Impetigo herpetiformis is a rare and acute pustular eruption that is often accompanied by fever and leukocytosis, which occurs during the 3rd trimester of pregnancy and usually resolves after delivery. In general, impetigo herpetiformis is regarded as a variant of psoriasis that has histopathologic features of pustular psoriasis. The lesions typically begin in the flexural areas, but rarely involve the mucous membranes. The face, palms, and soles are commonly spared. However, we report a 29-year-old woman with impetigo herpetiformis showing mucosal, face and palm involvement, atypical skin manifestation.
Female ; Fever ; Humans ; Impetigo ; Leukocytosis ; Mucous Membrane ; Pregnancy ; Psoriasis ; Skin ; Skin Manifestations

Xylitol is a five-carbon sugar alcohol that inhibits the growth of oral streptococci, including Streptococcus mutans. In this study, we tested xylitol sensitivity among the oral streptococci. We also compared nucleotide homology of putative fructose phosphotransferase system (PTS) and xylitol sensitivity, since xylitol is transported via the fructose PTS. Among the tested Streptococci, S. pneumonia showed the highest resistance to xylitol while S. gordonii and S. sanguinis showed the most sensitive growth inhibition. These streptococci could be grouped according to their xylitol sensitivity. S. mutans and S. salivarius showed similar bacterial growth inhibition by xylitol. S. mitis, S. oralis, S. pneumonia, S. intermedius and S. anginosus showed relatively low sensitivity to xylitol. When the genetic homologies of five fructose PTSs were compared among the tested streptococci, closely related streptococci showed similar sensitivity to xylitol. Taken together, fructose PTSs may mediate the sensitivity to xylitol in oral streptococci.
Fructose ; Pneumonia ; Streptococcus ; Streptococcus mutans ; Xylitol*

BACKGROUND: Cutaneous mucinoses are a heterogeneous group of disorders characterized by an abnormal amount of mucin in the skin. However, the pathomechanism of an excessive mucin deposition in the skin is still unknown. Eczematous dermatitis is sub-classified histologically into acute, subacute, and chronic variants. The characteristic histopathologic findings for chronic eczema are variable. However, periadnexal mucin deposition is not known as a feature of chronic eczema. OBJECTIVE: To evaluate the presence of periadnexal mucin deposition in chronic eczematous dermatitis. METHODS: We analyzed the skin biopsy specimens from 36 patients who were pathologically diagnosed with chronic eczematous dermatitis. Alcian blue, colloidal iron, and periodic acid-Schiff stains were used to evaluate the mucin deposition in histologic sections. Two dermatologists and two dermatopathologists evaluated the degree of mucin deposition using a 4-point scale. RESULTS: Various amounts of mucin deposition were observed in the periadnexal area of patients who were diagnosed with chronic eczema. Mucin deposition was more visible after staining with mucin-specific stains. Evaluation of the staining analysis scores revealed that the staining intensities were significantly higher in patients with chronic eczema than age- and site-matched controls (normal, acute to subacute eczema, and psoriasis vulgaris). CONCLUSION: Periadnexal mucin (secondary mucinoses) may be an additional finding of chronic eczematous dermatitis.
Alcian Blue ; Biopsy ; Colloids ; Coloring Agents ; Eczema* ; Humans ; Iron ; Mucinoses ; Mucins* ; Psoriasis ; Skin

No abstract available.
Baths* ; Dermatitis, Atopic* ; Water*

PURPOSE: This study is to report presurgical magnetic resonance imaging(MRI) findings of the temporomandibular joint which had perforation in the disc or its surrounding tissues and to improve its diagnostic rate using MRI. PATIENTS AND METHODS: The sample consisted of patients who visited the TMJ clinic at Yongdong Severance Hospital, Yonsei University, during the years, 1992 and 1997. They were diagnosed as TMJ internal derangement and received surgical treatment. We divided them into two groups. The first group comprised of 85 joints with perforated disc or its surrounding tissues and which were confirmed surgically. The second group of 62 joints which only had disc displacement without perforation, hyperemia or adhesion served as control. RESULTS: The preoperative diagnostic sensitivity of TMJ perforation using MRI was 74.1%. The MRI findings for diagnosis of the TMJ perforation were degenerative change of the condyle head or the articular fossa, bone to bone contact between the condyle head and the articular eminence or the articular fossa, bony spurring or osteophytosis of the condyle head, flattening of articular surface of the condyle head or the articular eminence, discontinuity of the disc and the arthrographic effect due to joint effusion. CONCLUSION: The preoperative diagnostic sensitivity of TMJ perforation using MRI in this study was 74.1% which was lower than the diagnostic rate using the arthrogram. Further investigations are needed to improve the diagnostic accuracy of TMJ perforation using MRI.
Diagnosis* ; Head ; Humans ; Hyperemia ; Joints ; Magnetic Resonance Imaging* ; Temporomandibular Joint Disc* ; Temporomandibular Joint*

BACKGROUND/AIMS: Optimal culture conditions for Helicobacter pylori have not been established. We compared the effectiveness of four different agar-based media for the growth of H. pylori. MATERIALS AND METHODS: G27, ATCC #43504 and 60190, and primary cultured strains were used. H. pylori strains were cultured for four days under four culture conditions: chocolate agar, Thayer-Martin (TM) agar containing vancomycin-colistin-nystatin inhibitor (VCNI), Brucella agar, and brain heart infusion (BHI) agar containing 5% horse blood and IsoVitaleX (BBL™ BD, USA). Culture of cells in each medium was repeated fourteen times. The growth of H. pylori was measured by using a spectrophotometer. RESULTS: TM, Brucella, and BHI agars showed mean absorbance values of 0.099, 0.059, 1.410, and 0.913, respectively. These values were significantly different (P=0.030). After post-adjustment by Bonferroni correction, similar growth was noted for in chocolate, Brucella, and BHI agars; however, TM agar significantly suppressed H. pylori growth compared with Brucella agar (P=0.031). CONCLUSIONS: Chocolate, Brucella, and BHI agars provided effective culture conditions for the growth of H. pylori. TM agar containing VCNI suppressed the growth of H. pylori and other organisms.
Agar ; Brain ; Brucella ; Cacao ; Heart ; Helicobacter pylori* ; Helicobacter* ; Horses

BACKGROUND: The acidic pH of the stratum corneum (SC) is important for epidermal permeability barrier homeostasis. Acidification of the skin surface has been suggested as a therapeutic strategy for skin disorders such as atopic dermatitis (AD). OBJECTIVE: We performed an animal study to evaluate the usefulness of acidification of SC for inhibition of AD lesions and to find out if the therapeutic effect of vinegar is attributable to its herbal contents, rather than its acidity. METHODS: Five groups of six oxazolone-treated (Ox)-AD mice were treated for three weeks with creams of different acidity: vehicle cream alone (pH 5.5), neutralized vinegar cream (pH 7.4), pH 5.0 vinegar cream, pH 3.5 vinegar cream, and pH 3.5 hydrogen chloride (HCl) cream. Also, we have compared two groups of Ox-AD mice treated with pH 5.5 vehicle cream or pH 5.5 vinegar cream. RESULTS: Ox-AD mice treated with acidic creams exhibited fewer AD-like lesions, had significantly lower eczema scores, decreased basal by transepidermal water loss (TEWL), and increased SC hydration compared to the groups given only vehicle and neutral cream. There was no significant difference between the acidic vinegar and HCl groups. Between the groups treated with vehicle and pH 5.5 vinegar cream, there was no difference in eczema score, basal TEWL and SC hydration. CONCLUSION: Application of topical acids, regardless of their source materials, inhibits the development of AD lesions by maintenance of skin surface pH and skin barrier function in murine model.
Acetic Acid ; Animals ; Dermatitis, Atopic* ; Eczema ; Homeostasis ; Hydrochloric Acid ; Hydrogen-Ion Concentration ; Mice ; Permeability ; Skin* ; Water

Purpose: We evaluated the status of patients enrolled in South Korea’s pediatric palliative care pilot project based on the experience of a single center. This study examined factors related to end-of-life services and differences in medical costs. Methods: The medical records of 120 patients referred by a pediatric palliative care team were analyzed retrospectively. Data from July 1 to February 28, 2022 were collected and analyzed using the chisquare test and the Mann–Whitney U test. Results: Volunteer programs and psychological support (100%), family support and education (99.2%), and financial support through institutional linkage (62.5%) were provided to the participants. In the deceased group, there were no significant differences in general characteristics, which included age, gender, primary disease, religion, duration of hospitalization in an intensive care unit (ICU) and nonintensive care unit (non-ICU). However, the ICU group had fewer opportunities to access individual pain and physical symptom management than the non-ICU group and there were limitations in linking with external resources. Medical expenses were significantly different for the ICU group, with a 3-times higher average cost than the non-ICU group. Conclusion Although an individualized approach is needed for each patient in pediatric palliative care, psychosocial care is essential. In addition, if early intervention for end-of-life pediatric patients is available from a palliative care team, the cost burden of medical care for patients and their families should be minimal.

OBJECTIVES: When a patient who attempts suicide visits the emergency room, it is important that the departments of emergency medicine, internal medicine, and psychiatry communicate with each other and prioritize treatment. This study was conducted to verify the effectiveness of the multidisciplinary emergency consultation system (ECS) for drug intoxicated patients. METHODS: We retrospectively analyzed the data from medical records prior to the ECS, from July 2017 to May 2018, and after the ECS, from July 2018 to May 2019, to verify the effectiveness of the system. RESULTS: After the ECS, admission to open wards was significantly higher than to the intensive care units (χ²=8.567, p=0.014). In addition, the proportion of consultations to the department of psychiatry among patients admitted to other departments tended to increase (χ²=4.202, p=0.053), and the time required for consultation response decreased (Z=−2.031, p=0.042). As a result of the consultation, the proportion of the patients who had been transferred to the department of psychiatry was increased (χ²=4.692, p=0.043), and the time spent to transfer tended to decrease (Z=−1.941, p=0.052). CONCLUSIONS After implementing the ECS for drug intoxicated patients, unnecessary intensive care unit admissions, consultation response time, and the time spent to transfer were reduced, and the rate of consultation referrals and transfer rates increased. This means that the multidisciplinary consultation system rapidly provided essential medical services to patients at lower medical costs.

Uremic patients undergoing hemodialysis (HD) therapy are prone to develop encephalopathy, but the cause is often unclear. Clinical signs of encephalopathy in the uremic patient often overlap with several other affections causing neurological disorders. Chorea or hemichorea occurs very rare, when basal ganglia are injured in HD patients. We hereby report a case of hemichorea of unknown cause in a hemodialysis patients. A 57-year-old diabetic HD patient was presented with sudden onset of right hemichorea. We could not find causes of hemichorea such as hyperglycemia, hepatic failure, drug, hyponatremia, and thiamine deficiency. T1-weighted MRI demonstrated hyperintense lesion limited to the left basal ganglion. Hemichorea disappeared completely 6 months after the onset with support care.