Neutrophilic eccrine hidradenitis(NEH) was originally described in 1982 by Harrist et al. in a patient with myelogenous leukemia receiving chemotherapy. Clinically NEH represents various cutaneous manifestations with or without tenderness and pruritus. Histologic examination demonstrates a neutrophilic infiltrate within and around the eccrine gland and degeneration of the eccrine gland structures. Although the pathogenesis and possible cause of NEH remain unknown, it is probably an unusual cutaneous reaction to chemotherapeutic agents. A few cases of infection associated eccrine hidradenitis are found in the literature. We report three cases of neutrophilic eccrine hidradenitis. Two cases were associated with hematologic malignancy. The third case was associated with an infection of Vibrio vulnificus.
Drug Therapy ; Eccrine Glands ; Hematologic Neoplasms ; Hidradenitis* ; Humans ; Leukemia, Myeloid ; Neutrophils* ; Pruritus ; Vibrio vulnificus

Monitoring fetal movement serves as an indirect rneasure of fetal well-being, especially for central nervous system integrity and function. Methods to monitor fetal movement vary from the simple approach of having the mother chart perceived movement to highly specialized methods. However there were no reliable objective monitoring methods in Korea. For development of objective method for evaluating fetal movement, during pregnancy, one-hundred and two pregnant patients were entered to this study. All patients were divided into following 3 groups and each type of monitoring methods were applied. Group 1(N=20): Type I using portable FHR Doppler unit(IFD-100 model, Intermed, Korea). Group 2(N=20): Type II using FHR Microphone(Prenatal Listening Kit, Model FS002, Unisar Inc., US). Group 3(N=62): Type III using conventional ultrasound transducer(Corometric 115 Model, US). In this study, accurate counting of the fetal movementutus were best performed using Type III, because of monitoring fetal movements has its greatest efficiency when using conventional ultrasound transducer of fetal monitor. It was also attractive to doctors and nurses as a convenient methods because it needed only single transducer when compared to Type I and II. Although monitoring fetal body movement permits a general assessment of well-being, no perfect technique is still reliable. Futher techniques would be developed using the results of this study for improvement of several factors such as accuracy and objectiveness
Central Nervous System ; Fetal Monitoring ; Fetal Movement* ; Humans ; Korea ; Mothers ; Pregnancy* ; Transducers ; Ultrasonography

A case of metastatic adrenal cortical carcinoma in which partial remission was achieved with transarterial embolization is presented as probably the first reported case in the literature to date. A 29-year-old woman was admitted because of adrenal cortical carcinoma which had not responded to mitotane. A left adrenalectomy with segmentectomy of the involved liver had been done previously. Abdominal computerized tomography demonstrated multiple large metastatic tumors in the liver. Transarterial embolization with Gelfoam and 20 mCi of 131I-labeled lipiodol was performed and resulted in a decrease in tumor size and biochemical parameters. Transarterial embolization can be one of the therapeutic modalities for metastatic adrenal cortical carcinomas.
Adrenal Cortex Neoplasms/metabolism/*therapy ; Adult ; *Embolization, Therapeutic ; Female ; Gelatin Sponge, Absorbable ; Hepatic Artery ; Humans ; Hydrocortisone/metabolism ; Iodine Radioisotopes ; Iodized Oil ; Liver Neoplasms/metabolism/*secondary/*therapy

PURPOSE: We compared orbital implants with hydroxyapatite and with Medpor (R) in operative group and observed clinical results by retrospective study. METHODS: We used hydroxyapatite implantation in 17 subjects(17 eyes) and Medpor(R) implantation in other 15 subjects (15 eyes) with enucleation and evisceration from April 1996 to May 2000. RESULTS: We observed clinical results for 10~34 month (average 20 month); Three cases of implant exposure, one case of peg extrusion, two cases of superficial conjunctival wound dehiscence, one case of granulation tissue overgrowth, and one case of implant self-infection after hydroxyapatite implantation; Two cases of implant exposure and one case of superficial conjunctivial wound dehiscence after Medpor(R) implantation. In measurement at 6 months after operation, fibrovascular ingrowth pattern after hydroxyapatite implantation was slightly better than Medpor R implantation, and prothesis motility was not different. CONCLUSIONS: We found high frequency of complication with implant exposure, superficial conjunctival wound dehiscence, granulation tissue formation after Hydroxyapatite implantation than Medpor(R) implantation, and that no different complication with the exception of noise of prosthesis movement in Medpor(R) implantation, which is better useful for peg drilling & enucleation. So it is thought to be Medpor(R) is more useful clinical materials for orbital implants than Hydroxyapatite.
Durapatite* ; Granulation Tissue ; Noise ; Orbit* ; Orbital Implants* ; Prostheses and Implants ; Retrospective Studies ; Wounds and Injuries

BACKGROUND: To investigate the effect of manganese on lipid peroxidation and compositional changes of fatty acids in hippocampus of rat brain. METHODS: Seven rats in experimental group were given with MnCl2 intraperitoneally for 4 weeks (4 mg/kg once daily, 5 days per week). Twenty four hours after the last injection, rats were decapitated and, hippocampus were separated from the rat brain. RESULT: In Mn-treated group, manganese concentrations increased significantly in the hippocampus by 222% compared with control group (P<0.01). MDA concentrations increased significantly by 149% compared with control group (P<0.05). Among fatty acids, total n-6 polyunsaturated fatty acids (PUFAs) increased significantly by 237% compared with control group (P<0.05). Linoleic acid (LA) and arachidonic acids (AA) increased by 213%, 238% (P<0.05, P<0.01, respectively). Among n-3 PUFAs except linolenic acids, eicosapentanoic acid(EPA) and docosahexanoic acids (DHA) decreased significantly by 70%, 50% respectively compared with control group (both P<0.01). CONCLUSION: Our results suggest that manganese may cause compositional changes of fatty acids in hippocampus of rat brain. Characteristics of fatty acids compositional changes by manganese were the decrease of EPAs and DHAs (n-3 PUFAs), and increase of AA and LA (n-6 PUFAs). These changes with the increase of MDA, suggest that manganese neurotoxicity is caused by lipid peroxidation.
alpha-Linolenic Acid ; Animals ; Arachidonic Acid ; Arachidonic Acids ; Brain* ; Fatty Acids* ; Fatty Acids, Omega-3 ; Fatty Acids, Unsaturated ; Hippocampus* ; Linoleic Acid ; Linolenic Acids ; Lipid Peroxidation* ; Malondialdehyde ; Manganese* ; Rats*

No abstract available.
Pneumonia* ; Squalene*

Several prognostic factors have been implicated in survival prolongation in patients with metastatic brain tumors. Among these, surgery has been regarded as very significant one with respect to life prolongation and improving the quality of survival in such patients. From August 1982 through July 1996, a series of 31 patients with metastatic brain tumors among 785 patients with operated brain tumors, whose medical records, X-rays and follow-ups were avilable, was studied retrospectively to evaluate the beneficial effects of surgery. Despite the limitations inherent to the retrospective study and limited number of patients, we divided these patients into two groups to find out any statistical differences in terms of survival and quality of survival among them: 1) Conservative group(8 nonoperated patients: 5 patients with biopsy or partial resection): 13, and 2) Surgical treatment group(17 totally resected patients: one patient with subtotal resection): 18. The quality of survival was assessed by Karnofsky performance(KP) scale before and after each treatment. The survival of the patients in the surgical treatment group was longer than the conservative treatment group(14.5 months/10 months), but this was not statistically significant(p value: 0.3305). However, improvement of quality of survival, in terms of KP scale, was significantly higher in the surgical treatment group(p value: 0.0027). Although confounded by the lack of controlled, randomized study and limitations of retrospective study, aggressive surgery can be regarded to have a significant role in improving the quality of survival in patients with metastatic brain tumors.
Biopsy ; Brain Neoplasms* ; Brain* ; Follow-Up Studies ; Humans ; Life Support Care ; Medical Records ; Pheniramine ; Retrospective Studies

Clevudine was approved as an antiviral agent for hepatitis B virus, which showed marked, rapid inhibition of virus replication without significant toxicity. However, several studies have reported myopathy associated with clevudine therapy. Also, we experienced seven patients who suffered from myopathy during clevudine therapy. To characterize clevudine-induced myopathy, we collected previously reported cases of clevudine myopathy and analyzed all the cases including our cases. We searched electronic databases that were published in English or Korean using PubMed and KoreaMed. Ninety-five cases with clevudine myopathy, including our seven cases, were selected and analyzed for the demographic data, clinical features, and pathologic findings. The 95 patients with clevudine-induced myopathy comprised 52 women and 43 men aged 48.9 years (27–76 years). The patients received clevudine therapy for about 14.2 months (5–24 months) before the development of symptoms. Weakness mainly involved proximal extremities, especially in the lower extremities, and bulbar and neck weakness were observed in some cases (13.7%). Creatine kinase was elevated in the majority of patients (97.9%). Myopathic patterns on electromyography were observed in most patients examined (98.1%). Muscle biopsy presented patterns compatible with mitochondrial myopathy in the majority (90.2%). The weakness usually improved within about 3 months after the discontinuation of clevudine. Though clevudine has been known to be safe in a 6-month clinical trial, longer clevudine therapy for about 14 months may cause reversible mitochondrial myopathy. Careful clinical attention should be paid to patients with long-term clevudine therapy.
Biopsy ; Creatine Kinase ; Electromyography ; Extremities ; Female ; Hepatitis B ; Hepatitis B virus ; Humans ; Lower Extremity ; Male ; Mitochondrial Myopathies* ; Muscular Diseases ; Neck ; Virus Replication

BACKGROUND: Currently the most common treatment modality of refractory ascites in patients with liver cirrhosis was large volume paracentesis, but this procedure usually needed albumin infusion and occasionally developed unwanted complications. By reason of albumin shortage in Korea and occasional unfavorable complications, we studied the usefulness of dialytic ultrafiltration as an another treatment modality of refractory ascites. METHODS: Dialytic ultrafiltration was done in 10 patients (total 48 times) with liver cirrhosis or hepatocellular carcinoma. Two drainage conduit (via 16 gauge angio-catheter) of input and output were made by puncture of patient's right and left lower quadrant abdomen. The initial ultrafiltration rate of dialyser was 250mL/min. Ascitic fluid was removed continuously until the filtration rate down at 50mL/min. After ultrafiltration, ascitic fluid contained concentrated albumin and large molecules was reinfused via input conduit. Pre-treatment and post-treatment level of blood chemistry, plasma renin concentration, aldosterone, and electrolytes in serum; total protein and albumin in ascites were measured. During the ultrafiltration, we closely observed the change of blood pressure, heart rates and mental status. RESULTS: The mean ultrafiltration time was 231+/-28min, ultrafiltrated volume was 5.15+/-1.41 L. During dialytic ultrafiltration, patient's blood pressure and heart rate were stable and there was no change of mental status. After dialytic ultrafiltration, blood urea nitrogen level significantly decreased from 30.5+/-23.7mg/dL to 25.7+/-20.2mg/dL; serum aldosterone level decreased from 807.3+/-301.1pg/ml to 431.1+/-187.2pg/ml in serum (P<0.01). The albumin level in the ascitic fluid significantly increased from 0.67+/-0.28g/dL to 1.90+/-1.16g/dL (P<0.01). Plasma renin concentration level tend to decreased (P=0.06). The patient's serum total protein, albumin, electrolytes, and creatinine were not changed. Complications of dialytic ultrafiltration were peritonitis (one case) and hypotension (one case). But these unwanted complications were readily managed by adequate antibiotics and intravenous fluid therapy. CONCLUSION: The dialytic ultrafiltration can be used effectively without albumin infusion in the treatment of refrartory ascites in patients with advanced liver cirrhosis.
Abdomen ; Aldosterone ; Anti-Bacterial Agents ; Ascites* ; Ascitic Fluid ; Blood Pressure ; Blood Urea Nitrogen ; Carcinoma, Hepatocellular ; Chemistry ; Creatinine ; Drainage ; Electrolytes ; Filtration ; Fluid Therapy ; Heart Rate ; Humans ; Hypotension ; Korea ; Liver Cirrhosis* ; Liver* ; Paracentesis ; Patient Rights ; Peritonitis ; Plasma ; Punctures ; Renin ; Ultrafiltration*

BACKGROUND: Previous studies indicated that a recently approved synthetic HMG-CoA reductase inhibitor, atorvastatin, reduces LDL cholesterol and triglyceride. To assess the efficacy on the level of serum LDL cholesterol and other lipoprotein fractions and its safety, we investigated 59 patients for lipid and side effect profile. METHOD: In patients with hypercholesterolemia, who showed 12-hours fasting serum LDL cholesterol>145 mg/dl and <250 mg/dl and triglyceride levels<400 mg/dl were enrolled to diet therapy for 4 weeks. After 4 weeks of diet therapy, serum lipid profile were reevaluated and patients with LDL cholesterol > or =130 mg/dl were assigned to receive 10 mg dose of atorvastatin once daily for 4weeks. After 4 weeks of drug therapy, serum lipid profile were rechecked, if showed LDL cholesterol level> or =130 mg/dl, assigned to receive 20 mg dose of atorvastatin once daily until 8 weeks. RESULTS: Of the 59 patients were assigned to receive atorvastatin therapy, 52 patients completed the study. Among lipid profiles, total cholesterol, triglyceride, LDL-cholesterol and apolipoprotein B levels showed significant reduction with mean reduction rate of 28%, 13%, 38%, 32% respectively after 4 weeks and 31%, 13%, 41% and 34% respectively after 8 weeks. HDL-Cholesterol and lipoprotein (a) level did not show significant change after 8 weeks of therapy. Nine patients had mild adverse events, such as elevated ALT, epigastric pain, insomnia, thumb pain. postural hypotension, palpitation and constipation. Only three patients of fifty-nine withdrew from the study due to adverse events related to drug treatment. CONCLUSION: The atorvastatin was highly effective and generally well tolerated with an acceptable safety profile in patients with primary hypercholestelemia.
Apolipoproteins ; Cholesterol ; Cholesterol, LDL ; Constipation ; Diet Therapy ; Drug Therapy ; Fasting ; Humans ; Hypercholesterolemia* ; Hypotension, Orthostatic ; Lipoprotein(a) ; Lipoproteins ; Oxidoreductases ; Sleep Initiation and Maintenance Disorders ; Thumb ; Triglycerides ; Atorvastatin Calcium