A case of familial cold urticaria is reported in a 29-year-old male who showed generalized erythematous macules and papules, finally an urticarial eruption shortly after cold exposure, particularly in cold windy weather with damp. Coincidentally, systemic symptoms such as headache, fever and chills, arthralgia, and conjunctival injection were acompanied. Autosomal dominant inheritance was found on examination of his pedigree in which 11 of 18 rnembers showed similar clinical manifestations. Routme laboratory findings were within normal limits except mild leukocytosis and elevated erythrocyte sedimentation rate. Biopsy specimen from a cold-evoked lesion revealed mild ederna and mild perivascular infiltrations composed of neutrophils, eosinophils and lymphocytes in the derms, Treatments included several widely-used antihistaminics, but turned out to be unsatisfactory.
Adult ; Arthralgia ; Biopsy ; Blood Sedimentation ; Chills ; Cryopyrin-Associated Periodic Syndromes* ; Eosinophils ; Fever ; Headache ; Humans ; Leukocytosis ; Lymphocytes ; Male ; Neutrophils ; Pedigree ; Weather ; Wills

Angiosarcoma is rare disease not only in Korea but throughout the world; it is all the more so on the skin. We made an observation on a case of angiosarcoma on the scalp of a 57 year-old man. Noteworthy in this case are: (1) the patient was suffered from a head trauma 6 years prior to onset of the disease, (2) the progress of the disease showed an extreme rapidity accompanied by severe headache intolerable by any medication, (3) no effect was resulted from X-ray irradiation, and (4) the patient survived for 7 months with the disease.
Craniocerebral Trauma ; Headache ; Hemangiosarcoma* ; Humans ; Korea ; Middle Aged ; Rare Diseases ; Scalp ; Skin

STUDY DESIGN: Thirteen patients with cervical interlocked facets dislocation in whom closed reduction by skull traction was failed were evaluated about the patterns of ruptured disc fragment. Objects : To evaluate the causes of failure at closed reduction, and the relation between ruptured discs and interlocked facets, and the treatment results through an anterior approach. SUMMARY OF LITERATURE REVIEW: In traumatic dislocation of the cervical facet joints, spinal cord or nerve roots injury associated with the ruptured disc fragment has been reported. However, there is few report evaluating the patterns of ruptured disc fragment as a cause of reduction failure. MATERIALS AND METHODS: Between 1988 and 1997, thirteen patients were treated by anterior fusion with plate after complete removal of the intervertebral disc through anterior approach and reduction of interlocked facets by O1iveira method. They have been followed for an average of 36 months(range : 12-96 months). The interlocking was bilateral in seven cases and unilateral in six cases. We assessed the types of ruptured disc fragment by preoperative MRI and CT and the clinical and radiological results. RESULTS: Ruptured disc fragment was found in all thirteen patients with interlocked facets dislocation. The patterns of ruptured discs were within the uncovertebral joints in 5 cases, posterioly under the posterior longitudinal ligament in 3 cases, anteriorly under intact anterior longitudinal ligament in 3 cases and combined under the anterior and posterior longitudinal ligament in 2 cases. The displacement of ruptured disc fragment were seemed to be the cause of failure in closed reduction. CONCLUSIONS: Intervertebral disc injury should be evaluated carefully with MRI and CT in the lower cervical interlocked facet dislocations before trial of reduction or decision makings of treatment.
Dislocations* ; Humans ; Intervertebral Disc ; Joints ; Longitudinal Ligaments ; Magnetic Resonance Imaging ; Skull ; Spinal Cord ; Spine* ; Traction ; Zygapophyseal Joint

BACKGROUND: Dermatophytosis is usually caused by a contact of the skin with the infective particles in the environment. OBJECTIVE: To investigate the extent and severity of environmental contamination by dermatophytes. METHOD: In addition to physical examination on the residents of 46 families in a rural town in Kyungpook Province, clinical material and house dust samples were cultivated for dermatophytes. RESULTS: Among 114 persons from the 46 families, dermatophytosis was detected in 33 persons(28.9%). The most frequent clinical type was tinea pedis. Trichophyton rubrum and T. mentagrophytes were etiologic agents. In 22 families (47.8%), T. rubrum (16 families, 34.8%) and T. mentagrophytes (6 families, 13.0%) were isolated from the skin lesions. The remaining 24 families (52.2%) were free from dermatophytosis. T. rubrum was detected in the house dust samples from 40(86.9%) of the 46 families, with a density of 34.0 colonies/g, the highest among isolates.; T. mentagrophytes, from 32(69.6%); Microsporum canis, from 1(0.2%); 3(6.5%) were without any dermatophytes. T. rubrum was isolated from the house dust of 15(93.7%) out of 16 families having tinea patients infected with the same fungus, and T. mentagrophytes in 5(83.3%) out of 6. Each case was frequently detected together with other dermatophytes. T. mentagrophytes subtypes were isolated from house dust singly in 19(41.3%), and in twos and threes in 13(28.3%) of the 46 families. Even in the families of the patient(s) with the fungus, the subtypes were not always identical with those from house dust. In a mating study with a total of 210 strains of T. mentagrophytes, 130 out of 136 (including 6 indeterminate) strains of granulosum-asteroides form turned out to be Arthroderma vanbreuseghemii " - ". But all the 70 strains of the powdery, persicolor and downy forms that showed strong sexual stimulation by tester strains, were "+". CONCLUSION: House dust was extensively and markedly contaminated by dermatophytes in a rural town. Further study is needed to evaluate the distribution of mating types of the members of T. mentagrophytes complex in a clinical setting.
Arthrodermataceae* ; Dust* ; Fungi ; Gyeongsangbuk-do ; Humans ; Microsporum ; Physical Examination ; Skin ; Tinea ; Tinea Pedis ; Trichophyton

Generalized granuloma annulare is manifested by numerous, symrnetrical, shiny, normal-skin colored, discrete or confluent, papular eruption on the sunexposed areas, mostly in females of past middle age. Up to date, a variety of therapeutic approaches have been tried with inconsistent results. Recently several agents have been reported to be inconsistent results. Recently several agents have reported to be effective in the treatment of genealizecl granuloma annulare. Of these, dapsone has been used with favorable respones. The fact dapsone can inhibit the lysosomal enzyme release and the mononuclear cell-rnediated rnyeloperoxidase cytotaxicity would account for its effect in granuloma annulare even in part. We observed a case of generalized granulare in a 49-year old man, who had had numerous normal-skin colored or faintly violaceous, flattopped papular eruption on the sun-exposed areas for 3 years. He was treated successfully with dapsone 100mg a day for about 22 months.
Dapsone* ; Female ; Granuloma Annulare ; Humans ; Middle Aged

The transarterial embolization has been widely used to control bleeding. It has a variety of clinical utility; to reduce bleeding on the surgical field, to reduce the size of malignant tumor as a preopearative treatment, to treat arteriovenous malformation or arterial aneurysm as a curative method and to promote life qua' ity of patient with diffuse or multiple hepatocellular carcinoma as a palliative treatment, etc. With the advance of modem technology, various embolic materials have been also developed. IIowever, it has not- been -fully investigated of histopathologic changes of the embolized organs according to the embolic materials used. This study was undertaken to investigate the histopathologic changes of embolized renal artery in rabbit by various embolic materials, according to each embolic material and to time passed by after embolization. Of the 5 arteries embolized by ethylene vinyl alcohol copolymer(EVAL), one showed abscess formation in embolized kidney. The other 4 allowed to perform further pathologic study: within a week after embolization there was no any specific change in vessels, however, r,unimal endothelial hypertrophy was observed following 2 weeks of embolization. Of the 8 renal arteries embolized by N-buthyl-2-cyanoacrylate(Histoacryl), 4 showed total occlusion of the main renal arteries as well as renal infarction, which reflects the strong adhesiveness of Histoacryl to vascular wall. The other 4 showed fibrinoid degeneration in vascular wall within a week. However, further change was not observed thereafter. In all the 5 renal arteries embolized by polyvinyl
Abscess ; Adhesiveness ; Aneurysm ; Arteries ; Arteriovenous Malformations ; Carcinoma, Hepatocellular ; Enbucrilate ; Hemorrhage ; Humans ; Hypertrophy ; Infarction ; Kidney ; Modems ; Palliative Care ; Polyvinyls ; Renal Artery*

BACKGROUND: Many physiologic, pharmacologic and immunologic abnormalities were reported in atopic dermatitis but the cause and pathogenesis of the disease remain obscure. OBJECTIVE: This study was done to investigate the systemic immunologic abnormalities in atopic dermatitis. METHOD: To evaluate the cell mediated immunity, me quantified pei ipheral blood T lymphocytes and their subsets, using flow cytometery, and assessed plasma neopteiin levels by means of radioimmunoassay. To evaluate the abnormal humoral immunity, we assessed the serum IgE levels by means of enzyme-immunoassay. RESULTS: Mean proportions of peripheral blood T lymphocytes and, heir subsets in atopic Dermatitis patients were within normal limits. Hut the suppvessor/cytotoxic T lyrphocytes(T8) were significantly decreased in the group of se"ere atopic dermatitis compared with the group of mild atopic dermatitis(P<0.05). Plasma neopterin lervels in the group of atopic dermatitis were found to be significantly elevated as compared vith the control group(P<0.01), but no significant cifference was found between the mild and severe group of atcpic dermatitis(P>0.05). Mean serum IgE levels in the patients with atopic dermatitis were higher than reference value. But there was no significant difference between the mild and severe atopic dermatitis group. Serum IgE levels ivere negatiiely correlated with T8(r=-0.3774, P<0.05) and positively with T4/T8 ratio(r =0.5007, P<0.05). Conclusions : These data;uggest that the atopic der matitis has abr ormalities in cell mediated immunity as well as elevated IgE level.
Dermatitis, Atopic* ; Humans ; Immunity, Cellular ; Immunity, Humoral ; Immunoglobulin E ; Neopterin* ; Plasma* ; Radioimmunoassay ; Reference Values ; T-Lymphocyte Subsets* ; T-Lymphocytes

A 5-month-old male infantshowed greasy sealy papules on the scalp, dirty scaly papules on the trunk and scaly petechial papules on both the palms and soles since birth. When admitted to the hospital, the patient exhibited lymphadenopathy, hepatomegaly, abdominal distension, mild fever and skin eruption. The biopsy specimens from the skin and lymph node showed an infiltrate composed almost entirely of histiocytic cells with irregularly shaped nuclei and abundant, well demarcated cytoplasm. The histiocytic cells of the infiltrate were proved as Langerhans cells by electron microscopic examination and S-100 protein study. He was treated with methotrexate 30mg/m twice a week and prednisolone 40mg/m daily. Initially skin lesions and general condition were improved, but the patient expired. due to septicemia after 3 months.
Biopsy ; Cytoplasm ; Fever ; Hepatomegaly ; Humans ; Infant ; Langerhans Cells ; Lymph Nodes ; Lymphatic Diseases ; Male ; Methotrexate ; Parturition ; Prednisolone ; S100 Proteins ; Scalp ; Sepsis ; Skin

BACKGROUND: Common environmental allergens play a role in the pathogenesis of urticaria via type I hypersensitivity reaction. Changes in the number of eosinophils and serum IgE in circulating blood in various allergic disorders have been reported by several investigators. However, there are only a few reports about the measurement of those numbers according to a clinical type of urticaria. OBJECTIVE: This study was undertaken to measure the peripheral blood eosinophil and serum IgE levels in 514 patients with different types of urticaria. METHOD: We measured the peripheral blood eosinophil and serum IgE levels in 514 patients who visited the Department of Dermatology, Kyungpook National University Hospital from November 1993 to December 1996. Of these patients there were 122 with acute urticaria (23.7%), 160 with chranic urticaria (31.2%), 164 with dermographism (31.9%), 11 with acute urticaria plus dermographism (2.1%) and 57 with chronic urticaria plus dermographism (11.1%).
Allergens ; Dermatology ; Eosinophils* ; Gyeongsangbuk-do ; Humans ; Hypersensitivity, Immediate ; Immunoglobulin E* ; Research Personnel ; Urticaria*

BACKGROUND: The changes in lipid composition during epidermal differentiation has been reported in human and animal models. Because of the difficulties in getting adeguate specimens from human subjects, the authors used easily obtainable circumcised prepuce for lipid analysis. OBJECTIVE: To investigate the changes in lipid composition duriig cornification of the epidermis, the lipid compositions of whole epidermis and stratum corneum were analyzed by thin layer chromatography(TLC). METHODS: From circumcied prepuce whole epidermis and stratum orneum were separated by 10mM EDTA(ethylene diamine tatraacetate) in PBS(phosphate-buffered saline) or heat(60C), and 0.5% trypsin in PBS respectively. Lipids were extracted with methanolctloroform-HO mixture(4:2:1.6, v/ v, Bligh-Dyer solvent), TLC was performed and lipid composition was quantitated by photodensitometer. RESULTS: In the composition of stratum corneum lipids, sphingoliids were the highest(33.3+2.9%) followed by cholesterol, free fatty acids and cholesterol esters in cleceasing order, there were small percentages of triglycerides, cholesterol sulfate and squalene. CONCLUSION: In this study the lipid composition of epidermis was similar to that of stratum corneum rather than those of previous reports on epidermal lipids, which may indicate the regional characteristics of epidermal/stratum orneum lipids in hyperkeratotic prepuie.
Cholesterol ; Cholesterol Esters ; Epidermis* ; Fatty Acids, Nonesterified ; Humans ; Models, Animal ; Squalene ; Triglycerides ; Trypsin