A 54-year-old woman with severe bullous pemphigoid (BP) associated with insulin dependent diabetes mellitus (DM), who showed unresponsiveness to conventional therapy with corticosteroids in combination of either cyclosporme or dapsone, was successfully treated with plasmapheresis followed each time by 3 successive days of pulse therapy of cyclophosphamide (500mg, intravenously). After six times of plasmapheresis, anti-basement membrane zone (BMZ) antibody titer decreased from 1:1280 to 1:40 and no new lesions developed at all. In severe refractory BP patients with uncontrolled DM, plasmapheresis is one of the valuable treatment modalities for a short period and the need for corticosteroids thus avoiding corticosteroid induced side effects. Herein we report a case of BP with uncontrolled DM who showed an excellent response to a low dose of corticosteroid and 150 mg oral azathioprine following plasmapheresis and cyclophosphamide pulse therapy.
Adrenal Cortex Hormones ; Azathioprine ; Cyclophosphamide* ; Dapsone ; Diabetes Mellitus ; Female ; Humans ; Insulin ; Membranes ; Middle Aged ; Pemphigoid, Bullous* ; Plasmapheresis*

No abstract available.
Lichens*

We present a case of onychogryphosis of both great toe nails associated with onychomycosis of all toe nails occurring in a 90-year-old female patient. She also had senile dementia. Affected nail plates were thickened, increased in length, and curved like the horn of a ram. The nail plates were removed surgically form the nail bed. Direct microscopic examination revealed many hyphae with potassium hydroxide. Trichophyton rnbrum was isolated from the culture in Sabouraud glucose agar media. On histopathologic examination, we found many hyphae in the nail plate. We suggest an onychomycosis as one of the causes of onychogryphosis.
Agar ; Aged, 80 and over ; Alzheimer Disease ; Animals ; Female ; Glucose ; Horns ; Humans ; Hyphae ; Onychomycosis* ; Potassium ; Toes ; Trichophyton

Objectives : A diverse range of adverse effects has been linked to the application of antidepressants for the treatment of depressive disorder. Recently, evidence has been emerging of the adverse metabolic effects of antidepressants. This study investigated the effects of antidepressants on plasma glucose and other factors in the fat and muscle tissue relating to metabolism. METHODS : Long-Evans-Tokushima-Ostuka (LETO) rats were used to evaluate the effects of different antidepressants. Amitriptyline, fluoxetine, and mirtazapine were administered to each of three subgroups for 4 weeks, between 11 and 15 weeks old, while a fourth subgroup was administered no antidepressant during the same period. Changes of weight and daily intake were monitored. Tissues and blood were collected at 15 weeks. RESULTS : The fluoxetine subgroup showed lower weight gain and lower food efficacy ratio than did the other subgroups. Blood glucose and other circulating factors showed no significant differences among groups, except for the leptin levels of the fluoxetine subgroup. However, the amitriptyline and mirtazapine subgroups showed similar patterns in the response of mRNA expression of peroxisome proliferator-activated receptors gamma cofactor-1 and uncoupling protein-1, 2, 3. CONCLUSION : These results could indicate possible differences in metabolic response based on the kind of antidepressant used.
Amitriptyline ; Animals ; Antidepressive Agents ; Blood Glucose ; Depressive Disorder ; Energy Metabolism ; Fluoxetine ; Glucose ; Leptin ; Mianserin ; Muscles ; Peroxisome Proliferator-Activated Receptors ; Plasma ; Rats ; RNA, Messenger ; Weight Gain

Thyroid dysfunction has heen reported as a side effect of alpha-interferon(IFN) therapy. The incidence of thyroid disorders was 1.2-12%' duripg 1FN therapy for chronic active hepatitis. We experienced a case of hypothyroidism developed after IFN therapy in a 48 year-old man with chronic hepatitis B. Baseline thyroid function before IFN therapy was normal and thyroid auioantibodies were also negative. High tiers ol' antimicrosomal antibody and anti-thyroglobulin antibody appeared and severe hypothyroidism followed at 6 months after starting the IFN therapy.
Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Hypothyroidism* ; Incidence ; Interferon-alpha* ; Middle Aged ; Thyroid Gland

Parakeratosis pustulrisa occurs most often on the upper cxtiemities of girls and that is considered to be a variant of either eczema or psoriasis. It presents with scaling of the tip of the finger, subungual hyperkeratosis, and irregular t.hickening and rumblirg of the distal nail plate. We report a 4-year-old female child patient, who showed spon.aneous nail extraction with erythematous scaly path with pustule formation on the left thumb, ring finger and right middle finger nails. The microbiologic and mycologic examinaiors revealed negative results. Histopathologic examination showed focal parakeratosis of the nail bed and the lower part of the nail plate. We treated her with etretinate(Tigason, 0.6mg/kg/day).
Child ; Child, Preschool ; Eczema ; Etretinate ; Female ; Fingers ; Humans ; Parakeratosis* ; Psoriasis ; Thumb

No Abstract Available.

Sparganosis is an infection caused by the migrating larvae of the cestode genus Spirometra. The most common clinical presentation of a sparganosis is a slow-growing, sometimes migratory, sub-cutaneous mass. In this report, a case of eosinophilic panniculitis by sparganum in a Korean woman is presented. The diagnosis was confirmed from the histopathologic findings, the micro-ELISA tests and a living sparganum derived from the patient while excising the new lesion
Cestoda ; Diagnosis ; Eosinophils* ; Female ; Humans ; Larva ; Panniculitis* ; Sparganosis* ; Sparganum ; Spirometra

Background: Intra-articular distal humeral fractures can be surgically challenging. It remains under discussion whether open reduction internal fixation (ORIF) or total elbow arthroplasty (TEA) is more beneficial for treatment of the elderly. This study aimed to compare the clinical and functional outcomes of ORIF and TEA for managing intra-articular distal humerus fractures in patients aged 65 years or older. Methods: Patients who underwent ORIF (n=28) or TEA (n=43) for in intra-articular distal humerus fracture between May 2008 and December 2018 were reviewed. Range of motion, Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, radiologic outcomes, and surgical complications were evaluated at the final follow-up visit. Results: The ORIF and TEA groups showed a mean arc of flexion–extension of 97°±21° and 101°±12°, respectively. The mean MEPS and DASH scores were 94±15 and 27±12 points, respectively, in the ORIF group and 81±27 and 47±28 points in the TEA group. This difference was statistically significant. The incidence of total complications was similar between the groups. Conclusions In patients older than 65 years with intra-articular distal humerus fracture, ORIF had better outcomes than TEA.

No abstract available.
Connective Tissue Diseases* ; Connective Tissue* ; Heart Block* ; Heart* ; Humans ; Mothers* ; Twins*