Erythema dyschromicum perstans is a cutaneous pigmentary dermatosis of unknown etiology chararcterizd by asymptomatic macules of an ashy gray color which was first presented by Ramirez. We reported a case of Erythema dyschromicum perstans in 57 year old female patient. The skin lesion were characterized by the presence of discreated or confluented bluish-gray colored pigrnentation on the lateral surface of hoth upper extremities. Histologically, the lesion showed hydropic degeneration of the epidermis witb in continence of pigmcnt and an apperence of malanin-hearing macrophages in upper dermis which are compatible with Erythema dyschromicum perstans.
Dermis ; Epidermis ; Erythema* ; Female ; Humans ; Macrophages ; Middle Aged ; Skin ; Skin Diseases ; Upper Extremity

Multiple lentigines syndrome is characterized by the presence of numerous dark brown macules on the skin but not mucous surfaces and known also by the mnemvnic "LEOPARD syndrome" are, besides the lentigines, electrocardiographic conduction defect, ocular hypertelorism, pulmonary stenosis, abnormalities of the genitalia consisting of gonadal or ovarian hypoplasia, retardation of growth, deafness and inherited by autosomal dominant trait. We experienced a case of multipIe lentigine syrrdrome in 20-year old woman. She had numerous pinhead to pea sized, dark brownish macules on the entire body skin a,nd had no associated anomalies of other organ. On laboratory examinations including the CBC, urinalysis., chest X-ray, EKG; EEG, Hormone assay was all normal except for the slight anemic finding. On histologic examina,tion of biopsied macular skin showed a slight elongation of rete ri.dges, an increase in the concentration of melanocyte in the basal layer and mild inflammatory infiltration in the upper dermis. Treatment was done by cryotherapy on the face with marked improvement.
Cryotherapy ; Deafness ; Dermis ; Electrocardiography ; Electroencephalography ; Female ; Genitalia ; Gonads ; Humans ; Hypertelorism ; Lentigo ; LEOPARD Syndrome* ; Melanocytes ; Peas ; Pulmonary Valve Stenosis ; Skin ; Thorax ; Urinalysis ; Young Adult

The results of ABO blood typing in 64-year-old patient with chronic renal and heart failure were positive with anti-B, delayed and weak positive with anti-A in the slide method for the cell typing, mixed-field agglutiniation by light microscopy in the tube method for the cell typing, and also was negative in anti-A, lectin and positive in anti-H, therefore blood typing of this patient was confirmed to A3B.
Blood Grouping and Crossmatching ; Heart Failure ; Humans ; Microscopy ; Middle Aged

BACKGROUND: To know the effect of droperidol and ondansetron on nausea and sedation in postoperative patients, we studied 120 gynecological patients receiving patient-controlled analgesia (PCA) with morphine and droperidol or ondansetron. METHODS: Subjects were randomly allocated to one of four groups according to PCA regimen, morphine 0.5 mg/cc alone (group M); morphine plus droperidol 0.034 mg/morphine 1 mg (group D); morphine plus ondansetron 0.132 mg/morphine 1 mg (group O1); morphine plus ondansetron 0.066 mg/morphine 1 mg (group O2). The PCA device, WalkMed was set at basal rate 2 ml/hr (1 mg/hr), bolus dose 1 ml (0.5 mg), lockout time 10min, 1 hour maximum dose 4 mg. The severity of nausea, sedation and pain were assessed at 1h, 4h, 8h, 12h, 24h, and 48h postoperatively. RESULTS: The occurrence of nausea was not different among groups. But there were statistical differences in the nausea severity (p<0.05). The group D and group O1 had lower nausea scores, and between them there was no difference. The scores for sedation were significantly lower in the group O1 compared with group M and group D (p<0.05). Overall pain scores were not different among groups. CONCLUSIONS: Ondansetron and droperidol are effective in reducing nausea. Ondansetron is superior to droperidol in avoiding excessive sedation.
Analgesia, Patient-Controlled* ; Droperidol* ; Humans ; Morphine ; Nausea ; Ondansetron* ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting*

BACKGROUND: There are many reports showing the efficacy of polymerase chain reaction(PCR) for the diagnosis of Mycobacterium tuberculosis in sputum. but only few reports in extrapulmonary specimens. Because of the difficulty in establishing a diagnosis of tuberculosis in the extrapulmonary specimens there have been considerable interest in the development of a rapid sensitive diagnostic test that might be useful. Therefore we used PCR for detection of M. tuberculosis DNA in extrapulmonary specimens and compared the results of conventional acid-fast stain, culture methods and PCR assay. METHODS: Total of 63 clinical samples(10 cerebrospinal fluids, 12 pleural fluids, 1 pericardial fluid, 3 bone marrow aspirates, 1 ascitic fluid, 25 fine needle aspirates of lymph nodes, 7 urine, 1 stool and 3 tissue biopsies) in Ewha Womans University Tongdaemun hospital were analysed by the PCR. We performed the PCR using a species-specific M. tuberculosis DNA fragment(mtp 40 gene) as primers that was cloned and sequenced at recent and a 396-bp fragment was specifically amplified. We analyzed sensitivity and specificity of AFB culture and PCR for the diagnosis of extrapulomonary tuberculosis. RESULTS: The positivity of AFB smear, culture and PCR were 2(10%), 4(20%), 13(65%) out of total 20 cases diagnosed as clinically active extrapulmonary tuberculosis. respectively. All of 2 smear-positive samples and 2 of 4 culture-positive and smear-negative samples were PCR-positive. And 9 of 14 smear and culture negative specimens also gave detectable DNA products in PCR The specificity of PCR(95.4%) is compared with those of smear and culture(100.0%). CONCLUSIONS: This results suggest that the PCR assay is a sensitive and rapid diagnostic alternative to classical procedures for the diagnosis of extrapulmonary tuberculosis.
Ascitic Fluid ; Bone Marrow ; Cerebrospinal Fluid ; Clone Cells ; Diagnosis* ; Diagnostic Tests, Routine ; DNA ; Female ; Humans ; Lymph Nodes ; Mycobacterium tuberculosis ; Needles ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Sputum ; Tuberculosis*

Hydroa Vacciniforme is a rare, light sensitive dermatitis characterized by discrete vesicles followed by varioliform scar formation, which was first described by Bazin on 1862. We have expe"ienced three cases of hydroa vacciniforme in childhood. The first case was a 6-year-old boy who had discrete vesicles, crusts and pitting scars on forehead, both cheeks, ears and dorsum of the hands in symmetrical distribution with itching sensation, which had used to recur in every summer since last three years ago. Histologic section of a primary lesion showed necrosis and severe edema in the epidermis and adjacent dermis with the dermal inflammatory cell infiltration. The second case was a 10-year-old girl who had discrete vesicles, crusts, erosive and depigmented patch and scars on face, lip, dorsum of the hand and forearm with itching sensation, which had also developed on last spring. The third case was a 7-year-old boy who had vesiclee, erosive patch, crusts and pitting scars on face, Iower lip, both dorsum of the hand and forearm with itching sensation, which had recurred in every summer since last two years ago, On urine examination, porphyrin, was negative in all three cases. Diagnosis was established by clinical characteristics and laboratory findings and histological pictures. Symptomatic treatment was done in all three cases. The literatures were briefly reviewed.
Cheek ; Child ; Cicatrix ; Dermatitis ; Dermis ; Diagnosis ; Ear ; Edema ; Epidermis ; Female ; Forearm ; Forehead ; Hand ; Humans ; Hydroa Vacciniforme* ; Lip ; Male ; Necrosis ; Pruritus ; Sensation

Primary hepatic carcinoid tumors are extremely rare although the liver is a frequent site of metastases from intestinal carcinoids. Recently we investigated a case of primary hepatic atypical carcinoid in a 47-year-old man who had infested with Clonorchis sinensis for 20 years. The resected right lobe of the liver was almost completely occupied by a huge tumor, measuring 20 x 19 x 12 cm. The cut surfaces of the mass were solid, soft and pale yellow, accompanied by several small satellite nodules, measuring up to 1.5 cm in diameter. Microscopically, the tumor consisted of polygonal to columnar cells with eosinophilic granular cytoplasm forming Lym-numerous small acini and large trabeculae. Their nuclei were round to polygonal with coarse stone chromatin, had obscure to small nucleoli and frequent mitoses. There were multiple necrotic foci of varing sizes. The surrounding dilated bile ducts contained several degenerating worms on in of Clonorchis sinensis. The tumor cells were argyrophil-positive but argentaffin-negative. Immunohistochemically, the tumor cells were positive for cytokeratin, chromogranin and somatostatin but were negative for CEA, AFP, insulin, glucagon, ACTH, growth hormone and volve-prolactin. Ultrastructually, the tumor cells contained variable-sized numerous electron dense of neurosecretory granules.
Male ; Humans ; Neoplasm Metastasis

BACKGROUND: Mivacurium has a characteristics of rapid onset and the shortest duration of non- depolarizing neuromuscular relaxants and the onset of action could be accelerate more rapidly by using priming principle. The purpose of this study was to compare the onset time of mivacurium by priming principle with succinylcholine during rapid endotracheal intubation. METHODS: 36 patients were randomly divided into 3 groups: mivacurium group by priming principle (Group 1), mivacurium group by bolus injection (Group 2) and succinylcholine group (Group 3). In Group 1, subparalyzing dose of 0.02 mg/kg was administered 2 minutes before principle dose of 0.25 mg/kg was given. Onset time and intubating conditions were observed when twitch tension was reduced by 25% block in each group. RESULTS: The onset of Group 1 (75 sec) was significantly faster than that of Group 2 (90 sec) (p<0.05) but was significantly slower than that of Group 3 (37.5 sec) (p<0.05). Intubating conditions were excellent in all groups. CONCLUSIONS: The attempts of priming principle with mivacurium could accelerate the onset of action of mivacurium compared with that of bolus injection but their onsets were shorter than those produced by succinylcholine.
Humans ; Intubation, Intratracheal* ; Succinylcholine*

Ritodrine hydrochloride (Yutopar (R)) is widely used for the treatment of premature uterine contraction with betasympathomimetic effect on the uterus but adverse effects associated with cardiopulmonary system are frequently reported. We experienced a case of pulmonary edema that occurred suddenly during cesarean section under epidural anesthesia. She had been treated with ritodrine for 3 days to arrest preterm labor of twin pregnancy. Intensive care including mechanical ventilation with PEEP via endotracheal intubation and diuretic therapy was attempted. At the 3rd day after operation patient was transferred to general ward without any sequale.
Anesthesia, Epidural* ; Cesarean Section* ; Female ; Humans ; Critical Care ; Intubation, Intratracheal ; Obstetric Labor, Premature ; Patients' Rooms ; Pregnancy ; Pregnancy, Twin ; Pulmonary Edema* ; Respiration, Artificial ; Ritodrine* ; Uterine Contraction ; Uterus

PURPOSE: Congenital limb anomalies are manifested in various degree of severity and complexity bearing confusion for description and nomenclature of each anomaly. We retrospectively analyzed the roentgenograms of congenital limb anomalies for the purpose of further understanding of radiologic manifestations based on the embryonal defect and also to find the incidence of each anomaly. MATERIALS AND METHODS: Total number of the patients was 89 with 137 anomalies. Recently the uniform system of classification for congenital anomalies of the upper limb was adopted by International Federation of Societies for Surgery of the Hand (IFSSH), which were categorized as 7 classifications. We used the IFSSH classification with some modification as 5 classifications;failure of formation of parts, failure of differentiation of parts, duplications, overgrowth, and undergrowth. RESULTS: The patients with upper limb anomalies were 65 out of 89(73%), lower limb were 21(24%), and both upper and lower limb anomalies were 3(4%). Failure of formation was seen in 18%, failure of differentiation 39%, duplications 39%, overgrowth 8%, and undergrowth in 12%. Thirty-five patients had more than one anomaly, and 14 patients had intergroup anomalies. CONCLUSION: The upper limb anomalies were more common than lower limb. Among the anomalies, failure of differentiation and duplications were the most common types of congenital limb anomalies. Patients with failure of formation, failure of differentiation, and undergrowth had intergroup association of anomalies, but duplication and overgrowth tended to be isolated anomalies.
Classification ; Extremities* ; Hand ; Humans ; Incidence ; Lower Extremity ; Retrospective Studies ; Upper Extremity