We report a case of lupus vulgaris following BCG vaccination in a 12-year-old male. The patient was vaccinated against tuberculosis on right shoulder 6 months ago. The erythemstous papular eruptions began to develop on the BCG vaccinated site 2 weeks after vaccination. The eruptions progressed to be pruritic, erythematous plaque which was flat, crescent shaped, and centrally covered by adherent scales for 6 months. Histopathological findings revealed tubercles and tuberculoid structures composed of epitheloid cells and Langhans giant, cells in the dermis. Caseation necrosis within the tubercles was slight or absent. In addition, there was an infiltrate of mononuclear cells around the tubercles. The skin lesions cleared after 6 months of treatment with oral isoniazid 300mg daily.
Child ; Dermis ; Humans ; Isoniazid ; Lupus Vulgaris* ; Male ; Mycobacterium bovis* ; Necrosis ; Shoulder ; Skin ; Tuberculosis ; Vaccination* ; Weights and Measures

Skin lipids are a major constituent of the epidermal barrier, impermeable to a great extent to many chemicals. The barrier cspacity of the skin must be diminished by its delipidization through extract of the fatty material. The objectives of this study were to determine the degree that lipids and proteins contribute to the binding of straturn corneum in percutaneous penetration of hydrocortisone following skin delipidization. The binding capacity of C-hydrocortisone partitioned to powdered stratum corneum without delipidization in 10 human subjects was 1,554.34+/-357.48 dpm, and when delipidization, was 2,234.68+/-761.12 dpm. The partitioning rate was 0.38% in powdered stratum corneum without delipidization in 10 subjects, and when with ddipidization, was 0.55%. The result that the binding capacity of hydrocortisone to stratum corneum with delipidization increased more than without delipidization are statistically significant (p<0.05).
Humans* ; Hydrocortisone* ; Skin

No abstract available.
Asian Continental Ancestry Group* ; Humans ; Humans* ; Sarcoma, Kaposi*

We report a case of acute graft-versus-host disease, which developed after bone marrow transplantation because of acute myelocytic leukemia in a 39-year old male, The pruritic, erythematous maculopapular eruptions began to developed on the perioral regions, and spreaded the face, the oral mucosa, both hands, and buttocks at the twenty fourth day after bone marrow transplanta.tion. The eruptions were confluent to form erythematous patches. Iistopathological findings show parakeratosis, lymphoid cell exocytosis, and papillary edema, lymphohistiocytic infiltration, and melanophage in the upper dermis, and basal vacuolation. He was treated systemically by methylprednisolone, and antilymphocytic globulin, and tapically by emollients and steroids.
Adult ; Bone Marrow ; Bone Marrow Transplantation ; Buttocks ; Dermis ; Edema ; Emollients ; Exocytosis ; Graft vs Host Disease* ; Hand ; Humans ; Leukemia, Myeloid, Acute ; Lymphocytes ; Male ; Methylprednisolone ; Mouth Mucosa ; Parakeratosis ; Steroids

It has been postulated that environmental factors, such as mechanical and sun injury, psychological stress, drugs, and infection, may play an important part in the development of psoriasis. The clinical picture and course in certain psoriatic patients, particularly in the palmo-plantar psoriasis and inverse or flexural psoriasis, may suggest involvement of an underlying trigger in the form of an irritant or a contact allergen. We report a case of flexural psoriasis in a 15-year-old man who had whitish scaly patches on the erythematous base on the inner aspects of the thighs and the buttocks including the inguinal areas and the perianal areas. The skin lesions had developed two days after wearing a diving suit overnight. The histopathological features were typical for psoriasis. The positive material by Korean standard patch test was p-phenylenediamine, i.e the ingredients of a diving suit. Therefore, our case strongly suggests involvement of an underlying trigger in the form of a contact allergen.
Adolescent ; Buttocks ; Diving* ; Humans ; Patch Tests ; Psoriasis* ; Skin ; Solar System ; Stress, Psychological ; Thigh

Rheumatoid arthritis is a chronic inflammatory systemic disease of young or middle aged adults, characterized by destructive and proliferative changes in the synovial membrane, periarticular structures, skeletal muscle and perineural sheath. Eventually, the joints are destroyed, ankylosed and deformed. Therfore, the aim of treatment is to keep the inflammatory process at a minimum, thereby preserving the joint motion, maintaining the health of muscle supplying motor power about the joint and preventing secondary joint stiffness and deformity. Surgical treatment in rheumatoid arthritis has progressed and there have been advances in the relief of pain and increase in the range of motion. Among them the results of total knee arthroplasty (TKA) have improved steadily during the past decade due to refinements in design, fixation, and surgical technique. At orthopedic department of seoul national university hospital, we performed 31 total knee replacement in 18 patients who had suffered from rheumatoid arthritis during the period from Aug. 1982 to Dec. 1988. Following results were obtained. 1. Knee score increased from 37.8 to 76.9. 2. Tibio-femoral angle was corrected from 0.9° valgus to 5.3° valgus. 3. Conplications were peroneal nerve palsy in 3 knees, instability in 1 knee, tuberculous arthritis in 1 knee. 4. In 25 out of 31 knees, good functional results were obtained.
Adult ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Congenital Abnormalities ; Humans ; Joints ; Knee ; Middle Aged ; Muscle, Skeletal ; Orthopedics ; Paralysis ; Peroneal Nerve ; Range of Motion, Articular ; Seoul ; Synovial Membrane

No abstract available.
Fetal Macrosomia*

No abstract available.
Candidiasis* ; Fluconazole*

BACKGROUND AND OBJECTIVES: Ventricular assist device(VAD) was developed for the bridge to cardiac transplantation, but the current research trends proceed to the purpose of bridge to cardiac recovery. We investigated the effects of long-term VAD implantation on the hemodynamic parameters related to the prognosis of heart failure by simulation to provide the preclinical and clinical applicability. MATERIAL AND METHODS: A moving-actuator type artificial heart developed by Seoul National University Artificial Heart Laboratory was used as a model of biventricular assist device. We set initial values of hemodynamic parameters according to the guideline of VAD implantation, and performed simulation of the change of hemodynamic variables related to successful device weaning and the prognosis of heart failure. RESULTS: Cardiac indices (CIs) at 1 hour and 6 months after VAD implantation were 2.98 l/min/m2 and 2.60 l/min/m2, respectively. Systolic/diastolic/mean aorta pressure were 121/84/99 mmHg at 6 months after VAD implantation. During pump-off state at 6 month, each value of hemodynamic parameters were as follows: CI 2.53 l/min/m2, pulmonary capillary wedge pressure 10 mmHg, left ventricular end-diastolic volume 105 ml, left ventricular ejection fraction 0.58, mean aorta pressure 84 mmHg, end-systolic wall stress 108 kdyn/cm2. Peak rate of change of power(peak dPWR(t)/dt) was 5.62x108 dyneXcm/s2 after 6-month VAD implantation. In a real VAD-implanted patient, simulation data were partly compatible with real hemodynamic data, especially in the aspects of predicting VAD weaning. CONCLUSION:Long-term VAD implantation partially improved the values of hemodynamic parameters related to the prognosis, and this simulation results will provide the basic concept and applicability of clinical trial for end-stage heart failure.
Aorta ; Heart Failure* ; Heart Transplantation ; Heart* ; Heart, Artificial ; Heart-Assist Devices ; Hemodynamics* ; Humans ; Prognosis ; Pulmonary Wedge Pressure ; Seoul ; Stroke Volume ; Weaning

Tension-free vaginal tape (TVT) has been accepted for a therapeutic modality of stress incontinence and presented as easy, safe, effective, and time-saving procedure with cure rate of more than 86% and another 11% significantly improved with no serious complication. However, there is not always safe without severe complications, because the TVT needle has to pass blindly through the pelvic cavity. Furthermore, it may be very serious once it happened. We, herein, present a case who bled to shock following TVT procedure but was controlled conservatively, and review its complications in the literatures.
Needles ; Shock ; Suburethral Slings* ; Vascular System Injuries*