Pigmented Bowen's disease (PBD) is a rare variant of Bowen's disease(BD). Most of the reported cases showed pigmented patches or thin plaques. Thus its clinical manifestations may simulated other various pigmented skin lesions. We experienced 2 cases of PBD in patients with multiple BD developed after taking Korean proprietary pills (KPP, "Hwan-Yak"), which were suspected to contain certain amount of arsenics. Both patients also showed arsenical keratosis on their palms and soles. The darker pigmentation of the PBL led us to differentiated them from melanoma.
Bowen's Disease* ; Humans ; Keratosis ; Melanoma ; Pigmentation ; Skin

BACKGROUND: It is traditiqnally considered that the non-bullous fonn of impetigo is primarily of streptococcal origin and the bullous form is of staphylococcal origin. However, recent reports have shown that Staphylococcus aureus (SA) has become the predominant cauative pathogen of non-bullous impetigo as well as of bullous impetigo. Objective. Our purpose was to evaluate the predominant causativi. pathogen, and to establish a therapeutic guideline for impetigo. METHOD: We described the characteristics of lesions and gerformed bacterial culture and susceptibility tests in patients with impetigo. Patients were treatecl by one of three frequently used antibiotics(erythromycin, cefuroxime, fusidic acid). RESULTS: Of 77 patients, there were 47 cases of crusted type(61.9%), 18 cases of mixed type with crusted and bullous lesiona(23.3%), 7 cases of mixed type with crusted and pustular lesions(9.1%) and 5 cases of bullous type(6.6%). SA was grown from 90.1% af the cases, in 83.1% of cases it was the only organism to be foind and no gowth of streptococcus was faund even in mixed infections. An antimicrobial susceptibility test of 63 strains of SA demonstrated high susceptibility to vancomycin(98.4%), cefuroxime(97.1%), oxacillin(96.4%), cephalothin(95.2%), fusidic acid(91.7%) etc, and high resistance to penicillin(93.7%), gentamicin(90.5%), tobramycin(88.9%) and erythromicin(80.9%). Of 19 patients treated with erythrornycin, 12(63.1% ) showed treatment failure at a weeks, while no treatment failure occured in groups treated with cefuroxime and usidic acid. There were statistically significant differences iri therapeutic effect between cefuroxirne and erythromycin(P=0.005 by two tailedy test), and betweer fusidic acid and erythromycin(P=0.0040. But there was no significant difference between cefuroxime and fusidic acid. CONCLUSION: The predominant pathogen of non-bullous impetigo a well as bullous impetigo was SA which were highly resistant to erythromycin and highly sensitive to efuroxime and fusidic acid. In the clinical response, cefuroxinie and fusidic acid treatment were most effective and erythromycin was inadequate for treatment of impetigo.
Cefuroxime ; Coinfection ; Erythromycin ; Furosemide ; Fusidic Acid ; Humans ; Impetigo* ; Staphylococcus aureus ; Streptococcus ; Treatment Failure

No Abstract Available.
Alopecia* ; Telemedicine*

The shortage of available organ donors is a significant problem and various efforts have been made to avoid the loss of organ donors. Among these, extracorporeal membrane oxygenation (ECMO) has been introduced to help support and manage potential donors. Many traumatic brain injury patients have healthy organs that might be eligible for donation for transplantation. However, the condition of a donor with a fatal brain injury may rapidly deteriorate prior to brain death determination; this frequently results in the loss of eligible donors. Here, we report the use of venoarterial ECMO to support a potential donor with a fatal brain injury before brain death determination, and thereby preserve donor organs. The patient successfully donated his liver and kidneys after brain death determination.
Brain Death* ; Brain Injuries* ; Brain* ; Extracorporeal Membrane Oxygenation* ; Humans ; Kidney ; Liver ; Tissue and Organ Procurement ; Tissue Donors*

No Abstract Available.
Sezary Syndrome*

We observed 2 cases of occupational radiodermatitis which occurred during the radioisotope transpierce test. Patient 1, a 40-year-old man, noticed swelling, erythema, and stiffness on his left 2nd, 3rd, 4th, and 5th fingers 5 days after the exposure to about 2700 rem. Patient 2, a 32-year-old man, noticed painful swelling, erythema, bullae and necrosis on his right palm and thumb 1 week after the exposure to about 5500 rem. Clinicopathologically, patient 1 and 2 came under 2 and 3 burns respectively. The symptoms have been improving after treatment with systemic and topical corticosteroids and antibiotics.
Adrenal Cortex Hormones ; Adult ; Anti-Bacterial Agents ; Burns ; Erythema ; Fingers ; Humans ; Necrosis ; Radiodermatitis* ; Thumb

We observed a family with 12 members in four consecutive generations affected by hereditary epidermolytic palmoplantar keratoderma(HEPPK). The affected family members demonstrated not only autosomal dominant inheritance, but also a high penetrance and constant expression. The lesion of all affected person had developed at birth or within the first few weeks of life. The lesions of three members(the proband, her sister and mother) were biopsed, and all of them showed the characteristic features of epidermolytic hyperkeratosis. Two of family members(the proband, her nephew-not affected by HEPPK) had vitiligo, but we concluded that this coexistance was accidental.
Family Characteristics* ; Humans ; Hyperkeratosis, Epidermolytic ; Keratoderma, Palmoplantar, Epidermolytic* ; Parturition ; Penetrance ; Siblings ; Vitiligo ; Wills

OBJECTIVE: Our purpose was to investigate the relation between types of early diastolic notch and placental location and to evaluate the differences in perinatal outcomes. METHODS: We evaluated the Doppler waveform of the uterine artery in 149 pregnant women having an early diastolic notch after 26 weeks gestation, however we were unable to follow the obstetric outcomes in 20 women. Placental location was determined by transverse view of ultrasonography and classified as central and lateral placenta. The unilateral diastolic notches were divided into 3 groups depending on the placental location (ipsilateral: same side of the placenta, contralateral: opposite side of the placenta, and median: central placenta) RESULTS: In the bilateral notch group, the S/D ratio of the contralateral uterine artery was higher than the ipsilateral one(n=60, mean=3.22 Vs 2.80, p=0.0067). Of the 89 unilateral notches observed, the S/D ratio of the uterine artery in patients having early diastolic notch was higher compared to those without early diastolic notch.(t-test, mean=2.74,1.92, p=0.0001) Patients with bilateral notches were associated with poor perinatal outcomes significantly more than the patients with unilateral notches(p=0.003). Among the unilateral groups (ipsilateral: n=10, median: n=21, contralateral: n=58), there was no significant difference in perinatal outcomes. CONCLUSION: The early diastolic notch can be observed on both or either sides of the uterine artery independent on placental location. More bilateral notches were associated with poor pregnancy outcomes than unilateral notches. The pregnancy outcomes tended to be similar in unilateral notch irrespective of placental location, but showed worse outcomes than the control group. Careful analysis of the uterine artery in nonplacental side is necessary because of the frequent appearance of early diastolic notch and higher vascular resistance.
Female ; Humans ; Placenta ; Pregnancy ; Pregnancy Outcome ; Pregnant Women ; Rheology* ; Ultrasonography ; Uterine Artery* ; Vascular Resistance

Predisposing factors for venous thrombosis can be identified in the majority of patients with established venous thromboembolism (VTE). However, an obvious precipitant may not be identified during the initial evaluation of such patients. In the present case, a 47-year-old female presented to the emergency department of our hospital after ingesting multiple drugs. She had no VTE-related risk factors or previous episodes, nor any family history of VTE. After admission to the intensive care unit sudden hypoxemia developed, and during the evaluation cerebral, renal, and splenic infarctions with pulmonary embolisms were diagnosed. However, the sources of the emboli could not be identified by transthoracic echocardiography or computed tomography angiography. Protein C deficiency was identified several days later. We recommend that hypercoagulable states be taken into consideration, especially when unexplained thromboembolic events develop in multiple or unusual venous sites.
Angiography ; Anoxia ; Causality ; Echocardiography ; Emergency Service, Hospital ; Female ; Humans ; Infarction* ; Intensive Care Units ; Middle Aged ; Protein C Deficiency ; Pulmonary Embolism ; Risk Factors ; Splenic Infarction ; Thrombophilia ; Venous Thromboembolism ; Venous Thrombosis

Colchicine poisoning is rare but can cause potentially life-threatening toxic complications such as hypovolemic shock, cardiovascular collapse and multiple organ failure. In this case report, we describe a case of a 20-year-old female who presented to the emergency department after suicidal ingestion of a toxic dose of colchicine. She developed thrombocytopenia, neutropenia and acute respiratory distress syndrome that required blood transfusion and administration of granulocyte colony stimulating factor for the prevention of infectious complications. With regard to the clinical manifestations of colchicine toxicity, we discussed suggested mechanisms.
Blood Transfusion ; Colchicine* ; Colony-Stimulating Factors* ; Eating ; Emergency Service, Hospital ; Female ; Granulocytes* ; Humans ; Multiple Organ Failure ; Neutropenia ; Poisoning* ; Respiratory Distress Syndrome, Adult ; Shock ; Thrombocytopenia ; Young Adult