We experienced an unusual case of acute encephalopathy in a 4 month-old boy He was admitted to our hospital because of lethargy and seizures after preceding symptoms of upper respiratory tract infection a few days before admission. On admission, he was in semicomatous mental state with decorticated rigidity. Laboratory tests showed normal blood sugar, ammonia, and transaminase levels. CSF was acellular and sterile. Brain MRI in both 71 and 72 weighted-image showed high signal density in both thalami and caudate nucleus head. After recovery, neurologic sequales of developmental delay, mental retardation, right hemiplegia and seizure remained. We report a case of acute encephalopathy that have clinical course similar to Reye syndrome but have specific brain image.
Ammonia ; Blood Glucose ; Brain ; Caudate Nucleus ; Head ; Hemiplegia ; Humans ; Infant ; Intellectual Disability ; Lethargy ; Magnetic Resonance Imaging ; Male ; Respiratory Tract Infections ; Reye Syndrome ; Seizures

Contact urticaria refers to a wheal-and-flare response after cutaneous exposure to certain chemicals. If contact urticaria is accompanied by systemic symptoms, it is referred to as contact urticaria syndrome. Herein we report two cases of contact urticaria syndrome occur-ring in nurses due to occupational exposure to cefotiam.
Cefotiam ; Occupational Exposure ; Urticaria*

Microcystic meningioma, a distinct morphological variant of meningiomas, is histologically characterized by a vacuolated appearance with multiple cystic spaces lined by vacuolated or stellate-shaped tumor cells. We report a case of microcystic meningioma occuring in right frontoparietal area of 42-year-old woman, with emphasis on differential diagnosis, along with a review of literatures. Immunohistochemically, most of the tumor cells demonstrated positive immunoreactivity for both epithelial membrane antigen and vimentin. Electron microscopy showed that the extracellular space was extensive, where eletron-lucent material was occasionally seen. The tumor cells had long cytoplasmic processes showing complex interdigitation and a large number of desmosomes.
Female ; Humans ; Diagnosis, Differential ; Meningioma

No Abstract Available.
Tinea Capitis* ; Trichophyton*

Cutaneous neuromas are uncommon, and three true neuromas exist in the skin: palisaded encapsulated neuroma, multiple mucosal neuroma, and traumatic neuroma. Traumatic neuroma is usually a solitary, skin-colored or pink, firm papule or nodule at the site a of scar following local trauma. The patient was a 51-year-old female and presented with a solitary 1X2X1.5cm sized erythematous to brownish tender polypoid firm mass on the left shoulder for 24 years. Although she could not remember any history of trauma or surgery on the lesional area, this case could be considered as traumatic neuroma on the basis of both the clinical and characteristic histological features and by ruling out other types of neuroma.
Cicatrix ; Female ; Humans ; Middle Aged ; Neuroma* ; Shoulder ; Skin

BACKGROUND: The terminal destruction of the striatal dopaminergic axon can produce the retrograde degeneration of nigral dopaminergic neurons. An analyses of the postsynaptic dopamine D1 & D2 receptors and the DOPAC/DA level, revealed that this model mimics the early course of Parkinson's disease in humans. We evaluated the time course of the retrograde dopaminergic neuronal degeneration and the pattern of dopaminergic neuronal loss in the substantia nigra after various doses of 6-hydroxydopamine (6-OHDA) injections in the striatum of rats. METHODS: Different doses of 6- OHDA (0.0, 1.25, 2.5, 5, 10 ug/ul in 3.5 ul of saline) were unilaterally injected into the right striatum of rats using a stereotaxic frame. Structural and functional deficits were quantified and compared using apomorphine-induced rotations and tyrosine hydroxylase-immunoreactive (TH-IR) cell numbers in the substantia nigra pars compacta (SNpc) at 3, 6, 9 weeks after lesioning. RESULTS: Striatal 6-OHDA lesions produced dose-dependent decreases in TH-IR cell numbers in SNpc at 3 weeks (-3.8%, 17.9%, 41.2%, 58.5%, 69.9% cell loss compared with the contralesional side respectively), where the ventrolateral portion of the SNpc were more affected. As time progressed, nigral cell loss was significantly increased in all dosage groups and the lesion extended to the medial side of the SNpc and the ventral tegmental area. Apomorphine-induced rotations did not correlate well with nigral TH-IR cell loss. CONCLUSIONS: Intrastriatal injections of 6-OHDA, results in time-dependent and dose-dependent progressive degeneration of nigral dopaminergic neurons. We conclude that this rat model can be useful for the evaluation of further neuroprotective and neurotrophic therapies.
Animals ; Apoptosis ; Axons ; Cell Count ; Cell Death ; Dopamine* ; Dopaminergic Neurons ; Humans ; Models, Animal ; Oxidopamine* ; Parkinson Disease ; Rats* ; Retrograde Degeneration ; Substantia Nigra ; Tyrosine ; Ventral Tegmental Area

Tsutsugamushi disease cases occur throughout the rural area in Korea, and the number of the reported cases has been increased recently. Tsutsugamushi disease is a kind of rickettsiosis, and causative organism of that is Rickettsia tsutsugamushi. The field rodents, especially Apodemus agrarius, are the animal hosts, and main vector is chigger, Leptotrombidium pallidum. The pathogen is transmitted to human via this chigger bite. We experienced 60 cases of tsutsugamushi disease at Uijungbu Saint Mary's Hospital from January 1993 to December 1996. A group(study group) consists of 8 patients. They complained of abdominal (RUQ or epigastric) pain and had a finding of GB wall thickening by ultrasonogram and computerized tomogram. B group (control group) consists of 52 patients. They had no abnormal findings of GB by that. A clinical analysis of those patients was done retrospectively. Then A group was compared to B group. The obtained results were as follows. 1) All patients(A group and B group) those visited emergency room from October to December complaining of fever had lived at north area of Kyonggi-Do and had experienced outdoor play in field two weeks before expression of symptoms. 2) Percentage of leukocytopenia was 26%(2/8 cases) and 10%(5/52 cases) in A and B group respectively. Thrombocytopenia was found in many patients, and serum AST and ALT level was elevated in all patients of A and B group. 3) Percentage of patients with hypoalbuminemia was 87%(7/8 cases) and 67%(35/52 cases) in A and B group respectively. 4) Mean age of A group patients was higher than that of B group patients(A:62.4, B:49-years-old), and only all patients of A group had abdominal pain and hyperbilirubinemia. 5) Mean thickness of GB wall in A group patients was 7.3 mm(range 4~14 mm) by ultrasonogram. Conclusively, tsutsugamushi disease should be considered as differential diagnosis when old patient with fever and abdominal pain visits ER in endemic area of that despite jaundice, leukocytopenia, thrombocytopenia, and GB wall thickening founded by ultrasonogram.
Abdominal Pain* ; Animals ; Diagnosis, Differential ; Emergency Service, Hospital ; Fever ; Gyeonggi-do ; Humans ; Hyperbilirubinemia ; Hypoalbuminemia ; Jaundice ; Korea ; Leukopenia ; Murinae ; Orientia tsutsugamushi ; Retrospective Studies ; Rodentia ; Saints ; Scrub Typhus* ; Thrombocytopenia ; Trombiculidae ; Ultrasonography

BACKGROUND: Dimethyl sulfoxide (DMSO) acts as an urticariogenic agent or a primary irritant, and a DMSO skin test which measures responses in skin after exposure for 5 minutes could be a simple and easy method in evaluating cutaneous irritation . Atopy is a hereditary allergy (such as atopic dermatitis, allergic rhinitis, asthma, or hay fever) characterized by symptoms produced upon exposure to the exciting antigen without inoculation . Some atopy such as atopic dermatitis are more likely to be susceptible to various irritants and have defects in cutaneous barrier function. OBJECTIVE: The purpose of this study was to compare the differences of cutaneous responses between atopy patients (atopic dermatitis and respiratory atopy) and normal persons after skin irritation with several concentrations of DMSO. METHODS: We used DMSO concentrations of 90%, 95% and 100%, and evaluated the skin responses such as visual scores by wheal, transepidermal water loss (TEWL) and erythema index (E-index) after DMSO testing on the forearm skin of atopic dermatitis patients, respiratory atopy patients and normal healthy persons. RESULTS: 1. The TEWL values were increased as DMSO concentrations increased, and both baseline and postirritation TEWL values of the lesional area in atopic dermatitis patients were higher than in normal areas of atopic dermatitis patients and in respiratory atopy patients and in normal persons. There were no maj or differences in baseline and postirritation TEWL values among the last three groups. 2. Both baseline and postirritation E-index of the lesional area in atopic dermatitis patients were higher than in normal areas of atopic dermatitis patients and in respiratory atopy patients and in normal persons . There were no significant increases in E-index after irritation with 90% and 95% DMSO of normal areas of atopic dermatitis patients and 95%, 100% DMSO of normal persons. Also, there were no differences in baseline and postirritation E-index among normal areas of atopic dermatitis patients and respiratory atopy patients and normal persons . 3.The visual scores were increased as DMSO concentrations increased. The visual scores of the lesional area in atopic dermatitis patients were likely to increase as DMSO concentrations increased than in normal areas of atopic dermatitis patients and in respiratory atopy patients and in normal persons. There were no differences in visual scores among normal areas of atopic dermatitis patients and respiratory atopy patients and normal persons. CONCLUSION: The lesional skin of atopic dermatitis is more susceptible to DMSO irritation. However, there were no significant differences in susceptibility to DMSO irritation between the normal skin of atopic dermatitis, the skin of respiratory atopy and the control group.
Asthma ; Dermatitis ; Dermatitis, Atopic ; Dimethyl Sulfoxide* ; Erythema ; Forearm ; Humans ; Hypersensitivity ; Irritants ; Rhinitis ; Skin Tests ; Skin*

The kidney and balances of fluid and volume are the basic components of bloocl pressure control, and the kidney is the primary site that initiates the hypertensive process and is affected by hypertensive vascular disease. In the kidney, the dopamine is a potent natriuretic and vasodilating agent, participat- ing in renal sodium excretion and maintenance of cardiovascular homeostasis. And the dopamine receptors in central nervous system and peripheral organs were identified by physiological, biochernical and radioligand binding techniques. Rut previous morphological and biochemical studies have been unable to characterize or determine the tissue distribution of the dopamine receptor subtypes because no selective ligands are available yet. Furthermore, the cellular distribution of the dopamine receptor subtypes in the rat kidney is not demonstrated well. In the SHR, the ability of exogenous and endogenous renal dopamine to engender a natriuresis is impaired. Since renal dopamine levels in genetic models of hypertension are not lower than their normotensive controls, the impaired intrarenal paracrine effect of dopamine in these animal models of hypertension appears to be receptor or postreceptor mediated. And renal dopamine derives mainly from renal tubular dopamine production and to a lesser extent from dopaminergic nerves. The present study utilizes imrnunohistochemistry with specific antibodies to characterize the renal distribution of dopamine receptor subtypes and recognize the role of dopamine receptor defect in the pathogenesis of hypertension in 14-week-old WKY (mean HP 108+/-5mmHg) and SHR (mean RP 174+/-7 mmHg) kidneys. Also it utilizes antibody of tyrosine hyclroxylase (TH) to recognize the site of the dopamine production mediated by TH using light microscopic immunohistochemistry. In the immunohistochemistry of the WKY kidney, dopamine D1 receptor protein is localized to glomerulus, proximal tubule, distal tubule, renal vessels, cortical and medullary collecting duct. And in the SHR kidney, dopamine D1 receptor protein is localized to glomerulus, distal tubule, renal vessels, cortical and medullary collecting duct, and juxtaglomerular apparatus (JGA). But there is no demonstrable positive reaction in the proximal tubule and weakly positive reactions in the renal arterioles of SHR compared with WKY kidney. In the immunohisto-chemistry of the WKY kidney, dopamine D1 receptor protein is localized to glomerulus, proxirnal tubule, distal tubule, renal vessels, cortical and rnedullary collecting duct. And in the SHR kidney, dopamine D2 receptor protein is localized to glomerulus, distal tubule, renal vessels, cortical and medullary collecting duct, and JGA. So, there is no demonstrable positive reaction in the proximal tubule of SHR compared with WKY. In the glomerulus of the WKY and SHR kidneys, both dopamine D1 and D2 receptors are localized. In the in situ hybridization of the WKY and SHR kidneys, dopamine D and D receptors are only demonstrated at the renal vessels. The positive reaction to TH immunohistochemistry of the WKY and SHR kidneys is only observed in the renal medulla compared with negative reaction on the renal cortex. Considering the excretion of sodium up to 65-70% with volume expansion may be mediated by dopamine D1-like receptors in the proximal tubule, our immunohistochemistry findings for the dopamine receptors may support the failure of natriuretic response in the SHR due to an abnormal dopamine receptor. Also our results rnay mean that the glornerular filtration rate is mediated by both dopamine D1 and Dz receptors comparing with the previous studies that the glomerular filtration rate was mediated by dopamine D2 receptor. I'here are some differences in the receptors expressing sites on the previous radioligand binding and pharmacologic studies, but our results suggest that at least some of the renal dopamine DA and DAz receptors correspond structurally to the central dopamine D1 and D2 receptors. Finally the result of TH immunohisto-chemistry suggests that the production of dopamine in the proximal tubule is not mediated by TH.
Animals ; Antibodies ; Arterioles ; Central Nervous System ; Dopamine* ; Filtration ; Glomerular Filtration Rate ; Homeostasis ; Hypertension ; Immunohistochemistry* ; In Situ Hybridization ; Juxtaglomerular Apparatus ; Kidney* ; Ligands ; Models, Animal ; Models, Genetic ; Natriuresis ; Rats* ; Rats, Inbred SHR* ; Receptors, Dopamine ; Receptors, Dopamine D1 ; Receptors, Dopamine D2 ; Sodium ; Tissue Distribution ; Tyrosine ; Vascular Diseases

Anhidrotic ectodermal dysplasia(AED) is a rare hereditary disorder characterized by hypohidrosis or anhidrosis, hypotrichosis, dental hypoplasia and characteristic facies. Additional less consistent symptoms include nail dystrophy, hyperkeratosis of the palms and soles, cleft palate, hyperplasia of facial sebaceous glands, susceptibility to atopic dermatitis, dryness of mouth and eyes, and hypoplasia of mucous and mammary glands. In general, the inheritance of this syndrome is determined by an X-linked recessive gene, and several hundred cases, of which over 90% are male, have been reported in many differnt races. We experienced a case of AED associated with atopic dermatis.
Cleft Palate ; Continental Population Groups ; Dermatitis, Atopic* ; Ectoderm ; Ectodermal Dysplasia* ; Facies ; Genes, Recessive ; Humans ; Hyperplasia ; Hypohidrosis ; Hypotrichosis ; Male ; Mammary Glands, Human ; Mouth ; Sebaceous Glands ; Wills