The hyperimmunoglobulinemia E (Jobs) syndrome (HIES) is characterized by marked elevated levels of IgE, recurrent cutaneous and systemic staphylococcal infections, atopic-like dermatitis, and defective neutrophil chemotaxis. Three cases of HIES have been reported in Korea, but not in the dermatology literature. We report a case of HIES with cutaneous infections and MRSA (methicillin-resistant Staphylococcus aureus). A 15-month-old girl presented with intractable pruritic excoriated papular pustular skin lesions and multiple subcutaneous abscesses. Surgical drainage of the abscesses and a course of antibiotic treatment in addition to topical steroids for about 7 weeks resulted in a remarkable improvement.
Abscess ; Chemotaxis ; Dermatitis ; Dermatology ; Drainage ; Female ; Humans ; Hypergammaglobulinemia* ; Immunoglobulin E ; Infant ; Job Syndrome* ; Korea ; Methicillin-Resistant Staphylococcus aureus ; Neutrophils ; Skin ; Staphylococcal Infections ; Staphylococcus ; Steroids

BACKGROUND: Cyclosporin A (CsA), a potent immunosuppressant, has been reported to be effective in the treatment of severe atopic dermatitis (AD). OBJECTIVE: The aim of this study was to evaluate the efficacy and side-effects of CsA in Korean patients with severe AD. MATERIALS AND METHODS: 16 patients with recalcitrant AD took CsA for at least 6 weeks. Among them, 11 patients were followed up for more than 16 weeks. Initial dose was 5mg/kg/day (maximum 300 mg/day) and the dose was reduced according to their therapeutic responses. SCORAD (Scoring AD) was used to evaluate clinical efficacy of CsA. During the 1st month of therapy, the therapeutic efficacy and side-effects were evaluated every 2weeks and after 1 month, every month. We checked blood pressure and laboratory abnormalities including liver function test, blood urea nitrogen (BUN), creatinine (Cr) and urinalysis at each visit in addition to observing clinical adverse effects. RESULTS: Significant reduction of SCORAD was noted in 15 patients after 6 weeks of CsA therapy. Only one patient stopped CsA therapy because of the elevation of blood pressure. Three patients showed albuminuria, which disappeared after CsA dose reduction. CONCLUSION: CsA can be used effectively and safely in severe Korean AD patients. Albuminuria seems to be a peculiar side-effect in Korean patients.
Albuminuria ; Blood Pressure ; Blood Urea Nitrogen ; Creatinine ; Cyclosporine* ; Dermatitis, Atopic* ; Humans ; Liver Function Tests ; Urinalysis

The authors analyzed 30 patients whose celiac artery or its branches were dissected during the procedure of transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC) and were followed up angiographically. The incidence of arterial dissection was 1.25%. The dissection occurred most frequently in the celiac artery (40% 12/30) and the proper hepatic artery(28% 7/30). The frequency of arterial dissection was affected by the status of the vessel and the experience of the operator. The follow-up angiography revealed complete recanalization in 40% (12/30), irregularity and narrowing of the lumen in 23% (7/30), pseudoaneurysm formation in 23%(7/30), and complete obstruction in 13% (4/30) of the cases. The rate of recanalization in the celiac artery was lower than that of any other arteries in our series. Recamalization to a certain degree without therapeutic intervention was observed in 72% of the dissected arteries enabling and contributing to subsequent successful TAE within 2 months in 78% of the patients with the dissection.
Aneurysm, False ; Angiography ; Arteries ; Carcinoma, Hepatocellular ; Celiac Artery* ; Follow-Up Studies* ; Humans ; Incidence

Although ultrasound has not been used to clarify bone lesions because of their high acoustic impendence and attenuation coefficient, aneurysmal bone cyst of the pelvis was imaged with ultrasound. Dual fluid levels and multiple loculations were discovered by ultrasound imaging through thin cortical bone. Ultrasonography is a simple, non-invasive method which can be utilized to detect bony lesions of an expansile nature and reveal characteric findings in an aneurysmal bone cyst.
Adolescent ; *Blood ; Bone Cysts/*diagnosis/surgery ; Case Report ; Female ; Human ; *Ilium/pathology/surgery ; Tomography, X-Ray Computed

BACKGROUND: Thymopentin(TP-5) is an immunomodulatory agent which may be a promising new drug in the treatment of patients with severe atopic dermatitis. OBJECTIVE: The aim of this study was to evaluate the efficacy of thymopentin for treatment of severe atopic dermatitis. MATERIAL AND METHOD: Fifteen patients with severe atopic dermatitis received subcutaneous injections of 50mg thymopentin three times per week for 6 weeks. Clinical extent and severity parameters were assessed at baseline, at regular intervals during therapy and 4 weeks posttherapy. Use of antihistamine and topical steroid were permitted. RESULT: Significant reduction in severity scores and body surface area involvement was observed and no significant side effects were noted(p<0.05). CONCLUSION: Thymopentin may be considered to be an effective adjunctive therapeutic agent in the treatment of severe atopic dermatitis. Further studies will be needed to determine the action mechanism of thymopentin.
Body Surface Area ; Dermatitis, Atopic* ; Humans ; Injections, Subcutaneous ; Thymopentin*

Malposition of catheter in the subdural space is a possible complication during attempted epidural anesthesia. We report here an inadvertent subdural block confirmed by the radiographic contrast materiaL Epidural anesthesia was planned for a full-term gravida and epidural catheter was inserted about 3 cm cranially at the level of L1-2. After injection of 19.5 ml local anesthetic, blood pressure was 70/50 mmHg. Fluid was rapidly infused and intravenous ephedrine 10 mg was given. After then, vital signs were well maintained and twin babies were delivered without events. Twentyfive minutes later, she complained chest tightness and became tachypneic. Ketamine 50 mg was given and endotracheal intubation was performed with ease. She obeyed command, but could not open her eyes for some duration. Self respiration returned after 110 minutes and minute ventilation was 6 liter/minute at that time. 160 minutes later, extubation was done and radiological examination was performed using contrast materiaL The cathter tip was positioned in anterior subdural space at T12 level.
Anesthesia, Epidural* ; Blood Pressure ; Catheters ; Ephedrine ; Humans ; Intubation, Intratracheal ; Ketamine ; Respiration ; Subdural Space ; Thorax ; Twins ; Ventilation ; Vital Signs

BACKGROUND: Contact dermatitis is frequently caused by cosmetics. Detection of causative allergens is important in prevention and treatment of cosmetic contact dermatitis. Patch test has been accepted as the only reliable diagnostic method to detect allergens. OBJECTIVE: The objectives of this study were to clarify evoluting trends of positive patch tests and to compare the positive frequencies of various allergens between different time sequences. MATERIALS AND METHODS: We reviewed patch test results of the 806 cosmetic contact dermatitis patients, who had visited our clinic from 1982 to 1997. We divided the patients into three groups as follows: I group:1982-1987, II group:1988-1992, III group:1993-1997 and compared the test results. The patch tests were performed with standard batteries, cosmetic-related allergens and the patients's own cosmetics. RESULTS: The results of the studies were summarized as follows; 1. Trends of increasing positivity in cosmetic-induced dermatitis was noted in a chronologic point of view. Among the patients, an increased proportion of males was notable. 2. In age distribution, a decreasing proportion of patients at the third & the fourth decades was observed. Contrary to this, the proportion of patients over the fifth decades was increased. 3. Among standard allergens, nickel sulphate showed the highest positive rate in all defined triple periods, whereas positive rates of neomycin sulphate & balsam of Peru were diminishing sequentially. Among fragrance allergens, cinnamic alcohol & cinnamic aldehyde revealed the highest positive rates. 4. In as is test, skin care products showed the highest positive rate, followed by toiletries and makeup products. Increasing positive rates of the toiletry products were observed in order of time. In fragrance products, positive rates reached their peak in the second period and declined in the third period. CONCLUSION: This study showed that perfume components were the most frequent allergens in cosmetics followed by preservative agents. Our study showed that comestic allergies in men seems to have increased.
Age Distribution ; Allergens ; Dermatitis ; Dermatitis, Allergic Contact ; Dermatitis, Contact* ; Humans ; Hypersensitivity ; Male ; Neomycin ; Nickel ; Patch Tests* ; Perfume ; Peru ; Skin Tests

BACKGROUND: Psoriatic lesions have reduced water-holding capacity and show increased transepidermal water loss (TEWL). The effect of D-PUVA therapy, which combines topical calcipotriol and PUVA therapy, on epidermal barrier function has not yet been evaluated. OBJECTIVE: The purpose of this study was to verify the change of TEWL in lesional and normal skin according to D-PUVA therapy in psoriasis patients. METHODS: TEWL was measured consecutively by TEWAMETER TM210®, in 13 psoriasis patients who received D-PUVA therapy. Clinical grading was done according to psoriasis severity index (PSI). RESULTS: TEWL of psoriatic lesion decreased as D-PUVA continued. TEWL of normal-looking skin gradually increased, although the increase was trivial. Clinical grading of scale and in-filtration followed the pattern of PSI in the decrease of TEWL, while that of erythema did not. CONCLUSION: In psoriatic plaques, TEWL was decreased according to the improvement. In normal-looking skin, D-PUVA therapy caused only a little effect on TEWL.
Erythema ; Humans ; Psoriasis ; PUVA Therapy ; Skin ; Water*

No abstract available.
Allografts* ; Humans ; Living Donors* ; Risk Factors*

PURPOSE: Sulphomucin is secreted by immature foveolar cells of the stomach and is expressed in gastric adenocarcinomas. Carcinoembryonic antigen (CEA) is well known to be expressed in gastric adenocarci nomas and is correlated with the cellular differentiation of gastric adenocarcinomas. However, at the moment, there are no conclusions about the relationships between the expression of sulphomucin and pathological classifications. METHODS: This study was designed to determine the significance of expression of sulphomucin and CEA in advanced gastric adenocarcinomas. Also, these two factors were compared with established clinicopathological prognostic factors. Thirty-two paraffin-embedded surgical specimens of gastric adenocarcinomas were obtained from January 1993 to December 1995 and were selected for study. The expressions of sulphomucin and CEA were studied by using the Spicer method and immunohistochemical staining with CEA 2-7 monoclonal antibody. RESULTS: The expressions of sulphomucin and CEA were positive in 9 (28%) cases and 25 (78%) cases, respectively. There was a significant correlation between sulphomucin expression and histologic differentiation (p<0.05). However, the expression of CEA was correlated with neither clinopathological factors nor sulphomucin expression. CONCLUSION: These results suggest that expressions of sulphomucin are well correlated with cellular differentiations of advanced gastric adenocarcinomas.
Adenocarcinoma* ; Carcinoembryonic Antigen ; Classification ; Noma ; Stomach