Generalized perforating granuloma annulare is a rare variant of granuloma. annulare, which was first described by Duncan et al 1) in 1973. A 21-year-old female had hundreds of 3 to 5mm papules over the whole body, which were mainly distributed in the extremities and trunk since three months ago. Individual papules developed a central umbilication with a peripheral collarette of scale. Histopathologic examination showed an epidermal perforation and transepidermal elimination of necrobiotic material. The epidermal perforation communicated with areas of necrobiotic collagen surrounded by palisading granulorna in the dermis. We treated her with oral prednisolone and dapsone, but there was no clinical improvement.
Collagen ; Dapsone ; Dermis ; Extremities ; Female ; Granuloma Annulare* ; Granuloma* ; Humans ; Prednisolone ; Young Adult

PURPOSE: Norepinephrine has modulatory effects on neuronal excitability and, in some cases, has a proconvulsant effect. Intraperitoneal imipramine treatment increases norepinephrine level, and to a lesser extent, dopamine and serotonin in brain dialysate from rats. We sought to determine the effects of imipramine on pilocarpine-induced seizures in the immature rats. METHODS: Right and left cortical and hippocampal electrodes were placed in 10~15 day old Sprague-Dawley rats. The following day 3-hour video EEG recordings were obtained to monitor electrographic seizures and status epilepticus induced by intraperitoneal injection of high dose(200mg/kg : HD) and low dose (75mg/kg : LD) pilocarpine. A first group of rats received HD pilocarpine alone(n=25), or pretreatment with 0.5(n=6). 1(n=6), 2(n=6), 5(n=6), or 10(n=11)mg/kg of imipramine. A second group of rats received LD pilocarpine alone(n=6) or pretreatment with 2mg/kg of imipramine (n=6). Data were analyzed using the Fisher exact test. RESULTS: Treatment with HD pilocarpine alone resulted in electrographic seizures in 76%(n=19) and status epilepticus in 44%(n=11). In the HD pilocarpine group, status epilepticus was seen in 100% of rats pretreated 1, 2, and 5mg/kg imipramine. 90.9% of the rats pretreated with 10mg/kg of imipramine developed seizures and 36.4% developed status epilepticus. Imipramine at 0.5, 1,2, and 5mg/kg increased the incidence of seizures and status epilepticus in the HD pilocarpine group, but the incidence was statistically significant only for status epilepticus(p<0.05). The latency for the occurrence of first status epilepticus was 12.3+/-1.3 min in the HD pilocarpine alone group, and it was 21+/-3.8 min and 25.3+/-5.7 min in the group pretreated with 5 and 10mg/kg imipramine, respectively(p<0.02). Treatment with LD pilocarpine alone resulted in seizures in 50% and status epilepticus in 16.7%. In the LD pilocarpine group with imipramine 2mg/kg pretreatment, 83.3% had seizures and status epilepticus. Imipramine at 2mg/kg increased the incidence of seizures and status epilepticus in the LD pilocarpine group, but the increase was statistically significant only for status epilepticus(p<0.05). CONCLUSION: Imipramine exhibits a proconvulsant effect at low doses and an anticonvulsant effect at high doses in the pilocarpine seizure model in immature rats. There may be a dose-dependent effect on monoaminergic receptors which results in increased neuronal excitability.
Animals ; Brain ; Dopamine ; Electrodes ; Electroencephalography ; Imipramine* ; Incidence ; Injections, Intraperitoneal ; Neurons ; Norepinephrine ; Pilocarpine ; Rats* ; Rats, Sprague-Dawley ; Seizures* ; Serotonin ; Status Epilepticus

No abstract available.
Asthma* ; Immunotherapy*

A hemangioma occurred in the bony epiphysis is extremly rare. A 5-year-old boy visited to our hospital with pain and flexion contracture on the right knee. MRI showed some lesions scattered in the epiphysis of the distal femur and the proximal tibia. Biopsy specimen from the distal femoral epiphysis revealed pathologic findings compatible with hemangioma. On 8 years follow-up, the lesion in the distal femoral epiphysis had been cured, and those in the proximal tibial epiphysis were spontaneously disappeared without surgery. The scanogram shows no leg length discrepancy and angular deformity. We reports a rare case of hemangioma occurred in the bony epiphysis with the results of 8 year follow-up with the review of literatures.
Biopsy ; Congenital Abnormalities ; Contracture ; Epiphyses ; Femur ; Follow-Up Studies ; Hemangioma ; Knee ; Leg ; Preschool Child ; Tibia

No abstract available.
Epilepsy*

Clinical studies were made on 50 cases of chronic cough infants who were admitted to the department of Pediatrics of Kangnam St. Mary' s hospital from January, 1990 to July, 1991. The results were as follows; 1) The age distribution was from 3 months to 24 months old, and the most prevalent age group was 13~18months old. The male to female was 2.1:1. 2) The etiologic classification of the 50 cases were infantile asthma in 23 cases(46%), viral lower respiratory infection in 13 cases(26%), and infantile asthma associated with sinusitis in 5 cases(10%). 3) Cough was the most common clinical manifestation in all cases and followed by rhinorrhea, dyspnea, fever, and nasal stuffiness. Among physical findings, wheezing rales, and chest retraction were noted. 4) The duration of cough was 5 to 8 weeks in 26 cases(52%), 2 to weeks in 19 cases(38%), and above 9 weeks in 5 cases(10%). 5) 13 of 50 cases had a past allergic history and 8 of 50 cases had a family history of allergy. 6) In 50 cases, formula feeding was done in 28 cases(56%), breast feeing in 13 cases(26%), and mixed feeding in 9 cases(18%). 7) Eosinophilia was noted in 39.3% of infantile asthma and total IgE level above 100IUm/ml was noted in 60.7% of infantile asthma and in 18.2% of other diseases. 8) RAST results of infantile asthma showed that the positivity was 21.4% in house dust, 32.1% in Dermatophagoides pteronyssinus, 28.6% in Dermatophagoides farinae, 28.6% in egg white, 35.7% in milk. The ratio of positive RAST results were higher in infantile asthma than in other diseases. 9) Abnormal findings, including overinflation, infiltration, increased bronchovascular marking, and atelectasis, were noted in 42 cases(84%) on chest X-ray. In 7 cases, total opacification was noted on Waters' and Caldwell's view. In conclusion, chronic cough in infancy is best managed by determining the precise cause of the cough, then specificially treating the underlying disorder.
Age Distribution ; Asthma ; Breast ; Child, Preschool ; Classification ; Cough* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dust ; Dyspnea ; Egg White ; Eosinophilia ; Fees and Charges ; Female ; Fever ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant ; Male ; Milk ; Pediatrics ; Pulmonary Atelectasis ; Respiratory Sounds ; Sinusitis ; Thorax

With the development of antenatal diagnostic tools such as ultrasonography, some congenital anomalies or diseases can be detected in early fetal life. Routine serial antenatal check-ups have made it possible to predict the prognosis of these problems, and a few life-threatening single anatomic malformations have been treated by open fetal surgery. The experience of fetal surgery revealed that the human fetus appears to heal without any scarring. In contrast to adult animals, the response to tissue injury in the fetus is conspiciously devoid of acute inflammation. Indeed, the absence of neutrophils is perhaps the most consistent observation in fetal wounds and seems to be followed by absent or scanty fibroblast infiltration, which results in healing with sparse and well organized collagen deposition. Actually, the amount and quality of the collagen deposition were decided by the fibroblasts which infiltrated the wound. It is well known that fetal wounds have sparse collagen deposition, however, the mechanisms are still unclear. This study was designed to evaluate the role of fibroblast activity in the differences of the scar formation between the fetus and neonate. Fibroblast activity such as the cell growth rate, the amount of collagen synthesis and the synthesized collagen types of fetus(IUP 18-22 weeks) was compared with that of neonate. The amount of collagen synthesis was measured by H-proline uptake and the amount of collagen type III was measured by Western blot using antihuman procollagen type III. The cell growth rate as determined by cell proliferation from the initial cell count of 5x10(5) to cell confluence was 3.6 x 10(6) in the fetal fibroblasts compared to 2.5x10(6) in neonatal fibroblasts. Fetal fibroblast synthesize 16.9 x 10(4) cpm of collagen and neonatal fibroblasts synthesize 2.7 x 10(4) cpm of collagen. The synthesized amount of type III collagen was 2.1x10(4) ug/ml, and 1.5x10(4) ug/ml by fetal and neonatal fibroblasts, respectively. In conclusion, fetal fibroblasts grow faster and synthesize a smaller amount of collagen, but produce more type III collagen than neonatal fibroblasts.
Adult* ; Animals ; Blotting, Western ; Cell Count ; Cell Proliferation ; Cicatrix ; Collagen Type III ; Collagen* ; Fetus* ; Fibroblasts* ; Humans ; Infant, Newborn ; Inflammation ; Neutrophils ; Prognosis ; Ultrasonography ; Wounds and Injuries

No abstract available.
Humans ; Hypothyroidism* ; Siblings*

The occurrence of pseudoaneurysm of the femoral artery after catheterization is uncommon. Ultrasonography-guided compression is currently the first choice of treatment, with a success rate of more than 90%. Recently, however, with the increasing use of larger percutaneous instruments and periprocedural anticoagulation, the incidence of pseudoaneurysm unresponsive to ultrasonography-guided compression is increasing. The authors encountered a case of pseudoaneurysm of the common femoral artery which did not respond to the repeated use of this technique, though treatemnt involving was successful. We believe that in ultrasonography-guided percutaneous thrombin injection was successful. We believe that in cases involving occlusion of a a pseudoaneurysm in which ultrasonography-guided mpression has failed, this is a simple, safe, and time-saving procedure.
Aneurysm, False* ; Catheterization ; Catheters ; Femoral Artery* ; Incidence ; Thrombin* ; Ultrasonography*

BACKGROUND: Korea is, known to be an endemic area of viral hepatitis B, and 5-6% of population are carriers. Immunization can reduce the spread of hepatitis B infection. Hower, not all people respond to hepatitis B immunsation. 5-15% of primary vaccinees fail to be immunized. After revaccination, only 37.5 44% of the primary failures elicit antibody response. Recent studies have reported that it is effective to inject a double dose vaccination in immunocompromsed patients. In some country, they recommend that neonate whode mother is HBV carrier shoud receive double dose vaccination. This study documented the results of double dose vaccintion only once to nonrsponders toward the HBV immunzation. METHODS: Healthy nonresponders to Hepatitis B immunization were recuited from Sep. 1995 to Aug. 1996. Subjects with their AST/ALT level over 40, or over 65 years old were excluded. They were received 2ml of plasma-derived vaccine(Hepavax-B) intramuscularly in the deltoid muscle. Anti-HBs antibody testing were performed at 1 to 3 months after vaccintion. RESULTS: 17 healthy nanreponders to Hepatitis B immunization(male 10, female 7) were included. Their mean ages were 47(32 to64), AST/ALT level 20/19(16 to 28/11 to 35), smoking 4.3pys(1 to 7). Seroconversion occured in 13 of them(76.5%). CONCLUSIONS: Nonresponders to Hepatitis B vaccintion respond well to double dose vaccination once.
Aged ; Antibody Formation ; Deltoid Muscle ; Female ; Hepatitis B* ; Hepatitis* ; Humans ; Immunization ; Immunization, Secondary ; Infant, Newborn ; Korea ; Mothers ; Smoke ; Smoking ; Vaccination*