A few cases of reticulate acropigmentary disorders have been reported in Korea. Most of them were reticulate acropigmentation of Kitamura, but not acropigmentation symmetrica of Dohi. A 21 year-old male patient diagnosed as acropigmentation symmetrica of Dohi had been previously treated with various treatment methods unsuccessfully. Re-treatment with the Q-switched alexandrite laser(755 nm, 100nsec) showed a temporary improvement but a relapse of the lesion was experienced again. We describe a case of acropigmentation symmetrica of hi treated with the Q-switched alexandrite laser.
Humans ; Korea ; Lasers, Solid-State* ; Male ; Recurrence

BACKGROUND: To evaluate depressure effect and safety of delapril, a new ACE inhibitor, in Korea. METHOD: Thirty three patients, aged 37-69, with mild to moderate essential hypertension were first observed for 2 weeks with placebo followed by administration of 15mg of delapril twice daily for 2 weeks, then doubled dosage to 30mg b.i.d. and combined with 25mg of dihydrochlorothiazide if optimal BP were not obtained at the end of 4th week, continued the same dose until the end of 10 week's trial period. RESULT: BP dropped 15/9mmHg inaverage at the end of 10th week rewarding 70% of cumulative effectiveness. Most frequent side reaction was dry cough, occurred in 9% of patients followed by chest tightness, headache, constipation and transient elevation of GPT. CONCLUSION: Delapril 15-30mg twice daily as monotheraphy or combined with diuretics is well tolerated and effective in the treatment of mild to moderate essential hypertension.
Constipation ; Cough ; Diuretics ; Headache ; Humans ; Hydrochlorothiazide ; Hypertension* ; Korea ; Reward ; Thorax

Urethral duplication is rare congenital anomaly. It may be complete or partial, We report a case of PPNG urethritis which limited to the accessory urethra and treated with kanamycin (2. 0gm, im), ampicillin(3. 5gm, po) and probenecid(l pgm, po).
Kanamycin ; Urethra* ; Urethritis*

To evaluate the possible functional role of serum during the process of parturition, 15 serum samples were collected and analyzed for the nickel concentrations in each 3 groups(Group 1 for the period during parturition, Group 2 for the period from delivery of fetus to delivery of placenta, and Group 3 for the period after delivery of placenta) of normal, uncomplicated full term vaginal delivery and one control group composed of healthy unmarried women in 3rd decades of age. Data revealed that average serum nickel concentration of Group 2(26.6 microgram/l) and Group 1(22.2 microgram/l) were significantly higher than that of Control group(13.7 microgram/l), but Group 3's(13.8 microgram/l) was almost same as Control group's. There were significant negative correlation between age and serum nickel concentration in group 2, and a tendency of higher nickel concentration in women who have no previous experiences of pregnancy than who have previous experiences of pregnancy, although it was not significant. These result could be indicative of close causal relationship between serum nickel concentration and the entire process of parturition.
Female ; Fetus ; Humans ; Nickel* ; Parturition ; Placenta ; Pregnancy ; Single Person

Early and delayed 201Tl SPECT studies were performed on 20 patients with intracranial meningioma who were classified into 4 groups according to Helsinki Grading System: Grade I: benign(n=15), Grade II: atypical(n=5), Grade III: anaplastic(n=0) and Grade IV: sarcomatous(n=0). The early uptake indices(eTl, ratios of average counts/pixel in the lesion to those of contralateral area on early image) were relatively high in all types: Grade I, 3.05+/-1.44(mean+/-standard deviation): Grade II, 2.66+/-1.29. There was no statistical difference in relation to pathological grade. The delay uptake indices were 2.64+/-1.34 and 2.67+/-1.31 respectively, there was no statistical difference in relation to pathological grade. The retention indices(RI, ratios of delay to early uptake indices) were 0.92+/-0.35, 1.04+/-0.36 respectively. there was no statistical differences in relation to pathological grade. In ten cases presenting mitosis, RI was 1.11+/-0.30. But other cases not presenting mitosis RI was 0.80+/-0.34. There was significant difference between two groups p<0.05. The 99mTc-MIBI SPECT study was performed in 14 patients who classified into 4 group: Grade I(n=10) and Grade II(n=4). The uptake ratios were high in all types: Grade I, 6.70+/-3.63 and Grade II, 5.40+/-0.92. There were no statistical difference. In this study, there was no malignant case(Grade III, IV). In summary, if the further study including malignant cases, this study would aid in overcoming to overcome the limitation of CT, MRI about tumor differentiation, with regards to possible detection of presence of residual tumor and viability of tumor after treatment.
Humans ; Magnetic Resonance Imaging ; Meningioma* ; Mitosis ; Neoplasm, Residual ; Tomography, Emission-Computed, Single-Photon*

Mycoplasma pneumoniae is a common cause of respiratory tract infections and typically causes mild disease. Extrapulmonary manifestations of M. pneumoniae infection are also common, but rhabdomyolysis is a rare complication. Here, we describe the case of a previously healthy 23-year-old male who displayed the simultaneous onset of rhabdomyolysis and severe pneumonia requiring mechanical ventilation. Both conditions were resolved by a 10-day course of antimicrobial treatment and the patient was discharged without complication.
Humans ; Male ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Respiration, Artificial ; Respiratory Tract Infections ; Rhabdomyolysis ; Young Adult

Purpura fulminans may be seen in three different clinical settings: (1) in the neonatal period from protein C and S deficiencies, (2) during severe bacterial infections such as “sepsis-associated” purpura fulminans, and (3) during the convalescence of an otherwise benign “preparatory” infectious disease most commonly involving the skin. We report a case of a 20-month-old male child with purpura fulminans as a presenting sign of disseminated intravascular coagulopathy (DIC). He had suffered from fever of unknown origin for a month. Although purpura fulminans is not a common disorder to dermatologists, the awareness of this disorder may be the clue to diagnose and treat underlying diseases.
Bacterial Infections ; Child ; Communicable Diseases ; Convalescence ; Fever of Unknown Origin ; Humans ; Infant ; Male ; Protein C ; Purpura Fulminans* ; Purpura* ; Skin

To systematically review relevant literature on efficacy and safety of immune checkpoint inhibitors (ICIs) in patients with advanced and metastatic urothelial cell cancer (UCC), renal cell cancer (RCC), and prostate cancer. In platinum pretreated UCC, efficacy of pembrolizumab was superior to chemotherapy, with longer median overall survival (OS; 10.3 months vs. 7.4 months), a higher objective response rate (ORR; 21.1% vs. 11.4%, p=0.001), and a lower adverse event rate (60.9% vs. 90.2%). Three randomized controlled trials (RCTs) assessed the safety and efficacy of nivolumab in advanced RCC. The median OS (25.0 months vs. 19.6 months) and the ORR (25% vs. 5%) were higher in patients treated with nivolumab compared with second-line everolimus. In patients with metastatic castration-resistant prostate cancer, 2 RCTs were identified, which did not show significant benefits for ipilimumab over placebo. In UCC and RCC, there was no conclusive association between programmed cell death receptor ligand 1 (PD-L1) expression in tumor tissue and clinical outcome during pembrolizumab and nivolumab treatment, respectively. Therefore, in metastatic UCC and RCC, pembrolizumab and nivolumab have superior efficacy and safety to second-line chemotherapy and everolimus, respectively. No beneficial effect of ipilimumab was observed in prostate cancer patients. PD-L1 expression status is currently not suitable as a predictive marker for treatment outcome.
Carcinoma, Renal Cell ; Cell Death ; Drug Therapy ; Everolimus ; Humans ; Immunotherapy ; Platinum ; Prostatic Neoplasms ; Treatment Outcome ; Urologic Neoplasms

Sheehans syndrome is a known complication of pregnancy, It was described as a syndrome of hypopituitarysm due to acute ischemic necrosis of the anterior pituitary gland secondary to severe postpartum bleeding and shock. The neurophysis is usually preserved. But it can be involved in severe cases manifesting as diabetes insipidus. Because of its rare coexistence with Sheehans syndrome, diabetes insipidus is seldom recognized as a potential postpartum complication. The report describes a patient who developed Sheehans syndrome and diabetes insipidus immediately following delivery. Diabetes insipidus resolved spontaneously after 15 months, while panhypopituitarysm is persistent.
Diabetes Insipidus ; Hemorrhage ; Humans ; Hypopituitarism ; Necrosis ; Pituitary Gland, Anterior ; Postpartum Hemorrhage ; Postpartum Period ; Pregnancy ; Shock

We experienced a case of Ebstein's anomaly prenatally by fetal sonography. Ebstein's anomaly is a rare congenital heart defect characterized by abnormally downward displacement of the septal and posterior leaflets of the tricuspid valve. In the absence of tricuspid regurgitation, this condition may be completely asymptomatic. On the other hand, symptomatic newborns often develop life-threatening congestive heart failure. A 30-year-old multiparous woman was referred for the evaluation of fetal cardiac defect at 26th gestational week from a private clinic. Fetal ultrasonography showed markedly enlarged right atrium and downward displacement of tricuspid valve into the right ventricle. After discussion with the patient, the pregnancy was terminated and Ebstein's anomaly was confirmed by autopsy.
Adult ; Autopsy ; Ebstein Anomaly* ; Female ; Hand ; Heart Atria ; Heart Defects, Congenital ; Heart Failure ; Heart Ventricles ; Humans ; Infant, Newborn ; Pregnancy ; Tricuspid Valve ; Tricuspid Valve Insufficiency ; Ultrasonography, Prenatal