The study comprises 13 cases of phenytoin induced drug eruption admitted and treated at Seoul National University Hospital during a 6-year period (1981-1986). The summaries are as follows : 1. The skin lesions were usually pruritic morbilliform maculopapular eruptions on face, trunk, extremites, including palms and soles. However, erythema multiform was observed in one case. 2. Hiistopathologically, the dermis showed perivascular accumulation of mononuclear cells with occasional eosinophils. In some cases, the epidermis showed vacuolar alteration of basaI layer, necrotic keratinocyte with dermal perivascular mononuclear cell infiltrations. 3. The frequencies of the associated features were as follows : fever(61.5%), lymphadenopathy(23.1%), leukocytosis(45.5%), esinophilia(72.7%), and liver function abnormalities(63.6%)
Dermis ; Drug Eruptions* ; Eosinophils ; Epidermis ; Erythema ; Keratinocytes ; Liver ; Phenytoin* ; Seoul ; Skin

Vertebral hemangioma is the most common benign spinal tumor. It is usually asymptomatic and extraosseous extension causing spinal cord compression with neurologic symptoms is rare. Pre-operative angiography and embolization should be done for definite diagnosis and prevention of excessive blood loss during the operation. In author's case, pre-operative angiography was done for diagnosis, but unfortunately embolization procedure was not available. We performed intra-operative vertebroplasty with polymethylmethacrylate(PMMA) for the prevention of excessive blood loss during the operation and the maintenance of postoperative stability.
Angiography ; Diagnosis ; Hemangioma* ; Neurologic Manifestations ; Spinal Cord Compression* ; Spinal Cord* ; Vertebroplasty*

PURPOSE: Mesenchymal stem cells (MSCs) are surfacing as a new method of treatment for various diseases that have poor outcome with drug treatments. In this study, we investigated the effects of MSCs in a murine intestinal inflammation model mimicking human Crohn's disease (CD) using 2,4,5-trinitrobenzene sulfonic acid (TNBS). METHODS: Colitis was induced by rectal administration of 2 mg of TNBS in 35% ethanol as experimental group compared to control group. Histological changes, surface molecules of T and B cells of the spleen and blood, and cytokine production (IFN-gamma, TNF-alpha, IL-4, IL-6, IL-10, and IL-12) were determined among 3 groups comprised of control group, TNBS group and TNBS/MSC group. RESULTS: In the mice treated with MSCs, there was a decrease in the wasting disease process and inflammatory histopathological changes. There was also a decrease in pro-inflammatory T-helper 1 (Th1) cytokines IFN-gamma and IL-12 and T-helper 2 (Th2) cytokine IL-4. Anti-inflammatory cytokine IL-10 increased in mice treated with MSCs compared to colitic mice. The blood CD4+CD25+ T-regulatory cells also increased and splenic CD19 B-cells decreased. CONCLUSION: The results of this study suggest that MSCs may have a therapeutic effect in controlling the Th1 and Th2 mediated immune response in patients with CD and aid in tissue regeneration.
Administration, Rectal ; Animals ; B-Lymphocytes ; Colitis ; Crohn Disease ; Cytokines ; Ethanol ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Interleukin-10 ; Interleukin-12 ; Interleukin-4 ; Interleukin-6 ; Mesenchymal Stromal Cells ; Mice ; Regeneration ; Spleen ; Tumor Necrosis Factor-alpha ; Wasting Syndrome

Cytomegalovirus (CMV) pneumonia is one of the major causes of morbidity and mortality in immunocompromised patients such as transplant recipients. But CMV pneumonia is unusually reported among adults with leukemia who have not undergone transplantation. Because it is a cause of life-threatening pneumonia in adults with leukemia receiving potent immunosuppressive therapies, CMV has emerged as an important pathogen. We report a case of CMV pneumonia and invasive pulmonary aspergillosis in a patient with acute leukemia who have not undergone transplantation. A 31-year-old man with acute myelogenous leukemia developed high fever on day 9 of second consolidation chemotherapy. Six days later, chest radiography showed patchy consolidation with central cavity on right upper lung. Considering fungal pneumonia, amphoterin B was started, then fever was subsided. Chest CT showed necrotizing pneumonia with cavity formation in posterior segment of right upper lobe. Because of several episodes of hemoptysis, lobectomy was performed. Grossly, the area of focal necrosis with central cavity formation and multiple small interstitial nodules were observed. In the area of interstitial nodules, giant cells with intranuclear inclusion and perinuclear halo were found. In the area of focal necrosis, fungal hyphae with acute branching and septation were found. Ganciclovir and immunoglobulin were administered for CMV pneumonia. On day 62 of the chemotherapy, the patient discharged with improved symptoms. After several weeks, unrelated HLA-matched allogeneic stem cell transplantation was performed. On day 14 of transplantation, the patient died due to septic shock of unknown cause.
Adult ; Aspergillosis ; Consolidation Chemotherapy ; Cytomegalovirus* ; Drug Therapy* ; Fever ; Ganciclovir ; Giant Cells ; Hemoptysis ; HMGB1 Protein ; Humans* ; Hyphae ; Immunocompromised Host ; Immunoglobulins ; Intranuclear Inclusion Bodies ; Invasive Pulmonary Aspergillosis ; Leukemia ; Leukemia, Myeloid, Acute* ; Lung ; Mortality ; Necrosis ; Pneumonia* ; Pulmonary Aspergillosis* ; Radiography ; Shock, Septic ; Stem Cell Transplantation ; Thorax ; Tomography, X-Ray Computed ; Transplantation

BACKGROUND: Acromegaly occurs by excessive secretion of growth hormone and more than 99% of cases are caused by a growth hormone-secreting pituitary adenoma. Pituitary adenomas expressing multiple immunoreactivities are common. We assumed that the pituitary adenomas which is immunochemically detected growth hormone and prolactin are responsible for it and reviewed 28 patients with acromagaly to determine the correlation between serum hormonal level and immunocytochemical finding. METHODS: Twenty-eight patients with acromegaly who underwent surgery of pituitary adenoma in Samsung Medical Center from October 1998 to may 2001 were included. Baseline hormonal evaluations and several endocine tests were performed. Immunocytochemical stain was done. RESULTS: According to the extent of hormonal stain, the adenoma was divided into two groups. The adenoma showing immunoreactivity over 50% to growth hormone was 100%, to prolactin was 71.4% and to FSH was 25.0%. The extent of other hormonal stain was less than 20%. There were no significant differences in age, sex, the ratio of macroadenoma and microadenoma, the basal serum GH level, serum IGF-1 level, and the response to TRH, somatostatin and bromocriptine suppression test between the two groups divided by the the extent of prolactin stain. But the serum prolactin level was 55.0+/-63.4 ng/mL, and 19.9+/-12.2 ng/mL each in two groups which was siginificantly increased in the adenoma showing immunoreactivity over 50% to prolactin. CONCLUSION: Acromegaly patients with higher expression of prolactin on immunocytochemical studies showed higher serum prolactin levels and patients with hyperprolactinemia showed higher serum IGF-1.
Acromegaly* ; Adenoma ; Bromocriptine ; Growth Hormone ; Growth Hormone-Secreting Pituitary Adenoma ; Humans ; Hyperprolactinemia ; Insulin-Like Growth Factor I ; Pituitary Neoplasms* ; Prolactin* ; Somatostatin

This nationwide, prospective cohort study evaluated pulmonary function and radiological sequelae according to infection severity in 73 survivors from the 2015 Middle East respiratory syndrome (MERS) outbreak in Korea. Patients with severe pneumonia in MERS-coronavirus infection had more impaired pulmonary function than those with no or mild pneumonia at the 1-year follow-up, which was compatible with the radiological sequelae. Severe pneumonia significantly impairs pulmonary function and makes long radiological sequelae in MERS.
Cohort Studies ; Coronavirus ; Coronavirus Infections* ; Follow-Up Studies ; Humans ; Korea ; Middle East* ; Pneumonia* ; Prospective Studies ; Survivors