We present an unusual case of molluscum contagiosum occurring in epidermal cyst on back of a 5-year-old girl. Histology showed an intradermal cyst containing lamellated horny materials and typical molluscum cells. In Korean literature, 5 such cases were reported. We report an additional case of molluscum occurring in epidermal cyst.
Child, Preschool ; Epidermal Cyst* ; Female ; Humans ; Molluscum Contagiosum*

A recent genetic study of alopecia areata shows that the patients with early onset, severe, familial group could be separated from the patients with later onset, milder severity with good prognosis in their genetic background. We have experienced an intractable clinical course of alopecia areata in dizygotic twin brothers and have come to sympathise with the genetic influence of the disease. The alopecia areata of the two brothers began for both at about 10 years of age and became severe and persistent over the twenties up to the present times. All treatments failed. The patients were thought to be an example showing the importance of genetic influences in the treatment of alopecia areata.
Alopecia Areata* ; Alopecia* ; Humans ; Prognosis ; Siblings ; Twins, Dizygotic*

PURPOSE: To evaluate the clinical significance of renal excretion of oral Gastrografin in gastric resectionpatients. MATERIAL AND METHOD: Seven days affter gastric resection, eight normal volunteers and 30 patientsunderwent abdominal and CT scanning before and 1-1.5 his after oral administiration of Gastrografin. Theattenuation coefficients of the bladder were measured and the maximal attenuation difference between pre-andpost-gastrografin administration was calculated. RESULTS: In the control group, there was no abnormal renalexcretion of oral Gastrografin, though in 83 % of patients(25 of 30), this was demonstrated as focal increase inthe density (> or = 20 HU) of the bladder and/or collecting system, or ureteral opacification. Mean maximal densitydifference was 84.4+/-82.9HU in the patient group (n=24), with renal excretion of enteral Gastrografin and,3.5+/-4.4 HU in the control group (n=7), with statistical significance (Student's t-test, p<0.01). No patientshowed either radiological or clinical evidence of direct leakage from the suture site. Patients who underwenttotal gastrectomy showed a higher maximal density difference than those in whom gastrectomy was subtotal. CONCLUSION: Unless direct leakage is visvalized on fluoroscopy or spot films, renal excretion of oralGastrografin should not be regarded as a sign of anastomotic leakage. Situations other than leakage, e. g.increased mucosal permeability or absorption, or increased bowel transit time in postoperative duration, should beconsidered as possible causes.
Absorption ; Administration, Oral* ; Anastomotic Leak ; Diatrizoate Meglumine* ; Fluoroscopy ; Gastrectomy ; Healthy Volunteers ; Humans ; Permeability ; Sutures ; Tomography, X-Ray Computed ; Ureter ; Urinary Bladder

Vascular endothelial growth factor (VEGF)-C and its receptor, vascular endothelial growth factor receptor (VEGFR)-3, are responsible for lymphangiogenesis in both embryos and adults. In epilepsy, the expression of VEGF-C and VEGFR-3 was significantly upregulated in the human brains affected with temporal lobe epilepsy. Moreover, pharmacologic inhibition of VEGF receptors after acute seizures could suppress the generation of spontaneous recurrent seizures, suggesting a critical role of VEGF-related signaling in epilepsy. Therefore, in the present study, the spatiotemporal expression of VEGF-C and VEGFR-3 against pilocarpine-induced status epilepticus (SE) was investigated in C57BL/6N mice using immunohistochemistry. At 1 day after SE, hippocampal astrocytes and microglia were activated. Pyramidal neuronal death was observed at 4 days after SE. In the subpyramidal zone, VEGF-C expression gradually increased and peaked at 7 days after SE, while VEGFR-3 was significantly upregulated at 4 days after SE and began to decrease at 7 days after SE. Most VEGF-C/VEGFR-3-expressing cells were pyramidal neurons, but VEGF-C was also observed in some astrocytes in sham-manipulated animals. However, at 4 days and 7 days after SE, both VEGFR-3 and VEGF-C immunoreactivities were observed mainly in astrocytes and in some microglia of the stratum radiatum and lacunosum-moleculare of the hippocampus, respectively. These data indicate that VEGF-C and VEGFR-3 can be upregulated in hippocampal astrocytes and microglia after pilocarpine-induced SE, providing basic information about VEGF-C and VEGFR-3 expression patterns following acute seizures.
Adult ; Animals ; Astrocytes ; Brain ; Embryonic Structures ; Epilepsy ; Epilepsy, Temporal Lobe ; Hippocampus ; Humans ; Immunohistochemistry ; Lymphangiogenesis ; Mice ; Microglia ; Pyramidal Cells ; Receptors, Vascular Endothelial Growth Factor ; Seizures ; Status Epilepticus ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factor C ; Vascular Endothelial Growth Factor Receptor-3

Arteriovenous fistulas of head and neck, especially the external carotid artery are uncommon lesions usually of traumatic origin. They also may be spontaneous, inflammatory, or congenital origin. They maybe accompanied by symptoms and signs such as pulsatile tinnitus, pulsatile mass, palpable thrill, and machine like bruit. Recently, we experienced a case of spontaneous arteriovenous fistula of external carotid artery, treated by coil embolization. The patient noticed pulsatile tinnitus in the left posterior auricular area and left upper neck area. She had no history of head trauma. External carotid angiogram showed fistula between the branches of the external carotid artery (occipital artery, middle meningeal artery, posterior auricular artery) and the internal jugular vein. The fistulas were successfully controlled by coil embolization.
Arteries ; Arteriovenous Fistula* ; Carotid Artery, External* ; Craniocerebral Trauma ; Embolization, Therapeutic ; Fistula ; Head ; Humans ; Jugular Veins ; Meningeal Arteries ; Neck ; Tinnitus*

A case of a mucin-producing intrahepatic cholangiocellular carcinoma (MPCC) is reported. A 58-year old female presented with epigastric discomfort of several years duration. The physical examination and laboratory findings were normal. Abdominal ultrasonography (US) and computed tomography (CT) showed a focal dilatation of the right posterior intrahepatic bile duct. There was no abnormal mass in the liver parenchyma. Endoscopic retrograde cholangiopancreaticography (ERCP) showed a filling defect in the right posterior hepatic duct. There was no anatomical abnormality and abnormal staining on the heaptic angiography. At the operation, the right posterior hepatic duct was filled with mucin. The patient had a right posterior segmentectomy. Histologically, a 2.5 X 0.6 X 0.6 cm sized mucin-producing intrahepatic cholangiocellular carcinoma was found in segment 6 of the liver. The postoperative recovery was good, and the patient has had a good social life for the last 3 years, with no evidence of tumor recurrence. In patients with a focal dilatation of the intrahepatic bile duct on CT or US with no underlying cause, an intrahepatic malignancy has to be suspected.
Angiography ; Bile Ducts, Intrahepatic* ; Cholangiocarcinoma ; Dilatation* ; Female ; Hepatic Duct, Common ; Humans ; Liver ; Mastectomy, Segmental ; Middle Aged ; Mucins ; Physical Examination ; Recurrence ; Ultrasonography

This study evaluated the effectiveness of the light emitting diode(LED) units for composite curing. To compare its effectiveness with conventional quartz tungsten halogen (QTH) light curing unit, the microhardness of 2mm composite, Z250, which had been light cured by the LEDs (Ultralume LED2, FreeLight, Developing product D1) or QTH (XL 3000) were compared on the upper and lower surface. One way ANOVA with Tukey and Paired t-test was used at 95% levels of confidence. In addition, the amount of linear polymerization shrinkage was compared between composites which were light cured by QTH or LEDs using a custom-made linometer in 10s and 60s of light curing, and the amount of linear polymerization shrinkage was compared by one way ANOVA with Tukey. The amount of polymerization shrinkage at 10s was XL3000 > Ultralume 2, 40, 60> FreeLight, D1 (P<0.05) The amount of polymerization shrinkage at 60s was XL3000 > Ultralume 2, 60> Ultralume 2,40> FreeLight, D1 (P<0.05) It was concluded that the LEDs produced lower polymerization shrinkage in 10s and 60s compared with QTH unit. In addition, the microhardness of samples which had been cured with LEDs was lower on the lower surfaces than the upper surfaces whereas there was no difference in QTH cured samples.
Polymerization* ; Polymers* ; Quartz ; Tungsten

PURPOSE: Uncontrolled bleeding is a leading cause of death in multiple-injury patients. It is very difficult to control hemorrhage due to microvascular injury in soft tissue by surgery or vascular intervention. Thus, hemostatic agents such as recombinant activated coagulation factor VII (rFVIIa) have become popular with regard to reducing transfusion volumes and correcting the hemorrhage-associated coagulopathy. METHODS: From March 2007 to January 2010 we used rFVIIa in 15 multiple-injury patients. Transfused packed red blood cell (pRBC) volume was compared before and 6 h after administration of rFVIIa. Complete blood count, prothrombin time and activated partial thromboplastin time were also checked. RESULTS: Mortality rate correlated strongly with initial severity of coagulopathy. Transfused pRBC volumes per hour were reduced significantly after rFVIIa (p=0.01), and coagulopathy was also significantly corrected. Thromboembolic events such as acute myocardial infarction and cerebrovascular attack, a fatal complication of rFVIIa, did not occur. CONCLUSION: The administration of rFVIIa can correct hemorrhage associated coagulopathy and reduce pRBCs transfusion volume. A quick decision regarding the administration of rFVIIa is needed for a more favorable outcome in multiple-injury patients with hemorrhagic shock.
Blood Cell Count ; Cause of Death ; Erythrocytes ; Factor VII ; Factor VIIa ; Hemorrhage ; Hemostasis ; Humans ; Multiple Trauma ; Myocardial Infarction ; Partial Thromboplastin Time ; Prothrombin Time ; Recombinant Proteins ; Shock, Hemorrhagic

PURPOSE: Uncontrolled bleeding is a leading cause of death in multiple-injury patients. It is very difficult to control hemorrhage due to microvascular injury in soft tissue by surgery or vascular intervention. Thus, hemostatic agents such as recombinant activated coagulation factor VII (rFVIIa) have become popular with regard to reducing transfusion volumes and correcting the hemorrhage-associated coagulopathy. METHODS: From March 2007 to January 2010 we used rFVIIa in 15 multiple-injury patients. Transfused packed red blood cell (pRBC) volume was compared before and 6 h after administration of rFVIIa. Complete blood count, prothrombin time and activated partial thromboplastin time were also checked. RESULTS: Mortality rate correlated strongly with initial severity of coagulopathy. Transfused pRBC volumes per hour were reduced significantly after rFVIIa (p=0.01), and coagulopathy was also significantly corrected. Thromboembolic events such as acute myocardial infarction and cerebrovascular attack, a fatal complication of rFVIIa, did not occur. CONCLUSION: The administration of rFVIIa can correct hemorrhage associated coagulopathy and reduce pRBCs transfusion volume. A quick decision regarding the administration of rFVIIa is needed for a more favorable outcome in multiple-injury patients with hemorrhagic shock.
Blood Cell Count ; Cause of Death ; Erythrocytes ; Factor VII ; Factor VIIa ; Hemorrhage ; Hemostasis ; Humans ; Multiple Trauma ; Myocardial Infarction ; Partial Thromboplastin Time ; Prothrombin Time ; Recombinant Proteins ; Shock, Hemorrhagic

BACKGROUND/AIMS: Bamboo joint-like (BJL) appearance is an endoscopic finding characterized by swollen longitudinal folds transversed by erosive fissures or linear furrows on the lesser curvature side of gastric body and cardia. It has been reported to be associated with Crohn's disease (CD). This study was aimed to evaluate the incidence of BJL appearance in Korean patients with CD. METHODS: From January to December in 2005, we performed esophagogastroduodenoscopy (EGD) in patients diagnosed as CD and ulcerative colitis (UC) in our hospital. Non-inflammatory bowel disease (IBD) subjects with upper gastrointestinal symptoms who underwent EGD were consecutively enrolled during the same period. One endoscopist performed all the endoscopic examinations to avoid inter-observer variation. A dye-spraying technique with 0.4% indigocarmine was used to allow the detection of subtle changes during the endoscopic examination. RESULTS: A total of 21 patients with CD (mean age+/-SD, 40+/-15 yr; M/F, 13/8), 28 patients with UC (42+/-15 yr; 21/7), and 685 non-IBD subjects (49+/-14 yr; 354/331) were enrolled. EGD findings in CD patients were gastric erosions (11/21), chronic superficial gastritis (5/21), chronic atrophic gastritis (1/21), duodenal erosions or ulcers (2/21), and normal (2/21). Incidence of BJL appearance was significantly higher in patients with CD (47.6%, 10/21) than others (UC, 3.6%, 1/28; non-IBD, 0.1%, 1/685) (p<0.0001). Among patients with CD, incidence of BJL appearance was not significantly different according to the sex, status of H. pylori infection, Vienna classification for phenotype, medications or EGD findings. CONCLUSIONS: BJL appearance on the gastric body and cardia can be a diagnostic clue to CD.
Adult ; Crohn Disease/diagnosis/*pathology ; Endoscopy, Digestive System ; Female ; Humans ; Male ; Middle Aged ; Stomach/*pathology