We herein presented a case of persistent variant of Grovers disease in a 83-year old male. He had a rather extensive eruption of erythematous scaly papules, which had been profusely grouped but discretely distributed over 2 years or more. The histopathologic findings of two lesions in the same patient revealed mixture of various histologic patterns, patterns resembling Dariers disease, pemphigus vulgaris, Hailey-Hailey disease and spongiosis. The ultrastructural findings of Darier pattern should be essentially similar to those of Dariers disease and also be common to those observed in the early stages of other causes of focal acantholytic dyskeratosis. The patient had been treated with topical and intralesional steroid and oral 13-cis-isotretinoin, however, the lesions had been persisted only with partial improvement of clinical appearance and reduction of pruritus.
Aged, 80 and over ; Darier Disease ; Humans ; Male ; Pemphigus ; Pemphigus, Benign Familial ; Pruritus

We report a case of fibroma of tendon sheath developed in a 22-year-old woman. The tumor of about 5 years duration was protruding on the volar surface of her 4th finger tip. It was well-demarcated rubbery-hard, and immovable on palpation. The surface on the tumor was smooth and had some telangiectasias. It was asymptomatic and non-tender. The histopathologic findings of excised specimen revealed well-demarcated lobulated mass with widely-spacd: fibroblasts in a hyalinized collagenous matrix. The characteristic slit-like spaces were found in hypoellular and fasciitis-like region. After excision, local recurrence has not been observed for about one and a half years of follow-up period.
Collagen ; Female ; Fibroblasts ; Fibroma* ; Fingers ; Follow-Up Studies ; Humans ; Hyalin ; Palpation ; Recurrence ; Telangiectasis ; Tendons ; Young Adult

We report a case of fibroma of tendon sheath developed in a 22-year-old woman. The tumor of about 5 years duration was protruding on the volar surface of her 4th finger tip. It was well-demarcated rubbery-hard, and immovable on palpation. The surface on the tumor was smooth and had some telangiectasias. It was asymptomatic and non-tender. The histopathologic findings of excised specimen revealed well-demarcated lobulated mass with widely-spacd: fibroblasts in a hyalinized collagenous matrix. The characteristic slit-like spaces were found in hypoellular and fasciitis-like region. After excision, local recurrence has not been observed for about one and a half years of follow-up period.
Collagen ; Female ; Fibroblasts ; Fibroma* ; Fingers ; Follow-Up Studies ; Humans ; Hyalin ; Palpation ; Recurrence ; Telangiectasis ; Tendons ; Young Adult

Kimura's disease is a chronic inflammatory condition of unknown cause. It usually appears as a painless nodule in the head and neck region often associated with regional lymphadenopathy, but there have rarely been reports of penile involvement or clinical presentation as an ulcerative plaque. We present a case of Kimura's disease occurring on the penile shaft as an ulcerative plaque in a 44-year-old man. A vesicular eruption had occurred on his penile shaft followed by an ulcerative plaque for 2 months. He had suffered from recurrent regional lymphadenopathy for 15 years and he had also exhibited intermittent eosinophilia. Histopathologic findings revealed diffuse eosinophilic infiltration in the dermis of the skin and eosmophilic abscesses in the lymphoid follicles of the mguinal lymph node. After short-term systemic steroid therapy and local injection of triamcinolone acetonide, the ulcerative plaque was healed.
Abscess ; Adult ; Dermis ; Eosinophilia ; Eosinophils ; Head ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Neck ; Skin ; Triamcinolone Acetonide ; Ulcer

In a 8 year-old boy who had epidural hematoma in the occipital area, had an episode of dislodgement of the endotracheal tube due to improper position. After operation, there were drowsy consciousness, irregular respiration, apnea, absence of cough reflex and swallowing reflex. Then these was no improvement in spite of treatment, and because of this hypoxic encephalopathy was diagnosed. WE suspected there might be some pathologic lesion volving the respiratory center and lower cranial nerves. CT scanning was performed and the result was diagnosed with epidural hematoma and subdural hematoma in the posterior fossa. The patient was reoperated.
Apnea ; Child ; Consciousness ; Cough ; Cranial Nerves ; Deglutition ; Hematoma* ; Hematoma, Subdural ; Humans ; Hypoxia, Brain ; Male ; Reflex ; Respiration ; Respiratory Center ; Tomography, X-Ray Computed

This study was undertaken to investigate the efficacy of 5% PABA cream using mouse ear swelling reaction(ESR). Mice were exposed to 100mJ/cm of UVB, five times a week for four weeks, on the both ventral aspect of the ear, with application of 5% PABA cream on the right ear. The results were as follows : 1. The intensity of ear swelling reaction of 5% PABA protected group was reduced greater than unproteeted group after the first 3 days of UUR. 2. The intensity of ear swelling reached at peak after 1 week of the ultraviolet radiation. Thereafter it has decreased gradually the following 4 weeks. The difference of ear swelling between the two groups was the greatest after 1 week, and the sunscreening efficacy of 5% PABA cream has remained persisted for 4 weeks. 3. The number of mice which have shown severe inflarnmatory response after ultravioiet radiation was more in unprotected group than that in 5% PABA protected group. 4. Determination of mouse ESR is considered a good method for the evaluation of longterm efficacy of sunscreen preparation.
4-Aminobenzoic Acid ; Animals ; Ear* ; Mice*

Asthma involves intermittent episodes of bronchospasm associated with wheezing and dyspnes and asymptomatic period. Many drugs and anesthetic agents can affect bronchomotor tone and asthmatic patients requiring anesthesia are at higher risk than nonasthmatics. The anesthetic management of the asthmatic patient continues to present a challenge to the clinical anesthesiologis, despite increased knowledge and better understanding of the pathogenesis of bronchial asthma and the availability of safer and more effective anesthetic agents and methods. We have experienced status asthmaticus during spinal anesthesia for Cesarian section of a chronic asthma patient. We report the case and review the relevant literature.
Anesthesia ; Anesthesia, Spinal* ; Anesthetics ; Asthma* ; Bronchial Spasm ; Humans ; Respiratory Sounds ; Status Asthmaticus*

Hyperinsullinism and the resultant hypoglycemia are hallmarks of functioning beta islet cell tumors of the pancreas. The management of one case of insulinoma during surgery for the removal of the tumor is described and the available literature on the subject reviewed. The outline of the anesthetic management for the insulinoma is as follows: 1) Anesthetists should understand the signs and the symptoms of hypoglycemia and hyperglycemia. 2) Preoprative management: a) infusion of glucose for avoiding hypoglycemia due to NPO after midnight. b) glucocorticosteroid administration with premedications. 3) Operative management: a) continuous determination of blood glucose level may be helpful. b) Maintenance of the glucose level about 50mg% above symptomatic CNS level have the advantage that exicision of the infulinoma can be immediately judged. c) The use of an agent that decreases CMRO2 and does not affect the insulin-glucose ratio is rational choice when concern about hypoglycemia exists. Thiopental-enflurane anesthesia with controlled ventilation maintaining normocarbia is recommended. d) beta-adrenergic blocker. These drugs must be avoided in the hypoglycemic state.
Adenoma, Islet Cell ; Anesthesia ; Blood Glucose ; Glucose ; Hyperglycemia ; Hypoglycemia ; Insulinoma ; Pancreas ; Premedication ; Ventilation

PURPOSE: The purposes of this study were to examine the level of social support, health promoting behaviors and depression among unmarried pregnant women and to identify the relationship between social support, health promoting behaviors and depression. METHOD: A descriptive correlational study was conducted. The participants were 102 unmarried pregnant women receiving shelter services from four facilities in two metropolitan cities. Data was collected using a self-administered questionnaire. Descriptive statistics, ANOVA and Pearson correlation were used for data analysis. RESULTS: The level of social support and health promoting behaviors were relatively lower and the level of depression was relatively higher than those of married pregnant women. The participants received especially low social support from their unmarried partner. There was a positive relationship between social support and health promoting behaviors. Moreover, there were negative relationships between social support and depression and between health promoting behaviors and depression. CONCLUSIONS: To promote physical and emotional health of unmarried pregnant women, more attention is necessary to increase their social support. A nursing intervention program to increase social support among unmarried pregnant women in needed.
Depression* ; Female ; Humans ; Nursing ; Pregnant Women* ; Surveys and Questionnaires ; Single Person* ; Statistics as Topic

PURPOSE: To compare the usefulness of contrast-enhanced voiding ultrasonography(US) with that of radiographic voiding cystourethrography(VCUG) for the diagnosis of vesicoureteral reflux(VUR) in children. MATERIALS AND METHODS: Ninety-five kidney-ureter units of 47 patients referred for investigation of VUR underwent contrast-enhanced voiding US followed by radiographic VCUG. After baseline US examination of the urinary tract, residual urine in the bladder was drained through an inserted Foley catheter and the bladder was gravity filled at a height of 1 m with normal saline. A galactose-based, microbubble-containing echo-enhancing agent (Levovist; Schering, Berlin, Germany) was then administered. The amount of this was approximately 10% of bladder capacity, and VUR was diagnosed when microbubbles appeared in the ureter or pelvo-calyceal system. Using radiographic VCUG as a reference point, the accuracy with which contrast-enhanced voiding US detected VUR was calculated. RESULTS: In 87 of 95 kidney-ureter units (91.6%), the two methods showed similar results regarding the diagnosis or exclusion of VUR, which was detected by both in 12 units, but by neither in 75. VUR was shown to occur in a total of 20 units, but in eight of these by one method only. In two units, VUR detected by contrast-enhanced voiding US was not demonstrated by radiographic VCUG; in six units, the reverse was true. In the detection of VUR, contrast-enhanced voiding US showed a sensitivity of 66.7%, a specificity of 97.4%, a positive predictive value of 85.7%, and a negative predictive value of 92.6%. CONCLUSION: Contrast-enhanced voiding US is highly specific and has high positive and negative predictive values; its sensitivity, however, is not sufficiently high. The modality appears to be a useful diagnostic tool for the detection of VUR without exposure to ionizing radiation, though to be certain of its value, more experience of its use is first required.
Berlin ; Catheters ; Child* ; Diagnosis ; Gravitation ; Humans ; Microbubbles ; Radiation, Ionizing ; Sensitivity and Specificity ; Ultrasonography* ; Ureter ; Urinary Bladder ; Urinary Tract ; Vesico-Ureteral Reflux*