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

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

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*

BACKGROUND: Trichophyton verrucosum (T. verrucosum) is a zoophilic dermatophyte distributed all around the world. In Korea, kerion celsi caused by T. verrucosum was first reported by Kim et al in the southeast province of Korea. Since then, many patients infected with T. verrucosum have been reported in Young-nam, Chungcheong province, and so on. OBJECTIVE: There have been few reports on the T. verrucosum in Korea, yet. Authors tried to offer the information on dermatophytosis due to T. verrucosum in the various aspects such as prevalence of each year, epidemiology, onset time of the year and season, distribution and characteristics of the regions, sex and age distribution, the clinical types, onset site of the body, and the relation between human beings and infected cattle and so on. METHOD: A total of 218 patients who visited Catholic Dermatologic Clinic in Daegu, Korea from 1986 to 2004, were finally diagnosed as T. verrucosum infection by KOH and fungal culture. The data were based on a retrospective survey of hospital records. However, whenever the information was lacking, we called patients to ask lists of questions for the investigation. RESULTS: The number of patients had increased every year since the first report in 1986. In 1988, the number was up to 44, which was the most. After the year 2000, the number of patients had been decreasing so continuously that there was no case in the year 2003 and 2004. As we see the distribution of province, 47 cases were from Daegu, 137 cases from Kyungsang bukdo, 29 cases from Kyungsang namdo, 5 cases from other provinces and cyties. In the distribution of season, 81 cases appeared in the spring, which was the most. Female to male ratio showed about a 1.2-fold predominance for male. And less than 15-year-old group was 41.3% of total patients. The most frequent onset site was face (36 cases, 16.5%), and the next were arm, trunk, head, leg, neck in the decreasing orders. Classifying the patients by the clinical type, 150 cases (68.8%) were in the tinea circinata type, and the next were kerion celsi type, tinea barbae type, agminated folliculitis type in the decreasing orders. Among 126 cases, 99 patients raised cattle with lesions caused by T. verrucosum, 8 patients raise cattle without lesions, 19 patients didn't breed cattle. CONCLUSION: This investigation is expected to help understand and obtain more information on T. verrucosum infection in Korea.
Adolescent ; Age Distribution ; Animals ; Arm ; Arthrodermataceae ; Cattle ; Daegu ; Epidemiology ; Female ; Folliculitis ; Head ; Hospital Records ; Humans ; Korea ; Leg ; Male ; Neck ; Prevalence ; Retrospective Studies ; Seasons ; Tinea ; Tinea Capitis ; Trichophyton*

No abstract available.
Colorectal Neoplasms* ; Fluorouracil* ; Leucovorin*

Ulcerative colitis (UC) is a chronic inflammatory disorder of the colonic mucosa that characteristically affects the rectum and involves the large bowel in a contiguous distribution. Upper gastrointestinal inflammation was not believed to be present in UC, but a few recent studies have reported a high incidence of gastroduodenal inflammation in patients with UC, although such occurrences are apparently rare and the stomach and duodenum are not generally considered target organs in UC. Here, we present the case of a 29.year.old man with UC who was found to have diffuse ulcerative duodenitis with endoscopic and histologic features identical to UC
Colitis, Ulcerative ; Colon ; Duodenitis ; Duodenum ; Humans ; Incidence ; Inflammation ; Mucous Membrane ; Rectum ; Stomach ; Ulcer