Hydrochlorothiazide is a diuretic drug used in the treatement of edema and hypertension. We report a case of hydrochlorothiazide induced photosensitivity in a 54 year old woman who had taken hydrochlorothiazide for 3 years for hypertension. She complained of itching and burning sensation with erythematous papules and lichenified plaques on light-exposed areas. Fhototest showed marked decrease of the minimal erythema dose(MED) for UVA. The symptoms subsided after the use of topical steroid and the substitution atenolol for hydrochlorothiazide.
Atenolol ; Burns ; Edema ; Erythema ; Female ; Humans ; Hydrochlorothiazide* ; Hypertension ; Middle Aged ; Pruritus ; Sensation

No abstract available.
Spine*

We report three cases of sarcoidosis with pulmonary involvement. The skin lesions showed three types of cutaneous manifestations which were erythema nodosum, pruritic maculopapular eruptions, and subcutaneous nodules respectively. Erythema nodosum in our cases accompanied by arthralgia and bilateral hilar adenopathy, so we call it Lofgrens syndrome. Histopathologic findings of the case with eythema nodosum revealed septal panniculitis and the others showed characteristic histopathologic findings of sarcoidosis so-called naked tubercle. Regressions of the skin lesions were obtained with systemic and/or topical corticosteroid therapy except for subcutaneous nodules. Subcutaneous nodules initially improved but new lesions have been found.
Arthralgia ; Erythema Nodosum ; Panniculitis ; Sarcoidosis* ; Skin

We report two patients with multiple peculiar skin eruptions and polyclonal hypergammaglobulinemia. Both patients visited our hospital for the evaluation of asymptomatic multiple nodular eruptions on almost their entire body except for the lower extremities. Histologic examinations disclosed prominent infiltration of plasma cells and lymphoid follicular hyperplasia in the dermis but these plasma cells showed neither a mitotic figure nor atypicalities. Laboratory examinations showed polyclonal hypergammaglobulinemias and increased erythrocyte sedimentation rates. In spite of various investigations, the cause of the hypergammaglobulinemia remained obscure.
Blood Sedimentation ; Dermis ; Humans ; Hypergammaglobulinemia* ; Hyperplasia ; Lower Extremity ; Plasma Cells ; Skin

We found an error in this article. The author's name should be corrected as following: from "Younsuk Koh" to "Younsuck Koh".

BACKGROUND: This study was performed to compare efficiency of embryonic stem (ES) cell-derived dopaminergic (DA) neurons from E12 mesencephalic neuronal-precursor derived DA neuron, and to assess the value of these neurons as a donor cells to transplant in Parkinson's disease. METHODS: ES cell-derived DA neurons from E12 mesencephalic neuronal-precursor derived DA neuron were transplanted in Parkinsonian rats and analyzed TH immunoreactivity and apomorphin-induced rotation test. RESULTS: Transplanting of ES cell derived DA neurons into the rat striatum caused gradual increase of expression of tyrosine hydroxylase (TH) immunoreactivity 6 weeks after transplant in host striatum. Rotation behavior was gradually on the decrease, 6 weeks after transplant of ES cell derived DA neurons. In case of E12 mesencephalic precursor derived DA neurons, the TH immunoreactivity expressed 6 weeks after transplant in striatum, and the behavioral restoration of DA-mediated motor asymmetry sustained gradually. However, transplanted ES cell derived DA neurons appeared in wide regions among the needle tract with a relatively high density of TH immunoreactivity in comparison to the E12 mesencephalic precursor DA neurons, and graft volume of ES cell derived DA neurons were larger than E12 mesencephalic precursor derived DA neuron. In addition, both cells did not appear cancerous change after transplantation. CONCLUSIONS: These results suggest that ES cell is more efficient than E12 mesencephalic precursor derived dopaminergic neuron and will supply efficient donor cells for transplantation in Parkinson's disease.
Animals ; Dopaminergic Neurons* ; Embryonic Stem Cells ; Humans ; Needles ; Neurons ; Parkinson Disease ; Rats* ; Tissue Donors ; Transplants ; Tyrosine 3-Monooxygenase

BACKGROUND: Critical care physician staffing is a crucial element of the intensive care unit (ICU) organization, and is associated with better outcomes in ICUs. Adult ICUs in Korea have been suffering from inadequate full-time intensivists and nurses because of insufficient reimbursement rates (<50% of the original critical care cost) from the National Health Insurance System. Recently, full-time intensivists have been introduced as a prerequisite for adult ICUs of tertiary hospitals in Korea. The purpose of this study was to examine the perception of intensivist staffing among critical care program directors regarding the barriers and solutions when implementing an intensivist model of critical care in Korea. METHODS: An email survey of critical care program directors in designated teaching hospitals for critical care subspecialty training by the Korean Society of Critical Care Medicine was performed. The survey domains included vision, culture, resources, barriers, and potential solutions to implementing intensivist physician staffing (IPS). RESULTS: Forty-two critical care program directors were surveyed. A total of 28 directors (66.7%) responded to email queries. Of these, 27 directors (96.4%) agreed that IPS would improve the quality of care in the ICU, although half of them reported a negative perception of relevant clinical colleagues for the role of full-time intensivists and poor resources for IPS in their hospitals. Increased financial burden due to hiring full-time intensivists and concerns regarding exclusion from the management of their critically ill patients in the ICU, together with loss of income for primary attending physicians were stated by the respondents to be major barriers to implementing IPS. Financial incentives for the required cost from the health insurance system and enhancement of medical law relevant to critical care were regarded as solutions to these issues. CONCLUSIONS: Critical care program directors believe that intensivist-led critical care can improve the outcome of ICUs. They indicated the financial burden due to IPS and underestimation of a full-time intensivist's role to be major barriers. The program directors agreed that a partnership between hospital leaders and the Ministry of Health and Welfare was needed to overcome these barriers.
Adult* ; Critical Care ; Critical Illness ; Electronic Mail ; Hospitals, Teaching ; Humans ; Insurance, Health ; Intensive Care Units ; Jurisprudence ; Korea ; Motivation ; National Health Programs ; Personnel Staffing and Scheduling ; Surveys and Questionnaires ; Tertiary Care Centers

BACKGROUND: Many investigators have advocated neural and especially regional sympathetic blockade for acute herpe. zoster pain. Some believe that nerve blocks not only relieve acute pain but also, if given early in the course of clinical disease, prevent progression to postherpetic neuralgia. OBJECTIVE: The purpose of this study was to evaluate the preventive effect of sympathetic blockade on herpes zoster METHODS: Fifteen patients with herpes zoster were treated with sympathetic blocks according to the severity of pain. RESULTS: The total score of pain degree decreased from 3.4 to 1.1 with sympathetic blocks in 15 patients in 2 months. Sympathetic blocks prevented or relieved postherpetic neuralgia in more than 90% of patients treated within 2 weeks of the onset of the acute phase of the disease and in more than 85% of patients over 60. CONCLUSION: Sympathetic blocks are effective in preventing postherpetic neuralgia if applied soon after the onset of the acute phase of herpes zoster.
Acute Pain ; Herpes Zoster ; Humans ; Nerve Block ; Neuralgia, Postherpetic* ; Research Personnel

No abstract available.
Microsurgery* ; Radiosurgery* ; Trigeminal Neuralgia*

Henoch-Sch nlein purpura is a small-vessel vasculitis characterized by palpable purpura, abdominal pain, hematuria and arthralgia. Joint involvement occurs in 2/3 of the cases and the joint symptoms are misapprehended as an orthopaedic problem because they are often severe and occurs before characteristic purpura. It has been reported that the joint symptoms can be improved without any sequelae. But, recently some authors suggest that severe joint destruction can occur when combined with rheumatoid arthritis and the patients are FILA-DR4 positive. So, the regular follow-up for joint symptoms and screening test for the risky patients having possibility for progression of arthritis are required. In order to increase the attention of the orthopaedic surgeons on this disease and study the progression of joint symptoms, possibility of development of screening test for the risky patients and the characterisitics of the disease, we analyzed the 58 patients of Henoch-Sch nlein purpura. The following results were obtained. Among 58 patients 34 cases were male and 25 cases were female, 5 to 10-year-old children were affected more frequently and the disease occurs frequently in spring and winter season. Joint symptoms developed in 22/58 patients(37.9%) and occurs before characteristic purpura in 5/22 patients(22.7%) among the joint symptom-developed patients. Knee and ankle were affected in most patients and the inflammatory signs such as high fever, leukocytosis and elevated ESR were accompanied with joint symptom, so it resembled the symptoms and signs of pyogenic arthritis. Most of the patients recovered without remaining sequelae but 9 patients(15.5%) among joint symptom-developed patients complained repeated attacks of arthralgia. The HLA B27 were all positive in those patients. So, it was assumed that the joint symptom in Henoch-Sch nlein purpura has a correlation with genetic environment and through the broad prospective study, the HLA typing can be a screening test for the risky group prone to suffer from repeated attack or aggravation of arthritis.
Abdominal Pain ; Ankle ; Arthralgia ; Arthritis ; Arthritis, Rheumatoid ; Child ; Female ; Fever ; Follow-Up Studies ; Hematuria ; Histocompatibility Testing ; Humans ; Joints* ; Knee ; Leukocytosis ; Male ; Mass Screening ; Purpura* ; Seasons ; Vasculitis