Relapse of Mantle Cell Lymphoma and This Was Diagnosed by Skin Metastasis on the Face / 대한피부과학회지

Mantle cell lymphoma (MCL) is an uncommon and aggressive form of non-Hodgkin lymphoma and this typically involves lymph nodes. Extranodal involvement is frequent and especially in the bone marrow, spleen, gastrointestinal tract and Waldeyer's ring. MCL is not well represented in the dermatology literature because the skin is rarely involved. We describe here a case of relapse of MCL that was diagnosed by skin metastasis of the face. A 71 year-old male patient presented with erythematous nodules that had been on the Rt. forehead for 6 months. The patient was initially diagnosed as having MCL and he had undergone chemotherapy. A year after complete remission, multiple nodules developed on the forehead. Biopsy of the nodule revealed skin metastasis of MCL.

A Case of Severe Chicken Meat Allergy Diagnosed by Oral Food Challenge / 소아알레르기및호흡기학회지

Anaphylaxis is a severe systemic allergic reaction that can be fatal in some patients. Identifying the cause of anaphylaxis is very important, because this disease is preventable. Food is one of the most frequent causes of anaphylaxis. Allergy to chicken meat is uncommon, and only a few cases have been reported on anaphylaxis to chicken meat. We herein report on a 7 year-old girl who had anaphylaxis to chicken meat, which was diagnosed with an oral food challenge.

Aquagenic Urticaria: A Report of Two Cases

Aquagenic urticaria is a rare form of physical urticaria, in which contact with water evokes wheals. A 19-year-old man and a 4-year-old boy complained of recurrent episodes of urticaria. Urticaria appeared while taking a bath or a shower, in the rain, or in a swimming pool. Well-defined pin head to small pea-sized wheals surrounded by variable sized erythema were provoked by contact with water on the face, neck, and trunk, regardless of its temperature or source. Results from a physical examination and a baseline laboratory evaluation were within normal limits. Treatment of the 19-year-old man with 180 mg fexofenadine daily was successful to prevent the wheals and erythema. Treatment with 5 ml ketotifen syrup bid per day resulted in improvement of symptoms in the 4-year-old boy.

A Statistical Survey of Major Cutaneous Malignant Tumors for the Last 10 Years (2000~2010, North-east Gyeonggido Province) / 대한피부과학회지

BACKGROUND: Major cutaneous malignant tumors (MCMT) including squamous cell carcinoma (SCC), basal cell carcinoma (BCC) and malignant melanoma (MM) result from multifactorial causes such as environmental and host factors. In particular, ultraviolet radiation (UVR) comprised of environmental factors is estimated to be one of the most important risk factors for MCMT. OBJECTIVE: The purpose of this study was to analyze recent changes in the incidence of MCMT in patients from the north-east area of gyeonggido, and compare that incidence with data previously reported. METHODS: We retrospectively reviewed the medical records of 212 patients diagnosed as MCMT at the Department of Dermatology at the Uijeongbu St. Mary's Hospital during the last 10 years. RESULTS: The average annual incidence of MCMT was 0.3% and it seemed to increase. Among the 212 cases of malignant tumors, the most common malignant tumor was BCC (62.7%). The incidence of SCC and MM were 25% and 12.3%, respectively. The mean age of patients was 68.4+/-14.15 years for those with MCMT; 66.8 y in BCC, 74.5 y in SCC and 64.5 y in MM. The ratio of men to women was 0.72:1. Compared with the incidence of MCMT in other provinces, the north-east portion of Gyeonggido (0.3%) had a high incidence of MCMT. CONCLUSION: High altitude may increase the amount of UVR exposure and influence the development of cutaneous malignant tumors. Individual behaviors including outdoor activity and use of sun blocks are important to the development of major cutaneous tumors and should not be ignored.

Early Diagnosis of Perinatal Ischemic Stroke Based on Clinical and Radiological Characteristics

PURPOSE: Perinatal ischemic stroke (PIS) has been increasingly recognized and regarded as one of the major causes of neurological disability occurring in the neonatal period. Due to its vague presenting symptoms, the clinical diagnosis of PIS can be delayed. The aim of this study was to delineate the clinical and radiological characteristics of PIS in order to establish its early diagnosis. METHODS: From January 2002 to October 2010, 24 neonates with evidence of ischemic cerebral infarction on brain magnetic resonance imaging (MRI) were enrolled. Perinatal and neonatal clinical characteristics, electroencephalogram (EEG), and brain MRI findings were retrospectively reviewed. Using those data, analysis was done to elicit clues for early diagnosis and prognostic factors of PIS. RESULTS: Sixteen males and eight females were diagnosed with PIS. Twelve cases presented with apnea and ten patients with seizures. The diagnosis of PIS was confirmed by brain MRI. Sixteen patients (66.7%) had infarction in the territory of the middle cerebral artery, and fifteen neonates had infarction in the left hemisphere. Of 11 infants who presented with a focal lesion on brain MRI, three patients were diagnosed by diffusion weighted images (DWI). Their T2- and FLAIR sequences showed subtle signal changes, whereas DWI revealed bright signal intensity. Thirteen patients were included in the delayed diagnostic group (diagnostic interval >24 hours). In those patients, apnea (69.2%) was more likely than seizures (15.4%) to be the initial symptom. The extent of the lesion on brain MRI was likely to be a better predictor of the neurologic outcome. Hemiplegia or hemiparesis was found in seven patients who had extensive lesions involving the gray and white matter, internal capsule, and basal ganglia. CONCLUSION: PIS should be considered as a differential diagnosis for neonates who present with apnea, lethargy or subtle seizures. DWI of brain MRI is very useful for early diagnosis of PIS. The extent of the lesion was also found to be significantly associated with poor outcome.

Therapeutic Effects of Topical Application of Ozone on Acute Cutaneous Wound Healing

This study was undertaken to evaluate the therapeutic effects of topical ozonated olive oil on acute cutaneous wound healing in a guinea pig model and also to elucidate its therapeutic mechanism. After creating full-thickness skin wounds on the backs of guinea pigs by using a 6 mm punch biopsy, we examined the wound healing effect of topically applied ozonated olive oil (ozone group), as compared to the pure olive oil (oil group) and non-treatment (control group). The ozone group of guinea pig had a significantly smaller wound size and a residual wound area than the oil group, on days 5 (P<0.05) and 7 (P<0.01 and P<0.05) after wound surgery, respectively. Both hematoxylin-eosin staining and Masson-trichrome staining revealed an increased intensity of collagen fibers and a greater number of fibroblasts in the ozone group than that in the oil group on day 7. Immunohistochemical staining demonstrated upregulation of platelet derived growth factor (PDGF), transforming growth factor-beta (TGF-beta) and vascular endothelial growth factor (VEGF) expressions, but not fibroblast growth factor expression in the ozone group on day 7, as compared with the oil group. In conclusion, these results demonstrate that topical application of ozonated olive oil can accelerate acute cutaneous wound repair in a guinea pig in association with the increased expression of PDGF, TGF-beta, and VEGF.

Measurement of the Mucosal Surface Distance in the Early Gastric Cancer Using CT Gastrography

PURPOSE: Recently, the incidence of early gastric cancer (EGC) patients is rapidly increased in Korea. However, they're often not perceptible by surgical palpation or inspection. The aim of this study is 1) to develope a software that can locate the tumor and measure the mucosal distance from an anatomic landmark to the tumor using CT gastrography and 2) to compare the distance measured by the developed software with the distance measured by the pathologic findings. MATERIALS AND METHODS: Between January 2004 and September 2005, sixty patients (male=45, female=15, mean 57.8 years old) estimated for EGC with preoperative CT scans and undergone gastrectomies in Kyungpook National University Hospital were enrolled in this study. Preoperative CT scans were performed after insufflations of room air via 5 Fr NG tube. The scans included the following parameters: (slice thickness/reconstruction interval: 0.625 mm, kVp: 120, mAs: 200). 3D volume rendering and measurement of the surface distance from the pylorus to the EGC were performed using the developed software. RESULTS: The average difference between the lesion to pylorus distances measured from pathologic specimens and CT gastrography was 5.3+/-2.9 mm (range 0~23 mm). The lesion to pylorus distance measured from CT gastrography was well correlated with that measured from the pathologic specimens (r=0.9843, P<0.001). CONCLUSION: These results suggest that the surface distance from an anatomic landmark to the EGC can be measured accurately by CT gastrography. This technique could be used for preoperative localization of early gastric carcinomas to determine the optimal extent of surgical resection.

A Case of Nodular Syphilid / 대한피부과학회지

Nodular syphilis is an uncommon manifestation of secondary syphilis and may appear on any area of the body, with the head and neck often affected. The lesions are generally red-brown or violaceous. Although the nodular lesions are said to be more common in tertiary syphilis, most recent reports have diagnosed them as a manifestation of secondary syphilis in patients who may also exhibit mild lymphadenopathy without associated constitutional symptoms. We report a case of nodular syphilid in a 43-year-old man who presented with numerous papular, nodular and plaque skin lesions, without involvement of the mucous membranes.

A Case of Nodular Syphilid / 대한피부과학회지

Nodular syphilis is an uncommon manifestation of secondary syphilis and may appear on any area of the body, with the head and neck often affected. The lesions are generally red-brown or violaceous. Although the nodular lesions are said to be more common in tertiary syphilis, most recent reports have diagnosed them as a manifestation of secondary syphilis in patients who may also exhibit mild lymphadenopathy without associated constitutional symptoms. We report a case of nodular syphilid in a 43-year-old man who presented with numerous papular, nodular and plaque skin lesions, without involvement of the mucous membranes.

Clinico-histopathologic Study of Syphilid and Characterization of Inflammatory Infiltrate / 대한피부과학회지

No abstract available.

Clinical Study of the Surgical Excision of Subcutaneous Tissue Combined with the Assistant Subcutaneous Shaver Method for treatment of Axillary Osmidrosis and Hyperhidrosis / 대한피부과학회지

BACKGROUND: Classical surgical treatment of axillary osmidrosis and hyperhidrosis results in many complications such as scarring, hematoma and necrosis, therefore, gentle skin flap cares is needed. OBJECTIVE: In order to lessen the complications and to obtain an improved clinical outcome, a new easy-learn, surgical excision method of treating subcutaneous tissue is required. METHOD: On 16 patients, We carried out a type-1 surgical method to treat axillary osmidrosis and hyperhidrosis. This invoved major removal of the subcutaneous tissue by scissor excision, and partial removal by the subwtaneous shaver method, to minimise trauma. We then analyzed the clinical efficiency, complications, patient satisfaction, and pathologic specimens according to clinical severity. RESULTS: All 16 patients showed an improved odor or sweating pattern, and a good or very good level of satisfaction. One patient also showed that hematoma was improved with proper post- operative care. Hyperactivity of the apocrine glands in osmidrosis and eccrine gland in hyperhidrosis was seen, and various morphologic features of apoeccrine glands were found in both osmidrosis and hyperhidrosis. We observed that apocrine and eccrine glands were completely excised by following the biopsy of 2 patients. CONCLUSION: Our present method of minimal skin incision and major removal of subcutaneous fat with manual scissor excision, in combination with partial excision with the subcutaneous shaver method, showed a good clinical outcome and few complications.

A Case of Nevus Sebaceus, Accompanied by Syringocystadenoma Papilliferum, a Basal Cell Carcinoma-like Tumor, Sebaceous Epithelioma, Apocrine Adenoma and Tumor of Follicular Infundibulum, with Repair by Subgaleal-periosteal Fixation / 대한피부과학회지

Nevus sebaceus is well-known for its potential to develop both benign and malignant neoplasms of epidermal and adnexal origin. We found 5 tumors including syringocystadenoma papilliferum, a basal cell carcinoma-like tumor, sebaceous epithelioma, a tumor of follicular infundibulum and apocrine adenoma within a single nevus sebaceus lesion in a 37-year-old man. This is a rarely reported case of a nevus sebaceus lesion containing a basal carcinoma-like, trichoblastoma-like skin tumor and tumors of follicular infundibulum. The lesion was treated by wide excision and repaired with subgaleal-periosteal fixation which resulted in good wound healing.

A Case of Rat Mite Dermatitis / 대한피부과학회지

Rat mite dermatitis caused by Ornithonysus bacoti, commonly referred to as the tropical rat mite, is characterized by pruritic papules in patients exposed to tropical rat mite. Histopathologic sections from the lesions of infected patients show moderate perivascular lymphohistiocytic infiltration intermingled with some eosinophils. Causative female mites, Ornithonyssus bacoti, can be collected from around the skin lesions. The conclusive diagnosis of tropical rat mite dermatitis is based on the identification of the arthropod O. bacoti at the home of the patient (husbandry of gerbils, etc.). Moreover, the diagnosis of rat mite dermatitis requires the detection of the parasite, which is more likely to be found in the host's environment rather than on the host's skin. We report a case of rat mite dermatitis in a 22-year-old female who presented with pruritic, multiple, erythematous papules on the abdomen, back and axilla.

A Case of Melanoma Arising from Acquired Nevus / 대한피부과학회지

Malignant melanoma is a tumor arising from melanocytes which originate in the neural crest. According to several reports, about 20-30% of all melanoma are associated with pre-existing nevi. Because early detection and intervention of aquired and congenital nevi is the only way to increase survival, the important risk factors should be carefully observed, especially if there are changes of to the number, size, and characteristic of the nevi. We present a 41 year-old man who has a superficial, spreading type of malignant melanoma, which arose from an acquired nevus following trauma to the right malleolar area. This case is interesting because of the clinical type and accompanying pathologic condition of the benign nevus.

Allergic Contact Dermatitis Caused by Pigosept(R) Swabs / 대한피부과학회지

Pigosept(R) is a prepackaged antiseptic swab for disinfection before blood sampling and intravenous injection. Tego(R) and isopropyl alcohol are the main components of Pigosept(R) swabs. Although Tego(R) has been reported as a common cause of allergic contact dermatitis (ACD), ACD from isopropyl alcohol is rare. We herein report a case of ACD caused by two components of Pigosept(R), Tego(R) and isopropyl alcohol, in a 50-year-old woman. This case demonstrates that dermatologists should be alert to the possibility of ACD due to isopropyl alcohol as well as Tego(R) in some prepackaged disinfectants such as Pigosept(R).

A case of the pancreatic carcinoma detected by cutaneous metastasis manifested as multiple nodules on whole body / 대한내과학회지

Carcinoma of the pancreas represents less than 5% of human malignant neoplasm. It's skin involvement is rare. A 73-year-old man presented with multiple skin lesions located on the face, neck and body. The histopathologic study of the skin lesion was confirmed to be an metastatic adenocarcinoma. The primary tumor was regarded as the mass at the head of the pancreas observed on the CT scan, but was not confirmed by biopsy. We report a case of multiple cutaneous metastasis from pancreatic carcinoma with brief review of related literature.

Analysis of Transmission Mode of Confirmed Shigellosis in Gyeongju, Korea / 한국역학회지

PURPOSE: This study was carried out to investigate the sources of infection and modes of transmission of an 107 (54males, 53 females) confirmed shigellosis in Gyeongju from Sept. 24 to Oct. 24, 1998. METHODS: We reviewed hospital records of all confirmed shigellosis. Thirty-two strains of Shigella sonnei isolated were analyzed in order to trace the source of infections by plasmid profile, antimicrobial drug resistance pattern, biotyping and pulsed-field gel electrophoresis (PFGE). RESULTS: The first source of infection was estimated to be contaminated underground water and simple piped water caused by leakage from the cess pool. Antimicrobial drug resistance pattern showed that all strains were multi-resistant. All isolates had the same XbaI and SfiI PFGE patterns, indicating the epidemiological relationship of the outbreaks strains in this area. The major characteristics of diarrhea were watery (84.2%) in nature. The clinical symptoms among the diarrheal cases included abdominal pain (86.1%), fever (83.2%), headache (78.2%), chill (45.5%) and tenesmus (41.6%). Six cases were asymptomatic. From initial manifestation to admission were 6.2+/-1.6 (median 6) days, so it could be transmitted to others in this infective period. Duration of admission were 5.5 +/-2.4 (median 6) days. We can find familial mean secondary attack rate were 38.5%. CONCLUSION: It's transmission to other areas were certified by contaminated water and contact with shigellosis, and unknown cases were estimated to be transmitted by contacts with inapparent infection. By plasmid profile and PFGE, the epidemiological relationship of the outbreaks strains in this area seemed to be the same micro-organisms.

A Case of Chondroid Syringoma / 대한피부과학회지

Chondroid syringoma or mixed tumor of the skin is a rare appendageal tumor with eccrine and appocrine, dual origin. It occurs mostly on the head and neck, being an asymptomatic solitary firm intradermal or subcutaneous nodule. Histopathologically, there are two types, which are tubular branching lumina type and small, tubular lumina type. Although it is uncommon, the incidence of this is higher than what we have previously considered. We present a case of chondroid syringoma presenting with asymptomatic, solitary, flesh-colored, firm, 1x1 cm sized, dome-shaped nodule on the left nasolabial fold in a 67 year-old woman.

A case of intestinal non-rotation incidentally detected on DISIDA scan / 대한내과학회지

The most common developmental anomaly of midgut rotation and fixation is non-rotation. Symptomatic intestinal malrotation is relatively common in infants and children but uncommon in later ages. Most adult cases are silent throughout life and are not discovered unless they cause acute or chronic abdominal pain. Many such patients have ill-defined abdominal complaints and are labeled as having a "functional" disorder since no definite clinical abnormalities are found other than the subjective complaints. The most frequent symptomatic presentation in the adult is midgut volvulus the symptom of which is usually self-limited although often recurrent and sometimes leading to an abdominal catastrophe. The diagnostic means for the adulthood malrotation include simple and contrast radiographic studies and CT scan. Malrotation first detected by cholescintigraphy is rare. We report a case of intestinal non-rotation incidentally discovered on DISIDA hepatobiliary scintiscan.

QT and RR interval variability and spectral characteristics in response to physiologic autonomic stimulation

Purpose: The purposes of this study were to compare the magnitude and phase between the RR interval and QT interval variability in the frequency domain. METHODS: Twenty four, 12-13 year old healthy males were randomly selected. At resting state and for 5 minutes, ECGs were obtained, and they were digitized to 1000Hz. After measurement of RR interval, QT interval variability was measured using template matching strategy. After normalization of the RR and QT interval time series, power spectral and cross spectral analysis were performed. From each of the time series, low- (0.04-0.15 hertz) and high- (0.15-0.4 hertz) frequency power were measured. From the phase spectrum, the phases and time lags between the two time series at each of the two frequency range were calculated. RESULTS: The average of RR interval and QT interval was 616.0+/-71.0, 364.0+/-47.0 msec, respectively. Their normalized low- and high- frequency power was 4.4+/-7.9 NU(normalized unit), 0.1+/-0.1 NU(p<0.005), and 11.0+/-30.0 NU, 0.3+/-0.3(NU, p<0.005), respectively. The phase differences and resulting time lags between the two interval were -0.5+/-0.4 pi radian(-0.9 seconds) and -0.2+/-0.3 pi radian(-0.4 seconds) in the low- and high-frequency range, respectively. CONCLUSION: During resting state, when compared to RR interval, QT interval oscillates in significantly lower amplitude in both low- and high- frequency ranges. However, the oscillations precede those of the RR interval 0.9 seconds and 0.4 seconds, respectively.