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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*

This study was conducted to assess the referral patterns to specialist from general practitioners in health center and perceived needs of referred patients for specialist care in health center. The study subjects were 249 patients who visited to health centers and were referred to other medical facilities. The data were obtained from questionnaire survey which was conducted in Kyongjuu-city Health center, Seongju-Gun Health center and Koryong-Gun Health center in Kyongsangbuk-Do, from June 10 to october 17, 1995. The total referral rate was 2.7%. The proportion of patients who wished to be referred to medical specialists was 85.9%, and the proportion of patients referred by general practitioners in health centers was 14.1%. Among the patients who wished to be referred to medical specialists, 45.9% visited directly to health centers, 34.6% visited health centers via local clinics and 19.5% visited health centers to get referral permission only. The reasons for getting referral permission in health centers were easy geographical accessibility(34.6 %), easy to get referral permission in health centers(27.l%), and very difficult to get referral permission in local clinics(l6.4%). Among the diseases of referred patients, diseases of the musculoskeletal system and connective tissue were most prevalent on a whole, but diseases of nervous system and sensory organs were comparatively high among the patients who wished to be referred to medical specialists and infectious and parasitic diseases were comparatively high among the patients referred by general practitioners in health centers. The most favorable medical facility was general hospital including university hospital in both groups of patients who wished to be referred to medical specialist and the patient referred by general practitioners in health centers. Regarding the needs for specialist care in health center, 75.2% patients who wished to be referred to medical specialists and 74.3% of patients referred by general practitioners in health center wanted the specialist care. The most frequently requested speciality is internal medicine(47.1%), and then orthopedics and general surgery. Based on above results, this study revealed that the majority of patients referred from health center wished to be referred to medical specialists at their own will, so, referral system at health center level should be changed. And if specialist care in health center be provided, the medical care by internist could be provided first, and then that of orthopedics and general surgery could be provided. These kinds of medical cares could be covered by local clinicians as a part-time job on a voluntary basis.
Connective Tissue ; General Practitioners ; Gyeongsangbuk-do ; Hospitals, General ; Humans ; Musculoskeletal System ; Nervous System ; Orthopedics ; Parasitic Diseases ; Surveys and Questionnaires ; Referral and Consultation* ; Specialization*

No abstract available.
Hirschsprung Disease*

This study was performed in order to explore the immunologic relationship between the skin lesions induced by the human serum and the lymphatic organs. For these purposes, the authors induced the dermatitis in the rabbits by the injections of pooled human serum with Freunds complete adjuvant into the skin, and administered prednisolone and azathioprine as immunosuppressive drugs to the rabbits. Immunologic asmy was performed by the measurement of the plasma ceIls and immunogobulin-bearing B lymphocytes in lymph node and spleen. The results were as follows: 1. By the injections of human serum pyroninophilic cells and immunoglobulining B lymphocytes in lymph node and spleen were increased. 2. By the administrations of prednisolone and azathioprine, pyroninophilic cells and immunoglobulin-bearing B lymphocytes in lymph node and spleen were all decre RSCd.
Azathioprine ; B-Lymphocytes ; Dermatitis* ; Humans ; Immunoglobulins ; Lymph Nodes ; Plasma ; Prednisolone ; Rabbits* ; Skin ; Spleen

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*

No abstract available.
Seat Belts*