Letterer-Siwe disease occurred in a 3 year 7 month old male child showing severe emaciation, hepatosplenomegaly, otitis media, hemorrhagic and impetiginous crusted patches on the body, and seborrheic dermatitis like skin rashes in the scalp. Also showed are severe anemia, thrombocytopenia, bronchopneumonia and multiple bony defects in skull. The child expired in a month after admission.
Anemia ; Bronchopneumonia ; Child ; Dermatitis, Seborrheic ; Emaciation ; Exanthema ; Histiocytosis, Langerhans-Cell* ; Humans ; Infant ; Male ; Otitis Media ; Scalp ; Skull ; Thrombocytopenia

No abstract available.
Arthrodermataceae* ; Humans ; Tinea*

BACKGROUND: Despite remarkable progress of understanding the pathophysiology and therapy of bronchial asthma, asthma morbidity and mortality are on the rise. Also hospitalization and attending rates of emergency department for asthma have been increasing gradually. We analyzed clinical characteristics and prognosis of patients who visited emergency room due to asthma attack in order to define clinical characteristics of these group of patients. METHOD: We reviewed 105 adult asthmatic patients who attended emergency department of Korea University Hospital between August 1995 and July 1996, retrospectively. RESULTS: 103 patients(56 female, 47 males, mean age : 48.6 years) attended-68 self referral, 18 practitioner referral and 17 OPD transfer- and 86 patients(83.5%) were admitted. Attending emergncy department was clearly more frequent in December(13.6%) and May(12.6%). Time lag between onset of asthmatic attack and arrival at the hospital was 14.2 15.5 hour and initial peak expiratory flow rate was 166.7 68.3L/min.(43.3% predicted) The commonest cause for visiting emergency room was aggravation of asthma due to upper respiratory tract infection in mild asthmatics. About half of them had history of previous ER visits. Their prognosis was not bad, but after discharge, about half of patients escaped from OPD follow-up. CONCLUSION: As a group they merit detailed attention and follow up arrangement. Clinician need to monitor and review the treatment plans, the medications, the patient's management technique, and the level of asthma control. For this group, plans for longer term treatment, including asthma education program and adjustment of overall treatment plan should be made.
Adult ; Asthma ; Education ; Emergencies* ; Emergency Service, Hospital* ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Korea ; Male ; Mortality ; Peak Expiratory Flow Rate ; Prognosis ; Referral and Consultation ; Respiratory Tract Infections ; Retrospective Studies ; United Nations

The identification of clinical predictors of clozapine response in schizophrenics might be helpful to make a selection of the patients for clozapine treaolent, and could also be useful to diminish the incidence of agranulocytosis, an unpredictable and potentially lethal side effect of clozapine. This study was designed to identify the characteristic symptoms which can predict a good response to clozapine in schizophrenics before or in early stage of clozapine treatmnet. The results were summarized as follows. First, while twenty four patients who had a reduction of 1 point or greater in CGI scores from baseline to six-week clozapine treatment were defined as clozapine responders, seventeen patients without such a change were defined as clozapine nonresponders. The classification between the two groups was assessed to be valid statistically. Second, both baseline BPRS total scores and each score of 6 BPRS items such as anxiety, hostility, hallucinations, bizarre behavior, self-neglect, and excitement were significantly higher in the clozapine responders than in the clozapine nonresponders. Third, in the responders artier the second week of clozapine treatment, there was a significant reduction from baseline on the anxiety and unusual thought content item scores. In conclusion, several symptomatic factors could be regarded as clinical predictors of clozapine response in schizophrenics, including anxiety, hostility, hallucinations, bizarre behavior, self-neglect, and excitement as well as the severity of psychoticism.
Agranulocytosis ; Anxiety ; Classification ; Clozapine* ; Hallucinations ; Hostility ; Humans ; Incidence

Dermatophytes infect the human hair, skin, nail and cause the dermatophytosis. The extracellular and intracellular proteinases of the dermatophytes commonly occur in the genus Trichophyton like T. rubrum, T. mentagrophytes, and T. granulosum. These enzymes play a prominent role in growth, multiplication and infection of the host tissue. Extracellular proteinases have been purified from the species of Trichophyton and Microsporum. We purified the proteinase partially from the culture filtrate of the Trichophyton tonsurans through Mono-Q and Superose 12 column and investigated its biochemical and enzymatic characters. The molecular size of the proteinase was estimated to be 41 kDa by SDS-PAGE. And pI was 3.2. The optimal temperature and pH for an enzymatic activity were 27C and 7.5, respectively. The purified porteinase degraded the keratin, bovine serum albumin, hemoglobin. The serine proteinase inhibitor like PMSF and DFP inhibited the proteolytic activity of the purified enzyme whereas the cysteinase inhibitor did not. These results demonstrated that the purified proteinase is a serine proteinase and can contribute the tissue invasion.
Arthrodermataceae ; Electrophoresis, Polyacrylamide Gel ; Hair ; Humans ; Hydrogen-Ion Concentration ; Isoflurophate ; Microsporum ; Peptide Hydrolases ; Serine Proteases* ; Serine* ; Serum Albumin, Bovine ; Skin ; Tinea ; Trichophyton*

Although there has been recently noted a nation-wide spread of Trichophyton verrucosum infection in cattle associated with promoted stock raising and dairy farming, there were no case reports in Korean dermatologic literature describing the characteristic clinical features of tinea barbae caused by that particular fungus. We report 3 cases of tinea barbae due to T. verrucosum that developed in male stock farmers breeding cattle. One Patient acted 37, experienced acutely inflamed bo99y tumors on the chin and sub-mandible. The others aged 43 and 46 experienced inflammatory lesions with multiple follicular pustules, crusts and loss of hairs on their upper lips. They were successfully treated with oral griseofulvin and local antifungal ointment combined with short-term oral antibiotics or corticosteroid for about one month.
Animals ; Anti-Bacterial Agents ; Breeding ; Cattle ; Chin ; Fungi ; Griseofulvin ; Hair ; Humans ; Lip ; Male ; Tinea* ; Trichophyton*

Diffusely infiltrating primary colorectal carcinoma is a rare disease. This type of carcinoma extensively spreads beneath the mucosal layer. Clinically, it resembles inflammatory colorectal disease and metastatic carcinoma and is difficult to diagnosis. Moreover, the prognosis is extremely poor. A 66-year-old man was admitted to our hospital because of lower abdominal pain. Barium enema showed circumferential long segment narrowing in the proximal sigmoid colon without definite mass or ulceration and abdominal CT demonstrated colonic wall thickening. So it was diagnosed as inflammatory condition by image study. Colonoscopic examination showed hypertrophied mucosa and luminal narrowing on the 40 cm from the anal verge, but the oral side couldn't be examined because of stenosis. Biopsy revealed poorly differentiated adenocarcinoma, and left hemicolectomy was done. The pathology showed diffusely infiltrating adenocarcinoma with metastasis in regional lymph node and mesentry involvement.
Abdominal Pain ; Adenocarcinoma ; Aged ; Barium ; Biopsy ; Colon* ; Colon, Sigmoid ; Colonic Neoplasms* ; Colorectal Neoplasms ; Constriction, Pathologic ; Diagnosis ; Enema ; Humans ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Pathology ; Phenobarbital ; Prognosis ; Rare Diseases ; Tomography, X-Ray Computed ; Ulcer

BACKGROUND: The prevalence of Gastro-esophageal reflux(GER) in patients with asthma is estimated to be 50~60% and treatment of GER has been shown to improve asthma symptoms in Western. But GER has been known to be less common in Eastern and GER prevalence rates in asthmatics are not available in Korea. METHOD: We compared the prevalence rate of GER in 42 patients with asthma to that in 20 healthy normal controls and examed the efficacy of new prokinetic drug, cisapride(40mg/day, 8weeks) in patients with GER and asthma. For acid GER to be considered pathological, 24 hour esophageal pH monitoring should reveal values exceeding upper limit of 95 percentile for at least one of 6 parameter of DeMesseter's table. RESULT: The results showed GER was more common in patients with asthma(11/42, 26.2%) than normal controls(3/20, 15%) and asthmatics group showed a significant longer supine time pH<4(%) and total time pH<4(%), and more reflux episodes as compared with normal control group. After 4 asthmatics with GER were treated with cisapride, their asthma symtom scores, FEV1 and composite scores of pH monitoring were improved. CONCLUSION: GER is more common in asthmatics than in normal controls in Korea and prepulsid reduces asthma symptoms in patients with GER and asthma.
Asthma ; Cisapride ; Esophageal pH Monitoring ; Gastroesophageal Reflux* ; Humans ; Hydrogen-Ion Concentration ; Korea ; Prevalence

No abstract available.
Pulmonary Embolism*

Relapsing polychondritis is a systemic disorder characterized by recurrent inflammation and degeneration of cartilaginous tissue throughout the body. The association with HLA-DR4 and the occurrence of antibodies to type II collagen and other antoantibodies suggest that an immunologic mechanism is involved in its pathogenesis. The eyes, oars, nose, larynx, trachea and articular areas are commonly involved. Airway narrowing or collapse from respiratory tract involvement, occurs in up It 50% of patients with relapsing polychondritis. Treatment consists of administration of corticosteroids arid other anti-inflammatory and immunosuppresive drugs. We experienced a case of relapsing polychondritis involving the tracheobronchial tree, nose and ears in a 49-year-old woman. The patient was clinically and histologically diagnosed as relapsing polychondritis according to McAdam's and Damiani's criteria. We report this case with a review of the literature.
Adrenal Cortex Hormones ; Antibodies ; Collagen Type II ; Ear ; Female ; HLA-DR4 Antigen ; Humans ; Inflammation ; Larynx ; Middle Aged ; Nose ; Polychondritis, Relapsing* ; Respiratory System ; Trachea