We report a case of Kyrles disease occuring in a 19-year-old man with chronic renal failure. The patient had multiple hyperkeratotic papules with central plug on the upper extremities, lower extremities and buttocks. Histopathological findings showed epidermal invagination filled with parakeratotic column and basophilic debris. Many dyskeratotic and vacuolated cells were present below the keratotic plug, and penetration of the parakeratotic column into the dermis was seen.
Basophils ; Buttocks ; Dermis ; Humans ; Kidney Failure, Chronic ; Lower Extremity ; Upper Extremity ; Young Adult

We report here a case of angioimmunoblastic lyinphadenopathy with dysprote inemia(AILD) in a 65-year-old male associated with skin nodules on the face. Physical examina.tion showed generalized lymphadenopathy, hepatosplenomegaly, erythematous maculopapular eruptions on the trunk and extremities, and er the matous nodules on the face. Lahoratory findings showed hemolytic anernia, arid polyclonal gammopathy. Histopathological findings of lymph node revealed typical features of AILD. I-iistopathological findings of maculopapules revealed lymphohistiocytic infiltra tion and extravasated erythrocytes around the blocked vessels, whereas histological picture of nodules on the face mirrorred that of the lymph node. After taking systemic chemotherapy, his general condition and skin lesions were improved.
Aged ; Drug Therapy ; Erythrocytes ; Extremities ; Humans ; Immunoblastic Lymphadenopathy* ; Lymph Nodes ; Lymphatic Diseases ; Male ; Skin*

We report a case of paraneoplastic acrokeratosis(Bazex syndrome) occurring in a 70 year old man with small cell carcinoma of the lung. The skin lesions showed violaceous erythema and psoriasiform scaling of the face, aural helices, scalp, and palmoplantar regions with severe nail dystrophy, Histcipathological findings revealed hyperkeratosis, acanthosis and spongiosis in the epiderrnis, and lyrnphocytic infiltration in the upper dermis. He was treated with cis-diamine dichloroplanum(Cisplan), 4 o-demethy-l-o-epipodo- phyllotoxin (Etoposide ) and steroid onitrnent. But eight months later, he died of lung carcinoma.
Aged ; Carcinoma, Small Cell ; Dermis ; Erythema ; Humans ; Lung ; Scalp ; Skin

BACKGROUND: Breast lesions in children and adolescents are rare and develop mainly in females. The management of breast masses in children and adolescents can be a perplexing problem for pediatricians and surgeons. It is well documented that breast lesions in females under 20 years of age rarely represent malignant disease. However, they frequently are a source of discomfort and anxiety for the patient, particularly when they do not resolve spontaneously. METHODS: To determine the frequency of different breast masses in females under 20 years of age on whom surgery was performed, we carried out a retrospective study of females under 20 years who were admitted to the Department. of Surgery of Soonchunhyang University Hospital for surgery between 1993 and 1995. RESULTS: The mean age was 17.9 years. A total of 44 surgical procedures were performed in 40 patients. The masses ranged in size from 0.8 cm through 7.0 cm. As to the location, the mass was in the right breast of 22 patients (50%) and in the left breast of 22 (50%). The most common location of the mass was in the right upper outer quadrant (13 patients, 29.5%). Of the 44 masses, fine-needle aspiration cytology was performed in 33 masses. Of them, 28 were fibroadenomas, 4 were fibrocystic disease, and 1 was a lipoma. Excisional biopsy was performed on 44 masses. Of them, 33 were fibroadenomas, 4 were fibrocystic disease, 5 was fibroadenoma and fibrocystic disease, 1 was a lipoma, and 1 was a lymphangioma. There were no malignancies. CONCLUSIONS: In female patients under 20 years of age, we suggest that benign breast should be studied for diagnosis, treatment, and histological feature.
Adolescent ; Anxiety ; Biopsy ; Biopsy, Fine-Needle ; Breast* ; Child ; Diagnosis ; Female* ; Fibroadenoma ; Humans ; Lipoma ; Lymphangioma ; Retrospective Studies

BACKGROUND: The several forms of treatment of Graves disease-thyroidectomy, antithyroid drugs and radioiodide therapy-are in wide use now. But which therapy is best is a matter of debate. Some authors reported that in patients who underwent thyroidectomy, higher titers of serum antimicrosomal antibody were associated with 1) higher formation rates of germinal centers, 2) more lymphocyte infiltration in the thyroid tissue, 3) higher incidence of hypothyroidism, and 4) lower incidence of recurrence. We were interested in the relationship of thyroid autoantibody titers, ADCC(antibody-dependent cell-mediated cytotoxicity) activity and the clinical response to antithyroid medication. METHODS: We measured ADCC activities from patients in Graves disease(n-48), Hashimoto thyroiditis(n=17) and normal control(n=9). The patients of Graves disease were followed up for more than 1 year, and they were grouped into A(n=17, well responsed group to antithyroid medication) and B(n=31, poorly responsed group). We examined ADCC activities of patients' sera by chromium release assay. RESULTS: 1) Mean age of patients with Graves disease was 34.4210.4 years and 15 patients were male(31%). 2) Results of thyroid function tests of the Graves' patients were T 585.9 +/- 255.3 ng/dL, T4 21.3 +/- 12.2 mg/dL, TSH 0.11 +/- 0.06mIU/mL. Concentrations of antimicrosomal antibody, antithyroglobulin antibody and thyrotropin binding inhibitory immunoglobulin were 1279.1 +/- 1486.7 IU/mL, 488.1 +/- 751.1 IU/mL, and 38.5 +/- 33.4U/L respectively. 3) There was no significant difference between levels of thyroid hormones or concentrations of thyroid autoantibodies and ADCC activities in graves patients. 4) The ADCC activity of the Graves patient group(24.49%) was significantly higher than that of the normal control group(3.76%), and significantly lower than that of the Hashimotos thyroiditis group(36.34%). 5) There was no significant difference in ADCC activity between group A(18.24 +/- 13.44%) and B(27.91 +20.02%). CONCLUSION: From this results, we suggested that ADCC activity seems to be no value as a prognostic factor in predicting the response to antithyroid drugs in Graves disease patients. But, further studies, larger number of patients and long-term follow up, are needed.
Antibody-Dependent Cell Cytotoxicity ; Antithyroid Agents ; Autoantibodies ; Chromium ; Follow-Up Studies ; Germinal Center ; Graves Disease* ; Humans ; Hypothyroidism ; Immunoglobulins ; Incidence ; Lymphocytes ; Recurrence ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Hormones ; Thyroidectomy ; Thyroiditis ; Thyrotropin

BACKGROUND: The MicroScan MICroSTREP plus panel for susceptibility testing of various streptococci, including Streptococcus pneumoniae, has recently been introduced in Korea. The current study evaluated the usefulness of MicroScan MICroSTREP plus panel for antimicrobial susceptibility test of S. pneumoniae. METHODS: A total of 75 clinical isolates of S. pneumoniae were tested for antimicrobial susceptibility to penicillin, cefotaxime, ceftriaxone, meropenem, vancomycin, clindamycin, erythromycin, and levofloxacin with the MicroScan MICroSTREP plus panel and clinical and laboratory standard institute (CLSI) reference broth microdilution method. For 46 of 75 isolates, additional susceptibility tests to penicillin and cefotaxime were performed with Etest. RESULTS: The overall essential agreement of MICs (within one dilution of MICs) defined by the MicroScan MICroSTREP plus panel and reference method was 93.0%. Overall there were 11.7% minor, 0.7% major, and 0.7% very major interpretative category errors observed. The results of antibiotic susceptibility testing by Etest were similar to those obtained by the MicroScan MICroSTREP plus panel. CONCLUSION: The MicroScan MICroSTREP plus panel, a commercial broth microdilution method, has a comparable accuracy to CLSI broth microdilution method for the resistance testing of S. pneumonia. This panel can be used for determining susceptibilities of S. pneumoniae to a wide variety of antimicrobial agents in clinical microbiology laboratories.
Anti-Infective Agents ; Cefotaxime ; Ceftriaxone ; Clindamycin ; Erythromycin ; Korea ; Ofloxacin ; Penicillins ; Pneumonia ; Streptococcus ; Streptococcus pneumoniae ; Thienamycins ; Vancomycin

Ventricular tachycardia is an important tachyarrhythmia which is encountered commonly in clinical field. The accompanying manifestations could be variable just from palpitation to sudden cardiac death. The classification of this arrhythmia has not completly settled yet, but in a broad way this arrhythmia is classified according to the prescence or abscence or underlying heart disease, especially coronary artery disease. Recently, therapeutic modalities for this arrhythmia have been changed a lot from classical antiarrhythmic drugs to radiofrequency ablation or ICD implantation although there are still some problems to overcome. We experienced a case of 34-year-old female having an incessant ventricular tacycardia which was abolished after endomyocardial biopsy performed to differentiate underlying myocardial pathology.
Adult ; Anti-Arrhythmia Agents ; Arrhythmias, Cardiac ; Biopsy* ; Catheter Ablation ; Classification ; Coronary Artery Disease ; Death, Sudden, Cardiac ; Female ; Heart Diseases ; Humans ; Pathology ; Tachycardia ; Tachycardia, Ventricular*

No abstract available.
Echocardiography, Transesophageal* ; Mitral Valve Insufficiency*

No abstract available.
Echocardiography, Transesophageal* ; Mitral Valve Insufficiency*

Familial combined hyperlipidemia is one af the manogenic disorders frequently found in humans and is seen in 0.5~2% of the general populatian, accounting for at least 10% of persons with pemature atlmmcletusis. The distinguishing feature of familial combined hyperlipidemia, in camparison with other single-gene abnarmalities of lipoprotein metabolism, is that not all affected members have the same plasma lipid phenotype; some individuals have an elevation of cholesterol concentration alane(type IIa lipoprotein pattern), while some athers have an elevation of triglyceride concentration alone(type IV pattem), and still others have elevations of both values(type IIb pattem). In any one persan, the lipid phenotype can change as a result of dietary or drug treatment. Familial combined hyperlipidemia should be suspected in those subjects with moderate hypertriglyceridemia and/or moderate hypercholestaolemia (lipoprotein types IIa, Ilb, IV), especially when premature coronary heart disease is evident in the family histary. Low plasma HDL-cholesterol, obesity, insulin resistance and hyperuricemia are often . Family members affected by familial combined hyperlipidemia should be identified and be treated, since tbe condition is associated with premature caronary heart diasease. We have found one family of familial combined hyperlipidemia with one member(case 1) associated with insulin resistance, hyperuricemia and gout, and another member(case 2) associated with diabetes mellitus and infertiTity.
Cholesterol ; Coronary Disease ; Diabetes Mellitus ; Gout ; Heart ; Humans ; Hyperlipidemia, Familial Combined* ; Hypertriglyceridemia ; Hyperuricemia ; Insulin Resistance ; Lipoproteins ; Metabolism ; Obesity ; Phenotype ; Plasma ; Triglycerides