PURPOSE: The aim of this study is to evaluate how much influence iliac vein compression exerts on the clinical feature of deep venous thrombosis (DVT). METHODS: One hundred five cases of lower extremity DVT were enrolled. The cases were grouped by location of the thrombus, left/right and inferior vena cava, iliac vein (IV), femoral vein (FV), popliteal vein, and calf vein. The estimated frequency was calculated by means of that the numbers of each goup were divided by the group's mean of DVT risk score. The minor distance from the right iliac artery to the fifth lumbar vertebral body overlying the left iliac vein was measured in computed tomography. Correlation of the severity and the minor distance was evaluated. RESULTS: Left, right, and bilateral DVT were represented in 66, 26, and 13 cases, respectively. Estimated frequencies were 2, 6.47, 5.47, 2.08, and 0.96 in the left side and 2, 1.44, 2.5, 1.33, and 1 in the right, respectively. Statistics significance was seen at the IV and FV levels. The means of minor distances in millimeters were 4.88, 3.98, 6.13, 6.20, and 4.20 in the left and 2.50, 7.00, 5.20, 7.33, and 6.50 in the right, respectively. Significance was seen only at the IV level. DVT severity and the minor distance could not be correlated with statistical significance. CONCLUSION: We consider that May-Thurner's anatomical changes impacts the DVT prevalence only at the proximal vein. We also suggest that the compression of the left iliac vein might be a contributing factor for developing DVT but not for severity of the DVT.
Femoral Vein ; Iliac Artery ; Iliac Vein ; Lower Extremity ; Popliteal Vein ; Prevalence ; Spine ; Thrombosis ; Veins ; Vena Cava, Inferior ; Venous Thrombosis

BACKGROUND: The utilization of botulinum toxin has rapidly expanded into various aesthetic applications. Achieving success with the aesthetic use of neurotoxins depends on several factors, including an understanding of the anatomy, the methods of dilution and the injection technique. Any guidelines representing a consensus for aesthetic treatments using botulinum toxin type A (BTA) have not been published in Korea. OBJECTIVE: We wanted to provide consensus recommendations on the treatment of facial wrinkles and benign masseter hypertrophy using BTA in Korean patients. METHODS: A panel of experienced Korean dermatologists was convened to develop a clinical consensus. The clinical consensus was comprised of the recommendations of the panel and the guidelines on general issues, such as the reconstitution and handling of the BTA, the procedural considerations, the dosing and injection-site standardizations, and the prevention and treatment of unwanted effects. Specific recommendations were provided according to the area of treatment, including glabellar lines, horizontal forehead lines, lateral periorbital wrinkles and benign masseter hypertrophy. RESULTS: The recommended final concentration of BTA was 50 units/ml (5 units/0.1 ml) after reconstitution with physiologic saline. For glabellar lines, the members recommend three injection points (a total of 8 units). For forehead wrinkles, the members recommend nine injections in two rows into the frontalis with 1 unit/point. For crow's feet, the members recommend three injections per side (7 units/side) at the lateral part of the orbicularis oculi. For benign masseter hypertrophy, three injections per side (24~30 units/side) were recommended. CONCLUSION: These consensus recommendations will provide a framework for Korean dermatologists who wish to perform safe and efficacious injection of BTA for facial rejuvenation.
Botulinum Toxins ; Botulinum Toxins, Type A ; Consensus ; Foot ; Forehead ; Handling (Psychology) ; Humans ; Hypertrophy ; Korea ; Neurotoxins ; Rejuvenation

Scedosporium (S.) apiospermum is the asexual stage of Pseudallescheria (P.) boydi. The organism is ubiquitous in nature, and has a world-wide distribution. It has been isolated from soil, plant debris, polluted water and sewage. It is an opportunistic organism with low virulence. Infection may occur via direct inoculation and usually affects the extremities. We report a case of cutaneous S. apiospermum infection which occurred in a 58-year-old male during immunosuppressive therapy, 3 months after a kidney transplantation. He presented with an one-month history of cutaneous nodules on the dorsum of the right foot. Cultural isolation showed S. apiospermum and we treated him daily with itraconazole and drainage.
Drainage ; Extremities ; Foot ; Humans ; Immunosuppression ; Itraconazole ; Kidney Transplantation ; Male ; Middle Aged ; Plants ; Pseudallescheria ; Scedosporium* ; Sewage ; Soil ; Virulence

Primary cutaneous CD30 positive large cell lymphoma is a cutaneous T-cell lymphoma with a favorable prognosis, which is characterized by solitary or localized skin lesions with a tendency of spontaneous regression and frequent relapses. On the basis of the morphologic and immunophenotypic similarities between the large atypical cells in lymphomatoid papulosis and the neoplastic cells in primary cutaneous CD30 positive large cell lymphoma as well as their favorable prognosis, these two diseases are now regarded to be in a spectrum of primary cutaneous CD30 positive lymphoproliferative disorder. We present a borderline case of primary cutaneous CD30 positive lymphoproliferative disorder which recurred on the anatomic site different to the primary lesions despite multiple-agent chemotherapy.
Drug Therapy ; Lymphoma ; Lymphoma, T-Cell, Cutaneous ; Lymphomatoid Papulosis ; Lymphoproliferative Disorders* ; Prognosis ; Recurrence ; Skin

Plasma cell cheilitis is a rare inflammatory disorder which shows a dense, band-like infiltrate of plasma cells in the upper dermis. Although the histological picture is shared with other diseases of the lips, plasma cell cheilitis is not associated with any known dermatoses. Some authors have shown the effectiveness of topical or intralesional corticosteroids; however, there have been many reports describing poor therapeutic response to topical steroids. We de-scribe two patients with plasma cell chielitis whose clinical condition responded rapidly to the intralesional injection of corticosteroids.
Adrenal Cortex Hormones* ; Cheilitis* ; Dermis ; Humans ; Injections, Intralesional* ; Lip ; Plasma Cells* ; Plasma* ; Skin Diseases ; Steroids

PURPOSE: The metastatic animal model of human cancer is important from a practical point of view in the research of cancer metastasis, because it resembles the original tumors morphologically, biologically and biochemically. We developed the animal model to investigate the clinically relevant metastasis of gastric cancer which is the leading cause of death in Korea. METHODS: Seven to eight-week-old specific-pathogen-free (SPF) BALB/c-nu mice were used. We developed an orthotopic transplantation model using the tissue obtained from an inoculation of the gastric cancer cell suspension (YCC-3) into a subcutaneous layer of mice. The mice were kept in laminar-flow cabinets under SPF condition and inspected everyday. RESULTS: Mice were sacrificed 8~12 weeks after the operation when they showed either a measurable mass or signs of distress. The metastatic pattern of this animal model was very similar to that of human gastric cancer. At autopsy, the local growth of the gastric cancer, lymph node metastasis and any distant metastasis were noted. CONCLUSION: We developed an animal model for human gastric cancer metastasis that will enhance our understanding of the biology of cancer metastasis and it will contribute to the development of the research and treatment of cancer metastasis.
Animals ; Autopsy ; Biology ; Cause of Death ; Humans* ; Korea ; Lymph Nodes ; Mice ; Models, Animal ; Neoplasm Metastasis ; Stomach Neoplasms*

Spontaneous medialstinal emphysema (pneumomediastinum) and pneumopericardium may be defined as the presence of free air or gas in the mediastinal structures and in the pericardial sac without an apparent precipitating cause. It most frequently occurs in young healthy adults without serious underlying pulmonary disease. Although pneumomediastinum and pneumopericardium is often asymptomatic, it may cause pain in the neck and chest, dysphonia and shortness of breath. Treatment is supportive unless the patient has a history of trauma from foreign body aspiration. The course of spontaneous pneumomediastinum and pneumopericardium is usually benign and self-limited. A case of spontaneous pneumomediastinum, pneumopericardium and subcutaneous emphysema in a 20-year-old male is reported in this paper
Adult ; Blood Gas Analysis ; Case Report ; Follow-Up Studies ; Human ; Male ; Mediastinal Emphysema/*complications/*radiography ; Pneumopericardium/*complications/*radiography ; Radiography, Thoracic ; Remission, Spontaneous ; Tomography, X-Ray Computed

We present two cases of compression of the common hepatic duct by overriding of the right hepatic artery. One case is gall bladder, common hepatic duct stone and one case is right intrahepatic duct stone. We observed the compression of the common hepatic duct caused by overriding of the right hepatic artery in the both cases. The final diagnosis was made at operative fields. These patient were successfully treated by dissection of adhesion, suture, fixation between gall bladder bed and right hepatic artery.
Diagnosis ; Hepatic Artery* ; Hepatic Duct, Common* ; Humans ; Sutures ; Urinary Bladder

OBJECTIVES: This study was purposed to determine the levels of PCBs and DDE in adipose tissue and serum and to evaluate the relations with factors affecting these levels. METHODS: We analyzed adipose tissues and sera from 52 gynecologic benign disease patients aged 27-78 years, except hormonal diseases such as breast cancer and endometriosis. We also surveyed age, education, occupation, body mass index (BMI), smoking, drinking, number of children, and duration of breastfeeding by questionnaires. Tissue and serum levels of PCBs and DDE were measured using gas chromatography. RESULTS: The median and geometric mean levels of PCBs were 48. 29 ng/g, 56. 78 ng/g for adipose tissue and 4. 67 uc/L, 4. 85 m/L for serum, and those of DDE were 142.89 ng/g, 117.06 ng/g for adipose tissue and l. 75 m/L, 2.09 ua/L for serum, respectively. Adipose tissue and serum levels for DDE showed high correlation (r=0. 310, p=0. 0002), but those of PCBs didn' t (r=0.029, p=0.2582). In analyses of the differences of the means of log transformed adipose tissue and serum PCBs and DDE levels for groups of potential covariates, only adipose tissue DDE levels were significantly associated with number of children (p=0.015), age at first birth (p=0.014) and BMI (p=0.035). In multiple regression analysis, adipose tissue DDE levels were significantly increased with decreasing number of children and increasing age at first birth. CONCLUSIONS: This study suggested that parity and adiposity were associated with levels of DDE in adipose tissue, and adipose tissue is a better biomarker than serum for evaluating the long-term exposure of organochlorines.
Adipose Tissue* ; Adiposity ; Birth Order ; Body Mass Index ; Breast Feeding ; Breast Neoplasms ; Child ; Chromatography, Gas ; Dichlorodiphenyl Dichloroethylene* ; Drinking ; Education ; Endometriosis ; Female ; Humans ; Occupations ; Parity ; Polychlorinated Biphenyls* ; Questionnaires ; Smoke ; Smoking

BACKGROUND AND AIMS: Propofol is a short-acting intravenous sedative-hypnotic agent that can be used as a hypnotics for upper gastrointestinal endoscopy. A study was conducted to evaluate the effectiveness and safety of propofol as a hypnotic agent for upper gastrointestinal endoscopy. METHODS: From June to October 1998, twenty eight patients undergoing upper gastrointestinal endoscopy were to receive propofol. Vital signs and peripheral oxygen saturation (SpO2) were monitored by pulse oximetry during continuous infusion of propofol. Propofol (1% solution) was initially infused by 26.7 mg/kg/hr until loss of eyelash reflex and then titrated to 6-10 mg/kg/hr according to the patient's response and vital sign. Propofol infusion was discontinued while the endoscopic fiber was removed. Recovery time was defined from discontinuation of infusion to positive Romberg test. Evaluation was made from the endoscopists' assessment, patients' satisfaction, patients' recall of the procedure, and consciousness of the patients. RESULTS: It was discovered that systolic, diastolic pressure and heart rate were significantly decreased, compared to control group. But clinically significant changes were not found. Apnea did not exist. And the respiration rate was significantly increased during propofol infusion. Peripheral oxygen saturation (SpO2) was transiently decreased during endoscopy. 14 patients (50%) complained of transient dizziness. Pain and redness over the infusion site was not found. The mean total dose of propofol was 133.6 mg. The mean infusion time of propofol was 6.2 minutes. Mean response and recovery time was 3.7 2.1, 20.9 5.4 minutes. Endoscopists' assessment and patients' comfort for endoscopy were satisfactory. When we asked 28 patients about willingness to undergo the same procedure in the future, 27 patients (96.4%) agreed. Degree of amnesia after examination revealed total amnesia in 27 patients (96.4%), partial amnesia in 1 patients (3.6%), and recall was not. CONCLUSIONS: Propofol has beneficial effects as hypnotic for upper gastrointestinal endoscopy without significant alteration in cardiopulmonary parameters. Patients' and endoscopists' assessment is good. This suggest that propofol may be used more frequently as a kind of premedication, especially in the cases of repeated endoscopy.
Amnesia ; Apnea ; Blood Pressure ; Consciousness ; Dizziness ; Endoscopy ; Endoscopy, Gastrointestinal* ; Heart Rate ; Humans ; Hypnotics and Sedatives ; Oximetry ; Oxygen ; Premedication ; Propofol* ; Reflex ; Respiratory Rate ; Vital Signs