Bleomycin is a glycopetide antibiotic isolated from Streptomyces verticillus which has a wide spectrum of antiturnor and antimicrobial activities and is currently used in treatment of certain neoplasms. Its selective effect on Squamous cell carcinoma was confirmed by Ichikawa(1969) and Ueno(1970). Bleomycin inhibits the synthesis of K)NA in animal cells and has sorne degree of selective toxicity against DNA virus infections. The drug has been reported to be useful in the topical treatment of verrucae by Fujita et al., in 1971. Since then many physicians have been using Bleomycin as topical therapeutic agent on. warts, esecially in Japan. The authors used Bleomycin as topical antiwart agent utilizing needle free syringe ." Dermo-Jet. 29 patients are studied, the clinical and histopathologial cha.nges are followed and reported. The advantages of utilizing Dern:o-Jet compared to that of usual needle syringe method are a) More accurate dosage of the drug can be infiltrated to the lesion, especially in the epidermis. b) Resulting pain is shorter in duration c) The fear, especially of children, created by the introduction of a hypodermic needle is diminished, d) The manipulation of this peculiar syringe n-ay give the patients hypnotic effect. Clinically 3 different ways of regressing processes are observed. 1. Casting off of dried keratinous r.naterial 2. Vesicle or pustule formation 3. Frogressive diminution of the size of warts. Histologic studies are carried out on 24, 48, 72 hours and I week after the injection. 1. The findings of specimens taken 24, 48, 72 hours after the injections include; a) Cells with small elongated deeply basophilic nuclei and eosinophilic cytoplasm whose boundaries are indistinct appeared in some areas of the epidermis. In the lower most layer of the epidermis several rows of small cells with. minute basopbilic nuclei lie in palisade arrangement. b) Loss of basal cell layer c) Necrosis of epidermal cells d) Subepidermal abscess 2. The findings of specimen taken 7 days after the injection are; In the mid part of horny laycr band like collection of yellowish-brown hemorrhage born material and small elongated deeply basophilic nuclei which were observed in l. a) are seen. Directly beneath this area the epidermis showes no basal cell layer and many finger like projectians of rete ridges whir,h is far more in number than normal skin, It is thought that healing process of wart through Bleomycin local injection can be accomplished by 1. The altered epidermal cells reject further wart virus replication and heals by casting off of all altered part of the epidermis. 2. The subepidermal abscess may brings wart to be cast off, 3. The wart virus be destroyed directly by Bleomycin. Bleomycin treatment with Dermo-Jet has a definite place in the management of warts.
Abscess ; Animals ; Basophils ; Bleomycin* ; Carcinoma, Squamous Cell ; Child ; Cytoplasm ; DNA Virus Infections ; Eosinophils ; Epidermis ; Fingers ; Hemorrhage ; Humans ; Hypnotics and Sedatives ; Japan ; Necrosis ; Needles ; Skin ; Streptomyces ; Syringes ; Virus Replication ; Warts*

Epidermolytic Hyperkeratosis is a rare variant of ichthyosis, transmitted as autosomal dominant inheritance. A 2-year-old male baby, in whom no hereditary back ground was found, showed typical clinical and histopathological features of Epiderrnolytic Hyperkeratosis. The possibility of occuring the disease without hereditary back grcund, clinical features, and histological characteristics of the disease are discussed.
Child, Preschool ; Humans ; Hyperkeratosis, Epidermolytic* ; Ichthyosis ; Male ; Wills

A case of Lupus vulgaris associated with scrofuloderma in a 11 year old girl is reported. The girl presented painless swellings, the left being more severe, on her both cheeks. A red, elevated, about 3 x 5 cm in size, partly eroded plaques is seen on her left cheek. On diascopy couple of so called apple jelly nodes are found within the plaque. A long linear red, scar like lesion is also found on her dlavicular area. Submandiblar lymph nodes are enlarged and hard. On right submandibular region there were two finger tip sized dome shaped red swellings which are connected with hard enlarged lymph nodes by cord like strings. The biopsy from left cheek disclosed typical picture of lupus vulgaris. The patient was refered to surgical clinic and was never seen again.
Biopsy ; Cheek ; Child ; Cicatrix ; Cytochrome P-450 CYP1A1 ; Female ; Fingers ; Humans ; Lupus Vulgaris* ; Lymph Nodes ; Tuberculosis, Cutaneous*

No abstract available.
Empyema*

No abstract available.
Humans* ; Saponins* ; Skin*

A case of systemic coccidioidomycosis with cutaneous lesions has been found in Dec. 1974, for the first time in Korea, which is proved through cutaneous biopsy .and mycologic culture from skin lesion. The patient was 57-year-old Korean male. Skin lesions on left extremities showed several skin colored or ligbt brownish papules and surrounding circular erythematous scaly patches with slightly elevated borders. The patient was also found to have moderate diabetes mellitus, hypokalemia and resultant neuropathy. Histopathology revealed granulomatous lesions in the upper dermis, and numerous spherules both inside and outside of giant cells. Mycologic culture from grind skin specimen on Sabourauds glulose agar showed snow-white colony and ather typical arthrospores. Ampbotericin B intravenous injection was started and continued for 16 days. During a,dministration of the drug, side effects consisting of chills, fever, headache, chest pain and dyspnea developed. Therefore, further administration of the drug could not be done. During tbe several months following last discharge from the hospital, the patient has been, with no further specific therapy, in relatively good general condition, and developed no new lesions. The old papules have diminished in size, but did not disappear.
Agar ; Biopsy ; Chest Pain ; Chills ; Coccidioidomycosis* ; Dermis ; Diabetes Mellitus ; Dyspnea ; Extremities ; Fever ; Giant Cells ; Headache ; Humans ; Hypokalemia ; Injections, Intravenous ; Korea ; Male ; Middle Aged ; Skin

PURPOSE: To evaluate the immunogenicity of hepatitis B vaccine among very low birth weight infants(VLBWI) who were vaccinated at 0, 1, 6 months of chronological age and to determine the factors associated with antibody formations. METHODS: A total of 243 VLBWI admitted to Seoul and Gangneung Asan Medical Center neonatal intensive care units from 1997 to 2004 were included. Of 243, 13 infants were born to HBs Ag positive mother. All infants were given DNA recombinant vaccine at 0, 1, and 6 months of chronological age. Infants born to HBs Ag positive mothers received hepatitis B immunoglobulin at birth and a total of 4 doses of vaccinations. An antibody level over 10 mIU/mL, tested at 3-4 months after last vaccination, was regarded as a positive seroconversion. RESULTS: The seroconversion rates were 84.4 percent and 84.5 percent for VLBWI and extremely low birth weight infants(ELBWI), respectively. Of 28 seronegative infants who were given revaccinations, 60.7 percent seroconverted, resulting in 95.3 percent, 97.5 percent seroconversion rates for VLBWI and ELBWI, respectively. 76.9 percent of infants born to HBsAg positive mothers seroconverted and none became hepatitis B carriers. Factors such as gestational age, sex, various neonatal illness, and kinds of vaccinations did not influence the formation of the hepatits B antibody, however, the higher the weight at time of first vacciation yielded better seroconversion rate. CONCLUSION: Revaccination of seronegative VLBWI after 3 doses of hepatitis B vaccinaton is very effective. Therefore, testing the immune status after the hepatitis B vaccination, a practice not routinely done, is highly recommended.
Chungcheongnam-do ; DNA ; Gangwon-do ; Gestational Age ; Hepatitis B Surface Antigens ; Hepatitis B Vaccines ; Hepatitis B* ; Hepatitis* ; Humans ; Immunization, Secondary ; Immunoglobulins ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care Units, Neonatal ; Mothers ; Parturition ; Seoul ; Vaccination*

PURPOSE: The objective of the study was to determine the anatomical and functional changes of the left ventricle (LV) in obese children less than 10 years old using the conventional echocardiography and tissue doppler. METHODS: A total of 45 children were enrolled for the study of which all including 12 obese children whose body mass index (BMI) exceeded 95th percentile for age and sex adjusted standard BMI of Korean children were screened by conventional echocardiographic and tissue doppler imaging examinations at Kangneung Asan hospital during June 2005 to October 2005. RESULTS: There was no statistical difference in age between control and obese group (CG vs. OG: 7.1+/-1.2 yr. vs. 8.0+/-1.5 yr). The average BMI in OG was 22.6+/-2.4 kg/m2. The conventional echocardiographic indices of LV including the diastolic LVID (LV Internal Dimension), LVPWT (LV Posterior Wall Thickness), the systolic IVST (Interventricular Septal Thickness), LVID and LVPWT were higher in OG compared to CG. Also, the LV mass (LVm), LV mass index (LVmI), fractional shortening (FS) and ejection fraction (EF) were higher in OG than CG. however, the early and late diastolic mitral inflow velocities (E, A) and their ratios (E/A) showed no differences between the two groups. The myocardial performance index (MPI) was higher in OG than CG: 0.42+/-0.09 vs. 0.35+/-0.07. The isovolemic relaxation time (IVRT) was prolonged in OG compared to CG: 55+/-8 ms vs. 46+/-9 ms. The indices of TDI including the systolic peak velocity (s') and late diastolic peak velocity (a') at mid-IVS were higher in OG than CG, but the early diastolic peak velocity (e'), e'/a', E/e' at mid-IVS showed no differences between the two groups. The indices of TDI at the lateral portion of mital annulus showed no differences between the two groups. CONCLUSION: This study showed that increased LVm, LVmI, EF, FS, MPI, IVRT and a' in obese children less than 10 years old. This result showed anatomical and functional early change of LV due to obesity similar to adult and adolescence more than 10 years old.
Adolescent ; Adult ; Body Mass Index ; Child* ; Chungcheongnam-do ; Echocardiography* ; Gangwon-do ; Heart Ventricles ; Humans ; Obesity ; Relaxation

This study was conducted to assess the health risk on the volatile organic compounds such as toluene, xylene, and styrene in painting workplace. It was monitored through personal air sampling during working time in selected 5 workplaces and analysed using gas chromatography. For the settlement of exposure situation, there were regarded working conditions such as working hours, yearly working days, and working years. Also, Monte-Carlo simulation was used for the induction of hazard index using toxicity value from IRIS(Integrated risk information system) database. The results of risk assessment were summarized as follows : 1. The air concentration of toluene was 7.096+/-15.6 ppm, 2.586+/-4.2 ppm for xylene, 1.914+/-5.3 ppm for styrene in blast painting workplaces. The level of toluene was different significantly compared with the level of xylene and styrene. 2. Computated chronic daily intake value of 95th percentile on toluene, xylene and styrene treated by Monte-Carlo simulation were 9.616, 3.567, 2.782 mg/kg/day, respectively. 3. Computated hazard index value of 75th percentile on toluene, xylene and styrene treated by Monte-Carlo simulation were 3.5, 1.0 and 1.6, respectively. Adverse health effects on the toluene, xylene and styrene would be expected by working exposure in blast painting workplace since the hazard indices of three compounds were exceeded 1 in the surroundings of percenitile 75 through having the low emerged frequency
Chromatography, Gas ; Humans ; Paint ; Paintings ; Risk Assessment* ; Styrene ; Toluene ; Volatile Organic Compounds* ; Xylenes

BACKGROUND: To evaluate the role of emergency debridement performed in conjunction with an empirical antibiotic therapy in clinically diagnosed, full-blown Vibrio vulnificus sepsis. METHODS: Immediate surgical debridement was performed on 13 out of 15 patients who were clinically diagnosed as having Vibrio vulnificus sepsis. RESULTS: Among 15 patients Vibrio vulnificus was isolated in 8 patients. Underlying diseases were liver cirrhosis (2), chronic alcohol ingestion or chronic liver disease (10), diabetes mellitus (3), gastrectomy (1) and in 4 cases no underlying condition was identified. All patients had skin lesions such as erythema, bulla, vesicle and gangrene. All but one initially showed variable degree of hypotension, thrombocytopenia, hepatic dysfunction, renal failure and mental confusion. Their mean APACHE III score was 84. Immediate survival (within 48hrs) in clinically diagnosed Vibrio sepsis was 80% (12/15) and long term survival rate among them was 66.6%. Forty-eight hour survival rate in bacteriologically confirmed cases of Vibrio vulnificus sepsis was 75%, where their long-term survival was 62.5%. CONCLUSION: In treating full-blown Vibrio vulnificus sepsis, immediate emergency surgical debridement performed in conjunction with the empirical antibiotics gives a possibility to improve both immediate and long term prognosis of the disease.
Anti-Bacterial Agents* ; APACHE ; Debridement* ; Diabetes Mellitus ; Eating ; Emergencies* ; Erythema ; Gangrene ; Gastrectomy ; Humans ; Hypotension ; Liver Cirrhosis ; Liver Diseases ; Prognosis ; Renal Insufficiency ; Sepsis* ; Skin ; Survival Rate ; Thrombocytopenia ; Vibrio vulnificus ; Vibrio*