central hyperpigmentation, with the edge of the lesions showing multiple papules and pustules. Microspores were found in potassium hydroxide preparations of these lesions, and large-sized circular, cream colored, raised, smooth, and dentate colonies were found in culture media. Histologically, sectioning showed mild acanthosis of the epidermis and perivascularinflammation in the superficial dermis. PAS-stained sections showed spheric to oval yeast organisms in the follicularepithelium. In PCR analysis, Malassezia sympodialis was identified. The patient was treated with oral itraconazle, resulting in complete clearing of the lesions. Here, we report an interesting case of Malassezia follicultis that showed clinical configuration of erythema annulare centrifugum.
Acantholysis ; Adult ; Arm ; Culture Media ; Dermatitis, Seborrheic ; Dermis ; Epidermis ; Erythema ; Folliculitis ; Fungi ; Humans ; Hydroxides ; Hyperpigmentation ; Ichthyosis ; Malassezia ; Papilloma ; Polymerase Chain Reaction ; Potassium ; Potassium Compounds ; Skin ; Skin Diseases ; Tinea Versicolor ; Yeasts