An 18-year-old man had suffered from intense burning with redness and an increased temperature of both the lower legs, forearms and hands since the age of 5. Symptoms were exacerbated by exposure to heat or walking. The patient obtained temporary relief by immersing his feet and hands in cold water. We observed the increase of skin temperature in relation to pain by thermography. No specific abnormalities were noted in laboratory studies. Treatment with aspirin was ineffective. We report a rare case of primary erythermalgia with typical features.
Adolescent ; Aspirin ; Burns ; Erythromelalgia* ; Foot ; Forearm ; Hand ; Hot Temperature ; Humans ; Leg ; Skin Temperature ; Thermography ; Walking ; Water

PURPOSE:Craniopharyngioma is one of the most common causes of organic growth hormone deficiency leading to pituitary hormonal insufficiency. However, some growth hormone(GH)-deficient children with craniopharyngioma may grow normally or even show accelerated growth. This study was designed to evaluate several factors associated with growth of patients with craniopharyngioma. METHODS:Forty children operated on for craniopharyngioma were evaluated for their pituitary function, serum insulin like growth factor-I(IGF-I), serum insulin like growth factor binding protein-3(IGFBP-3) and serum prolactin levels. We also observed their growth status and corresponding changes with or without GH treatment. RESULTS:Among 40 patients, one had normal pituitary hormonal status and one had isolated GHD(GH deficiency). The other patients showed multiple pituitary hormone deficiency including GH(98%), LH, FSH(75%), TSH(65%), ACTH(62%), and ADH(38%) deficiencies. Patients with GHD were categorized into 2 groups. Group 1 consisted of children who showed normal growth, thus had not received GH treatment(n=14) and Group 2, those who showed subnormal growth(n=25). Patients in Group 2 were subdivided into Group 2A, when the patients had not received GH treatment in spite of subnormal growth(n=9) and Group 2B, when GH treatment had been added later on(n=16). There were no differences in the age at diagnosis of GHD, initial height standard deviation score(Ht SDS), body mass index(BMI), peak GH concentration between Group 1 and Group 2. Height velocities in Group 1, 2A, and 2B were 8.1+/-.2 cm/yr, 2.4+/-.2 cm/yr, 2.7+/-.2 cm/yr during the first year of endocrinologic follow-up, 7.1+/-.8 cm/yr, 1.2+/-.1 cm/yr, 7.6+/-.7 cm/yr during the second year, 5.9+/-.0 cm/yr, 2.8+/-.9 cm/yr, 7.3+/-.7 cm/yr during the third year, respectively. BMI changes during the first year of endocrinologic follow-up and postoperative prolactin levels were not significantly different between Group 1 and Group 2A. Postoperative IGF-I and IGFBP-3 levels in Group 1 were significantly higher than those in Group 2A(P<0.05). Both IGFBP-3 and prolactin levels correlated significantly with height velocity in Group 1 and 2A(P=0.004 r=0.64 and P= 0.035 r=0.74 , respectively). CONCLUSION: In this study, growth in children with craniopharyngioma was likely to be associated with IGF-I, IGFBP-3 and prolactin levels. Further studies are needed to unravel other growth promoting factors related to GH independent growth.
Child* ; Craniopharyngioma* ; Diagnosis ; Follow-Up Studies ; Growth Hormone ; Humans ; Insulin ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Prolactin

No abstract available.
Arteries* ; Female ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Umbilical Arteries*

Genital melanosis is an acquired, irregular, brown to black discoloration of the glans or shaft of the penis, or of the vulva and vagina. Although genital melanosis seems similar to malignant melanoma clinically, the histologic findings of genital melanosis show basal layer hyperpigmentation with or without melanocytic hyperplasia and no atypia of the melanocytes. We report a rare case of genital melanosis ; a vulvar melanosis.
Hyperpigmentation ; Hyperplasia ; Male ; Melanocytes ; Melanoma ; Melanosis* ; Penis ; Vagina ; Vulva

We report a case of cutaneous calcinosis following extravasation of calcium calcium chloride in a 3-week old neonate, After extravasation of 3% calcium chloride infusion, rapid and marked swelling, erythema, and signs of soft tissue necrosis developed over the extensor surface of both upper extremities. Through the small channels of the destroyed epidermis, tiny white pieces of calcific masses were eliminated spontaneously. Histologically the calcium deposits were found as amorphous masses in the upper dermis and the discharge of calcium deposits also took place by means of transepidermal elimination. The central bone formation and surrounding calcium deposition were present along with dense lymphohistiocytic cell infiltration in the deep dermis. Complications of extravasation of calcium solution during intravenous infusion included localized calcification and, ocasionally necrosis. The incidence of compllcations was about eight percent. This is a case which again emphasises of the danger of using calcium chloride intravenously in the neonate or young infant.
Calcinosis* ; Calcium Chloride* ; Calcium* ; Dermis ; Epidermis ; Erythema ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infusions, Intravenous ; Necrosis ; Osteogenesis ; Upper Extremity

No abstract available.
Food Hypersensitivity* ; Humans ; Immunoglobulin E*

No abstract available.
Thyroid Gland*

BACKGROUND: The Histidine-Tryptophan-Ketoglutarate (HTK) solution has been shown to provide the excellent myocardial protection as a cardioplegia. The HTK solution has relatively low potassium as an arresting agent of myocardium, and low sodium content, and high concentration of histidine biological buffer which confer a buffering capacity superior to that of blood. Since HTK solution has an excellent myocardial protective ability, it is reported to protect myocardium from ischemia for a considerable time (120 minutes) with the single infusion of HTK solution as a cardioplegia. The purpose of this study is to evaluate the cardioprotective effect of HTK solution on myocardium when the ischemia is exceeding 120 minutes at two different temperature (10 to 12degrees C, 22 to 24degrees C) using the Langendorff apparatus. MATERIAL AND METHOD: Hearts from Sprague-Dawley rat, weighing 300 to 340 g, were perfused with Krebs-Henseleit solution at a perfusion pressure of 100 cm H2O. After the stabilization, the heart rate, left ventricular developed pressure (LVDP), and coronary flow were measured. Single dose of HTK solution was infused into the ascending aorta of isolated rat heart and hearts were preserved at four different conditions. In group 1 (n=10), hearts were preserved at deep hypothermia (10~12degrees C) for 2 hours, in group 2 (n=10), hearts were preserved at moderate hypothermia (22~24degrees C) for 2 hours, in group 3 (n=10), hearts were preserved at deep hypothermia for 3 hours, and in group 4 (n=10), hearts were preserved at moderate hypothermia for 3 hours. After the completion of the preservation, the heart rate, left ventricular developed pressure, and coronary flow were measured at 15 minutes, 30 minutes, and 45 minutes after the initiation of reperfusion to assess the cardiac function. Biopsies were also done and mitochondrial scores were counted in two cases of each group for ultrastructural assessment. RESULT: The present study showed that the change of heart rate was not different between group 1 and group 2, and group 1 and group 3. The heart rate was significantly decreased at 15 minutes in group 4 compared to that of group 1 (p<0.05 by ANCOVA). The heart rate was recovered at 30 minutes and 45 minutes in group 4 with no significant difference compared to that of group 1. The decrease of LVDP was significant at 15 minutes, 30 minutes and 45 minutes in group 4 compared to that of group 1 (p<0.001 by ANCOVA). Coronary flow was significantly decreased at 15 minutes, 30 minutes, and 45 minutes in group 4 compared to that of group 1 (p<0.001 by ANCOVA). In ultrastructural assessment, the mean myocardial mitochondrial scores in group 1, group 2, group 3, and group 4 were 1.02+/-0.29, 1.52+/-0.26, 1.56+/-0.45, 2.22+/-0.44 respectively. CONCLUSION: The HTK solution provided excellent myocardial protection regardless of myocardial temperature for 2 hours. But, when ischemic time exceeded 2 hours, the myocardial hemodynamic function and ultrastructural changes were significantly deteriorated at moderate hypotherma (22~24degrees C). This indicates that it is recommended to decrease myocardial temperature when myocardial ischemic time exceeds 2 hours with single infusion of HTK solution as a cardioplegia.
Animals ; Aorta ; Biopsy ; Cardioplegic Solutions ; Heart Arrest, Induced ; Heart Rate ; Heart* ; Hemodynamics ; Histidine ; Hypothermia ; Ischemia ; Myocardium ; Organ Preservation ; Perfusion ; Potassium ; Rats* ; Rats, Sprague-Dawley ; Reperfusion ; Sodium

We report a case of sarcoidosis which developed in the skin, lung and eyes in a 50-year-old woman. The skin lesions showed two types of cutaneous manifestations which were subcutaneous nodules on her back and erytrematous papules on the face for several months. Our patient's seurm angiotensin converting enzyme (ACE) level was elevated at 33.5 IU/L(reference range, 8.3-21.4 IU/L) and the purified protein derivative(PPD) skin test had a negative result. On her roentgenographic examinations, we could find multiple nodular densities with hazziness on both her lungs and radionuclides(Gallium 67) uptakes in right lower lung field. The ratio of helper to suppressor T cells was 9 in bronchial lavage. Diagnosis of sarcoidosis was made on the basis of histologic findings of non-caseating granulomas from skin and lung tissue. Treatment was initiated with oral alternate-day prednisone 40mg. The cutaneous lesions and dyspnea improved in 2 and 4 weeks respectively, and serum ACE level returned to normal in 2 months.
Bronchoalveolar Lavage ; Diagnosis ; Dyspnea ; Female ; Granuloma ; Humans ; Lung ; Middle Aged ; Peptidyl-Dipeptidase A ; Prednisone ; Sarcoidosis* ; Skin ; Skin Tests ; T-Lymphocytes

No abstract available.
Humans ; Infant, Newborn*