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

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: 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

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

Many factors associated with a patient's lifestyle may disrupt timely access to dementia diagnosis and management. The aim of this study was to compare characteristics of lifestyle factors at the time of initial evaluation for dementia across degrees of dementia, and to identify risk factors relating to late detection of dementia, in order to understand the various lifestyle barriers to timely recognition of the disease. We reviewed medical records of 1,409 subjects who were diagnosed as dementia among 35,723 inhabitants of Gwangjin-gu. Dementia severity was divided into three degrees. Age, sex, education, income, smoking, heavy drinking, physical activity, religion, and living conditions were evaluated. There was a significantly greater proportion of individuals who were old age, female, less educated, who had never smoked or drank heavily, without physical activity, with no religious activity and living with family other than spouse in the severe dementia group. The lifestyle risks of late detection were old age, lower education, less social interactions, less physical activity or living with family. We can define this group of patients as the vulnerable stratum to dementia evaluation. Health policy or community health services might find ways to better engage patients in this vulnerable stratum to dementia.
Aged* ; Community Health Services ; Dementia* ; Diagnosis ; Drinking ; Education ; Female ; Health Policy ; Health Services ; Humans ; Interpersonal Relations ; Life Style ; Mass Screening ; Medical Records ; Motor Activity ; Risk Factors ; Smoke ; Smoking ; Social Conditions ; Spouses

Laryngoscopy and intubation cause an adrenergic response manifested by tachycardia and hypertension. Various phamacological agents have been administered prior to induction in an attempt to attenuate the adrenergic response but they all have limitations. The objective of our study was to determine if esmolol would be equally effective when adrninistered in a bolus with and without fentanyl. A double-blind, randomized trial was conducted in sixty ASA physical status 1 patients undergoing elective surgery. All patients were premedicated with 0.2 mg/kg diazepam orally and glycopyrrolate 0.04 mg/kg intramuseularyly 1 hour beforehand. Induction of anesthesia was accomplished with 4 mg/kg thiopental intravenously foUowed immediately by 0.15-0.2 mg/kg vecuronium and study drug (placebo, esmolol 150 mg, esmolol 150 mg and fentanyl 100 mcg). Endotracheal intubation was performed at 2 minutes after study drug adrninistration. Anesthesia was maintained with 1 MAC (+/-10%) isoflurane in 60% nitrous oxide in oxygen at a 5 L/min flow for 6 minutes. Heart rate and blood pressure were measured every minute by an automatic recording device. After laryngoscopy and intubation, maximum increase in stolic blood pressure above awake levels was 33 mmHg (p<0.05) and 14 mmHg (p<0.05) in esmolol 150 mg, esmolol 150 mg with fentanyl 100 mcg respectively, whereas systolic blood pressure increased 62 mmHg after tracheal intubation in patients with placebo. In six patients with esmolol 150 mg, rate-pressure product reached a level considered potentially dangerous to patients with coronary artery disease. However, when used with fentanyl, esmolol provides effectvie protection against the adrenergic response and increase of the rate-pressure product to laryngoscopy and intubation.
Anesthesia ; Blood Pressure* ; Coronary Artery Disease ; Diazepam ; Fentanyl* ; Glycopyrrolate ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Intubation ; Intubation, Intratracheal* ; Isoflurane ; Laryngoscopy ; Nitrous Oxide ; Oxygen ; Tachycardia ; Thiopental ; Vecuronium Bromide

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