We report a case of plexiform neurofibroma developed under the overlying speckled lentiginous nevus, which occurred in a 20 year-old man. In this patient and his family no other signs of von Recklinghausens disease were found. Discussion is focussed on the fact that both plexiform neurofibroma and speckled lentigmous nevus, which represent a defect in the neural crest, occurred in the same area of the skin.
Humans ; Neural Crest ; Neurofibroma, Plexiform* ; Neurofibromatosis 1 ; Nevus* ; Skin

BACKGROUND: It is not clear whether mild hypothermia (34 degrees C) enhances stress hormonal responses during surgery under general intravenous anesthesia. The purpose of this study was determine how mild hypothermia affects hemodymic and stress hormonal responses introperatively and during extubation in patients undergoing cerebral aneurysm surgery under general intravenous anesthesia. METHODS: Anesthesia was induced intravenously with thiopental sodium 5 mg/kg, succinylcholine 1 mg/kg, and maintained with 50% O2, 50% N2O, and propofol using a target controlled system; Diprifusor(R) (3-5 microgram/ml) and muscle relaxation were administered with intravenous vecuronium intermittently. For the normothermia and the hypothermia groups, body temperatures were maintained at 36.9+/-0.3degrees C and 34.2+/-0.2 degrees C, respectively, up to the recovery room. Hemodynamic changes were recorded continuously. Arterial blood gas analysis, glucose, hemoglobin, stress hormones comprising epinephrine, norepinephrine, ADH, ACTH and cortisol were measured at whilst awake, intraoperatively, and just after extubation. RESULTS: Hemodynamic changes from the awake control state to postextubation were not significantly different between the normothermia and hypothermia groups. In the control awake state, all five hormonal concentrations were similar in the two groups. Intraoperatively and during extubation, all hormonal concentrations tended to be lower in the hypothermia group than in the normothermia group, except epinephrine during extubation. During the same period, all except ACTH decreased sufficiently to reach statistical significance (P < 0.05) versus the awake control state. But no significant differents were found between the two groups. CONCLUSIONS: Our data suggest that intraoperative mild hypothermia dose not significantly affect hemodynamic changes or the plasma concentrations of stress hormones.
Adrenocorticotropic Hormone ; Anesthesia ; Anesthesia, Intravenous* ; Blood Gas Analysis ; Body Temperature ; Epinephrine ; Glucose ; Hemodynamics* ; Humans ; Hydrocortisone ; Hypothermia* ; Intracranial Aneurysm ; Muscle Relaxation ; Neurosurgery ; Norepinephrine ; Plasma ; Propofol ; Recovery Room ; Succinylcholine ; Thiopental ; Vecuronium Bromide

PURPOSE: The widely used chemotherapeutic agents exert their anti-cancer effects by the inducing of apoptosis in sensitive tumor cells. Recently, the protective effect of zinc ion on apoptosis has been reproted. However, it is not well understood about the effects of zinc ion on the anticancer drug-induced apoptosis. In general, zinc inhibits a nuclear endonuclease, thereby causing inhibition of apoptosis. In addition, there is other possibility that zinc can prevent apoptosis at earlier stage such as the activation of caspase-3 than that of the activation of endonuclease. Therefore, we investigated the effects of zinc ion on the apoptosis of HL-60 cells caused by adriamycin (ADR). METHODS: HL-60 cells were cultured in RPMI 1640 and treated with various concentrations and time periods of ADR with or without pretreatment of zinc ion. Cellular DNA was extracted and analyzed by electrophoresis on a 1.5% agarose gel to detect DNA fragmentation. The activity of caspase-3 was measured by the proteolytic cleavage of the fluorogenic substrate DEVD-AMC. Poly-ADP-ribose polymerase (PARP) cleavage was analyzed by western blotting using anti-PARP antibody. RESULTS: ADR induced the apoptotic death of HL-60 cells in a dose and time dependent manner, which was characterized by increasing ladder-pattern DNA fragmentation. Pretreatment of HL-60 cells with zinc ion caused potent inhibition of ADR-induced apoptosis. Consistent with apoptotic death of HL-60 cells, ADR induced the catalytic activation of caspase-3. After pretreatment of zinc ion, the activation of caspase-3 and the proteolysis of PARP induced by ADR were markedly inhibited. CONCLUSION: These results indicate that zinc ion prevents the ADR-induced apoptosis of HL-60 cells through an inhibition of caspase-3 activity, which occurs upstream from the activation of endonuclease.
Apoptosis* ; Blotting, Western ; Caspase 3 ; DNA ; DNA Fragmentation ; Doxorubicin ; Electrophoresis ; Fluorescent Dyes ; HL-60 Cells* ; Humans ; Proteolysis ; Sepharose ; Zinc*

Sturge-Weber syndrome is a congenital disorder characterized by facial nevus flammeus along the distribution of the trigeminal nerve, ipsilatal leptomeningioma, buphthalmos, and choroidal angioma. The Authors experienced a case of Sturge-Weber syndrome in 9 year old female patient and glaucoma was controlled by trabecuectomy without any complications.
Child ; Choroid ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Female ; Glaucoma ; Hemangioma ; Humans ; Hydrophthalmos ; Port-Wine Stain ; Sturge-Weber Syndrome* ; Trigeminal Nerve

Two patients with cutaneous leishmaniasis were treated with itraconazole. One patient was a 24-year-old man who had several erythematous papulonodules on the extremities for 1 month, which revealed cutaneous leishmaniasis, histopathologically. He was treated with itraconazole (200 mg/day) for 2 months. After treatment he showed clinical healing and the biopsy specimens no longer showed leishmania organisms. The other patient was a 27-year-old female who had several erythematous papulonodules on the face and neck for 3 months. The skin lesions revealed leishmania organisms in the tissue sections and culture media. She was also treated with itraconazole (200 mg/day) for 2 months. After treatment she also showed satisfying clinical healing and the biopsy specimens revealed no leishmania organisms. No specific side effects were encountered in both patients during the treatment. From these results, itraconazole is considered to be one of the promising anti-leishmanial drugs.
Adult ; Biopsy ; Culture Media ; Extremities ; Female ; Humans ; Itraconazole* ; Leishmania ; Leishmaniasis, Cutaneous* ; Neck ; Skin ; Young Adult

The characteristics of ocular injury is that the extent of visual disturbance is variable and serious in spite of inconsiderable trauma. Moreover, the prognosis of ocular injury in infancy and childhood is poorer than that in adulthood because the visual funjction of infants and children has not completely matured yet. And the visual disturbance will influence unfavorably upon the selection of occupation in future. Therefore, further investigation of pediatric ocular injuries is thought to be necessary for the establishment of measures of treatment and prevention. The authors clinically analysed 161 eyes of 152 pediatric ocular injurise under the age of 15 year-old who visited emergency room of Masan Koryo General Hospital during the 3 years from January 1, 1986 to December 31, 1988. The ambulation rate of pediatric ocular injuries was 7.5% of total eye patients through emergency room and the incidence was higher in male. The most common disease of all pediatric ocular injuries was lid laceration, followed by subconjunctival hemorrhage and traumatic hyphema. It was revealed that the age group from 4 to 6 was the most hazardous stage for pediatric ocular injuries and a pierced wound by sharp pointed materials was the most harmful and the most dangerous mode of injury.
Adolescent ; Child ; Emergencies* ; Emergency Service, Hospital* ; Hemorrhage ; Hospitals, General ; Humans ; Hyphema ; Incidence ; Infant ; Lacerations ; Male ; Occupations ; Prognosis ; Walking ; Wounds and Injuries

No abstract available.
Churg-Strauss Syndrome* ; Humans ; Vasculitis*

BACKGROUND AND OBJECTIVES: Imidapril, one of the ACE inhibitor, has been used to treate hypertension, congestive heart failure, diabetes mellitus and renal disease. ACE inhibitor, however often causes dry cough and this adverse effect affects the compliance rate negatively. This report aimed to examine the incidence rate of coughing caused by Imidapril treat-ment. And we compared the results with the incidence and tendency of dry cough caused by the other ACE inhibitors. MATERIALS AND METHOD: This study enrolled 38 patients who followed up at internal medicine and took Imidapril from the period of May 9, 1997 to December 17, 1997. We tested its effectiveness, safety and tolerance. The initial dosage of it was 5mg/day and the maximum dosage according to blood pressure was 10mg/day for 8 weeks. The tendency and the incidence of dry cough have been analyzed and compared with recently published Korean reports. RESULTS: The 5 mg dosage of Imidapril showed 68.1% in lowering blood pressure rate and it went up to 81.8% during the 8 weeks treatment perriod. The blood pressure regularity rate was 36.3% after the 8 weeks treatment. The overall rate of adverse effect occurrence was 26.1% (6/23) and 8.7% of them were likely to cough. One of the patients who showed nausea stopped medication. The recent articles reported that the incidence of dry cough had been reduced: Enalapril (33.8%), Fosinopril (16%), Ramipril (15%), Imidapril (7.8 - 8.7%), Losartan (4.3%). CONCLUSION: Imidapril is as safe and effective as other ACE inhibitors. Various ACE inhibitors that were newly developed show their effectiveness in lessening incidence rate of dry cough, and Imidapril is thought to be an excellent drug for this matter. Even though Losartan shows the lowest incidence rate of dry cough, it needs to more regular usages since it is still on the stage of its medical adaptation.
Angiotensin-Converting Enzyme Inhibitors ; Angiotensins* ; Blood Pressure ; Compliance ; Cough* ; Diabetes Mellitus ; Enalapril ; Fosinopril ; Heart Failure ; Humans ; Hypertension ; Incidence* ; Internal Medicine ; Losartan ; Nausea ; Peptidyl-Dipeptidase A* ; Ramipril

The first author's name was misspelled.

Background: Abnormal liver function tests (LFTs) are commonly seen in pediatric patients with acute infectious diseases. Few studies and no definite clinical guidelines for these conditions are available. The present study aimed to elucidate the causes and factors associated with prolongation of liver enzyme elevation. We also investigated actual real-world practices in Korea. Methods: A retrospective study was performed on all patients younger than 18 years, who visited six tertiary teaching hospitals around Korea in 2018 for acute infectious diseases and showed alanine aminotransferase (ALT) levels above 60 IU/L without other specific conditions that could cause ALT elevation. We categorized the infections that cause LFT elevation into six groups: respiratory infection, gastrointestinal infection, urinary tract infection, other febrile disease, Epstein-Barr virus infection, and cytomegalovirus infection. We collected data on the medical specialty of the attending physician who followed up the subject, follow-up duration, percentage of follow-up loss, and their investigation. Results: A total of 613 patients were enrolled in this study, half of whom (50.7%) were younger than 12 months. The mean initial aspartate aminotransferase and ALT values were 171.2 ± 274.1 and 194.9 ± 316.1 IU/L (range 23–2,881, 60–2,949 IU/L), respectively; however, other LFTs were within the normal range. Respiratory infection was the most common diagnosis (45.0%), and rhinovirus was the most commonly identified pathogen (9.8%). The follow-up rate was higher with pediatric gastroenterologists (90.5%) and non-gastroenterology pediatricians (76.4%) than with pediatric residents and emergency doctors. Older age was related to better ALT recovery (odds ratio [OR] of age for month = 1.003; 95% confidence interval [CI], 1.001–1.004; P = 0.004), while the number of infection episodes (OR = 0.626; 95% CI, 0.505–0.777; P < 0.001) was associated with poor ALT recovery. Abdominal sonography was the most commonly used diagnostic tool (36.9%), followed by the hepatotropic virus workup. The modalities of hepatitis workup were significantly differently applied by physicians based on their specialties and institutions. Conclusion Abnormal liver function test after a systemic infection was common in respiratory infection and under the age of 1 year. Age, number of infections, and initial results of LFTs were related to ALT recovery time. Inter-physician, inter-institution, and inter-specialty variances were observed in real-world practice.