No abstract available.
Central Venous Catheters* ; Fibrin*

Kasabach- Merritt syndrame consists of thrombocytopenia, microangiopathic hemolytic anemia, and an acute or chronic censumptive coagulopathy in associati an with a rapidly enlarging hemangioma. Most vascular turrnrs causing Kasabach-Merritt syndon e are benign but the associated coagulopathy may be lifethreatening. Our patient, a 30-day-old female infant, was admitted after an increase in the size of a hemangioma present since birth on the right leg with extension to the lower abdomen and left inguinal area. Her herrnglobin count fell to 7.1g/dl, platelet count was 26,000/ul, prothrombin time was 26 seconds, and hypofibrinogenemia developed. The patient was treated with transfusions of platelets, fresh frozen plasma and red cells and prednisolone. for 2 weeks without improvement. We started interferon alfa-2a therapy. Over the past 6 months, he hemangioma progressively diminished in size withcut any serious complication.
Abdomen ; Anemia, Hemolytic ; Female ; Hemangioma ; Humans ; Infant* ; Interferon-alpha* ; Interferons* ; Kasabach-Merritt Syndrome ; Leg ; Parturition ; Plasma ; Platelet Count ; Prednisolone ; Prothrombin Time ; Thrombocytopenia

Sepsis refers to the systemic response to serious infection. Patients with sepsis usually manifest fever, tachycardia, tachypnea, leukocytosis, and a localized site of infection. Methicillin-resistant Staphylococcus aureus(MRSA) is a gram-positive, nonmotile, aerobic, catalase- positive coccus, which is resistant to all the B -lactam antibiotics. Cutaneous manifestations in sepsis are maculopapules, nodules, petechiae, ecchymoses, purpurae, pustules, vesiculobullae, hemorrhagic bullae and ulcers. When MRSA is identified in blood cultures and skin tissue cultures, the skin lesions can be considered as cutaneous manifestations in sepsis caused by MRSA. We report two cases with erythematous pustules, petechiae, hemorrhagic bullae and maculopapules caused by MRSA sepsis. MRSA grew in blood cultures and skin tissue cultures.
Anti-Bacterial Agents ; Ecchymosis ; Fever ; Humans ; Leukocytosis ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Purpura ; Sepsis* ; Skin ; Staphylococcus ; Tachycardia ; Tachypnea ; Ulcer

No abstract available.
Peptic Ulcer Perforation* ; Peptic Ulcer*

BACKGROUND: Keloids may occur at any age, but tend tend velop between the ages of 10 and 30. The incidence and median age of onset are equal for both sexes. Keloids are common among the darker pigmented rices, but there have been a few clinia studies of keloids in Korea. OBJECTIVE: The purpcse of this study was to evaluate the variable clinical characteristics of keloids in Korea. METHODS: This clinical investigation was made with 223 of patients of keloid who had visited the Department of Derrnatology, Chonnam University Hosptal from January 1984 to December 1993. RESULTS: 1.The annual incidenie averaged over 10 years was 0.831 (361 cases of total 43,752 outpatients). 2.The ratio of male to female was 1: 0.94(Male. 115, Feila 108). 3.The mean age of the onset and at the first visit to our hospital were 24.5years and 29.2 years respectively. 4.In our series tte presternal area was the most commor saes, the shouder region next. Most keloids on the shoulder were related to BCG vaccination in ifoncy or chilhood. 5.The precipitating fa ctors associated with keloid were riaeeding dermatologic diseases(33.2 %), unknown(17.9%) rejection & vaccination(15.2%), operation(13.9%), burn(13.9%) and laceration(5.8%) in descending order. 6.Among preceeding as, iociated dermatologic diseases, acne w s the most common. 7. A positive family history is more likely in cases of mitile keloidal (p<0,001), and severe keloidal formation. 8.Most patients did not. complain of any symptorns(45.3%) nd a symptom of pain or tenderness(40.8%) was piesert rather than pruritus(13.9%). 9.The most prevaent tr eatment modality was intralesional injection with triamcinolone acetonide (84.3%). CONCLUSION: According, to this study, usually keloids occore in patients between 10 and 29 years of age, and most keloids were located on the antetio partion of the chest, shoulders, and face and scalp. A positive family history is more likely in as of multiple, severe keloidal for mation.
Acne Vulgaris ; Age of Onset ; Female ; Humans ; Incidence ; Injections, Intralesional ; Jeollanam-do ; Keloid* ; Korea ; Male ; Mycobacterium bovis ; Scalp ; Shoulder ; Thorax ; Triamcinolone Acetonide ; Vaccination

A 38-year-old male patient visited our clinic complaining of three skin lesions on the scalp. There were yellowish to brownish, waxy, non-tender, walnut-sized nodules. Hematoxylin and eosin staining revealed amorphous pinkish material deposits in the dermis. The Congo red stain and Dylon stain under polarizing microscopy showed yellow-green birefringence and the immunoglobulin-lambda light chain stain showed a positive reaction. An electron microscopic examination revealed filaments with uniform diameter(6 to 10nm) that were straight and neither branched nor anastomosed. Based on the clinical, histopathological, immunohistochemical and electron microscopical findings, the skin lesions were diagnosed as nodular amyloidosis.
Adult ; Amyloidosis* ; Birefringence ; Congo Red ; Dermis ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Male ; Microscopy ; Scalp ; Skin

We report a case of para.psoriasis variegata in a 19 year-old male patient wha has brownish flat scaly papules that are confluent in a retiform pattern characterized by symmetrical distribution on trunk and upper extremities. A skin biopsy specimen showed hyperkeratosis, focaI parakeratosis, hyperpigmentation of basal cell layer, and a mild lymphocytic perivascular infiltrate. No evidence was found for a relationship to lymphoma.
Biopsy ; Humans ; Hyperpigmentation ; Lymphoma ; Male ; Parakeratosis ; Parapsoriasis* ; Skin ; Upper Extremity ; Young Adult

Winging of the scapula is characterized clinically by a prominence of the vertebral border and inferior angle of the scapula. Trauma, neuritis, neural injury during surgical procedure and many other causes may develop winging of scapula. When pain and functional impairment persist, surgical intervention may become appropriate. We report two cases of winged scapula. One case was serratus anterior palsy due to blunt trauma, which was treated by transfer of teres major and pectoralis minor elongated with a tensor fascia strip. Another case was trapezius muscle palsy due to iatrogenic spinal accessary nerve injury, which was treated by transfer of the levator scapulae, rhomboid major and rhomboid minor muscle. In the former case, there was no weakness nor deformity of affected shoulder. In the later case, there was some residual pain and limitation of motion.
Congenital Abnormalities ; Fascia ; Neuritis ; Paralysis ; Scapula* ; Shoulder ; Superficial Back Muscles

The single enzyme P-450c17 hydroxylase catalyzes the 17a-hydroxylation of both pregnenolone and progesterone and the side-chain cleavage of 17a-hydroxypregnenolone and 17a-hydroxypro- gesterone to dehydroepiandrosterone and androstenedione. This enzyme is located in the endoplasmic reticulum and consists of a P-450c17 and a specific flavoprotein NADPH-cytochrome P-450 reductase. The clinical picture and hormonal pattern in 17a-hydroxylase deficiency have been consistent in both genotypic sexes with hypergonadotropic hypogonadism in whom the virtual absence of gonadal steroids results in a female phenotype with primary amenorrhea and pseudohermaphro- ditism in the male and underdeveloped secondary sex characteristics and hypermineralocorticoidism with hypertension, hypokalemia, suppressed renin-angiotensin system and extremely reduced aldo-sterone production. A 17-year-old girl visited endocrine clinic because of amenorrhea, absence of pubic and axillary hair, and hypertension. she had elevated levels of serum corticosterone, deoxycorticosterone(DOC), 18-hydroxycorticosterone(18-OHB). Stumulation with ACTH effected minimal increase in the elevated steroids and the ACTH-stimulated 18-OHB to aldosterone ratio was more than 280. These hormonal patterns appear to be homozygote in 17a-hydroxylase deficiency.
Adolescent ; Adrenocorticotropic Hormone ; Aldosterone ; Amenorrhea ; Androstenedione ; Corticosterone ; Dehydroepiandrosterone ; Endoplasmic Reticulum ; Female ; Flavoproteins ; Gonads ; Hair ; Homozygote ; Humans ; Hypertension ; Hypogonadism ; Hypokalemia ; Male ; Oxidoreductases ; Phenotype ; Pregnenolone ; Progesterone ; Renin-Angiotensin System ; Sex Characteristics ; Steroids

Synovial chondromatosis is a condition of metaplastic and focal formation of cartillage in the intimal layer of synovial membrane. The etiology is unknown. The cartilagenous foci become pedunculated and may be sequestrated into the synovial cavity to form loose body. The center of focus may calcify and ossify. Of the ten cases of synovial chondromatosis experiences by the authors, five cases invo1ved the knee joint, one case both knee joint, two cases the hip joint, two cases the elbow joint, one case the wrist joint. The diagnosis of synovial chondromatosis was made by the histopathological finding of the excised masses.
Chondromatosis, Synovial ; Clinical Study ; Diagnosis ; Elbow Joint ; Hip Joint ; Knee Joint ; Synovial Membrane ; Wrist Joint