Pseudoxanthoma elasticum (PXE) is an uncommon heritable disorder of elastin characterized by cutaneous, ocular and vascular abnormalities. Typical skin lesion shows yellowish papules and redundant skin folds on the neck, axilla and groin due to degeneration and calcification of elastic fibers in deep dermis. As in all heritable disorders of connective tissue, no curative therapy is presently know. Redundant and unsightly skin folds about the neck can be improved by surgery, but irregular papular lesion on skin does not improved by surgery. A-44-year-old female who had a skin lesion and angioid streak was treated as follows: Skin folds on the neck were excised successfully without any significant problem such as intraoperative bleeding, wound dehiscence or hypertrophic scar formation. To evaluate whether we could smooth the irregular skin surface due to multiple papules, laserbrasion with a SLT contack Nd:YAG laser system was performed experimentally on a limited area which was located on the right supracla-vicular area about 2 x 3cm in size. An acceptable aesthetic appearance was achieved with surgical excision 12 months after the operation. Biopsy of the laserbrasion site revealed disappearance of the calcium deposit. This study emphasizes the possibility of using laserbrasion in solving troblesome skin lesion of the PXE.
Angioid Streaks ; Axilla ; Biopsy ; Calcium ; Cicatrix, Hypertrophic ; Connective Tissue ; Dermis ; Elastic Tissue ; Elastin ; Female ; Groin ; Hemorrhage ; Humans ; Neck* ; Pseudoxanthoma Elasticum ; Skin ; Wounds and Injuries

Neoplasms of the nasophrynx are rare in neonates and infants. The most common nasopharyngeal tumor encountered in this age group is teratoma-neoplasm containing multiple heterotopic tissues. Four histologic types of nasopharyngeal teratoma occur-dermoid, teratoid, true teratoma, epignathiof which dermoid is most frequently seen. We have experienced a case of nasopharyngeal teratoma in a female neonate with signs and symptoms of upper airway obstruction. It was diagnosed by cervical. CT and confirmed as ture teratoma by histological examination. Nesopharyngeal teratoma was removed by contact Nd:YAG laser. In addition, we briefly reviewed the literature of neonatal nasopharyngeal teratoma.
Airway Obstruction* ; Choristoma ; Dermoid Cyst ; Female ; Humans ; Infant ; Infant, Newborn ; Teratoma*

OBJECTIVE: To evaluate the changing pattern of serum leptin level and the correlation between estradiol level during the clomiphene citrate challenge test(CCCT) or controlled ovarian hyperstimulation(COH) cycle. METHODS: Twenty-seven women who underwent CCCT and fourteen women who underwent controlled ovarian hyperstimulation were recruited to measure the serum leptin level. After correction of serum concentration with body mass index(BMI), changes of leptin level and correlation with serum estradiol level during CCCT and COH cycle were analyzed. RESULTS: Circulating leptin levels were significantly correlated with BMI at each time point in CCCT cycle(P<0.01). In CCCT cycle, leptin/BMI level was significantly increased at midluteal phase compared to that of menstrual cycle day 3 and 10(p<0.05). In women with regular menstruation, leptin/BMI level at midluteal phase was significantly higher than that of menstrual day 3 and 10, but this difference was not seen in women with irregular menstruation. The leptin/BMI level in COH cycle showed increasing tendency throughout ovarian stimulation. But there was no significant correlation between leptin/BMI and estradiol level in CCCT and COH cycle. CONCLUSION: There is a significant correlation between BMI and circulating leptin level. Midluteal leptin level is significantly higher than that of follicular phase in CCCT cycle, and there is an increasing tendency in leptin level after ovarian stimulation in CCCT and COH cycle without statistical significance. These findings suggest that circulating estradiol concentration has no major influence on circulating leptin level.
Clomiphene* ; Estradiol ; Female ; Follicular Phase ; Humans ; Leptin* ; Menstrual Cycle ; Menstruation ; Ovulation Induction

No abstract available.
Head* ; Neck*

The ankle is a modified hinge joint consisting of tibial plafond, medial and lateral malleolus, talus and many soft tissue structures, which plays important role in weight bearing and walking. Hence, the ankle injuries include not only fractures of bone but often also the rupture of ligaments and soft tissues, so if the structures were not accurately repaired, many complications may develop. The authers analysed 98 cases (96 patients) of the ankle fractures which were admitted and treated in Orthopaedic Department, Soon Chun Hyang University Hospital from January 1979 to August 1983. The results obtained are as follows: 1. Of the 98 cases, male was 70 cases(71.9%), female was 28 cases and the average age of the patient was 31,1 years. 2. The most common cause of the fracture was traffic accident and the other causes were slip down, sports injury, fall down and industrial injuries in order. 3. 83 cases(84.7%) out of the 98 cases of ankle fractures were closed fracture and the rest was open fracture. 4. The most common type of the ankle fracture, according to the classification of Lauge-Hansen, was supination external rotation type. 5. 68 cases were treated with open reduction and internal fixation and 30 cases were treated with closed reduction, among the cases of closed reduction, the 14 cases were indicated to open redu- ction but it was impossible due to improper skin condition, severe comminution and anesthetic problem. 6. The average duration of the cast immobilization in closed treatment was 10.1 weeks and in operative treatment was 6.3 weeks. 7. The results of the treatment was better in those cases of the open reduction, the early reduction and the mildly displaced cases than the results of closed reduction, delayed reduction and severely displaced cases. 8. The incidence of complication, such as traumatic arthritis and nonunion occured higher in the cases treated with closed method.
Accidents, Traffic ; Ankle Fractures ; Ankle Injuries ; Ankle ; Arthritis ; Athletic Injuries ; Classification ; Clinical Study ; Female ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Incidence ; Joints ; Ligaments ; Male ; Methods ; Rupture ; Skin ; Supination ; Talus ; Walking ; Weight-Bearing

Epiphora is a symptom in which tears overflow onto the face, with its most common cause being the obstruction of the nasolacrimal system. As a cause of nasolacrimal system obstruction, nasolacrimal duct tumors are very rare. Angioleiomyoma, which is a benign tumor, arises from vascular smooth muscle, occurs in the nasolacrimal duct, and is extremely rare. With the development of endoscopic intranasal approach for the treatment of nasolacrimal duct obstruction, there is increased importance for the consideration of otorhinolaryngological evaluation and treatment as well as dacryocystorhinostomy by conventional external approach. In this article, we introduce a case in which angioleiomyoma in the nasolacrimal duct was detected by nasal endoscopy and was successfully treated with endoscopic surgery.

Invasive fungal sinusitis is common in immunodeficiency patients and can spread into the orbit or intracranial cavity. The Onodi cell, which is one of the anatomical variations of the ethmoid sinus, refers to the space that has been pneumatized superolateral to the sphenoid sinus. We experienced a case of invasive fungal sinusitis that caused vision loss by invading the Onodi cells. Endoscopic sinus surgery and antifungal treatment successfully recovered the patient’s vision and we herein report on the case with a review of the literature.

Pigmented contact dermatitis is characterized by a dark brown pigmentation that results from repeated exposure to small amounts of contact allergen. Histopathologic findings are liquefactive degeneration of the basal layer cells and melanophages in the upper dermis. We report a case of a 73-year-old man with dark brownish mottled hyperpigmented patches on the both cheeks and forehead. Patch tests were positive to isoeugenol, benzyl salicylate and after shave lotion. After shave lotion that the patient used maybe contain these fragrances. Improvement was seen 3 months after ceasing the use of after shave lotion.
Aged ; Cheek ; Dermatitis, Contact* ; Dermis ; Forehead ; Humans ; Patch Tests ; Pigmentation

BACKGROUND: The diagnostic significance of ECG ergonovine test and the incidence of vasospastic angina in patients with chest pain are still uncertain. METHODS: From May 1998 to June 1999, 133 consecutive patients with chest pain were admitted for diagnostic coronary angiography. ECG ergonovine provocation tests were performed in 64 patients who have a clinical history suggesting vasospatic angina, including 27 of 28 patients with vasospastic angina documented electrocardiographically, or who's coronary angiographic findings could not be explained by their clinical history. Ergonovine was administered intravenously in incremental dose of 0.05, 0.1, 0.2, 0.3, 0.4 mg up to total cumulative dosage of 1.0mg during coronary angiography(41 cases), in the exercise laboratory(21 cases) or both(2 cases). RESULTS: Of 133 patients with chest pain, vasospastic angina was documented in 32(24%), unstable angina in 52(34%), stable angina in 10(8%), and others in 39(29%). Angiography demonstrated coronary spasm in 4 additional patients as well as 22 patients with vasospastic angina documented electrocardiographically, but ergonovine tests in the exercise laboratory showed positive response in 5 of 6 patients with vasospastic angina documented. Among the 25 patients with coronary spasm proved angiographically during ergonovine test, ECG findings at the time of coronary spasm were ST segment elevation in 21(84%), depression in 1(4%) and no change in 3(12%) patients, who had branch vessel spasm, 3 vessel spasm or incomplete spasm on coronary angiogram. Of the 31 patients with vasospastic angina who underwent ergonovine tests, positive response occurred in 24(77%) after a cumulative dose of < or = 0.4mg and in additional 3(10%) after the higher dose of >0.4mg. However the other 4(13%) had no ECG changes even after the higher dose(>0.4mg) of ergonovine. CONCLUSION: This results suggest that vasospastic angina appear to be a common cause of chest pain, and ECG ergonovine test with high dose can improve diagnostic sensitivity but cannot detect some patients with vasospastic angina.
Angina, Stable ; Angina, Unstable ; Angiography ; Chest Pain ; Coronary Angiography ; Depression ; Electrocardiography* ; Ergonovine* ; Humans ; Incidence ; Spasm

BACKGROUND: Cladosporium spp. are dematiaceous fungi that are commonly isolated from indoor and outdoor environments, including hospital air. This fungus is rarely pathogenic to humans, but has been reported to cause infections of the skin and toenails, as well as sinusitis and pulmonary infections. The monitoring of culture results was conducted to identify the outbreak of an unknown black fungal infection between January and March 2006 in a University hospital, and infection control activity was performed to identify the cause of the outbreak. METHODS: An epidemiological investigation of 22 patients with infections caused by an unknown black fungus was conducted. Microscopic examination and molecular analysis on the internal transcript spacer (ITS) region was performed to identify the black fungus. To detect the source of contamination, a culture of environmental specimens was performed, and then, disinfection of the laboratory was implemented. RESULTS: The patients with black fungi belonged to various departments and wards. No symptoms of fungal infection were recognized on the basis of the survey. The black fungus was identified as Cladosporium spp. on the basis of morphological features and ITS region sequencing. Culturing of environmental specimens was performed in the laboratory. Black fungi were isolated from a specimen from a rack and had the same morphological features with Cladosporium spp. from clinical specimens. After the rack was autoclaved, Cladosporium spp. from clinical specimens was no longer isolated. CONCLUSION: Epidemiological investigation, microscopic examination, and molecular analysis revealed that the sudden increase in the isolation rate of Cladosporium spp. from clinical specimens was the result of a pseudo-outbreak caused by the contamination of a rack. To our knowledge, this is the first report of a pseudo-outbreak of Cladosporium spp. Continuous monitoring of culture results is important to avoid unnecessary labor for nosocomial infection control.
Cladosporium ; Cross Infection ; Disinfection ; Fungi ; Humans ; Infection Control ; Nails ; Sinusitis ; Skin