Over the past years, hydrocolloid dressings have been introduced routinely in the treatment of various types of wounds. They provide a moist environment promoting autolytic debridement, and stimulate angiogenesis. However, long-term application often leads to inflammation of the skin in the immediate area of the ulcer, causing irritant dermatitis in many cases, but sometimes also leads to contact sensitization. A 32 year-old woman burnt herself by an iron, and presented to our clinic and was treated with Duoderm extrathin(R). Nine days later, she again presented with an erythematous oozing patch with edema, and allergic contact dermatitis was suspected. A patch test (TRUE test) was performed and a positive reaction to colophonium was obtained. Duoderm extrathin(R) contains hydrogenated rosin (colophonium) as the tackifying agent, so we could diagnose this case as allergic contact dermatitis due to the hydrogenated rosin in Duoderm extrathin(R). We report another case of allergic contact dermatitis due to Duoderm extrathin(R) in a 32 year-old woman.
Bandages, Hydrocolloid ; Debridement ; Dermatitis, Allergic Contact ; Dermatitis, Irritant ; Edema ; Female ; Humans ; Hydrogen ; Inflammation ; Iron ; Patch Tests ; Resins, Plant ; Skin ; Ulcer

PURPOSE: Survival outcome of locally advanced pancreatic cancer has been poor and little is known about prognostic factors of the disease, especially in locally advanced cases treated with concurrent chemoradiation. This study was to analyze overall survival and prognostic factors of patients treated with concurrent chemoradiotherapy (CCRT) in locally advanced pancreatic cancer. MATERIALS AND METHODS: Medical records of 34 patients diagnosed with unresectable pancreatic cancer and treated with definitive CCRT, from December 2003 to December 2012, were reviewed. Median prescribed radiation dose was 50.4 Gy (range, 41.4 to 55.8 Gy), once daily, five times per week, 1.8 to 3 Gy per fraction. RESULTS: With a mean follow-up of 10 months (range, 0 to 49 months), median overall survival was 9 months. The 1- and 2-year survival rates were 40% and 10%, respectively. Median and mean time to progression were 5 and 7 months, respectively. Prognostic parameters related to overall survival were post-CCRT CA19-9 (p = 0.02), the Eastern Cooperative Oncology Group (ECOG) status (p < 0.01), and radiation dose (p = 0.04) according to univariate analysis. In multivariate analysis, post-CCRT CA19-9 value below 180 U/mL and ECOG status 0 or 1 were statistically significant independent prognostic factors associated with improved overall survival (p < 0.01 and p = 0.02, respectively). CONCLUSION: Overall treatment results in locally advanced pancreatic cancer are relatively poor and few improvements have been accomplished in the past decades. Post-treatment CA19-9 below 180 U/mL and ECOG performance status 0 and 1 were significantly associated with an improved overall survival.
Chemoradiotherapy* ; Follow-Up Studies ; Humans ; Medical Records ; Multivariate Analysis ; Pancreatic Neoplasms* ; Survival Rate

BACKGROUND: Cell death is divided into two types, cell necrosis and apoptosis. In contrast to cell necrosis, an apoptotic cell is ingested by phagocytes and apoptosis is not accompanied by local inflammatory cells. Recently, apoptosis is considered to be involved in the pathogenesis of autoimmune diseases. OBJECTIVE: We investigated the presence of apoptotic cells in discoid lupus erythematosus, lichen planus, and psoriasis which are cutaneous autoimmune diseases, and also in erythema multiforme, which is not an autoimmune disease and of which characteristic in histopathologic features is necrotic keratinocytes. METHODS: A total of forty-six skin biopsy specimens were chosen. The specimen is made up of ten of each discoid lupus erythematosus, lichen planus, psoriasis, erythema multiforme and six of normal skin. We performed TUNEL stain on each specimen to observe apoptotic cells in the epidermis and dermis. The mean numbers of apoptotic cells were compared using the Kruskal-Wallis test and post hoc according to Conover. RESULTS: In discoid lupus erythematosus, apoptotic cells were observed as the most common disease in the epidermis and also in the dermis. In lichen planus, apoptosis was rarely observed in the epidermis, but was observed as the second common disease in the dermis. In psoriasis, apoptosis was rarely observed in both the epidermis and dermis. In erythema multiforme, apoptosis was observed in both the epidermis and dermis, and especially observed as the second common disease in the epidermis among four diseases. CONCLUSION: Apoptosis may contribute to pathogenesis of discoid lupus erythematosus and also in part to lichen planus and erythema multiforme. However, in psoriasis, apoptosis was rarely observed and resistance to apoptosis may be involved in the pathogenesis of psoriasis.
Apoptosis ; Autoimmune Diseases ; Biopsy ; Cell Death ; Dermis ; Epidermis ; Erythema Multiforme ; In Situ Nick-End Labeling ; Lichen Planus ; Lupus Erythematosus, Discoid ; Necrosis ; Phagocytes ; Psoriasis ; Skin

CD4+/CD56+ hematodermic neoplasm is a rare and aggressive lesion that affects many organs, and skin involvement is highly characteristic. It is also termed blastic natural killer cell lymphoma in the World Health Organization classification. Several origins of tumor cells have been proposed, but recent studies have shown a relationship with plasmacytoid dendritic cells. A 2-year-old boy presented with multiple bruise-like violaceous subcutaneous nodules and plaques on the trunk, upper and lower extremities. Histological examination showed small-to-medium-sized blastoid cellular infiltration in the dermis and subcutaneous tissue. Tumor cells were positive for CD4, CD56 and TdT, and negative for CD8, CD20 and MPO. It primarily affects elderly patients, but, in this case, occurred in an infant. Due to its rarity, we present a case of CD4+/CD56+ hematodermic neoplasm affecting a pediatric patient.
Aged ; Dendritic Cells ; Dermis ; Humans ; Infant ; Killer Cells, Natural ; Lower Extremity ; Lymphoma ; Preschool Child ; Skin ; Subcutaneous Tissue ; World Health Organization

Infectious mononucleosis(IM) is a benign self-limiting disease and result from a polyclonal B cell proliferation secondary to Epstein-Barr virus (EBV) infections. The infection is controlled by cytotoxic T cells triggered by EBV infected B cells. However, rare cases develop severe or fatal IM accompanied by hemophagocytic syndrome. We report a case of a 4-year-old girl who presented with high fever, hepatosplenomegaly, hepatic failure, pancytopenia and coagulopathy. Despite intensive treatment, the patient's condition deteriorated rapidly and died 3 days after admission. At autopsy, there was prominent infiltration of atypical lymphocytes with hemophagocytosis in multiple organs, especially liver, spleen and lymph nodes. Atypical lymphocytes were immunopositive for T cell markers and showed positive signal in EBV in situ hybridization.
Autopsy ; B-Lymphocytes ; Cell Proliferation ; Child, Preschool ; Female ; Fever ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Infectious Mononucleosis* ; Liver ; Liver Failure ; Lymph Nodes ; Lymphocytes ; Lymphohistiocytosis, Hemophagocytic ; Pancytopenia ; Spleen ; T-Lymphocytes

This study was conducted to draw out prevalence and the risk factors of diabetes mellitus and impaired fasting glucose for adults,(age 30-69). The subjects were 2096 adults, who had regular health examinations between January and December of 1999 at K Hospital in Seoul. The data was analyzed using chi-square test, unpaired t-test and logistic regression. Diabetes Mellitus and impaired fasting glucose were diagnosed by ADA (American Diabetes Association, 1997) criteria. The results were as follows: 1. Mens' prevalence of Diabetes Mellitus was 7.9% and womens' prevalence of Diabetes Mellitus was 3.8%. Mens' prevalence of impaired fasting glucose was 10.4% and womens' prevalence of impaired fasting glucose was 6.5%. Prevalences of Diabetes Mellitus and impaired fasting glucose increased with age. 2. Prevalence of Diabetes Mellitus and impaired fasting glucose of obese subjects (relative body weight>=162) was higher than that of overweight subjects (110<=relative body weight<=119) in men and women. 3. The diagnoses of Diabetes Mellitus and impaired fasting glucose increased with systolic blood pressure and triglyceride. 4. Significant factors associated with diabetes in the logistic regression best gut model were age, relative body weight, systolic blood pressure, triglyceride in men, and systolic blood pressure in women. In conclusion, as age, weight, systolic blood pressure and triglyceride get higher, Diabetes Mellitus and impaired fasting glucose prevalence also increases, porportionally.
Adult* ; Blood Pressure ; Body Weight ; Diabetes Mellitus* ; Diagnosis ; Fasting* ; Female ; Glucose* ; Humans ; Logistic Models ; Male ; Overweight ; Prevalence* ; Risk Factors* ; Seoul ; Triglycerides

Carcinosarcoma is a highly malignant tumor characterized by dual malignant histologic differentiation of epithelial and mesenchymal components. The tumor is extremely rare in the sinonasal tract. We report a case of a 62-year-old man with carcinosarcoma involving the maxillary sinus.
Carcinosarcoma ; Maxillary Sinus

Lichen planus pigmentosus (LPP) is an uncommon variant of lichen planus, which manifests as hyperpigmented dark brown macular hyperpigmentations chiefly involving the face and upper extremities. The histopathologic changes consist of vacuolar degeneration of the basal layer, presence of dermal melanophages, and lichenoid lymphocytic infiltrations. LPP with exclusive localization in intertriginous areas is named as LPP-inversus, and is infrequently reported in previous dermatologic literature. A 16-year-old girl presented with several brownish to dark grayish patches on both axilla for 7 months. The lesions were asymptomatic and did not have preceding erythema. The patient had not come into contact with any chemicals and denied existence of previous allergy episodes, and her medical history was non-contributory. A skin biopsy from a brownish patch revealed vacuolar alteration of the basal layer, and band-like lymphocytic infiltration with pigment incontinence. We report a typical case of LPP-inversus with relevant literature.
Adolescent ; Axilla ; Biopsy ; Erythema ; Humans ; Hypersensitivity ; Lichen Planus ; Lichens ; Skin ; Upper Extremity

Objective: To report the experiences of triplet pregnancies complicated by twin-to-twin transfusion syndrome (TTTS) treated with fetoscopic laser coagulation at a single center. Methods: Herein, we conducted a retrospective analysis to investigate the management and perinatal outcomes of triplet pregnancies with TTTS treated at a single institution between 2017 and 2022. Results: Seven of the 98 triplet pregnancies (7.1%) encountered were complicated by TTTS, and all were dichorionic triamniotic triplets. Of the seven triplet pregnancies complicated by TTTS, four were treated with fetoscopic laser coagulation at our center, at a median gestational age of 20 weeks. No procedure-related complications or maternal complications were observed. The survival rate was higher and perinatal outcomes were better in fetoscopic laser coagulation cases than in other management cases. Four donor and four recipient triplets survived, with a median gestational age of 33 weeks at delivery. Although there were no cases of poor neonatal outcomes, one case was diagnosed with white matter injury, suspected to be hypoxic-ischemic encephalopathy on postnatal investigation. Conclusion Fetoscopic laser coagulation is a feasible treatment option for triplet TTTS, provided the attending specialists have extensive experience with this technique.

BACKGROUND: Epstein-Barr virus (EBV) is associated with various lymphoproliferative disorders and nasopharyngeal carcinoma. Recently, some gastric cancer cells were observed to contain the EBV sequence. We detected EBV in gastric cancer by using PCR to determine the frequency of EBV-associated gastric cancer, and performed immunohistochemical staining for the latent membrane protein (LMP1), p53 and CD44 to investigate the possible mechanism in EBV-associated gastric cancer. METHODS: Eighty-seven formalin-fixed and paraffin-embedded blocks (40 gastric adenocarcinomas, 34 adjacent normal tissues, 13 metastatic lymph nodes) from 40 surgically resected gastric specimens were studied. All patients were diagnosed with gastric cancer at the Kang-Nam St. Mary's Hospital between April 1995 and April 1997. After DNA was extracted from each paraffin block, we performed PCR and immunohistochemical staining for the LMP1, p53 and CD44. RESULTS: EBV was detected in 4 of 40 cases (10%). In 1 of 4 EBV-positive cases, EBV was also detected in a metastatic lymph node. The immunohistochemical staining for the LMP1, p53 and CD44 were negative in all the EBV-positive cancer patients. Of the patients having these cancers, 2 had a poorly differentiated adenocarcinoma with a lymphoepithelioma-like morphology. DISCUSSION: The frequency of EBV-associated gastric cancer is about 10% in Korea. Considering the negative result of the immunohistochemical staining for the LMP1, p53 and CD44, EBV-associated gastric cancer seems to have a different mechanism of tumorigenesis from ordinary gastric cancer or other EBV-associated cancers. This specific mechanism must be determined by further large scale studies.
Adenocarcinoma/metabolism/*virology ; Adult ; Antigens, CD44/metabolism ; Female ; Herpesvirus 4, Human/*isolation & purification ; Human ; Immunohistochemistry ; Male ; Middle Aged ; Polymerase Chain Reaction ; Protein p53/metabolism ; Stomach Neoplasms/metabolism/*virology ; Viral Matrix Proteins/metabolism