Sneddon's syndrome consists of widespread livedo reticularis and ischemic cerebral manifestations. We report a case of a 70-year-old Korean woman with extensive livedo reticularis, hypertension, positive laboratory results for antinuclear antibodies and the lupus anticoagulant test, and idiopathic Parkinson's disease.
Aged ; Antibodies, Antinuclear ; Female ; Humans ; Hypertension ; Livedo Reticularis ; Lupus Coagulation Inhibitor ; Parkinson Disease

BACKGROUND: Cyclosporine, an immune suppressive agent has been reported to potentiate the neuromuscular blockade induced by vecuronium and atracurium. And the potentiation degree was more prominent in the vecuronium. Rocuronium and mivacurium have been introduced into clinical practice recently and there is no report whether the cyclosporine potentiates the neuromuscular blocking effects of these agents. We, therefore studied the effect of Sandimun (cyclosporine in cremophor-ethanol) on the neuromuscular blockade action of rocuronium and mivacurium in rabbits. METHOD: The effect of Sandimun on the rocuronium and mivacurium were investigated in anesthetized 30 rabbits. The rabbits were divided into five groups; rocuronium group (rocuronium bromide 1 mg/kg iv), rocuronium - Sandimun group (rocuronium bromide 0.1 mg/kg iv after Sandimun 5 mg/kg iv), mivacurium group (mivacurium chloride 0.064 mg/kg iv), mivacurium - Sandimun group (mivacurium chloride 0.064 mg/kg iv after Sandimun 5 mg/kg iv) and Sandimun group (Sandimun 5 mg/kg iv). Neuromuscular block was assessed by measuring the response of anterior tibial muscle to 0.1Hz single twitch stimulation of the common peroneal nerve. Onset time, duration of muscle relaxation and recovery index were compared among the groups. RESULTS: There were no significant differences in onset time and recovery indices among the groups. Significant difference was found in duration between the rocuronium group and the rocuronium-Sandimun group (p<0.05). CONCLUSION: Sandimun potentiates the rocuronium - induced neuromuscular blockade but not the neuromuscular blocking action of mivacurium.
Atracurium ; Cyclosporine* ; Muscle Relaxation ; Muscle, Skeletal ; Neuromuscular Blockade* ; Peroneal Nerve ; Rabbits ; Vecuronium Bromide

The volatile anesthetic agent, halothane and ethrane, are most commonly used in general anesthesia practice and a depolarizing neuromuscular blocker, succinylcholine, is also used for endotracheal intubation, if not contraindicated. There were many reports that the volatile anesthetics affect the neuromuscular transmission in akeletal muscles and potentiate the neuromuscular black induced by depolarizing muscle relaxant in moderate to high concentration. But in halothane, a result was different from those of others. It was well known fact that in pregnant woman, the MAC of the volatile anesthetics is decreased. Therefore, present study was performed to determine whether halothane and ethrane may affect the action of succinylcholine or not, in their low concentration, in 40 healthy pregnant women and we divided them randomly in two groups: halothane administered group(group A), ethrane administered group(group B). Ulnar nerve was stimulated at the wrist through surface electrode, using a peripheral nerve stimulator with supramaximal single twitchimpulse of 0.2 msec duration at a rate of 1.0 Hz. The responses of the adduction of thumb were measured with a force displacement transducer and recorded with a biophysiograph(San Ei, Japan). The single twitch were measured before and after intravenous succinylcholine 1 mg/kg and when full paralysis occurred, 0.5% halothane administered in group A and 1% ethrane administered in group B and observed the effects of halothane and ethrane on the neuromuscular blocking action of succinylcholine. The results were as follows. The time from intravenous succinylcholine onset of paralysis was 15.5+/-3.21 sec in halothane group, and 14.8+/-3.17 sec in ethrane group. The time from onset of paralysis to full paralysis was 42.2+/-5.98 sec in halothane group, and 47.1+/-13.55 sec in ethrane group. Duration of full paralysis was 283.9+/-68.02 aec in halothane group, and 270.8+/-44.49 sec in ethrane group. Recovery index(T26-T76) was 68.4+/-16.11 aec in halothane group, and 75.4+/-21.93 sec in ethrane group. We conclude that there is no significant difference between the effects of halothane and ethrane on the neuromuscular blocking actioa of succinylchpline, in their low concentraction, in healthy pregnant women.
Anesthesia* ; Anesthesia, General ; Anesthetics ; Cesarean Section* ; Electrodes ; Enflurane* ; Female ; Halothane* ; Humans ; Intubation, Intratracheal ; Muscles ; Neuromuscular Blockade ; Paralysis ; Peripheral Nerves ; Pregnancy ; Pregnant Women ; Succinylcholine* ; Thumb ; Transducers ; Ulnar Nerve ; Wrist

The hyperimmunoglobulinemia E (Jobs) syndrome (HIES) is characterized by marked elevated levels of IgE, recurrent cutaneous and systemic staphylococcal infections, atopic-like dermatitis, and defective neutrophil chemotaxis. Three cases of HIES have been reported in Korea, but not in the dermatology literature. We report a case of HIES with cutaneous infections and MRSA (methicillin-resistant Staphylococcus aureus). A 15-month-old girl presented with intractable pruritic excoriated papular pustular skin lesions and multiple subcutaneous abscesses. Surgical drainage of the abscesses and a course of antibiotic treatment in addition to topical steroids for about 7 weeks resulted in a remarkable improvement.
Abscess ; Chemotaxis ; Dermatitis ; Dermatology ; Drainage ; Female ; Humans ; Hypergammaglobulinemia* ; Immunoglobulin E ; Infant ; Job Syndrome* ; Korea ; Methicillin-Resistant Staphylococcus aureus ; Neutrophils ; Skin ; Staphylococcal Infections ; Staphylococcus ; Steroids

BACKGROUND: Urticaria pigmentosa(UP) is primarily a disease of children. There have been no clinical studies of UP in Korea. OBJECTIVE: This study was performed to find the clinical characteristics of UP in Korean child-hood patients. METHOD: Twenty-nine cases of urticaria pigmentosa confirmed clinically and histopathologically were analyzed. RESULTS: The maculopapular type was the most common with the usual age of onset before the age of 6 months, and the lesions tended to be distributed in the central portion of the body. Darier sign was positive in 92% of the patients(24/26). No systemic involvements were detected in any of the patients with minimal associated symptoms. Seven patients of the maculopapular type and one patient of the multiple nodular type followed up for more than 2 years showed a tendency to improve or clear by the age of 6 years. CONCLUSION: Neonatal or infantile-onset patients of UP in Korean pediatric population were considered to have a benign clinical course and to require no aggressive therapy.
Age of Onset ; Child* ; Clinical Study* ; Humans ; Korea ; Methods ; Urticaria Pigmentosa* ; Urticaria*

PURPOSE: This study was designed to evaluate the effects of an individual breast-feeding promotion program to address breast-feeding knowledge, attitude, method and rate of practice for married immigrant women. METHODS: A non-equivalent control group quasi-experimental design was used (experimental group=16, control group=17). The intervention consisted of 3 phases: (1) Within 2 hours of delivery - individual breast-feeding training through video/verbal/practical training education and demonstration (2) After 1~2 days - group training using video, model doll, and breast models (3) After 7 days - family visit, counseling, retraining and reinforcement training. The data were analyzed using non-parametric tests with the SPSS program. RESULTS: Married immigrant women who participated in the individual breast-feeding program scored high in knowledge, attitude, method and rate of practice compared to the control group. CONCLUSION: The results indicate that the individual breast-feeding program is very effective in increasing breast-feeding knowledge, attitude, method and rate of practicing breast feeding for married immigrant women. So, nurses are encouraged to aggressively utilize individual breast-feeding programs to help married immigrant women, who are exposed to vulnerability due to various situations.
Adult ; *Breast Feeding ; Counseling ; Emigrants and Immigrants/*psychology ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Interviews as Topic ; Marriage ; Mothers/psychology ; Pregnancy ; *Program Evaluation ; Social Support ; Young Adult

So many modalities have been suggested for the treatment of servere pain and ankylosis of the elbow with destruction of the articular surfaces. Among them, two major methods which have been widely used are resection arthroplasty and prosthetic replacement arthroplasty. However prosthetic replacement arthroplasty has some problems. Its indications are limited in the elderly inactive subjects. And there have been many kinds of complications including loosening and infection. Also, resection arthroplasty in now rarely indicated due to severe instability. From July 1980 to July 1987, we tried distraction arthroplasty in 8 cases of elbow with severe destruction of its articular surfaces, mainly in the young active persons. The average follow-up period was 45 months. The effect of distraction arthroplasty on relief of pain was not remarkable. The average increase in ROM, including that of one reankylosed elbow, was 51 ±22 degrees in flexion-extension and 48 ±23 degrees in pronstion-supinstion. No deep wound infection and instability which was main complication of resection arthroplasty were observed with our method of distraction arthroplasty. On the basis of functional results, the the results were excellent in 4, good in 1, fair in 2 and poor in 1 cases. In conclusion, distraction arthroplasty of the elbow can be one of the of effective methods reconstruction for the young active patients with the destruction of the elbow, if they are intelligent and motivated.
Aged ; Ankylosis ; Arthroplasty ; Arthroplasty, Replacement ; Elbow ; Follow-Up Studies ; Humans ; Methods ; Wound Infection

BACKGROUND: Trichloroacetic acid(TCA) chemical peel has been used for variable skin lesions. However, the effect of TCA chemical peel on acne scars has not been studied. OBJECTIVE: The object of this study is to evaluate the effect of TCA chemical peel on atrop hic acne scars. METHOD: Twenty three patients with atrophic acne scars, who were treated with TCA chemical peel were included. The patieits were interviewed for evaluation of the therapeutic efficacy of TCA chemical peel regarding the number of treatment and satisfaction rates. RESULTS: Those who received treatment for more than 6 times with good or excellent results were 13 out of 15 patients, whereas, those who received treatment for 4 times with good or excellent results were 4 out of 7 patients Thus, chemical peel on acne scars showed that the more often the treatment was carried out, the better the therapeutic effect. There was no significant complication. CONCLUSION: TCA chemical peel is safe and effective for the treatment of atrophic acne scars.
Acne Vulgaris* ; Cicatrix* ; Humans ; Skin ; Trichloroacetic Acid

Clinically adult-onset xanthogranuloma is somewhat different to that of juvenile xanthogranuloma. There seems to be no definitive sites of predilection and concomitant extracutaneous lesions, and spontaneous resolution does not occur in the adult form. The lesions of the adult form are usually asymmetric or solitary. We describe an adult with a solitary xanthogranuloma on the left shoulder. Histological findings of this case show minor differences from juvenile xanthogranuloma but immunohistochemical findings were very similar to those of juvenile xanthogranuloma.
Adult* ; Humans ; Shoulder ; Xanthogranuloma, Juvenile

A 81-year-old man was referred for respiratory failure by emergency medical technicians. He admitted at intensive care unit for ventilator treatment. Several hours before admission, he took sildenafil 100 mg for erectile dysfunction without prescription. The episodes of hemoptysis occurred several hours later. Computed tomography revealed multifocal diffuse ground-glass attenuation in both lungs. And the more we performed bronchoalveolar lavage, the more the color of it was turned into red. We treated him with empirical antibiotics and tranexamic acid, and hemoptysis was stopped in one day after admission. But in the 5th admission day, he died from sepsis combined with pneumonia caused by Acinetobacter baumannii abruptly.
Acinetobacter baumannii ; Aged, 80 and over ; Anti-Bacterial Agents ; Bronchoalveolar Lavage* ; Emergency Medical Technicians ; Erectile Dysfunction* ; Hemoptysis* ; Hemorrhage* ; Humans ; Intensive Care Units ; Lung ; Male ; Pneumonia ; Prescriptions ; Respiratory Insufficiency ; Sepsis ; Tranexamic Acid ; Ventilators, Mechanical ; Sildenafil Citrate