A 34-year-old woman presented with several intensely pruritic erythematous serpiginous thread-like skin lesions which began as a small papule on the epigastrium 4 months prior to her visit and was migrating to the left chest area. The laboratory examination showed eosinophilia and the total serum IgE level was slightly increased. Histopathologic examination revealed a pustular burrow in the epidermis with a larva-like cystic lesion apart from the burrow in the epidermis. The patient was treated with topical 10 % albendazole cream 3 times daily for 1 week without recurrence for 22 months up to now. We thought this was a rare case which was confirmed by a skin biopsy showing larva in the epidermis.
Adult ; Albendazole ; Biopsy ; Eosinophilia ; Epidermis ; Female ; Humans ; Immunoglobulin E ; Larva ; Larva Migrans* ; Recurrence ; Skin ; Thorax

Correct discrimination of the first and the second twin is important. Case: (1) The first fetus, whose amnionic cavity was closest to the cervix at 19 weeks, even though its body was higher than the second fetus, was found to be closer to the cervix by 23 gestational weeks than its twin. (2) The result of the chromosomal study of dichorionic twins at 17 gestational weeks was male with 9 inversion of the presumed first, and female with trisomy 21 of the presumed second. AT 19 gestational weeks, the sex and order of the two were found to be reversed at sonography for selective termination. In diamnionic twins, the fetus in the amnionic sac closest to the cervix is nominated as the first.
Amnion ; Cervix Uteri ; Diagnosis* ; Discrimination (Psychology) ; Down Syndrome ; Female ; Fetus* ; Humans ; Male ; Pregnancy, Twin* ; Twins*

In Albright's hereditary osteodystrophy (AHO) including the syndromes of pseudohypoparathyroidism (PHP) and pseudopseudohypoparathyroidism (PPHP), multiple areas of intracutaneous ossification are often encountered. The characteristic features are short stature, round face, short neck, obesity, cutaneous ossifications, and various skeletal anomalies including short metacarpal and metatarsal bones, curve of radius, and brachydactyly. The patient was a 10-month-old male infant. He presented slightly depressed erythematous hard plaques on the left upper chest and left thigh. We had taken biopsies from both skin lesions, confirming cutaneous ossification or bone formation. He also had the characteristic features of AHO. He had a history of admission due to patent ductus arteriosus and atrial septal defect. The laboratory results showed slightly decreased calcium, increased phosphorus and PTH levels. The patient received no specific corrective measures because his calcium and phosphorus levels were not far from normal values until newly developed similar skin lesions appeared.
Biopsy ; Brachydactyly ; Calcium ; Ductus Arteriosus, Patent ; Heart Septal Defects, Atrial ; Humans ; Infant ; Male ; Metatarsal Bones ; Neck ; Obesity ; Osteogenesis ; Phosphorus ; Pseudohypoparathyroidism* ; Pseudopseudohypoparathyroidism ; Radius ; Reference Values ; Skin ; Thigh ; Thorax

Multiple dermatofibromas are rare and some case reports show this disease has been related to generalized defective immune function: autoimmune disease and altered immunity, such as AIDS and systemic lupus erythematosus(SLE), can be treated with immunosuppressive agents. But there are no specific reports of this disease developing in healthy people. We describe a case of multiple dermatofibromas in a 38-year-old healthy man who showed no abnormality of the immune function.
Adult* ; Autoimmune Diseases ; Histiocytoma, Benign Fibrous* ; Humans ; Immunosuppressive Agents

No abstract available.
Rickettsia typhi* ; Rickettsia*

There have been several reports of more than one type of porokeratosis occurring in the same family or the same individual. We hope to support the view of different phenotypic expressions of a common genetic aberration by describing an additional case of porokeratosis of Mibelli on the perianal area and DSAP on the face, forearms occurring in a 45-year-old man.
Actins* ; Forearm ; Hope ; Humans ; Middle Aged ; Porokeratosis*

Metoclopramide is prokinetic drug that inhibits dopamine receptors, and it is commonly used in emergency rooms because of its anti-emetic effect. A 71-year-old man visited the hospital with upper abdominal pain and nausea, but agitation and cold sweating were observed after 5 minutes of metoclopramide injection. The vital signs were blood pressure: 120/70 mmHg, heart rate: 170/minute, respiration: 23 breaths/minute, and temperature: 37.5。C, and the electrocardiogram (ECG) showed ventricular tachycardia. One hour after the injection of amiodarone, normal sinus rhythm was shown on the ECG and the vital signs were stable. Metoclopramide is known to be relatively safe, but rarely causes serious cardiovascular side effects. Therefore, emergency physicians should be aware that metoclopramide can cause serious side effects.

Xanthogranulomatous pyelonephritis in childhood is a rare chronic pyelonephritis often assodiated with calculi of urinary tract obstruction, with a clinical presentation of renal mass. A 3-year old boy was admitted to Korea University Hospital complaining of intermittent fever and palpable mass at right upper quadrant of the abdomen. The CBC revealed increased ESR and the finding of iron deficientcy anemia. Proteus mirabilis was cultured from the urine. We found the idiopathic hypercalciuria was affected also. Intravenous pyelogram. ultrasonogram and abdominal computerized tomogrhapy demonstrated a multiple cystic lesion with renal calculi at upper and lower pole of right kidney. Right nephrectomy was performed under the suspicion of the renal abscess with renal stone. Postoperatively microscopic examination revealed parenchymal destruction with infiltration of foamy phagocytes, giant cells, and plasma cells. In conclusion, we experienced a case of xanthogranulomatous pyelonephritis with idiopathic hypercalciuria in a child. So, we report it with a review of literature.
Abdomen ; Abscess ; Anemia ; Calculi ; Child* ; Child, Preschool ; Fever ; Giant Cells ; Humans ; Hypercalciuria* ; Iron ; Kidney ; Kidney Calculi ; Korea ; Male ; Nephrectomy ; Phagocytes ; Plasma Cells ; Proteus mirabilis ; Pyelonephritis ; Pyelonephritis, Xanthogranulomatous ; Ultrasonography ; Urinary Tract

BACKGROUND: Transforming growth factor (TGF)- has a large variety of biological functions, including the modulation of inflammation and the immune system, and is presumed to play important roles in repairing wounds and reducing scarring. The objective of this study is to examine the effects of TGF-1 on healing wounds and reducing scarring. We have also analysed the ability of the hemagglutinating virus of Japan (HVJ) liposome mediated antisense oligodeoxynucleotides (ODNs) to specifically inhibit wound-induced expressions of TGF-1 proteins and mRNA in the rat skin. METHODS: Skin wounds were created on the backs of 80 anesthetized rats. The first group of wounds, as the controls, was unmanipulated. The second group of wounds, as positive controls or an excessive scarring model, was injected with TGF-1 subcutaneously. The third group of wounds was injected with anti-TGF-1 antibody subcutaneously. The fourth group of wounds was injected with HVJ liposome mediated antisense ODNs for TGF-1 subcutaneously. The wounds of all groups were bisected and analysed histologically 5, 10, 15, 30, and 50 days after the wounds were made. RESULTS: All control wounds (TGF-1 or no injection) healed with scarring, whereas the wounds treated with the antibody or antisense ODNs healed with less scar formation compared to the control group. The wounds treated with the antibody or antisense ODNs had fewer macrophages, less collagen and fibronectin contents than the other wounds. Northern blotting and in situ hybridization analysis showed that wound sites treated with HVJ liposome mediated antisense ODNs for TGF-1 exhibited decreased levels of TGF-1 mRNA after injury. CONCLUSIONS: These findings suggest an important new approach to controlling scarring in normal wound healing, complementing the practice of adding exogenous growth factors to chronic wounds in the attempt to inhibit collagen deposition.
Animals ; Blotting, Northern ; Cicatrix* ; Collagen ; Complement System Proteins ; Fibronectins ; Genetic Therapy* ; Immune System ; In Situ Hybridization ; Inflammation ; Intercellular Signaling Peptides and Proteins ; Liposomes ; Macrophages ; Oligodeoxyribonucleotides ; Oligoribonucleotides ; Rats ; RNA, Messenger ; Sendai virus ; Skin ; Transforming Growth Factor beta ; Transforming Growth Factors ; Wound Healing ; Wounds and Injuries

Kennedy's disease is an adult onset form of motor neuron disease characterized by progressive proximal and bulbar muscle weakness. The authors report the anaesthetic management of a 43-year-old man with Kennedy's disease who underwent elective orthopaedic surgery under spinal anaesthesia. The anaesthetic implications of this X-linked lower motor neuron disorder are discussed, and guidelines for safe anaesthetic management are suggested.
Adult ; Humans ; Motor Neuron Disease ; Motor Neurons ; Muscle Weakness