Hypergammaglobulinemic purpura of Waldenstrom is characterized by recurrent episodes of petechiae, hypergammaglobulinemia, an elevated erythrocyte sedimentation rate, and the presence of rheumatoid factor, and leukocytoclastic vasculitis or mild lymphocytic perivasculitis. There is a primary type and a secondary type which is associated with other autoimmune diseases. We present a csae of a 48 year-old female with hypergammaglobulinemic purpura of Waldenstrom. She showed characteristic clinical, histopathological and laboratory findings consistent with hypergammaglobulinema purpura of Waldenstrom. Although there was a decrease in the Schimer test, we couldt den ostrate an association with Sjogrens syndrome. We think that this case may be a secondary type and needs a follow-up study.
Autoimmune Diseases ; Blood Sedimentation ; Female ; Follow-Up Studies ; Humans ; Hypergammaglobulinemia ; Middle Aged ; Purpura ; Purpura, Hyperglobulinemic* ; Rheumatoid Factor ; Sjogren's Syndrome ; Vasculitis

No abstract available.
Candidiasis, Cutaneous*

PURPOSE: This study was performed to investigate the epidemiologic and clinical features of human metapneumovirus (hMPV). METHODS: We performed real-time reverse transcription polymerase chain reaction with nasopharyngeal samples from 2,403 children who were hospitalized with acute respiratory infection. Then medical records of 120 children, who were diagnosed with hMPV respiratory infection between 2011 and 2014, were retrospectively analyzed retrospectively and compared to epidemiologic data on respiratory virus infection reported by Korea Centers for Disease Control and Prevention. RESULTS: We detected 120 hMPV-positive cases out of 1,723 virus-positive specimens (7.0%), which prevailed mostly in spring between March and May. Respiratory infection with hMPV was more common in female patients (55.0%) and hPMV infection was prevalent among children aged <5 years (80.8%). Coinfections with other respiratory viruses were observed in 34 patients of 120 hMPV-positive cases (28.3%), mostly with rhinovirus (52.9%). In addition, hPMV infection mostly presented with pneumonia (71.7%). Among 120 hMPV-positive patients during the recent 4 years, most (68.3%) were diagnosed in 2014. During 2011–2014, influenza virus infection was prevalent mainly from January to March, and hMPV infection started to appear just after the end of influenza virus outbreak. CONCLUSION: In Korean children, hMPV was a common causative organism of viral pneumonia during the spring season. The hMPV infection pandemic was observed in 2014 and the clinical importance of hMPV has recently been increasing. Therefore, additional studies are required to define the epidemiology, disease characteristics caused by hMPV, and the cause of recent outbreak.
Centers for Disease Control and Prevention (U.S.) ; Child* ; Coinfection ; Epidemiology* ; Female ; Humans* ; Korea ; Medical Records ; Metapneumovirus* ; Orthomyxoviridae ; Pandemics ; Pneumonia ; Pneumonia, Viral ; Polymerase Chain Reaction ; Respiratory Tract Infections ; Retrospective Studies ; Reverse Transcription ; Rhinovirus ; Seasons

BACKGROUND: The incidence of cutaneous squamous cell carcinoma(SCC) has been increasing, but no analysis of the causative diseases of cutaneous SCC has been performed. OBJECTIVE: The purpose of this study was to investigate the causative disease of SCC. METHODS: Eighty-seven patients with cutaneous SCC were retrospectively studied. RESULTS: The possible causative diseases of cutaneous SCC were actinic keratosis(18 csaes), Bowen's disease(17 cases), actinic cheilitis(8 cases), burn scar(4 cases), arsenical keratosis(3 cases), xeroderma pigmentosum(3 cases), chronic discoid lupus erythematosus(2 cases), epidermodysplasia verruciformis(2 cases), leukoplakia(1 case), chronic radiodermatitis(1 cases), erythroplasia of Queyrat (1 case), osteomyelitis sinus(1 case), lichen planus(1 case), porokeratosis of Mibelli(1 case), and the other 21 cases were of unknown origin. CONCLUSION: The causative diseases of cutaneous SCC were related to sun-exposure, and chronic dermatoses.
Actins ; Burns ; Carcinoma, Squamous Cell* ; Erythroplasia ; Humans ; Ichthyosis ; Incidence ; Lichens ; Osteomyelitis ; Porokeratosis ; Retrospective Studies ; Skin Diseases

BACKGROUND: The incidence of cutaneous squamous cell carcinoma(SCC) has been increasing, but no analysis of the causative diseases of cutaneous SCC has been performed. OBJECTIVE: The purpose of this study was to investigate the causative disease of SCC. METHODS: Eighty-seven patients with cutaneous SCC were retrospectively studied. RESULTS: The possible causative diseases of cutaneous SCC were actinic keratosis(18 csaes), Bowen's disease(17 cases), actinic cheilitis(8 cases), burn scar(4 cases), arsenical keratosis(3 cases), xeroderma pigmentosum(3 cases), chronic discoid lupus erythematosus(2 cases), epidermodysplasia verruciformis(2 cases), leukoplakia(1 case), chronic radiodermatitis(1 cases), erythroplasia of Queyrat (1 case), osteomyelitis sinus(1 case), lichen planus(1 case), porokeratosis of Mibelli(1 case), and the other 21 cases were of unknown origin. CONCLUSION: The causative diseases of cutaneous SCC were related to sun-exposure, and chronic dermatoses.
Actins ; Burns ; Carcinoma, Squamous Cell* ; Erythroplasia ; Humans ; Ichthyosis ; Incidence ; Lichens ; Osteomyelitis ; Porokeratosis ; Retrospective Studies ; Skin Diseases

No abstract available.
Peutz-Jeghers Syndrome*

BACKGROUND: Familial benign chronic pemphigus is a rare autosomal dominant disorder characterized by persistently recurrent bullous and vesicular dermatitis of the sides of the neck, axillae, and apposing surfaces. Hailey and Hailey, Montes, and other some investigators reported the presence of bacteria in the lesions of familial benign chronic pemphigus, and suggested that bacteria was associated in the its pathogenesis. OBJECTIVE: The purpose of this study was to elucidate the association of bacteria in thepathogenesis of familial benign chronic pemphigus. METHODS: We performed Brown & Brenn Gram stain in 14 biopsy tissues, bacterial culture and sensitivity test in 10 cases, and decided the effective treatment methods in each case. RESULTS: 1. Man to woman ratio was 3.67: 1 and about 60% of patients were in their third and forth decades. The family history was found in 6 out of 14 cases(42.9%). 2. The lesions were predomiriantly distributed on the groins(85.7%), axillae(71.4%), neck(64.3 %), trunk(50.5%), antecubital fossa(214%). 3. In Brown & Brenn gram stain, the bacterial colonies in the stratum corneum were found in 12(85.7% ) out of 14 biopsy tissues. The cells and its keratohyaline granule in granular layer had blue or nealy black color in 13(92.9%) out of 14 cases. 4. In bacterial culture and sensitivity test, Staphylococcus aureus was identified in 7 cases(70.0 %), Staphylococcus hemolyticus, 2 cases(20.0%) and Streptococcus species, 1 case(10.0%). 5. The number of cases which showed effective response to antibiotics therapy was 8 (57.1%) out of 14 cases. CONCLUSION: These results suggest that bacteria or its toxin play a part of role in the production of lesions of familial benign chronic pemphigus and recurrent bacterial infection may cause recurring of this disease in the genetically predisposed persons.
Anti-Bacterial Agents ; Axilla ; Bacteria* ; Bacterial Infections ; Biopsy ; Dermatitis ; Female ; Humans ; Neck ; Pemphigus, Benign Familial* ; Research Personnel ; Staphylococcus ; Staphylococcus aureus ; Streptococcus

PURPOSE: Accurate evaluation of side branch (SB) ostium could be critical to the treatment of bifurcation lesions. We compared measured and calculated values of side branch ostial length (SBOL) in coronary bifurcation lesions with intravascular ultrasound (IVUS). MATERIALS AND METHODS: Pre-intervention and post-intervention IVUS was performed in 113 patients who underwent stent implantation of bifurcation lesions. For the IVUS longitudinal reconstruction of the bifurcation lesions, SBOL, SB diameter, and the angle between the distal portion of the main vessel (MV) and SB were directly measured. In addition, SBOL was calculated as: SB diameter/sin (angle between distal MV and SB). The relationship between measured and calculated SBOL was then evaluated. RESULTS: The angled between the distal MV and SB were 57.3+/-12.4degrees at pre-intervention and 59.4+/-12.6degrees at post-intervention. The mean measured and calculated SBOL values were 2.91+/-0.86 mm and 3.06+/-0.77 mm at pre-intervention and 2.79+/-0.82 mm and 2.92+/-0.69 mm at post-intervention, respectively. Differences between measured and calculated SBOL were 0.15+/-0.44 mm at pre-intervention and 0.13+/-0.41 mm at post-intervention. We found that calculated SBOL was correlated with measured SBOL (pre-intervention r=0.863, p<0.001; post-intervention r=0.868, p<0.001). CONCLUSION: There was a good correlation between measured and calculated SBOLs of the bifurcation lesions in IVUS longitudinal reconstruction. SBOL in the bifurcation lesions can therefore be estimated using the SB diameter and the angle between distal MV and SB.
Aged ; Angioplasty, Balloon, Coronary ; Coronary Angiography ; Coronary Artery Disease/surgery/*ultrasonography ; Coronary Vessels/*ultrasonography ; Female ; Humans ; Male ; Middle Aged ; Ultrasonography, Interventional

BACKGROUND AND OBJECTIVES: With recent advances in equipment and techniques, infrapopliteal angioplasty has shown results that are comparable to those of surgical bypass in patients with critical limb ischemia (CLI). In this study, we evaluated the efficacy and the feasibility of infrapopliteal angioplasty in patients with CLI. SUBJECTS AND METHODS: Between March 2002 and May 2008, infrapopliteal angioplasty was performed on 118 limbs of 101 patients (79 males; mean age 66 years) with CLI (Rutherford category 4, 5 or 6). Freedom from reintervention, limb salvage, and overall survival were analyzed. RESULTS: The median follow-up duration was 30 months. Initial technical and clinical success rates were 69.5% and 83.1%, respectively. No major complication requiring surgical intervention developed after angioplasty. Among 82 limbs with initial technical success, the rate of freedom from any reintervention at 2 years was 70.7% and that from limb salvage was 97.6%. Young age and Rutherford category 6 at initial presentation were independent predictors associated with poor 2 year primary patency in these patients with CLI. Overall survival at 1 year was 86.4% and that at 2 years 76.3%. A history of cerebrovascular accident was an independent predictor associated with poor 2 year survival in these patients. CONCLUSION: Infrapopliteal angioplasty as a primary choice of treatment in CLI patients showed favorable clinical outcomes and feasibility.
Angioplasty ; Extremities ; Follow-Up Studies ; Freedom ; Humans ; Ischemia ; Limb Salvage ; Stroke ; Tibial Arteries

PURPOSE: To assess the efficacy of superselective intra-arterial chemotherapy (SSIAC) via the bilateral uterine arteries in cases of cervical carcinoma. MATERIALS AND METHODS: Eighteen patients with stage IIa (n=10), IIb (n=7), or IIIa (n=1) cervical carcinoma underwent one (n=2) or two (n=16) courses of preoperative SSIAC with Vincristine, Cisplatin, and Mitomycin C. We estimated the extent of reduction of tumor volume and improvement of stage, comparing pre-SSIAC MRI to postoperative results. Tumor vascularity, as seen on uterine arteriography, and procedural complications, were also evaluated. RESULTS: A marked reduction in tumor volume was observed in all patients, an average reduction volume of 94.7%. Improvement of stage was noted in 16 patients, and in six of these, no residual viable tumor or microinvasive residual tumor was seen. On angiography, tumor hypervascularity was demonstrated in seven patients, but its degree was not substantially related to therapeutic response. In no case did significant systemic complications of result from chemotherapy; in one patient, however, we experienced a serious complication of necrotizing cystitis due to malpositioning of a catheter in the superior vesical artery. CONCLUSION: SSIAC via the bilateral uterine arteries is an effective complementary modality for the treatment of various stages of cervical carcinoma.
Angiography ; Arteries ; Catheters ; Cisplatin ; Cystitis ; Drug Therapy* ; Humans ; Magnetic Resonance Imaging ; Mitomycin ; Neoplasm, Residual ; Tumor Burden ; Uterine Artery* ; Vincristine