PURPOSE: Serum levels of G-CSF and GM-CSF were measured and CFU-GM assay using G- CSF, GM-CSF and SCF was conducted to evaluate the influence of hematopoietic growth factor on the precursor cells of cyclic neutropenia. METHODS: A 7-year-old male with cyclic neutropenia was studied. Marrow mononuclear cells were isolated at neutrophil nadir and recovery and cultured in methylcellulose media with or without G-CSF, GM- CSF and SCF. CD34 positive cells were evaluated using flow cytometry. Serum levels of G-CSF and GM-CSF were measured by ELISA. RESULTS: The Numbers of CFU-GM without growth factors were 50 at neutrophil nadir and 33 at the recovery phase in the patient and show increased colony forming capacity. CD34 positive cells were 9.32% at nadir and 14.17% at recovery. Increasement of CFU-GM with G-CSF at nadir and recovery were 46% and 118% and those with GM-CSF were 70% and 78% respectively, compared with 54.4% and 78.2% in control groups. In contrast, the presence of SCF did not enhance CFU-GM number in the patient, but in the control group, increasement with SCF was 28.9 %. There an was inverse relationship between serum G-CSF levels and peripheral neutrophil count whereas those of GM-CSF were constant. CONCLUSION: Serum G-CSF level showed inverse relationship with neutrophil counts. The response of progenitor cells to G-CSF and GM-CSF was not impaired. The presence of SCF did not enhance CFU-GM number in the patient. This result suggests that the abnormality in hematopoiesis in cyclic neutropenia may involve more immature progenitor cells responsive to SCF.
Bone Marrow ; Child ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Granulocyte Colony-Stimulating Factor* ; Granulocyte-Macrophage Colony-Stimulating Factor* ; Granulocyte-Macrophage Progenitor Cells* ; Hematopoiesis ; Humans ; Intercellular Signaling Peptides and Proteins* ; Male ; Methylcellulose ; Neutropenia* ; Neutrophils ; Stem Cells

Acquired perforating dermatosis (APD) is a skin disorder occurring in the patients with chronic renal failure (CRF), diabetes mellitus (DM) or both. The purpose of this study was to clarify the clinical and histopathological features of APD, and evaluate role of scratching in the pathogenesis of APD. Twelves patients with APD associated with CRF and DM were enrolled in the study. In six patients who required hemodialysis, the lesions appeared 2-5 yr (mean 3 yr) after the initiation of dialysis, 18-22 yr (mean 19.3 yr) after the occurrence of DM. The other patients who did not receive hemodialysis noted the lesions 4-17 yr (mean 9.5 yr) after the onset of DM. All patients had an eruption of generally pruritic keratotic papules and nodules, primarily on the extensor surface of the extremities and the trunk. The histologic features of our cases showed a crateriform invagination of the epidermis filled by a parakeratotic plug and basophilic cellular debris. The period of treatment for patients who suffered from severe (7 cases) or very severe (3 cases) on the pruritus intensity was longer than that of patients who had mild pruritus (2 cases). These data showed that scratching appear to play a critical part in the pathogenesis of APD.
Adult ; Aged ; Diabetes Mellitus, Type I/*complications ; Diabetes Mellitus, Type II/*complications ; Female ; Histamine H1 Antagonists/therapeutic use ; Human ; Kidney Failure, Chronic/*complications ; Male ; Middle Aged ; Phototherapy ; Pruritus/drug therapy/etiology ; Skin Diseases/drug therapy/*etiology/pathology ; Tranquilizing Agents/therapeutic use

Bleeding complications of central nervous system following snake bite are well known. However, nonhemorrhagic manifestations such as ischemic stroke are extremely rare. As far as we know, only four such instances involving middle cerebral artery territory have ever been reported in the literature up to now. A 53-year-old farmer noted right side motor weakness and severe dysarthria 3 hours after a snake bite on right middle finger. Magnetic resonance T2WI showed high signal intensity on left pontine region extending to basal surface and bilateral tegmentum of the pons. He had neither atherogenic risk factors nor cardiogenic embolic sources. Laboratory findings were within normal limits except for mild consumptive coagulopathy. Cerebral angiogram revealed abrupt occlusion of proximal basilar artery. We report a case of brainstem infarction caused by a Korean viper (Agkistrodon blomhoffii brevicaudus) bite and discuss possible mechanisms for cerebral infarction.
Basilar Artery ; Brain Stem Infarctions* ; Brain Stem* ; Central Nervous System ; Cerebral Infarction ; Dysarthria ; Fingers ; Hemorrhage ; Humans ; Middle Aged ; Middle Cerebral Artery ; Pons ; Risk Factors ; Snake Bites* ; Snakes* ; Stroke

OBJECTIVE: The association of obesity, diabetes mellitus, drug compliance, and body image with use of antipsychotic medication has been documented in many studies. We aimed to assess the effects of antipsychotics and sodium valproate combination therapy on glucose, cholesterol level and weight in schizophrenic patients. METHODS: Chronic schizophrenic patients were grouped according to drug combination: risperidone, olanzapine, haloperidol, risperidone+valproic acid (VP), olanzapine+VP, haloperidol+VP. Planned assessment of included glucose and cholesterol, which were collected at baseline and at the end of the 12 weeks later. RESULTS: There were significantly increased glucose and cholesterol level, in olanzapine+VP group, but not in risperidone group. Cholesterol levels were not increased at the end of 12 weeks for haloperidol and risperidone group. Glucose and cholesterol levels had no significant association with weight gain. CONCLUSION: Changes in glucose and cholesterol level, weight, and body mass index associated with antipsychotics including sodium valproate combination were reported in our report. In the future, we need follow up study and various studies about other combination drug and metabolic symptoms.
Antipsychotic Agents* ; Body Image ; Body Mass Index ; Cholesterol* ; Compliance ; Diabetes Mellitus ; Follow-Up Studies ; Glucose* ; Haloperidol ; Humans ; Obesity ; Risperidone ; Valproic Acid* ; Weight Gain

PURPOSE: To analyze the results between PFN (Proximal Femoral Nail) and DHS (Dynamic Hip Screw) on the operative treatment of unstable intertrochanteric fractures retrospectively. MATERIALS AND METHODS: 35 cases of unstable intertrochanteric fractures (grouped 24 patients with DHS and 11 patients with PFN) who were taken the operations from Jan. 2001 to Mar. 2002 were analysed regarding to union state, union time, operation time, sliding length of lag screws, blood loss, postoperative complications and functional recovery scores by Sk?vron with ANOVA and multivariate linear regression. RESULTS: The means of union time were 17.9 weeks (DHS) and 17.0 weeks (PFN), sliding length of lag screws were 3.9 mm (DHS) and 2.1 mm (PFN), perioperative blood losses were 743 cc (DHS) and 736 cc (PFN), operation time were 93.4 minutes (DHS) and 102 minutes (PFN), and the functional recovery scores by Sk?vron were 71.8% (DHS) and 76.8% (PFN), respectively. The results of our study indicate that there were not statistically significant differences between PFN and DHS groups in treatment of unstable intertrochanteric fractures (p>0.05). But, there was less sliding of lag screws in PFN group in statistical significance (p<0.05). CONCLUSION: Authors think that PFN is one of the useful implants in treating unstable intertrochanteric fractures of the femur in regarding to sliding.
Femur* ; Hip Fractures ; Hip* ; Humans ; Linear Models ; Postoperative Hemorrhage ; Retrospective Studies

We report a case of subcutaneous phaeohyphomycosis caused by Exophiala(E,) jeanselmei in a 66-year-old female, who showed a mild tender, 4.5x3.5cm sized, erythematous cystic mass with satellite lesions on the left forearm for 4 months. Histopathologically, suppurative granulomatous inflammation, brownish conidia in a chain and hyphae were observed. Fungal culture grew out the typical black-gray velvety colonies of E. jeanselmei after 2 weeks. The isolate grow well at 25 C, but very poorly at 37 C. No growth could be observed at 40 C. Sporulation adequate for evaluation was present on the malt extract agar. We confirmed E. jeanselmei by colony and microscopic morphology, temperature tolerance and sugar assimilation tests. The patient had been treated with itraconazole for 6 momths. Complete remission was observed.
Agar ; Aged ; Exophiala* ; Female ; Forearm ; Humans ; Hyphae ; Inflammation ; Itraconazole ; Phaeohyphomycosis* ; Spores, Fungal

BACKGROUND: Diabetes mellitus is a common condition, and the majority of patients have one or more cutaneous complications. Among them, xerosis is well known to be closely related to diabetics. The xerosis is inversely reflected upon skin surface hydration, the state of which can be exactly assessed with various investigating instruments, such as a hydrometer and corneometer. OBJECTIVE: Our purpose was to compare the hydration state of diabetics with normal persons by the use of a corneometer and hydrometer. METHODS: A total of 267 diabetics were asked whether they felt xerosis or pruritus. In a subgroup of 31 patients, the water content was evaluated and compared by the parameters of diabetic severity. Forty-one non-diabetics were selected for the normal control.
Diabetes Mellitus ; Humans ; Pruritus ; Skin* ; Water

BACKGROUND: Contact dermatitis is frequently caused by cosmetics. Detection of causative allergens is important in prevention and treatment of cosmetic contact dermatitis. Patch test has been accepted as the only reliable diagnostic method to detect allergens. OBJECTIVE: The objectives of this study were to clarify evoluting trends of positive patch tests and to compare the positive frequencies of various allergens between different time sequences. MATERIALS AND METHODS: We reviewed patch test results of the 806 cosmetic contact dermatitis patients, who had visited our clinic from 1982 to 1997. We divided the patients into three groups as follows: I group:1982-1987, II group:1988-1992, III group:1993-1997 and compared the test results. The patch tests were performed with standard batteries, cosmetic-related allergens and the patients's own cosmetics. RESULTS: The results of the studies were summarized as follows; 1. Trends of increasing positivity in cosmetic-induced dermatitis was noted in a chronologic point of view. Among the patients, an increased proportion of males was notable. 2. In age distribution, a decreasing proportion of patients at the third & the fourth decades was observed. Contrary to this, the proportion of patients over the fifth decades was increased. 3. Among standard allergens, nickel sulphate showed the highest positive rate in all defined triple periods, whereas positive rates of neomycin sulphate & balsam of Peru were diminishing sequentially. Among fragrance allergens, cinnamic alcohol & cinnamic aldehyde revealed the highest positive rates. 4. In as is test, skin care products showed the highest positive rate, followed by toiletries and makeup products. Increasing positive rates of the toiletry products were observed in order of time. In fragrance products, positive rates reached their peak in the second period and declined in the third period. CONCLUSION: This study showed that perfume components were the most frequent allergens in cosmetics followed by preservative agents. Our study showed that comestic allergies in men seems to have increased.
Age Distribution ; Allergens ; Dermatitis ; Dermatitis, Allergic Contact ; Dermatitis, Contact* ; Humans ; Hypersensitivity ; Male ; Neomycin ; Nickel ; Patch Tests* ; Perfume ; Peru ; Skin Tests

Dermatomyositis is a multiple disease characterized by inflammatory myopathy with specific cutaneous findings including heliotroph erythema, Gottron's papules, lupus erythematosus-like skin lesions, and cutaneous calcinosis. We report a case of childhood dermatitis that developed in a 9-year-old girl. Skin lesion showed malar erythema, Gottron's papule, cutaneous calcinosis, poikiloderma, and scalp dermatitis. These were compatible with dermatomyositis. and other clinical, laboratory, and histopathologic findings supported the diagnosis of dermatomyositis. She was treated with methotrexate, oral corticosteroid, and hydroxychloroquine.
Calcinosis ; Child ; Dermatitis* ; Dermatomyositis* ; Diagnosis ; Erythema ; Female ; Humans ; Hydroxychloroquine ; Methotrexate ; Myositis ; Scalp* ; Skin

Targetoid hemosiderotic hemangioma is a benign vascular tumor characterized by a small solitary lesion consisting of a brown to violaceous papule, surrounded by a thin, pale area and a peripheral ecchymotic ring. We report a case of targetoid hemosiderotic hemangioma on left lower abdomen of a 33-year-old female. She had a 5 mm x 5 mm sized slightly raised violaceous papule surrounded by an ecchymotic halo on left lower abdomen. We took a biopsy of the lesion and identified it as targetoid hemosiderotic hemangioma. This case showed characteristic clinical and histologic findings of targetoid hemosiderotic hemangioma.
Abdomen ; Adult ; Biopsy ; Female ; Hemangioma* ; Humans