A case of subcorneal pustular dermatosis is reported. This 39 year old woman repeatedly developed the erythematous vesicopustular eruptions on the trunk and the extremeties with scvere tiching sensation for about 7 months. Histological examinstion revealed the subcorneal pustules and the mild inflammatory cell infiltration, so tetracycline 1500mg. And chloramphenicol 1000mg. Were adminiistered without benefit. The second biopsy was obtained and it revealed as the subcorneal pustular dermatosis. Therapy with DDS was instituted and was followed by marked clearing of the lesions.
Adult ; Biopsy ; Chloramphenicol ; Female ; Humans ; Sensation ; Skin Diseases* ; Skin Diseases, Vesiculobullous ; Tetracycline

Twenty newly admitted acute schizophrenic patients were treated with haloperidol for 6 weeks. HVA and 5-HIAA were sampled at baseline, 3days after initial neuroleptic dose, and after 1, 2, 3, 4, 6 weeks of treatment. Nine patients were classified as responders in this prospective haloperidol treatment trial. They had a score of change in the BPRS total scores of 25% or greater. Eleven patients were classified as nonresponders, based on a score of changes in the BPRS total scores of less than 25%. 1) There was no significant difference in plasma HVA/5-HIAA ratio between responder and non-responder before and after haloperidol treatment. 2) There was no significant correlations between plasma HVA/5-HIAA ratio and BPRS total scores. This study could not support the hypothesis that neuroleptic treatment would be effective by changing dopamine and serotonin function and/or by altering their interaction.
Dopamine ; Haloperidol ; Humans ; Hydroxyindoleacetic Acid ; Plasma* ; Prospective Studies ; Schizophrenia* ; Serotonin

This experimental study was conducted to evaluate the effect of indomethacin and methylprednisolone on PAN-induced nephrosis in rats. Sprague-Dawley rats weighing 150~200gm were used and divided into controls, group I (PAN intraperitoneally), group II(PAN intraperitoneally, followed by indomethacin peritoneally for 12 days), group III (PAN intraperitoneally, followed by methylprednisolone peritoneally for 12 days) and group IV (PAN intraperitoneally, followed by cyclosporin subcutaneously for 12 days). Twenty four-hour urinary protein excretion was measured on day 0, 5, 10 and 17. On the 17th day, rats were sacrificed for the determination of total serum protein, albumin and cholesterol levels. Foot process widths of glomerular epithelial cells were measured, and anionic sites of lamina rara externa were determined by using PEI as cationic probes. The following results were obtained. Twenty four-hour urinary protein excretion (mg/day) of group I was significantly increased to 455.7+/-188.8 on the 5th day compared to 15.2+/-3.7 on day 0 (p<0.01), and increased gradulally to 525.6+/-203.5 on the 10th day, then decreased to 280.6+/-25.2 on the 17th day. In group III, 24 hr urinary protein excretion on 17 th day (180.7+/-64.5) was significantly lower than that of group I (280.6+/-25.2). Total serum protein of group III was significantly lower than that of group I, and serum albumin and cholesterol did not show any significant difference among Group I, II, III and IV. Foot process widths (nm) of glomerular epithelial cells in group I, II, III and IV were 409.5+/-15.2, 387.8+/-49.2, 279.9+/-36.9 and 398.3+/-38.3, respectively. And the value of group of group III was significantly lower than that of group I (p<0.01). The number of anionic sites per 1micrometer length of glomerular basement membrane in Group I, II, III and IV were 10.3+/-1.3, 10.1+/-1.6, 12.5+/-1.5and 10.2+/-1.5, respectively. And the value of group III was significantly lower than that of group I (P<0.01). In conclusion, cyclosporin and indomethacin did not show any significant effect on PAN nephrosis in rat. However, methylprednisolone reduced the urinary protein excretion and showed significant recovery of foot process widths and number of anionic sites of glomerular basement membrane.
Animals ; Cholesterol ; Cyclosporine* ; Epithelial Cells ; Foot ; Glomerular Basement Membrane ; Indomethacin* ; Methylprednisolone* ; Nephrosis* ; Nephrotic Syndrome ; Rats* ; Rats, Sprague-Dawley ; Serum Albumin

No abstract available.
Chlorambucil* ; Nephrotic Syndrome*

Annexin-1 (ANX1) is a 37 kDa protein that is induced and secreted by glucocorticosteroid hormone. The secreted ANX1 has been believed to exert its function by binding to its putative rnembrane receptor. In this report we demonstrate that ANXl receptor (ANX1R) signal blocks the interleukin-1B (IL-1B) receptor signal pathway in human peripheral blood mononuclear cells (PBMCs). When PBMCs were treated with both IL-1B (100 ng/ml) and PMA (10 ng/ml) in the absence or presence of dexamethasone for 5 days, dexamethasone (100 nM) suppressed lymphocyte proliferation to 24% of the control. However addition of anti-ANX1 polyclonal antibody of 1:200 and 1:1,000 dilution to this system induced recovery of proliferation to 80% and 40%, respectively, when compared to the control. In the mixed lymphocyte reaction, dexamethasone suppressed lymphocyte proliferation to 9% of that of control when stimulated with IL-1B (100 ng/ml) and phorbol myristate acetate (10 ng/ml). Addition of anti-ANX1 polyclonal antibody (1:1,000) to this system also recovered the proliferation to 20% of that of the control system. In the ANX1 receptor induction experiment using flow cytometry, ANX1 receptor expression on lymphocytes, CD4+ T cells, CD8+ T cells and monocytes increased depending on the externally added IL-1B ranging from 10 to 1,000 ng/ml. From these results, it is evident that dexamethasone induces ANX1 secretion into the culture medium and anti-ANX1 polyclonal antibody abolishes the effects of dexamethasone. Furthermore these results imply that extracellular ANX1 exerts its effects by binding to the receptor on the cell membrane and the activated signal(s) of ANX1R block IL-1B receptor signal in the lymphocytes.
Cell Membrane ; Dexamethasone ; Flow Cytometry ; Humans ; Interleukin-1* ; Lymphocyte Culture Test, Mixed ; Lymphocytes* ; Monocytes ; Signal Transduction ; T-Lymphocytes ; Tetradecanoylphorbol Acetate*

OBJECTIVES: Pneumonia is one of the leading causes of death in the intensive care unit (ICU). Many biomarkers for predicted prognosis have been suggested; among these, procalcitonin (PCT) is known to increase in cases of bacterial infection. However, there have been many debates regarding whether PCT is an appropriate prognostic marker for pneumonia. Therefore, we investigated whether PCT can serve as a biomarker for pneumonia, and compared it with CURB-65, which is a known tool for predicting the prognosis of pneumonia. METHODS: Levels of PCT and CURB-65 scores were compared between 30-day non-survival (n = 30) and survival (n = 101) patients. Relationships between PCT and CURB-65 were determined by using linear regression analysis, as well as by using receiver operating characteristic (ROC) curve analysis and calculation of the area under the curve (AUC). High and low PCT groups were compared. RESULTS: High PCT and high CURB-65 score were positively associated with 30-day mortality. For the prediction of 30-day mortality, initial PCT and CURB-65 exhibited AUCs of 0.63 and 0.66; these were not significantly different (P = 0.132). We found that the high PCT group had a higher rate of initial treatment failure (91%, P = 0.004). CONCLUSIONS: Initial PCT can be a prognostic biomarker for mortality in severe pneumonia, similar to the CURB-65 score. Initial high PCT was positively associated with initial treatment failure.
Area Under Curve ; Bacterial Infections ; Biomarkers ; Cause of Death ; Critical Care ; Humans ; Intensive Care Units ; Linear Models ; Mortality ; Pneumonia ; Prognosis ; ROC Curve ; Treatment Failure

No abstract available.
Female ; Ovary* ; Teratoma*

BACKGROUND: The use of a low-dose naloxone infusion concomitant with intravenous morphine PCA (patient-controlled analgesia) attenuates opioid-related side effects without reducing analgesic effects. The authors compared the incidence of morphine-related side effects and the quality of analgesia in adding low-dose naloxone, normal saline or droperidol to an IV fentanyl PCA regimen. METHODS: One hundred eight patients undergoing ocular plastic surgery were enrolled in the study. General anesthesia was induced and maintained with propofol TCI (target controlled infusion), vecuronium or pancuronium and nitrous oxide. After intubated, they received intravenous fentanyl as PCA. They were randomized to receive normal saline, droperidol or low-dose naloxone concomitant with IV fentanyl PCA. Verbal rating scores for pain, the degree of patients' satisfaction (1-4), nausea, vomiting, requests for antiemetics, urinary retention, pruritus and respiratory depression were recorded after 24 hours. RESULTS: There was no difference in the VRS (verbal rating score) for pain, degree of the satisfaction and the incidence of nausea, vomiting and requests of antiemetics among the three groups. There was no incidence of pruritus or respiratory depression. One subject developed urinary retention in the control group, and three cases in the droperidol group, but none was developed in the low-dose naloxone group. CONCLUSIONS: There was no difference in the prevention of postoperative nausea, or vomiting among the normal saline, droperidol, and naloxone groups with an IV fentanyl PCA. Low-dose naloxone, however, had a reducing effect on urinary retention; it may become an alternative choice according to the anesthesiologist's preference.
Analgesia ; Analgesia, Patient-Controlled* ; Anesthesia, General ; Antiemetics ; Droperidol ; Fentanyl* ; Humans ; Incidence ; Morphine ; Naloxone* ; Nausea ; Nitrous Oxide ; Pancuronium ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Propofol ; Pruritus ; Respiratory Insufficiency ; Surgery, Plastic ; Urinary Retention ; Vecuronium Bromide ; Vomiting

BACKGROUND: Optimal control for the management of the length of stay in the postanesthesia care unit (PACU) following general anesthesia in adults is an important strategy for surgical patients' care. A model to predict the results of the PACU stays could be used to improve the utilization of the PACU and resources of the operating room through a more efficient arrangement. The purpose of this study was to evaluate the performance of the decision tree based analysis using clinical sets of data from adult patients undergoing general anesthesia. METHODS: The decision tree was trained with 351 clinical sets (86% in 409 data sets) using a Chi-squared automatic interaction detection (CHAID) algorithm and validated through independent testing of 58 cases (14%). Twenty-two independent variables were used to find determinant variables and to predict categorical dependent values (lengths of stay in the PACU). RESULTS: The decision tree based analysis correctly predicted in 68% of real situations and identified influencing variables as intubation state, complication in the PACU, and intraoperative transfusion. CONCLUSIONS: We concluded that the decision tree based analysis could provide a useful predictive and classifying model for the optimization of limited resources of the PACU. The decision tree based analysis is an alternative way of classifying, and a predicting method for developing a model for lengths of stay in the PACU with easy interpretation and clear graphical displays of the structure of variables.
Adult ; Anesthesia, General ; Decision Trees ; Humans ; Intubation ; Length of Stay* ; Operating Rooms

In order to determine the prevalence rate and find out the sexual difference of abnormal electrocardiographic findings manifested by computerized EKG, which is equipped with auto-analyzing function, a total of 2,083 electrocardiograms that were taken from population over 20 years-old from October 1996 to February, 1997 were studied according to their age, gender and blood pressure. l. Using the electrocardiography, with auto-analyzing function, 33 kinds of abnormal findings were manifested. The prevalence rate of abnormal findings was 52.8% in male and 43.7% in female. Among them, the most common finding was sinus bradycardia found in 17.6% of male and 15.4% of female. Left ventricular hypertrophy by voltage criteria, minimal voltage of left ventricular hypertrophy, left axis deviation and atrial fibrillation were more common in male than in female statistically. Both of nospecific T wave and ST segment abnormality were more common in female than in male statistically. 2. Thirty-three kinds of abnormal findings were manifested. They revealed one abnormal finding alone or combined with some other ones making 128 kinds of abnormal findings. The most common abnormal finding that manifested alone was right axis deviation (100%), then myocardial ischemia (95.7%) the next. The most common abnormal finding that complexed with other abnormal findings were left anterior fascicular block(percentage of single manifestation; 26.2%) and nonspecific T wave abnormality(percentage of single manifestation; 32.9%). Also, combination of sinus bradycardia and minimal voltage of left ventricular hypertrophy, and combination of sinus bradycardia and left ventricular hypertrophy were included in 25th sequences of abnormal findings. 3. The prevalence rate of abnormal electrocardiographic findings were higher in older group, hypertensive group, and the group of higher systolic or diastolic pressure in both sexes. 4. Abnormal findings that commonly manifested with sinus bradycardia were voltage criteria or minimal voltage of left ventricular hypertrophy(38.6%): sinus arrhythmia(10.5%); nonspecific T wave or ST segment abnormality(18.4%) and first degree AV block(7.2%) in descending order. 5. The most common site which manifested myocardial ischemia was posterior and inferior wall with equal percentage of 23.4%. And then anterior wall(19.l%), and antero-lateral wall and septum with equal percentage of 10.6% was noted in descending order.
Atrial Fibrillation ; Axis, Cervical Vertebra ; Blood Pressure ; Bradycardia ; Electrocardiography* ; Female ; Humans ; Hypertrophy, Left Ventricular ; Male ; Myocardial Ischemia ; Prevalence ; Young Adult