Extraskeletal Ewing's Sarcoma of the Head and Neck Presenting as Blindness

Extraskeletal Ewing's sarcoma is rarely found in the head and neck regions. We report an unusual case of extraskeletal Ewing's Sarcoma of the parapharynx region in a 49-year-old man who presented with blindness. MRI examination showed marked enhancement of tumor thrombosis involving the superior sagittal sinus, straight sinus, transverse sinus, sigmoid sinus, and internal jugular vein. The final diagnosis was extraskeletal Ewing's sarcoma after biopsy of the internal jugular vein thrombosis by histopathological evaluation and immunohistochemical assay. In addition, the patient was diagnosed as having adenocarcinoma of the rectum by biopsy of the rectal mass. The patient was treated with systemic chemotherapy and showed improved response with durable remission. The patient's visual acuity, however, did not improve.

The Usefulness of Colonoscopy as a Colon Cancer Screening Test for Asymptomatic Adults / 대한소화기내시경학회지

BACKGROUND/AIMS: This study evaluated the prevalence and location of colonic adenomatous polyps in asymptomatic adults. METHODS: A total of 2,849 asymptomatic adults underwent colonscopic screening as a part of health evaluation from January 2003 to September 2005. Completed questionnaires as well as the colonoscopic and pathologic findings were analyzed. RESULTS: There were 406 (14.3%) subjects with adenomatous polyps including 78 (2.7%) with advanced polyps. There was a trend toward an increased prevalence of adenomatous polyps with age. The relative risk of a proximal polyp according to the distal findings was 5.7 (95% CI 4.3 ~ 7.4) for adenoma, 4.9 (95% CI 3.0 ~ 7.7) for advanced adenoma compared with that for no adenomatous polyp. There were no index polyps at the distal colon in 30% of the 406 subjects. CONCLUSIONS: Though distal polyps are associated with the proximal polyps, 30% of asymptomatic adults with proximal polyps are not associated with any distal index polyps. For those without any contraindication to the procedure, colonoscopy performed by experienced colonoscopists as a screening test is feasible for detecting those patients with colorectal polyps.

Gemcitabine-Induced Radiation Recall Dermato-Myositis / 결핵및호흡기질환

A radiation recall reaction refers to an inflammatory reaction at previous irradiated areas subsequent to the administration of a variety of pharmacological agents. The skin is the major site of radiation recall reactons with the muscle and internal organs being less commonly affected. These reactions usually occur days to weeks after exposure to the causative agents. We report a case of gemcitabine-induced radiation recall dermato-myositis the developed in a female patient with a metastatic non-small cell lung cancer. She had received a palliative radiation therapy of 3900 cGy to the metastatic lesion on the femur shaft prior to chemotherapy. The pain, swelling and erythema of the left thigh resolved after the cessation of gemcitabine and the use of a systemic steroid.

UVB-induced Apoptosis and p53 Expression in Cultured Normal Human Keratinocyte / 대한피부과학회지

Cutaneous absorption of ultraviolet B(UVB) in the skin occurs primarily in keratinocyte, causing DNA and protein damage. p53 tumor suppressor gene appeared in the epidermis after UVB irradiation, and the wild type has been known to be responsible for apoptosis and plays an important role in excluding abnormal cells with significant DNA damage. While p53 has been implicated in both DNA repair and apoptosis, it is unclear whether the p53 protein is involved in both of these processes within the same cell. Therefore, UVB-induced apoptosis and changes in p53 expression were studied in cultured normal human keratinocyte to determine that the cellular response to UVB induced DNA damage(DNA repair or apoptosis) correlated with p53 expression. The cultured normal human keratinocytes were irradiated with the doses of UVB(25-150 mJ/cm2) and incubated for various times(3, 6, 12, 24 hour) after radiation. At UVB doses of 100 and 150 mJ/cm2, acridine orange/ethidium bromide(Ao/Eb) staining-positive cells and TUNEL (TdT mediated dUTP-biotin nick end labeling) staining-positive cells increased significantly after 3 hours and 6 hours postirradiation respectively. Twelve hour postirradiation, staining-positive cells increased at each level of UVB-radiation exposure. These results suggest that there were significant influences of UVB doses and time course after irradiation to the number of Ao/Eb and TUNEL staining-positive cells. To determine whether all Ao/Eb and TUNEL-positive cells were actually undergoing apoptosis, cellular DNA was extracted from keratinocytes at 12 hours after UVB irradiation and seperated by electrophoresis on an 2.5% agarose gel to detect the internucleosomal DNA fragmentation(DNA ladder). 'DNA ladder' occurred at every dose of UVB 12 hour after irradiation, but did not appear early after irradiation, suggesting that whether Ao/Eb and TUNEL-positive cells observed early after irradiation were not undergoing apoptosis. Activation of p53 and the response to DNA damage is not observed universally, but is dependent on tissue specificity, species specificity and type of genotoxic damage. To correlate p53 level with UVB-induced apoptosis at the dose of 100mJ/cm2 UVB, p53 levels were determined by western blot analysis. The accumulation of p53 protein was apparent after 6 hours postirradiation, and UVB irradiation caused a dramatic increase in p53 levels at 12 and 24 hours. These results demonstrate that p53 is required for UVB-induced apoptosis in cultured normal human keratinocyte and p53 has a time-dependent effect in the initiation of apoptosis. In this study, the results indicated that a low dose(25mJ/cm2) of UVB irradiation could induce apoptosis in human keratinocyte in vitro and UVB exerts a time-dependent effect on inducing apoptosis. And the results also give support to increasing evidence that p53 may play a role in UVB-induced DNA damage and the induction of apoptosis in cultured normal human keratinocyte and that p53 is involved in the decision process which determines the fate of keratinocyte after UVB -induced DNA damage.

Treatment of Facial Wrinkels with Char-Free Carbon Dioxide Laser and Erbium: YAG Laser / 대한피부과학회지

BACKGROUND: Laser facial skin resurfacing has become a method of treatment for photoaging and pigmentary conditions. Although excellent results can be obtained by high-energy, pulsed carbon dioxide(CO2) laser, significant morbidity exists due to the considerable thermal damage to the skin. The Erbium: Yttrium Aluminum Garnet(Er: YAG) laser, with a wavelength of 2940 nm, is well absorbed in water. This leads to a very small zone of thermal necrosis, compared ta the CO2 laser. OBJECTIVE: The purpose of this study was to evaluate the results of the combined use of the char-free CO2 laser and the Er: YAG laser in the treatment of facial wrinkles. METHODS: Forty-six patients, aged between 30 and 68 years, with facial wrinkles, were evaulated. Two types of resurfacing laser systems were utilized in this study, a high-energy, short-pulsed CO2 laser and a Er: YAG 1aser. Wrinkle improvement was evaulated by the patients satisfaction, clinical improvement, and photographic analysis before and after the resurfacing procedure. RESULTS: Twenty-six of the 46 patients had greater than an 80% improvement, and 19 patients had a 60-80% improvement. Only one patient showed a 50% or less improvement. CONCLUSIONS: The combination of char-free CO2 laser and Er: YAG laser for facial wrinkles is a safe and effective modality for laser skin resurfacing.

Basal Cell Carcinoma and Actinic Keratosis Treated with Intralesional Injection of Recombinant Alpha-2 Interferon

BACKGROUND: The effects of intralesional recombinant alpha-2 interferon(IFN) in the treatment of basal cell carcinoma(BCC) and actinic keratosis(AK) would be of value in selected patients. OBJECTIVE: Our purpose is to evaluate the differences of cellular immune reactions between the responded and the unresponded cases treated with IFN. METHODS: We treated five patients with BCC and two patients with AK with the intralesional injection of recombinant alpha-2 IFN. We performed immunohistochemical stainings with paraffin-embedded specimens from the pretreated and posttreated skin lesions. RESULTS: Four patients(three with BCC and one with AK) were healed and three patients showed improvement after treatment. In immunohistochemical stainings, there was an increased number of T cells in the dermal infiltrate of the responded cases but not in the unresponded cases. CONCLUSION: Intralesional IFN may induce T cell-mediated immune response at the site of the tumor by immune modulation.

Prevalence of PPNG in Seoul ( 1993 ) / 대한피부과학회지

BACKGROUND: In recent years gonorrhea has been panendemic and remains one of the most common STDs in the world, especially in developing countries. OBJECTIVE & METHOD: For the detection of a more effective teripeutic regimen and assessing the prevalence of PPNG, will have been trying to study the paieits who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. RESULTS: In 1993, 187 strains of N. gonorrhoeae were isolated, ar, ong which 139(74.3%) were PPNG. CONCLUSION: Our results suggests that the prevalence of PPNG in Seoul is still increasing.

Study on Superoxide Dismutase Activity in Scar Tissues / 대한피부과학회지

BACKGROUND: Superoxide disrnutase(SOD) provides a protective defease mechanism against potential cytotoxicity of superoxide radical in the aerobic organism. Although human skin is constantly at risk for developing acute and chronic changes by ultraviolet radiation and phototoxic reactions with exogenous and endogenously procluced photosensitizing molecules, studies in SOD in the human skin are rare. OBJECTIVE: We measured the level of SOD activities in the scar tissues and the normal human skin specimens. This study was to investigate changes of SOD activity by age, sex, and regional differences of SOD activities in the scar issues and the normal skin. METHODS: Aut,hors assayed the level of SOD activit,ies in 32 scar tissues(male 8, female 24) and 11 normal human skin specimens(male 8, female 3), which were obtaine 3 from face/neck(17 and 3 specimens), forearm(only 4 scar tissues), trunk(10 and 8 specimens), and lower extremity(only 1 scar tissue). RESULTS: First, activities of total SOD, Cu, Zn-SOD, and Mn-SOL ere 18.93+5.49, 16.97+55.31, and 1.96+0.90 units/mg proteiii respectively in the scar tissues. Second activities of total SOD, Cu, Zn-SOD, and Mn-SOD were 17.27+7.09, 13.82+6.44, and 3.45+1.07 units/mg protein respectively in the normal skin. Third, the changes of total SOD, Cu, Zn-SOD, and Mn-SOD activities by age and sex were similar each other and three were no significant, differneces between age groups in total, Cu, Zn- SOD, and Mn-SOD activities. Fourth, in sun exposed area and unexposed area there were no significant differences in the scar tissues in SOD activities. But, SOD activite.(total, Cu, Zn, and Mn-SOD) in face/neck were higher than those in trunk and lower extremity in tae normal skin(P<0.05). CONCLUSION: These findings suggest that there are no differences in the intrinsic SOD activities by age and sex in the mature scar tissues and the normal skin. Differences between exposed and unexposed area in the normal skin are due to the induction of exogenous SOD activity by sun-light generation of superoxide radicals. In wound, increased production of leukocyte derived superoxide radicals is the main factor of increased level of SOD activity.