BACKGROUND: In patients with systemic lupus erythematosus(SLE), LE-specific cutaneous lesions include malar rashes, widespread/morbilliform erythema, oral ulcer and bullous lesions. OBJECTIVE: Clinical observations were carried out to define cutaneous features of morbilliform erythema and to see possible relevancy of this erythema to disease activity of SLE. METHODS: Examinations were performed on 7 SLE patients with morbilliform erythema regarding the distribution and course of the cutaneous lesions; some SLE-activity related hematologic/immunologic data taken during/around the time of this skin disease were also assessed in each patient. RESULTS: In most of those patients with morbilliform erythema, which covered the trunk and extremities, the skin lesions lasted for about 2 weeks until their disappearance. At or around the time of suffering from this skin disease of acute eutaneous LE, activities of systemic disease were recognized as "in a state of flare-up or aggravation" with hypocomplementemia and high titers of anti-nDNA autoantibodies. CONCLUSION: As with malar rashes, morbilliform erythema of acute cutaneous LE seems to develop more frequently at the time of severe systemic involvement of immunopathological processes of SLE.
Autoantibodies ; Blister ; Erythema* ; Exanthema ; Extremities ; Humans ; Lupus Erythematosus, Systemic* ; Oral Ulcer ; Skin ; Skin Diseases

BACKGROUND: It is known that 20% of childhood epilepsy is refractory to anticonvulsants therapy, Recently, a few new anticonvulsants has been introduced. One of these, gabapentin is known to effective in such refractory cases. This study has been done to estimate the effectiveness of gabapentin in refractory childhood as well as adult epilepsies. SUBJECTS AND METHODS: 43 patients(male 25, female 18) has been selected among refractory epilepsies during the period of March, 1981 to Feb, 1996 diagnosed and treated at pediatric neurologic clinic School of Medicine, Yonsei University Those were already treated with various anticonvulsants and gabapentin was added to previous medication, and effectiveness of seizure frequency and the degree has been investigated over more than 3 month period as well as the side effect. RESULTS: 30 patients out of 43, showed seizure free or decreased frequency of seizure, those patients whose the seizure frequency was decreased over 50% was 11 cases, partial seizure 10 cases, generalized seizure 1 cases. 15 case out of 43 showed no changes or increased frequencies of seizure in 4 out of 27 in partial epilepsies, 1 out of 16 in generalized seizure, and 6 cases out of 43 manifested side effects such as behaviour change, abdominal pain and headache. CONCLUSION: Gabapentin was effective by add on therapy in refractory epilepsies and reducing the frequency of seizure over 50% was 25.6%. Most of these patients was partial seizure. We concluded that gabapentin as add on therapy is effective at least in 1/4 cases of refractory partial seizures.
Abdominal Pain ; Adult ; Anticonvulsants ; Epilepsies, Partial ; Epilepsy ; Female ; Headache ; Humans ; Seizures*

Eczema herpeticum occurred in a patient with pemphigus foliaceus and esophageal cancer. The patient's initial skin lesions composed of large flaccid bullaes showed subcorneal bullae with typical acantholytic cells. Subsequent grouped small vesicles appeared widely on the erythematous base were diagnosed herpes simplex virus infection by Tzanck smear and histopathological findings. The patient died one week after the development of the widespread herpes virus infection.
Eczema* ; Esophageal Neoplasms ; Humans ; Kaposi Varicelliform Eruption* ; Pemphigus* ; Simplexvirus ; Skin

No abstract available.
Acute Kidney Injury ; Mannitol* ; Renal Insufficiency*

The term “ganglion” was given by Hippocrates to designate a knot of tissue filled with mucin. A ganglion may be defined as a cystic benign tumor filled with a mucoid material usually surrounded by a thin wall and occurring in the region of the capsule and connective tissue of joints and tendon sheaths. The regions of the wrist, ankle, and knee and the volar regions of the fingers and hand are most frequently affected. The authors experienced a case of ganglion which had occurred at anteromedial aspect of right hip joint and had been connected with hip joint by cord like band.
Ankle ; Connective Tissue ; Fingers ; Ganglion Cysts ; Hand ; Hip Joint ; Hip ; Joints ; Knee ; Mucins ; Tendons ; Wrist

Torsion of a mucocele of the vermiform appendix is an extremely rare condition and also a rare cause of an acute abdomen with a clinical presentation that is indistinguishable from acute appendicitis, and thus, the condition is diagnosed during operation. Here, the authors describe the case of a 78-year-old female, who presented with intermittent abdominal pain. The appendix had a pelvic position and the torsion was counterclockwise. In addition, the torsion was associated with mucocele of the appendix, which was considered a secondary factor of torsion. Appendectomy and drainage were performed.
Abdomen, Acute ; Abdominal Pain ; Aged ; Appendectomy ; Appendicitis ; Appendix ; Drainage ; Female ; Humans ; Mucocele ; Torsion Abnormality

Cockayne syndrome is a rare autosomal recessive disorder that results in postnatal growth failure and progressive neurological dysfunction. Associated clinical features are gait disturbance, progressive pigmentary retinopathy and other ocular anomalies such as cataracts and optic disk atrophy, sensorineural hearing loss, dental caries and cutaneous photosensitivity. The disease is clinically heterogeneous with a wide range in the type and severity of symptoms. We experienced a case of Cockayne syndrome in 13 year-old male, who had delayed development, hypophasia, characteristic physical appearance, cutaneous photosensitivity, dental caries. We reported the case with review of literatures.
Adolescent ; Atrophy ; Cataract ; Cockayne Syndrome* ; Dental Caries ; Gait ; Hearing Loss, Sensorineural ; Humans ; Male ; Optic Disk ; Retinitis Pigmentosa

BACKGROUND: Pemphigus is an autoimmune bullous disease with circulating desmosomal autoantibodies of IgG. In direct IF studies with perilesional tissue, IgA or IgM antibodies can be seen in addition to IgG. OBJECTIVE: We examined sera of patients with pemphigus for the presence/frequency of IgA autoantibodies as well as IgG by indirect IF and immunoblot assay. Patients: Twenty patients of pemphigus (PV 10, PF 10) who showed positive findings in indirect IF examinations. METHODS: Indirect IF study with normal human skin substrates and immunoblot analysis using A431 cell extracts (with multi-step immunostaining) were performed with patients sera. RESULTS: In indirect IF, IgA autoantibodies that bind to the epidermal keratinocyte antigens were detected in 4 cases among the 20 patients (PV 2 and PF 2). In immunoblot analysis IgA bands reacting to PV/PF antigens were observed in 7 cases from the 20 patients with pemphigus (PV 3, PF 4). The serum titers of IgA autoantibodies were lower than those of IgG in every single case. CONCLUSION: In patients with pemphigus (PV/PF), 35% of cases have serum IgA autoantibodies as well as IgG autoantibodies specific to the pemphigus antigens (Dsg 1/Dsg 3). However, pathogenic roles of the associated IgA autoantibody are not clear.
Antibodies ; Autoantibodies ; Cell Extracts ; Humans ; Immunoglobulin A* ; Immunoglobulin G ; Immunoglobulin M ; Keratinocytes ; Pemphigus* ; Skin

BACKGROUND: Diclofenac is a nonsteroidal anti-inflammatory drug widely used as adjuvants for postoperative pain management with opioid sparing effect. The effect of diclofenac on postoperative opioid analgesia of morphine and meperidine was evaluated in 180 women after cesarean section. METHODS: One hundred eighty parturients were randomly allocated to four groups and each group had 45 women. The parturients were given loading dose of morphine in M group and meperidine in D group using intravenous patient controlled analgesia (PCA) device for up to 48 hours when the parturients awoke and complained abdominal pain. The parturients received diclofenac 75 mg every 12 hours intramuscularly followed by loading dose of morphine in MV group and meperidine in DV group. We evaluated the postoperative opioid requirement, numerical rating pain score, delivery/demand ratio, patient's satisfaction and side effects including respiratory depression, itching, nausea, urinary retention and dizziness. RESULTS: Diclofenac decreased over 40% of morphine or meperidine requirement and also pain score at 1, 2, 3, 6, 12, 24 and 48 hours in the use of PCA morphine and at 6, 12 and 24 hours in the use of PCA meperidine. And the incidence of sedation and itching decreased in MV and DV group. CONCLUSION: We concluded that diclofenac as adjuvant of opioid for postoperative pain after cesarean section could decrease requirement of morphine and meperidine, increase pain relief and decrease sedation and itching.
Abdominal Pain ; Analgesia ; Analgesia, Patient-Controlled ; Cesarean Section* ; Diclofenac* ; Dizziness ; Female ; Humans ; Incidence ; Meperidine* ; Morphine* ; Nausea ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis* ; Pregnancy ; Pruritus ; Respiratory Insufficiency ; Urinary Retention

A 13-year-old male presented with a walnut-size tender swelling of the left supraclavicular area. The lesion developed 4 months after BCG vaccination in a left. upper arm location. The supraclavicular lesion gradually increased in size and became suppurative witii resultant sinus formation. Histopathological examination of the nodular lesion showei3 foci of epithelioid granulomas with caseation necrosis, and several Langhans' type giant cells. After a diagnosis of BCGitis was made, the patient was, treated with isoniazid an l rifampin for two months without much benefits. Surgical excision of the lesion were performed to expedite clinical regression. After six months of antituherculous chemctherapy, a clinical remission was evident. Scrofuloderma-like BCGitis as well as other cutaneous complications of BCG vaecination are not uncommon. Thus, the practicing dermatologist should be aware of these complications, for correct diagnosis and treatment.
Adolescent ; Arm ; Diagnosis ; Giant Cells ; Granuloma ; Humans ; Isoniazid ; Male ; Mycobacterium bovis ; Necrosis ; Rifampin ; Vaccination