No abstract available.
Thioacetamide*

Background: Complicated acute pyelonephritis (APN) is a life-threatening condition that requires immediate intervention. This study examined the characteristics of APN occurring as a complication of ureteral stone. Methods: We retrospectively reviewed 85 patients diagnosed with APN complicated by ureteral stone between December 2006 and July 2017 at our institution. Patients with concomitant renal stone, multiple ureteral stones, ureteral strictures, ureteral cancer, and urogenital anomalies, including vesicoureteral reflux were excluded. Clinical characteristics including age, sex, underlying disease, medical history, stone characteristics, initial laboratory data, and the procedure used to correct urinary obstruction were summarized, and the risk factors associated with sepsis and septic shock were analyzed. Results: Sepsis was diagnosed at initial presentation in 62 patients, 17 of whom suffered from septic shock. Disease-related death did not occur in any patient. Previous history of stone (P = 0.015), leukocytosis (P < 0.001), elevated C-reactive protein levels (P = 0.006), and low albumin (P = 0.038) were significant risk factors for progression to sepsis. The absence of hypertension (P = 0.047), thrombocytopenia (P = 0.006), decreased erythrocyte sedimentation rate (ESR) (P = 0.003), elevated blood urea nitrogen (P = 0.016), and positive blood culture (P= 0.018) were significant predictors for progression to septic shock.Multivariate analysis revealed that previous history of stone (P = 0.015) was an independent risk factor for sepsis, while the absence of hypertension (P = 0.047), thrombocytopenia (P= 0.013), and decreased ESR (P = 0.009) were risk factors for shock. Conclusion The risk factors associated with the progression from APN to sepsis differed from those associated with the progression from sepsis to septic shock. Various factors should be considered while selecting treatment options based on the severity of APN associated with ureteral stone. It should be managed with aggressive treatment and close observation, especially in the presence of risk factors.

Pheniramine maleate(avil(R)) is a H1-antagonist that is derived from alkylamine. Skin reactions with parenteral administration of avil(R) are uncommon. A 29-year-old woman visited our department with a 3-year history of relapsing generalized multiple pruritic evanescent erythematous wheals after antihistamine and steroid injection. Intradermal skin test with Avil(R) was positive. We treated with 5 mg of mequitazine administration three times a day for 2 years.
Adult ; Female ; Humans ; Pheniramine* ; Skin ; Skin Tests ; Urticaria*

Tuberculosis generally affects the respiratory tract. In developing nations, the pericardium is the most common location of extrapulmonary tuberculosis; however, tuberculous pericarditis rarely appears as a localized mass or tuberculoma. We present here a case of a 62-year-old woman with pericardial tuberculoma. She had a history of effusive tuberculous pericarditis and drainage. Because she had taken regular medication over a period of six months, the pericardial mass with an adjacent lung nodule newly detected on the chest radiogram was initially suspected of being invasive lung cancer. Prior to pathologic confirmation, precise information from imaging tests, including computed tomography, magnetic resonance imaging, and positron emission tomography-computed tomography are helpful when making decisions regarding which methods should be used for surgical approach and treatment. Through imaging, our case showed typical features of pericardial tuberculoma and a favorable clinical course after two months with a change in antituberculous therapy.
Developing Countries ; Drainage ; Electrons ; Female ; Humans ; Lung ; Lung Neoplasms ; Magnetic Resonance Imaging ; Middle Aged ; Pericarditis, Tuberculous ; Pericardium ; Respiratory System ; Thorax ; Tuberculoma ; Tuberculosis

Silica contaminates frequently accidental wounds, but most silica-contaminated wounds heal uneventfully with normal scarring. In exceptional cases, a delayed hypersensitivity granulomatous reaction occurs at the site of the old scar. We report a case of silica granuloma in a 30-year-old female. She had presented four discrete asymptomatic, mildly erythematous to skin colored papules or deep-seated nodules on upper extremity and trunk for 3 months. Histopathology of right upper arm lesion showed a well-demarcated conglomerate nodule in subcutaneous tissue, composed of numerous non-caseating granulomas without central necrotic or hyalinized foci. Small polarizable birefractile fibrous particles are found within the nodule. Scanning electron microscopy(SEM) revealed thin needle shaped fibers with fracture ends and energy dispersive X-ray analysis(EDXA) of the fiber showed major peak for a silica component.
Adult ; Arm ; Cicatrix ; Female ; Granuloma* ; Humans ; Hyalin ; Hypersensitivity, Delayed ; Needles ; Silicon Dioxide* ; Skin ; Subcutaneous Tissue ; Upper Extremity ; Wounds and Injuries

Isotopic response is the occurrence of a new skin disorder at the site of another, unrelated, and already healed skin disease. Various diseases have been reported in terms of isotopic response associated with herpes zoster, but the development of comedones is uncommon. We report a case of comedones that had developed on the site previously affected by herpes zoster in a 59-year-old male, which is thought to be an isotopic response. Eight months ago, he visited with herpes zoster lesions on the left upper eyelid, forehead and scalp(dermatome cranial nerve V1). He had grouped and discrete, slightly elevated, skin colored papules with dark, firm hyperkeratotic plug on the healed site of herpes zoster.
Cranial Nerves ; Eyelids ; Forehead ; Herpes Zoster* ; Humans ; Male ; Middle Aged ; Skin ; Skin Diseases

The skin lesion of herpes zoster is limited to one dermatomal area, but multidermatomal invasions have been occasionally reported. Most cases of multidermatomal herpes zoster have contiguous skin lesion. We report a case of herpes zoster duplex unilateralis with herpes zoster generalisatus that has characteristic clinical manifestation of noncontiguous skin involvement with multiple scattered vesicles. A 68-year-old male patient showed painful grouped erythematous vesicles on the left abdomen and the left face accompanyed with multiple scattered vesicles and pustules. Histopathologic findings were consistent with herpetic infection. We treated with an administration of acyclovir 1.5g a day for 7 days.
Abdomen ; Acyclovir ; Aged ; Herpes Zoster* ; Humans ; Male ; Skin

Pityriasis versicolor is a mild chronic superficial fungal infection, usually involving the seborrheic area of the neck, upper arms, and back. In a few instances, however, the eruption has been confined to highly atypical areas, such as one palm, the soles, the face, the scalp, the penis, and the groin. Inverse pityriasis versicolor refer to clinical disease located predominantly in flexural areas. We report three cases of inverse pityriasis versicolor in a 55-year-old man, in a 47-year-old man, in a 27-year-old man. The lesion were manifested by slightly scaly, brownish macules on the groin. Potassium hydroxide (KOH) prepatation showed numerous short hyphae and spores, and Wood's lamp examination showed yellowish brown fluorescence of involved skins. Fungal culture on Leeming and Notman's media grew out the typical colonies of M. globosa and M. sympodialis after 2 weeks at 34 degrees C. The patients were treated with 200 mg of itraconazole daily for 1 week and topical antifungals.
Adult ; Arm ; Fluorescence ; Groin ; Humans ; Hyphae ; Itraconazole ; Male ; Middle Aged ; Neck ; Penis ; Pityriasis* ; Potassium ; Scalp ; Skin ; Spores ; Tinea Versicolor*

Pityriasis versicolor is a mild chronic superficial fungal infection, usually involving the seborrheic area of the neck, upper arms, and back. In a few instances, however, the eruption has been confined to highly atypical areas, such as one palm, the soles, the face, the scalp, the penis, and the groin. Inverse pityriasis versicolor refer to clinical disease located predominantly in flexural areas. We report three cases of inverse pityriasis versicolor in a 55-year-old man, in a 47-year-old man, in a 27-year-old man. The lesion were manifested by slightly scaly, brownish macules on the groin. Potassium hydroxide (KOH) prepatation showed numerous short hyphae and spores, and Wood's lamp examination showed yellowish brown fluorescence of involved skins. Fungal culture on Leeming and Notman's media grew out the typical colonies of M. globosa and M. sympodialis after 2 weeks at 34 degrees C. The patients were treated with 200 mg of itraconazole daily for 1 week and topical antifungals.
Adult ; Arm ; Fluorescence ; Groin ; Humans ; Hyphae ; Itraconazole ; Male ; Middle Aged ; Neck ; Penis ; Pityriasis* ; Potassium ; Scalp ; Skin ; Spores ; Tinea Versicolor*

Although dermatophytes are still the main etiologic agents of onychomycosis, some species of nondermatophytic molds and yeasts are also capable of invading the nails. Fusarium (F.) solani is a nondermatophytic mold which is saprophytic fungus in soil. Onychomycosis due to Fusarium species almost always involve the great toenails, particularly in the presence of traumatic or dystrophic abnormalities. We report a case of toenail onychomycosis caused by F. solani in a 42-year-old female. The patient presented with typical distal subungual onychomycosis. Direct microscopic examination of scrapings on the potassium hydroxide preparation revealed fungal elements and repeated cultures on Sabouraud's dextrose agar showed the same whitish to cream-colored, cottony colonies. Multiple, sickle-shaped, multiseptate macroconidia and long, slender monophialides were observed in the slide culture. We confirmed F. solani by gross and light microscopic morphology of the colony. The patient was treated with 250 mg of terbinafine daily for 3 months.
Adult ; Agar ; Arthrodermataceae ; Female ; Fungi ; Fusarium* ; Glucose ; Humans ; Nails ; Onychomycosis* ; Potassium ; Soil ; Yeasts