We present 6 patients with systemic lupus erythematosus who had papulosquamous skin lesions. These skin lesions were consistent with the findings of subacute cutaenous lupus erythematosus(SCLE) clinically and histopathologically. The. distribution of the skin lesions were on the face, upper extremities and upper trunk in one group, and the upper and lower extremities in other group of these patients. After confirmation of the skin lesions as a type of SCLE, they were regressed with anti-malarial and/or systemic corticosteroids, within 2 months in all patients. For the better management of the patient with lupus erythematosus, understanding of clinically distinct LE-specific skin lesions, including the papulosquamous cuta-neous manifestation of SCLE, may be necessary.
Adrenal Cortex Hormones ; Humans ; Lower Extremity ; Lupus Erythematosus, Systemic* ; Skin* ; Upper Extremity

No abstract available.
Female ; Ovary* ; Theca Cells* ; Thecoma*

We report two cases of malignant schwannoma of skin in association with non-familial neurofibromatosis. Case 1, a 47 year old man, had a large subcutaneous tumor on the sacral area and case 2, a 62 year old woman, a painful, ulcerating tumor on the posterior aspect of the left arm. Both cases were histopathologically confirmed as malignant schwannomas and immunohistochemical studies showed 5-100 protein in the tumor cells. After surgical excision of the tumors, case 1 was lost to follow up, while case 2 remained without evidence of disease for more than one and half years.
Arm ; Female ; Humans ; Lost to Follow-Up ; Neurilemmoma* ; Neurofibromatoses* ; Skin ; Ulcer

Ki-1 monoclonal antibody is a well known marker for Reed-Sternberg cells in Hodgkin's disease, but also occasionally reacts with activated lymphoid cells of either benign or malignant nature. Recently, Ki-1 antibody positive Non-Hodgkin's lymphoma, usually of large cell and/or polymorphous type, has been reported in the lymph nodes, skin, soft tissue, and stomach, but not in the bone. We report a case of multifocal primary bone lymphoma in a seven-year old body involving the left shoulder and right frontal bone, which proved to be a large cell, polymorphous lymphoma, helper T-cell type expressing Ki-1 antigen.
Child ; Male ; Female ; Humans

STATEMENT OF PROBLEM: Porcelain veneers have become a popular treatment modality for aesthetic anterior prosthesis. Fitting porcelain veneers in the mouth usually involve a try-in appointment, which frequently results in salivary contamination of fitting surfaces. PURPOSE: An in vitro study was carried out to investigate the effect of silane treatment timing and saliva contamination on the resin bond strength to porcelain veneer surface. MATERIAL AND METHODS: Cylindrical test specimens (n = 360) and rectangular test specimens (n = 5) were prepared for shear bond test and contact angle analysis. Whole cylindrical specimens divided into 20 groups, each of which received a different surface treatment and/or storage condition. The composite resin cement stubs were light-polymerized onto porcelain adherends. The shear bond strengths of cemented stubs were measured after dry storage and thermocycling (3,000 cycles) between 5 and 55 degrees C. The silane and their reactions were chemically monitored by using Fourier Transform Infrared Spectroscopy analysis (FTIR) and contact angle analysis. One-way analysis of variance (ANOVA) and Dunnett' multiple comparison were used to analyze the data. RESULTS: FT-IR analysis showed that salivary contamination and silane treatment timing did not affect the surface interactions of silane. Observed water contact angles were lower on the saliva contaminated porcelain surface and the addition of 37 percent phosphoric acid for 20 seconds on saliva contaminated porcelain increased the degree of contact angle. Silane applied to the porcelain, a few days before cementation, resulted in increasing the bond strength after thermocycling. CONCLUSION: Within the limitation of this study, it can be concluded that it would be better to protect porcelain prosthesis before saliva contamination with silane treatment and to clean the contaminated surface by use of phosphoric acid.
Cementation ; Dental Porcelain ; Mouth ; Phosphoric Acids ; Prostheses and Implants ; Resin Cements ; Saliva ; Spectroscopy, Fourier Transform Infrared ; Water

BACKGROUND: Cyclosporine (CS) is widely used to treat various skin diseases. Gastrointestinal (GI) discomfort is the most common adverse effect of orally administered CS for dermatologic indications. However, few studies on CS-associated adverse GI events have been conducted. OBJECTIVE: In this study, we aimed to describe the major features of adverse GI events associated with CS therapy using a validated symptom questionnaire, and to investigate the factors contributing to their development. We also evaluated the effectiveness of three empirical GI medications in relieving adverse GI events. METHODS: This study consisted of 2 phases. Phase I was a prospective observational cohort study to investigate the characteristics of CS-associated adverse GI events in 942 consecutive patients treated with CS. Phase II was a randomized controlled trial to evaluate the efficacy of three different classes of GI medications. RESULTS: CS-associated adverse GI events occurred in 119 patients (12.6%). GI complications were more common in female patients (p=0.04), patients with a history of GI disorders (p=0.02), and patients whose initial CS doses were greater than 3 mg/kg/day (p=0.05). In patients treated with any one of the three GI medications, the mean Gastrointestinal Symptom Rating Scale scores significantly decreased (p<0.001). CONCLUSION This study demonstrated that adverse GI events are common during early CS treatment, especially in women, patients receiving high doses of CS, and those with a history of GI disorders. Our results suggest that new-onset CS-associated GI side effects can be effectively managed with the addition of GI medications.

Sorafenib is an inhibitor of receptor tyrosine kinases and the rat sarcoma/mitogen-activated protein kinase (RAS/MAPK) pathway that is approved for the treatment of patients with metastatic hepatocellular carcinoma (HCC) and renal cell carcinoma. Sorafenib is known to have various cutaneous adverse effects, including hand-foot reaction, facial and scalp eruption, xerosis, and alopecia1.A 56-year-old man presented with non-painful, nonpruritic psoriasiform lesions that has been present for approximately 1 month (Fig. 1A∼E). Six months prior to presentation, he had been prescribed sorafenib at a daily dosage of 600∼800 mg after diagnosis of HCC with distant metastasis to the lung. A punch biopsy showed psoriasiform dermatitis (Fig. 1F, G). The skin lesions improved gradually after discontinuing sorafenib. However, at 1 month after discontinuation of sorafenib, considering the dose-dependent adverse effect of the medication, the patient resumed sorafenib at 400 mg daily after an oncology consultation. The lesions recurred beginning at 1 week after restarting sorafenib. A clinical diagnosis of sorafenib-associated psoriasiform drug eruption was made. The sorafenib treatment was maintained at 400 mg daily in conjunction with concurrent phototherapy and topical and intralesional corticosteroids for thick erythematous plaques, and intermittent systemic corticosteroid treatment when the cutaneous eruptions flared up.After approximately 2 years of sorafenib treatment, the patient presented with new crusting lesions without any other systemic adverse reactions. Multiple papules and plaques with central hyperkeratotic and crusted papules were present (Fig. 2A∼D). Punch biopsy showed a ‘perforating phenomenon’ (PP) (Fig. 2E∼G). The brownish hyperkeratotic crusts occurred consistently in prolonged psoriasiform plaques and resolved over time (Fig. 2A∼D). The psoriasiform eruptions and delayed-onset PP persisted with continuing sorafenib use (Fig. 2H). Along with a dose-decrease of sorafenib at 400mg daily, he was treated with systemic and topical corticosteroids, intralesional triamcinolone injection and narrowband ultraviolet B therapy. However, the patient showed recurrent cutaneous lesions aggravation upon tapering the dosage of corticosteroid.The psoriasiform lesions improved and then worsened with sorafenib dose change, and the PP featured hyperkeratotic crusts within multiple, long-lasting psoriasiform plaques. This phenomenon might have occurred to eliminate connective tissue or inflammatory material2 and differs from the appearance of transepidermal elimination in previously reported sorafenib-associated acquired perforating dermatosis cases3,4. Transepidermal elimination is a similar process to wound healing2, and considering that our patient had no history of diabetes, renal insufficiency, and trauma, our case might have exhibited the perforating and resolving phenomenon in response to the abnormal psoriasiform drug eruption.The RAS/MAPK cascade that is inhibited by sorafenib could be activated paradoxically; due to its role in antiangiogenesis, this activation results in epidermal disruption. The reduction and suppression of the hepatocyte growth factor-enhanced expression of matrix metalloproteinase induced by sorefenib could influence homeostasis of dermal elastic fibres, resulting in their disruption5. A few cases of psoriasiform drug eruption and PP after administration of sorafenib and other various tyrosine kinase inhibitors have been reported.The PP could represent a manifestation of the resolution of inflammation whereby the psoriasiform hyperplasia and the proliferated dermal tissue might be eliminated via a trans-epidermal route.

OBJECTIVE: This study was aimed to investigate factors associated with quality of life (QOL), anxiety and depression in patients with intracranial meningioma. METHODS: This is the cross-sectional study of patient with intracranial meningioma in Korea. The European Organisation for Research and Treatment of Cancer QOL Questionnaire 30 and hospital anxiety depression scale were used to assess QOL, anxiety and depressive mood. Multivariate linear regression analysis was used to analyze the related factors. RESULTS: 37 patients in total enrolled to be analyzed. In QOL, general health came out low in the patient group with peritumoral edema. Functional scales got lower as patients had higher neurotic tendency and bigger size of tumor. Symptoms scales got higher as patients' neurotic tendency got higher or as patients had peritumoral edema. Anxiety came out highly related to neurotic tendency and depression found to be related to young age, low agreeableness, high neurotic tendency, and having peritumoral edema. CONCLUSION: The QOL, anxiety and depression of meningioma patients were both related to their personal character traits and disease-related factors. More attention is needed for the QOL and mental health of intracranial meningioma patients.
Anxiety* ; Cross-Sectional Studies ; Depression* ; Edema ; Humans ; Korea ; Linear Models ; Meningioma* ; Mental Health ; Quality of Life* ; Weights and Measures

BACKGROUND: This study provides up-to-date survival data on cardiac resuscitation in adult in-patients. The main objectives of the study were to evaluate the incidence, causes, and outcomes of perioperative cardiac arrest. Objective data might encourage more meaningful attitude in anesthesiologists, surgeons, and patients. METHODS: We retrospectively reviewed patients who experienced perioperative cardiac arrest while receiving noncardiac surgery between January 2004 and December 2012. Collected data included patient characteristics, preoperative evaluations, American Society of Anesthesiologists Physical Status (ASA PS) classification, surgical status (e.g., elective or emergency), type of surgery, and outcomes. RESULTS: We identified 30 cases of perioperative cardiac arrest that occurred in 457,529 anesthetized patients (incidence = 0.66 per 10,000 anesthetized patient; all-cause mortality = 0.21 per 10,000 anesthetic cases). Two-thirds of patients (19 of 30) were emergency cases (21% survival rate; 4 of 19 patients). Most cardiac arrest patients (60%; 18 of 30 patients) were ASA PS IV-V, and only 40% patients were ASA PS I, II and III. Four cases were associated with anesthesia and the patient recovered, and 3 patients recovered after resuscitation. The main causes of cardiac arrest were respiratory- (75%) and medication-related events (25%). CONCLUSIONS: In accordance with anesthetic management guidelines and the development of anesthetic agents, anesthesia-related cardiac arrests decreased in terms of incidence and mortality. However, we recommend that clinicians cautiously keep in mind airway management and the administration of medications, which are important preventative factors.
Adult ; Airway Management ; Anesthesia ; Anesthetics ; Classification ; Emergencies ; Heart Arrest* ; Hospitals, Teaching* ; Humans ; Incidence ; Korea ; Mortality ; Resuscitation ; Retrospective Studies* ; Survival Rate

Simultaneous thrombosis of multiple coronary arteries in acute myocardial infarction is very rare in clinical settings. Its mechanism is not yet clear, but patients displaying multivessel simultaneous thrombosis tend to have poor clinical outcomes. Hence, it is important to recognize this condition and provide timely and proper management. We report a case of simultaneous thrombosis involving multiple coronary arteries in a patient with ST-segment elevation myocardial infarction.
Coronary Occlusion ; Coronary Vessels* ; Humans ; Myocardial Infarction* ; Thrombosis*