Herpes zoster involving noncontiguous dual dermatomes is very rare in both immunocompetent and immunocompromised persons. This unique presentation has been referred to as zoster duplex unilateralis or bilateralis, depending whether one or both halves of the body are involved. A 22-year-old woman, who had been treated for acute leukemia, congestive heart failure and chronic disseminated candidiasis, was referred to our department for painful papulovesicular eruptions on the right side of the anterior chest and upper back for 2 days, and the left buttock for 1 day. Tzanck smear revealed multinucleated giant cells with intranuclear inclusion bodies. We report a rare case of zoster duplex bilateralis.
Buttocks ; Candidiasis ; Female ; Giant Cells ; Heart Failure ; Herpes Zoster* ; Humans ; Intranuclear Inclusion Bodies ; Leukemia ; Thorax ; Young Adult

Eosinophilia-myalgia syndrome(EMS) is a systemic illness that occurred as an epidemic by ingestion of over-the counter L-tryptophan preparation in the United States in October 1989. We report a Korean case of EMS not associated with the ingestion of either L-tryptophan or other nutritional supplements such as lysine and niacin.
Eating* ; Eosinophilia-Myalgia Syndrome* ; Lysine ; Niacin ; Tryptophan ; United States

Idiopathic atrophoderma of Pasini and Pierini(IAPP) is an uncommon condition of unknown etiology and typically affects persons in the second and third decades of life. IAPP consists of asymptomatic grey to brown depressed lesions with "cliff drop" borders, which are usually bilateral and located on the trunk. A 40-year-old woman visited our department because of unilateral atrophic lesions on the abdomen, right arm, and posterior aspect of right thigh for 20 years. Laboratory evaluations were normal and histologic examination revealed significantly decreased thickness in dermis. We report an unusual case of idiopathic atrophoderma of Pasini and Pierini presenting unilateral distribution.
Abdomen ; Adult ; Arm ; Dermis ; Female ; Humans ; Thigh

Diffuse aspiration bronchiolitis is defined as a clinical entity characterized by a chronic inflammation of bronchioles caused by recurrent aspiration of foreign particles. Clinical symptoms are bronchorrhea, bronchospasm, and dyspnea, and chest radiographs show the presence of regional or disseminated srnall nodular shadows and hyperlucency. Chest CT should help in detecting diffuse nodular shadows of bronchiolitis. Pathologic findings of diffuse aspiration bronchiolitis are characterized by localization of chronic mural inflammation with foreign body reaction in bronchioles. Recurrence of small amounts of aspiration might play an important role in the pathogenesis of diffuse aspiration bronchiolitis. We report a case of diffuse aspiration bronchiolitis in a 4-month- old female infant who had recurrent aspiration due to dysphagia and presented with recurrent fever, dyspnea and wheezing. She showed typical radiologic and histologic findings compatible to diffuse aspiration bronchiolitis. She was improved with treatment of nasogastric tube feeding. We emphasize the importance of recognizing this disease entity and differentiating it from pulmonary diseases associated with bronchospasm. (J Korean Pediatr Soc 2000;43:842-845)
Bronchial Spasm ; Bronchioles ; Bronchiolitis* ; Deglutition Disorders ; Dyspnea ; Enteral Nutrition ; Female ; Fever ; Foreign-Body Reaction ; Humans ; Infant* ; Inflammation ; Lung Diseases ; Radiography, Thoracic ; Recurrence ; Respiratory Sounds ; Tomography, X-Ray Computed

No abstract available.
Leiomyosarcoma* ; Rectum*

Diffuse alopecia due to occult syringoma of the scalp has rarely been reported but the authors of the cases presented different opinions about which one is the primary event between the two conditions and if the syringoma is true or a reactive ductal proliferation. We have found a case whose diffuse alopecia is believed to be due to true syringoma of the scalp. A 43-year old woman showed simultaneous and gradual development of diffuse alopecia and multiple papular elevations on the face and neck adjoining the frontal and temporal hair lines. Histopathology of the scalp and the facial papular elevations all revealed typical syringomatous infiltrations with epithelial comma-tails and sclerotic stroma. All of the clinicopathological findings supported that the diffuse alopecia of the patient was due to the occult syringoma of the scalp.
Adult ; Alopecia* ; Female ; Hair ; Humans ; Neck ; Scalp ; Syringoma*

BACKGROUND: Recurrent wheezing is probably related to airway hyperresponsiveness. Many young infants wheeze during viral lower respiratory tract infections, but the pathogenesis of these episodes and their relation to the development of asthma or other allergic disease later in life are not well understood. Whether environmental allergen exposure affects the inception of asthma remains to be determined. OBJECTIVE: We performed this study to determine whether recurrent wheezing in infancy is related to atopy and if so, when infantile asthmatics become sensitized to house dust mite allergens. METHODS: In a cross-sectional study, we investigated the factors related to recurrent wheezing before the age of three. A total of 119 infants were selected for this study and they were divided into two groups : 88 infants who experienced wheezing episodes more than three times before the age of two as infantile asthmatics, and 31 infants who had never experienced wheezing before visiting our hospital between January 1998 and July 1999. For these subjects, we performed assessments including measurement of peripheral total eosinophil counts, serum total IgE levels, specific IgE levels (Dermatophagoides pteronyssinus, Dermatophagoides farinae and food allergens) and questionnaires were completed by the children's parents. RESULTS: The group who experienced recurrent wheezing showed significantly higher total eosinophil counts, serum concentrations of total IgE, D.p- and D.f-specific IgE than controls (p<0.05). There were no significant differences in the history of respiratory disease, familial history of allergic disease and environmental factors(domestic animals, bed cloth, carpet, smoking etc) between the group with recurrent wheezing and controls. The group who experienced recurrent wheezing showed significantly higher total eosinophil counts among those over 12 months old, and serum concentration of total IgE among those under 12 months old than controls(p<0.05). The concentration of D.p-specific IgE, but not D.f-specific IgE, in the recurrent wheezing group was higher than controls who were aged over 24 months(p<0.05). CONCLUSION: The infants with recurrent wheezing are strongly related to a predisposition to atopy. Eosinophilia is one of the important markers of recurrent wheezing. The period of sen- sitization of inhalant allergens like a D.p occurs as early as 24 months old. These findings suggest that early recognition of atopy and environmental controls are important to manage re- current wheezing in infants.
Allergens ; Animals ; Asthma ; Child, Preschool ; Cross-Sectional Studies ; Dermatophagoides pteronyssinus ; Dust* ; Eosinophilia ; Eosinophils* ; Floors and Floorcoverings ; Humans ; Immunoglobulin E* ; Infant* ; Parents ; Pyroglyphidae* ; Respiratory Sounds* ; Respiratory Tract Infections ; Smoke ; Smoking ; Surveys and Questionnaires

BACKGROUND: Numerous clinical trials have demonstrated the efficacy of specific allergen immunotherapy in allergic disease. Although allergen immunotherapy has been shown to cause changes in numerous clinical, inflammatory, and immunological parameters, the mechanisms of successful immunotherapy are still poorly understood. OBJECTIVE: To investigate the mechanism of conventional immunotherapy in house dust mite sensitive asthmatics, cellular proliferative responses and cytokine productions of peripheral blood T cells were compared before and after immunotherapy. METHODS: Nine patients who were sensitive to house dust mite participated in the immunotherapy with Dermatophagoides pteronyssinus and Dermatophagoides farinae. Patients were evaluated before and when maintenance was achieved for lymphocyte proliferative responses and for cytokine productions under the stimulation of Der p 1 and phytohemagglutinin (PHA) + 12-0-tetradecanoylphorbol-12-acetate (TPA), and without stimulation. RESULTS: Conventional immunotherapy for house dust mite resulted in significant increase in interferon-gamma production, particularly under the stimulation of Der p 1 and without any stimulation after immunotherapy, but no differences under the stimulation of PHA+TPA. And the cellular proliferative responses to the dose of Der p 1 were not decreased after immunotherapy. CONCLUSION: Conventional immunotherapy resulted in significant increase in interferon-gamma production to the response of Der p 1 specifically after immunotherapy. These findings suggest that the specificity and the mechanism of conventional immunotherapy may be linked to the increase in interferon-gamma production, possibly through increase in Th1 cells.
Asthma ; Child* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Desensitization, Immunologic ; Dust* ; Humans ; Immunotherapy* ; Interferon-gamma* ; Interleukin-4* ; Lymphocytes ; Pyroglyphidae* ; Sensitivity and Specificity ; T-Lymphocytes* ; Th1 Cells

BACKGROUND: To identify the expression patterns and usefulness of various antibodies in making diagnoses and predicting prognoses, an immunohistochemical study was performed on thymic epithelial tumors (TETs). METHODS: Forty-two cases of TETs were reclassified according to the new World Health Organization (WHO) classifications. CD3, CD5, CD79a, CD99, pan-, high- and low-molecular weight cytokeratins, EMA, vimentin, MIB-1 (Ki67) and p53 immunostaining were carried out. RESULTS: There were two, twelve, eight, two, thirteen and one case for type A, AB, B1, B2, B3 and C, respectively. Combined B1/B2 and B2/B3 were 2 cases each. Fourteen cases (33.3%) had myasthenia gravis. CD99 was immunoreactive mainly in cortically derived lymphocytes, while CD3 and CD5 were immunoreactive in medullary-derived lymphocytes. CD5 immunoreactivity was negative in all thymic epithelial cells, except for one case of type B3. MIB-1 indices were highly expressed in cortical lymphocytes and some thymic epithelial cells, but did not show any correlation with grades. p53 in thymic epithelial cells was expressed in 6 (46%) out of 13 cases of type B3 and one case of type C, and it was negative in all other subtypes. CONCLUSIONS: Only p53 was helpful for predicting high grades (B3 and C) (P<0.05). By MIB-1 indices, we could tell how many cortical immature lymphocytes were occupied in TETs, however, grading could not be achieved.
Antibodies ; Classification ; Diagnosis ; Epithelial Cells ; Immunohistochemistry ; Keratins ; Lymphocytes ; Myasthenia Gravis ; Prognosis ; Thymus Gland ; Vimentin ; World Health Organization* ; World Health*

PURPOSE: To understand the characteristics of early childhood asthma, we evaluated and compared the characteristics between early persistent wheezers and late wheezers. METHODS: From January, 1998 to December, 1998, 106 children aged six to seven years were divided into three groups according to the onset of wheezing:Early persistent wheezers (n=36) who had wheezing both before three years of age and at six, late wheezers (n=48) who had no wheezing before the age of three years but had wheezing at six years, and control group (n=22) who had never wheezed at the age of six years. We performed pulmonary function and methacholine challenge tests, and measured the concentration of serum total IgE, D. pteronyssinus & D. farinae-specific IgE and total eosinophil count in these children. RESULTS: Early persistent wheezers had significantly diminished FEF25-75% than late wheezers and control group. Both early persistent wheezers and late wheezers had airway hyperresponsiveness to methacholine. Late wheezers had higher concentrations of serum total IgE than control group. The concentration of D. pteronyssinus and D. farinae-specific IgE and total eosinophil count were elevated significantly in early persistent wheezers and late wheezers than control group. CONCLUSION: Late wheezers are more closely related to atopy. Early persistent wheezers have diminished FEF25-75%, suggesting that early persistent wheezers may have abnormalities of peripheral airway. Therefore, these results strongly suggest that wheezing during childhood may be a heterogenous condition and there are apparently different two groups, early persistent wheezers and late onset wheezers, in childhood asthma.
Asthma* ; Child ; Eosinophils ; Humans ; Immunoglobulin E ; Methacholine Chloride ; Respiratory Function Tests ; Respiratory Sounds*