The second case of this serial reports under the title of unusual cutaneous manifestations of connective tissue diseases is a woman with primary idiopathic dermatomyositis who developed cutaneous ulcerations on her arms and legs, which is thought to b a rare manifestation of adult dermatomyositis. These multiple ulcerations are about bean sized, polymorphous, and grouped on the poikilodermatous lesional skin. In this patient these ulcerative lesions became regressive and healed with disfiguring scars after the activity of the disease has controlled by prednisolone and methotrexate.
Adult ; Arm ; Cicatrix ; Connective Tissue Diseases* ; Connective Tissue* ; Dermatomyositis* ; Female ; Humans ; Leg ; Methotrexate ; Prednisolone ; Skin ; Ulcer*

To study the gyrA mutations of E. coli from clinical specimens, 410 strains were isolated from 1994 to 1997 in Kyungpook National Vniversity hospital. Antimicrobial susceptibility tests, PCR and sequencing of gyrA, and in vitro induction of quinolone resistance were done. The frequency of quinolone resistant E. coli strains increased constantly during 1994 through 1996. Quinolone-resistant strains were more often resistant to unrelated antibiotics than quinolone-susceptible strains (chi-square test, p<0.05). All of the randomly selected 55 quinolone- resist#ant strains were highly resistant to nalidixic acid (NAL) but had low level resistance to fluoroquinolones. All of the 55 quinolone-resistant strains showed an amino acid substitution of Ser -> Leu (TCG -> TIG) at codon 83. In addition, four different types of amino acid substitution affecting codon 87 (Asp) were detected, 1) type I: Asn (GAC -> AAC); 2) type II: Tyr (GAC -> TAC); 3) type III: Oly (GAC -> GGC); 4) type IV: His (GAC -> CAC). The mutation of type IV has not been reported previously in quinolone-resistant E. coli strains. It is thought that the specific amino acid substitution probably affects minimum inhibitory concentrations (MIC) of quinolones because the MICs of ciprofloxacin, norfloxacin, and ofloxacin in type II were significantly higher than those of type I. By in vitro induction, MICs to quinolone-susceptible strains resulted in the increase in the MICs of all quinolones tested by 2- to 2048-fold. The induced mutants by quinolones had amino acid substitutions at codon 83, SerLeu or Asp87Asn, Gly or Tyr. Alteration of Ser83 results in the most effective increase in the MIC of quinolone such as NAL and alterations of Asp87 result in the effective increase of MIC of fluoroquinolone. These results suggest that the continuous use of quinolones might induce the specific amino acid substitution at gyrA.
Amino Acid Substitution ; Anti-Bacterial Agents ; Ciprofloxacin ; Codon ; Escherichia coli* ; Escherichia* ; Fluoroquinolones ; Gyeongsangbuk-do ; Microbial Sensitivity Tests ; Nalidixic Acid ; Norfloxacin ; Ofloxacin ; Polymerase Chain Reaction ; Quinolones

Majocchi's disease is one of chronic vascular disorders of the skin, histologically showing capillaritis with lymphoid cell infiltration. Although the hypothesis of delayed type hypersensitivity reaction against foreign antigen is proposed as the mechanism producing this condition, there are much yet to be defined. We tried to examine the lesional skin of five patients with Majocchi's disease by the direct immunofluorescence with anti-human immunoglobulins, C 3, and fibrin. As a result we found the deposition of immunoglobulins (M, and G) in papillary blood vessels in four patients, and C 3 and fibrin were found in all five patients. C3 was also found at the dermoepidermal junction in three patients. These findings suggest the posssibility that antibody mediated immunologic processes may alsobe involved in the pathogenesis of this disorder. With this observation Majocchis disease could be considered as a chronic immune vasculitis.
Blood Vessels ; Fibrin ; Fluorescent Antibody Technique, Direct ; Humans ; Hypersensitivity ; Immunoglobulins ; Lymphocytes ; Skin ; Vasculitis

No abstract available.
Craniocerebral Trauma* ; Head* ; Perfusion* ; Tomography, Emission-Computed, Single-Photon*

OBJECTIVE: To evaluate the relationship between amniotic fluid interleukin-8 and the presence, severity and pattern of acute inflammatory lesions in the placenta delivered after preterm labor with intact membranes. METHODS: The relationship between placental histologic finding and amniotic fluid interleukin-8 was examined in 46 consecutive patients who were admitted with the diagnosis of preterm labor with intact membranes and who delivered singleton gestations within 5 days. RESULTS: The prevalence of acute histologic chorioamnionitis was 63.0%(29/46) and that of positive amniotic fluid culture was 17.4%(8/46). The most frequent site of histologic inflammation was chorion-decidua(56.5%, 26/46). The median amniotic fluid interleukin-8 increased significantly according to the presence and higher severity of inflammation in each type of placental section (p<0.05 for each). Three patterns of inflammation were identified in chorion-decidua: non-marginating, marginating, and mixed. Median amniotic fluid interleukin-8 and the rate of severe histologic chorioamnionitis (grade> or = 4) increased significantly in the order of non-marginating, marginating, and mixed (p<0.05 for each). CONCLUSION: Both the presence and greater severity of acute histologic chorioamnionitis are associated with an elevated amniotic fluid interleukin-8. A marginating and mixed pattern of inflammation are associated with a higher amniotic fluid interleukin-8. Amniotic fluid interleukin-8 is a reliable prenatal marker of histologic chorioamnionitis.
Amniotic Fluid* ; Chorioamnionitis ; Diagnosis ; Female ; Humans ; Inflammation* ; Interleukin-8* ; Membranes ; Obstetric Labor, Premature* ; Placenta ; Pregnancy ; Prevalence

No abstract available.
Aneurysm* ; Kidney* ; Renal Artery*

A Dieulafoy's lesion is an uncommon, but important, cause of gastrointestinal bleeding. It is associated with massive, life-threatening hemorrhage and is typically difficult to diagnose. Although originally described in the stomach and rarely found below the proximal stomach, identical lesions have been reported in other gastrointestinal organs, including the duodenum, jejunum, colon, and rectum. Most cases occur with bleeding in the gastrointestinal tract. However, we present an incidental asymptomatic Dieulafoy's lesion in the colon, which was treated successfully by using an endoscopic hemoclipping technique.
Colon ; Duodenum ; Gastrointestinal Tract ; Hemorrhage ; Jejunum ; Rectum ; Stomach

Clothing dermatitis frequently goes unrecognized either becaue he clinical picture is mistaken for other disorders, such as seborrheic dermatitis, and prurius, or beacuse it is difficult to trace the causal agent. Contact dermatitis to disperse dyes, especially to azo dyes, has been well known and the most frequent sources of sensitization to dyes are dresses, stockings, and trousers made of synthetic fabrics We described a case of hat band contact dermatitis due to disperse dyes, proven by a patch test. Although chrome was not proven by the diphenylcirbizide method, many dyes known to be contact allergens were proved in different kinds of hat bands.
Allergens ; Clothing* ; Coloring Agents* ; Dermatitis ; Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Patch Tests

PURPOSE: To evaluate the efficacy of combined treatment of metallic biliary stent placement and radiotherapy in malignant biliary obstruction. MATERIALS AND METHODS: Between January 1992 and February 1994, 22 patients with malignant biliary obstruction were treated with metallic biliary stent placement and radiotherapy. The causes of the obstruction included cholangiocarcinoma(n=14), gallbladder carcinoma(n=4), colon cancer(n=2), pancreatic head cancer (n=1), and stomach cancer(n=1). According to the sites of obstruction level, patient were divided into 2 groups; hilar obstruction(n=18) and common bile duct obstruction(n=4). The patients received dose of 45 Gray/18 fraction by external radiotherapy and 20Gy/8f by high dose rate brachytherapy with iridium--192 source through percutaneous transhepatic biliary drainage(PTBD) catheter. The duration of stent patency after placement, survival period and survival rate by Kaplan Meier method were calculated in dead and alive patients, respectively. RESULTS: In all 22 patients, the duration of stent patency was 5.5(1.3--18.5)months. Survival periods after stent placement and PTBD were 5.3(2.0--8.5 )months and 7.9(4.0--14.7)months respectively in 9 dead patients and 7.7(1.3--21.0)months and 9.5(2.3--23.0)months in 13 alive patients. In all 22 patients, the survival rates in 6, 12 and 18 months were 78.9%, 47.5 % and 35.6 %, respectively. CONCLUSIONS: The results with combined metallic biliary stent placement and radiotherapy for the palliative treatment of malignant biliary obstruction in this study was more favorable, as compared with those of the other authors with only metallic biliary stent placement.
Brachytherapy ; Catheters ; Colon ; Common Bile Duct ; Gallbladder ; Head and Neck Neoplasms ; Humans ; Palliative Care ; Radiotherapy* ; Stents* ; Stomach ; Survival Rate

No abstract available.
Immunoglobulin G* ; Influenza, Human*