Laparoscopic duodenal segmental resection and duodenojejunostomy for symptomatic duodenal diverticula in three cases treated at a community hospital

The duodenum is the second most common site of diverticula following the colon, but is associated with fewer complications than colonic diverticula. Diverticulitis, cholangitis, pancreatitis, perforation, hemorrhage, and blind loop syndrome may occur as complications of duodenal diverticula. Although nonoperative treatment is an option for patients in good condition without signs of sepsis, surgery is generally required for definitive treatment of complications. There are several surgical procedures for symptomatic duodenal diverticula. We performed laparoscopic duodenal segmental resection and duodenojejunostomy without open conversion in three cases. We believe that this procedure is ideal for cases of symptomatic duodenal diverticula when performed by an experienced surgeon with the goal of definitive treatment.

Urine culture and serologic test for diagnosis of trichomoniasis in male patients with nongonococcal urethritis / 대한피부과학회지

Trichomoniasis, a common and sometimes distressing condition in women, is caused by infection of the genitourinary tract by the pathogenic protozoan Trichomonris aginalis(T. vaginalis). Men may also be infected, although frequently without any symptoms, and most cases of trichomoniasis are sexually transmitted. The best evidence for an etiologic role for T. vaginalis is in nongonococcal urethritis(NGU). In epidemiologic studies, T,ginalis has been isolated from 1 to 68 percent in men with NGU. The nurnber of NGU is increasing rapidly than gonorrhea in deeloped nations, and in some developing countries, especially in Korea, In view of the difficulties in findng trichomonads by direct microsco by in men, urine culture and serodiagnosis plays an important role in the diagnostic work. Urine culture, indirect fluorescent antibody test(IFAT) and enzyme-linked immunosorbent assay (ELISA) were used to elecect T.vaginalis in 221 patients with male NGU. These patients visited the VD Clinic of ChoongKu Public Health Center in Seoul from May to August, 1989 and from March, 1990 to December, 1991. The results obtained were as follows.: 1. T. vaginalis was grown from only one of the 221 samples on TPS-1 meida. 2. In 208 NGU patients, there were 10(4.8%) positive reactions on IgG antibody in IFAT. 3. In 208 NGU patient, there were 14(6.7%) positive reactions to IgG antibody in ELISA. 4. No statistical significant correlation was found between then sults of IFAT and ELISA in individual patients. In conclusion, 1. Male trichomoniasis in patients with NGU was detected at a, significantly low rate. Due to the small number of patients in the test, further epidemiologic stidies of trichomoniasis in male NGU patient are necessary. 2. Serologic studies (IFAT and ELISA) have detected sorre trichomoniasis in male patients with NGU. These tests seem to be helpful in the diagnosis of male t-ichomoniasis.

Clinical Study and Therapeutic Experience in Tinea Versicolor / 대한피부과학회지

Fifty-six patients with tinea versicolor were studied clinically and therapeutically, from July 1984 to August 1985, at the Department of Dermatology, Hanyang University. L atients were treated with 20g sodium thiosulfate solution, 1g isoconazole nitrate cream, lg bifonazole cream and. oral ketoconazole. The result obtained were as follows: 1. The average age of all patients at visit was RO. 1 years, the oldest patient was 72 year-old and the youngest patient was 13 year-old. The male to female ratio was 3. 7: 1. 2. Distribution of lesions were anterior chest(26.8%), back(23.9%), abdomen (19%), axilla (17%), neck(6. 3%), pubic area(4. 2%), upper extremities(1. 4%), hip(0.7%) and lower extremities(0.7%). The incidence of hyperpigmented lesions was 76. 8%, and that of hypopigmented lesions was 23. 2g. 3. Average of treatment duration in each trial group indicated 3. 71-I--0 83 weeks (M+SD) in 20g sodium thiosulfate regimen group, 3. 07+ 0. 73 weeks in 1g isoconazole nitrate, 3.29+1.14 weeks in bifonazole, R. 00+0. 68 weeks in oral ketoconazole. No treatment results show statistically significant differences among the trial groups.

A Case of Verruciform Xanthoma Transformed from Lesions of Epidermal Nrvus Syndrome / 대한피부과학회지

We experienced a case of 16-year-old female with verruciform xanthoma transformed from lesions of epidermal nevus syndrome. The biopsy specimen of yellowish brown to red verrucous papule on the right buttock showed 1) uniform and verrucous acanthosis without cytological atypia, 2) parakeratosis and hyperkeratosis,3) variable foci of superficial necrosis with crusting and microabscess in the granular layer, 4) rete ridge elongation and papillomatosis, 5) characteristic foam cells located within the papillary dermis, but not below the rete ridges. Our case was diagnosed verruciform xanthoma by histopathologic finding which occured as a secondary development in lesions of epidermal nevus syndrome.

A Study on Postgonococcal Urethritis / 대한피부과학회지

The subject were 653 male patients with uncomplicated gonorrhea at the VD Clinic of Choong Ku Public Health Center in Seoul from January to November 1985. 653 male patients with uncomplicated gonococcal infection were treated one of the following regimens. Five treatment regimens used were 2, 0 gm spectinomycin single 1M, 4 0 mega unit fortified procain penicillin G+2. 0 gm kanamycin sulfate IM preceded by 1 pgm probenecid PO, 6.0 mega unit fortified procain penicillin G+2 pgm kanamycin sulfate IM preceded by 1. 0 gm probenecid PO, 5, 0 rnega unit aqueous crystaline penicillin+2. 0 gm kanamycin sulfate irn preceded by 1, 0 gm probenecid PO and 9 tablets of cotrimoxazole+ 2. 0 gm kanamycin sulfate IM. There were no significant differences in the incidence of PGU among the five treatment groups. The overall PGU rate was 67.3% 59.2% and 53.6% at 3~5, 7~10 and 14 days after treatment respectively. The incidence of PGU at 7-10 days was not significantly higher than that of at 14 days after treatment. It is suggested that it is best to test PGU at 7 days after treatment. Because the longer one waits, the harder to follow the patients, and in earlier period, post-inflammatory irritation might be too frequent. It is also suggested that at 3 5 days after treatment examination of urethritis might serve to compare the effect of treatment regimens on the incidence of PGU.

Erosive Adenomatosis of the Nipple / 대한피부과학회지

We experienced a case of erosive adenomatosis of the nipple (EAN) in a 20-year-old lady. She have had an eczematous, erosive and crusted nipple, on the right si.de, with a serosanguineous discharge for the past two years. The biopsy specimen of eczematous lesion on the affected nipple showed focal erosion and acanthosis in the epidermis. Florid intraductal epithelial proliferation and solid nests were scattered in the nipple stroma without showing any cellular pleomorphism. The lining epithelium maintained two layers of cells the inner colurnnar cells and the outer cuboidal cells. Chronic inflammatory infiltrates of relatively dense lymphohisiocytes were found in the surrounding stromal tissue, Paget cells or underlying malignancy were not seen, and a group of tumor netst was confined to the upper part of the subareolar tissue.

A Case of Scleredema / 대한피부과학회지

Scleredema is a rare scleradematosis of unknown cause involving the face, neck, upper portion of the trunk, and proximal upper extremities. The clinical features of the disease are nonpitting indurated edema or stiffness of the neck, which may be sudden or insidious in onset. Diabetes mellitus and its complications have been frequently described to be associated with this disease. We present a case of scleredema developed on the nape, upper portion of the back and shoulder in 60-year-old man who had been suffered from diabetes mellitus for the past ten years.