Once splinter hemorrhage can be considered as a pathognomonic sign of subacute bacterial endocarditis. But it can also be associated with a variety of systemic disorders that increase capillary fragility or primary nail bed involvement in dermatologic disorders. The cause of splinter hemorrhage can usually be established by careful history and physical examination. We report a case of 33-year-old man with splinter hemorrhages, who had polycythemia vera.
Adult ; Capillary Fragility ; Endocarditis, Subacute Bacterial ; Hemorrhage* ; Humans ; Physical Examination ; Polycythemia Vera* ; Polycythemia*

OBJECTIVE: The pathogenesis of endometriosis is generally accepted that retrograde menstruation and alterations in the local pelvic immune environment. This study was performed to help elucidate what kind of role various cytokines might play in the pathogenesis of endometriosis. METHOD: Concentrations of peritoneal fluid cytokines were compared in 7 women with normal pelvic finding and 23 women with endometriosis by enzyme-linked immunosorbent assay(ELISA). The patterns of cytokine mRNA expression in 8 ovarian endometrioma and 12 superficial pelvic endometriosis lesions were investigated by reverse transcription-polymerase chain reaction(RT-PCR) amplification method. RESULT: Both IL-6 and IL-10 levels in peritoneal fluid specimens with endometriosis tended to be higher than normal. However, there were no significant differences between peritoneal fluid concentrations of IFN-gamma, TNF-alpha, IL-1beta, and IL-5 of women with and without endometriosis. The levels of IL-6 and IL-10 were significantly higher in peritoneal fluid of women with severe endometriosis compared to women with mild endometriosis. IL-1beta mRNA was expressed in all of 8 deep and 12 superficial endometriosis lesions. IL-5 and IL-6 mRNA were expressed in only two black lesions respectively, however, both were not expressed in the all deep lesions. Expressions of IL-10 mRNA occurred in one red and one black lesion while this was expressed in only one of the deep lesions. TNF-alpha mRNA was expressed in one red and one black lesion of 12 superficial lesions compared with four of the deep lesions. There was the difference between kinds of increased cytokines in the peritoneal fluid and those of expressed cytokines in the endometriotic lesions of patients with endometriosis. CONCLUSION: This study supports the concept that local immunologic factors may be important in the pathogenesis and pathophysiology of endometriosis. The pattern of cytokine mRNA expression of endometriotic lesions would seem to indicate that proinflammatory cytokines such as IL-1beta and TNF-alpha are responsible for the development or progression of endometriosis.
Ascitic Fluid ; Cytokines ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunologic Factors ; Interleukin-10 ; Interleukin-5 ; Interleukin-6 ; Menstruation Disturbances ; RNA, Messenger* ; Tumor Necrosis Factor-alpha

BACKGROUND: Alopecia areata (AA) is a common dermatologic disorder and the course is so variable that some patients undergo spontaneous remission and others undergo total hair loss. There is no clearly superior therapy for the treatment of alopecia areata. Currently, topical immunotherapy with DPCP represents the most accepted therapeutic modality for the treatment of extensive alopecia areata, but their response rates have varied in the literature. OBJECTIVE: We evaluated the efficacy, prognostic factors, and side effects of DPCP in the treatment of extensive AA. METHOD: Thirty nine patients with extensive AA (>50 % scalp hair loss), treated for at least 6 months at the Department of Dermatology of Inha University Hospital between March 2000 and April 2003 participated in the study. After sensitization with 1% DPCP, progressively higher concentrations beginning from 0.001% were applied weekly onto the entire scalp. The primary study end point, i.e. clinically significant regrowth with DPCP therapy, was defined as a cosmetically acceptable response (as judged by the patient) or significant regrowth resulting in greater than 90% of the scalp being covered with terminal hair (as determined by the investigators) RESULT: A clinically significant regrowth was obtained in 91.3% of the patients with 50% to 99% AA and 50.0% with alopecia totalis/universalis. The overall clinically significant regrowth rate was 74% (29 of 39 patients). Variables associated with clinically significant regrowth were the beginning age of DPCP therapy and the extent of AA. Relapse was observed in 56.3% of the patients who achieved significant hair regrowth after 6 months of follow-up. The Clinically significant adverse effects observed were eczematous reaction with blistering, swelling of cervical lymph nodes, urticaria, and erythema multiforme. CONCLUSION: Treatment with DPCP for extensive AA is very effective. Response of AA patients to DPCP treatment is affected by the beginning age of DPDP therapy and the extent of AA.
Alopecia Areata* ; Alopecia* ; Blister ; Dermatology ; Erythema Multiforme ; Follow-Up Studies ; Hair ; Humans ; Immunotherapy ; Lymph Nodes ; Recurrence ; Remission, Spontaneous ; Scalp ; Urticaria

No abstract available.
Down Syndrome*

We report a case of the transradial approach for carotid artery stenting (CAS) as a useful alternative to the traditional transfemoral approach when femoral access is not available. A 50-year-old male visited our emergency room with dysarthria and right-side weakness. Magnetic resonance imaging showed acute cerebral infarction on the left middle cerebral artery territory and carotid stenosis on both sides. CAS for each carotid stenosis was attempted by the usual femoral access, but there was no pulse on either side of the femoral artery, and computed tomography angiogram of the lower extremity revealed Leriche syndrome, which is an aortoiliac occlusive disease. So, we changed the access to the radial artery and was successfully performed.

Developmental venous anomalies (DVAs) are cited as the most common intracranial vascular anomaly. In the majority of cases, it has a benign clinical course, and complications such as intracranial hemorrhage (ICH) are rarely reported. In the rare cases of DVAs presenting ICH, the causes of hemorrhage are usually by a combined vascular anomaly, mostly cavernous malformation (CM) or complicated DVAs, such as thrombosis in the vein of DVAs. We report a rare case of uncomplicated DVA presenting hemorrhage without accompanied vascular anomaly, such as CM. The cause of hemorrhage is suggested to be a specific form of DVA, arterialized DVA. Arterialized DVAs should be noted that they have a greater risk of hemorrhage than classic DVAs.

We report a case of the transradial approach for carotid artery stenting (CAS) as a useful alternative to the traditional transfemoral approach when femoral access is not available. A 50-year-old male visited our emergency room with dysarthria and right-side weakness. Magnetic resonance imaging showed acute cerebral infarction on the left middle cerebral artery territory and carotid stenosis on both sides. CAS for each carotid stenosis was attempted by the usual femoral access, but there was no pulse on either side of the femoral artery, and computed tomography angiogram of the lower extremity revealed Leriche syndrome, which is an aortoiliac occlusive disease. So, we changed the access to the radial artery and was successfully performed.

Developmental venous anomalies (DVAs) are cited as the most common intracranial vascular anomaly. In the majority of cases, it has a benign clinical course, and complications such as intracranial hemorrhage (ICH) are rarely reported. In the rare cases of DVAs presenting ICH, the causes of hemorrhage are usually by a combined vascular anomaly, mostly cavernous malformation (CM) or complicated DVAs, such as thrombosis in the vein of DVAs. We report a rare case of uncomplicated DVA presenting hemorrhage without accompanied vascular anomaly, such as CM. The cause of hemorrhage is suggested to be a specific form of DVA, arterialized DVA. Arterialized DVAs should be noted that they have a greater risk of hemorrhage than classic DVAs.

Arteriovenous malformation (AVM) consists of an abnormal connection between artery and vein without any interposed capillary bed, and is usually congenital. However, acquired AVM is quite rare, and is usually caused by injury, which induces direct arteriovenous shunting. Acquired digital AVM is a distinct entity, which was first described by Kadono et al. in 2000, and was thought to result from shunts between an artery and a vein in a finger tip. We report a case of acquired digital AVM in a 44-year-old women. The patient showed punctate hyperketatotic ectasia on the pulp of the right thumb. Histological finding showed dilated venous and arterial vessels in upper and lower dermis, and shunts between arteriols and venules.
Adult ; Arteries ; Arteriovenous Malformations* ; Capillaries ; Dermis ; Dilatation, Pathologic ; Female ; Fingers ; Humans ; Thumb ; Veins ; Venules

PURPOSE: To compare the clinical results of short-term visual acuity and quality of vision after implantation of a yellow-tinted blue light-filtering intraocular lens (IOL) (Acrysof IQ® SN60WF) and an clear ultraviolet (UV) light filtering IOL (enVista™ MX60) in the same patient. METHODS: 44 patients with bilateral cataract received an SN60WF in one eye and an MX60 in the other eye. All eyes were evaluated for refraction power and uncorrected visual acuity (UCVA) at preoperative and 1, 3 months postoperatively. At postoperative 3 months, corrected visual acuity, quality of vision (OQAS II®), contrast sensitivity (CGT 2000®) and visual field (Humphrey Field Analyzer®), and subjective patients' response to the degree of brightness were evaluated. Furthermore, glistening degree, intraocular stability, and posterior capsular opacification were examined. RESULTS: There were no significant differences in average refractive power or UCVA at 1 and 3 months (p > 0.05) between the two groups. At 3 months after cataract surgery, the quality of vision according to OQAS II®, the contrast sensitivity according to CGT 2000® with the glare either on or off, and visual field; showed no difference between the two groups (p > 0.05). Both IOLs had no glistening and posterior capsular opacity. The patients' response to the degree of brightness shows that MX60 (48.3%) has a higher degree of satisfaction. CONCLUSIONS: Yellow-tinted blue light-filtering IOL and clear UV light-filtering IOL had no difference in short-term visual acuity and quality of vision. Subjective brightness perception, however, was better with clear UV light-filtering IOL.
Cataract ; Contrast Sensitivity ; Glare ; Humans ; Lenses, Intraocular* ; Visual Acuity ; Visual Fields