BACKGROUND: The skin of patients with atopic dermatitis (AD) exhibits a striking susceptibility to colonization with Staphylococcus aureus (S. aureus). Superantigens produced by S. aureus and their specific IgE antibodies are thought to be important precipitating factors of AD, but there are few reports evaluating these 2 factors at the same time, particularly in adult AD patients. OBJECTS: Our purpose was to investigate the differences in the culture degree of S. aureus from the lesion, non-lesion, and control group of child and adult AD patients, to research the correlation between the exotoxin production, total IgE, anti-SEA IgE and the disease severity by SCORAD index, to ascertain the differences between child and adult AD patients. METHODS: The clinical severity of 30 child (2 to 15 years of age) and 30 adult patients (16 to 40 years of age) with AD was evaluated by using SCORAD index. S. aureus was isolated from lesional and non-lesional skin of AD patients, and from healthy controls. Staphylococcal exotoxins were detected by using reversed passive latex agglutination toxin detection kits. Anti-SEA IgE antibody was determined by using AlaSTATt assay RESULTS: S. aureus colonizations were found in 11 (36.7%) of the lesional skin, in 5 (16.7%) of the non-lesional skin of 30 child AD patients, and in 26 (86.7%), in 20 (66.7%) of 30 adult AD patients, respectively. The colonization rates of S. aureus in child patients were much lower than those in adult patients, both form lesional skin and non-lesional skin. Staphylococcal exotoxins were detected in 5 (45.5%) of the 11 colonizations from lesional skin, in 2 (40%) of the 5 colonizations from non-lesional skin of children, and in 10 (38.5%) of the 26 colonizations, in 9 (45%) of the 20 colonizations of adults, respectively. Staphylococcal enterotoxin A (SEA) was most frequently detected in both groups. S. aureus colonization was correlated with the severity of AD in childhood, but not in adulthood. However, there were no statistical significances between severity of AD and others such as exotoxin production, and the level of total IgE and anti-SEA IgE in both groups. CONCLUSION: The colonization of S. aureus was more common in adult AD patients than child AD patients. Anti-SEA IgE level was much higher in adult AD patients than in child AD patients. It is tempting to speculate that the colonization of S. aureus and exotoxin production might be related to the disease. duration rather than clinical severity of AD.
Adult ; Agglutination ; Antibodies ; Child ; Colon ; Dermatitis, Atopic* ; Enterotoxins* ; Exotoxins* ; Humans ; Immunoglobulin E* ; Latex ; Precipitating Factors ; Skin ; Staphylococcus aureus ; Strikes, Employee ; Superantigens

No abstract available.
Child* ; Humans ; Meningitis*

In order to study the clinical efficacy of the metallic stent of the treatment of iliac arterial stenosis, the clinical and arteriographic findings of the 8 patients were retrospectively reviewed. All 8 patients were males with an age of 51 to 79. The Fontaine class for the functional status of lower extremities was II in 4 patients, III in 3 patients and IV in 1 patients. Self expandable Gianturco stent was inserted in 7 iliac arteries and balloon expandable Palmaz stent was inserted in 2 iliac arteries in the 8 patients. The indications for the metallic stent application were localized dissection with significant residual stenosis in 6sites, recoiling due to calcification in one case and eccentricity of the stenotic lesion in 2 sites. The deployment of the metallic stent was successful in all the cases to maintain the patency of iliac arteries with residual stenosis less than 30%. The Fontaine class was improved to I in 6 patients, II a in 1 patients IIb in another one. During the follow-up period of 3 to 14 months, none except one developed recurrence of the symptom. On the basis of our experience, we believe that metallic stent is safe and effective for the treatment of iliac arterial stenosis. However, we think that it is a complementary measure to the percutaneous transluminal angioplasty. The comparative study between different types of metallic stent and the long-term effect should be investigated further.
Angioplasty ; Constriction, Pathologic* ; Follow-Up Studies ; Humans ; Iliac Artery ; Lower Extremity ; Male ; Recurrence ; Retrospective Studies ; Stents* ; Treatment Outcome

In order to study the clinical efficacy of the metallic stent of the treatment of iliac arterial stenosis, the clinical and arteriographic findings of the 8 patients were retrospectively reviewed. All 8 patients were males with an age of 51 to 79. The Fontaine class for the functional status of lower extremities was II in 4 patients, III in 3 patients and IV in 1 patients. Self expandable Gianturco stent was inserted in 7 iliac arteries and balloon expandable Palmaz stent was inserted in 2 iliac arteries in the 8 patients. The indications for the metallic stent application were localized dissection with significant residual stenosis in 6sites, recoiling due to calcification in one case and eccentricity of the stenotic lesion in 2 sites. The deployment of the metallic stent was successful in all the cases to maintain the patency of iliac arteries with residual stenosis less than 30%. The Fontaine class was improved to I in 6 patients, II a in 1 patients IIb in another one. During the follow-up period of 3 to 14 months, none except one developed recurrence of the symptom. On the basis of our experience, we believe that metallic stent is safe and effective for the treatment of iliac arterial stenosis. However, we think that it is a complementary measure to the percutaneous transluminal angioplasty. The comparative study between different types of metallic stent and the long-term effect should be investigated further.
Angioplasty ; Constriction, Pathologic* ; Follow-Up Studies ; Humans ; Iliac Artery ; Lower Extremity ; Male ; Recurrence ; Retrospective Studies ; Stents* ; Treatment Outcome

Infantile digital fibromatosis is a rare benign tumor on the fingers and toes of infants and childhood which is characterized by fibroblastic proliferation. Usually the lesions occur singly or severally on the dorsal or lateral aspects of the distal phalanges of the toes and fingers. The thumb and great toe are usually spared. These asymptomatic, firm, red, smooth nodules, some lcm diameter, occur during the first year of life. Forty-seven percent occur in the first month of life. This disease can occur after trauma. The lesions do not metastasize. Occasionally, spontaneous regression has been reported. After excision, recurrence can be possible. A 2 years old female infant had three large bean sized erythematous masses on the left 2,3,4th fingers. The erythematous aacule was developed at 6 months old and grew slowly. We could find inclusion body stained bright red with Massons trichrome and purple with PTAH in cytoplasm of fibroblast. The patient was treated with a simple excision followed by a skin graft. During 5 rnonths after operation, recurrence was not occurred.
Child, Preschool ; Cytoplasm ; Female ; Fibroblasts ; Fibroma* ; Fingers ; Humans ; Inclusion Bodies ; Infant ; Recurrence ; Skin* ; Thumb ; Toes ; Transplants*

We report a case of cutaneous B cell lymphoma in a 65-year-old male who had several bizarre shaped erythematous to brownish plaques on the both shins for 2 months. An abdominal CT scan revealed gastrohepatic ligament, retroperitoneal, mesenteric and bilateral external iliac lymphadenopathies. Histologic examinations revealed diffuse dense infiltration of the large atypical cells with vesicular nucleus and prominent nucleoli in the entire dermis. They showed a positive reaction to the LCA, CD20 and kappa light chain in the immunohistochemical study, suggesting that these neoplastic lymphoid cells are B cell lineage. We treated him with COPBLAM-V regimen. In the course of treatment, new skin lesions developed on both upper arms and herpes zoster on the left thigh. So we changed the regimen into IMVP-16. No relapses have been found up to the present date for 9 months.
Aged ; Arm ; B-Lymphocytes* ; Cell Lineage ; Dermis ; Herpes Zoster ; Humans ; Ligaments ; Lymphocytes ; Lymphoma, B-Cell* ; Male ; Recurrence ; Skin ; Thigh ; Tomography, X-Ray Computed

No abstract available.
Angiokeratoma* ; Fabry Disease*

BACKGROUND: Nowdays, modernization and industrialization cause many social problems and the abdominal stab wound is one of them. Recently, the number of accidents has increased along with the population of Puchen city where Holy Family Hospital is located. For the treatment of abdominal stab wounds, it is important to make a proper diagnosis. METHODS: We perform a retrospective clinical study of 52 patients who were operated on for abdominal stab wounds at Holy Family Hospital during the 10 years from January 1989 to December 1998. RESULTS: The age distribution revealed a high incidence in the twenties (44%), and the sex distribution, with a male-to-female ratio of 3:1, showed a male predominance. The seasonal distribution showed the highest incidence in the summer (35%) but there was no prominent difference in the seasonal incidence. It was made by others (44%), self (31%) and accident (25%) but 5 cases (10%) were made by the family circle. The most common clinical manifestations and the most commonly used instrument were abdominal pain (69%) and a knife (69%). In the most anemic patients, major vessel injury and thoracic injuries were combined. Among the 29 gastrointestinal injuries, 6 cases (21%) showed free air on radiologic study, and in the 13 cases with abdominal paracentesis, the sensitivity was 83% and the predictability was 91%. Among the abdominal injuries, except those to the omentum, the most commonly injured organ and combined organ were the small bowel (48%) and the thorax (55%). The average time interval from emergency-room treatment to surgery was 60 minutes. In 23 cases (45%), there was no blood transfusion during treatment. Blood transfusions above 11 units were required in 4 cases (2%). The complication rate was 15% and, no injured organs were overlocked. CONCLUSIONS: This review revealed that abdominal stab wounds were mainly caused by unknown male in their twenties, in the summer, and with a knife, but 10% were caused by number of the family circle. The diagnosis to operate was made with various methods, but we recommend a diagnostic laparoscopy with paracentesis in order to decrease negative laparotomies.
Abdomen ; Abdominal Injuries ; Abdominal Pain ; Age Distribution ; Blood Transfusion ; Diagnosis ; Humans ; Incidence ; Laparoscopy ; Laparotomy ; Male ; Omentum ; Paracentesis ; Retrospective Studies ; Seasons ; Sex Distribution ; Social Change ; Social Problems ; Thoracic Injuries ; Thorax ; Wounds, Stab*

BACKGROUND: The skin of patients with atopic dermatitis (AD) exhibits a striking susceptibility to colonization with Staphylococcus aureus (S. aureus). Superantigenic exotoxins produced by S. aureus and their specific IgE antibodies are thought to be important precipitating factors of AD, but there are few reports evaluating these 2 factors at the same time. OBJECT: Our purpose was to examine whether the isolation of S. aureus colonies and the presence of the exotoxins from the skin of childhood AD patients and the level of anti-staphylococcal enterotoxin A(SEA) IgE antibody in their sera correlated with their severity of AD. METHODS: Thirty patients with mild-to-severe AD, 2 to 15 years of age, were evaluated by using SCORAD index. S. aureus was isolated from lesional and non-lesional skin of AD patients, and from healthy controls. By using reversed passive latex agglutination toxin detection kits, we examined whether staphylococcal exotoxins could be detected. Anti-SEA IgE antibody was determined by using AlaSTAT(R)assay. RESULTS: S. aureus colonizations were found in 11(36.7%) of the lesional skin and in 5(16.7%) of the non-lesional skin of 30 AD patients. Staphylococcal exotoxins were detected in 5(45.5%) of the 11 colonizations from lesional skin and in 2(40%) of the 5 colonizations from non-lesional skin. SEA was most frequently detected. S. aureus colonization was correlated with the severity of AD. However, there were no statistical significances between severity of AD and others such as exotoxin production, and the level of total IgE and anti-SEA IgE. Total IgE level was significantly higher in the group of exotoxin production, and correlated with the level of anti-SEA IgE. CONCLUSION: The correlation between S. aureus colonization and severity of AD in our study might support the role of S. aureus in patients with AD. On the other hand, it could be considered that exacerbation of AD trigger more colonization of S. aureus by way of disruption of skin barrier function from scratching or reduced immune responses needed for defense against bacteria. Although there was no correlation between AD severity and exotoxin production and the level of anti-SEA IgE in this study, staphylococcal exotoxins and their specific IgE antibodies might play a role at least in a subset of AD patients.
Agglutination ; Antibodies ; Bacteria ; Colon ; Dermatitis, Atopic* ; Enterotoxins* ; Exotoxins* ; Hand ; Humans ; Immunoglobulin E* ; Latex ; Precipitating Factors ; Skin ; Staphylococcus aureus ; Strikes, Employee

PURPOSE: We wanted to evaluate the relationship between the clinical outcomes and cuff integrity after open rotator cuff repair and we wanted to analyze the causes of rotator cuff retear. MATERIALS AND METHODS: 78 patients who underwent open rotator cuff repair were enrolled from 2004 to 2006. All the patients were observed for a minimum follow-up of 12 months and they were evaluated by magnetic resonance imaging (MRI). The clinical outcomes were accessed by dividing the patients into the retear group and the intact group. The groups were also compared to analyze the cause of rotator cuff retear according to the preoperative tear size, the symptom duration, and so on. RESULTS: The clinical outcome of the retear group (n=22) was improved significantly after operation (p<0.001, p<0.001), but the muscle power was not improved significantly (p=0.099, p=0.243). More retears were found in the patients who had a larger preoperative tear (p<0.001) and the symptom duration of the retear group was longer (p=0.027). CONCLUSION: Although there were retear after rotator cuff repair, the clinical outcomes were improved. Yet the muscle power of the supraspinatus and external rotator were not improved significantly. There were more retears for the cases that had a larger preoperative tear size and a longer duration of symptoms.
Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Muscles ; Rotator Cuff