We repart herein a case of psoriasifomi sarcoidosis. A histopathological examination reveaied sarcoidal ulomas throughout the dermis. There wa no systemic nvolvement, The skin lesions resolved aftier one month following treatment with low dose oral prednisolone. This is the first case of psoriasiform sarcoidosis in Korea.
Dermis ; Korea ; Prednisolone ; Sarcoidosis* ; Skin

A case of fibrocalcifying pseudotumor occuring at a very unusual site, the intraosseous region of axis, is presented. Previous reports of similar lesions in skull base, intracranial parenchyme, soft tissue around spine, mediastinum, and pleura have been described under the designation 'fibro-osseouslesions' and 'calcifying pseudoneoplasm' The etiology, pathogenesis and natural course of the lesion are still unknown. Bvt the lesion is probably benign nature and reactive lesion rather than neo-plastic. Authors performed resection of lamina, spinous process, and a portion of pedicles and occipitocervical fusion to prevent spinal cord compression due to cortical expansion or fracture. Microscopically, amorphous, basophilic, hyaline, and chondroid calcifying masses were rimmed by palisading histiocytes and foreign body-type giant cells. No evidence of malignancy was found.
Axis, Cervical Vertebra* ; Basophils ; Giant Cells, Foreign-Body ; Histiocytes ; Hyalin ; Mediastinum ; Pleura ; Skull Base ; Spinal Cord Compression ; Spine

PURPOSE: To evaluate potential usefulness of dynamic Gd-DTPA enhanced MRI in the diagnosis of HgCI2 induced acute tubular necrosis of rabbits. MATERIALS AND METHODS: Sixteen rabbits were used as control group, and 14 rabbits and 12 rabbits were used as acute tubular necrosis groups of 24 hours and 48 hours after HgCI2 injection, respectively. Sequential dynamic MR imagings were acquired using Gd-DTPA(0.25mmol/kg), and time-signal intensity curves were obtained from cortex, outer medulla and inner medulla. RESULTS: In control group, a dark band, which reflects concentrated Gd-DTPA, migrated from cortex to inner medulla of the kidney, and the ratio of the signal intensity of post Gd-DTPA injection to the signal intensity of pre Gd-DTPA injection(RSI) decreased below 1 at 13sec and 26sec (mean:17 +/- 6.2sec) in cortex, at 52sec (mean :52sec) in outer medulla, and after 117sec(mean :112 +/- 33.9sec) in inner medulla of the kidney. In acute tubular necrosis group of 24 hours after HgCI2 injection, the dark band did not appear and signal intensity in cortex and medulla increased diffusely, and RSI increased above 1 in all locations. In acute tubular necrosis group of 48 hours after HgCI2 injection, the dark band appeared only in the cortex and no sign of migration was observed, and RSI is little changed except in cortex at 13sec(0.76 +/- 0.05) and 26sec(0.86 +/- 0.06). There were statistically significant differences in the time-RSI curves among cortex, outer medulla, and inner medulla in study groups, respectively (p<0.0001). CONCLUSION: Dynamic Gd-DTPA enhanced MRI of the kidney could be utilized to evaluate both renal structure and functional changes.
Diagnosis ; Gadolinium DTPA* ; Kidney ; Magnetic Resonance Imaging ; Necrosis* ; Rabbits*

PURPOSE: To correlate histologic subtypes with MR signal intensity in meniagioma and to find etiologic factors responsible for the signal characteristics of T2WI. MATERIALS AND METHODS: We. reviewed MRIs and histopathologic studies in 35 cases of meningioma. MR signal intenisty was measured with respect to cerebral cortex(gray matter) as hypointense, isointense, or hyperintense. Pathologically, meningioma was classified into subtypes, acording to the new WHO classification of brain tumors. The degree of cellularity, collagen, and vascularity was graded from 1 to 3, and presence or absence of psammoma bodies, microcysts, micronecrosis and microhemorrhage was obeserved. Multiple linear regression analysis was done to find relationship between the pathologic findings and MR signal intensity of T2WI. RESULTS: Even in the same subtype, cellularity, collagen and vascularty of the tumor were different. T1WI was not useful in discriminating pathologic subtype because most tumors were isointense or hypointense to the cortex regardless of histologic type. Most tumors showed various signal intensity on T2WI, but T2WI were not useful, either. Exceptionally, all five cases of microcystic meningiomas were hyperintense on T2W1. In analysing the relationship between MR signal intensity and pathologic factor, increased collagen content produced decreased signal intensity(P<0.01) and the existence of microcyst resulted in high signal intensity(P<0.01). Cellularity, vascularity, microcalcification, micronecrosis and microhemorrhage had no relationship with signal intensity on T2WI. CONCLUSION: Except for the five microcystic meningiomas with hyperintenty on T2WI there was no relationship between MR signal intensity and subtype of meningiomas. Pathologic factors influencing T2 signal intensity were microcyst and collagen. Even in the same subtypes of meningiomas, the T2 signal intensity was different. This may be due to different ratio of microcyst and collagen.
Brain Neoplasms ; Classification ; Collagen ; Linear Models ; Magnetic Resonance Imaging* ; Meningioma*

Background: Umeclidinium/vilanterol (UMEC/VI; ANORO ELLIPTA, GSK) is a commonly used dual bronchodilator. This study evaluated the safety and effectiveness of UMEC/VI in Korean patients with chronic obstructive pulmonary disease (COPD) over a 6-year period. Methods: This was an open-label, multicentre, observational, post-marketing surveillance study. A total of 3,375 patients were enrolled consecutively in 52 hospitals, by 53 physicians, between July 2014 and July 2020. Patients who were administered UMEC/VI (fixed-dose 62.5 μg/25 μg) at least once and were monitored for safety and effectiveness were included in the analysis. Incidence and severity of adverse events (AEs) reported after administrating at least one dose of UMEC/VI were monitored, including unexpected adverse events (UAEs) and adverse drug reactions (ADRs). Effectiveness of UMEC/VI after 24 weeks of administration was also assessed using physician’s evaluation (effective, ineffectiveo change, worsening, indeterminable) and lung function improvement. Results: Of 3,375 patients, 3,086 were included in the safety assessment group (mean age±standard deviation: 69.76±8.80 years; 85.9% male [n=2,652]; 73.1% aged ≥65 years [n=2,255]). The overall incidence of AEs was 28.8% (n=890), of which 2.2% (n=67) were ADRs. Serious AEs and UAEs were reported in 181 (5.9%) and 665 (21.6%) patients, respectively, and two patients (<0.1%) reported unexpected severe ADR. Of the 903/3,086 patients analysed for effectiveness, most (82.8%, n=748) showed overall disease improvement after UMEC/VI treatment. Conclusion This study confirmed UMEC/VI administered to Korean patients according to the prescribing information was well-tolerated and can be considered an effective option for COPD treatment.

This study was carried out to investigate the morphologic characteristics and localization of antigenic molecules of Pneumocystis carinii in experimentally induced P. carinii pneumonia in rats. After six weeks of administration of low protein diet and dexamethasone, Sprague-Dawley rats were sacrificed to submit lungs or bronchoalveolar lavage for the study. Monoclonal (092, 900, 902, and 904) and polyclonal (SP-D) antibodies were used for immunohistochemistry and immunoelectron microscopy (ITEM and ISEM). Immunohistochemically P. carinii organisms were well identified as clusters or separated forms in the alveolar spaces being frequently attached to the alveolar walls. Immunoelectron microscopically the adherences of gold particles were observed on the surface of all stages of the P. carinii. Occasionally positive immunogold labeling was observed in the cytoplasm of the trophozoites and on the pellicle of the intracystic bodies within the cysts. The monoclonal antibodies 092, 900, 902, and 904 reacted mainly with pellicles of P. carinii, whereas SP-D labeled on the pellicles, intracystic bodies, cytoplasms of the alveolar macrophages, and free floated surfactant material in the alveolar spaces. The immunogold particles were observed more diffusely and intensely in the cysts than in the trophozoites. These results indicate that antigen is mainly localized on the pellicles, and accumulated during development from the trophozoite to the cyst stages.
Animals ; Antibodies ; Antibodies, Monoclonal ; Bronchoalveolar Lavage ; Cytoplasm ; Dexamethasone ; Diet, Protein-Restricted ; Immunohistochemistry ; Lung ; Macrophages, Alveolar ; Microscopy, Electron ; Microscopy, Immunoelectron ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia ; Pulmonary Surfactant-Associated Protein D ; Rats ; Rats, Sprague-Dawley ; Trophozoites

Clothing dermatitis frequently goes unrecognized either becaue he clinical picture is mistaken for other disorders, such as seborrheic dermatitis, and prurius, or beacuse it is difficult to trace the causal agent. Contact dermatitis to disperse dyes, especially to azo dyes, has been well known and the most frequent sources of sensitization to dyes are dresses, stockings, and trousers made of synthetic fabrics We described a case of hat band contact dermatitis due to disperse dyes, proven by a patch test. Although chrome was not proven by the diphenylcirbizide method, many dyes known to be contact allergens were proved in different kinds of hat bands.
Allergens ; Clothing* ; Coloring Agents* ; Dermatitis ; Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Patch Tests

PURPOSE: To measure the size of normal corpus callosum in each portion using objective and reproducible method with MRI and evaluation of morphological change of corpus callosum by grade of hydrocephalus. MATERIALS AND METHODS: Midsagittal Tl-weighted MR imaging of the corpus callosum was investigated in 41 volunteers of normal Korean adults and 19 patients with hydrocephalus. Corpus callosum was measured for the anteroposterior length(A), height(B), and the thickness of genu(C), body (D), splenium(E), and the narrowest portion of body(F). And the analysis of morphology and signal intensity of the corpus callosum were also evaluated. Hydrocephalus was graded as mild, moderate, and severe, and comparision of thickness with normal corpus callosum in each portion was done. RESULTS: The mean length and height were 72.3mm, 28.6mm in male, and 70.7ram, 28.9mm in female. And the mean dimention for C, D, E, and F were 13.1 ram, 8ram, 13.2mm, 5.2ram in male, and 12.8mm, 7.5ram, 12.3 ram, 5mm in female. The morphology of normal corpus callosum was "hook" shaped on midline sagittal Tl-weighted image. Narrowing at posterior third portion of body were present on 30 cases(73.2%) and even in thickness of the body in 11 cases(26.8%). The signal intensity of the corpus callosum on midsagittal Tl-weighted spin echo image of normal cases was homogeneous hyperintense as compared with cerebral gray matter. In hydrocephalus, A and B were increased and other portions were decreased in thickhess. Genu and the narrowest portion of body showed significant difference of thickness according to the grade of hydrocephalus. CONCLUSION: The mean dimention of all portion of corpus callosum were larger in male than female except for callosal height but not significant statistically with the exception of splenium. Hydrocephalus lead to morphological change of the corpus callosum. Among the portion of corpus callosum, genu and the narrowest portion of the body were thought to be the most sensitive indicators of degree in hydrocephalus.
Adult* ; Corpus Callosum* ; Female ; Humans ; Hydrocephalus* ; Magnetic Resonance Imaging* ; Male ; Volunteers

BACKGROUND: The aim of this study is to evaluate the influence of immunosuppressants on in-hospital mortality from sepsis. METHODS: Using data of the Health Insurance Review & Assessment Service, we collected data from patients who were admitted to the hospital due to sepsis from 2009 to 2013. Based on drugs commonly used for immunosuppression caused by various diseases, patients were divided into three groups; immunosuppressant group, steroid-only group, and control group. Patients with no history of immunosuppressants or steroids were assigned to the control group. To identify risk factors of in-hospital mortality in sepsis, we compared differences in patient characteristics, comorbidities, intensive care unit (ICU) care requirements, and immunodeficiency profiles. Subgroup analysis according to age was also performed. RESULTS: Of the 185,671 included patients, 13,935 (7.5%) were in the steroid-only group and 2,771 patients (1.5%) were in the immunosuppressant group. The overall in-hospital mortality was 38.9% and showed an increasing trend with age. The steroid-only group showed the lowest in-hospital mortality among the three groups except the patients younger than 30 years. The steroid-only group and immunosuppressant group received ICU treatment more frequently (p < 0.001), stayed longer in the hospital (p < 0.001), and showed higher medical expenditure (p < 0.001) compared to the normal group. Univariate and multivariate analyses revealed that age, male gender, comorbidities (especially malignancy), and ICU treatment had a significant effect on in-hospital mortality. CONCLUSIONS: Despite longer hospital length of stay and more frequent need for ICU care, the in-hospital mortality was lower in patients taking immunosuppressive drugs than in patients not taking immunosuppressive drugs.
Comorbidity ; Health Expenditures ; Hospital Mortality ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Insurance* ; Insurance, Health ; Intensive Care Units ; Korea* ; Length of Stay ; Male ; Mortality ; Multivariate Analysis ; Risk Factors ; Sepsis* ; Steroids

No abstract available.
Humans