No abstract available.
Diagnosis* ; Humans ; Thoracic Injuries* ; Thorax* ; Tomography, X-Ray Computed*

We report a case of infantile acropustulosis in a 7 month-old female infant who had a family history of scabies in her parents and brother. She had pruritic papulovesicles and pustules, predominantly on the hands and feet. Histopathologically, there was a well-circumscribed unilocular, subcorneal pustule filled with neutrophils, mostly. Under the diagnosis of an infantile acropustulosis associated with scabies, she was treated with a potent topical corticosteroid and oral antihistamines without recurrence.
Diagnosis ; Female ; Foot ; Hand ; Histamine Antagonists ; Humans ; Infant ; Neutrophils ; Parents ; Recurrence ; Scabies* ; Siblings

BACKGROUND: Pityriasis versicolor is often found following pathologic transformation of Malassezia fungi from yeast to mycelial forms by a poorly understood mechanism and is characterized by squamous skin lesions manifesting hyper- or hypo-pigmentation. Itraconazole is a synthetic oral antifungal agent of triazole family, which acts as a selective inhibitor of the cytochrome P-450-dependent synthesis of ergosterol and is reported to demonstrate a potent antifungal efficacy against Malassezia yeasts. OBJECT: The present clinical study was designed to evaluate the therapeutic efficacy of one- week regimen of itraconazole by studying 20 patients with pityriasis versicolor, who were diagnosed both clinically and mycologically. In addition, we wished to identify Malassezia species from skin lesions of pityriasis versicolor and examine the possible correlation of a certain Malassezia(M.) species and pityriasis versicolor. METHODS: Twenty patients (ages, 18 to 49) were included in the study, following the diagnosis of pityriasis versicolor, which was based on clinical examinations and mycological studies (microscopy and culture). Patients received a single 200 mg dose of itraconazole (Sporanox? capsules daily with a full meal for one week. For all patients, clinical examinations and culture and microscopic studies were done before treatment, at the end of treatment, and 4 weeks later. Scales obtained from skin lesions were studied by Parker-KOH smear examination and culture studies to identify Malassezia yeasts. Cultures were done using agar media of Leeming & Notman. RESULTS: By comparing skin lesions before and immediately after treatment, marked improvement was observed in 7 patients (35%) and moderate improvement in 12 patients (60%) among a total of 20 patients, and 1 patient (5%) showed no response. On the other hand, by comparing skin lesions examined before treatment and 4 weeks after completing medication, complete cure was observed in 13 cases (65%), marked improvement in 5 (25%), and moderate improvement in 2 (10%). With culture studies before treatment, M. globosa, M. furfur, and M. restricta were isolated as a major fungal species in 18, 1, and 1 patients, respectively. CONCLUSION: The result suggested that administration of a single dose of 200 mg itraconazole (Sporanox? capsules daily for a week is a very effective treatment for pityriasis versicolor and also indicated that pityriasis versicolor is very closely related with the infection of M. globosa.
Agar ; Capsules ; Cytochromes ; Diagnosis ; Ergosterol ; Fungi ; Hand ; Humans ; Itraconazole* ; Malassezia ; Meals ; Pityriasis* ; Skin ; Tinea Versicolor* ; Weights and Measures ; Yeasts

Pityriasis lichenoides Chronica is a cutaneous disorder of unknown etiology and characterized pathologically by vasculitis and clinically by its marked chronicity and lack of specific treatment. Emollient-phototherapy is a recently introduced effective treatment for psoriasis. The authors treated 3 patients with pityriasis lichenoides chronica by the emollient-phototherapy technic with quite satisfactory results.

No abstract available.
Contusions*

We experienced a case of mitral incompetence due to rupture of anterolateral papillary muscle in a 56-year-old male who complained of abdominal pain and mild dyspnea after being struck by car. Clinical manifestation immediately following injury was minimal, but heart failure progressed rapidly 3 days after injury. Echocardiopraphic evaluation revealed ruptured anterolateral papillary muscle and severe mitral regurgitation on color flow imaging. There was no evidence of coronary artery disease on coronary angiography. Operation revealed that the haed of anterolateral papillary muscle was torn out of its insertion. Mitral valve replacement with mechanical prosthesis was performed on the 50th day after injury.
Abdominal Pain ; Coronary Angiography ; Coronary Artery Disease ; Dyspnea ; Heart Failure ; Humans ; Male ; Middle Aged ; Mitral Valve ; Mitral Valve Insufficiency ; Papillary Muscles* ; Prostheses and Implants ; Rupture* ; Thorax*

The use of prokinetics/antiemetics is one of the leading causes of drug-induced parkinsonism (DIP) observed in neurology clinics. Cognitive dysfunction in DIP has recently been recognized, but pathologies related with cognitive dysfunction is unknown. Among our retrospective cohort of 385 consecutive parkinsonian patients enrolled in our parkinsonism registry, 14 patients were identified who satisfied our inclusion criteria: parkinsonism caused by prokinetics/antiemetics, existing T1-weighted 3D volumetric MR images, and normal [18F]-N-3-fluoropropyl-2-beta-carboxymethoxy-3-beta-(4-iodophenyl) nortropane PET scan images. For the comparison of volumetric MR data, 30 age- and sex-matched healthy individuals were included in this study. Among 14 patients with DIP, 4 patients were diagnosed with dementia, and all other patients had mild cognitive impairment (MCI). Comparisons of MR volumetric data between DIP patients with MCI and controls show that cortical gray matter volumes are reduced bilaterally in DIP (P=0.041) without changes in either total white matter volume or total intracranial volume. Among subcortical structures, the volume of the right hippocampus is reduced in DIP patients compared with controls (P=0.011, uncorrected). In DIP, cortical thickness is reduced in the bilateral lingual (P=0.002), right fusiform (P=0.032) and part of the left lateral occipital gyri (P=0.007). Our results suggests that cognitive dysfunction in DIP caused by prokinetics/antiemetics is common. Structural changes in the brain by 3D MRI may be associated with cognitive decline in DIP.
Aged ; Aged, 80 and over ; Antiemetics/*adverse effects ; Brain/drug effects/pathology ; Cognition Disorders/*chemically induced/*pathology ; Female ; Gastrointestinal Agents/*adverse effects ; Humans ; Male ; Parkinson Disease, Secondary/*chemically induced/*pathology ; Republic of Korea ; Retrospective Studies ; Risk Assessment ; Treatment Outcome

BACKGROUND: Subcapital femoral neck is known to cause many complications, such as avascular necrosis (AVN) of the femoral head or nonunion, compared with other femoral neck fractures. The purpose of this study was to analyze the incidence of AVN and fixation failures in patients treated with internal fixation using cannulated screws for the subcapital femoral neck fractures. METHODS: This study targeted a total of 84 cases of subcapital femoral neck fractures that underwent internal fixation using cannulated screws. The average follow-up time after surgery was 36.8 months (range, 24 to 148 months). RESULTS: Nine hips (10.7%) showing AVN of the femoral head and 6 hips (7.1%) showing fixation failures were observed. The factors affecting the incidence of AVN of the femoral head after sustaining fractures correlated well with fracture types in the Garden classification (p = 0.030). The factors affecting fixation failure were the degree of reduction (p = 0.001) measured by the Garden alignment index and firm fixation (p = 0.009) assessed using the technique of 3-point fixation through the inferomedial cortical bone of the femoral neck. CONCLUSIONS: The complication rates for subcapital femoral neck fractures were lower than those previously reported; hence, internal fixation could be a primary treatment option for these fractures.
Classification ; Femoral Neck Fractures* ; Femur Neck* ; Follow-Up Studies ; Fracture Fixation ; Head ; Hip ; Humans ; Incidence ; Necrosis ; Risk Factors

Anastomoses between a coronary artery and bronchial or mediastinal arteries have been described since the 19th century. Although coronary-to-bronchial artery communication has been well described, it remains an unusual finding. We report one adult case of abnormally enlarged two coronary-to-bronchial artery communications in a severe cystic bronchiectasis patient. In this case, the bronchial arteries were also supplied from the multiple systemic arteries (the internal mammary, subclavian, inferior phrenic and intercostal arteries) because of severe cystic bronchiectasis. We treated the patient by embolization of the bronchial artery with the abnormal anastomoses and then by surgical resection of the cystic bronchiectatic lung lesion. To date, the patient remains free of symptoms.
Adult ; Arteries* ; Bronchial Arteries ; Bronchiectasis* ; Coronary Vessels ; Humans ; Lung

BACKGROUND/AIMS: To compare the clinical characteristics and outcomes of systemic lupus erythematosus between male and female Korean patients. METHODS: A retrospective analysis was performed at a single tertiary hospital from August 1994 to May 2010. Male patients were matched with two to three female patients based on age and disease duration. Organ damage was assessed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index (SLICC/ACR DI). RESULTS: Fifty-three male patients were compared with 150 female patients. Renal disorders were found more frequently in male patients at disease onset (p < 0.001); the adjusted odds ratio (OR) demonstrated a significant sex preponderance for renal manifestations (OR, 3.26; 95% confidence interval [CI], 1.62 to 6.57). Diffuse proliferative lupus nephritis and end-stage renal disease requiring dialysis during the disease course were more prevalent in male patients (p = 0.025 and p < 0.001, respectively). The risk for requiring long-term dialysis was significantly higher in male than in female patients (OR, 4.02; 95% CI, 1.07 to 15.06), as was the mean SLICC/ACR DI (1.55 +/- 1.35 vs. 1.02 +/- 1.57, respectively; p = 0.028). CONCLUSIONS: Our data demonstrate that Korean patients with lupus have characteristics similar to those of cohorts reported previously. Male patients had significantly higher incidences of renal manifestations and organ damage.
Adult ; *Asian Continental Ancestry Group ; Female ; Humans ; Immunosuppressive Agents/therapeutic use ; Incidence ; Kaplan-Meier Estimate ; Kidney Failure, Chronic/diagnosis/ethnology/therapy ; Lupus Erythematosus, Systemic/diagnosis/*ethnology/mortality/therapy ; Lupus Nephritis/diagnosis/ethnology/therapy ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Prevalence ; Prognosis ; Renal Dialysis ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Sex Distribution ; Sex Factors ; Tertiary Care Centers ; Time Factors ; Young Adult