Anomalous union of the pancreaticobiliary duct (AUPBD) is a congenital anomaly that is defined as a junction of the bile duct and pancreatic duct outside the duodenal wall. This anomaly results in a loss of normal sphincteric mechanisms at the pancreaticobiliary junction. As a result, regurgitation of pancreatic juice into the biliary system develops and causes choledochal cysts, choledocholithiasis, cholangitis, pancreatitis and malignancy of the biliary tract. Gallbladder cancer or common bile duct cancer associated with AUPBD and choledochal cysts have been frequently reported. But, intrahepatic cholangiocarcinoma associated with this condition has been only rarely reported. Here, we report a case of intrahepatic cholangiocarcinoma associated with AUPBD and choledochal cyst.
Adult ; Bile Duct Neoplasms/*diagnosis/etiology/pathology ; *Bile Ducts, Intrahepatic ; Cholangiocarcinoma/*diagnosis/etiology/pathology ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Choledochal Cyst/complications/*diagnosis ; Female ; Humans ; Positron-Emission Tomography and Computed Tomography ; Tomography, X-Ray Computed

This study was performed to examine the relationship between the abstinence results of alcohol dependents after discharge and the level of insight at the time of discharge. 117 male Korean alcohol dependents discharged from a community-based alcohol treatment center were followed up to determine the initial months of abstinence on a successive basis (IMA), total months of abstinence during 12-month period (TMA), and complete abstinence for one full year after discharge. Analyses of abstinence results with adjustment for the differences in baseline characteristics were performed for subjects' insight levels (poor, fair and good). The mean IMA of patients with good insight was significantly (p<0.01) longer than that of patients with poor insight and TMA of patients with good insight was significantly (p<0.001) longer than that of others. Using patients with good insight as the reference, patients with poor insight showed an adjusted odds ratio (OR) of 0.07 (95% confidence interval [CI]=0.01-0.75, p<0.05) for complete abstinence for one full year after discharge and patients with fair insight, adjusted OR of 0.17 (95% CI=0.03-0.81, p<0.05). These results suggest that alcohol dependents' insight could be regarded as a factor related with abstinence.
Temperance/*psychology ; Middle Aged ; Male ; Humans ; Alcoholism/*psychology ; Adult

BACKGROUND: It has been suggested that CDT is a potential biological marker in the Western countries to reflect the degree of past alcohol consumption. This study was performed to compare CDT, AST (aspartate transaminase), ALT (alanine transaminase), and GGT (gamma- glutamyl transferase) as a biological marker reflecting drinking amounts in Korean patients. METHODS: The 25 males with moderate drinking(<14 drinks/week) and 26 males with heavy drinking (>21 drinks/week) were studied for the relationships between their weekly drinking amount and the blood levels of CDT, AST, ALT, and GGT. RESULTS: Only CDT was significantly correlated (P=0.001) with weekly drinking amount among heavy drinkers, while both CDT (P=0.029) and GGT (P=0.000) were significantly correlated in moderate drinkers. Stepwise multiple regression revealed that GGT had R2 of 49.1% in moderate drinkers and CDT had R2 of 38.9% in heavy drinkers for the weekly drinking amount. CONCLUSION: The results described above suggested that CDT can be a potential biological marker for the purpose of quantitative monitoring the drinking behavior of heavy drinkers in Korea.
Alcohol Drinking* ; Biomarkers ; Drinking ; Drinking Behavior ; Humans ; Korea ; Male* ; Transferrin*

We report a case of a 27-year-old male showing Becker's nevus on his trunk and lower extremities. It represented symmetrically bilateral and extensive(about 50% of body surface) involvement. In addition to the usual clinical findings of Becker's nevus, grouped small darker spots were noted on the lesion of the buttock featuring agminated lentigine. Histologic findings of the brownish pigmented lesion consisted of mild acanthosis, hyperkeratosis, elongation of rete ridges, increase of basal layer pigmentation, and numerous terminal hair follicles. A dark macule in agminated lesions on the buttock showed more dense basal layer pigmentation and more regular elongation and fusion of rete ridges consistent with the histologic findings of lentigo simplex. This report describes a rare case of a giant Becker's nevus involving 50% of body surface in a bilateral and symmetrical distribution with associated agminated lentigine.
Adult ; Buttocks ; Hair Follicle ; Humans ; Lentigo ; Lower Extremity ; Male ; Nevus* ; Pigmentation

We report a case of a 27-year-old male showing Becker's nevus on his trunk and lower extremities. It represented symmetrically bilateral and extensive(about 50% of body surface) involvement. In addition to the usual clinical findings of Becker's nevus, grouped small darker spots were noted on the lesion of the buttock featuring agminated lentigine. Histologic findings of the brownish pigmented lesion consisted of mild acanthosis, hyperkeratosis, elongation of rete ridges, increase of basal layer pigmentation, and numerous terminal hair follicles. A dark macule in agminated lesions on the buttock showed more dense basal layer pigmentation and more regular elongation and fusion of rete ridges consistent with the histologic findings of lentigo simplex. This report describes a rare case of a giant Becker's nevus involving 50% of body surface in a bilateral and symmetrical distribution with associated agminated lentigine.
Adult ; Buttocks ; Hair Follicle ; Humans ; Lentigo ; Lower Extremity ; Male ; Nevus* ; Pigmentation

BACKGROUND: This study was intended to present the importance of insight status concerning the abstinence of alcoholics. METHODS: The 214 subjects, who participated in insight improving programs during hospitalization in an alcohol treatment center, were followed up for their abstinent status during the 12 month period after discharge. The relation between their abstinence results and insight status was investigated. To find out the influence of other factors upon abstinence, stepwise multiple regression was performed over variables including disease severity, sociodemographic, therapeutic and familial features. RESULTS: The 73 individuals (34.1%) had 'no remission', 110 (51.4%) 'early full remission', and 31 (14.5%) 'sustained full remission'. The insight degree was significantly correlated with both 'initial consecutive months of sobriety'(IMS) after discharge and 'total months of sobriety'(TMS) during the follow up. The 153 subjects (71.5%) relapsed within four months after discharge, and the rate of continuous abstinence at each month differed significantly among three insight groups. On the inter group shifts during hospitalization, the abstinent months were greater in the group whose insight changed from 'poor ' to 'good insight' than the one from 'fair ' to 'good insight'. By stepwise multiple regression analysis, the higher insight scores, older age and shorter hospital days, in a decreasing order of association, the longer IMS and TMS, while absence of religion and lower MAST scores was associated only with IMS, with their overall R2 value of 18.5% and 20.8%, respectively. CONCLUSION: The insight degree was related to the length of abstinence and thus it is necessary to develop insight improving programs which can be of help to recovering patients.
Alcoholics ; Alcoholism ; Follow-Up Studies ; Hospitalization ; Humans ; Prognosis

Blue nevus is a benign melanocytic neoplasm and represents itself usually as a solitary blue or blue-black papule. It rarely occurs as multiple lesions grouped in a circumscribed area. How-ever, non-grouped disseminated blue nevi are exceedingly rare. We report a patient with acquired multiple blue nevi that was distributed over the entire body discretely and showed an increase in the number of the nevi without any causal factors.
Humans ; Nevus ; Nevus, Blue*

BACKGROUND: Human skin color shows variations throughout life and many extrinsic and intrinsic factors influence melanogenesis. The characteristics of skin pigmentation have been studied largely in white Caucasians. However, pigmentary changes due to various regulatory factors may be different in Orientals. OBJECTIVE: We observed the variations in skin color due to aging, seasonal changes and gender differences in Koreans with skin type IV or V. METHODS: Skin pigmentation was measured at five body sites (buttock, glabella, V-neck area, inner arm, and dorsal forearm) using skin reflectance spectroscope in 109 subjects in winter and summer. RESULTS: Constitutive pigmentation of the buttock was at the highest level in the first decade of life. It then decreased during the next two decades. This decreased level was maintained after the third decade. The pattern of pigmentation changes of other four sites with aging was similar to that of the buttock. Gender differences were significant except in the first decade. Seasonal change of pigmentation level was observed in dorsal forearm. Interestingly, our study did demonstrate some differences from the observations in Caucasians. We found that facultative pigmentation in Koreans was not increased with aging, so the sun exposure index was not reliable as a measure of cumulative lifetime UV exposure. CONCLUSION: These differences between races could imply that genetically determined basal skin color has important effects on characterizing later responsiveness to UV lights and sex hormones. Understanding these differences in skin pigmentation would be helpful in treating pigmentary diseases and skin cancers, and in studying the regulatory mechanisms of melanogenesis.
Aging ; Arm ; Buttocks ; Continental Population Groups ; Forearm ; Gonadal Steroid Hormones ; Humans ; Intrinsic Factor ; Pigmentation ; Seasons* ; Skin Neoplasms ; Skin Pigmentation* ; Skin* ; Solar System ; Ultraviolet Rays

We report herein a 82-year-old male patient having pruritic purple or violaceous grouped papules and nodules based on the dark bluish plaques of a 5-year duration on both dorsa of the feet and toes. Also he complained of moderate-degree pitting edema and varicose veins for 30 years on both lower legs. We diagnosed his skin lesion as Mali variant of pseudo-Kaposi's sarcoma probably caused by chronic lymphedema and venous insufficiency.
Aged, 80 and over ; Edema ; Foot ; Humans ; Leg ; Lymphedema ; Male ; Mali ; Sarcoma* ; Skin ; Toes ; Varicose Veins ; Venous Insufficiency

Isotopic response describes the occurrence of a new skin disorder at the site of another one, already healed and unrelated. The preceding diseases are mostly herpes zosters. Reactive perforating collagenosis is rare dermatosis that has characteristic histopathologic features; transepidermal elimination of degenerated dermal collagen fibers. There has been only one report of an reactive perforating collagenosis occurring on the healed site of herpes zoster. We present a case of acquired reactive perforating collagenosis that was developed on the site previously affected by herpes zoster in a 67-year-old woman, which is thought to be an isotopic response.
Aged ; Collagen ; Female ; Herpes Zoster* ; Humans ; Skin ; Skin Diseases