Afloqualone is a centrally acting muscle relaxant and has been used in therapy for musculotensive diseases. A 35-year-old female had been taking afloqulaone for a left hemifacial spasm for one month. The patient visited our hospital with erythematous papules and patches on the sun exposed area. A photopatch test with afloqualone ointment with the concentration of 0.1%, 1%, 5% turned out negative. An oral provocation test was also done and it showed a positive result with a decrease of MED to UVA (10 J/cm²).
Adult ; Dermatitis, Phototoxic* ; Female ; Hemifacial Spasm ; Humans ; Solar System

BACKGROUND: The growth of cells is closely related to components in a culture medium. There are many reports about cellular characteristics of melanocytes grown in a PMA-contained medium. However, only a few reports have been studied by using a physiologic mitogens-contained medium. To understand melanocyte in vivo, it is necessary to know the cellular biology of melanocytes grown in a physiologic mitogens-contained medium. OBJECTIVE: To investigate any differences between melanocytes grown in phorbol 12-myristate 13-acetate(PMA)-contained medium and in physiologic mitogens-contained medium. METHOD: We examined morphology, number and melanin contents of cultured human melanocytes grown in a PMA-contained medium and physiologic mitogens-, such as bFGF, ET-1 and a a-MSH contained medium. Result : The results are summarized as follows : 1. There were no significant morphologic differences between cells in PMA-contained medium and in physiologic mitogens-contained medium. 2. The number of melanocytes were significantly more numerous in PMA-contained medium on the 2nd day (p<0.05), but significantly less numerous in the same medium on the 6th day (p<0.05). So, the proliferation rate of melanocytes in PMA-contained medium became lower than in physiologic mitogens-contained medium as time went by. 3. Melanocytes grown in PMA-contained medium had significantly increased melanin contents regardless of the time (p<0.05). Conclusion : The proliferation of melanocytes was better in physiologic mitogens-contained medium, the melanization was higher in melanocytes of PMA-contained medium.
Humans* ; Melanins ; Melanocytes*

BACKGROUND: Fixed drug eruptions(FDE) are a cutaneous reaction characterized by one or more circumscribed lesions that recur at the same site in response to a given medication. OBJECTIVE: The purpose of this study was to find the clinical and histopathological characteristics of FDE and to compare early FDE with late FDE histopathologically. METHOD: We clinically investigated 54 cases of FDE that visited the department of dermatology at the Kyunghee medical center from January 1993 to December 1996. Among them, 31 patients had skin biopsies and were evaluated histopathologically on the basis of duration. RESULTS: The results were summarized as follows: 1. Development of FDE did not show any difference according to sex and was evenly distributed over all the ages. 2. The latent periods of FDE were diverse in appearance from 30 minutes to 10 days, but mostly, the skin lesions erupted within 4S hours. 3. The most common skin lesions were erythematous macules. 4. Distribution of the lesions came out as solitary: 20.4%, multiple: 79.6%. S3.7% of the multiple lesions were localized to a part of body, and 16.3% were distributed over the whole body. 5. The areas in which the eruptions developed were (in descending order): upper extremity(37.0%), hand(31.5%), trunk(24.1%), face(24.1%). 6. In most cases(68.6%), the size and the number of lesions were greater in recurrente, rather than in first attacks. 7. The histopathological findings commonly showed perivascular mononuclear cell(MNC) infiltration (100%), pigmentary incontinence(77.4%), basal hydrophic degeneration(71.0%), eosinophil infiltration in dermis(61.3%), etc. 8. The epidermal histopathological findings such as spongiosis, exocytosis of MNC, basal hydrophic degeneration, keratinocyte necrosis and subepidermal vesicles could be seen more frequently in early lesions than in late ones. CONCLUSION: In our study, we were able to obtain meaningful results based on data from the combination of clinical and histopathological investigations. This study may give help to understand the characteristics of fixed drug eruptions and to plan future studies.
Biopsy ; Dermatology ; Drug Eruptions* ; Eosinophils ; Exocytosis ; Humans ; Keratinocytes ; Necrosis ; Skin

The frequency of metastasis to the skin from lung cancer is 1-12%. The incidence of cutaneous metastasis was high in patients with large-cell lung cancer, whereas squamous cell and small-cell lung cancer showed the least tendency to extend to cutaneous sites. Adenocarcinoma was intermediate in the tendency to metastasize in the skin. Histological findings of small-cell lung cancer show solid, tumor cell nests composed of neoplastic cells with large, round nuclei. So, it is often difficult to distinguish small-cell lung cancer from other poorly differentiated small-cell tumors, such as Merkel cell carcinoma, metastatic carcinoid, lymphoma, etc. We report here two cases of skin metastasis from small-cell lung cancer. Case one was a 74-year-old man presenting with a single, round, dome-shaped nodule on the alar nasi which had been present for 1 month. The second case was a 73-year-old man who had found three, non-tender, freely movable subcutaneous nodules on the abdomen 3 days before. Both cases were diagnosed as small-cell lung cancer. On histopathological examination of the skin lesions, we could observe that small round to oval cells with dark staining nuclei and scant cytoplasms were arranged in anastomosing trabecular streams through the dermis, separated by strands of connective tissue in both cases. In the first case, the tumor cells were positive to cytokeratin and NSE, negative to neurofilament antiagen and LCA.
Abdomen ; Adenocarcinoma ; Aged ; Carcinoid Tumor ; Carcinoma, Merkel Cell ; Connective Tissue ; Cytoplasm ; Dermis ; Humans ; Incidence ; Keratins ; Lung Neoplasms ; Lymphoma ; Neoplasm Metastasis* ; Rivers ; Skin ; Small Cell Lung Carcinoma*

No Abstract Available.

OBJECTIVES: Seoul-Activities of Daily Living(S-ADL) was developed to assess elderly person's basic activities of daily living. This study aims to develop standardized ADL assessment scale and confirm the reliability and validity of the S-ADL. METHODS: It was participated in 336 controls and 145 patients diagnosed Alzheimer's disease. RESULTS: In controls, it was statistically significant to age, but not sex, education, region and presence of spouse. Also, reliability and validity were statistically significant. Principal axis factoring analysis revealed three factors that accounted for 66.67% of the total variance(1.self-care/hygiene, 2.ambulation, 3.toileting). According to each CDR stage, there were significant difference, except for CDR 0.5 and CDR 1 suggesting early dementia. Particularly, it was remarkable for functional impairment in CDR 2 and CDR 3 suggesting moderate to severe dementia. The order of the loss of function was (1) self-care/hygiene, (2) toileting, and (3) ambulation. CONCLUSIONS: Our study showed that the S-ADL could be a very reliable and valid tool for the assessment of functional disabilities of Korean dementia patients. Particularly, S-ADL would be useful in assessing daily function of moderate to severe AD.
Activities of Daily Living ; Aged ; Alzheimer Disease ; Axis, Cervical Vertebra ; Dementia ; Education ; Humans ; Reproducibility of Results* ; Spouses ; Walking

Few cases of ichthyosis bullosa of Siemens(IBS) have been reported since 1939, as a distinct entity from bullous congenital ichthyosiform erythroderma(BCIE). IBS can be differentiated from BCIE by the absence of congenital erythroderma and a different distribution of involved skin area. It's characteristic features include blistering, superficial erosion or moulting of the outer skin. Histological features are tonofilaments aggregation confined to the granular and upper spinous layer of the epidermis. However, in BCIE these findings are present in the whole suprabasal compartment. The original reports of Siemens and cases from other authors showed an autosomal dominant inheritance. Our patient developed IBS sporadically without a familial background.
Blister ; Dermatitis, Exfoliative ; Epidermis ; Humans ; Ichthyosis Bullosa of Siemens* ; Ichthyosis* ; Intermediate Filaments ; Molting ; Skin ; Wills

BACKGROUND: Microalbuminuria in type 2 diabetes is a predictor of development of clinical nephropathy and cardiovascular disease. But, it has been reported that reduced glomerular filtration rate (GFR) may occur in some normoalbuminuric diabetic patients. The aim of this study was to identify whether decreased GFR without microalbuminuria is to predict diabetic vascular complications. METHODS: Between January 1998 and February 2001, 73 patients with type 2 diabetes who visited Yeungnam university medical center were divided into 5 groups according to initial GFR ranges: group 1 (GFR < 30 mL/min), group 2 (30 < or = GFR < 60 mL/min), group 3 (60 < or = GFR < 90 mL/min), group 4 (90 < or = GFR < 125 mL/min), group 5 (125 mL/min < or = GFR). They were examined for microvascular and macrovascular complications initially and after 4 years. RESULTS: Decreased GFR had a negative correlation with age (r = -0.472, P = 0.001). Decreased GFR without microalbuminuria had a significant correlation with development of diabetic nephropathy (P = 0.016) after 4 years. There were no significant correlation with the prevalence of diabetic retinopathy, peripheral neuropathy, and macrovacular disease. But, our study showed that coronary artery disease had an increasing tendency with decreased GFR without statistical significance (P = 0.085). CONCLUSIONS: Our data suggest that reduced GFR, independent of albuminuria, may be an important predictor of diabetic nephropathy and coronary artery disease to some extent. So we recommend that not only the microalbuminuria, but also the decrease in GFR should be evaluated at the follow-up of patients with type 2 diabetes.
Academic Medical Centers ; Albuminuria ; Cardiovascular Diseases ; Coronary Artery Disease ; Diabetic Nephropathies ; Diabetic Retinopathy ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Peripheral Nervous System Diseases ; Prevalence

PURPOSE: In the present study, a case of diffuse lamellar keratitis after trabeculectomy in a patient who had received laser in situ keratomileusis many years prior is reported. CASE SUMMARY: A 54-year-old male diagnosed with binocular primary open-angle glaucoma underwent trabeculectomy in the left eye because of poor intraocular pressure control and visual field defect progression even with maximal medical treatments. Faint, non-progressing subepithelial opacities pre-existed in the left cornea but no treatment was administered. The patient had a history of laser in situ keratomileusis in both eyes 12 years prior. On the first postoperative day, conjunctival buttonhole was found and because leaking from the hole continued, topical steroid was discontinued on the fourth postoperative day. On the seventh postoperative day, diffuse lamellar keratitis developed on the central cornea without intraocular pressure elevation, and diffuse infiltration under the corneal flap was observed in the anterior segment on optical coherence tomography. The patient was treated with topical steroid eye drops every 3 hours for the first 2 days and the frequency was increased to every hour because the keratitis did not improve. On the ninth postoperative day, keratitis began to improve and 2 months postoperatively, subepithelial lamellar infiltration improved significantly but did not show complete remission. CONCLUSIONS: Diffuse lamellar keratitis can develop in an eye with laser in situ keratomileusis after trabeculectomy if appropriate treatment with topical steroid eye drops is not administered.
Cornea ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Keratitis* ; Keratomileusis, Laser In Situ* ; Male ; Middle Aged ; Ophthalmic Solutions ; Telescopes ; Tomography, Optical Coherence ; Trabeculectomy* ; Visual Fields

Addison's disease is a rare disorder resulted from a chronic deficiency of the adreanl cortical hormone. The clinical manifestations are general weakness, weight loss, hyperpigmentation, hypovolemia with hyponatremia and hyperkalemia. We report a case of Addison's disease in a 60-year-old woman who has experienced slowly progressive weakness, weight loss and generalized cutaneous pigmentation, especially sun exposed area, extensor surface and nail bed for the last, 2 years. On a hormonal assay of the adrenal glands, basal plasma cortisol level was decreased and basal plasma ACTH level was markedly elevated. A chest X-ray showed streaky tuberculous infiltration in left, upper lobe field and adrenal CT scan showed calcific densities of both adrenal glands with nodular enlargement of right adrenal gland. There was a clinical improvement with steroid replacement therapy and anti-tuber- culosis chemotherapy. A nearly normal appearance was obtained after 5 months' treatment.
Addison Disease ; Adrenal Glands ; Adrenocorticotropic Hormone ; Drug Therapy ; Female ; Humans ; Hydrocortisone ; Hyperkalemia ; Hyperpigmentation ; Hyponatremia ; Hypovolemia ; Middle Aged ; Pigmentation ; Plasma ; Solar System ; Thorax ; Tomography, X-Ray Computed ; Weight Loss