We report 2 cases of eosinophilic pustular folliculitis, one in s 29-year-old woman and the other in a 24-year-old man. Crops of papules and pustules developed on well demarcated, walnut-sized, erythematous plsques on the cheeks and forehead. Eruptions were more pronounced on the periphery of the plaques with central clearing. Blood eosinophilia was evident in case 1. Histologic findings showed a dense inflammatory infiltration and abscesses composed mainly of eosinophils in and around hair follicles, sebaceous glands and around blood vessels. We could see beneficial responses by administration of dapsone in both cases, but its effect was just suppressive and temporary.
Abscess ; Adult ; Blood Vessels ; Cheek ; Dapsone ; Eosinophilia ; Eosinophils* ; Female ; Folliculitis* ; Forehead ; Hair Follicle ; Humans ; Sebaceous Glands ; Young Adult

No abstract available.
Contrast Media* ; Glass* ; Syringes*

No abstract available.
Nephritis, Hereditary*

No abstract available.

OBJECTIVES: Rapidly progres s ive glomerulonephritis (RPGN) is a clinico- pathologic entity characterized by extens ive crescent formation(usually involving 50% or more of glomeruli) as the principal his tologic finding and a rapid deterioration of kidney function, which can lead to end s tage renal disease within a few weeks. T he etiology and incidence of RPGN has been well defined in Europe and North America, however, there has been no report of a large series in Korea. T he aim of the present s tudy was to analyze the etiology and clinico- pathologic features of 26 patients with RPGN, seen during 1983-1997. METHODS: T wenty-six patients with RPGN(crescents in > 50% of glomeruli) were obs erved during a period of las t 14 years. Male to female ratio was 1:1.4, and the mean age was 30(6-75) years. Mean time from the initial symptoms to the ESRD was 3.1 months . RESULTS: The incidence of RPGN in our series was 2.1% of primary glomerulonephritis. Immunecomplex mediated disease was presented in 14 cases (54%), including 6 sys temic lupus erythematos us, 3 post- streptococcal glomerulonephritis, 3 Henoch- Schonlein purpura, and 2 IgA nephropathy. Pauci- immune disease was presented in 12 cases (46%), including 3 Wegener' s granulomatos is, one necrotizing crescentic glomerulonephritis, and 8 idiopathic crescentic glomerulonephritis. However, there was none of anti-GBM- mediated disease in our s tudy. ANCA were found in 6 patients. All 3 patients with WG were C- ANCA pos itive, whereas one patient with PSGN, necrotizing cres centic GN, and idiopathic crescentic GN were P- ANCA pos itive, respectively. Initial clinical and laboratory features included edema(80%), hypertens ion(72%), oliguria(68%), a decreased renal function(serum creatinine > 5mg/dL, 35%), and gros s hematuria(36%). Renal biopsy showed large crescents more than 80% of the glomeruli in 14 cases (54%) which were predominantly fibrocellular. Fifteen patients (58%) were treated with prednis olone alone, and 12 of them received puls e doses of corticosteroids. Five patients were treated with prednisolone and cyclophos phamide IV pulse. Two cases received plasma exchange. During the mean follow-up of 31+/-37 months, 18 patients (69%) developed inexorable progression of renal failure, three(12%) showed recovery of renal function, and two(8%) showed partial improvement, which is followed by varying degrees of renal insufficiency. During follow-up, three patients died : two from res piratory failure with severe pulmonary hemorrhage and one from opportunistic pulmonary infection during immunosuppressive therapy. Poor prognos is is as sociated with hypertension, increased serum creatinine level at the time of diagnosis, large crescents more than 85% of glomeruli, and glomerular scleros is . CONCLUSION: We conclude that an earlier diagnos is including kidney biopsy and the more aggressive treatment are essential in the management of RPGN.
Adrenal Cortex Hormones ; Antibodies, Antineutrophil Cytoplasmic ; Biopsy ; Creatinine ; Diagnosis ; Europe ; Female ; Follow-Up Studies ; Glomerulonephritis* ; Glomerulonephritis, IGA ; Hemorrhage ; Humans ; Hypertension ; Immune System Diseases ; Incidence ; Kidney ; Kidney Failure, Chronic ; Korea ; Male ; North America ; Plasma Exchange ; Prednisolone ; Purpura ; Renal Insufficiency ; Systemic Vasculitis

PURPOSE: Relaxation of the penile cavernosum smooth muscle is a critical event in erection. Artemisia iwaymogi(AI) is a perennial herb growing in Korea. The aerial parts have been used in folk medicine. Bioassay-guided fractionation of an H2O extract of AI has furnished an inhibitory substance (PCLS-2). We investigated compound extracted in the rabbit corporal cavernosum smooth muscle. MATERIALS AND METHODS: Bioassay-guided fractionation of an H2O extract was used. A strip of rabbit corpus cavernosum was mounted in an organ chamber to measure the isometric tension. PCLS-2 compound induced relaxations were evaluated by in vitro study using muscarinic receptor blocker atropine (ATR), cyclo-oxygenase inhibitor indomethacin, nitric oxide synthase (NOS) ihibitor Nitro-L Arginine-Methyl Ester (NAME), guanylate cyclase inhibitor 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin 1-one (ODQ), intrinsic neurotransmission inhibitor tetrodotoxin (TTX), or/and potassium channel blockers. RESULTS: PCLS-2 showed relaxation in a dose-dependent manner. Atropine, Indomethacin, NAME, ODQ, TTX, glibenclamide, tetraethylammonium, 4-aminopyridine, charybdotoxin, or apamin did not inhibit the relaxation induced by PCLS-2 compound. CONCLUSIONS: The present results suggest that the PCL-2 compound has effect of relaxation of corpus cavernosum smooth muscle and the relaxation was not involved muscarinic receptor, nitric oxide, prostaglandin, potassium channels and intrinsic neurotransmission. Other mechanisms may by involved in the PCLS-2 induced relaxation in the rabbit corpus cavernosum smooth muscle.
4-Aminopyridine ; Apamin ; Artemisia ; Atropine ; Charybdotoxin ; Glyburide ; Guanylate Cyclase ; Indomethacin ; Korea ; Medicine, Traditional ; Muscle, Smooth* ; Nitric Oxide ; Nitric Oxide Synthase ; Potassium Channel Blockers ; Potassium Channels ; Prostaglandin-Endoperoxide Synthases ; Receptors, Muscarinic ; Relaxation ; Synaptic Transmission ; Tetraethylammonium ; Tetrodotoxin

OBJECTIVES: To test the neurodevelopmental hypothesis of the schizophrenia, we compared MR brain scans of schizophrenic patients with headache patients. METHOD: We conducted 7mm-slice magnetic resonance imaging study to evaluate the prevalence of CSF in a sample of 28 headache patients and 23 schizophrenic patients. All subjects are right-handed person by Annett's questionaires. RESULTS: Any size CSF was fecund 13/23(56.5%)schizophrenics and 16/28(57.1%) of headache patients. But larger CSF was found 26.1% of schizophrenics and 10.7% of headache patients. No statistically significant difference in gender and clinical subtype. CONCLUSIONS: Higher incidence of CSF in schizophrenic patients supports the hypothesis that anomalous development of the brain is an important aspect of the schizophrenia.
Brain ; Headache ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Prevalence ; Schizophrenia*

[Background] Over the last thirty years, majority of researches on clinical effectiveness of acupuncture have been explanatory (or experimental) randomized controlled trial. The benefits of acupuncture in clinical trials are stillcontroversial and most studies concluded that further control studies were required. Standardized combinations of acupuncture points for all the experimental subjects in various past studies have been criticized because such treatments do not reflect current routine clinical treatment.
[Objective] This paper aims to review pragmatic clinical trials on the effect of acupuncture treatment and to develop the ideal clinical research methodology of acupuncture study.
[Method] Clinical studies of acupuncture relevant with pragmatic or individualized trials were searched mainly in Pubmed and Science direct databases. All articles were fully reviewed by researchers, and data were evaluated by usage of a standardized form.
[Results & Suggestion] Pragmatic acupuncture researches were tried for various symptoms (eg. low back pain, hypertension, depression during pregnancy, sleep quality in HIV disease, chronic poststroke leg spasticity, headache, etc). Individualized acupuncture treatments based on oriental disease pattern diagnosis reflexes practical treatments which is more effective than unified and fixed acupuncture treatments without any theoretical basis of oriental medical philosophy.
[Conclusion] To overcome the controversies and limitations of past explanatory acupuncture trials, more individualized and tailored acupuncture trials with the theoretical basis of oriental medical diagnosis is highly recommended. Also clear definition and categorization of pattern identification should be established for further active clinical researches and applications of acupuncture.

Hypotension is frequently followed by spinal anesthesia using hyperbaric agents, and is one of the common, immediate complications of spinal anesthesia. Trendelenburg position has been used for the management of hypotension and shock since its first introduction in 1890. But this position may increase level of spinal anesthesia and decrease blood pressure even further in the hyperbaric spinal anesthesia. And it has been known that Trendelenburg position does not increase carotid blood flow in shock state. After all, Trendelenburg position seems to have little benefit in the management of hypotension during hyperbaric spinal anesthesia. If the simple elevation of lower extremities can raise blood pressure without greater cephalad spread, it will replace Trendelenburg position for the prevention and the management of hypotension during hyperbaric spinal anesthesia. We measured the changes of spinal anesthetic level, blood pressure and heart rate for 20 minutes during spinal anesthesia in the patients with 0degree 10degree,20degree and 30 leg elevation(10 patients for each group). Every patient was premedicated with 10mg of valium orally and hydrated with lactated Ringer's solution at the rate of 10 ml/minute during the whole procedure of this study. The analgesic levels (expressed as dermatome) were increased by 2 dermatomes at 20 minutes in comparison with the levels at 5 minutes after spinal anesthesia in all groups. The systolic blood pressure was decreased by 10% in 0degree-elevation group, by 15% in 10degree-elevation group, by 8% in 20degree- elevation group, and by 11% in 30degree-elevation group. But, there was no significant statistical difference in the changes of systolic blood pressure between any groups. Similar results were found in the changes of diastolic blood pressure and heart rate, which were not statistically significant, either. In conclusion, leg elevation from 10degree to 30degree is not recommended to prevent hypotension after hyperbaric spinal anesthesia, because leg elevation does not bring the changes of vital signs, although it causes no further raising of spinal anesthetic level.
Anesthesia, Spinal* ; Blood Pressure ; Diazepam ; Head-Down Tilt ; Heart Rate ; Humans ; Hypotension ; Leg ; Lower Extremity ; Shock ; Vital Signs*

BACKGROUND: The aim of the present study was to investigate the effect of spinal cord stimulation (SCS) on the electrically evoked responses of the dorsal horn neuron. An additional aim was to examine whether adenosine receptor activation is involved in the effects of SCS. METHODS: SCS was performed in a rat with a selective spinal nerve (L5/L6) ligation. Adenosine receptor antagonist, theophylline, was administered intraperitoneally after SCS. Extracellular recordings were made from dorsal horn neurons receiving C- and A-fiber input from the ipsilateral hindpaw. Neuronal responses were elicited by supramaximal electrical stimulation, given in the sciatic nerve. RESULTS: Following intraperitoneal administration of theophylline (50 mg/kg), the decreased C-fiber evoked responses were by SCS suppression restored to a pre-SCS level. SCS and theophylline did not produce any significant change in the A-fiber evoked response. CONCLUSIONS: These results indicate that C-fiber evoked responses are inhibited in preference to A-fiber evoked responses by SCS, and that adenosine-dependent mechanisms may be involved in the resulting SCS effect.
Adenosine* ; Animals ; Electric Stimulation ; Ligation ; Neurons ; Posterior Horn Cells* ; Rats* ; Receptors, Purinergic P1 ; Sciatic Nerve ; Spinal Cord Stimulation* ; Spinal Cord* ; Spinal Nerves ; Theophylline