Utilization of Ultrasonography in Dermatology: Two Case Reports of Calcinosis Cutis

Development of newer generation of cost-effective ultrasonic devices in recent years has increased the use of ultrasonography in dermatology. Several lesions can be diagnosed and managed using ultrasonography. Calcinosis cutis involves the deposition of insoluble calcium salts in the cutaneous and subcutaneous tissues. On ultrasonography, it specifically presents as hyperechoic deposits with a posterior acoustic shadowing artifact due to the acoustic properties of calcium. A 62-year-old female patient presented with a solitary, skincolored, palpable nodule on the inner side of the right lower leg. The lesion was beneath the intact skin and detectable only on palpation. However, ultrasonography demonstrated a clear delineation of the lesion, showing hyperechoic deposits with a posterior acoustic shadow (15 MHz, linear probe). Skin biopsy and curettage were performed, revealing histological features consistent with calcinosis cutis. Four weeks after the procedure, ultrasonography performed to evaluate the outcome of treatment, showed recurrence. Another 18-year-old female patient presented with a skin-colored deep-seated nodule on the left temple. On ultrasonography, linear hyperechoic deposits with a posterior acoustic shadow were visible. Skin biopsy was performed, and histopathologic features showed calcified material in the subcutaneous tissue. These two cases of calcinosis cutis highlight the diagnostic value of ultrasonography in dermatology.

The Role of Plant Extracts in Alleviating Particulate Matter-induced Inflammation in Barrier-interrupted Skin / 대한피부과학회지

Background@#The adverse effects of particulate matter (PM) on the skin have been concerning recently. @*Objective@#We investigated PM induced inflammation on barrier-interrupted skin and relieving effects of plant extracts on PM-induced skin irritation. @*Methods@#A total of 20 participants were enrolled for the induction of skin irritation. Sodium lauryl sulfate (SLS) patch was affixed to the forearm for 24 hours. After patch removal, total suspended particulates (TSPs) were applied. After inducing skin irritation using SLS and TSP, cream containing 0.1% mixture of plant extracts (Citrus sunki, Sceptridium ternatum (Botrychium ternatum), and Korthalsella japonica) was applied. The a* value, erythema index (EI), and transepidermal water loss (TEWL) were measured. @*Results@#The a* value was significantly higher at the site where TSPs were applied than that at the site where TSPs were not applied at 1 and 2 days after SLS patch removal. The a* value, EI, and TEWL were significantly low in the cream-applied area 7 days after the introduction of the SLS patch and TSPs. @*Conclusion@#PM induced skin irritation in a previously disrupted skin barrier. Topical application of plant extracts alleviated skin irritation symptoms caused by dust exposure.

The Role of Plant Extracts in Alleviating Particulate Matter-induced Inflammation in Barrier-interrupted Skin / 대한피부과학회지

Background@#The adverse effects of particulate matter (PM) on the skin have been concerning recently. @*Objective@#We investigated PM induced inflammation on barrier-interrupted skin and relieving effects of plant extracts on PM-induced skin irritation. @*Methods@#A total of 20 participants were enrolled for the induction of skin irritation. Sodium lauryl sulfate (SLS) patch was affixed to the forearm for 24 hours. After patch removal, total suspended particulates (TSPs) were applied. After inducing skin irritation using SLS and TSP, cream containing 0.1% mixture of plant extracts (Citrus sunki, Sceptridium ternatum (Botrychium ternatum), and Korthalsella japonica) was applied. The a* value, erythema index (EI), and transepidermal water loss (TEWL) were measured. @*Results@#The a* value was significantly higher at the site where TSPs were applied than that at the site where TSPs were not applied at 1 and 2 days after SLS patch removal. The a* value, EI, and TEWL were significantly low in the cream-applied area 7 days after the introduction of the SLS patch and TSPs. @*Conclusion@#PM induced skin irritation in a previously disrupted skin barrier. Topical application of plant extracts alleviated skin irritation symptoms caused by dust exposure.

Cutis Verticis Gyrata and Acanthosis Nigricans: Just a Coincidence? – A Case Report / 대한피부과학회지

Cutis verticis gyrata (CVG) is a rare scalp condition that presents as convoluted folds and furrows, which resemble the cerebral cortex. Although the pathogenesis is not fully elucidated, recent investigations suggest the possible role of fibroblast growth factor receptor 2 (FGFR2) which may contribute to dermal hypertrophy in CVG pathogenesis.On the other hand, acanthosis nigricans (AN) is a dermatosis that is commonly associated with benign endocrine disorders, and increasing evidence suggest that AN is a convergent phenotype resulting from the activation of tyrosine kinase growth factor receptors (TKR), with mitogenic and antiapoptotic effects on keratinocytes. CVG presenting with AN has only been reported once in the previous literature and no association regarding their pathogeneses has been drawn yet. We report a rare case of a patient presenting CVG with concurrent AN, and suggest a shared underlying pathogenesis in these two disease entities which may be related to FGFR2 signaling pathway.

A Case of Myopericytoma and Review of Korean Literature / 대한피부과학회지

Myopericytoma, previously called as hemangiopericytoma, is a rare, soft tissue neoplasm. It usually presents as an asymptomatic solitary lesion, and it most commonly affects the lower extremities. It is characterized by the distinctive perivascular organization of oval-to-spindle-shaped cells in a concentric pattern. Here we report a case of myopericytoma, which was diagnosed in a 60-year-old woman who presented with a one-year history of a deep-seated nodule and reviewed previous cases in the Korean literature and found a predominance of female cases of myopericytoma, contrary to known predilections. Hence, we have reported a typical case and summarized clinical findings in the Korean population.

Antifungal and Anticancer Activities of a Protein from the Mushroom Cordyceps militaris

The mushroom Cordyceps militaris has been used for a long time in eastern Asia as a nutraceutical and in traditional Chinese medicine as a treatment for cancer patients. In the present study, a cytotoxic antifungal protease was purified from the dried fruiting bodies of C. militaris using anion-exchange chromatography on a DEAE-Sepharose column. Electrophoretic analyses indicated that this protein, designated C. militaris protein (CMP), has a molecular mass of 12 kDa and a pI of 5.1. The optimum conditions for protease activity were a temperature of 37degrees C and pH of 7.0~9.0. The enzyme activity was specifically inhibited by the serine protease inhibitor phenylmethylsulfonyl fluoride. Amino acid composition of intact CMP and amino acid sequences of three major peptides from a tryptic digest of CMP were determined. CMP exerted strong antifungal effect against the growth of the fungus Fusarium oxysporum, and exhibited cytotoxicity against human breast and bladder cancer cells. These results indicate that C. militaris represents a source of a novel protein that might be applied in diverse biological and medicinal applications.

Comparative study of removal effect on artificial plaque from RBM treated implant

0.05).3. SEM findings after mechanical treatment disclosed as follows; Prophyflex group looked like sound implant surface, and there were some paste on implant surface at PMTC group, and there were some artificial plaque at interdental brush group.4. SEM findings after chemical treatment disclosed as follows; there were some dark lesions which were supposed as the product from Streptococcus mutans at Chlorhexidine, Citric acid and HCl tetracycline groups.CONCLUSION: All six methods using in this study have good ability to remove artificial plaque on RBM treated implant. According to SEM findings, prophyflex is a superior method for removing of dental plaque among test groups.

Comparison of Radiologic Measurements of Total Knee Replacement using Computer-assisted Navigation System and Conventional System in Varus Deformity of the Knee / 대한정형외과학회잡지

PURPOSE: To compare the radiologic measurements of the mechanical axis and the implant position of Total Knee Arthroplasty (TKA) using a computer-assisted navigation system with those using conventional TKA in varus deformity. MATERIALS AND METHODS: From January 2004 to January 2005, 49 TKAs using a CT-free navigation system (Vector Vision(R), BrainLab, Heirnstetten, Germany) (Group I) and 24 TKAs using the conventional technique (Group II) were performed on patients who had a preoperative varus deformity>10degrees. The patients were also subdivided into two groups, patients with a varus deformity 20degrees (group B). The PFC Sigma implants were used in both groups. The mechanical axis and implant position were measured by 2 observers according to the reontgenographic evaluation system of the American Knee Society. RESULTS: There was no significant difference in alpha, beta, delta angle and mechanical axis between group I and II. There was a significant difference in the gamma angle between group I and II (p20degrees tended to have more postoperative varus mechanical alignment than those with a preoperative varus deformity between 10degrees and 20degrees after TKA. More careful attention during the registration of the femoral mechanical axis should be paid in patients with a larger varus deformity in TKA using a computer-assisted navigation system. On the other hand, a reasonable mechanical valgus angle should be considered in femoral bone cutting for a varus deformity of the distal femur in conventional TKA. In addition, inadequate positioning of intramedullary rod should be recognized in conventional TKA.

The comparison of IL-6, elastase and alpha1-PI expressions in human chronic periodontitis with type 2 diabetes mellitus / 대한치주과학회지

No abstract available.

Minimally Invasive Quadriceps Sparing Total Knee Arthroplasty

PURPOSES: To compare the radiologic results in the minimally invasive quadriceps sparing total knee arthroplasty(MIS-QS TKA) with those in conventional total knee arthroplasty(TKA). MATERIALS AND METHODS: Between June 2004 and December 2004, we underwent 20 MIS-QS TKAs (group I) and 20 conventional TKAs(group II). All cases were female with osteoarthritis. The average age was 68.0 years in group I and 65.0 years in group II. The mechanical axis and the implant position were measured by 2 observers according to the reontgenographic evaluation system of the American Knee Society. RESULTS: The mean length of skin incision was 9.2 cm in group I and 16.1 cm in group II. The mean operative time was 127 minutes in group I and 85 minutes in group II. The mean postoperative mechanical axis was varus 1.35 degrees in group I and varus 0.37 degrees in group II. And the mean alpha, beta, gamma and delta angle were 94.9, 90.6, 4.5 and 85.5 degrees in group I, and 94.3, 91.4, 4.7 and 84.6 degrees in group II, respectively. There was no significant difference in the radiologic results between both groups. CONCLUSIONS: There was no significant difference in the implant position and mechanical axis between MIS-QS TKA group and conventional TKA group. Average skin incision was shorter in MIS-QS TKA, but longer operation time taken compared to that of conventional TKA.

The clinical and radiological results of open wedge high tibial valgus osteotomy: short term results

PURPOSE: The purpose of this study is to evaluate clinical and radiological results of open wedge valgus high tibial osteotomy without bone graft in varus knees with osteoarthritis or chondral defect of medial compartment. MATERIALS AND METHODS: We reviewed 27 cases in 24 patients who underwent open wedge valgus high tibial osteotomy without bone graft in varus knees with osteoarthritis or chondral defect of medial compartment. Patients who had malalignment of femur, varus deformity due to ligamentous injuries, and concomitant autologous chondrocyte implantation or meniscus transplantation were excluded. There were 4 men and 20 women, mean age was 47.3 years old. Minimum follow-up period was 1 year(1 year to 4 year 9 months). we did arthroscopic debridement before the osteotomy in all cases. Results were radiologically evaluated by the joint obliquity, mechanical axis, femorotibial angle, time to bone union, and leg length, and clinically by range of motion, Lysholm scores, and subjective pain scales. RESULTS: The joint obliquity in coronal plane improved varus 9.6 to varus 1.9 degrees. The posterior tibial slope in sagittal plane increased 7.9 to 10.7 degrees. The mechanical axis improved 13.2 to 61.1%. The femorotibial angle improved varus 3.9 to valgus 7.4 degrees. The leg length increased 80.6 to 81.6 cm. The mean plate size was 10.5 mm. The mean period to bone union is 3.9 months(3 to 7 months). Range of motion changed 135.4 to 135.0 degrees. The mean Lysholm knee scores improved 54.6 to 84.3 points. The subjective pain scales improved 50.7 to 85.4 points. CONCLUSION: The open wedge high tibial valgus osteotomy in varus knees with osteoarthritis or chondral defect of medial compartment is useful procedure to reduce pain, to correct mechanical axis, femorotibial angle and joint obliquity in coronal plane, and to obtain bony union without bone graft. But the increase of the posterior tibial slope in sagittal plane and lengthening of tibia may develop.

Stability Of Two-Jaw Surgery And Single Mandibular Surgery In Mandibular Prognathism

6months); were analyzed by linear measurement to evaluate changes in position (hard tissue B, Pogonion point)and compare relapse both group.The results obtained were as follows ; In view of B-point, the horizontal relapse rate of single mandibular surgery was 10.17%at post-op 1month,12.52%at post-op 3months,13.01%at post-op 6months and two-jaw surgery was 10.23%at post-op 1month,11.84% at post-op 3months,12.97%at post-op 6months. the horizontal relapse rates of Pogonion point were 10.78% at post-op 1month,12.21% at post-op 3months,12.98%at post-op 6months in single mandibular surgery and those were 10.27%at post-op 1month,11.33% at post-op 3months, 12.01%at post-op 6months in two-jaw surgery. In terms of vertical relapse rate, rates of B point were 22.96%at post-op 1month,28.30%at post-op 3months,29.56%at post-op 6months in single mandibular surgery and 21.14%at post-op 1month, 25.45% at post-op 3months,28.86% at post-op 6months in two-jaw surgery.Those of Pogonion point were 26.63%at post-op 1month,28.40% at post-op 3months,29.29% at post-op 6months in single mandibular surgery and 20.20%at post-op 1 month, 25.44% at post-op 3 months, 27.68% at post-op 6months in two-jaw surgery. There were no statistical difference between single mandibular surgery and two-jaw surgery in mandibular stability.

A Phase II Study with Gemcitabine and Carboplatin in Patients with Advanced Non-small Cell Lung Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: To evaluate the efficacy and safety of gemcitabine and carboplatin (GC) in the treatment of advanced non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: Between November 1999 and April 2001, 34 patients were enrolled in this study. The median age was 66 (range: 52-74) years old and all were male. Sixteen patients demonstrated stage IIIB, 15 stage IV, and 3 recurrence of disease after surgery. Twenty-two patients showed a ECOG performance status of 0 or 1 and 12 had 2. Twenty patients presented with squamous cell carcinoma, 11 adenocarcinoma and 3 unclassified NSCLC. The treatment regimen consisted of intravenous carboplatin AUC of 6 on day 1 and gemcitabine 1,250 mg/m2 on day 1 and 8. The treatment was repeated every 28 days. Toxicities were evaluated according to WHO toxicity criteria. RESULTS: All thirty-four patients were evaluable. Partia responses were observed in 15 patients. The overall response rate was 44% (95% confidence interval: 27-61%) and the median response duration was 26 (range 8-60 ) weeks. The median survival of all patients was 50 (range 8-70 ) weeks. During a total of 144 cycles, granulocytopenia greater than WHO grade 2 occurred in 2%, thrombocytopenia in 2%, and anemia in 3%, respectively. Non- hematologic toxicities were minor and easily controlled. CONCLUSION: A combination chemotherapy of intravenous gemcitabine and carboplatin has a relatively high activity with acceptable toxicities in patients with advanced NSCLC.

A Case of Acute Staphylococcal aureus Esophagitis in Immunocompromised Patients / 감염

Bacterial esophagitis is an uncommon disease and has not been well characterized. Bacterial infection of the esophagus is usually presented as a superimposed infection upon a preexisting viral or fungal esophagitis and most patients are immunocompromised hosts. A 67-year-old man was admitted for retrosternal pain and hematemesis, who had a past history of long-standing diabetes mellitus and end stage renal disease, also had a history of steroid medication. Extensive esophageal ulcerations of the mucosa were visualized by endoscopy. Staphylococcus aureus grew in blood culture. After the 2 weeks of antibiotics treatment, he was successfully recovered without any sequelae. Due to its rarity, this case is herein reported with a review of the corresponding literature.

Pathologic Fracture of Primary Malignant Bone Tumor: Survival, Limb Salvage, Local recurrence / 대한정형외과학회잡지

PURPOSE: This study analyzes the indication, survival rate, local recurrence and limb salvage possibility of primary malignant bone tumors that have had pathologic fractures. MATERIALS AND METHODS: Eighteen cases that received preoperative chemotherapy and surgery were eligible for this study. Primary tumors were osteosarcoma (13) , Ewing's sarcoma (2) and MFH (3) . Primary locations were femur (10) , humerus (6) , and tibia (2) . Fractures were classified into three grades. Grade I (10) was mild displacement, II (5) was moderate but intracompartmental, III (3) was extracompartmental. Average follow-up was 40 months. RESULT: Limbs were salvaged in 16 cases, 2 cases had amputation. Union was acquired in 7 (7/10) cases for grade I and 4 (4/6) cases for grade II. Two cases with severe displacement both ended in non-union. There were two local recurrences. The actual survival rate of the 13 cases with osteosarcoma was 33% in 80 months, showing significantly lower results compared to 238 contemporary cases of IIB (P=0.04) . CONCLUSION: Conservative external immobilization and preoperative chemotherapy for pathologic fracture of primary malignant bone tumor was good initially in the care of amputation. Local recurrence rate was 11 percent and survival rate was significantly worse.

Resection, Reconstruction and Functional Result for Malignant Neoplasm of Humerus / 대한정형외과학회잡지

PURPOSE: This purpose of this study is to analyze the results of resection, reconstruction and functional results for malignant humeral lesions. MATERIALS AND METHODS: Thirty-five cases were eligible to this study. There were stages IB (3) , IIB (26) , and IIIB (6) . Resection type varied from extraarticular humeral resection (3) , intraarticular humeral resection (31) , to humeral segmental resection (1) . Reconstruction consisted of spacer arthroplasty (18) , shoulder fusion (4) , composite arthroplasty (8) , fibular graft (2) , intercalary reconstruction with autogenous recycled bone (1) , and tumor prosthesis (2) . RESULTS: 138 months actual/continuous disease free survival rate for 16 osteosarcomas were 47/25%. Complications needed operation were local recurrence (4) , failure of distal fixation (1) . Overall functional score of the 35 cases was 24, spacer arthroplasty (23) , composite arthroplasty (25) and shoulder fusion (22) , respectively. CONCLUSION: There were no functional difference among reconstructive options and shoulder fusion and arthroplasty. More biologic reconstructions such as living fibula or autogenous recycled bone are recommendable options for cases which nesessitate resection up to 3/4 of humerus.

Organo-axial volvulus of the stomach with diaphragmatic eventration

Gastric volvulus occurs when the stomach rotates about its longitudinal axis (organo-axial volvulus), or about an axis joining the lesser and greater curvatures (mesentero-axial volvulus). Primary gastric volvulus, making up one third of cases, occurs when the stabilizing ligaments are too lax as a result of congenital or acquired causes. Secondary gastric volvulus, making up the remainder of cases, occurs in association with a paraesophageal hernia or other congenital or acquired diaphragmatic defects. While gastric volvulus may occur acutely, especially in children, it may not be clinically apparent and discovered incidentally. The authors present a case of chronic organo-axial volvulus of the stomach secondary to left hemidiaphragmatic eventration with a review of the relevant literature.

A Case of Invasive Pulmonary Aspergillosis Cured with Liposomal Amphotericin, Granulocyte Transfusion and Surgery in an Allogeneic Hemopoietic Stem Cell Transplantation Recipient / 대한혈액학회지

The prognosis of invasive aspergillosis in allogeneic bone marrow transplantation recipients is grave in the absence of bone marrow recovery in spite of antifungal treatment with amphotericin B. Beneficial role of granulocyte transfusion in neutropenic patients with fungal infection has been re-evaluated since granulocyte colony-stimulating factor made effective collection of granulocyte possible. And Liposomal amphotericin appears to be an effective alternative to conventional amphotericin B with much less toxicity. A 34-year-old patient with acute lymphoblastic leukemia developed invasive pulmonary aspergillosis during very early period of allogeneic hemopoietic stem cell transplantation. We treated the case successfully with liposomal amphotericin and granulocyte transfusion and surgery in spite of known high mortality of invasive aspergillosis in transplantation patients.

Clinical Study of the Intravenous Amiodarone in Acute Myocardial Infarction with Life-Threatening Refractory Ventricular Tachyarrhythmias

BACKGROUND: Recently, the amiodarone has emerged as a promising antiarrhythmic agent and its efficacy and safety has been widely accepted with many literatures. But there was no general agreement regarding the dosage and indication of intravenous (IV) amiodarone in acute myocardial infarction with life-threatening refractory ventricular tachyarrhythmias. METHOD: From October 1995 through October 1997, we recruited retrospectively 9 patients of acute myocardial infarction who had received IV amiodarone for life-threatening refractory ventricular tachyarrhythmias and analyzed the initial response, adverse effect, and loading dose. RESULTS: 1) Acute efficacy:Eight of 9 patients promptly restored normal sinus rhythm immediately after intravenous amiodarone administration. 2) In-Hospital Mortality:One patients died due to ventricular tachyarrhythmias refractory to aggressive management and 5 in 8 patients who had responded promptly with IV amiodarone discharged alive and other 3 patients died due to cardiogenic shock with normal sinus rhythm. 3) Immediate adverse effects:Five patients experienced immediate adverse effects after IV amiodarone; 3 patients of hypotension, 1 patient of first degree AV block, and the other of Morbitz type 2 AV block. 4) Long term follow-up:Among 5 patients discharged alive, one died as unexpected consequence. Other 4 patients have been still alive without maintenance medication. CONCLUSION: The IV amiodarone for suppression of life-threatening ventricular tachyarrhythmias in patients with acute myocardial infarction seemed to be an effective second-line therapeutic drug and have acceptable adverse effects. In the future, the large scale study regarding the dosage and indication might be warrented.

Bilateral Congenital Coronary Arteriovenous Fistulas

Coronary arteriovenous fistulas (CAVF) are rare malformations of the coronary circulation. They are seen in approximately 0.1% to 0.2% of all patients undergoing selective coronary angiography. We experienced a 58-years old male patient with bilateral coronary AV fistulas whoes diagnosis was confirmed by selective coronary angiography.