Confluent and reticulated papillomatosis(CRP) is a rare dermatosis. The lesions are hyperkeratotic, verrucous papules and plaques, resulting in a confluence of lesions centrally and a reticulated pattern at the periphery. It is more common in women and during puberty. The histopathological findings show papillomatosis, hyperkeratosis and a sparse superficial perivascular lymphocytic infiltrate. We report a case of CRP that responded to oral etretinate in an 18-year-old man.
Acitretin* ; Adolescent ; Etretinate* ; Female ; Humans ; Papilloma* ; Puberty ; Skin Diseases

Epithelioid hemangioendothelioma(EH) is a low-grade tumor of vascular endothelial cell origin, which most commonly occur in the lower extremities of middle-aged patients with an equal gender distribution. It may occur on internal organs such as the liver or lung or bones. A 54-year-old woman who had a history of metastatic adenocarcinoma of unknown origin on the right inguinal lymph node, was presented to us because of a 1.0 x 1.0cm-sized and 2 x 2cm-sized two subcutaneous nodule on her right shin. On H & E stain, there were nests of round nucleated, polygonal, vacuolated cells, some of which contained fragmented erythrocytes. Factor VIII related antigen, CD31 was positive. A diagnosis of epithelioid hemangioendothelioma was established based on histologic, immunohistochemical studies. Wide excision was performed. There was no recurrence nor the development of new lesions so far.
Adenocarcinoma ; Diagnosis ; Endothelial Cells ; Erythrocytes ; Female ; Hemangioendothelioma, Epithelioid* ; Humans ; Liver ; Lower Extremity ; Lung ; Lymph Nodes ; Middle Aged ; Recurrence ; von Willebrand Factor

Microsporum canis is one of the zoophiles and pets(especially dogs and cats) play a role as a source of this organism. M. canis is most likely transmitted by contact of these animal hosts with humans. We report on 16 foreigners who are infected with M. canis transmitted from a show tiger. Fourteen of the patients had directly contact with a show tiger on occasion. Patients showed typical tinea corporis lesions on the extremities, and the tiger showed hairless patches on the abdomen. The culture and microscopic findings from patients' lesions revealed M. canis as the causative fungus.
Abdomen ; Animals ; Dogs ; Emigrants and Immigrants ; Extremities ; Fungi ; Humans ; Microsporum* ; Tigers* ; Tinea

BACKGROUND AND OBJECTIVES: Intratympanic gentamicin injection is used as one of the treatment modalities for medically intractable Meniere's disease. But the ideal dosage and concentration of gentamicin were not established in consideration of therapeutic efficacy and the risk of postoperative hearing loss. We analyzed the clinical outcome of low-concentration intratympanic gentamicin injection in patients with Meniere's disease. And we also tried to find factors anticipating for the response to treatment. SUBJECTS AND METHOD: A retrospective review was conducted on 45 subjects who had been diagnosed as 'definite' Meniere's disease (AAO-HNS, 1995) and had no response to medical treatment over 3 months in our clinic. The concentration of gentamicin was 7 mg/cc, which was very low compared with previous studies. We reviewed postoperative changes on vertigo, tinnitus and hearing by questionnaire and pure tone audiometry. We also analyzed preoperative patients' characteristics for acquisition of predictive factors of treatment response. RESULTS: Vertigo was completely disappeared in 37 (82%) patients and there was no vertigo improvement in 8 (18%) patients despite multiple injections. Tinnitus was controlled in 11 (24%) patients, and aggravated in 4 (8%) patients. A significant postoperative hearing loss over 10 dB occurred in only 6 (13%) patients. Preoperative patients' hearing threshold, frequency of vertigo, functional level and finding in electrical test, such as electrocochleogram, were not different regarding treatment response. CONCLUSION: Low-concentration gentamicin was enough to control vertigo and could reduce the risk of postoperative hearing loss in patients with Meniere's disease.
Audiometry ; Gentamicins ; Hearing ; Hearing Loss ; Humans ; Meniere Disease ; Surveys and Questionnaires ; Retrospective Studies ; Tinnitus ; Vertigo

BACKGROUND: Patent foramen ovale (PFO) is increasingly being recognized in stroke patients. The capability of transcranial Doppler (TCD) to detect a PFO has been established. We studied the frequency of PFO in patients with ischemic stroke. METHODS: Eighty-nine patients with ischemic stroke (62 men, mean age: 56.5) consecutively underwent a contrast-enhanced TCD with monitoring of the bilateral middle cerebral arteries (MCA). The contrast solution, which consisted of 8 ml of normal saline, 1 ml of air, and 0.2 ml of patient's blood, was injected twice during normal breathing and the Valsalva maneuver. High intensity transient signals (HITS) were counted for 30 seconds after the injection. RESULTS: Patent foramen ovale was detected in 19 patients (21%). The mean age was similar in those with (55 years) and those without (57 years) PFO. Patent foramen ovale was more frequent among men (26%) than women (11%). There were no differences in the frequency of PFO among stroke subtypes (large artery atherosclerosis, 18%; small artery occlusion, 27%; cardioembolic, 27%; undetermined cause, 11%). CONCLUSIONS: Patent foramen ovale is common in patients with ischemic stroke of all subtypes.
Arteries ; Atherosclerosis ; Female ; Foramen Ovale, Patent* ; Humans ; Incidence* ; Male ; Middle Cerebral Artery ; Respiration ; Stroke* ; Valsalva Maneuver

PURPOSE: To describe the characteristics of CT findings in nasal lymphoma. MATERIALS AND METHODS: We retrospectively reviewed CT findings and pathologic findings of eight patients (six males and two females) aged between 24 and 68 years with pathologically-proven nasal lymphoma. We analyzed mass location, laterality, size, margin, mass effect, adjacent bony change and contrast enhancement pattern. RESULTS: All eight cases werenon-Hodgkin's lymphoma, intermediate grade, diffuse large cell type. Seven cases were B-cell type and one was T-cell. In all cases, tumors were located in the medial wall of the inferior turbinate. In four cases, they were also found in the anterior ethmoidal sinus, and in one case, in the nasal septum. The mean size of the main mass was 3.3 cm. In seven cases, tumors were unilateral (one on the right; six on the left), and in the remaining case, bilateral. In six cases tumor margin was smooth and in two cases focal nodularity was seen. In two cases there was no bony change, and in four, there was mucosal thickening along the nasal septum; in one of these four, minimal bony erosion was also found. In the other two cases, bony destruction was seen, and tumors were very large (7 cm in diameter) or bilterally located. In three cases, the nasal septum was displaced by the mass. In all cases with bony change, the nasal septum was involved. All tumors were homogeneously well enhanced after IV contrast administration. CONCLUSION: The main CT findings of nasal non-Hodgkin's lymphoma were smooth margin, unilateral location (mainly in the medial wall of the inferior turbinate and growing to the medial side without bony destruction) mucosal thickening along the nasal septum and clear homogeneous enhancement after IV contrast administration. These characteristics will help diagnosis, help determine the appropriate region for radiation and other appropriate therapy, and facilitate prognosis in patients with nasal non-Hodgkin's lymphoma.
B-Lymphocytes ; Diagnosis ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Male ; Nasal Septum ; Prognosis ; Retrospective Studies ; T-Lymphocytes ; Turbinates

BACKGROUND: The National Institutes of Health Stroke Scale (NIHSS) is regarded as a valid and reliable tool to measure the severity of neurological deficits in acute stroke, but has been criticized for its complexity and variability. Therefore, the modified NIHSS (mNIHSS) was developed, eliminating redundant and less reliable items from the full version of the NIHSS. The aim of the present study was to evaluate the validity of the mNIHSS according to the subtypes of stroke and the location of affected arterial territories. METHODS: The severity of stroke in 155 patients with acute cerebral infarction was measured. Each patient was evaluated by two neurologists using both the NIHSS and mNIHSS, and the stroke subtype was determined according to the TOAST classification. The vascular territory of lesion was classified into an anterior and posterior circulation. The criterion-related validity was evaluated by the Pearson Correlation Coefficient between the NIHSS and mNIHSS scores. RESULTS: When considering the NIHSS scores as the gold criteria, the Pearson correlation coefficients of the mNIHSS were 0.96 in the subtype of large artery atherosclerosis, 0.91 in small vessel occlusion, 0.98 in cardioembolism, and 0.99 in undetermined etiology. On the other hand, the correlation coefficient was 0.98 in patients with an anterior circulation infarction, and was 0.94 in patients with a posterior circulation infarction. CONCLUSIONS: The criterion-related validity of the mNIHSS scoring system was very high in general. However, the correlations were relatively low in patients with the TOAST subtype of small vessel occlusion and also a posterior circulation infarction.
Arteries ; Atherosclerosis ; Cerebral Infarction* ; Classification* ; Hand ; Humans ; Infarction ; National Institutes of Health (U.S.) ; Stroke*

BACKGROUND: Intravenous hypnotics are used in pregnancy, labor and delivery. The aim of the present study was to investigate and compare the relaxant effects of propofol, thiopental, ketamine, and etomidate on isolated rat uterine smooth muscles. METHODS: Uterine smooth muscle preparations were obtained from non-pregnant female rats. The uterus of the rat was dissected and cut into 10 mm strips. The muscle strips were bathed in Krebs solution. After spontaneous uterine contractile activity had been accomplished, propofol, ketamine, thiopental, and etomidate in various concentrations were added cumulatively to the baths and resting tension, active tension, and frequency of contration were recorded at each concentration of agents. EC(5), EC(25), EC(50), EC(75), and EC(95) of each drug on active tension and frequency of contraction were calculated using a probit model. RESULTS: Propofol, thiopental, and etomidate reduced uterine contractions in a concentration-dependent manner. Ketamine concentrations of 10(-7) to 10(-5) M augmented uterine contractions but ketamine concentrations of 10(-4) to 10(-3) M attenuated uterine contractions. The EC(50)'s of propofol, thiopental, ketamine, and etomidate on active tension were 1.56 x 10(-5) M, 4.97 x 10(-5) M, 3.52 x 10(-4) M, and 2.73 x 10(-5) M, respectively. CONCLUSIONS: All four intravenous hypnotics relaxed the uterine smooth muscle of rats except for ketamine in low concentrations (10(-7) to 10(-5) M). Propofol had the greatest relaxant effects on isolated rat uterine smooth muscle among these hypnotics. It seems that ketamine is a suitable obstetric hypnotic agent for hypovolemic parturients and propofol is a useful hypnotic agent for uterine relaxation during pregnancy.
Animals ; Baths ; Contracts ; Etomidate ; Female ; Humans ; Hypnotics and Sedatives ; Hypovolemia ; Isotonic Solutions ; Ketamine ; Muscle, Smooth ; Muscles ; Pregnancy ; Propofol ; Rats ; Relaxation ; Thiopental ; Uterine Contraction ; Uterus

BACKGROUND: As the elderly population is fast growing, the incidence of stroke is also increasing. We studied the clinical characteristics of nonagenarian stroke compared to a population of patients under the age of ninety. METHODS: Subjects included 44 nonagenarian stroke patients and 22,227 control patients aged under ninety. Clinical characteristics including age, sex, risk factors, stroke subtype, and outcome (one-year prognosis, evaluated by a modified Rankin scale) were analyzed. RESULTS: The proportion of nonagenarian stroke accounted for 0.2% of all cases of stroke. Ischemic stroke was more common than hemorrhagic stroke in the nonagenarian group. In addition, the female gender was more frequent (p<0.01). As the patients were older, their admission period was shorter, the discharge against medical advice was increased, and the mortality was higher. Hypertension and atrial fibrillation were significantly higher (p<0.05, p<0.001, respectively) in the nonagenarian ischemic stroke patients. CONCLUSIONS: Nonagenarian stroke patients have unique clinical characteristics compared with stroke patients under the age of ninety.
Aged ; Aged, 80 and over* ; Atrial Fibrillation ; Female ; Humans ; Hypertension ; Incidence ; Mortality ; Prognosis ; Risk Factors ; Stroke*