The acardiac twin, or twin reversal of arterial perfusion (TRAP) sequence is encountered in approximately 1% of monozygotic twins with an incidence of one in 35,000 births. The problem results from vascular anastomoses between the arterial and venous circulation of normal "pump" twin and that of recipient "perfused" acardiac twin. The recipient twin may display severe and lethal anomalies, including acardia and acephalus. The pump twin is structurally normal. Mortality of about 50-75% in cases without treatment is due to heart failure, prematurity or cord entanglement. We report a case of acardiac twin diagnosed by ultrasound prenatally.
Heart Failure ; Humans ; Incidence ; Mortality ; Parturition ; Perfusion ; Twins, Monozygotic ; Ultrasonography*

Eruptive vellus hair cysts are asymptomatic, flesh-colored- to-bluish, 1-to-4 mm-sized papules that are usually located on the chest and extremities of children and young adults. Histologically, small cysts are observed in the mid-dermis and these cysts contain multiple hair shafts and keratinous materials. We report here on a case of eruptive vellus hair cysts that developed on a rare site, the labium major.
Child ; Extremities ; Hair ; Humans ; Keratins ; Thorax ; Young Adult

Verrucous carcinoma is an uncommon low-grade variant of squamous cell carcinoma. It is clinically characterized by its verrucous and fungating appearance and it is histologically characterized by well-differentiated epithelial proliferations that push the underlying dermis. There are some reports of verrucous carcinoma associated with abscess or fistula, but there have been no case reports of verrucous carcinoma complicated with a subcutaneous abscess involving the adjacent tissue in Korea. We report here on a case of verrucous carcinoma that presented with focal verrucous nodule infiltrating the adjacent subcutaneous tissue with diffuse subcutaneous abscess formation.
Abscess ; Buttocks ; Carcinoma, Squamous Cell ; Carcinoma, Verrucous ; Dermis ; Fistula ; Korea ; Subcutaneous Tissue

Transmission of animal scabies to human is probably rare because of the relative host specificity of the mites. However, recurrent exposure to animal scabies mites can produce troublesome and diagnostically puzzling lesions. We report herein on a human infestation of canine scabies and this occurred in a 26-year-old male who presented with a 4-month history of severe pruritic skin lesions. His puppy was diagnosed with scabies infestation by a veterinarian two months previously. Since that time, he no longer raised the puppy. Microscopic examination of a mineral oil preparation after scraping the papules revealed a mite. He was diagnosed with canine scabies.
Adult ; Animals ; Host Specificity ; Humans ; Male ; Mineral Oil ; Mites ; Scabies ; Skin ; Veterinarians

This study was conducted to investigate the factors related to the poor school performance of the elementary school children. Two schools in Taegu, one in the affluent area and the other in the poor area, were selected and a total of 175 children whose school performance was within low 10 percentile(poor performers) and 97 children whose school performance were within high 5 percentile(good performers) in each class of 2nd, 4th and 6th grades were tested for the physical health, behavioral problem and family background. Each child had gone through a battery of tests including visual and hearing acuity, anthropometry(body weight, height, head circumference), intelligence(Kodae Stanford-Binet test), test anxiety(TAI-K), neurologic examination by a developmental pediatrician and heavy metal content(Pb, Cd, Zn) in hair by atomic absorption spectrophotometry. A questionnaire was administered to the mothers for prenatal and perinatal courses of the child, family environment, child's developmental history, and child's behavioral and learning problems. Another questionnaire was administered to the teachers of the children for the child's family background, arithmatic and language abilities and behavioral problem. The poor school performance had a significant correlation with male gender, high birth order, broken home, low educational and occupational levels of parents, visual problem, high test anxiety score, attention deficit hyperactivity disorder(ADHD), poor physical growth(weight, height, head circumference) and low I.Q. score. The factors that had a significant correlation with the poor school performance in multiple logistic regression analysis were child's birth order(odds ratio=2.06), male gender(odds ratio=5.91), broken home(odds ratio=9.29), test anxiety score(odds ratio=1.07), ADHD(odds ratio=9.67), I.Q. score(odds ratio=0.85) and height less than Korean standard mean-1 S. D.(odds ratio=11.12). The heavy metal contents in hair did not show any significant correlation with poor school performance. However the lead and cadmium contents were high in males than in females. The lead content was negatively correlated with child's grade(p<0.05) and zinc was positively correlated with grade(p<0.05). Among the factors that showed a significant correlation with the poor school performance, high birth order, short stature and ADHD may be modified by a good family planning, good feeding practice for infant and child, and early detection and treatment of ADHD. Also, teacher and parents should restrain themselves from inducing excessive test anxiety by forcing the child to study and over-expecting beyond the child's intellectual capability.
Anxiety ; Birth Order ; Cadmium ; Child* ; Daegu ; Family Planning Services ; Female ; Hair ; Head ; Hearing ; Humans ; Infant ; Language ; Learning ; Logistic Models ; Male ; Mothers ; Neurologic Examination ; Parents ; Parturition ; Surveys and Questionnaires ; Spectrophotometry, Atomic ; Zinc

Acute generalized exanthematous pustulosis (AGEP) is an uncommon aseptic pustular eruption that usually follows recent administration of oral or parenteral drugs. Characteristic AGEP features include the sudden onset of fever with widespread erythematous eruption, rapidly progressing to a fine, non-follicular, micropustular rash. The illness usually resolves spontaneously with fever and pustulation clearing within 15 days, sometimes followed by desquamation. Histopathology shows non-follicular spongiotic pustules in the epidermis filled with neutrophils, a mixed perivascular infiltrate of neutrophils and occasional eosinophils with papillary dermal edema. We describe a 10-month-old boy with AGEP secondary to exposure to amoxicillin. This is an uncommon condition in children.
Acute Generalized Exanthematous Pustulosis ; Amoxicillin ; Child ; Drug Eruptions ; Edema ; Eosinophils ; Epidermis ; Exanthema ; Fever ; Humans ; Infant ; Neutrophils

OBJECTIVE: The qualitative test of fibronectin of the cervices and vaginae as well as the C-reactive protein test of pregnant mothers with symptoms of preterm labor were performed in an attempt to examine clinical validity of these factors as predictable elements of preterm delivery. METHODS: This prospective study was conducted on ninety (90) single pregnancies of gestational age from 24 weeks and 1 day to 34 weeks and 6 days admitted to the hospital with symptoms of preterm labor, which occurred in the period from October 1, 1999 through March 31, 2001. Among these pregnant women, those with a uterine contraction rate of 4 per hour or greater and uterine dilatation of less than 3 cm without PROM were used as the subjects. The qualitative test of fetal fibronectin (ROM check, Adeza Biochemical, USA) of the cervices and vaginae as well as the C-reactive protein test by means of latex agglutination method using maternal blood were performed on these subjects. Of the 90 mothers that participated in this study, 15 dropped out and 75 underwent the qualitative test of fetal fibronectin and C-reactive protein test. The results of each test and the combined tests of both at preterm delivery (1) within 1 week, (2) prior to 34 weeks and (3) prior to 37 weeks were compared and analyzed. RESULTS: 1. 22.4% (15/67) resulted in preterm delivery prior to 34 weeks while 48.0% (36/75) ended up with preterm delivery prior to 37 weeks. 2. In predicting preterm delivery within 7 days and prior to 37 weeks after the test, the fetal fibronectin and C-reactive protein qualitative test were statistically insignificant. The combined tests of both fetal fibronectin and C-reactive protein were statistically insignificant in predicting preterm delivery within 7 days (Odds ratio of 4.2; 95% CI 0.7-23.3 p=0.199) and prior to 37 weeks (Odds ratio of 5.3; 95% CI 0.6-48.3 p=0.116). 3. In predicting preterm delivery prior to 34 weeks, fetal fibronectin and C-reactive protein qualitative test were insignificant statistically. Nevertheless, these two tests in combination showed a statistical significance for preterm delivery prior to 34 weeks: It showed a sensitivity of 26.7% (4/15), a specificity of 95.6% (43/45), a positive predictability of 66.7% (4/6), and negative predictability of 79.6% (43/53) [Odds ratio of 7.8; 95% CI 1.3-48.3, p=0.03]. CONCLUSION: Specificity and positive predictive value improved when the combined fetal fibronectin and C-reactive protein tests in pregnancies with symptoms of preterm labor were performed for preterm delivery before 34 weeks. Consequently, this is a clinically valid predictor of preterm delivery before the 34th week.
Agglutination ; C-Reactive Protein* ; Dilatation ; Female ; Fibronectins* ; Gestational Age ; Humans ; Latex ; Mothers ; Obstetric Labor, Premature ; Pregnancy ; Pregnant Women ; Premature Birth* ; Prospective Studies ; Sensitivity and Specificity ; Uterine Contraction ; Vagina

BACKGROUND AND OBJECTIVES: The correlations between plaque characteristics and plaque rupture location according to segmental lesion analysis have not been well defined. The aim of this study was to assess those characteristics of ST-segment elevation myocardial infarction (STEMI) culprit lesions according to segmental lesion geometry using virtual histology intravascular ultrasound (VH-IVUS). METHODS: Sixty single discrete lesions found in the left anterior descending (LAD) coronary arteries of 60 patients with STEMI were included. Each lesion was divided into 3 segments based on lumen area (LA) index, calculated by dividing the lesion LA by the reference LA. RESULTS: Among the 3 segments, the mid-segment showed the highest proportion of necrotic core (NC; proximal, mid-, and distal segments: 20.9±11.8%, 22.7±11.3%, and 17.5±11.2%, respectively, p=0.044). VH-IVUS-derived thin-cap fibroatheroma (VH-TCFA) was also more frequently found in the mid-segment than in proximal and distal segments (36.7%, 58.3%, and 16.7%, p < 0.001). The mid-segment also showed the highest prevalence of plaque rupture (45.0%, 78.3% and 11.7%, p < 0.001) and thrombus (61.7%, 95.0%, and 41.7%, p < 0.001) compared to proximal or distal segments. When the lesions were divided into 2 groups according to the median value (4.0 mm2) of minimum lumen area (MLA), plaque rupture at the distal segment was observed only in high MLA lesions (23.3% vs. 0.0%, p=0.011). CONCLUSION: Analysis of longitudinal lesion geometry using the LA index can be useful in evaluating plaque vulnerability and the incidence of plaque rupture and thrombus in STEMI patients.
Coronary Artery Disease ; Coronary Vessels ; Diagnostic Imaging ; Humans ; Incidence ; Myocardial Infarction* ; Plaque, Atherosclerotic ; Prevalence ; Rupture ; Thrombosis ; Ultrasonography

Takotsubo cardiomyopathy, also called apical ballooning syndrome or stress-induced cardiomyopathy, is a unique reversible cardiomyopathy that is frequently precipitated by a stressful event, and is described as a typical form of acute transient left ventricular dysfunction. The classic situation is postmenopausal women presenting with chest pain or dyspnea. The overall prognosis is favorable. We report a case of a 75-year-old female patient who came to our hospital with dizziness, which was found to be caused by transient apical ballooning following permanent pacemaker implantation.
Aged ; Atrioventricular Block ; Cardiomyopathies ; Chest Pain ; Dizziness ; Dyspnea ; Female ; Humans ; Life Change Events ; Pacemaker, Artificial ; Porphyrins ; Prognosis ; Takotsubo Cardiomyopathy ; Ventricular Dysfunction, Left

Impetigo herpetiformis is a rare and severe pustular disorder which primarily occurs in pregnancy. Etretinate and acitretin are effective in impetigo herpetiformis with systemic steroid. A major concern with the use of systemic retinoids is their high teratogenic potential. Isotretinoin is another retinoid but its teratogenic potential lasts only for two months. Hence, isotretinoin may be used to treat women of childbearing years with impetigo herpetiformis. We report a case of impetigo herpetiformis in a 26-year-old woman whose condition was improved with isotretinoin.
Acitretin ; Adult ; Etretinate ; Female ; Humans ; Impetigo ; Isotretinoin ; Pregnancy ; Retinoids