Angioedema is a disorder characterized by well-demarcated nonpitting edema involving the tongue, floor of the mouth, larynx, lips, and face. The incidence of angiotensin converting enzyme(ACE) inhibitor related angioedema has been reported to be about 0.1% to 0.2%, and the time of onset is usually during the first week of therapy. These ACE inhibitors include captopril, enalapril, and lisinopril. A 53-year old man with an 8 month history of hypertension previously controlled with atenolol, was presented to the dermatologic department with angioedema of the face and tongue. He had begun therapy with captopril one day before this episode. Even though he was treated with epinephrine and methylprednisolone sodium succinate, the edema gradually progressed and finally dyspnea developed. He was urgently intubated and treated with steroids and pheniramine maleate in the intensive care unit. The edema resolved after 24 hours.
Angioedema* ; Angiotensin-Converting Enzyme Inhibitors ; Angiotensins ; Atenolol ; Captopril* ; Dyspnea ; Edema ; Enalapril ; Epinephrine ; Humans ; Hypertension ; Incidence ; Intensive Care Units ; Larynx ; Lip ; Lisinopril ; Methylprednisolone Hemisuccinate ; Middle Aged ; Mouth ; Pheniramine ; Steroids ; Tongue

Rudimentary meningoceles represent a developmental anomaly in which meningothelial elements are found in the skin. The majority of rudimentary meningoceles occur on the scalp over the occiput or along cranial suture lines. They are present as a pink papule, nodule or an area of alopecia. Histologically, the lesion consists of scattered foci of meningothelial cells, an anastomosing network of empty spaces with psammoma bodies and collagen bodies, and small vessels, which may be located from the dermis to the subcutis. Immunohistochemically, the meningothelial cells are commonly positive for vimentin and often positive for EMA. We report the cases of two infants who were noted at birth to have scalp hair anomalies. One had a translucent, bald, slightly atrophic patch on the midline of the vertex and the other had a subcutaneous nodule surrounded by long hairs, so called "hair collar sign" on the midline of the occipital area. The latter had an underlying skull defect without a communication with intracranial spaces. Due to the occasional presence of connection to the central nervous system, any midline lesion in an infant, including rudimentary meningocele, deserves careful preoperative evaluation including imaging studies.
Alopecia ; Central Nervous System ; Collagen ; Cranial Sutures ; Dermis ; Hair ; Humans ; Infant ; Meningocele* ; Parturition ; Scalp ; Skin ; Skull ; Vimentin

BACKGROUND: Trichophyton (T.) tonsurans infection has been increasing gradually in non-athletes, i.e. general population as well as athletes since it was first reported that athletes had been infected in Korea in 1995, whereas it is a common dermatophyte species in the United States and Europe. OBJECTIVE: We performed retrospective study to observe tinea infections caused by T. tonsurans. METHOD: The clinical and epidermiological study was made with 105 patients of T. tonsurans infection among out-patients in our skin clinic from March, 1995 to December, 2003. RESULT: In 105 cases of T. tonsurans infection 73 ones were athletes such as wrestlers and judo players, and 32 ones were non-athletes. The infected skin lesions of 114 cases showed mild to moderate inflammation, whereas 7 ones showed moderate to severe inflammation. The results of KOH wet mount were positive in 92 cases (87.6%). In fungal culture with Potato dextrose agar-corn meal-tween 80, the mahogany variety (53.3%) was more than the sulfreum one (22.8%), which was less significant because the percentage of unclassified cases (23.8%) influenced on variety distribution considerably (p> 0.05, chi-test). Microscopic findings of cultured fungus showed hyphae with match-box type microconidia. Preferred anatomical sites were scalp (35.2%), face (32.4%), upper extremities (16.2%), and neck (14.3%). The rate of sex was 89 cases in male and 16 ones in female. The mean age was 16.1+/-4.6, ranged from 3 to 44 years. There is no difference between athletes and non-athletes. Preferred seasons were winter (44.8%) and spring (33.3%). The occurrence of the cases in athletes, which reached the peak in 1997, has been maintained since 1995, while the number of the cases in non-athletes has minimally increased until 2003. Throughout this study it proves that the occurrence of the infection has been disseminating with athletes of a hand-to-hand fight through a lot of physical contact in the center because of frequent athletic meetings since T. tonsurans was introduced in Korea in 1995. Moreover, there is a increasing tendency toward T. tonsurans infection in non-athletes. Therefore, athletic and medical associations should make continual observations of T. tonsurans infection and take close consideration into systematic management and strategy against the infection in order to suppress probable prevalence of the contagion in our society.
Arthrodermataceae ; Athletes ; Europe ; Female ; Fungi ; Glucose ; Humans ; Hyphae ; Inflammation ; Korea ; Male ; Martial Arts ; Neck ; Outpatients ; Prevalence ; Retrospective Studies ; Scalp ; Seasons ; Skin ; Solanum tuberosum ; Sports ; Tinea ; Trichophyton* ; United States ; Upper Extremity

PURPOSE: This study was conducted to survey children's health status and need of customized visiting health care services in one province. METHODS: The participants in this study were 237 caregivers of infants and preschoolers. Data were collected at the participant's home or public health center. RESULTS: Many of the children did not receive developmental screening tests or dental examinations. In the beneficiary group, the prenatal checkup rate and children's vaccination rate were lower, and caregivers had more health problems than the other groups. On the assessment of home safety, unsafe conditions were more frequently found in the beneficiary group. The caregivers in the beneficiary group showed lower child rearing confidence than the other groups, and wanted customized visiting health care services most in the areas of developmental screening, regular health check-up and counseling, nutritional supplementation, and oral health care. CONCLUSION: These results indicate that it is necessary for children and parents in poverty to be provided with professional home visiting interventions for the promotion of child health and prevention of developmental problems and diseases. These findings can be used for developing future customized visiting health care service programs for infants and children in this community area.
Caregivers ; Child Rearing ; Child Health ; Child* ; Counseling ; Delivery of Health Care* ; House Calls ; Humans ; Infant ; Mass Screening ; Oral Health ; Parents ; Poverty ; Public Health ; Social Class* ; Vaccination

Childhood granulomatous perioral dermatitis(CGPD) is a distinctive granulomatous form of perioral dermatitis of unknown cause with a benign and self-limited course and no associated systemic manif estations. It is characterized by an asymptomatic monomorphous papular eruption, with or without scale or pustules, around the mouth, nose, and eyes primarily in prepubertal children. This condition may resemble sarcoidosis both clinically and histologically. A 3-year-old boy first presented with a month-history of mildly pruritic rash around the mouth. When he returned for follow-up after an eight-week period of topical corticosteroid therapy, multiple new follicular papules and pustules developed. Histopathologic examination revealed that a granulomatous lesion consisted of nodular infiltration of multiple histiocytes admixed with lymphocytes in the dermis. The condition resolved in about three weeks after using an unknown topical agent prescribed by a private practicing dermatologist.
Child ; Child, Preschool ; Dermatitis, Perioral* ; Dermis ; Exanthema ; Follow-Up Studies ; Histiocytes ; Humans ; Lymphocytes ; Male ; Mouth ; Nose ; Sarcoidosis

Drug-induced acute interstitial nephritis is characterized by renal interstitial inflammatory cell infiltration and commonly presents as acute renal failure. This is caused mainly by methicillin, non-steroidal antiinflammatory drugs, sulfonamide diuretics such as thiazide, but cases induced by furosemide are rare. We report a patient with acute interstitial nephritis causing reversible acute renal failure and dermatitis while she was taking furosemide. A 37-year old woman was referred to our hospital because of generalized skin rash and non-oliguric acute renal failure. She had peripheral eosinophilia (1,577/mm3) and serum creatinine level of 6.8mg/dL. Skin biopsy showed leukoclastic vasculitis and percutaneous renal biopsy showed severe interstitial infiltration of lymph ocyte and mild interstitial fibrosis with focal tubular atrophy. After withdrawal of furosemide, renal function and skin lesions were completely recovered.
Acute Kidney Injury ; Adult ; Atrophy ; Biopsy ; Creatinine ; Dermatitis ; Diuretics ; Eosinophilia ; Exanthema ; Female ; Fibrosis ; Furosemide* ; Humans ; Methicillin ; Nephritis, Interstitial* ; Skin ; Vasculitis

Cephalic brain-like heterotopias, so called nasal gliomas, are masses of mature glial tissue resulted from an error in embryonic development and are frequently located on the bridge of the nose. They often give rise to the clinical suspicion of dermoid cyst, hemangioma, or lipoma. Histologically, they are composed of fibrillary neuroglial cells, mainly large astrocytes, which are interlaced with a variable amount of fibrous and vascular connective tissue. Mitoses are rare. The possible tumor stalk is usually fibrous without glial elements. Due to the occasional presence of connection to the intracranial space it deserves a careful preoperative evaluation including imaging studies. We report a case of cephalic brain-like heterotopia. A sixteen day-old infant presented a mass which was suspended to the forehead by a fibrous stalk. Th excised lesion showed characteristic pathologic features of cephalic brain-like heterotopia.
Astrocytes ; Connective Tissue ; Dermoid Cyst ; Embryonic Development ; Female ; Forehead ; Glioma ; Hemangioma ; Humans ; Infant ; Lipoma ; Mitosis ; Neuroglia ; Nose ; Pregnancy

PURPOSE: To report a case of visual improvement in methanol poisoning treated with intravenous methylprednisolone. CASE SUMMARY: A 64-year-old man presented with decreasing vision in both eyes after ingesting a car window cleanser. His initial visual acuity was the ability to count fingers in the right eye and hand motion in the left eye. The patient received intravenous methylprednisolone (1.0 gram), slowly over 1 hour. The same dose of methyl prednisolone was repeated on the second and third day. Then, oral prednisolone was given and tapered over a period of 7 weeks. On the 5th day after treatment, there was an improvement in the visual acuity of the right eye to 0.4 but no improvement of vision was observed in the left eye. On 16th day after treatment, the visual acuity was 0.7 in the right eye and counting fingers in the left eye. At 2 months after ingestion, the visual acuity of the right eye returned to 1.0 with no improvement in the left eye. Optic disc pallor was suspected and P100 delay was observed in the left eye with VEP showing a favorable outcome in the right eye. CONCLUSIONS: A visual improvement of 1 eye was observed in methanol poisoning treated with intravenous methylprednisolone.
Amblyopia* ; Eating ; Fingers ; Hand ; Humans ; Methanol* ; Methylprednisolone ; Middle Aged ; Pallor ; Poisoning ; Prednisolone ; Visual Acuity

BACKGROUND: One of the unique feature of ambulatory blood pressure monitoring is its ability to describe the variations of BP throughout the day and night. Left ventricular hypertrophy and other measures of target organ damage in hypertension are more closely related to the average 24-h BP than to clinic BP. In addition to the mean levels of BP, the characteristics of the 24-h BP profile might be a further determinant of organ in essential hypertension. METHODS: Data were obtrained from 105 patients with essential hypertension and 44 normal subjects. Echocardiography and 24 hour ambulatory blood pressure monitoring were performed in all subjects. At first, relative wall thickness(RWT) and left ventrcular mass index were calculated from normal subject and normal values(RWT<0.44, LV mass index,120gm/m2) were applied to hypertensive patients which were classified to dipper and non-dipper according to the result of ambulatory monitoring. RESULTS: 1) There were 49 dippers and 56 non-dipper in hypertensive patients subjects. 2) Among the dippers, left ventricular mass index and relative wall thickness were normal in 51%, whereas 8.2% had increased relative wall thickness with normal ventricular mass(concentric remodeling), 32.7% had increased mass with normal relative wall thickness(eccentric hypertrophy) and 8.2% had typical hypertensive concentric hypertrophy. 3) Among the non-dippers, left ventriculat mass index and relative wall thicksness were normal in 40%, whereas 41.8% had eccentric hypertophy, 16.4% had concentric hypertrophy, only 1.8% had concentric remodeling. 4) The incidence of concentric hypertophy was significantly increased in non-dipper subjects(15.2%) than dippers(8.2%), especially in non-dipper female patients. 5) The incidence of concentric remodeling was increased in dipper(8.2%), especially in dipper female patients. 6) There were no difference between left ventricular geometies in duration of hypertension, ejecton fracton, fractional shortening, and cardiac index. 7) There were no difference between dipper and non-dipper subjects in total peripheral resistance except dipper female patients(1,484+/-535 dynes.s.cm5). CONCLUSION: Patterns of left ventricular hypertophy and geometric remodeling in essential hypertension may not be influenced by the duration of hypertension, but by gender, blood pressure level, diurnal rhythm and total peripheral resistance.
Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Circadian Rhythm ; Echocardiography ; Female ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular ; Incidence ; Monitoring, Ambulatory ; Vascular Resistance

No abstract available.
Etoposide* ; Fluorouracil* ; Stomach Neoplasms*