We experienced a case of venous hemangioma occuring on the inner aspect of right forearm of 40-year-old woman. The skin lesion was slight tender, pea sized, dark brown surfaced, subcutaneous mass. The entire dermis was filled with numerous coiled thick walled vessels surrounded by fibrous stroma on the histopathologic examination. The wall, lined by a single layer of endothelial cells, lacked elastic fibers on the specimen of Verhoeff-Van Gieson and Massons trichrotne stains.
Adult ; Coloring Agents ; Dermis ; Elastic Tissue ; Endothelial Cells ; Female ; Forearm ; Hemangioma* ; Humans ; Peas ; Skin

BACKGROUND: Aplastic anemia is an uncommon disease characterized by marrow hypocellularity, resulting in a reduction of the counts of circulating red blood cells, neutrophils, and platelets. The etiology of aplastic anemia remains unknown in the majority of cases. An association of aplastic anemia with pregnancy has been reported but the strength of such a relationship remains somewhat controversial. OBJECTIVE: To evaluate the association of aplastic anemia with pregnancy and the optimal management of patients with aplastic anemia during pregnancy. METHODS: This retrospective study was done by review of medical records of 18 patients with aplastic anemia, of whom 8 patients were diagnosed before pregnancy and 10 patients were diagnosed during pregnancy, who had a total of 25 pregnancies after the diagnosis from January, 1990 to October, 1997 at the Seoul National University Hospital, RESULTS: The incidence of aplastic anemia during pregnancy was one in 806 persons(18/14, 507) in this study. During pregnancy, the circulating blood cell levels decreased in all pregnancies. In all 7 cases that showed a relapse during pregnancy the remission occurred following the termination of pregnancy. 12 patients presenting with severe aplastic anemia during pregnancy had poorer hematological improvement than patients with mild aplastic anemia after termination of pregnancy. CONCLUSION: In all patients with aplastic anemia during pregnancy the circulating blood cell levels decreased. The successful outcome in these cases illustrates the benefit of modern supportive care in the management of such patients. The present observations suggest that a pregnancy which occurs during the long-term remission of aplastic anemia may be allowed to progress to birth.
Anemia* ; Anemia, Aplastic ; Blood Cells ; Bone Marrow ; Diagnosis ; Erythrocytes ; Female ; Humans ; Incidence ; Medical Records ; Neutrophils ; Parturition ; Pregnancy ; Pregnant Women* ; Recurrence ; Retrospective Studies ; Seoul

PURPOSE: Status epilepticus (SE) is a pathologic state where pharmacokinetic alterations can be more pronounced and more rapid than during the other epileptic states. The consequences of such changes can exert negative influences on the timely adequate treatments for stopping uncontrolled seizures during SE. Topiramte (TPM) is one of new antiepileptic drugs with high efficacy in epilepsy, which can also be effectively used in SE. The aim of this study was to evaluate the pharmacokinetic changes during the SE by an analysis of the therapeutic drug monitoring (TDM) of TPM in patients with SE.METHODS: We retrospectively analyzed 49 serum measurements of TPM from 22 subjects with SE. The serum concentrations of TPM were measured by HPLC-tandem mass spectrometry. TDM data were categorized into malignant status epilepticus (MSE), refractory status epilepticus (RSE), and non-status epilepticus (NSE) groups. We compared concentration-to-dose ratio (CDR) among those groups.RESULTS: Among 49 cases, 11 were in MSE, 19 in RSE, and 19 in NSE. The daily dose of TPM was higher in MSE (median, interquartile range: 600, 600-800 mg) than in RSE (300, 250-600 mg) and NSE (200, 150-400 mg). The daily dose adjusted for body weight was also higher in MSE (12.2, 10.4-13.9 mg/kg) than in RSE (4.5, 3.8-12.2 mg/kg) and NSE (4.1, 2.3-7.1 mg/kg) (p<0.01). Serum concentrations of TPM were less in MSE (5.8, 4.2-7.3 mg/L) and RSE (4.9, 2.9-6.0 mg/L) than in NSE (5.5, 3.3-9.0 mg/L), which were not significantly different among the groups (p>0.1). However, the concentration-to-dose ratio (CDR) was significantly lower in MSE (0.41, 0.35-0.59 kg/L) and RSE (0.85, 0.39-1.23 kg/L) than in NSE (1.72, 0.96-2.24 kg/L) (post hoc analysis, p<0.005, 0.05).CONCLUSIONS: The serum concentrations of TPM can be influenced by SE, particularly in MSE. The higher range of dose of TPM could be needed for an adequate treatment of SE.
Anticonvulsants ; Body Weight ; Drug Monitoring ; Epilepsy ; Fructose ; Humans ; Mass Spectrometry ; Retrospective Studies ; Seizures ; Status Epilepticus