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

Color Doppler echocardiographic examination was performed to detect and evaluate semiquantitatively the severity of mitral regurgitation in 38 patients who underwent left ventriculography. The sensitivity and specificity of the technique in the detection of mitral regurgitation was 84% and 100% as compared with left ventriculography.Mitral regurgitation in the false negative cases was mostly mild. On the bases of the farthest distance reached by the regurgitation flow signal from the mitral value orifice, the severity of regurgitation was graded on a four point scale and these results were compared with those of angiography. A significant correlation(r=0.87) was found between Doppler imaging and angiography in the evaluation of the severity of mitral regurgitation.Also results was obtained for the evaluation based on the area covered by the regurgitant signals in the left atrial cavity & the regurgitant jet area(RJA) experssed as a percentage of the left atrial are(LLA) obtained in the same plane(RJA/LLA%). In conclusion, Color Doppler echocardiography is a useful noninvasvive thechique that is not only sensitive and specific in the identification of mitral regurgitation but also provides accurate estimation og its severity.
Angiography ; Echocardiography ; Echocardiography, Doppler, Color ; Humans ; Mitral Valve Insufficiency* ; Sensitivity and Specificity

No abstract available.
Humans ; Pregnancy*

Aconitine is an anti-inflammatory agent with therapeutic uses in oriental medicine as an analgesic and for treatment of stroke. Because of its sodium channel effect, aconitine can promote undesirable, wide complex tachyarrhythmia. If tachycardia develops during use of aconitine, class Ia and class III anti arrhythmic drugs can be utilized for treatment. However there are no single anti-arrhythmia agents which are uniformly effective. We report a case, characterized by wide complex tachyarrhythmia and severe hypotension, which was successfully treated by simultaneous injections of amiodarone and lidocaine. A 59-year-old woman exhibiting clinical signs of drowsiness as a result of ingesting 6 g of aconitine, was admitted to the emergency department. Initially, wide complex tachyarrhythmia (ventricular tachycardia and pulse rate of 180 beats/min) and severe hypotension (blood pressure of 53/26 mmHg) was observed. After simultaneous injection of amiodarone and lidocaine, the patient's rhythm pattern changed to an accelerated junctional rhythm with ventricular premature complex. Two hours later, the patient's heart pattern became a sinus rhythm. As demonstrated by this case, simultaneous injections of amiodarone and lidocaine can be useful in treating ventricular arrhythmia induced by aconitine.
Aconitine ; Amiodarone ; Anti-Arrhythmia Agents ; Arrhythmias, Cardiac ; Emergencies ; Female ; Heart ; Heart Rate ; Humans ; Hypotension ; Lidocaine ; Medicine, East Asian Traditional ; Middle Aged ; Sleep Stages ; Sodium Channels ; Stroke ; Tachycardia ; Tachycardia, Ventricular ; Therapeutic Uses ; Ventricular Premature Complexes

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

BACKGROUND: The distinction between secretors and nonsecretors of ABH and Lewis substances is made by inhibiting an antiserum agglutinin reaction with saliva, but many variables such as ethnic group, Lewis and ABO genotype, saliva collection method and antiserum influence the detection of salivary substances. Human secretor (1,2) fucosyltransferase (FUT II) gene determines the ABH secretor status and influences the Lewis phenotype of an individual. The aim of this study is to comparison between the genotype of the secretory (FUT II) gene and the secretory phenotype of the saliva and evaluate the usefulness of genotyping secretory gene. METHOD: In order to explore the secretory genotypes, the 79 specimens were analyzed by the PCR-RFLP method designed for the detection of the A385T, the C357T and the G428A mutations of FUT II gene. Also, we performed secretory phenotyping of the saliva by hemagglutination inhibition test and compared between the genotype of FUT II gene and secretory phenotype of the saliva. RESULT: The frequencies of Se1, Se2 and sej among 158 alleles examined in a random sample were 11.1%, 40.5% and 48.4%. The frequencies of Se1/Se1, Se1/Se2, Se2/Se2, Se1/sej, Se2/sej and sej/sej among 158 genotypes were 3.2%, 3.2%, 20.3%, 12.7%, 37.3% and 23.4%. The frequencies of Secretor and nonsecretor phenotypes were 76.6% and 23.4%. There were 3 mismatch individuals between phenotype and genotype, all three cases were nonsecretor in phenotype but secretor (Se1/Se1, Se1/Se2, Se2/sej) in genotype. CONCLUSION: PCR-RFLP method can be effectively used for the genotyping of the FUT II gene and offer an attractive alternative to the phenotype of secretor state using saliva.
Alleles ; Ethnic Groups ; Genotype* ; Hemagglutination Inhibition Tests ; Humans ; Phenotype* ; Saliva*

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*