Acute generalized exanthematous pustulosis(AGEP) is a disease entity caused mostly by drugs or viral infections. Clinically it manifests as generalized erythema, erythema multiforme and amicrobial pustules with fever. Histologically, AGEP is composed of neutrophilic subcorneal and spongiform pustules. A 70-year-old female, with no personal or family history of psoriasis, was given medication including diltiazem for hypertension. Fourteen days after taking the medications, pustular eruptions appeared on the face and rapidly spread to the trunk and limbs. A Laboratory examination revealed neutrophilic leukocytosis and an elevated erythrocyte sedimentation rate. The skin biopsy showed subcorneal and spongiform pustules. We report here a case of AGEP probably due to diltiazem.
Acute Generalized Exanthematous Pustulosis* ; Aged ; Biopsy ; Blood Sedimentation ; Diltiazem ; Erythema ; Erythema Multiforme ; Extremities ; Female ; Fever ; Humans ; Hypertension ; Leukocytosis ; Neutrophils ; Psoriasis ; Skin

Most of the malignant tumors of the pancreas are adenocarcinomas arising from the ductal epithelium. Primary leiomyosarcoma of the pancreas, even though it is the most common sarcoma of the pancreas, is very rare. We present a case of leiomyosarcoma of the pancreas, probably primary, with metastases to the stomach, lymph nodes, and abdominal wall. A 52-year-old woman visited the hospital with vague right upper abdominal pain and weigh loss of 6 kg for 2 months. The radiological and endoscopic examination revealed that she had a large heterogeneous mass, 11 cm in size, in the pancreatic body and tail, a 4 cm-sized mass in the paraaortic area, and a 3 cm-sized polypoid mass in the stomach. Histologically, they were all similar to one another and composed of markedly pleomorphic cells. Immunohistochemical and electron microscopic studies showed definite smooth muscle differentiation of the tumor cells. Two months later, the patient underwent an excision of a new 3 cm mass in the right lower abdominal wall, showing features of well differentiated leiomyosarcoma.
Abdominal Pain ; Abdominal Wall ; Adenocarcinoma ; Epithelium ; Female ; Humans ; Leiomyosarcoma* ; Lymph Nodes ; Middle Aged ; Muscle, Smooth ; Neoplasm Metastasis ; Pancreas* ; Sarcoma ; Stomach

No abstract available.
Blood Flow Velocity* ; Humans ; Infant, Newborn*

Obstruction on the urinary tract eventually results in damage to the kidneys and loss of function. The questions that concern the clinician are the degree of nephron loss in that kidney and the potential for recovery following the relief of obstruction. 99mTc DMSA accumulates in tubule cells and has been proposed as a marker of the tubular mass. The authors estimated the renal uptake ratio of 99mTc DMSA for the degree of nephron loss corresponding to duration of hydronephrosis following left ureteral ligation in 5 NewZealand white rabbits and the potential for recovery following percutaneous nephrostomy of hydronephrosis in 24 rabbits. While the renal uptake ratio of 99mTc DMSA of the kidney with unilateral hydronephrosis following ureteral ligation reduced dramatically within 24 hour, that of the opposite healthy kidney increased, and the total renal uptake ratio was same as normal functioning kidneys before ureteral ligation. Upon ureteral release, there was no evidence of definite recovery or impairment in the experimental kidneys for 5 days. The authors conclude that a combination of ureteral release and administration of some drugs such as renal vasodilator or diuretics is an appropriate treatment for the recovery of function in unilateral hydronephrosis.
Diuretics ; Hydronephrosis* ; Kidney ; Ligation ; Nephrons ; Nephrostomy, Percutaneous* ; Rabbits ; Recovery of Function ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Ureter ; Urinary Tract

To evaluate characteristic CT findings of orbital pseudotumor and to define differentialpoints from other pathology, the authors retrospectively reviewed CT of 19 patients who were prooen to have orbital pseudotumor by clinical course and, in some cases, biopsy. A variety of CT findings including extraocular muscle thickening(11 cases), streaky infiltration of retroorbital fat(11 cases), mass formation(10 cases), optic nerve thickening (6 cases), conjunctival thickening (5 cases), scleral thickening(4cases), enlarged lacrimal gland(4 cases) and destruction of orbital bone (2 cases) were observed. Thickening of the anterior portion and irregular margin were characteristic findings of extraocular muscle and optic nerve lesions. Mass formation predominantly occurs in the anterior portion of the orbit. In most cases more than two orbital structures are involved by lesion.
Biopsy ; Humans ; Optic Nerve ; Orbit* ; Orbital Pseudotumor* ; Pathology ; Retrospective Studies

Chondroid syringoma is a rare primary skin tumor arising from eccrine sweat gland. In 1982, Nasse had found a primary skin tumor having similar morphology as in the mixed tumor of the salivary glands. In 1961, Hirsch and Helwig proposed more descriptive diagnostic term, "Choindroid syringma". The authors experienced two cases of chondroid syringma. The first case was a 47 year old male patient who had had a subcutaneous nodule in the right forehead for two months. It was a well circumscribed mass, that showed tan gray myxoid cut surface with firm consistency. Microscopically, it was a wel diagnosed as chondroid syringoma with tubular, branching lumina. The second case was a 51 year old female patient who had had a subcutaneous nodule in the left forehead for 3 months. It was well circumscribed, ad easily shelled out. It had a typical microscopic features of chondroid syringoma with small, tubular lumina.
Female ; Male ; Humans

Incontinentia pigmenti (IP), also known as Bloch-Sulzberger syndrome, is a rare X-linked dominant disorder that is generally lethal to males and almost always leads to death in utero. This disorder is a genodermatosis with characteristic cutaneous lesions and manifestations affecting the eyes, teeth, hair, and central nervous system. Genodermatosis is a hereditary disease caused by mutations in the nuclear factor-kappa B essential modulator gene mapped to chromosome Xq28. This gene encodes a variety of cytokines and chemokine regulators and is indispensable for protecting cells from tumor necrosis factor-induced apoptosis. Here we describe a case of male newborn with vesiculobullous cutaneous lesions over the left thigh and leg. We first considered the cutaneous lesions a skin infection, as they improved with intravenous antibiotics. However, recurrence and the need for repeated hospitali zations made us consider the differential diagnosis of IP, for which we performed a skin biopsy and chromosome analysis. The histology results were compatible with IP, that is, eosinophilic infiltration in the dermis and epidermis, and individual cell dyskeratinization. The chromosome analysis result was a normal 46, XY karyotype.Here we report the case of a male newborn with IP that manifested as multiple vesiculobullous skin lesions and was initially misdiagnosed as a recurrent skin infection.

Arachnoid cysts are benign developmental cysts that occur between aachnoid layers, which represent approximately 1 percent of all intracranial space-occupying lesions, their most common location being the middle cranial fossa. Current surgical treatment options for intracranial arachnoid cyst are either craniotomy and excision of cyst or shunting of cyst contents extracranially. We treated 10 cases of intracranial arachnoid cyst by excision during last two years. For the best surgical curability, we have, not only removed the cyst wall and adhesive gliotic tissue as possible, but also made the opening to basal cistern for communication. During average 8.4 months follow up, we observed, not specific morbidity and mortality, but good clinical improvement and brain expansion. As above result, if haven't specific problem, the direct surgical removal may be the primary choice for intracranial arachnoid cyst, especially in children with noncommunicating type in sylvian.
Adhesives ; Arachnoid Cysts* ; Brain ; Child ; Cranial Fossa, Middle ; Craniotomy ; Follow-Up Studies ; Humans ; Mortality

BACKGROUND: Whether the changes of risk factors (hypertension, diabetes mellitus, smoking, alcohol) can precipitate stroke remains unknown, and antecedent infection and psychologic stress are described inss case-control study, 113 consecutive patients with acute cerebrovascular disease (38 small vessel disease, 43 large vessel disease, 11 cardiogenic infarction, 4 infarction of undetermined cause, and 17 intracerebral hemorrhage) and 23 control subjects were evaluated. Changes of the risk factors (and their management) were interviewed. A sign/symptom based questionnaire was used to characterize the prevalence of recent prior infection and exposure to coldness. Psychologic stress was measured with the use of Social Readjustment Rating Scale. RESULTS: The negative change of alcohol drinking was significantly higher in the stroke group. However, there was no significant difference between stroke and control groups in the changes of thether risk factors. The prevalence of previous (within 1 month) infection was significantly higher in the stroke group compared with control subjects (p=0.03). However, there were no significant differences among the stroke subtypes in the prevalence of infection(p=0.08). Upper respiratory tract infections constituted the most common type of infection. The exposure to coldness was significantly higher in the stroke group compared with control subjects (p=0.002). The level of stress within the prior 1 month/1 year was significantly higher in the stroke group than control group (p=0.01). CONCLUSION: Our data suggest that preceding infection, exposure to coldness, psychologic stress, and the negative change of alcohol drinking may be comm.
Alcohol Drinking ; Case-Control Studies ; Diabetes Mellitus ; Humans ; Infarction ; Moyamoya Disease* ; Prevalence ; Surveys and Questionnaires ; Respiratory Tract Infections ; Risk Factors ; Smoke ; Smoking ; Stress, Psychological ; Stroke

It is well known that halogenated anesthetics have been mainly used for inhalation anesthesia these days. However many controversies still exist concerning hepatic cellular damage after halothane anesthesia. Although several articles have been issued concerning the effects of halogenated anesthetics for hepatitis B surface antigen positive patients, a study of frequent research and strict case collections is meaningful. The authors observed the effects of enflurane anesthesia on 15 HBsAg positive patients who had not recognized themselves whether they had hepatitis symptoms or were carriers. During the period of study, all groups(enflurane study group and enflurane and halothane control groups) did not experience any difficulty with the anesthesia, blood transfusion, and jaundice, etc. The comparative data of liver function tests did not show great differences during the convalescent period. According to this and other recent studies, we can positively conclude that halogenated anesthetics, especially enflurane, may favorably be used to administer HBsAg positive patients, unless any undesirable problems related to anesthesia exist.
Anesthesia* ; Anesthesia, Inhalation ; Anesthetics ; Anesthetics, Inhalation ; Blood Transfusion ; Enflurane* ; Halothane ; Hepatitis ; Hepatitis B Surface Antigens* ; Humans ; Jaundice ; Liver Function Tests