Impetigo herpetiformis is a form of pustular psoriasis that occurs during pregnancy and may be life-threatening. The pathogenesis and etiology of impetigo herpetiformis is not clear, but several reports have associated onset of this disorder with hypocalcemia, hypoparathyroidism, and the use of oral contraceptives. The typical lesions are erythematous patches that are studded with tiny superficial pustules particularly coalescing at their margins causing pain, and a burning sensation. Laboratory findings include an elevated erythrocyte sedimentation rate, increased peripheral blood leukocyte counts, hypoalbuminemia, and in severe cases, hypocalcemia. The histopathology is the same as that of pustula psoriasis. Our patient, a 31 year-old female (Intra Uterine Pregnancy 28 weeks), was admitted to our hospital due to generalized skin eruption and severe constitutional symptoms. Her clinical features, laboratory and histopathologic findings were compatible with that of impetigo herpetiformis. In spite of our all efforts, intrauterine fetal death was noted at her 33rd week of pregnancy. We report a case of impetigo herpetiformis terminating in fetal death with the review of literature.
Adult ; Blood Sedimentation ; Burns ; Contraceptives, Oral ; Female ; Fetal Death* ; Humans ; Hypoalbuminemia ; Hypocalcemia ; Hypoparathyroidism ; Impetigo* ; Leukocyte Count ; Pregnancy ; Psoriasis ; Sensation ; Skin

No abstract available.
Humans

BACKGROUND AND OBJECTIVE: The aim of this study was to compare the residual diameter stenosis after PTCA with fractional flow reserve (FFR) and coronary flow reserve (CFR), and investigate the correlation between FFR and CFR in patients with acute myocardial infarction (AMI). MATERIALS AND METHOD: The study population consisted of twenty seven patients with myocardial infarction. Baseline and hyperemic average peak velocity (APV) were measured using Doppler wire 15 minutes after restoration of infarct-related artery (IRA). CFR was obtained by the ratio of distal hyperemic APV to baseline APV. Distal coronary arterial pressure (Pd) was measured with advancing the wire distal to the lesion of IRA. Simultaneous proximal aortic pressure (Pa) was measured using guiding catheter. Myocardial FFR was obtained by the ratio of hyperemic Pd to hyperemic Pa. RESULTS: Post-interventional CFR and FFR were 0.85+/-0.44, 0.91+/-0.09. CFR did not show significant correlation with luminal diameter stenosis (%ST). There was no significant correlation between FFR and CFR with a correlation coefficient of 0.29 (p=.25). But, significant correlation was found between %ST and FFR, %ST and hyperemic PG (hPG) with correlation coefficient of -0.70 (p=.0012) and 0.68 (p=.0018). CONCLUSION: In AMI patients, %ST has a significant correlation with FFR and hPG after PTCA. But, there was no significant correlation between FFR and CFR.
Arterial Pressure ; Arteries ; Catheters ; Constriction, Pathologic ; Humans ; Myocardial Infarction* ; Phenobarbital

PURPOSE: We compared estimates of ejection fraction (EF) determined by gated Tl-201 perfusion SPECT (g-TI-SPECT) with those by gated blood pool (GBP) scan. MATERIALS AND METHODS: Eighteen subjects underwent g-TI-SPECT and GBP scan. After reconstruction of g-TI-SPECT, we measured EF with Cedars software. The comparison of the EF with g-TI-SPECT and GHP scan was assessed by correlation analysis and Bland Altman plot. RESULTS: The estimates of EF were significantly different (p<0.05) with g-TI-SPECT (40%+/-14%) and GBP scan (43%+/-14%). There was an excellent correlation of EF between e-TI-SPECT and GBP scan (r=0.94, p<0.001). The mean difference of EF between GRP scan and g-TI- SPECT was +3.2%, Ninety-five percent limits of agreement were +9,8%. EF between g-TI-SPECT and GBP scan were in poor agreement. CONCLUSION: The estimates of EF by g-TI-SPECT was well correlated with those by GBP scan. However, EF of g-TI-SPECT doesn't agree with EF of GBP scan. EF of g-TI-SPECT cant be used interchangeably with EF of GBP scan.
Perfusion* ; Tomography, Emission-Computed, Single-Photon*

Aplasia cutis congenita is a congenital localized or widespread absence of the skin. We report a case of aplasia cutis congenita, type V, in a 6-day-old male infant born with the stellate and linear skin lesions covered by granulation tissue and soft capsule with slightly elevated erythematous edges on the trunk and lower extremities without any associated family history. The patient had amniotic bands and were diagnosed as aplasia cutis, type V. The patient received conservative treatment such as antiseptic dressing and prophylactic systemic antibiotics with healing of the ulcer.
Amniotic Band Syndrome ; Anti-Bacterial Agents ; Bandages ; Ectodermal Dysplasia* ; Granulation Tissue ; Humans ; Infant ; Infant, Newborn ; Lower Extremity ; Male ; Skin ; Ulcer

We present a case of hyaline vascular type Castleman disease involving the bilateral cervical lymph nodes. To our knowledge, no previous case of this localized form of the disease has been reported. Dynamic CT demonstrated a hypervascular pattern of enhancement, with central less enhanced areas that corresponded histologically to fibrosis. For the diagnosis of this uncommon lymph node disease, these findings might be helpful.
Diagnosis ; Fibrosis ; Giant Lymph Node Hyperplasia* ; Hyalin ; Lymph Nodes ; Neck*

Bipotent progenitors for T and natural killer (NK) lymphocytes are thought to exist among early precursor thymocytes or liver lymphocytes. The identification of such a progenitor population or mature NK cells in such organs remains undefined. Here we report the identification of a novel receptor of NK cells, p58 (HLA class I-specific inhibitory receptors), in fetal thymocytes and fetal liver lymphocytes. Our finding suggests the NK cells mature in the developmental stage during feta1 ontogeny. Flow cytometric analysis revealed p58 positive cells in thymocytes or in fetal liver lymphocytes and reverse transcription PCR also showed amplification of p58 RNA. The result of single stranded conformational polymorphism (SSCP) showed it discriminates one or two base pair differences of the p58 gene. Although the question still remains as to whether the expression of p58 is due to the NK cells or natural T cells, it is clear the p58 is expressed in fetal thymocytes or liver lymphocytes. And SSCP analysis using appropriate sets of primers used in this study, is helpful to study the diversity of p58.
Base Pairing ; Killer Cells, Natural ; Liver* ; Lymphocytes* ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Reverse Transcription ; RNA ; T-Lymphocytes ; Thymocytes*

No abstract available.
Aspirin* ; Coronary Aneurysm ; Mucocutaneous Lymph Node Syndrome*

The polyglandular autoimmune syndrome designates the dysfunction of endocrine and nonendocrine system involving two or more organs on the basis of an autoimmune mechanism. The autoimmune nature of these diseases has been based on the presence of lymphocytic infiltration in the affected gland, organ specific autoantibodies in the serum, cellular immune defects and an association with the HLA DR/DQ genes or immune response genes. This syndrome is usually classified into three classes and their etiology or pathogenesis is still not completely understood. A 28-year-old woman developed vitiligo and insulin dependent diabetes mellitus during the treatment of Graves' disease with antithyroid drug. She had a tendency of spontaneous ketonemia and serum c-peptide levels were low(0.21, 0.16ng/mL: fasting and glucagon stimulated). Thyrotrophin binding inhibitor immunoglobulin and pancreas iIslet cell cytoplasmic antibody were positive. We report here a case of polyglandular autoimmune syndrome, type III manifesting Graves' disease, vitiligo, and insulin dependent diabetes mellitus.
Adult ; Autoantibodies ; Bone Diseases ; C-Peptide ; Cytoplasm ; Diabetes Mellitus ; Fasting ; Female ; Genes, MHC Class II ; Giant Cells ; Glucagon ; Granuloma ; Graves Disease ; Humans ; Immunoglobulins ; Insulin ; Ketosis ; Pancreas ; Pedigree ; Thyrotropin ; Vitiligo

BACKGROUND: Irbersatan, an orally active antihypertensive agent, effectively reduce blood pressure by directly blocking angiotensin II receptors without any significant adverse effects. The purpose of this study is to evaluate the efficacy and safety of irbesartan in patients with mild to moderate hypertension. METHODS: This study enrolled 83 patients who had diastolic pressure above 95 mmHg and below 110 mmHg on two measurements. Sixty eight patients were administered 150mg of irbesartan, an angiotensin II receptor blocker, daily for four weeks as an initial dosage. If the sitting diastolic pressure was equal to or greater than 90 mmHg after a 4 week treatment period, the dosage was doubled until the end of 8 weeks. Baseline pressures, antihypertensive effect, side effects, laboratory findings were compared before and after treatment. RESULTS: Fourty two patients out of 53 patients having completed this study showed decreased blood pressure equal to or more than 5 mmHg of the sitting diastolic pressure (response rate=79%). Twenty one patients out of 53 patients showed normalized blood pressure below 90 mmHg of the sitting diastolic pressure (normalization rate=40%). The extent of decrease in diastolic and systolic blood pressure after eight week treatment was an average 11.7+/-10.1 mmHg and 16.3+/-18.9 mmHg, respectively (p<0.05). Nineteen ontoward side effects was observed in 17 patients out of 68 patients with medication (frequency of ontoward effects=25%). Only one case with headache was considered to be related to the medication. Abnormal laboratory findings were observed in eight patients, and only one case with elevation of bilirubin and ALT levels was considered to be related to the medication. CONCLUSION: In conclusion, irbesartan is a safe and effective antihypertensive drug in patients with mild to moderate hypertension with tolerable side effects.
Bilirubin ; Blood Pressure ; Headache ; Humans ; Hypertension* ; Receptors, Angiotensin