The technique of plssma exchange has been applied to a number of immune disorders in which c4eulating antibodies are present. We observed a patient with bullous pemphigoid and serious side effects of longterm use of steroid therspy. We applied ten times of plasmapheresis to him over six months period. After the plasmapheresis, clinical symptoms have greatly improved and steroid maintenance doses have been decreased. We have not observed any side effect of plasmapheresis such as thrambotopenia or hypogarnrnaglobulinemia during the whole therapeutic period.
Antibodies ; Humans ; Immune System Diseases ; Pemphigoid, Bullous* ; Plasmapheresis*

Rasch was the first to use the term carcinoma erysipelatoides in the dermatologic literature, and it is most frequently associated with breast carcinoma. This inflammatory type of rnetastatic carcinoma of the breast is an uncommon but well known entity. It occurrs almost exclusively in women, tends to appear in the anterior chest wall, and is usually found after recognition of the primary tumor which is usually adenocarcinoma or undifferentiated carcinoma. It has an acute inflammatory process with rapid progress, with many fatalities resulting in a short time. We report a case of carcinoma erysipela,toides originating from a breast carcinoma with characteristic clinical and histopathologic findings.
Adenocarcinoma ; Breast ; Breast Neoplasms ; Carcinoma ; Female ; Humans ; Skin* ; Thoracic Wall

The altered hemodynamics of arteriovenous fistul lead to overvascularization with trophic hypertrophy of a part or ulceration and tissue necrosis following local circulatory decompensation. A twenty years old female had been suffered from chronic ulcerative dermatitis on the dorsal aspect of left foot and multiple hemangioma on ber left great toe. The ligation of main communicating vessel and excision of fistula masses were performed in the surgical treatment. The ulceration on the dorsal aspect of left foot was healed completely and the size of hemangioma was reduced.
Arteriovenous Fistula ; Dermatitis ; Female ; Fistula ; Foot ; Hemangioma ; Hemodynamics ; Humans ; Hypertrophy ; Ligation ; Necrosis ; Toes ; Ulcer

BACKGROUND: The purpose of this article was to identify the risk factors related to development of hemodynamically significant cardiac arrythmias in patients with mechanical ventilation. METHODS AND RESULTS: Holter recording and echocardiogram were performed after 30 minutes of ventilator initiation in patients on mechanical ventilation(MV) owing to respiratory failure(RF) from various reasons. From 68 patients, hemodynamically significant cardiac arrythmias were detected in 18 patients(26.5%). Initial mean arterial pressure, maximal heart rate, and initial pH were identified as risk factors for hemodynamically significant cardiac arrythmias. Additionally, the patients with pressure-controlled ventilation as an initial ventilatory mode developed hemodynamically significant cardiac arrythmias less frequently than the patients with other modes(15.8% vs. 40%, p=0.03). In multivariate analysis, initial mean arterial pressure(<70mmHg, odds ratio[OR]:5.5;95% confidence interval[CI]:1.2 to 24.2, p=0.026), maximal heart rate(>120/min, OR:19.7;95% CI:2.0 to 190.0, p=0.01), and pressure-controlled ventilation(OR:0.13,95% CI:0.03 to 0.55, p=0.006) were associated with the development of hemodynamically significant cardiac arrhythmias. CONCLUSION: Theses findings suggest that during the early stages of mechanical ventilation with acute respiratory failure, hemodynamically significant cardiac arrhythmias are directly associated with tachycardia(>120/min), initial MAP(<70mmHg), and, inversely, the initial use of pressure-controlled ventilation.
Arrhythmias, Cardiac* ; Arterial Pressure ; Heart ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Multivariate Analysis ; Respiration, Artificial* ; Respiratory Insufficiency* ; Risk Factors* ; Ventilation ; Ventilators, Mechanical

No abstract available.
Nipples* ; Poroma*

Serum IgE values were determined in 100 patients vith atogic dermatitis in the Department of Dermatology at Severance Hospital, Yonsei University College of Medicine, from Oct. 1, 1978 to Mar. 31, 1980. Mean IgE value of patients is 293. 4 unit/ml which is significantly higher than reference value, and the following results were obtained. 1. The mean IgE value in adults with atopic dermatitis, 339.8 unit/ml, 30 cases: more tian 16 years old) was significantly higher than in children(251. 4 unit /ml, 70 cases). 2. Male patierts showed higher IgE va,lue (mean 324. 5 unit/ml, 62 cases,' than female patients (242.7 unit/ml, 38 cases). 3. No close correlation was demonstrated between IgE values and eosiniphils in blood. 4. Patients with parasitic infesta,tion (5 cases) showed relatively increased IgE values (mean; 116. 2 unit/ml;. 5. Patients wifh bronchial asthma (2 cases) showed high IgE values exceeding 1000 unit/ml, 6. IgE. values roughly correlated with severity of the dermatitis. Four cases with high IgE values exceeding 1000 unit/ml were included in the clinically severe group.
Adult ; Asthma ; Dermatitis ; Dermatitis, Atopic* ; Dermatology ; Female ; Humans ; Immunoglobulin E* ; Male ; Reference Values

Schonlein-Henoch purpura is a generalized small vessel vasculitis characterized by nonthrombocytopenic purpura, arthritis, abdominal pain and nephritis. In 1914 Osler described an allergic purpura associated with hemiplegia. After then Lewis et al. reported the cases of Schonlein-Henoch purpura associated with convulsion, coma, confusion, intracranial hemorrhage, and chorea, CNS complication has been reported in 1-8% of children and subsided spontaneously in most cases. Headache is a remarkable sympton and appears nonspecific nature. In 1991 Ostergaard and Storm reported that headache occured during the first week following skin rash and frequently showed abnormal EEG findings. We investigated prospectively the presence of a possible cerebral and renal involvement in the case of Schonlein-Henoch purpura. EEG abnormality demonstrated in 52.6% of all cases, and headache or irritability in 47.4% of all cases. A significant association was found between abnormal EEG finding and presence of headache, but was not found between EEG findings and presence of renal involvement and hypertension. Patients with abnormal EEG had no Past or famity history of febrile convulsion or ididopathic epilepsy.
Abdominal Pain ; Arthritis ; Child ; Chorea ; Coma ; Electroencephalography* ; Epilepsy ; Exanthema ; Headache ; Hemiplegia ; Humans ; Hypertension ; Intracranial Hemorrhages ; Nephritis ; Prospective Studies ; Purpura, Schoenlein-Henoch* ; Seizures ; Seizures, Febrile ; Vasculitis

Congenital hypoprothrombinemia is a rare congenital coagulation defect. The clinical signs are manifestation of generalized tendency such as; mucosal bleeding, hypermenorrhea and post tooth extraction hemorrage. It is associated with prolongation of PT and PTT with normal thrombin time and decreased serum prothrombin level. A case with congenital hypoprothrombinemia was experienced by the authors. A 36 days old male baby was admitted with palor skin and vomiting started one day before admission. Right side brain parenchymal hemorrhage and left shift of lateral ventricle were on brain CT scan. Prologation of prothrombin time and partial prothrombin time with decreased serum prothrombin level were resulted. Serum factor I, V, VII, VIII, IX and X were within normal level. We report a case congenital hypoprothrombinemia with a brief review of relaed literatures.
Brain ; Female ; Fibrinogen ; Hemorrhage ; Humans ; Hypoprothrombinemias* ; Lateral Ventricles ; Male ; Menorrhagia ; Prothrombin ; Prothrombin Time ; Skin ; Thrombin Time ; Tomography, X-Ray Computed ; Tooth Extraction ; Vomiting

No abstract available.
Female ; Hysterectomy, Vaginal*

The determination of motor nerve conduction velocity is an important part to electrodiagnosis. Its value as neurophysiologic investigative procedure has been known for many years, and recently it has been utilized as a chinical diagnostic technic. Its most valuable role is differentiating between those conditions which affect the axon primarily and those which affect the anterior horn cell. Many factors such as temperature in the vicinity of the nerve, diameter of the axon, degree of myelinization, age of the patient, local environment of the nerve and intensity of electrical stimulation have been demonstrated to affect the rate of propagation of impulses along motor fibers. Pathologic conditions affecting the axon usually alter the excitability along involved segments and, therefore, result in reduced conduction velocity. The purpose of this study was to determine the normal data of the motor nerve conduction velocities of median, ulnar, tibial and peroneal nerves in Korean. 1. The motor nerve conduction velocities of median, ulnar, peroneal and tibial nerves were 61.54±6.95 (46.7–94.2) m/sec, 61.74±7.28 (45.6–95.0)m/sec, 48.80±5.54 (38.8–69.9) m/sec, 47.39±4.85 (36.2–64.2 m/sec respectively. 2. The condition velocity in the upper extremities has been found 13.5 m/sec faster than in the lower extremities. 3. A significant decline in motor nerve conduction velocities was noted in the over 60 year old age group. 4. There were significant differences between the sexes.
Anterior Horn Cells ; Axons ; Electric Stimulation ; Electrodiagnosis ; Humans ; Lower Extremity ; Myelin Sheath ; Neural Conduction ; Peroneal Nerve ; Tibial Nerve ; Upper Extremity