Generalized pustular psorissis which is originary described by von Zumbusch in 1910, is the most intense form of the acute exanthematic variant among psoriasis and it is to be occured as a rare disease. We presented a case of generalized pustular psoriasis of a 16 year-old girl, who suddenly developed wide spread pustules during the acute exacerbating course of the psoriasis which had started from the primary plaque on her left anterior chest one month ago. She was free from subjective symptom. As the objective sign, the leukocytosis was only one of the significant laboratory findings. All skin lesions were almost eleared by the oral administration of methotrexate in 3 months.
Administration, Oral ; Adolescent ; Female ; Humans ; Leukocytosis ; Methotrexate ; Psoriasis* ; Rare Diseases ; Skin ; Thorax

A case of urticaria pigmentosa, the first case of nodulo-bullous variety in Korea, is herein, described. A 4-mo#nth old female baby was brought: to our hospital by her mother with the presenting signs of darkish brown infiltrated macules and nodules scattered on the trunk, neck, and extremities. The first lesion was noticed by her mother as a pea sized flat macule of pinkish brown, which was seated on the right shin at birth For the period of 4 months, it has developed into multiple similar macules on the above mentioned areas, and most of them became gradually to the nodules with lichenoid surface, She also experienced frequent bullae on them and occasional facial flushing without any specific cause. A strong stroke, performed on the nodule, produced a severe whea1ing reaction followed by marked erythema around it. and facial flushing ensued, The histologic findings of the nodule revealed massive infiltration of cuboidal cells throughout the entire dermis which proved to be mast cells on toluidine blue staining. Oral administration of the reserpine and periactin proved to be effective in this case.
Administration, Oral ; Cyproheptadine ; Dermis ; Erythema ; Extremities ; Female ; Flushing ; Humans ; Korea ; Mast Cells ; Mothers ; Neck ; Parturition ; Peas ; Reserpine ; Stroke ; Tolonium Chloride ; Urticaria Pigmentosa* ; Urticaria*

Animal experiment was carried out to measure the physiologic changes of thoracic or thoracolumbar spine that occurred as a result of electrical stimulation, and to evaluate the usefulness of electrical stimulation as a possible treatment for scoliosis. Unilateral electrical stimulations were applied to the back muscle of immature rabbits.They were subgrouped into medial, intermediate, and lateral muscle stimulated groups in order to observe the effects of various electrode placements. The radiograms were taken every other week to observe the changes of the spinal curvatures for the period of 12 weeks. The histological studies of the muscles, which were obtained from the stimulated(right) and the nonstimulated(left) sides at the same level, also were carried out to determine the response of the muscles to the electrical stimulation. The results were as follows. l. A significant scoliotic curvature was observed two weeks after electrical stimulation, and those curvatures did not change more for the next six weeks in spite of prolonged stimulation. 2. Scoliotic curvature induced by electrical stimulation for eight weeks remained unchanged for another four weeks after stopping stimulation. 3. There were no statistical differences in the induced scoliotic curvature among the three groups stimulated at different sites of the medial, intermediate, and lateral regions respectively. 4. A prolonged unilateral electrical stimulation could induce the scoliosis, and may be used as a method for treatment of scoliosis.
Animal Experimentation ; Back Muscles ; Electric Stimulation ; Electrodes ; Methods ; Muscles ; Scoliosis ; Spinal Curvatures ; Spine

PURPOSE: Trauma has been recognized to be accompanied by alterations of leukocyte, functions such as cytokine release. The regulatory mechanisms involved in these changes are still poorly defined. The aims of this prospective clinical study are to evaluate serum concentrations of cytokines in trauma patients with high risk of developing multiple organ failure, to investigate early change, and to examine the possible prognostic value of these elements. METHODS: Thirty-two patients with multiple traumatic injuries were studied. Patients were classified by age, sex, vector, Injury Severity Score (ISS), Triage Revised Trauma Score (T-RTS), and Systemic Inflammatory Response Syndrome (SIRS). Patients were categorized into two groups, depending on the severity of injury. Group 1 (n=21) consisted of patients with severe injuries and an ISS equal to or greater than 17 points. Group 2 (n=11) consisted of patients with minor injuries and an ISS less than 17 points. Whole blood and serum were obtained immediately after admission to the emergency department, and on days 1 and 3 after trauma. The post-traumatic serum levels of TNF-alpha, IL-4, IL-6, IL-10, and IL-12 were monitored using an enzyme-linked immunosorbent assay technique (ELISA). RESULTS: The 32 severely injured patients had a mean Injury Severity Score of 19.28+/-7.35 points. SIRS developed in 24 patients. Serum levels of IL-6, IL-10, and TNF-alpha were increased immediately and at 1 day and 3 days after the trauma, but the levels of IL-4 and IL-12 were not changed. Serum levels of IL-4, IL-6, IL-10, IL-12, and TNF-alpha were not related to the severity of the injury. However, the serum level of IL-10 was significantly increased at admission and on day 1 in patients who died (p<0.05 ). CONCLUSION: Serum IL-6, IL-10, and TNF-alpha levels were affected by injury. However, their levels did not correlate with the degree of injury. The serum level of IL-10 was significantly increased at admission and on day 1 in patients who died.
Cytokines ; Emergency Service, Hospital ; Enzyme-Linked Immunosorbent Assay ; Humans ; Injury Severity Score ; Interleukin-10 ; Interleukin-12 ; Interleukin-4* ; Interleukin-6 ; Leukocytes ; Multiple Organ Failure ; Prospective Studies ; Systemic Inflammatory Response Syndrome ; Triage ; Tumor Necrosis Factor-alpha*

PURPOSE: This study was designed to investigate the validity of the WHOQOL-BREF (Brief form of the World Health Organization Quality of Life Assessment Instrument) and explore the quality of life (QOL) of breast cancer patients who survived after an operation, using the Korean version of the WHOQOL-BREF. METHODS: Fifty (50) breast cancer patients after their operations and obtaining their informed consent were recruited. Hospital staff members served as the controls. The 100 item-WHOQOL instrument was employed for testing all the subjects. The scores of the WHOQOL-BREF, which is a short version (26 questions) of the WHOQOL, includes four domains (physical, psychological, social, and environmental), were compared with those of the WHOQOL. RESULTS: The scores of the WHOQOL-BREF were significantly correlated with those of the WHOQOL in all domains. The physical, psychological, and environmental domains were associated with a worse quality of life in patients with breast cancer. CONCLUSION: The WHOQOL-BREF is a valid and useful instrument for evaluating the quality of life in patients with breast cancer.
Breast Neoplasms* ; Breast* ; Humans ; Informed Consent ; Quality of Life* ; World Health Organization

PURPOSE: This study was designed to explore the quality of life (QOL) for breast cancer patients who survived after operation by using the World Health Organization Quality of Life (WHOQOL) instrument-Korean version. METHODS: Fifty patients with breast cancer were recruited after their operations, and an informed consent was obtained from each of them. Hospital staff members served as the controls. The 100 item-WHOQOL instrument included questions on the physical, psychological, social, independence, environmental and spiritual domains, and it was employed for testing the all subjects. RESULTS: The physical, psychological, independence and social domains were shown to have a worsened quality of life for patients with breast cancer who survive after their operations. Quality of life in the physical and social domains were perceived as worse by patients having advanced stage tumor, with mastectomy. Patients with mastectomy who survived their cancer felt a worse quality of life in the psychological domain. The quality of life scores for patients having advanced stage tumor with mastectomy, during the early postoperative period (< or =2 years) was lower for the independence domain. Patients at middle postoperative period (2~5years) felt a better quality of life in spiritual domain. CONCLUSION: Not only is the objective medical success important to female breast cancer survivors, but the individual subjective perception of their condition is also important. The psychological status of these women needs to be considered when managing patients with breast cancer after their surgical operation. In this context, the WHOQOL reflects a measurement of a multi-dimensional state of well- being, and it could be a useful tool across a variety of cultural and value systems in the world.
Breast Neoplasms* ; Breast* ; Female ; Humans ; Informed Consent ; Mastectomy ; Postoperative Period ; Quality of Life* ; Survivors ; World Health Organization

Coronary artery fistula draining into lung parenchymal vasculature has not been reported. Herein, we describe a case of an 81-year-old woman who presented with a localized pulmonary edema on right upper lobe associated with coronary fistula emptied into vasculature in right upper lobe. She underwent transcatheter closure of the fistula with an Amplatzer Vascular Plug 4, which resulted in complete occlusion and improved localized pulmonary edema.
Aged, 80 and over ; Coronary Vessels* ; Female ; Fistula* ; Humans ; Lung* ; Pulmonary Edema*

Infected aneurysm of the aorta is a rare but life-threatening condition. The traditional strategy for treating infected aortic aneurysms is open surgical repair with antibiotic therapy. Endovascular repair of infected aortic aneurysms has been performed only sporadically. Case: A 70-year-old man with a history of diabetes who presented with intermittent fever for one month was referred to our institution. Before admission, antibiotic treatment had been already started and on admission, his general condition was not critical. A CT scan showed two saccular aneurysms of the infrarenal abdominal aorta and a retroperitoneal inflammation including hematoma. No microorganism was identified on blood culture. On follow-up CT scan 15 days later, a further increase in aneurysmal diameter was detected and endovascular repair was performed by using Gore Excluder stent graft. The patient was recovered and discharged on hospital day 29. One month after discharge, the patient was readmitted due to chilling and fever. Abdominal CT showed a retroperitoneal abscess around the previously repaired aortic aneurysm. Surgical drainage was performed without reconstruction with extra-anatomical bypass or in situ replacement. Culture from the abscess revealed the growth of Klebsiella pneumoniae. The patient was discharged on postoperative day 31 and continues to be observed.
Abscess* ; Aged ; Aneurysm ; Aneurysm, Infected ; Aorta ; Aorta, Abdominal ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Blood Vessel Prosthesis ; Drainage ; Fever ; Follow-Up Studies ; Hematoma ; Humans ; Inflammation ; Klebsiella pneumoniae ; Tomography, X-Ray Computed

Infected aneurysm of the aorta is a rare but life-threatening condition. The traditional strategy for treating infected aortic aneurysms is open surgical repair with antibiotic therapy. Endovascular repair of infected aortic aneurysms has been performed only sporadically. Case: A 70-year-old man with a history of diabetes who presented with intermittent fever for one month was referred to our institution. Before admission, antibiotic treatment had been already started and on admission, his general condition was not critical. A CT scan showed two saccular aneurysms of the infrarenal abdominal aorta and a retroperitoneal inflammation including hematoma. No microorganism was identified on blood culture. On follow-up CT scan 15 days later, a further increase in aneurysmal diameter was detected and endovascular repair was performed by using Gore Excluder stent graft. The patient was recovered and discharged on hospital day 29. One month after discharge, the patient was readmitted due to chilling and fever. Abdominal CT showed a retroperitoneal abscess around the previously repaired aortic aneurysm. Surgical drainage was performed without reconstruction with extra-anatomical bypass or in situ replacement. Culture from the abscess revealed the growth of Klebsiella pneumoniae. The patient was discharged on postoperative day 31 and continues to be observed.
Abscess* ; Aged ; Aneurysm ; Aneurysm, Infected ; Aorta ; Aorta, Abdominal ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Blood Vessel Prosthesis ; Drainage ; Fever ; Follow-Up Studies ; Hematoma ; Humans ; Inflammation ; Klebsiella pneumoniae ; Tomography, X-Ray Computed

Rosai-Dorfman disease (RDD), or sinus histiocytosis with massive lymphadenopathy, is a rare idiopathic histiocytosis that most commonly involves the cervical lymph nodes, Extranodal involvement occurs in 30- 40% of cases, most often in the head and neck. Characteristic histological findings include emperiopolesis (intracellular engulfment) of lymphocytes and S-100 protein positivity. Treatment of Rosai-Dorfman disease is unnecessary unless the disorder becomes life-threatening, since the disease will resolve spontaneously in most patients. We experienced a case of extranodal RDD at the nasal cavity as the initial lesion prior its nodal involvement. The patient was a 18-year-old woman who complained of nasal obstruction for 4 years and had a submandibular mass that persisted during the last 3 months. Histologically, all specimens taken from the left nasal cavity, the left submandibular mass and the left upper jugular lymph node showed heavy infiltration of plasma cells, lymphocytes and sheets of macrophages with abundant pale cytoplasm which replaced the existing organ architecture.
Adolescent ; Cytoplasm ; Female ; Head ; Histiocytosis ; Histiocytosis, Sinus* ; Humans ; Lymph Nodes ; Lymphocytes ; Macrophages ; Nasal Cavity* ; Nasal Obstruction ; Neck ; Plasma Cells ; S100 Proteins ; Salivary Glands*