A case of impetigo herpetiformis occurring in a 25-year-old multigravida woman is reported. Superficial grouped pustules on an erythematous base developed on the flexual areas of both extremities and disseminated all over the body with mild pruritus, fever and burning sensation at her 14th weeks of pregnancy. Histopathologic findings showed acanthosis and subcorneal. pogiform pustule. All lesions had gradually improved within 2 weeks after artificial abortior. Our case demonstrates the characteristic features of impetigo erpetiformis, as compared with pustular psoriasis. This, we emphasize the need to preserve it as a separate entity.
Adult ; Burns ; Extremities ; Female ; Fever ; Humans ; Impetigo* ; Pregnancy ; Pruritus ; Psoriasis ; Sensation

We report a case of eczema herpeticum associated with secondry staphylococcal infection in a 19 year-old male patient with Dariers disease during tratment with etretinate. Diagnosis was made by the history, clinical feature and histologic examination with light microscope & electron microscope. This patients condition was improved by the treatment with systemic and topical antibiotics within 1 week of admission.
Acitretin* ; Anti-Bacterial Agents ; Darier Disease ; Diagnosis ; Eczema* ; Etretinate* ; Humans ; Kaposi Varicelliform Eruption* ; Male ; Staphylococcal Infections ; Young Adult

No abstract available.
Chloroform*

A 45-year-old woman presented with a generalized fixed drug eruption due to mefenamic acid, characterized by recurring erythematous patches with central bullae on the same sites of the whole body and leaving hyperpigmentation after each attack. Patch testing of a quiescent lesion with 50% mefenamic acid in vaselin revealed an eczematous reaction after 48 hours. The disease course was mild compared to the severe clinical manifestation. We here-in report a case of generalized fixed drug eruption due to mefenamic acid which is considered a rare occurrence.
Drug Eruptions* ; Female ; Humans ; Hyperpigmentation ; Mefenamic Acid* ; Middle Aged ; Patch Tests

46, XX male is a rare sex cluomasomal constitution characterized by the development of bilateral testis in persons who lack a Y chomosome. The majority of affected persons have normal external genitalia and usually seek medical advice due to infertility, hypogonadism and/or gynecomastia in adulthood. Although Y chromosomsl sequences can be detected in the majority of male subjects with 46, XX karyotype, several studies have shown thst approximately 10 % of patients lack Y chromosomal material including the SRY ( sex-determining region of Y-chromosome) gene. Several hypothesis have been proposed to explain the etiology of this constitution. 1. Translocation of the testis-determining factor (TDF) fiom the Y to the X chromosome or autosome. 2. Acquisition of Y chromosome function by a mutant autosomal or X-linked gene. 3. Undetected mosaicism with Y-bearing cell line 4. Loss of Y chmmosome hom the XXY Klinefelter zygote. We experienced a case of 46, XX male who was 30 years old. We report a case with review of the literature.
Adult ; Cell Line ; Constitution and Bylaws ; Genes, X-Linked ; Genitalia ; Gynecomastia ; Humans ; Hypogonadism ; Infertility ; Karyotype ; Male* ; Mosaicism ; Sex-Determining Region Y Protein ; Testis ; X Chromosome ; Y Chromosome ; Zygote

The pulmonary arterial pressure(PAP) was reported to be higher in essential hypertensives than in normotensives, but the underlying mechanisms for the higher PAP were not known exactly. In order to observe the changes of pulmonary hemodynamics and to get an insight into the mechanism of the pulmonary hypertension, if any, in essential hypertensive patients, the autors performed the cardiac catheterization in 13 normal controls(group A), 14 coronary patients with normal systolic left ventricular function and systemic blood pressure(group B), and 15 essential hypertensives with normal coronary artery and systolic left ventricular function(group C). 1)Pulmonary arterial pressure(PAP) was 19.2+/-3.2/8.1+/-1.9/12.0+/-1.9(s/d/m)mmHg in group A, 25.0+/-6.2/12.8+/-4.0/16.3+/-4.5mmHg in group B, 29.3+/-6.1/12.8+/-4.0/18.2+/-3.6mmHg in group C. The PAP was higher in group B and C than that of group A(p<0.005). 2) Pulmonary vascular resistance(PVR) was 88.2+/-34.9 dyne.sec.cm(-5) in group A. 137.8+/-74.5 dyne.sec.cm(-5) in group B and 173.9+/-77.5 dyne.sec.cm(-5) in group C. In group B and C, PVR was increased compared to that of group A(p<0.05, p<0.005, respectively). 3) Pulmonary capillary wedge pressure(PCWP) was 6.6+/-2.8 mmHg in groupa A. 9.9+/-2.9mmHg, and 9.6+/-3.6 mmHg in group C. PCWP in group B and C were higher than that of group A(p<0.005). 4) Systemic vascular resistance(SVR) was 1298+/-340 dyne.sec.cm(-5) in group A, 1466+/-362 dyne .sec.cm(-5) i group B and 2255+/-439 dyne.sec.cm(-5) in group C. In group C, SVR was increased compared to that of group A and B(p<0.002). 5) Significant correlation was demonstrated between PVR and PCWP in group A(r=-0.74, p<0.05). 6) In group B, significant correlations were shown between PAP and PCWp(r=0.55, p<0.05), between PAP and PVR(r=0.69, p<0.05). 7) In group C, significant correlations were demonstrated between PAP and PCWP(r=0.55, p<0.05), between PVR and SVR(r=<0.51, p<0.01). Above results revealed that PAP and PVR were increased in essential hypertensives without left ventricular failure and this elevated PAPseemed to be affected in part by increased PCWP, and increased PVR in accordance with increased SVR.
Capillaries ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Hemodynamics* ; Humans ; Hypertension* ; Hypertension, Pulmonary ; Ventricular Function, Left

Acute generalized exanthematous pustulosis (AGEP) has symptoms of abrupt onset of a widespread pustular eruption on an erythematous. base. Most cases appear to be related to drug reactions, mainly antibiotics, but viral infections and hypersensitivity to mercury may cause AGEP. The essential features of AGEP include. (1) numerous (several dazen) small((5mm), mostly non follicular pustules arising on a widespread erythema:purpura and target-like lesions may be associated; (2) histology showing intraepidermal or subcorneal pustules associated with one or more of the following.clermal edema, vasculitis, perivascular eosinophils, or focal necrosis of keratinocytes; (3) fever (over 38C); (4) neutrophilia, and (5) acute evolution with spontaneous resulotion of pustules within 15 days. We report a case of AGEP which presented with widespread tiny pustules on the whole body except the face, palms and soles. There were petechia, purpura, and vesiculobullous lesions on the axilla, popliteal fossa and upper abdomen. A biopsy specimen from a pustule showed subcorneal pustules with perivascular polymorphous cellular infiltration, marked dermal edema and necrotic keratinocytes. There was complete resolution of the lesions within 10 days.
Abdomen ; Acute Generalized Exanthematous Pustulosis* ; Amoxicillin ; Anti-Bacterial Agents ; Axilla ; Biopsy ; Drug Eruptions ; Edema ; Eosinophils ; Fever ; Hypersensitivity ; Keratinocytes ; Necrosis ; Purpura ; Vasculitis

OBJECTIVES: To evaluate the relation between diagnostic clinical parameters and the depth of trophoblastic invasion in tubal pregnancy and decide the most predictable parameter. Methods: Total 50 patients who were confirmed as tubal pregnancy pathologically, from Jan. to Dec. 1997, were included in this study. Menstrual missed periods was calculated by clinical history, volume of gestational mass was calculated as sphere, beta-hCG was titered with preoperative blood sample. All surgical specimens were examined pathologically and divided into two groups such as intraluminal and extraluminal, defined as intact tubal musculature and trophoblastic invasion beyond musculature, n=22 and n=28, respectively. Statistical analysis was performed among three parameters and between each parameter and the depth of trophoblastic invasion. Statistical analysis included were Student's t-test, Chi square, linear regression, and linear correlation analysis using SPSS statistical package and statistical significance was determined as p<0.05. RESULTS: There was a correlation between volume of gestational mass and beta-hCG(p<0.05), but not between beta-hCG and missed period or volume of gestational mass and missed period. beta-hCG level was 1843.7+/-1524.7 mIU/ml(Mean+/-SD) in intraluminal and 12144.3+/-10561.6 mIU/ml(Mean+/-SD) in extraluminal. There was a predictive correlation between beta-hCG and the depth of trophoblastic invasion(p<0.05), and cut off level 3,500 mIU/ml showed the highest sensitivity, specificity, positive predictive value, negative predictive value, 0.79, 0.86, 0.88, 0.76, respectively. Two parameters(volume of gestational mass and missed period) had no ability to predict whether intraluminal or extraluminal. CONCLUSION: We suggest that successful medical treatment of tubal pregnancy depend on lesional intactness of vasculature for drug delivery. In patient selection for medical treatment, it should be important to predict intraluminal type because of intact vasculature. Of clinical parameters, beta-hCG is single most predictive parameter, cut off level of 3,500 mIU/ml was the most reasonable level in this study.
Female ; Humans ; Linear Models ; Patient Selection ; Pregnancy ; Pregnancy, Tubal* ; Sensitivity and Specificity ; Trophoblasts*

No abstract available.
Anemia* ; Cross-Sectional Studies* ; Female* ; Humans ; Prevalence*

OBJECTIVE: The accuracy of analytical results of blood and urine heavy metals came out to the main issue on occupational health from late eighties. The discrepancy of the results for same samples from different laboratories made the diagnosis for occupational diseases be unreliable. Therefore, a quality control program for analysis of samples taken from workplace had been introduced in Korea since 1992. This study aims to show the quality control program f'or analysis of blood and urine samples and its proficient rates from 1992 to 1999 and to know how they have been being used in occupational health. METHODS: The quality control program runs twice a year with mandatory items of blood lead and urine hippuvic acid and voluntary items of blood cadmium and manganese and urine mandellic acid and methyl hippuric acid. Participant laboratories are receiving three levels for each items and two out of three samples have to be qualified for being a proficient laboratory for the item. The acceptable range of blood lead and urine hippuric acid is +/-15% and that of the others is within 3 SD(standard deviation) from the reference values. RESULTS: The proficient rates of blood lead and urine hippuric acid was 89%, 90%, repectively, however those of the other voluntary items have been from 51% to 62%. The proficient rates of urine mercury and urine N-methylformamide(NMF), which are introduced since 1999, were very poor. Urine hippuric acid and blood lead were analyzed frequently for the purpose of biological monitoring conducting by special health examination organizations. Urine and blood manganese and urine metabolites of trichloroethylene, urine phenol, methylhippuric acid and cadmium were followed. CONCLUSIONS: In conclusion, the quality control program for biological monitoring has dramatically improve the ability of analysing blood and urine samples and eventually contributes to diagnose occupational diseases and to prevent occupational poisoning. However, some biological monitoring data, such as urine manganese, mercury and NMF, have been still reported from laboratories that were not accepted as a proficient laboratory.
Cadmium ; Diagnosis ; Environmental Monitoring ; Korea ; Manganese ; Metals, Heavy ; Occupational Diseases ; Occupational Health ; Phenol ; Poisoning ; Quality Control ; Reference Values ; Trichloroethylene