The prevalence of latex allergies has been on the increase along with the greater use of rubber products in daily life, medical, dental and occupational settings. Allergic reactions to latex can take two clinical forms of either contact dermatitis or immediate hypersensitivity reactions, which are provoked by the natural latex proteins or chemical additives used in the manufacturing process, respectively. A 25-year-old female, an operating room nurse, complained of recurrent pruritic erythematous wheals on both hands after the wearing of latex rubber gloves. The prick test and the usage Mlit't to the latex gloves were positive, and the RAST was class 3. To the best of our knowledge, is the first case report of contact urticaria from latex rubber gloves in Korean dermatologic literature.
Adult ; Dermatitis, Contact ; Female ; Hand ; Humans ; Hypersensitivity ; Hypersensitivity, Immediate ; Latex Hypersensitivity ; Latex* ; Operating Rooms ; Prevalence ; Rubber ; Urticaria*

Primary carcinoma of the bile ducts is an uncommon lesion that is difficult to diagnosis in early stage. Correct diagnosis with determination of site and extent of the carcinoma is essential for proper management. Authors presented 35 cases of bile duct carcinoma, confirmed at Seoul National University Hospital from 1978 to 1981, and analyzed their clinical and radiological findings. The results were as follows; 1. The 6th decade was the predilection age, and the ratio of male to female was 4:3. 2. The locations of bile duct carcinomas were common bile duct in 31%, porta hepatis in 26%, junction in 17%, diffuse involvement in 17%, and common hepatic duct in 9% in order of frequency. 3. Ultrasonography was done in 31 cases. Dilatation of intrahepatic ducts was noticed in 28 cases. Among the 28 cases, correct diagnosis as bile duct carcinoma were made in 5 cases. Proximal obstructive patterns were observed in 14 cases and distal obstructive patterns in 9 cases. 4. ERCP was done in 15cases. Successful studies of ERCP were done in 8 cases of them. Among the cases, diagnosis as bile duct carcinoma were made in 4 cases. 5. PTC was done in 20 cases and successful in all of them. Correct diagnosis as bile duct carcinoma were made in 16 cases and the diagnostic accuracy was 80%.
Bile Ducts ; Bile ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Diagnosis ; Dilatation ; Female ; Hepatic Duct, Common ; Humans ; Male ; Seoul ; Ultrasonography

The changes of electroencephalogram(EEG) in patients with dementia are most commonly studied by analyzing power or magnitude in certain traditionally defined frequency bands. However because of the absence of on identified metric which quantifies the complex amount of information, there are many limitations in using such a linear method. According to chaos theory, irregular signals of EEG cal also result from low dimensional deterministic chaos. Chaotic nonlinear dynamics in the EEG can be studied by calculating the correlation dimension. The authors have analyzed EEG epochs from three patients with dementia of Alzheimer type and three matched control subject. The result showed that patients with dementia of Alzheimer type had significantly lower correlation dimension than non-demented controls on 12 channels. Topographic analysis showed that the correlation dimensions were significantly lower in patients with Alzheimer's disease on frontal, temporal, central, and occipital head regions. These results show that brains of patients with dementia with dementia of Alzheimer type have a decreased complexity of electrophysiological behavior. We conclude that the nonlinear analysis such as calculating correlation dimension can be a promising tool for detecting changes in the complexity of brain dynamics.
Alzheimer Disease ; Brain ; Dementia* ; Electroencephalography* ; Head ; Humans ; Nonlinear Dynamics*

Dyskeratosis congenita is a rare genodermatosis of ectodermal dysplasia, which is characterized by the diagnostic triad consisting of reticulated hyperpigmentation, dystrophic nails, and leukoplakia. There is a predisposition to malignancy, particularly at sites of leukoplakia. Bone marrow failure can occur in about a half of the cases. A 16-year-old boy was presented with asymptomatic reticulated pigmentation of the neck and nail dystrophy. The patient also had leukoplakia on the tongue, nasolacrimal duct obstruction and cataract. The histopathological findings taken from the reticulated lesion were consistent with poikiloderma atrophicans vasculare. These clinical and histopathological findings were typical features of dyskeratosis congenita.
Adolescent ; Bone Marrow ; Cataract ; Dyskeratosis Congenita* ; Ectodermal Dysplasia ; Humans ; Hyperpigmentation ; Leukoplakia ; Male ; Nasolacrimal Duct ; Neck ; Pigmentation ; Tongue

The May-Hegglin anomaly is a rare autosomal dominant trait characterized by platelet abnormalities in the peripheral blood and large (up to 5mu) pale blue staining inclusions in the cytoplasm of neutrophils, eosinophils, basophils, and monocytes. We experienced a case of May-Hegglin anomaly in a 7 year old male and another case out of his family. His initial complaints at the admission were petechiae and intermittent epistaxis. Diagnosis was confirmed by peripheral blood smear and family study. We report the case with brief review of related literature.
Basophils ; Blood Platelets ; Child ; Cytoplasm ; Diagnosis ; Eosinophils ; Epistaxis ; Humans ; Male ; Monocytes ; Neutrophils ; Purpura

Elastofibroma is a rare disease which presents as a slowly-growing, solid, ill-defined fibroelastic mass occuring almost exclusively in elderly women and arising mainly from the connective tissue between the lower part of the scapula and chest wall. Of the 270 cases of elastofibroma which have been reported, 170 cases had developed in Japanese patients. Despite the fact that there have been only two case reports in Korea, there might be a higher prevalence of elastofibroma in Korea than expected because of geographical similarity. We experienced a case of elastofibroma occurring in a 56-year-old man. To our knowledge, this is the first case report of elastofibroma in Korean dermatologic of literature.
Aged ; Asian Continental Ancestry Group ; Connective Tissue ; Female ; Humans ; Korea ; Middle Aged ; Prevalence ; Rare Diseases ; Scapula ; Thoracic Wall

No abstract available.
Lissencephaly* ; Walker-Warburg Syndrome

It was not above two or three decades from the changes began that regarding nicotine dependence as a kind of addictive disorder and a therapeutic target. Despite the short period of history, lots of medications were developed and showing significant clinical outcomes. In this review, we introduce the both of medications available at this time and in the status of developing for nicotine dependence. The clinical efficacies, practical ways of prescription, and common adverse events of the medications currently available are described through the survey of literatures. The novel medications in the process of developing are arranged by the proposed mechanism of action and summarized the phases of clinical trials at present. Among the diverse pharmacological tools now available, nicotine replacement and bupropion could be the first-line recommendation drugs and nortriptyline and clonidine could be the second-line recommendation drugs. Other medications like several antidepressants (e.g., moclobemide), buspirone, and naltrexone may be helpful in some specific population. Most of medications currently available have uncertainties in the aspects of their mechanisms of action except nicotine replacement materials; however, medications in developing have clearer neurobiological basis in their applications. Therefore, we can expect higher treatment outcomes by new products. Additionally, introduction of nicotine vaccines for high-risk group is drawing near. It could be possible for the individualizing for strategies of smoking cessation according to the patients' specific situation in a future.
Antidepressive Agents ; Bupropion ; Buspirone ; Clonidine ; Naltrexone ; Nicotine* ; Nortriptyline ; Prescriptions ; Smoking Cessation ; Tobacco Use Disorder* ; Vaccines

Alcohol and nicotine dependencies are known to be severe disorders on their own and particularly they get worse if they coexist. However, few optimal therapeutic approaches are available for comorbid nicotine and alcohol dependencies, although studies have suggested that more than 95% of alcoholics had comorbid nicotine dependence. Nonetheless patients, caregivers, and even health professionals gave a failure to notice of the health problems caused by nicotine dependence. In addition, some clinicians believe that concomitant intervention of nicotine dependence may have the risks increased during treatments of alcohol dependence, possibly by aggravating symptoms of alcohol dependence or provoking relapse. However, we need to give more attention onto the fact that harmful effects of alcohol and nicotine would be amplified when they coexist. In fact currently available data showed that medical morbidity may be dramatically increased when the two psychiatric conditions coexist. Furthermore, alcoholics have an increased tendency of smoking during a recovery phase from alcohol dependence and even may suffer more complications from smoking. Hence we will review the health risks posed by concurrent alcohol and nicotine dependencies as well as explore the effects of additional smoking cessation therapy on the quitting rate, the alteration of drinking behavior and relapse rate of alcohol dependence, in comorbid alcohol and nicotine patients. Finally proper smoking cessation therapy should be also provided for motivated patients to quit smoking at proper treatment phase and routine clinical advices should be appropriately provided for patients who are not motivated to quit smoking as well in clinical practice.
Alcoholics ; Alcoholism ; Caregivers ; Comorbidity ; Drinking Behavior ; Health Occupations ; Humans ; Nicotine ; Recurrence ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Use Disorder

Nicotine is the major substance that accounts for the addictive nature of smoking. Nicotine induces neurobiological and behavioral responses through diverse neurochemical mechanisms over the central nervous system. The brain reward system, particularly the dopaminergic pathway from the ventral tegmental area to nucleus accumbens, is central to understanding the behavioral reinforcement underlying substance addictions such as the addiction to nicotine. Nicotine acts as an agonist provoking activation or desensitization of nicotinic acetylcholine receptors in different brain areas including the brain reward system. Nicotine also indirectly influences the glutaminergic, GABAergic, noradrenergic, and serotonergic neurotransmission that lead ultimately to activation of the dopaminergic pathway in the brain reward system. Chronic exposure to nicotine activates neuroadaptation and associative learning with the nicotine-related stimulus through dopaminergic or cholinergic systems, which can lead to nicotine dependence or withdrawal. In sum, the neurobiological processes described above are deeply involved in the basis of nicotine dependence and underlie the frequent failure of attempts to quit smoking. In this review we discuss the neurobiological mechanisms of nicotine addiction focusing on the roles of the nicotinic acetylcholine receptor.
Brain ; Central Nervous System ; Dopamine ; Learning ; Nicotine ; Nucleus Accumbens ; Receptors, Nicotinic ; Reinforcement (Psychology) ; Reward ; Smoke ; Smoking ; Synaptic Transmission ; Tobacco Use Disorder ; Ventral Tegmental Area