Angioma serpiginosum is a rare acquired naevoid disorder, characterized by minute red or purple punta that are frequently arranged in serpiginous patterns in the lower extremities and buttocks. It usually begins in childhood and is more common in females. Histopathologically, thin-walled capillaries in the dermal papillae and the superficial reticular dermis are widely dilated without extravasation of red blood cells. We report a case of angioma serpiginosum on the lateral aspect of the right arm along the lines of Blaschko in a 36-year-old woman.
Adult ; Arm ; Buttocks ; Capillaries ; Dermis ; Erythrocytes ; Female ; Hemangioma* ; Humans ; Lower Extremity

BACKGROUND: Drug reactions are common problems in hospital inpatients and outpatients. Reliable diagnosis is essential but often difficult. OBJECTIVE: This study attempts to define the clinical features and causative drugs in the patients with drug eruptions, and to evaluate the diagnostic value of skin tests. METHODS: Sixty one patients with drug eruptions were reviewed clinically. In 18 patients, patch and prick tests were performed using suspected drugs. RESULTS: 1. The highest incidence of drug eruptions was observed in the third and forth decades(44.2%) and there was no sexual prodominence. 2. The most frequent latent peroid was 4 hours to 1 week(49.2%). 3. The common morphological features were exanthematous eruptions(57.3%), urticaria(14.8%) and fixed drug eruptoins(11.5%). 4. The major causative drugs were antibiotics(cephalosporin, ampicillin), antipyretics/anti-inflammatory analgesics(aspirin, piroxicam) and CNS depressants(diphenylhydantoin). 5. Clinical manifestations according to possible causative drugs were as follows; exanthematous eruptions by antibiotics, antipyretics/analgesics, herbs, CNS depressants, propylthiouracil and captopril; urticaria by antibiotics and herbs; fixed drug eruption by sulfonamide, antipyretics/analgesics and phenobarbital; acneiform eruptions by diphenylhydantoin and isoniazid; Stevens-Johnson syndrome by ampicillin, sulfonamide, aspirin and piroxicam, erythema nodosum by sulfonamide, and lichenoid drug eruptions by propylthiouracil. 6. Positivity to patch and prick tests was shown in 2 of the 18 patients and in 1 of 18 patients, respectively. CONCLUSIONS: The most frequent clinical feature of the drug eruptions were exanthematous in nature and the most common causative drugs were antibiotics, as suspected. To search for the causative drug of the drug eruption, the only usual methods of patch and prick tests were not sufficient in our study.
Acneiform Eruptions ; Ampicillin ; Anti-Bacterial Agents ; Aspirin ; Captopril ; Central Nervous System Depressants ; Diagnosis ; Drug Eruptions* ; Erythema Nodosum ; Humans ; Incidence ; Inpatients ; Isoniazid ; Outpatients ; Patch Tests ; Phenobarbital ; Phenytoin ; Piroxicam ; Propylthiouracil ; Skin Tests* ; Skin* ; Stevens-Johnson Syndrome ; Urticaria

Polymyalgia rheumatica is characterized by pain and stiffness of the shoulder and pelvic girdles, morning stiffness, constitutional symptoms and an elevated erythrocyte sedimentation rate. We have experienced a 45-year-old female patient with polymyalgia rheumatica who presented with pain and stiffness of the shoulder and pelvic girdle, an elevated erythrocyte sedimentation rate and dramatic response to low-dose steroids. To our knowledge, thes is the second case of polymyalgia rheumatica with a brief review of literature.
Blood Sedimentation ; Female ; Humans ; Middle Aged ; Polymyalgia Rheumatica* ; Shoulder ; Steroids

OBJECTIVE: There have been no clinical studies regarding the epidemiology and treatment outcome for unruptured intracranial aneurysm (UIA) in South Korea yet. Thus, The Korean Society of Cerebrovascular Surgery (KSCVS) decided to evaluate the clinical and epidemiological characteristics, and outcome of the treatment of UIA in 2006, using the nationwide multicenter survey in South Korea. METHODS: A total of 1,696 cases were enrolled retrospectively over one year at 48 hospitals. The following data were obtained from all patients : age, sex, presence of symptoms, location and size of the aneurysm, treatment modality, presence of risk factors for stroke, and the postoperative 30-day morbidity and mortality. RESULTS: The demographic data showed female predominance and peak age of seventh and sixth decades. Supraclinoid internal carotid artery was the most common site of aneurysms with a mean size of 5.6 mm. Eight-hundred-forty-six patients (49.9%) were treated with clipping, 824 (48.6%) with coiling, and 26 with combined method. The choice of the treatment modalities was related to hospital (p = 0.000), age (p = 0.000), presence of symptom (p = 0.003), and location of aneurysm (p = 0.000). The overall 30-day morbidity and mortality were 7.4% and 0.3%, respectively. The 30-day mortality was 0.4% for clipping and 0.2% for coiling, and morbidity was 8.4% for clipping and 6.3% for coiling. Age (p = 0.010), presence of symptoms (p = 0.034), size (p = 0.000) of aneurysm, and diabetes mellitus (p = 0.000) were significant prognostic factors, while treatment modality was not. CONCLUSION: This first nation-wide multicenter survey on UIAs demonstrates the epidemiological and clinical characteristics, outcome and the prognostic factors of the treatment of UIAs in South Korea. The 30-day postoperative outcome for UIAs seems to be reasonable morbidity and mortality in South Korea.
Aneurysm ; Carotid Artery, Internal ; Diabetes Mellitus ; Female ; Humans ; Intracranial Aneurysm ; Korea ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Stroke ; Treatment Outcome

BACKGROUND: Generalized sterile pustular eruption with fever which occurs in generalized pustular psoriasis (GPP) and acute generalized exanthematous pustulosis(AGEP) present a diagnostic and therapeutic problems. In Korea, there are a few studies of clinical and histopathologic reviews of these diseases, but long term follow-up and comparative clinicopathologic studies of these two diseases are not available. OBJECTIVE: This study attempts to identify the differences of these two diseases in the aspects of clinical, laboratory, and histopathologic findings. METHODS: We evaluated the clinical features, laboratory and histopathologic findings in 41 patients with generalized pustular eruption who had visited Pusan National University hospital during the past 20 years and reviewed the literature. RESULTS: 1. The ratio of patients with GPP(n=32) to ones with AGEP(n=9) was 3.6:1. 2. The mean age at diagnosis was 32.9(male) and 28.9(female) years in GPP, and 10.3 years(male) and 62.8 years(female) in AGEP. 3. The number of patients of GPP with previous personal history of psoriasis vulgaris were 15/32(46.9%) and the number of ones with previous family history of psoriasis vulgaris were 2/32(6.3%). 4. There was no patient of AGEP with personal or familial history of psoriasis. 5. The number of patients with recent drug intake history were 4/32(12.9%) in GPP and 9/9(100%) in AGEP. And common drugs suspected to cause AGEP were antibiotics(4 cases) and analgesics(3 cases). 6. Associated systemic symptoms were fever(37.5%), arthralgia(18.8%), and itching(62.5%) in GPP, whereas 66.7%, 33.3%, and 55.6%, respectively in AGEP. 7. The mean duration of pustules was 32.9 days in GPP and 7.2 days in AGEP. 8. Reccurences of generalized pustular eruption were 46.9% in GPP and 0% in AGEP. 9. Laboratory findings revealed leukocytosis(34.4%), elevated erythrocyte sedimentation rate(28.1%), hypoalbuminamia(25.0%), and eosinophilia(6.3%) in GPP, whereas 77.8%, 55.6%, 33.3%, and 71.4%, respectively in AGEP. 10. GPP and AGEP are diseases sharing similar clinical features, but these two diseases show distinctive clinical, laboratory, and histologic features. We suggest that it is important to be aware of these distinctions for avoidance of unnecessary aggressive therapy indicated for GPP.
Acute Generalized Exanthematous Pustulosis* ; Blood Sedimentation ; Busan ; Diagnosis ; Fever ; Follow-Up Studies ; Humans ; Korea ; Psoriasis*

We report two cases of toxic methemoglobinemia caused by an inert ingredient in pesticide product after intentional ingestion of pesticide. First, 51-year-old male visited to the emergency department (ED) after the ingestion of pesticide in a suicide attempt. Initial methemoglobin (MetHb) level was 25.6%. We did not know the cause of methemoglobinemia at that time. Second, 56-year-old female visited to the ED after the ingestion of the same pesticide in a suicide attempt. MetHb level after 30 minutes was 16.1%. The patients were treated with methylene blue. We contacted to the Korean Rural Development Administration and estimated that magnesium nitrate was more likely to cause methemoglobinemia. This report highlights the importance of considering the possibility of methemoglobinemia caused by inert ingredient in pesticide and early antidotal therapy.
Eating* ; Emergency Service, Hospital ; Female ; Humans ; Magnesium ; Male ; Methemoglobin ; Methemoglobinemia* ; Methylene Blue ; Middle Aged ; Pesticides ; Social Planning ; Suicide

PURPOSE: Hospital disaster plans usually involve evacuation of hospital patients, including discharge or transfer to non-affected hospitals or facilities. However, this is difficult in cases of isolated hospitals. Disaster plans for isolated hospitals, therefore, must account for the preparation of supplies that will allow survival of their patients when transfer is impossible. The aim of this study was to assess the disaster supply preparedness of isolated hospitals in Korea. METHODS: We surveyed hospitals to assess various aspects of their disaster preparedness: drinking water, food, fluids, wound dressing sets, suture sets, shelter, emergency generator systems, triage systems, and communication equipment. Preparedness was compared between hospitals according to their emergency department (ED) level. RESULTS: We obtained complete data from 71 EDs of the 118 hospitals having emergency medical centers. Less than one fourth of these 71 EDs had reserve water (12.7%), food (7.0%), fluids (23.9%), dressing sets (21.1%), suture sets (21.1%) available for 3 days and emergency flashlights (4.2%), emergency blankets (16.9%), or portable oxygen tanks (4.2%) available enough during a disaster. Sixty-six EDs (93.0%) had emergency electric power, but independent EMC emergency electric power was available in only 7 (9.9%). A very small number of EDs had radiation detectors (15.5%), air shelters (11.3%), or decontamination tents (12.7%), with regional and specialized EMCs much more likely to have such supplies available than were local EMCs (p=0.008, 0.009, < 0.001, respectively). CONCLUSION: This study provides preliminary nation-wide survey data for disaster preparedness of isolated hospitals in Korea. At present, EDs in the vast majority of isolated hospitals are insufficiently prepared with supplies and equipments to cope with emerging threats during a disaster.
Bandages ; Decontamination ; Disaster Planning ; Disasters ; Drinking Water ; Emergencies ; Equipment and Supplies ; Humans ; Korea ; Oxygen ; Phosphatidylethanolamines ; Sutures ; Triage ; Water

We report two cases of kerion celsi caused by Trichophyton tonsurans, One is a 16-year-old male Judo-player in athletic high school and the other is a 7-year-old boy. Kerion celsi is a highly inflammatory, suppurative fungal infection of the scalp caused mainly by zoophilic dermatophytes transmitted from animals to man. The first case presented with a 4cm sized, markedly inflammatory, boggy mass on the occipital scalp. The second one showed several 2-3cm sized, erythematous, follicular pustules and plaques with partial hair loss on the frontal and parietal scalp. The diagnosis was established by histopathologic and mycologic studies that are KOH, fungus culture, slide culture and histopthologic exams of the lesional specimen. All the lesions of the patients were cleared with itraconazole for several weeks and short-term systemic steroid.
Adolescent ; Animals ; Arthrodermataceae ; Child ; Diagnosis ; Fungi ; Hair ; Humans ; Itraconazole ; Male ; Rabeprazole ; Scalp ; Sports ; Tinea Capitis* ; Trichophyton*

BACKGROUND: Although elevated serum cholesterol level has been considered as a significant health problem because it is associated with coronary artery disease, the relation with various health problem (esp. depression) from low serum cholesterol is not well known in Korean people. The authors tried to observe the degree of depression in low serum cholesterol group for its better management. METHODS: The study population was selected among adults who visited the National University Hospital Health Screening Center between May and July 1998. They had no history of cancer and liver disease and no significant medical illnesses which may affect blood cholesterol level. Using the Korean standard BDI, we evaluated the degree of depression scale. RESULTS: The number of subjects with low serum cholesterol was 77 (males 42, females 35) and that of the control group was 82 (males 47, females 34). The low serum cholesterol group had a statistically significantly higher BDI score(12.2+/-8.2) than the control group (7.6+/-6.3) (P<0.05). In males the mean BDI score of 11.9+/-7.4 in the low serum cholesterol group was significantly higher than the mean score of 5.0+/-3.8 in the control group (P<0.05). In females, there was no significant difference in depression scale between both groups. CONCLUSION: Since the male low serum cholesterol group had a high depression scale, the multi-disciplinary approaches which include psychological supports may be required to manage and treat them. And persistent significant association between low serum total cholesterol level and psychological problems suggests that further long-term study on the association of low cholesterol with depression is necessary.
Adult ; Cholesterol* ; Coronary Artery Disease ; Depression* ; Female ; Humans ; Liver Diseases ; Male ; Mass Screening

No abstract available.
Humans ; Pregnancy*