There are three major type of malignant melanoma which differ in their mode of onset, course; lentigo maligna melanoma, superficial spreading malignant melanoma and nodular malignant melanoma. Malignant melanoma may aris on apparently normal skin, in a junction nevus, rarely in a compound nevus and extremely rately in an intradermal nevus. We presented a case of malignant melanoma arising from compoud nevus in 51 year old male patient. Ulcerated verrucous walnut sized brown-black tumor mass was nticed on the posterolateral surface of right foot. There were no palpable lymph nodes in whole body. Tumor cells were epithelioid type and lie in irregularly alveolar formation histologically. There were also numerous nevus cells in dermis and nevus cell nest in lower epidermis with tumor cells. Surgical excision of tumor mass and skin graft was performed.
Dermis ; Epidermis ; Foot ; Humans ; Hutchinson's Melanotic Freckle ; Juglans ; Lymph Nodes ; Male ; Melanoma ; Middle Aged ; Nevus* ; Nevus, Intradermal ; Skin ; Transplants ; Ulcer

During 1964 to 1967, a survey of 30,534 persons for filariasis was made on all over the country with the following results: Among 24,816 draftees from all over the country in the army recruitment camp 155(0.63 %) were found infected with Brugia malayi. Cheju Do showed the highest microfilaria rate(3.5 %), North Kyongsang Do(1.4 %) the next and South Cholla Do(1.2 %) the third. Blood films from 2,308 inhabitants were examined and 407(17.6 %) showed microfilaria in Cheju Do. 30(3.1 %) out of 974 inhabitants in North Kyongsang Do were found to be infected. The microfilaria rates were 2.0 per cent for 400 inhabitants of Chindo island in South Cholla Do. However, no positive case of microfilaria was found in the inhabitants of Kokumdo among 1,820 persons examined in South Cholla Do and of Namhae island(among 165 persons examined) in South Kyongsang Do. The mean microfilarial density per 20 cu. mm of blood was 52.6 in the inhabitants of Cheju Do, 12.2 in North Kyongsang Do and 27.3 in Chindo island(South Cholla Do). Any distinct relationship between the incidence of positive cases of microfilariae and age or sex of the cases was not observed in Cheju Do. However, in Norh Kyongsang Do and South Cholla Do the microfilaria rate of the male group is higher than the one of the female group of the inhabitants. From the above survey results it turned out that filariasis was found throughout Southern Korea except Kyonggi Do and South Kyongsang Do. A total 30,534 persons examined, 601(2.0 %) were found to be infected by Brugia malayi. Therefore, it seems that there are some endemic foci of malayian filariasis in three main areas such as North Kyongsang Do, South Cholla Do and Cheju Do.
parsitology-helminth-nematoda-Brugia malayi ; filariasis ; epidemiology ; Army

We observed three patients who showed widespread macular ashy-colored eruptions. They fit clinically and histopathologically with the typical erythema dyschromicum perstans (ashy dermatosis). Erythoma dyschromicum perstans is a peculiar pigmented condition of unknown etiology characterized by persistent ashy-gray colored macule, refractory to any modality. All of them have similar skin lesions which are multiple, variable sized oval-shaped, ash-colored macular eruption on the trunk and extremities. Histologic findings of 2 patients reveal the characteristic feature of focal hydropic degeneration of the basal cell layer of the epidermis, perivascular infiltrates of lymphocytes and histiocytes and melanin-laden macrophages in the corium, however, merely pigmentary incontinence into the corium in 1 patient. Literatures are briefly reviewed.
Dermis ; Epidermis ; Erythema* ; Extremities ; Histiocytes ; Humans ; Lymphocytes ; Macrophages ; Skin

BACKGROUND: Complete clearance of the lesions by using calcipotriol alone have not been re-ported commonly in the treatment of psoriatic patients. Moreover, lesional and perilesional irritation are reported in some patients using calcipotriol, which may result in premature termination of the treatment due to impairing the compliance. OBJECTIVE: A clinical study was conducted to determine whether, in the topical treatment of psoriasis, a combination of calcipotriol cream and methylprednisolone aceponate was more effective than calcipotriol monotherapy. METHODS: Twenty-one psoriasis patients who had the symmetric lesions on the right and left lower legs were enrolled in the study. A combination of calcipotriol cream and methylprednisolone aceponate therapy was done on the left lower legs, whereas calcipotriol alone was applied on the right lower legs twice daily. PASI score and adverse events were recorded at each visit (1, 2, 3, 4, 6 week). The overall therapeutic result was also assessed by the physician and patients. RESULTS: The initial PASI score was 7.09 on both legs. After 6 weeks, the mean PASI score was 3.85 on the left leg, and 5.70 on the right leg (p<0.05). In the physicianOs global assessment, the percentage of patients who showed the improvement of more than half of lesions was 29% in the monotherapy and 62% in the combination therapy area. Two patients complained of mild itching sense on monotherapy, but there was no specific side effect on combination area. CONCLUSION: The combination therapy was more effective, as assessed by all evaluated variables. Furthermore, this combination reduces the adverse effects caused by long-term use of topical corticosterois as well as the irritation associated with. calcipotriol.
Compliance ; Humans ; Leg ; Methylprednisolone* ; Pruritus ; Psoriasis*

No abstract available.
Diaphragm* ; Ultrasonography*

Acropustulosis of infancy is an uncommon, but not rare syndrome established as a new disease entity by Kahn and Rywlin(1976), which is characterized by recurrent, intensely pruritic vesicopustules on the distal extremities. We'd like to report a case of acropustulosis of infancy. Our patient was 19 month old girl who had been suffering from her skin disease since the age of 12 months. Intensely pruritic, 1 to 2 mm vesicopustules erupted on the palms, soles and the ventral aspects of the fingers. There were no bacteria, fungus and parasites(Sarcoptes scabiei) on the pustular lesions. Histopathologically, biopsy specimen of the left sole revealed large, well circumscribed intraepidermal pustule which was filled wth polymorphonuclear leukocytes. We confirmed our case as typical case of acropustulosis of infancy by it's characteristic clinical features and histopathologic findings. Severity of the skin lesions seems closely related to the dosage of dapsone. The eruptions were unresponsive to topical steroid, antibiotics and antihistaminics. But we observed that dapsone has dose dependent relationship with acropustulosis of infancy.
Anti-Bacterial Agents ; Bacteria ; Biopsy ; Dapsone ; Extremities ; Female ; Fingers ; Fungi ; Humans ; Infant ; Neutrophils ; Skin ; Skin Diseases

The authors report a case in which a cerebral arteriovenous malformation(AVM'S) disappeared completely and spontaneously within 7 years without bleeding episodes or surgical intervention. During the interval, he has been completely asymptomatic and had received no treatment except anticonvulsant medication for 6 months. There was no more epilepsy and mild muscular atrophy in the right lower extremity. A similar case has previously been described and is discussed briefly along with other cases of complete AVM'S regression.
Arteriovenous Malformations ; Epilepsy ; Hemorrhage ; Intracranial Arteriovenous Malformations* ; Lower Extremity ; Muscular Atrophy

Refractory status epilepticus (RSE) is defined as seizure activity that continues after treatment with conventional anticonvulsants. Mortality rates of range from 2% to 100%. RSE are associated with significant morbidity and high mortality as evidenced by older age of the patient, acute etiology for the seizure, no previous history of seizures, low initial Glasgow Coma Scale, and the significant duration of the RSE. An intravenous valproic acid (VPA) was suggested as a useful drug in controlling RSE. A continuous infusion VPA was an efficient method of rapidly achieving VPA concentrations in the upper region of the therapeutic range while minimizing adverse effects. A 10-year-old female suffered a generalized tonic clonic seizure that developed into refractory status epilepticus. Her Glasgow Coma Scale was deteriorated to 4. Status epilepticus was refractory to phenytoin, phenobarbital, midazolam, thiopental. After 4days of unsatisfactory control of seizure activity, high dose VPA was administered for 2 months. The clinical and electrolgraphic seizure improved and the patient has made an satisfactory neurologic recovery
Anticonvulsants ; Child ; Female ; Glasgow Coma Scale ; Humans ; Midazolam ; Phenobarbital ; Phenytoin ; Seizures ; Status Epilepticus ; Thiopental ; Valproic Acid

The objectives of the study were to provide the basic informations needed in the development of balanced medical services throughout the nation. As the national health care system was expanding rapidly along with the economic growth, quantitative re-evaluation of the system is of great need. For that reason, characteristics of the admitted patients were analyzed for the case-mix and patients' flow within and through regions. Materials were 421,530 cases of inpatients, who were reported through Medical Insurance Corporation(KMIC) for insurance claim, during the period of March 1, 1985 through February 28, 1987. Korean Diagnosis Related Groups(K-DRGs) classification system was adopted for the study of case-mix and 189 cities and countries were classified into 5 district groups by factor analysis results of K-DRGs. The major findings of this study were as follows ; 1) Factor analysis of case-mix, employing K-DRG system, revealed 5 distinct functional district groups. Group A(18 district) was prominent for tertiary medical care. In group B(36 districts), rather simple procedures were prevalent. Group C(26 districts) was distinctive for the medical care of well organized internal medicine practices with qualified clinical laboratories. Group D(17 districts) was characterized by relatively high balanced medical care. Group E (92 districts) was with very low level of medical care. 2) Analysis of the case-flow through the districts showed 3 types of flow patterns ; inflow, outflow, and balanced types. Inflow type of case-flow was found in Group A, C and D while Group B and E showed outflow type. Inflow was most prominent in Group A and Group E was of typical outflow type. Group B was consistently the outflow type except for Major Diagnostic Category XX regardless of the disease treaders, but Group C and D were inflow or outflow types according to the disease tracers.
Classification ; Delivery of Health Care* ; Diagnosis ; Economic Development ; Factor Analysis, Statistical ; Humans ; Inpatients* ; Insurance ; Internal Medicine ; Rationalization

The authers report a case of intracerebral extraventricular cyst of possible neuroectodermal origin, presenting as a right frontotemporoparietal mass lesion which has no communication with the subaracnhnoid space or ventricular system. A 4 months old male patinet recovered rapidly after partial removal of cystic wall, cystoventriculostomy and cystoperitoneal shunt. The pathogenesis and principles of diagnosis and surgical management of this rare lesion is discussed.
Diagnosis ; Humans ; Infant ; Male ; Neural Plate