A case of lupus miliaris desseminatus faciei, 23 year old male was reported. The multiple minute discrete yellowish brown superficial nodules, 2 to 3 mm in diameter, revealed apple-jelly color under diascopy without any subjective symptoms since June, 1971. The lesions affect lower eyelids, forehead, cheeks, malar region, upper lip, chin and nasolabial folds symmetrically. Histopathological findings revealed conglomerated individual tubercles with prominent central caseation necrosis. He was given 600mg of INH and 12 mg of PAS daily per os for 2 months. The eruptions were healed gradually with pitted scars.
Cheek ; Chin ; Cicatrix ; Eyelids ; Forehead ; Humans ; Lip ; Male ; Nasolabial Fold ; Necrosis ; Young Adult

Authers observed one case of typical reactive perforating collagenosis (RPC) which did not seem to have been described in the Korean literature. A 19 year old male patient complained of a skin eruption involving his face, upper and lower extremities, and trunk in June 1973. The skin eruption appeared at the age of 10 and consisted of discrete papules of which the earliest lesion was a pinhead-sized, skin-colord papule, but it became older, it increased in size and developed a small central area of umbilication containing keratinous material. As new papules continued to develop, the older lesions regressed and disappeared with residual scar. No subjective symptom was obtained except intermittent, mild itching sensation which probably due to a irritation. The Keobner's phenomenon was observed on the dorsum of hands. He has acne vulgaris on the face with many of the individual comedones showing development into RPC. He also had a chronic maxillary sinusitis which was seemed to aggravate the skin eruption. In follow up period (about 5 months), the sinusitis was cured with operation, but the skin eruption was not improved. The family history was negative. Histopathological studies revealed typical RPC, i.e., a cup-shaped epidermal depression of which center was lacked the epidermis was noted, and through it, necrobiotic connective tissue, degenerating inflammatory- cells and collagen bundles are extruded to form a plug. Diagnosis was confirmed by clinical appearance and typical histopathologic features. The patient did not responed to topical application of 0. 1% Retinoic acid solution and Vitamin A and D.
Acne Vulgaris ; Cicatrix ; Collagen ; Connective Tissue ; Depression ; Diagnosis ; Epidermis ; Follow-Up Studies ; Hand ; Humans ; Lower Extremity ; Male ; Maxillary Sinus ; Maxillary Sinusitis ; Pruritus ; Sensation ; Sinusitis ; Skin ; Tretinoin ; Vitamin A ; Young Adult

A 17 year old female with Klippel-Trenaunay-Weber Syndrome is presented. Of particular interest was presence of congenital heart anomaly. The nevus flarnmeus invoIved her entire right leg and foot with hypertrophy, elongation and partial ulecration. Elongation of the right leg Iead cornpensatory vertebral scoliosis (Fig.1,2). The cutaneous temperature of affected side was higher than the other side, and. was larger on somatometry and osteometry (Table 1). On auscultation, grade III systolic blowing murmur was heard on left upper sternal border with second heart sound splitting. Electrocardiograrn revealed complete right bundle branch block (Fig. 3). Chest X-ray revealed cardiomegaly, increase 3 hilar shadaws and rnild pulmonary congestion (Fig. 4). Above mentioned signs suggests strongly secundum type of atrial septal defect. Femoral angiography didnt show arteriovenous malformation (Fig. 5). Authors experienced this rare variant of Klippel-Trenaunzy-Weber Syndrome acco- mapanying with congenital heart anamaly, and report this with review of literatures.
Adolescent ; Angiography ; Arteriovenous Malformations ; Auscultation ; Bundle-Branch Block ; Cardiomegaly ; Estrogens, Conjugated (USP) ; Female ; Foot ; Heart Septal Defects, Atrial ; Heart Sounds ; Heart* ; Humans ; Hypertrophy ; Klippel-Trenaunay-Weber Syndrome* ; Leg ; Nevus ; Scoliosis ; Thorax

Two Cases of Juvenile XanthogranuIoma(JXG) are reported with review of literatures. JXG is a rare disease, and have not yet been reported in this country. Case I: Two months oId healthy female infant has two firm, discrete, brownish yellow waxy nodules on the left postauricular region and the left forearm. The lesion had begun as erythematous pinhead sized papules, and have been enlarged rapidly to pea siez during last three weeks. Case II: Three year old healthy male has firm, discrete, pinhead to pea sized scattered 16 papules and nodules on the trunk and right side of neck. Laboratory findmgs and X-ray studies were normal in both cases and there were no evidence of metabolie disorder or bony abnormality. Histopathologic studies show similar findings in both cases. In hematoxylin-eosin staining, epidermis shows parekeratosis and slight elongation of rete ridges with suprapapillary thinning with focal spongiosis and invasion of inflammatory cells. The entire dermis, from dermal papillae to sbcutis, is replaced by granulomatous lesion composed with histioeytes and a few giant cell reaction, in addition to histiocytic proliferation, considerable amount of eosinophils are infiltrated with some lymphocytes and plasma cells. The dermal collagen fibers are partly degenerated. In the upper most portion, some foamy histiocytes are also seen. In frozen section and Sudan III fat staining, the tissue shows rnild reactivities.
Collagen ; Dermis ; Eosinophils ; Epidermis ; Female ; Forearm ; Frozen Sections ; Giant Cells ; Histiocytes ; Humans ; Infant ; Lymphocytes ; Male ; Neck ; Peas ; Plasma Cells ; Rare Diseases ; Sudan ; Xanthogranuloma, Juvenile*

PURPOSE: The purpose of this study was to analyze research in the Korean Journal of Rehabilitation Nursing and to suggest further perspective for rehabilitation nursing research. METHOD: In this study we reviewed the contents of 134 articles published in this journal from its beginning year 1998 to 2004. RESULTS: The majority of subjects were adult patients. The type of disease were Cerebrovascular Accident, Neuromuscular disease, Cancer patients, Urogenital disease such as Chronic Renal Failure, Spinal cord injury. Domain of research almost was client, type of research were survey (34.3%), quasi experimental study (20.9%), correlation study (19.4%). Nursing intervention of experimental study was exercise (39.0%), education (17.1%). Place of data collection was hospital (58.2%), position of researcher was professor (67.2%), method of data collection was questionnaire (50.7%). CONCLUSION: There has been a lack of written consent, child rehabilitation, measurement tool development, qualitative research. More studies about rehabilitation nursing are needed to extend the role and fields for professional nursing.
Adult ; Child ; Data Collection ; Education ; Humans ; Kidney Failure, Chronic ; Neuromuscular Diseases ; Nursing ; Qualitative Research ; Surveys and Questionnaires ; Rehabilitation Nursing* ; Rehabilitation* ; Spinal Cord Injuries ; Statistics as Topic ; Stroke

BACKGROUND: Irregular antibodies are antibodies that are not regularly present in the serum of particular blood groups and its presence results in many problems including HDN (hemolytic disease of newborn) in transfusion medicine. Column agglutination test was recently introduced and has been widely used for advantages of standardized working procedures, standard reactions, stable reactions for hours and Coombs test without washing steps. We tested irregular antibodies in cord blood by column agglutination test and investigated its incidence and relation with HDN. METHODS: We tested the cord blood collected during delivery from 200 pregnant women. Column agglutination test was done on DiaMed ID MicroTyping System (DiaMed, Switzerland) and both LISS/Coombs and NaCl/Enzyme ID-cards were used. The antibody screening test was done first and antibody identification test was done to positive cases in same way. The cell typing and Rh phenotyping for cord blood of positive cases were also done. RESULTS: 2 cases of 200 samples (1%) were positive in the antibody screening test and each was identified as anti-D and anti-E antibody. CONCLUSIONS: Irregular antibody screening in cord blood by column agglutination test is thought to be helpful in early diagnosis and treatment of HDN.
Agglutination Tests* ; Agglutination* ; Antibodies ; Blood Group Antigens ; Coombs Test ; Early Diagnosis ; Erythroblastosis, Fetal ; Female ; Fetal Blood* ; Humans ; Incidence ; Infant, Newborn ; Mass Screening* ; Pregnant Women ; Transfusion Medicine

We have recently encounted a case of Kasabach-Merritt syndrome which were characterized by hemangioma, thrombocytopenia, and disseminated intravascular coagulation. The skin of anterior neck and tongue was involved by large mass of hemangioma. Patient was taken ventilator care from upper airway obstruction of hemangioma. He was placed on combined therapy with steroid and interferon alfa-2a for 13weeks. Blood platelet count increased to acceptable range(>20000/mm3) after 10weeks of interferon alfa-2a treatment and the hemangioma decreased in size. But, he expired from failure of airway maintenance, uncontrollable bleeding and septic shock on hospital day 93. A brief review of the literature ensues with the case report.
Airway Obstruction* ; Disseminated Intravascular Coagulation ; Hemangioma ; Hemorrhage ; Humans ; Interferons* ; Kasabach-Merritt Syndrome* ; Neck ; Platelet Count ; Shock, Septic ; Skin ; Thrombocytopenia ; Tongue ; Ventilators, Mechanical

Staphylococcus aureus is the most common bacterium present in upper respiratory tract, and the toxins it produced are involved in allergic inflammation pathogenesis. In this study, we investigated the clinical significance of IgE in association with staphylococcal superantigens in allergic asthma with rhinitis (BAwAR) and allergic rhinitis alone (AR). We recruited 100 patients with BAwAR (group I), 100 patients with AR (group II), and 88 healthy controls (group III). Patients were clinically diagnosed by physicians, and were sensitized to house dust mites. Specific IgE antibodies to staphylococcal superantigen A (SEA), B (SEB), and toxic shock syndrome toxin-1 (TSST-1) were measured using the ImmunoCAP system. Other clinical parameters were retrospectively analyzed. All specific IgE antibodies to SEA, SEB, and TSST-1 were detected most frequently in group I (22%, 21%, and 27%), followed by group II (11%, 14%, and 21%) and group III (4.5%, 3.4%, and 2.3%). Absolute values of serum specific IgE to SEA, SEB, and TSST-1 were also significantly higher in group I (0.300+/-1.533 kU/L, 0.663+/-2.933 kU/L, and 0.581+/-1.931 kU/L) and group II (0.502+/-2.011 kU/L, 0.695+/-3.337 kU/L, and 1.067+/-4.688 kU/L) compared to those in group III (0.03+/-0.133 kU/L, 0.03+/-0.14 kU/L, and 0.028+/-0.112 kU/L). The prevalence of serum specific IgE to SEA was significantly higher in group I compared to group II (P=0.025). Blood eosinophil counts were significantly higher in patients with specific IgE to SEA or SEB, and higher serum levels of specific IgE to house dust mites were noted in patients with specific IgE to TSST-1. In conclusion, the present study suggested that IgE responses to staphylococcal superantigens are prevalent in the sera of both BAwAR and AR patients. This may contribute to an augmented IgE response to indoor allergens and eosinophilic inflammation.
Allergens ; Antibodies ; Asthma* ; Eosinophils ; Humans ; Immunoglobulin E* ; Inflammation ; Prevalence* ; Pyroglyphidae ; Respiratory System ; Retrospective Studies ; Rhinitis* ; Shock, Septic ; Staphylococcus aureus ; Superantigens*

Asthma is a chronic disease causing psychological stress which leads to the activation of hypothalamus-pituitary-adrenal axis. The purpose of this study is to compare morning salivary cortisol levels in persistent asthma patients according to their disease severities and control status. Total 206 adult asthma patients were recruited from four university hospitals. Spirometry, questionnaire of Asthma Quality of Life (AQOL) and Asthma Control Test (ACT) were completed, and saliva samples were collected prospectively to measure morning cortisol level. The mean patient age was 56.5+/-15.3 years with mean asthma duration of 9.1+/-11.1 years. Sixty five patents (31.6%) were classified as mild persistent asthma, and 141 patients (68.4%) were classified as moderate persistent asthma according to the Expert Panel Report 3. The mean predicted FEV1 was 88.8%+/-18.4%, and the methacholine PC20 was 9.6+/-8.5 mg/mL in all study population. The mean ACT score for all patients was 19.9+/-3.6, and there were 71 (34.5%) patients in poorly controlled and 135 (65.5%) in well controlled asthma. The poorly controlled asthma patients were characterized by significantly lower FEV1 (84.6%+/-17.6% vs 91.1%+/-18.5%, P=0.018), lower AQOL scores (46.0+/-13.9 vs 73.8+/-26.3, P<0.001), and lower salivary cortisol levels (0.14+/-0.08 vs 0.18+/-0.11 microg/dL, P=0.04) compared to well controlled asthma. The ACT score was significantly related to salivary cortisol levels (P=0.034) after adjusting for age. There was no significant difference in salivary cortisol levels (0.17+/-0.12 vs 0.16+/-0.08, P=0.725) when analyzed according to the dose of used corticosteroid and lung function. Asthma control status affects morning salivary cortisol level. Measuring the morning salivary cortisol level might be a simple and new way to assess asthma control status.
Adult* ; Asthma* ; Axis, Cervical Vertebra ; Chronic Disease ; Hospitals, University ; Humans ; Hydrocortisone* ; Lung ; Methacholine Chloride ; Prospective Studies ; Quality of Life ; Saliva ; Spirometry ; Stress, Psychological

Objective: This study aimed to examine the validity of the Korean version of the Autism Diagnostic Interview-Revised (K-ADI-R) and determine its efficacy in identifying individuals with autism spectrum disorder (ASD). Methods: Data were pooled from several past and ongoing studies as well as clinical records acquired at Seoul National University Bundang Hospital from 2008 to 2017. The K-ADI-R were administered and scored by trained research reliable examiners. Measurements to investigate the validity of the K-ADI-R was through sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and Cohen’s kappa. Results: A total of 1,271 (age 88.9±62.42 months, male=927) participants were included. The K-ADI-R yielded strong psychometric properties with high sensitivity (86.06–99.27%), specificity (84.75–99.55%), PPV (92.33–99.72%), and NPV (79.43–98.64%). There were significant differences in item scores across the K-ADI-R diagnostic algorithm regardless of age and sex (p<0.001). Agreement between the K-ADI-R and other ASD related measurements ranged between levels of good to excellent. Conclusion Despite language or cultural boundaries, the K-ADI-R demonstrated high levels of sensitivity, specificity, PPV, and NPV within a wide range of participants; hence, suggesting promising usage as a valuable diagnostic instrument for individuals with ASD.