Helical CT Findings of Gastric Wall Thickening by Peptic Ulcer: Compared with Gastric Adenocarcinoma with Ulcer

PURPOSE: To compare on the basis of helical CT findings gastric wall thickening of peptic gastric ulcer with that of gastric adenocarcinoma with ulcer. MATERIALS AND METHODS: Thirty-eight patients with athologically proven gastric lesion [17 cases of peptic ulcer and 21 cases of ulcerative or ulceroinfiltrative gastric cancer (Borrman type II, III)] underwent helical CT, and the findings were retrospectively reviewed in terms of maximum abnormal wall thickness, preservation of the inner enhancing layer, the presence of three discriminate layers of gastric wall, and enhancment pattern. The enhancment pattern of abnormally thick wall was compared with that of the portal phase of back muscle, and was defined as low, iso, or high. The Chi-square test and Student t test were used for statistical analysis. RESULTS: In cases of peptic ulcer and gastric cancer with ulceration, maximum abnormal wall thickness was 7-30 (mean, 16.1)mm, and 11-33 (mean, 21.8)mm, respectively. The inner enhancing layer was preserved in 15 of 17 patients (88.2%) and one of 21 (4.8%); three discriminate layers of gastric wall were observed in 8 of 17 patients (47.0%), and one of 21 (4.8%). The enhancement pattern was low in 12 of 17 patients (70.5%), and 3 of 21 (14.3%); iso in 4 of 17 (23.5%), and 4 of 21 (19.0%), and high in one of 17 (5.9%), and 14 of 21 (66.7 % ). All figures refer, respectively, to the two distinct onditioins. In terms of preservation of the inner enhancing layer, three discriminate layers of gastric wall, and a low enhancement pattern, there were statistically significant differences between peptic ulcer and gastric adenocarcinoma with ulcer. Where the enhancement was high, however, the statistically significant difference between the two conditions was even greater. There was no statistically significant difference in terms of gastric wall thickness or iso-attenuation of thickened gastric. CONCLUSION: Helical CT findings of gastric wall thickening, preservation of the inner enhancing layer, and three discriminate layers of gastric wall, as well as the nature of the observed enhancement pattern, may help differentiate between peptic ulcer and gastric adenocarcinoma with ulcer.

A Case of Granuloma Pyogenicum Treated with Intralesional Triamcinolone Acetonide / 대한피부과학회지

We observed a 55-year-old man who had granuloma pyogenicum on the medial border of the right fifth toe which developed after scratching of the wound. Histopathological findings showed many newly formed capillaries that had prominant endothelial cells and showed varying degrees of dilation without appearance of epidermal collarette signs. We tried intralesional treatment with triamcinolone acetonide (10mg%, 1/week*3). After 3 sessions of treatment, the lesion dramatically regressed nearly to normal size.

A Case of Iatrogenic Cushing's Syndrome in Atopic Dermatitis / 대한피부과학회지

Iatrogenic Cushings syndrome is caused by administration of systemic steroids for some disorders, and is clinically characterized by truncal obesity, hypertension, fatigability, amenorrhea, hirsutism, abdominal striae, edema, glucosuria and osteoporosis. We report herein a case of iatrogenic Cushings syndrome in the treatment of atopic dermatitis. The patient, a 32-year-old male, had been diagnosed with atopic dermatitis and was intermittently treated with topical and systemic steroids for 12 years. He revealed facial edema, truncal obesity and striae distensae in both the axilla and abdomen. Steroids are one of the important agents in the treatment of atopic dermatitis but care must be taken in their administration.

A Case of Ota's Nevus Treated by Combination Therapy with Cryosurgery and the Q-Switched Alexandrit Laser / 대한피부과학회지

Ota's nevus is a mongolian spot-like macular blue-black or gray-brown patchy pigmentation that most commonly occurs unilaterally in areas innervated by the first and second division of the trigeminal nerve. We report a case of Ota's nevus treated by combination therapy with cryosurgery and a Q-switched Alexandrite laser. A 48-year-old female had had a type III Ota's nevus from birth. Cryosurgery was tried at first using hard chalk dry ice on the lesion of the forehead and cheek. After that, The Q-switched Alexandrite laser was used three times at twelve week intervals at the site of the eyelid. Good therapeutic effects were gained and our patient was very satisfied. There were no complications or scarring. A Biopsy of the area treated revealed a similar histological pattern with significantly less melanin indicating melanin removal. Combination therapy with cryosurgery and an Alexandrite laser on the Ota's nevus may be cheaper, more effective and a safer method. It may also reduce the limitation of the two methods when used individually.

A Clinical Study of 133 Patients with Rosacea / 대한피부과학회지

BACKGROUND: A clinical study of rosacea has never been reported in Korea. OBJECTIVE: The purpose of this study was to elucidate the clinical observations of rosncea. METHODS: During a 5-year-period from Jan. 1990 to Dec. 1994, 133 patients were evaluated with regard to age, sex, location of skin lesions, clinical type, duration, and precipitating factors. RESULTS AND CONCLUSIONS: 1. Of the 7,787 cases amongst outpatients, 133 cases(1.7% ) were dignosed with rosacea. Of there 46 were male patients and 87 females, giving a sex ratio of 1:1.9 in favor of females. 2. The most common type of rosacea was vascular rosacea(60.2%) 3. The average duration of rosacea was 3.4 years. 4. Rosacea afflict persons aged 40-49 most frequently. 5. The predilection sites of the rosacea were : cheek(42.9%), nose(23.3%), entire face(11.3%), cheek & nose(9%), zygomatic area(6.8%), extra-facial area(3.8%), forehead(2.9%). 6, The aggravating factors of rosacea were : unknown cause(32.3%), coffee & tea(18%), alcohol(13.5%), emotional stress(10.5%), sun exposure(9.8%), multi-factoral(7.5%), drugs(steroids)4.6%).

The Effect of UVB on the NF-kB and AP-1 Activity in Cultured Human Keratinocytes and Fibroblasts / 대한피부과학회지

BACKGROUND: Ultraviolet B(UVB) light, which can cause severe damage like induction and promotion of cancer, cutaneous inflammation and immunosuppression, represents one of the most important environmental impacts for humans. Keratinocytes are natural target cells of UVB in humans. NF-kB plays a role in the cell of the immune system, where it controls the expression of various cytokines and the major histocompatibility complex gene. OBJECTIVE: The purpose of this study was to examine the effect of UVB on the NF-kB and AP-1 activity in cultured human keratinocytes and fibroblasts. METHODS: Keratinocyte and fibroblast cultures were produced with DMEM medium. Cells were irradiated for 100J/m, 200J/m, 300 J/m. and Nuclear proteins were extracted. AP-1 and NF-kB activities were measured by the gel shift mobility assay. RESULTS: Gel shift mobility assay. 1. The NFkB activity was increased upon UVB in a dose dependent manner in the keratinocyte. 2. Enhanced levels of AP-1 binding activity in the radiated extracts frorn human skin keratinocytes were detected. 3. The levels of GRE (glucocorticoid responsive element) binding activity were similar in both radiated and unradiated extracts from fibroblasts and keratinocytes. CONCLUSIONS: The activities of NF-aB and AP-1 are increased following stimulation of a cell with UVB irradiation. Therefore, UV induced skin tumors, abnormal cell proliferation, cutaneous inflammation and immunosuppression, may be due to these transcriptional factors.

A Case of Ecthyma Gangrenosum Associated with Liver Abscess / 대한피부과학회지

Ecthyma Gangrenosum is a rapidly progressing skin infection charact,erized by edema, hemorragic bullae and necrosis. Ecthyma Gangrenosum occurs almost exclusively in severely imrnunocompromised patients during the course of pseudomanas aeruginosa septisemia. A 5 month-old boy was transferred to our department because of multiple well defined central necrotic black-colored large erythematous bullae. In the bacterial cultures of skin, stool and liver aspiration fluid, Pseudomonas aeruginosa was grown. In the abdominal ultrasonogram and computed tomogram, the multiple liver abscess, hepatomegaly and ascites were shown on both hepatic lobes. Herein we report a case of ecthyma gangrenosum associated with liver abscess.

A Case of Bullous Systemic Lupus Erythematosus / 대한피부과학회지

Vesiculobullous eruptions are a rare cutaneous manifestation of systemic lupus erythematosus (SLE). They are related to intense inflammation within the cutaneous lesions and subsequent blister formation. We report a case of vesiculobullous eruption of SLE in a 23-year-old male. The bullous eruptions were present ori the lip, forehead, both feet and hands. He met ARA(American Rheumatism Association) is criteria for a diagnosis of SLE and the eruptions developed during a systemic attack of the disease. Routine histology of the lesion showed subepidermal blisters with intact epidermis and dense neutrophilic infiltration in the upper dermis. Direct immunofluorescence of lesional skin showed a linear-granular pattern of immune deposits at the dermoepidermal junction. Electronmicroscopy of the lesional skin showing subepidermal bullae are located beneath the lamina densa. Combination therapy of prednisolone and hydrochloroquine showed complete clearing of the lesions within several weeks. We observed a good response without evidence of recurrence.