Acute generalized exanthematous pustulosis(AGEP) is a disease entity caused mostly by drugs or viral infections. Clinically it manifests as generalized erythema, erythema multiforme and amicrobial pustules with fever. Histologically, AGEP is composed of neutrophilic subcorneal and spongiform pustules. A 70-year-old female, with no personal or family history of psoriasis, was given medication including diltiazem for hypertension. Fourteen days after taking the medications, pustular eruptions appeared on the face and rapidly spread to the trunk and limbs. A Laboratory examination revealed neutrophilic leukocytosis and an elevated erythrocyte sedimentation rate. The skin biopsy showed subcorneal and spongiform pustules. We report here a case of AGEP probably due to diltiazem.
Acute Generalized Exanthematous Pustulosis* ; Aged ; Biopsy ; Blood Sedimentation ; Diltiazem ; Erythema ; Erythema Multiforme ; Extremities ; Female ; Fever ; Humans ; Hypertension ; Leukocytosis ; Neutrophils ; Psoriasis ; Skin

No abstract available.
Fibroma*

Plasmid vectors with either RSV or CMV promoter are frequently used for DNA- mediated immunization due to the availability in commercial. Consequently, influence of the vector constituents, such as promoter, enhancer and transcription termination signal etc. on vaccination efficiency is not studied extensively. As an initial attempt to develop an efficient vector system for DNA-rnediated immunization, influence of promoter for antigen gene expression on vaccination efficiency has been analyzed. Initially, plasmids with either B-actin or muscle creatine kinase (MCK) promoter were constructed from the plasmid with prototype CMV promoter. In addition, ovalbumin (OVA) antigen gene has been cloned into each vectors to generate the plasmid vectors with different promoters for induction of the anti-OVA immune responses. Antigen protein expression in antigen gene transfected mouse muscle myoblast cells showed that the level from MCK promoter containing plasmid was slightly higher than those from either CMV or B-actin promoter containing plasmids. Also, the same plasmid turned out to be slightly more efficient than other plasmids in antibody imrnune response induction in vivo, when they were applied both through intramuscularly and intradermally. These results suggest that the commonly used CMV promoter containing plasmid vector could be further modified to develop an efficient vector for DNA-mediated immunization.
Animals ; Clone Cells ; Creatine Kinase, MM Form ; Gene Expression ; Immunization ; Mice ; Myoblasts ; Ovalbumin ; Plasmids* ; Vaccination*

We report a patient who had been initially diagnosed as a myelodysplastic syndrome in 1998 presenting purpuric patches on the left arm that started to develop about a year prior. The purpuric lesions were diagnosed as leukemia cutis by skin biopsy. Her subsequent bone marrow biopsy showed progression into an atypical chronic myeloid leukemia with increased numbers of leukocytes in the peripheral blood. Leukemia cutis typically is regarded as a sign of progression of disease or a manifestation of recurrent disease in treated patients with an established diagnosis of leukemia. We suggest that the skin lesion in this patient could have been a sign of con-version into atypical chronic myeloid leukemia.
Arm ; Biopsy ; Bone Marrow ; Diagnosis ; Humans ; Leukemia* ; Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative* ; Leukocytes ; Myelodysplastic Syndromes* ; Skin

The fractures of the ankle in children are differ from those of adults in terms of the fracture pattern and the possibilities of influence to growth. The injuries of the ankle in children occur mostly at the bony structure rather than ligamentous structure, and some injuries of the growth plate may result in the arrest of entire growth plate or parts of growth plate and these may lead to leg length discrepancy or deformity. Many authors agree that the prognosis of injuries of the growth plate is dependent on the fracture type, the age of the patient at the onset of injuries, the degree of displacement of the fracture fragments, whether the injuries open or closed, and the efficacy of reduction. But the authors can not postulate one uniformed method of classification and treatment of the children's ankle fracture because of the variability of injuries. We have reviewed 35 cases of children's ankle fracture treated at our clinics from Dec. 1979 to Feb. 1984. The results obtained are as follows: l. Over half of the patients were between the ages of 13 and 16 years (54.3%). 2. The incidence of each type as Salter-Harris classification was that of type II(48.6%), type I(20.0%),type III(14.3%),type IV (8.6%). 3. The traffic accidents were the main causes of injury (68.5%). 4. The type I fractures occured mostly under 10 years of age and the type II fractures in adolescents. 5. All the type I fractures were treated conservatively without any complication, and the type II fractures were treated conservatively in 13 cases (76.5%) and operatively in 4 cases (23.5%) with variable results. 6. Overall incidence of complication was 20.0%, consisted with two cases of conservatively treated but not accurately reduced type II fractures, a conservatively treated type III fracture, a triplane fracture, and the others.
Accidents, Traffic ; Adolescent ; Adult ; Ankle Fractures ; Ankle ; Child ; Classification ; Clinical Study ; Clothing ; Congenital Abnormalities ; Growth Plate ; Humans ; Incidence ; Leg ; Ligaments ; Methods ; Prognosis

PURPOSE: Recent studies have revealed close relationships between hepatic injury, metabolic pathways, and gut microbiota. The microorganisms in the intestine also cause irritable bowel syndrome (IBS). The aim of this study was to examine whether IBS was associated with elevated hepatic enzyme [alanine aminotransferase (ALT) and aspartate aminotransferase (AST)], gamma-glutamyl transferase (gamma-GT) levels, and metabolic syndrome (MS). MATERIALS AND METHODS: This was a retrospective, cross-sectional, case-control study. The case and control groups comprised subjects who visited our health promotion center for general check-ups from June 2010 to December 2010. Of the 1127 initially screened subjects, 83 had IBS according to the Rome III criteria. The control group consisted of 260 age- and sex-matched subjects without IBS who visited our health promotion center during the same period. RESULTS: Compared to control subjects, patients with IBS showed significantly higher values of anthropometric parameters (body mass index, waist circumference), liver enzymes, gamma-GT, and lipid levels. The prevalences of elevated ALT (16.9% vs. 7.7%; p=0.015) and gamma-GT (24.1% vs. 11.5%; p=0.037) levels were significantly higher in patients with IBS than in control subjects. A statistically significant difference was observed in the prevalence of MS between controls and IBS patients (12.7% vs. 32.5%; p<0.001). The relationships between elevated ALT levels, MS, and IBS remained statistically significant after controlling for potential confounding factors. CONCLUSION: On the basis of our study results, IBS may be an important condition in certain patients with elevated ALT levels and MS.
Adult ; Alanine Transaminase/analysis/*metabolism ; Aspartate Aminotransferases/analysis/*metabolism ; Body Mass Index ; Case-Control Studies ; Cross-Sectional Studies ; Female ; Humans ; Irritable Bowel Syndrome/diagnosis/*enzymology/epidemiology ; Liver/metabolism ; Male ; Metabolic Syndrome X/complications/diagnosis/*enzymology/epidemiology ; Middle Aged ; Obesity/epidemiology ; Prevalence ; Retrospective Studies ; Waist Circumference ; gamma-Glutamyltransferase/analysis/*metabolism

BACKGROUND: Pyoderma gangrenosum is a rare disease in which a painful nodule or pustule breaks down to form a progressive enlarging ulcer. Until now, only 8 cases of pyoderma gangrenosum have been reported in Korea. Therefore, we thought it necessary to perform a clinical analysis of pyoderma gangrenosum in Korea with a review of literature. OBJECTIVE: Our purpose was to find the clinical features of pyoderma gangrenosum in Korea. METHODS: Fourteen cases with pyoderma gangrenosum were investigated by reviewing medical records. Results There were 6 males and 8 females. The onset age was between 4 years and 65 years, and most(9 cases) had developed the condition between the ages of 20 and 60. Thirteen cases involved the extremities and 3 cases had whale body involvement, Seven cases(50%) had multiple lesions. All cases had pain at the lesional sites. Two cases were classified as the bullous type and the others were ulcerative in nature. The histological fmdings were non-specific. Dense inflarnmatory infiltrates composed of lymphocytes and predominant neutrophils were found in the epidermis and dermis associated with ulceration. Two cases were treated only with systemic steroids, and 2 cases with dapsone and steroids, 2 cases with colchicine and steroids, and 1 case with steroids, dapsone and colchicine. One case was treated with colchicine and anti-Tbc drug, 1 case with dapsone, 3 cases with antibotics, 1 case with the anti-Tbc drug and 1 case with anti-cancer drugs. Systemic disease was present in 5D% of the cases. The associated diseases were Behcets disease(3 cases), tuberculosis(2 cases), systemic lupus erythematosus(1 case), pancytopenia(1 case), iron deficiency anemia(1 case), acute leukemia(1 case), and colon adenoma(1 case). Recurrence developed in 2 cases and positive pathergy reactions were observed in 3 cases. CONCLUSION: Pyoderma gangrenosum was eccompanied with systemic disease in 50% of the cases and the most common therapeutic drugs were steroids. It is therefore impartant to detect the presence of any underlying disease and to treat this alongside pyoderma gangrenosum.
Age of Onset ; Colchicine ; Colon ; Dapsone ; Dermis ; Epidermis ; Extremities ; Female ; Humans ; Iron ; Korea ; Lymphocytes ; Male ; Medical Records ; Neutrophils ; Pyoderma Gangrenosum* ; Pyoderma* ; Rare Diseases ; Recurrence ; Steroids ; Ulcer ; Whales

Spinal epidural abscesses were evaluated using Gadolinium-enhanced magnetic resonance imaging (MRI) in 19 surgically and clinically confirmed cases, including 13 with tuberculous spondylitis and 6 with pyogenic spondylitis. We observed rim enhancement patterns in 10 patients and diffuse enhancement patterns in 9 patients. The spread patterns were localized to ventral or dorsal epidural space and encircled entire epidural space. We conclude that rim enhancement indicates abscess and diffuse enhancement indicates granulation tissue and fibrosis. Tuberculous epidural abscess spreads to ventral epidural space and pyogenic epidural abscess encircles entire epidural space.
Abscess ; Epidural Abscess* ; Epidural Space ; Fibrosis ; Granulation Tissue ; Humans ; Magnetic Resonance Imaging* ; Spondylitis

Maintenance of normal rate of tear production and elimination is essential for the proper controlled envionment for the cornea and the conjunctiva. We analyzed tear turnover rates in normal subjects, which mainly depend on tear production. We scanned 65 eyes of 36 normal subjects after instillation of 2% fluorescein solution 1u into the lower conjunctival fornix, using fluorophotometer (Fluorotron Master). After instillation of fluorescein solution, we scanned the eyes every 3 minutes for 30 minutes to measure tear film fluorescence. We calculated the tear turnover rate using tear film fluorescence valuse. Mean tear turnover rates were 12.3+/-6.6 %/min in normal subjects, 12.7+/-6.9 %/min in men, and 11.7+/-6.6 %/min in women. Mean tear turnover rates of men did not differ significantly from those of women (p>0.05). Mean tear turnover rates of younger subjects(25 years old~40 years old) (16.2 +/-7.4 %/min) were found to be significantly higher than ghose of older subjects(41 years old~73 years old) (9.1+/-40 %/min) (p<0.05). The morning tear turnover rates (13.5+/-1.6 %/min) were found to be higher than those for the afternoon (10.2+/-4.9 %/min), but the differences were not significant(p>0.05). We think that this study might be useful to study the diagnosis and treatement of tear secretory system disorders.
Conjunctiva ; Cornea ; Diagnosis ; Female ; Fluorescein ; Fluorescence ; Humans ; Male ; Tears*

Human papillomavirus (HPV) is associated with cervical cell changes, genital warts, recurrent respiratory papillomatosis, laryngeal papillomatosis, head and neck cancer, and cervical cancer. Two commercial HPV vaccines have successfully been made available in the clinical field. This review covers the progress of cervical disease by understanding the nature of HPV infection, as well as the relationship between the host factors and HPV vaccine effectiveness. Among these host factors, microbiota has been revealed to influence the development and function of both the innate and adaptive immune systems. Therefore, the composition of the microbiome may ultimately affect vaccine efficacy. Understating the relationship between host factors and HPV infection/vaccine efficacy may prove to be useful in earlier diagnosis, as well as disease prophylaxis.
Condylomata Acuminata ; Diagnosis ; Head and Neck Neoplasms ; Humans* ; Immune System ; Microbiota ; Papilloma ; Papillomavirus Infections* ; Papillomavirus Vaccines ; Probiotics ; Uterine Cervical Neoplasms