We report a rare case of sporadic keratosis punctata palmaris et plantaris in a 49-year-old woman. Thirty years ago, firm semitranslucent papules developed on the middle portion of her palms without any subjective symptom. The lesions had flat-topped smooth surfaces. They were concentrated along the margins of the hands, especially on the lateral surfaces of both index fingers and finger tips/ Ten years ago, similar hyperkeratotic papules with or without central craters developed on the weight bearing portions of her soles. Her family and past histories were negative. The biopsy specimen revealed a dense hyperderatotic stratum corneum which fitted into a cup shaped depression in the stratum malpighii and a turning inward of the rete ridges at the margin. The Masson trichrome and elastic strains showed no peicific dermal changes.
Biopsy ; Depression ; Female ; Fingers ; Hand ; Humans ; Keratosis* ; Middle Aged ; Weight-Bearing

A 33-year-old man with alopecia totalis presented with facial erythema and flares, conjunctival injection, and dyspnea developed within several minutes following the ninth application of dinitrochlorobenzene (DNCB). A scratch skin test produced positive reactions in concentrations of 0.01, 0.05, 0.1% DNCB showing flares and wheals, whereas concentrations of 0.001, 0.01, 0.05% diphenylcyclopropenone (DPCP) showed negative results. Contact urticaria due to DNCB is very rare, but this complication must be fully noted because of the widespread and frequent use of DNCB in dermatotherapeutic fields. We report herein a rare case of contact urticaria following topieal application of DNCB in the treatment of alopecia totalis.
Adult ; Alopecia ; Dinitrochlorobenzene* ; Dyspnea ; Erythema ; Humans ; Skin Tests ; Urticaria*

A 34-year-old man visited our hospital with alopecia areata on the occipital scalp, which began to develop two months prior to his visit. He was sensitized with 0.2% diphenylcyclopropenone(DPCP) in acetone that was applied to the inner side of his right arm. Two weeks after sensitization, we applied DPCP on his bald lesion once weekly for skin challenge. Following the third application of DPCP, polycyclic erythematous target-like lesions developed around the sensitized area. A clinical diagnosis of erythema multiforme was made. Histologically, the target-like lesion showed few eosinophilic dyskeratosis, exocytosis, and hydropic de-generation of basal layer in the epidermis, and mononuclear infiltration around superficial blood vessels in the dermis. We report herein a rare case of erythema multiforme following topical application of DPCP in the treatment of alopecia areata. This complication must be noted because of the wide-spread and frequent use of DPCP in dermatotherapeutic fields.
Acetone ; Adult ; Alopecia Areata ; Arm ; Blood Vessels ; Dermis ; Diagnosis ; Eosinophils ; Epidermis ; Erythema Multiforme* ; Erythema* ; Exocytosis ; Humans ; Scalp ; Skin

A 25-year-old woman transferred to pain clinic complaining of severe throbbing eye ball pain, eyelid edema and severe tearing in her left eye under the diagnosis of herpes zoster ophthalmicus that was developed 3months ago. In addtion to conventional medication, she had been taken stellate ganglion block, supraorbital and supratrochlear nerve block to contol of pain, but the response was poor. So we tried to administer ketamine subcutaneously, because not only ketamine, NMDA receptor antagonist, played a significant role to reduce neuropathic pain and pain caused by nerve injury, but also she wanted to work in her office during the treatment. We used subcutaneous ketamine 3 mg/hr (0.06 mg/kg/hr) in patient with postherpetic neuralgia of the ophthalmic nerve, and accomplished almost complete pain relief without any sign of side effect.
Adult ; Diagnosis ; Edema ; Eyelids ; Female ; Herpes Zoster Ophthalmicus ; Humans ; Infusions, Subcutaneous* ; Ketamine* ; N-Methylaspartate ; Nerve Block ; Neuralgia ; Neuralgia, Postherpetic* ; Ophthalmic Nerve* ; Pain Clinics ; Pain Management* ; Stellate Ganglion

A rostro-caudal topography of the oculomotor nerve fascicles is relatively well known in animal but not in human. We experienced two cases of midbrain infarctions presenting with isolated oculomotor nerve palsies. The MRI of the patient who had monocular elevation palsy with ptosis revealed a lesion in the middle to lower midbrain, whereas that of the other who had monocular depression and adduction palsy with pupillary mydriasis showed a discrete lesion in the upper to middle midbrain. We present the rostro-caudal arrangement of the oculomotor fascicles within midbrain based on MRI findings.
Animals ; Depression ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Mesencephalon* ; Mydriasis ; Oculomotor Nerve ; Oculomotor Nerve Diseases ; Paralysis

No abstract available.
Antibodies* ; Arthritis, Rheumatoid* ; Rheumatoid Factor

No abstract available.
Ceruloplasmin* ; Cholesterol, HDL* ; Copper* ; Humans ; Infant, Newborn* ; Iron* ; Zinc*

Supernummerary breast is a rare developmental anomaly occurring along the course of the embryological milk lines, which run from the anterior axillary folds to the inner thighs. Kajava first described the classification of supernumerary tissue in 1915, and this term is still in use. We herein report two cases of supernumerary breast, classified as Kajava classification type 3 and 6.
Breast* ; Classification ; Milk ; Thigh

Continuous assessment of arterial oxygenation is important in the clinical management of critically ill patients. Analysis of arterial blood gas is reliable but is invasive and only provides intermittent informations. In order to determine the accuracy of pulse oximeters in ICU patients, arterial oxygen saturation was measured in 58 patients in ICU using two kinds of pulse oximeters (Ohmeda, CSI), while simutaneously analyzing arterial blood gases. The relationship between the pulse oximeters saturation (SpO2) and arterial oxygen saturation (SaO2) was evaluated, Group l consisted of 102 samples of SpO2 using an Ohmeda pulse oximter in 45 of 72 patients. Group ll included 102 samples of SpO2 using a CSl pulse oximeter in 45 of 72 patients. Both Ohmeda and CSI pulse oximeters were applied to 32 patients. Group lll had 204 samples, thE Sum of Groups l and ll. The results were as follow ; 1) The correlation coefficients of SpO2 to SaO2 in Groups l, ll and lll were 0.97, 0.90 and 0.96 (p < 0.775). 2) Mean difference between SaO2 and SpO2 in Groups l, ll and lll were almost within the limit of 1%. 3) The correlation coefficient of SpO2 between Ohmeda andcsr pulse oximeter was 0.79, and there was no mean difference between them in the 32 patients who were tested with both the Ohmeda and the CSI pulse oximeters. In conclusion, a pulse oximter is an accurate noninvasive device which assesses arterial oxygenation and provides information continuously. Wider clinical indication will follow.
Critical Illness ; Gases ; Humans ; Oximetry* ; Oxygen

No abstract available.
Stomach Neoplasms* ; Stomach* ; Water*