The Dowling-Meara type of epidermolysis bullosa simplex(EBS) is genetic disease that is transmitted as an autosomal dominant trait and is charscterized clinically by pherpetiform clustering of blisters and palmo-plantar keratoderma. The disease usually presents at with or in early infancy. Although serious and hemorrhagic Wers may occur on any part of the body, the lesions heal without scaning in general. The disease shows a tendency to improve by progressian of age and it usually follows a relatively benign course. Microecopically, there are intraepidermal bli.ter s forming as a result of cytolysis of basal cells. In addition, the is a highly characteristic clumping of tonofilaments of keratinocytes in the lower epidermis, which is not seen in any other form of EBS. We report a case of Dowling-Meara type of EBS that is first destribed in Korean medical literatures.
Blister ; Epidermis ; Epidermolysis Bullosa Simplex* ; Epidermolysis Bullosa* ; Intermediate Filaments ; Keratinocytes

Chronic compression or ischemia of the spinal cord in the cervical spine causes a clinical syndrome known as cervical myelopathy. Recently, a new term “degenerative cervical myelopathy (DCM)” was introduced. DCM encompasses spondylosis, intervertebral disk herniation, facet arthrosis, ligamentous hypertrophy, calcification, and ossification. The pathophysiology of DCM includes structural and functional abnormalities of the spinal cord caused by static and dynamic factors. In nonoperative patients, cervical myelopathy has a poor prognosis. Surgical treatments, such as anterior or posterior decompression accompanying arthrodesis, arthroplasty, or laminoplasty, should be considered for patients with chronic progressive cervical myelopathy. Surgical decompression can prevent the progression of myelopathy and improve the neurologic status, functional outcomes, and quality of life, irrespective of differences in medical systems and sociocultural determinants of health. The anterior surgical approach to the cervical spine has the advantage of removing or floating the intervertebral disk, osteophytes, and ossification of the posterior longitudinal ligament that compress the spinal cord directly. The posterior surgical approach to the cervical spine is mainly used for multisegment spinal cord compression in patients with cervical lordosis. In this review article, we addressed the pathophysiology, clinical manifestations, differential diagnosis, and treatment options for DCM.

During the course of infectious mononucleosis, intake of ampicillin and its analogues such as amoxicillin may cause hypersensitivity skin rashes. We report herein a case of ampicillin induced skin rash in a 41-year-old female patient with infectious mononucleosis. Infectious mononucleosis was confirrned by datetion of IgM antibody against Epstein-Barr(EB) viral capsid antigen(VCA) in her serum. During the icuteillness, she taked ampicillin for 3 days, and 1 week after the intake of ampicillin, a genertliz:d erythernatous and purpuric maculopapualr eruption developed. Physicians should be careful not to use ampicillin and its analogue if batients are suspected to be infected with EB virus as ampicillin induces severe skin rashes in patients with infectious mononucleosis.
Adult ; Amoxicillin ; Ampicillin* ; Capsid ; Exanthema* ; Female ; Humans ; Hypersensitivity ; Immunoglobulin M ; Infectious Mononucleosis* ; Skin*

Various dermatological complications have been reported following the BCG vaccination although this vaccination has been recommended to all healthy infants in our country. A 4-months-old boy, who had a BCG vaccination three weeks after birth, developed erythematous papules and pustules on the whole body, especially on the face and upper extremities. Two erythematous subcutaneous soft nodules were also noted on the left side of the neck. A biopsy specimen from the right forearm revealed caseous necrosis surrounded by a granulomatous inflammation consisting of epithelioid cells and lymphocytes. It was centered along the axis of the damaged pilosebaceous follicle. No acid-fast bacilli could be demonstrated by AFB stain. A marked improvement of his skin eruptions was observed after anti-tuberculosis medication. However, nod-ules in the cervical area perforated spontaneously and healed leaving scars several months after the cutaneous eruptions subsided. The clinical and histologic findings and a good response to anti-tuberculous therapy support the diagnosis of papular tuberculid and suppurative lymphadenitis after BCG vaccination.
Axis, Cervical Vertebra ; Biopsy ; Cicatrix ; Diagnosis ; Epithelioid Cells ; Forearm ; Humans ; Infant ; Inflammation ; Lymphadenitis* ; Lymphocytes ; Male ; Mycobacterium bovis ; Neck ; Necrosis ; Parturition ; Skin ; Tuberculosis, Cutaneous* ; Upper Extremity ; Vaccination*

Acute generalized exanthematous pustulosis(AGEP) is a disease entity caused mostly by drugs or viral infections. Clinically it manifests as generalized erythema, erythema multiforme and amicrobial pustules with fever. Histologically, AGEP is composed of neutrophilic subcorneal and spongiform pustules. A 70-year-old female, with no personal or family history of psoriasis, was given medication including diltiazem for hypertension. Fourteen days after taking the medications, pustular eruptions appeared on the face and rapidly spread to the trunk and limbs. A Laboratory examination revealed neutrophilic leukocytosis and an elevated erythrocyte sedimentation rate. The skin biopsy showed subcorneal and spongiform pustules. We report here a case of AGEP probably due to diltiazem.
Acute Generalized Exanthematous Pustulosis* ; Aged ; Biopsy ; Blood Sedimentation ; Diltiazem ; Erythema ; Erythema Multiforme ; Extremities ; Female ; Fever ; Humans ; Hypertension ; Leukocytosis ; Neutrophils ; Psoriasis ; Skin

Retear patterns after arthroscopic rotator cuff repair are classified into two patterns according to retear location. Type 1 is when the retear pattern occurs directly on the tendon at the bone repair site using the suture anchor repair method. Type 2 is when the retear pattern occurs at the musculocutaneous junction with a healed footprint in patients who undergo the suture bridge method. Here, the authors report another retear pattern, which was identified as a type 2 retear on magnetic resonance imaging in patients who had undergone arthroscopic rotator cuff repair by the suture-bridge technique. This pattern was different from the type 2 retear and occurred at the portion of the cuff away from the healed rotator cuff under the view of the arthroscope.
Arthroscopes ; Humans ; Magnetic Resonance Imaging ; Methods ; Rotator Cuff* ; Suture Anchors ; Sutures ; Tendons

Previous studies implied association of osteoporosis with estrogen deficiency, immobilization and low calcium absorption only through epidemiological studies. There have been only a few experimental studies verifying the etiologic factors of osteoporosis in vivo condition. Authors conducted an experimental study using white rats(Sprague Dawley) in order to find out what the endocrinological and biochemical changes of experimentally induced osteoporosis are and how they behave with or against each other. White rats, eighty five in number of 3 to 6 months females and weighing 220±12.7gm were divided into four groups. They consisted of Group I(n=10) for control, Group II(n=25) for bilateral oophorectomy, Group III(n=25) for bilateral division of sciatic nerve and hip spica cast immobilization, and Group IV(n=25) for bilateral oophorectomy and bilateral division of sciatic nerve plus hip spica cast immobilization. Blood samples were taken preoperatively and postoperatively at six weeks to check Estradiol and Osteocalcin levels there of. And then, rats were sacrified immediately after the second sampling to retrieve femora for bone mineral density measurement and torsional stress test. Estradiol levels before operation were 21.4±13.3pg/ml for Group I, 31.6±3.1pg/ml for Group II, 25.6±4.5pg/ml for Group III and 33.7±4.5pg/ml for Group IV, respectively. There were no significant differences observable among the groups. Estradiol levels at six weeks postoperatively were 42.3±18.8pg/ml for Group I, 5.4±2.7pg/ml for Group II, 40.8±5pg/ml for Group III and 6.2±2.3 pg/ml for Group IV, respectively. Apparent reductions in group II and IV were proved of statistical significance. Osteocalcin levels preoperatively were 1.2±0.6ng/ml for Group I, 1.7±0.4ng/ml for Group II, 1.5±0.1lng/ml for Group III and 1.5±0.1.lng/ml for Group IV, respectively. At six weeks postoperatively they were 1.6±0.1lng/ml for Group I, 1.7±0.3ng/ml for Group II, 1.8±0.3ng/ml for Group III and 1.2±0.1lng/ml for Group IV, respectively. The differences and changes among the groups and measurements were not of statistical significance. Bone mineral contents at six weeks postoperatively were 0.248±0.03g for Group I, 0.177±0.03g for Group II, 0.226±0.04g for Group III and 0.092±0.01g in Group IV, respectively. Low values of Group II and IV compared to those of Group I and III were of statistical significance.(P=0.0001) Torsional strength of bones at six weeks postoperatively were 4.0±0.2N/m for Group I, 1.5±0.1N/m for Group II, 1.5±0.1N/m for Group III and 1.4±0.1N/m for Group IV, respectively. Decreases of experimental groups(II, III, IV) compared to that of control group(I) were of statistical significance, but differences among the experimental groups were not of significance(p>0.05). For above observations, it was possible to conclude that osteoporosis measurable by bone mineral content and torsional stress test was caused by oophorectomy and immobilization in vivo, the former of which was more rapid and profound than the latter during early phase. When both factors, i.e., oophorectomy and immobilization are exerated simultaneously. the resultant osteoporosis was found in higher degree than either factor only, but not at incremental degree as one may expect.
Absorption ; Animals ; Bone Density ; Calcium ; Epidemiologic Studies ; Estradiol ; Estrogens ; Exercise Test ; Female ; Hip ; Humans ; Immobilization ; Osteocalcin ; Osteoporosis ; Ovariectomy ; Rats ; Sciatic Nerve

OBJECTIVE: To analyze the clinical characteristics of obese infertile women. MATERIAL AND METHOD: Height, weight, body mass index, menstrual pattern, glucose, insulin, glucose / insulin ratio, dehydroepiandrosterone sulfate (DHEA-S), testosterone, free testosterone and plasminogen activator inhibitor (PAI-1) of 15 obese infertile women were tested. RESULTS: Of 15 obese infertile women, the number of diabetes mellitus, hyperinsulinemia, and insulin resistance was 2 (13%), 2 (13%), 2 (13%), respectively. The incidence of increased DHEA-S, testosterone, and free testosterone was 7 (47%), 1 (7%), 6 (40%), respectively. Notably, all patients showed increased PAI-1. CONCLUSIONS: Obesity is associated with infertility as well as many kinds of health problems. Obesity is closely related to insulin resistance and it also causes hyperandrogenism. Increased PAI-1 is one of the important causes of thrombophilia. Consequently, in the workup of obese infertile patient, many aspects of health problems should be considered.
Body Weight ; Dehydroepiandrosterone Sulfate ; Diabetes Mellitus ; Female ; Glucose ; Humans ; Hyperandrogenism ; Hyperinsulinism ; Incidence ; Infertility ; Insulin ; Insulin Resistance ; Obesity ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Testosterone ; Thrombophilia

No abstract available.
Neuroma*

A 46-year-old male patient had recurrent episodes of generalized pruritic wheals during hemodialysis. He has experienced urticaria during hemodialysis whenever he used a capillary dialyser sterilized by ethylene oxide(EO, Polysulfone-) gas which is used to sterilize hemodialysers and other medical equipment. On the other hand, capillary dialyser sterilized by Gamma ray (Hemophad) has not evoked urticaria. Although the presence of EO-specific antibodies was not detected, urticarial rash never developed when the equipment was switched to a gamma-sterilized one. We herein report a case referred to ethylene oxide induced cutaneous hypersensitivity during hemodialysis.
Antibodies ; Capillaries ; Ethylene Oxide ; Exanthema ; Gamma Rays ; Hand ; Humans ; Hypersensitivity* ; Kidneys, Artificial ; Male ; Middle Aged ; Renal Dialysis* ; Urticaria