Hemosiderosis is a disorder characterized by deposits of hemosicerin in multiple organs without organ dysfunction or injury. The color of the skin becomes brown, espeially on sun exposured areas. Mucous mernbranes are also affected in up to 5-25% of cases. A 43-year-old woman visited our clinic due to generalized brown colotation of her skin, including conjunct we and oral mucous mernbrane which she had had for 10 months. She had been treated with multiple he nodialysis combined with periodic transfusion for renal failure 3 times a month during the last 5 yeadrs Her plasma ferrit in level was elevated markedly and TIBC decreased, but cortisol and ACTH levels were within normal limits, Histopathologic findings of the neck skin showed hyperpigmentation of basal layer and deposition of brown pigment wrthin and around the sweat glands. In Fontana-Masson stain, the lower epidermis showed a massive deposition of melanin. Prussian blue stain revealei hemosiderin within snd around, the sweat glands. Hemosiderin could also be noticed on specirnens of thliver biopsy. The patient improved progressively after the rstriction of trasnfusion and treatment of renal failure.
Adrenocorticotropic Hormone ; Adult ; Biopsy ; Epidermis ; Female ; Hemosiderin ; Hemosiderosis* ; Humans ; Hydrocortisone ; Hyperpigmentation ; Melanins ; Neck ; Plasma ; Renal Insufficiency ; Skin ; Solar System ; Sweat Glands

BACKGROUND: Lymphomatoic papulosis, a disease with recurrent and hemorrhagic papu-lonodular lesions, shows a benign course clinically but lymhomatous features histopathologically. Although sporadic cases have been reported, we could not find any comprehensive report of clinical and histopathologic features of lymphomatoid papulosis in Korean literature. OBJECTIVE: The purpose of this study was to examine the clinical and histopathologic features and follow up observation of 16 patients with lymphomatoid papulosis. METHODS: We reveiwed the clinical and histopathologic findings, associated diseases, and response to various treatments in 16 patients with lymphomatoid papulosis during the 10 year period from January 1984 to May 1994. RESULTS: The results were summarized as fallows. 1. There were 14 males and 2 females. Sex distribution showed a male predominence with male : female ratio of 7: 1. 2. Age distribution ranged from 20 to 65, with the mean age of 43 years. 3. Duration of symptoms ranged from 4 days to 10 years, with a mean duration of 2.4 years. 4. The lesions were located on the trunk and extremities(7 cases), extremities(7 cases), and trunk(2 cases). 5. The morphology of lesions were papules or plaques(11 cases), and nodules(5 cases). 6. Associated diseases were tuberculosis(2 cases), Behcet's disease(2 cases), Klatskin tumor(1 case), osteomyelitis(1 case), hypertesion and peptic ulcer(1 case), and chronic active hepatitis(1 case). 7. Histopathologic features revealed wedge-shaped superficial and deep perivascular polymorphic infiltrate with pleomorphic cells in all specimens except one. Histopathologic types classified by Willemze's Classification were type A(9 cases), type B(6 cases), and type A and type B(1 case). 8. Treatment including PUVA, methotrexate and systemic steroid had beneficial effect only temporarlly. 9. In one patient, large anaplastic CD30 lymphoma(Ki-1 lymphoma) of the skin and inguinal lymph node developed 3 years after the onset of Lymphomatoid papulosis. CONCLUSION: All pat.ients with lymphomatoid papulosis should be followed up for a long-term period to rule out the development of lymphoma.
Age Distribution ; Classification ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes ; Lymphoma ; Lymphomatoid Papulosis* ; Male ; Methotrexate ; Sex Distribution ; Skin

BACKGROUND: Lymphomatoic papulosis, a disease with recurrent and hemorrhagic papu-lonodular lesions, shows a benign course clinically but lymhomatous features histopathologically. Although sporadic cases have been reported, we could not find any comprehensive report of clinical and histopathologic features of lymphomatoid papulosis in Korean literature. OBJECTIVE: The purpose of this study was to examine the clinical and histopathologic features and follow up observation of 16 patients with lymphomatoid papulosis. METHODS: We reveiwed the clinical and histopathologic findings, associated diseases, and response to various treatments in 16 patients with lymphomatoid papulosis during the 10 year period from January 1984 to May 1994. RESULTS: The results were summarized as fallows. 1. There were 14 males and 2 females. Sex distribution showed a male predominence with male : female ratio of 7: 1. 2. Age distribution ranged from 20 to 65, with the mean age of 43 years. 3. Duration of symptoms ranged from 4 days to 10 years, with a mean duration of 2.4 years. 4. The lesions were located on the trunk and extremities(7 cases), extremities(7 cases), and trunk(2 cases). 5. The morphology of lesions were papules or plaques(11 cases), and nodules(5 cases). 6. Associated diseases were tuberculosis(2 cases), Behcet's disease(2 cases), Klatskin tumor(1 case), osteomyelitis(1 case), hypertesion and peptic ulcer(1 case), and chronic active hepatitis(1 case). 7. Histopathologic features revealed wedge-shaped superficial and deep perivascular polymorphic infiltrate with pleomorphic cells in all specimens except one. Histopathologic types classified by Willemze's Classification were type A(9 cases), type B(6 cases), and type A and type B(1 case). 8. Treatment including PUVA, methotrexate and systemic steroid had beneficial effect only temporarlly. 9. In one patient, large anaplastic CD30 lymphoma(Ki-1 lymphoma) of the skin and inguinal lymph node developed 3 years after the onset of Lymphomatoid papulosis. CONCLUSION: All pat.ients with lymphomatoid papulosis should be followed up for a long-term period to rule out the development of lymphoma.
Age Distribution ; Classification ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes ; Lymphoma ; Lymphomatoid Papulosis* ; Male ; Methotrexate ; Sex Distribution ; Skin

Milwaukee shoulder syndrome is a rare clinical entity that is a rapid destructive shoulder arthropathy associated with deposition of calcium hydroxyapatite crystals. It mainly affects elderly women. It is characterized by the presence of large amount of noninflammatory synovial fluid containing calcium hydroxyapatite crystals, a complete tear of the rotator cuff and progressive degenerative changes at the humeral head, leading to almost complete functional impairment. We present a case of a 65-year-old woman suffered by Milwaukee shoulder syndrome with literature view.
Aged ; Durapatite ; Female* ; Humans ; Humeral Head ; Rotator Cuff ; Shoulder* ; Synovial Fluid

PURPOSE: The C677T polymorphism of the methylenetetrahydrofolate reductase(MTHFR) has been suggested as a risk factor of maternal meiotic nondisjunction for Down syndrome. Recently, a second genetic polymorphism in MTHFR at position 1298 was reported. However, a positive association between the A1298C MTHFR polymorphism and Down syndrome has not been reported. Therefore, this study was undertaken to determine which polymorphism of MTHFR gene was associated with the increased risk of a child suffering from Down syndrome(DS). METHODS: We enrolled 33 patients with Down syndrome and 100 healthy individuals and analyzed the MTHFR C677T and A1298C polymorphism by a PCR-restriction fragment length assay. RESULTS: Frequencies of MTHFR C677T genotypes(CC, CT, and TT) were 9(27%), 22(67%), and 2 (6%) in the DS patients and 24(24%), 55(55%) and 21(21%) in the control, respectively. The frequency of mutant 677TT was significantly low in the DS patients(OR : 0.14; 95% CI : 0.02-0.95; P= 0.04). For the MTHFR A1298C polymorphism, frequencies of genotypes(AA, AC, and CC) were 16(48 %), 15(45%) and 1(3%) in DS patients and 77(77%), 21(21%) and 2(2%) in the control, respectively. The frequency of mutant 1298AC was significantly increased in DS patients with an odds ratio of 3.3(95% CI : 1.39-7.82; P=0.007). CONCLUSION: Our results suggest that MTHFR mutant 677TT may have a protective effect against Down syndrome, but MTHFR mutant 1298AC may be an independent risk factor in Down syndrome.
Child ; Down Syndrome* ; Humans ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Odds Ratio ; Polymorphism, Genetic ; Risk Factors

Pachydermodactyly is a form of digital dermal fibromatosis of unknown etiology, characterized by asymptomatic soft tissue swelling on the lateral aspects of the proximal interphalangeal joints of the hands. It usually affects young men and often associated with repetitive mechanical trauma. As a rule, it is a benign condition and a specific therapy or extensive investigation is not necessary in most cases. However, pachydermodactyly is not well recognized by physician. So it can be confused with other rheumatic conditions, such as rheumatoid arthritis or juvenile idiopathic arthritis. A prompt diagnosis is crucial for preventing inappropriate or possible toxic treatment. We describe a case of pachydermodactyly in a 20-year-old military man, who had painless swellings of the hand joints.
Arthritis, Juvenile ; Arthritis, Rheumatoid ; Diagnosis ; Fibroma ; Hand ; Hand Joints ; Humans ; Joints ; Male ; Military Personnel ; Young Adult

Necrolytic migratory erythema is a cutaneous reaction pattern with specific histopathologic features that is typically associated with a functioning pancreatic islet cell neoplasm such as a glucagonoma. However, cases without. glucagonoma have also been reported, such as, liver cirrhosis, chronic pancreatitis, celiac sprue etc. Other clinical features include anemia, glossitis and weight loss. We report a case of neccrolytic migratory erythema induced by a pancreatic insufficiency without glucagonoma. A 43-year-old male was seen at our department because of rnultiple erythematous, desquamative and erosive patches on the whole body for 1 month. He also had weight loss(25Kg) and stomatitis. Seven years previously he had a Whipple's procedure for a pancreatic head rupture. The laboratory data showed a low protein and zinc level, and high glucagon level. Histopathologic findings of the case showed epidermal edema and pallor, and superficial epiderrnal necrosis. The patient improved progressively after intravenous infusion of amino acids with a pancreatic enzyme supplementation.
Adult ; Amino Acids ; Anemia ; Celiac Disease ; Edema ; Erythema ; Exocrine Pancreatic Insufficiency* ; Glossitis ; Glucagon ; Glucagonoma ; Head ; Humans ; Infusions, Intravenous ; Islets of Langerhans ; Liver Cirrhosis ; Male ; Necrolytic Migratory Erythema* ; Necrosis ; Pallor ; Pancreatitis, Chronic ; Rupture ; Stomatitis ; Weight Loss ; Zinc

Purpose: To analyze the change in the weekly incidence of epidemic keratoconjunctivitis (EKC) per 1,000 outpatients during the coronavirus disease 2019 (COVID-19) pandemic by comparing the mean weekly proportion of EKC of 2020 with that from 2016 to 2019. Methods: Using data from the Korea Disease Control and Prevention Agency for 2016-2020, we analyzed the weekly proportion of EKC per 1,000 outpatients. The data were also analyzed according to age, semester and vacation periods, region, and social distancing stages. For the Daegu data, we also analyzed the effects of social distancing in an area. Results: The mean weekly proportion of EKC per 1,000 outpatients in 2020 was lower than in previous years for all ages (2016-2019 19.77 ± 7.17‰, 2020 7.28 ± 2.97‰; p < 0.001). During the semester, the mean difference between 2016-2019 and 2020 was significant, particularly for preschool children. In Daegu, the weekly proportion of EKC per 1,000 outpatients during the extra 12-18 weeks of social distancing was significantly lower (2016-2019, 18.78 ± 6.61‰; 2020, 8.94 ± 2.92‰; p < 0.001). Conclusions The public health interventions implemented during the COVID-19 outbreak not only reduced the prevalence of COVID-19 but also reduced the prevalence of EKC. Therefore, maintaining hygiene principles and standard precautions may help prevent EKC.

BACKGROUND AND AIMS: This research was conducted in order to study the clinical usefulness and stability of the propofol used for sedation during upper gastrointestinal endoscopy. METHODS: The objective of this research was to study one hundred patients, who were chosen based upon their preference to be examined through diagnostic upper gastrointestinal endoscopy accompanied with propofol from July 1998 to August 1998, and who showed normality in the pulmonary function test and ECG. The elements observed were hemodynamic variations, injection dosage, injection time, recovery time and side effects. RESULTS: All patatints had no recollection of the procedure during gastrointestinal endoscopy. It was found that the older the patients were, the less amount of propofol sleep was indued. Systolic blood pressure, diastolic blood pressure and the mean arterial blood pressure were lowered noticeably after sleep, compared with those before the injection of propofol, while the heart rate hardly changed. CONCLUSIONS: Profopol is believed to be a useful sedative for upper gastrointestinal endoscopy. As blood pressre can be lowered however, a cautious attitude should be considered when injecting propofol in the elderly or in patients who have cardiovascular disease.
Aged ; Arterial Pressure ; Blood Pressure ; Cardiovascular Diseases ; Electrocardiography ; Endoscopy, Gastrointestinal* ; Heart Rate ; Hemodynamics ; Humans ; Propofol* ; Respiratory Function Tests

Cervical spondylotic myelopathy (CSM) is a spinal cord dysfunction involving compression of the vascular and neural structures due to bony spurring or soft tissue hypertrophy in patients with degenerative cervical disorders. It presents initially as subtle gait disturbance with gradual deterioration. An elderly patient presenting with gait disturbance due to spasticity and motor weakness of both lower extremities without mental change can be easily misdiagnosed as CSM. We report on a case of gait disturbance due to chronic bilateral subdural hematoma mimicking CSM.
Aged ; Gait* ; Hematoma, Subdural* ; Humans ; Hypertrophy ; Lower Extremity ; Muscle Spasticity ; Spinal Cord ; Spinal Cord Diseases*