In about 20 to 30 percent of cases with organoid nevus (nevus sebaceus), benign and/or ma-al lignant tumors of the epidermis and adnexae may develop. We describe a 71-year-old woman with sebaceous carcinoma and basal cell epithelioma developed in organoid nevus.
Aged ; Carcinoma, Basal Cell* ; Epidermis ; Female ; Humans ; Nevus* ; Organoids*

BACKGROUND: The hypereosinophilic syndrome(HES) represents a leukoproliferative process likely caused by a number of disorders, all of which are marked by sustained over-production of eosinophils. OBJECTIVES: The purposes of this study were aimed at evaluating the clinical and histopathological characteristics of HES. METHODS: The medical records and hist opathological slides of patients with HES who had skin biopsies performed in our department were reviewed. Criteria for the diagnosis of HES include (1) peripheral blood eosinophilia with eosinophil counts greater than 1,500/L for at least 6 months; (2) no evidence of parasitic, allergic, or other known causes of eosinophilia; and (3) presumptive signs and symptoms of multiple organ involvement. RESULTS: Four male and three female patients were included. HES developed in adulthood or old age (mean, 43.4 years). Because only the patients with cutaneous involvement were included, all the patients showed skin lesions. Heart, liver, stomach, nervous system, lymph nodes, and lung were involved organs in decreasing order of frequency. At the onset of HES, 40 to 80% of white blood cells were eosinophils in peripheral blood. White blood cell count and serum IgE level were elevated in all the tested patients. In six patients (85.7%), the level of serum erythrocyte sedimentation rate was elevated. Persistent hypereosinophilia (>1,500/L) was present for longer than 6 months in all patients. Stool examination and skin test for parasitic infestation all gave negative results. All the patients were not taking any medication. Histopathological examinations revealed perivascular mixed inflammatory cell infiltration; predominantly eosinophils in the stomach, liver, and nerve as well as in the skin. Interestingly, two patients who were presented with skin lesions showed the findings of eosinophilic vasculitis. In these patients, the skin lesions were consisted of Raynaud's phenomenon, digital gangrene, and several erythematous plaques. The most common cutaneous manifestations were papules and nodules on the extremities. The main treatment modality was systemic steroid. Except for one patient presented with central nervous system involvement of HES, all the patients were in a well-controlled state. In one patient with the typical clinical and hematologic features of HES, Hodgkin's disease followed. After the complete remission of Hodgkin's disease with chemotherapy, HES subsided. CONCLUSIONS: HES is a heterogenous collection of disorders marked by hypereosinophilia and organ damage. Most common cutaneous manifestations were papules and nodules on the extremities. Raynaud's phenomenon and digital gangrene can be the primary manifestation of HES in which cases cutaneous lesions showed eosinophilic vasculitis. Five patients (71%) responded well to systemic steroids. HES may be a herald of malignancy such as Hodgkin's disease. Further investigation will be mandatory ro elucidate the etiology and pathogenesis of HES.
Biopsy ; Blood Sedimentation ; Central Nervous System ; Diagnosis ; Drug Therapy ; Eosinophilia ; Eosinophils ; Extremities ; Female ; Gangrene ; Heart ; Hodgkin Disease ; Humans ; Hypereosinophilic Syndrome* ; Immunoglobulin E ; Leukocyte Count ; Leukocytes ; Liver ; Lung ; Lymph Nodes ; Male ; Medical Records ; Nervous System ; Skin ; Skin Tests ; Steroids ; Stomach ; Vasculitis

Purpura fulminans may be seen in three different clinical settings: (1) in the neonatal period from protein C and S deficiencies, (2) during severe bacterial infections such as “sepsis-associated” purpura fulminans, and (3) during the convalescence of an otherwise benign “preparatory” infectious disease most commonly involving the skin. We report a case of a 20-month-old male child with purpura fulminans as a presenting sign of disseminated intravascular coagulopathy (DIC). He had suffered from fever of unknown origin for a month. Although purpura fulminans is not a common disorder to dermatologists, the awareness of this disorder may be the clue to diagnose and treat underlying diseases.
Bacterial Infections ; Child ; Communicable Diseases ; Convalescence ; Fever of Unknown Origin ; Humans ; Infant ; Male ; Protein C ; Purpura Fulminans* ; Purpura* ; Skin

Laugier-Hunziker syndrone is a rare, pigmentary disorder of the lips, oral mucosa, and nails. The absence of intestinal polyposis differentiated it from Peutz-Jeghers syndrome. We describe a 16-year-old boy with multiple, brownish, lenticular macules on the lips, oral mucosa, perianal area and anal mucosa, and on the digits of his fingers and toes, in wham intestinal polyposis was not detectable.
Adolescent ; Fingers ; Humans ; Intestinal Polyposis ; Lip ; Male ; Mouth Mucosa ; Mucous Membrane ; Peutz-Jeghers Syndrome ; Toes

Intravascular fasciitis (IVF), a rare distinct variant of nodular fasciitis, possesses the same clinical and histologcal features of nodular fasciitis, but in addition, involves predominantly small to medium- sized veins and/or arteries intraluminally, intramurally and extramurally. Only 3 cases of intraoral IVF have been reported in the English literature. Herein we report a case of IVF developing on the inner lower lip and it was successfully treated with simple excision.
Arteries ; Fasciitis* ; Lip ; Veins

BACKGROUND: Discrepancies exist in the existing researches regarding the association between social capital and self-efficacy, and most of these researches have been done in developed countries. The aims of this study were to assess the independent association between individual social capital and self-efficacy and to assess the associations between individual social capital, self-efficacy and self-rated health. METHODS: Data were obtained from the Gyeongnam health survey (6,500 persons) conducted in 2008. A self-administered questionnaire was additionally administered to gather information on demographic variables, health behaviors, chronic diseases, self-efficacy, social capital, and self-rated health status. Total study population was 3,843 as those with chronic diseases were excluded. RESULTS: In males, trust was positively associated with confidence and preference to task difficulty, and participation was negatively associated with confidence and positively associated with regulation and preference to task difficulty. In females, trust was positively associated with confidence and preference to task difficulty and negatively associated with regulation. Participation was positively associated with preference to task difficulty. In males, the odds for self-rated health status was better for persons with confidence (95% confidence interval, CI 1.088-1.705), trust (95% CI 1.172-1.821) and participation (95% CI 1.268-2.117). In females, the odds for self-rated health status was better for those with confidence (95% CI 1.250-1.803), preference of task difficulty (95% CI 1.019-1.683) and participation (95% CI 1.024-1.555). CONCLUSIONS: High social capital measured at an individual level may promote self-efficacy and health status.
Chronic Disease ; Developed Countries ; Female ; Health Behavior ; Health Surveys ; Humans ; Male ; Self Efficacy ; Surveys and Questionnaires

An antrochoanal polyp is a solitary polypoid mass that arises from the maxillary sinus, and protrudes through the natural ostium into the middle meatus, and reaches the choana, The polyp does not differ histologically from an ordinary nasal polyp, which is composed of edematous, hyperplastic submucosal connective tissue stroma, and is relatively hypocellular, In this sequence of events. Its computed tomographic(CT)findings are characteristic. We retrospectively analyzed CT studies of nine cases, all of which showed similar CT findings; a solitary, homogeneous, hypodense mass without bony destruction that extends from the maxillary sinus through the widened ostium into the choana.
Connective Tissue ; Maxillary Sinus ; Nasal Polyps ; Polyps* ; Retrospective Studies

The Measurement of CSF glucose and CSF glucose-to-blood glucose ratio is a very useful laboratory test for the differential diagnosis of meningitis. We have observed the change of blood glucose & CSF glucose-to-blood glucose ratio according to the time of blood sampling in 84 patients with aseptic meningitis who had been admitted to the department of pediatrics, Dong Kang hospital from May 1993 to June 1993. The results obtained were as follows: 1) The blood glucose level examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 98.29+/-16.20mg/dl and 106.49+/-19.47mg/dl, respectively. 2) The blood glucose level examined with blood sample drawn just before lumbar puncture and one 30 min. after lumbar puncture was 96.47+/-21.52mg/dl and 117.00+/-22.12mg/dl, respectively. 3) The CSF glucose-to-blood glucose ratios examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 67.70+/-12.40% and 62.83+/-12.62%, respectively. 4) The CSF glucose-to-blood glucose ratios examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 70.10+/-21.77% and 56.35+/-13.75%, reskpectively. We concluded that a simultaneous blood glucose level should be taken just before lumbar puncture.
Blood Glucose ; Diagnosis, Differential ; Glucose* ; Humans ; Meningitis ; Meningitis, Aseptic* ; Pediatrics ; Spinal Puncture

BACKGROUND: Epidural clonidine reduces pain after surgery. The aim of this study was to evaluate the effect of adding low-dose clonidine to continuous epidural local anesthetics and fentanyl on pam relief. METHODS: 100 patients scheduled for gynecologic low abdominal surgery were investigated. All patients were given 10cc of 0.25% bupivacaine with fentanyl 100 ug through epidural catheter. Group I was infused with combined 0.15% bupivacaine and fentanyl 5 ug/ml at a rate of 2cc/hr. Group II was infused with combined 0.15% bupivacaine and fentanyl 5 ug/ml and 150 ug of clonidine at a rate of 2cc/hr. Pain was assessed on a visual analogue pain scale for 2 postoperative days. Changes in blood pressure, heart rate, and incidence of side effects were observed. RESULTS: VAS observed 20min, 1hr, 1day, 2days after operation were significantly lower in Group II than Group I . Blood pressure and heart rates were significantly changed in Group II but not in Group I for 2 hours after epidural injection. The incidence of side effects was similar between Group I and Group II. CONCLUSIONS: Continuous low-dose epidural clonidine infusion reduces blood pressure and heatt rates significantly but enhances postoperative analgesic effect of combined epidural bupivacaine and fentanyl without increased side effects.
Anesthetics ; Anesthetics, Local ; Blood Pressure ; Bupivacaine* ; Catheters ; Clonidine* ; Fentanyl* ; Heart Rate ; Humans ; Incidence ; Injections, Epidural ; Pain Measurement ; Pharmacology

BACKGROUND: Mixed tumor of the skin or chondroid syringoma is a benign neoplasm characterized by histological features of a mixture of epithelial and mesenchymal components. It is a rare and benign appendageal tumor, found mostly on the head and neck, and present as an asymptomatic, firm, subcutaneous nodule. There have only been a few reported cases in Korea. OBJECTIVES: This study was aimed to characterize the clinical and histopathlological features of mixed tumor of the skin. METHODS: We reviewed the clinical data and histologic slides of seven patients who have been diagnosed with mixed tumor of the skin by histopathological examination. RESULTS: There were six male patients and only one female. Age of onset of mixed tumor of the skin varied from 26 to 65 years. A11 patients had the lesion on the head: perioral area (3 cases), nose (2 cases), cheek (1 case), and temple area (1 case). Each tumor was a solitary, asymptomatic, and firm, about 0.5-1.5 cm sized, subcutaneous nodule. Histopathologically, all 7 cases presented apocrine differentiation. Two cases showed follicular differentiation, and 2 cases showed sebaceous differentiation. Every tumor showed myxoid stroma except two with typical chondroid matrix. Adipose metaplasia of the matrix was present in 2 cases. In 3 cases, the so-called hyaline cells were rich in the stroma. CONCLUSION: Mixed tumor of the skin was most commonly seen as an asymptomatic, firm subcutaneous nodule on the head. Tumors showing apocrine differentiation were more common than that of eccrine differentiation, All 7 cases presented apocrine differentiation. Follicular and sebaceous differentiation might occur in apocrine type of mixed tumors of the skin. The stroma of mixed tumor of the skin might be myxoid, chondroid, or adipose.
Adenoma, Pleomorphic ; Age of Onset ; Cheek ; Female ; Head ; Humans ; Hyalin ; Korea ; Male ; Metaplasia ; Neck ; Nose ; Skin*