A 15-year-old female patient had malignant atrophic papulosis(Degos' disease) that affected the skin and probably intestinal tract. She had multiple erythematous papules with porcelain-white atrophic centers on the trunk and extremities. Also she suffered from intermittent nausea, vomiting and abdominal pain. She received appendectomy for abdominal pain 2 months ago. Histopathologic studies showed atrophic epidermis and necrobiotic dermis. There were endothelial thickening, fibrinoid necrosis of bload vessels, perivascular lymphocytic infiltation in the lower dermis. She was treatd with acetyl salicylic acid and dipyridamole, but there was no improvement.
Abdominal Pain ; Adolescent ; Appendectomy ; Dermis ; Dipyridamole ; Epidermis ; Extremities ; Female ; Humans ; Malignant Atrophic Papulosis* ; Nausea ; Necrosis ; Salicylic Acid ; Skin ; Vomiting

BACKGROUND: This study was performed in order to investigate the changes of Na+ transport system in the red blood cells of patients with essential hypertension. METHODS: Na(+)-Li(+) countertransport and Na(+)-K(+) pump activity were measured in 30 cases of essential hypertension and 20 healthy normal controls. And these measurements were analyzed in terms of some important clinical parameters in the patients, i.e., body mass index(BMI), status of hypertension and plasma lipids. RESULTS: Na(+) and K(+) contents of red cells in hypertensive patients were 16.9+/-1.4 and 77.8+/-2.1mmol/L cells, respectively, and no significant difference was found compared with respective value of normal control(14.2+/-0.9 and 82.2+/-2.8mmol/L cells). Na(+)-Li(+) countertransport in the patients group was significantly ancreased compared with control group(62.5+/-4.5 and 46.8+/-3.0umol/L cells.hr), and Na(+)-K(+) pump activity was also showed a significant depression(8.72+/-0.80 and 12.79+/-0.52umol Pi/mg.hr). In the analysis regarding the relationship between Na(+) transport system and some important clinical parameters of the patients with essential hypertension, Na(+)-Li(+) countertransport was related to BMI, and the level of triglyceride. On the other hand, Na(+)-K(+) pump activity was related to the WHO stage and the levels of total cholesterol and triglyceride. But level of blood pressure did not show a significant correlation with either are of the two Na(+) transport system. CONCLUSION: These resluts suggest that Na(+)-Li(+) countertransport and Na(+)-K(+) pump activity in patients with essential hypertension were significantly altered compared with heathy normal controls, and these Na(+) transport system were also influenced by BMI, WHO stage, and the levels of cholesterol and triglyceride. And the individual variation in Na(+) transport system were also suggested by the findings being overlapped between hypertensive patients and controls.
Blood Pressure ; Cholesterol ; Erythrocytes* ; Hand ; Humans ; Hypertension* ; Plasma ; Triglycerides

The clinical study was performed to 28 patients with the pericardiac effusion who were admitted in Busan university Hospital and Paik Hospital, In-Je Medical College, Busan, korea during March 1976 and July 1981. The results were as following; 1) 12 cases(42.9%) of total 28 pericardiac effusion occured in 3rd decade, 8(28.5%) in 2nd decade and 5 cases(17.9%) in 4th decade. Sex distribution showed male to female 2.5:1. 2) With etiological distribution there were 15 cases(53.6%) tuberculous, 5(17.9%) nonspecific, 3(10.7%) malignant, 2(7.1%) pyogenic, 2 traumatic and 1(3.6%) rheumatic. 3) On admission 28 cases(100%) complained of dyspnea, 24(85.7%) distant heart sound, 20(71.4%) each engorged jugular vein and edema, 18(64.3%) each cough and abdominal fullness, 17(60.7%) each sputum and chest discomfort and pain, 12(42.9%) fever, 11(39.1%) orthopnea, 10(35.7%) chilling, 7(25%) oliguria, 4(14.6%) palpitation and 3(17.2%) headache. Increased cardiac dullness was observed in 26 cases(71.4%), hepatomegaly 18(64.3%), pulmonary rales 17(60.7%), ascites 13(46.1%), fever 12(42.9%), pericardiac friction rub 10(35.7%), splenomegaly 7(25%), paradoxical pulse 6(21.4%) and jaundice 2(7.1%). 4) On amission SGOT and SGPT level was increased each in 15(53.6%) and 13(46.7%), TTT and CCF abnormal in 10(35.7%), and 8(28.5%), serum NPN, BUN, creatinine increased in each 10(35.7%), 11(39.1%), 8(28.5%), WBC increased in 6(21.4%), RBC decreased in 8(28.5%) and ESR increased in 16(57.1%). 5) Characteristics of pericardiac effusion showed hemorrhagic 17(60.7%), serosangeous 6(21.4%), sangeous 3(17.2%) and pyogenic 2 cases(7.1%). 6) The ECG on admission revealed low voltage in 25(89.1%), depressed ST segment in 13(46.1%) and inverted T wave in 12(42.9%). 7) Chest X-ray showing cardiomegaly 28(100%), pleural effusion in 20(71.4%), and pulmonary congestion in 16(57.1%). 8) The m mode and 2-D Echocardiogram showed echo free space in 28 cases and after pericardiocentesis the space was reduced or disappeared. 9) 19 cases of 28(67.5%) were improved clinically, while 5 cases(17.9%) were not improved and 4 cases(14.6%) died.
Alanine Transaminase ; Ascites ; Aspartate Aminotransferases ; Busan ; Cardiomegaly ; Cough ; Creatinine ; Dyspnea ; Edema ; Electrocardiography ; Estrogens, Conjugated (USP) ; Female ; Fever ; Friction ; Headache ; Heart Sounds ; Hepatomegaly ; Humans ; Jaundice ; Jugular Veins ; Korea ; Male ; Oliguria ; Pericardiocentesis ; Pleural Effusion ; Respiratory Sounds ; Sex Distribution ; Splenomegaly ; Sputum ; Thorax

11,609 of childhood new outpatients seen in Department of Dermatology of Seoul National University Hospital from 1975 to 1984 were analyzed statistica,lly. The study results were summarized as follows: l. 11, 609 out of 48, 188 new outpatients were under 15 years old age, amounting to 24. l %. 2. The 10 most common dermatoses were atopic dermatitis, vitiligo, urticari, hemangiorna, contact dermatitis, fungal disease, molluscum contagiosum, scabies, impetigo and nevocellular neuvs. The most freguent age groups were 2 to 6 years amounting to 47 2p, af total outpatients. 4. The peak incidence occurred in August, while the lowest incidence occurred in November and October. 5. Dermatoses which showed increasing tendency were nevocellular nevus and vitiligo, those of decreasing tendency were contact dermatitis and impetigo,
Adolescent ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatology ; Humans ; Impetigo ; Incidence ; Molluscum Contagiosum ; Nevus ; Outpatients ; Scabies ; Seoul ; Skin Diseases* ; Statistics as Topic* ; Vitiligo

We present a case of perforating granuloma annulare which appeared as multiple small papular lesions with central umbilication on the dorsum of both foot and sides of foot, The patient was a 12 year-old female child who had slightly tender lesions of one month's duration. Histologic study showed perforation of the epiderrnis and release of the abnormal necrobiotic material transepiderrnally. The epidermal perforation communicated with area of granuloma annulare in the dermis that consist of necrobiotic collagen surrounded by palisading mononucler phagocytes in the dermis. All the lesions resolved spontaneously with a slight hyperpigmentation in 4 months. She also had erythematous tender nodules, which diagnosed as erythema nodosum, on both shins. The lesions responded to potassium iodide 1.0g for 2 weeks.
Child ; Collagen ; Dermis ; Erythema Nodosum ; Female ; Foot ; Granuloma Annulare* ; Granuloma* ; Humans ; Hyperpigmentation ; Phagocytes ; Potassium Iodide

Purpose: This study examined the demographic and radiological risk factors for later reduction loss of distal radius fractures treated conservatively. Materials and Methods: This study enrolled patients treated for distal radius fractures between January 2017 and December 2019. Seventy-eight patients were included in the analysis and divided into two groups. The patients who showed minimal reduction loss within an acceptable radiologic angle after initial manual reduction were classified as Group A. The patients who showed reduction loss out of an acceptable radiologic angle and finally malunited or converted to surgical treatments were classified as Group B. The patient’s age and bone marrow density were used as demographic data. The initial X-ray images were evaluated to determine the fracture type. Various radiological parameters were measured. Results: The 78-patient study cohort consisted of nine men and 69 women with a mean age of 67 years. Forty-eight cases were sorted into Group A, and 30 cases into Group B. On logistic regression analysis, the age of 80 or older was a risk factor for later fracture displacement among the demographic factors (p=0.037, odds ratio=4.937). Among the radiographic factors, the presence of distal ulnar fracture and dorsal cortical comminution were disclosed as risk factors of later displacement (p=0.049, 0.003, odds ratio=3.429, 7.196). Conclusion When conservative management for distal radius fracture is decided in patients more than 80 years of age or accompanied by a distal ulnar fracture or with dorsal cortical comminution, the possibility of later displacement of the distal radius should be considered.

Bisphosphonate is used widely for osteoporosis management. On the other hand, some studies have reported that prolonged use of bisphosphonate without a proper resting period can cause insufficiency fracture and, in rare cases, fractures on the femur neck. This paper reports a case of an elderly patient who suffered bilateral femur neck insufficiency fractures induced by non-stopped long-term bisphosphonate therapy. The patient complained of pain in her buttocks at the first visit. During the admission period, inguinal area pain newly developed. Both a femur neck insufficiency fracture was observed on the hip radiographic image. Hip pinning and postoperative parathyroid hormone treatment were performed. The patient was discharged without specific complications and reported improvement in symptoms on the last follow-up. Several authors have reported one-sided femoral neck insufficiency fractures due to bisphosphonate use, but the present case is uncommon in that it occurred simultaneously in both femur necks. In addition, in the case of bilateral femur fractures, the walking ability after surgery is lower than that of one-sided fracture cases, so active rehabilitation is necessary.

STUDY DESIGN: Case study of two cases. OBJECTIVES: The aim of our study is to describe atypical patterns of tuberculous spondylitis. SUMMARY OF LITERATURE REVIEW: Few reports of tuberculous spondylitis have discussed atypical cases, which resulted in a poor prognosis due to the delay in early diagnosis and proper treatment. MATERIALS AND METHODS: A 74-year-old female underwent an incision and drainage, and posterior decompression and fusion (PDF) due to tuberculous epidural abscess after vertebroplasty of a compression fracture at T12. A 52-year-old female underwent interbody fusion and posterior lateral fusion (PLF) because of aggravation of an abscess and neurologic symptoms following non-invasive intervention to treat atypical tuberculous spondylitis. RESULTS: Clinical symptoms and serological tests of the patients were improved at postoperative 6 months. CONCLUSIONS: When a patient presents with focal bony or soft tissue abnormality on an image study, the possibility of non-typical tuberculous spondylitis has to be considered when infective spondylitis or a tumor is detected. Moreover, an invasive diagnosis tool such as biopsy will be needed for proper management.
Abscess ; Aged ; Biopsy ; Decompression ; Diagnosis ; Drainage ; Early Diagnosis ; Epidural Abscess ; Female ; Fractures, Compression ; Humans ; Middle Aged ; Neurologic Manifestations ; Prognosis ; Serologic Tests ; Spondylitis* ; Vertebroplasty

BACKGROUND: It was recently shown that human atherosclerotic plaque contains large numbers of T lymphocytes : this indicates that immune and inflammatory mechanism may be important factors in the pathogenesis of atherosclerosis. By measuring the soluble interleukin 2 receptor(sIL-2R) level we can evaluate the activation of T lymphocyte. The purpose of this study is to evaluate relationship between T cell activation and ischemic heart disease by measuring the soluble interleukin 2 receptor (sIL-2R) level in patient with ischemic heart disease. METHOD: Seventy-two patients(40 males and 32 female, mean age : 56.5+/-9.9 years) who were taken coronary angiography were included in this study. Among them, 49 patients showed abnormal coronary angiographic findings and 23 patients showed normal coronary angiographic findings. Ten mililiters of arterial blood was drawn at the time of coronary angiography. The blood was allowed to coagulate and then the serum was removed and tested in duplicate for soluble interleukin 2 receptor (sIL-2R) level by ELISA. RESULTS: 1) The soluble interleukin 2 receptor (sIL-2R) level was significantly different between abnormal coronary angiographic findings and normal coronary angiographic findings (P < 0.001). 2) According to clinical severity of ischemic heart disease (i.e. stable angina, unstable angina, acute myocardial infarction.), soluble interleukin 2 receptor (sIL-2R) level was not significantly different between single vessel disease group and multivessels disease groups (p > 0.05), but showed increasing tendency with clinical severity. 3) According to numbers of involved coronary vessels, soluble interleukin 2 receptor (sIL-2R) level was not significantly different between single vessel disease group and multivessels disease groups (p > 0.05). CONCLUSION: T lymphocyte activation, as reflected in elevated soluble interlekin 2 receptor (sIL-2R) level, is frequent in patient with ischemic heart disease. In the further we will investigate relationship between clinical diagnosis of ischemic heart disease of the numbers of involved coronary vessels and T cell activation.
Angina, Stable ; Angina, Unstable ; Atherosclerosis ; Coronary Angiography ; Coronary Vessels ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Interleukin-2 ; Lymphocyte Activation ; Lymphocytes ; Male ; Myocardial Ischemia* ; Plaque, Atherosclerotic ; Receptors, Interleukin-2 ; T-Lymphocytes

BACKGROUND: Newly developed alpha-, beta-receptor blocker, Amosulalol HCI(YM-09538) was evaluated for its hypotensive efficacy, safety and usefulness in patients with mild to moderate essential hypertension. METHODS: Thirty patients of essential hypertension(male 8, female 22), mean age 55 years were included for the study. Amosulalol HCI was administered 20-60mg daily for 10 weeks and initial starting dose was 10mg twice daily and dose was increased 40mg and 60mg daily in cases of insatisfactory hypotensive effect ever 2 weeks interval. Patients were evaluated every two weeks on blood pressure, pulse rate, improvement of subjective symptoms and side effects. Laboratory examinations were carried out routinely in principle two times before trial and after completion of study. RESULTS: Blood pressure began to fall significantly after tow weeks of administration and changed from initial 172.4mmHg of systolic pressure to final 149.3mmHg and from 104.7mmHg of diastolic pressure to final 92.5mmHg. The response rates were marked fall in 30%, satisfactory fall in 40%, thus overall hypotensive effect was observed in 70%. Pulse rate decreased slightiy but significantly from 4 weeks of administration. Improvement of subjective symptoms were observed in 7 cases out of 12 cases and no significant side effects were observedd except of two mild transitory cases of polyuria and indigestion. Laboratory examination also did not show any significant changes before and after medication. CONCLUSION: The daily administration fo 20-60mg of Amosulalol HCI to moderate essectial hypertension seems to be effective and safe with clinical usefulness.
Blood Pressure ; Dyspepsia ; Female ; Heart Rate ; Humans ; Hypertension* ; Nifedipine ; Perindopril ; Polyuria