We reviewed two cases of keratosis punctata palmaris et plantaris(KPP) and the scanning electron microscopic findings(SEM). The skin lesions of KPP are multiple, hyperkeratotic on the palms and soles with central pitting. There was no subjective symptoms. The histologic findigs revea,l marked hyperkeratosis, hypergranulosis, and acanthosis with depression of the underlying malpighian layers. The SEM findings reveal one hyperkeratoic plug on punctate lesion(case I ) and three hyperkeratotic plugs on depression of the malpighian layer(case ll ).
Depression ; Keratoderma, Palmoplantar* ; Keratosis* ; Skin

Primary renal lymphoma is a rare tumor of the kidney that typically presents with bilateral nodular enlargement in the absence of extrarenal masses. We describe MR findings of a case of primary renal lymphoma along with ultrasound and CT findings. MR imaging demonstrated globular enlargement of both kidneys with multilobulated contour and multiple masses which had isosignal intensity on T1WI and low signal intensity on T2WI. The masses enhanced slightly on dynamic contrast enhanced scan.
Kidney ; Lymphoma* ; Magnetic Resonance Imaging ; Ultrasonography

A case of low-grade endometrial stromal sarcoma resembling ovarian sex-cord tumor in the uterus of a 43-year-old woman is described. This tumor belongs to the group II category of uterine tumors resembling ovarian sex-cord tumor described by Clement and Scully, and the epithelial-like elements show prominent smooth muscle differentiation, proved by immunoreactivity for desmin and actin. The patient did not receive any adjuvant therapy; she is alive and well without recurrence 8 months postoperatively.
Female ; Humans

A 7-month-old boy was presented with growth retardation. The brain CT scan and the cerebral angiography revealed hydrocephalus resulting from venous hypertension and a high-flow direct arteriovenous fistula at the distal M2 segmnt of the middle cerebral artery which was drained into the sphenoparietal sinus. The echocardiogram disclosed a ventricular hypertrophy. The patient was treated by gradual ligation of fistulous portion in ten minutes to prevent sudden increase of peripheral resistance and cardiac overloading. It is stressed that slow obliteration of an arteriovenous fistula is a paramount procedure to prevent congestive heart failure.
Arteriovenous Fistula ; Brain ; Cerebral Angiography ; Fistula* ; Heart Failure ; Humans ; Hydrocephalus ; Hypertension ; Hypertrophy ; Infant ; Ligation ; Male ; Middle Cerebral Artery ; Tomography, X-Ray Computed ; Vascular Resistance

This study was carried out to reveal the epidemiologic characteristics of psoriasis in Korea. Seventeen university hospitals were engaged in this study, and the results were as follows : 1. The number of psoriasis patients during the 10 years from January 1977 to March 1987 was 1.05% of all the outpatients; the male to female-ratio was 1.08:1. 2. In the prospective study, the number of psoriasis patients was 2.3% of all the outpatients in 1987, 2.8% of all the outpatients in 1988 and the male to female ratio was 1.26:1. 3. The most prevalent age of onset was 20-29 years ; 81.1% were living in urban areas; and a family history was obtainable in 19.8% with parents holding the highest rank of 7.8%. 4. The most frequent duration of disease activity was under 5 years in 63.3%; the most common age for the worst condition was 20-29 yrs. The most common area size of skin involvement at the peak of the worst condition was less than 10%. 5. The most common initiating skin lesion began on the scalp in 20.2%, on the nail in 17.2%, pruritus in 63.0% with joint symptoms in 10.8%, and Koebner phenomena in 50.6%. 6. Emotional stress was the most common aggravating factor in 34.4%. The method of treatment that attained the best result was the combination therapy of oral medication and a topical agent. The best treatment modality was said to be the application of ointment with p.o.medication by as many as 28.4% of patients who took the leading rank. Photo-chemotherapy, effective with few complications, was not used much as it was not well-known in Korea until after 1980. Most people had an accurate knowledge of psoriasis.
Age of Onset ; Epidemiologic Studies* ; Epidemiology ; Female ; Hospitals, University ; Humans ; Joints ; Korea ; Male ; Methods ; Outpatients ; Parents ; Prospective Studies ; Pruritus ; Psoriasis* ; Scalp ; Skin ; Stress, Psychological

A 36-year-old female patient with aplastic anemia developed massive hemoptysis and was placed on ventilator support. However, airway obstruction by blood clots triggered desaturation and ventilator malfunction. Manual ventilation was initiated to improve oxy-genation, and emergency flexible bronchoscopy was performed to clear the airway. Nevertheless, the patient developed extensive subcutaneous emphysema, pneumothorax, and pneumomediastinum.
Adult ; Airway Obstruction ; Anemia, Aplastic ; Barotrauma* ; Bronchoscopy ; Emergencies ; Female ; Hemoptysis* ; Humans ; Mediastinal Emphysema ; Pneumothorax ; Subcutaneous Emphysema ; Ventilation* ; Ventilators, Mechanical

BACKGROUND: The polymerase chain reaction (PCR) assay, introduced as a fast and sensitive diagnostic method, has been known to be useful in detecting Mycobacterium tuberculosis. Therefore the purpose of this study was to evaluate the usefulness of an in-house PCR assay in the detection of Mycobacterium tuberculosis by comparing PCR results with those of conventional diagnostic techniques. METHODS: We assessed the diagnostic yield of the in-house PCR assay retrospectively based on the patient's medical records using data from previously evaluated specimens submitted for PCR amplification IS6110 sequences by GeneAmp PCR system 9600 (Perkin Elmer, CT, USA). All samples had been examined for detection of M. tuberculosis by acid-fast stain and culture assay and the results from the 3 methods were analyzed. RESULTS: The majority of cases (1,727 cases, 96.6%) showed concordant results between in-house PCR, AFB stain, and culture methods; only 60 cases (3.4%) displayed discordant results. The sensitivities, specificities and positive and negative predictive values of each method were as follows: 81.0%, 99.6%, 95.0% and 98.4%, respectively for the in-house PCR; 63.4%, 100%, 100% and 96.9%, respectively for AFB staining method; and 83.8%, 100%, 100% and 98.6%, respectively for culture assays. CONCLUSIONS: The PCR assay shows a high sensitivity and specificity and is a reliable test for an early diagnosis of tuberculosis.
Early Diagnosis ; Medical Records ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction* ; Retrospective Studies ; Sensitivity and Specificity ; Tuberculosis

PURPOSE: We report a case of inadvertent staining of the vitreous with Trypan Blue during cataract surgery. CASE SUMMARY: We performed cataract surgery in a 44-year-old male patient on an eye with mature cataract. Preoperatively, he had no zonular weakness or lens subluxation. We used trypan blue to stain the anterior capsule to facilitate capsulorhexis. We observed zonular weakness during surgery. During phacoemulsification, the dye entered into the vitreous cavity through the area of zonular weakness and a sudden loss of the red fundus reflex developed. However, we did not perform any specific procedure to correct the problem and finished phacoemulsification and intraocular lens insertion. After surgery, slit lamp examination showed a blue fundal glow, which persisted for 1 week. As expected, the patient's BCVA was better than before the operation. CONCLUSIONS: Use of trypan blue is relatively safe for use in cataract surgery. But to use trypan blue or other dye during cataract surgery, it is necessary to have careful pre operative ocular examination. And if some risk factors like zonular weakness or lens subluxation exists, more caution during surgery is needed.
Adult ; Capsulorhexis ; Cataract ; Diminazene ; Eye ; Humans ; Lens Subluxation ; Lenses, Intraocular ; Male ; Phacoemulsification ; Reflex ; Risk Factors ; Trypan Blue

Drug-induced agranulocytosis is a potentially lethal disorder characterized by selective neutropenia. G-CSF has been utilized for its treatment. We report a case of acute agranulocytosis probably associated with injection of sulpyrine(dipyrone). A three-year old girl was admitted to Taejon St. Mary's Hospital following five days of fever and two days of chills and prostration. During this period, she had been treated at local clinics with oral acetaminophen, ibuprofen, and miokamycin. Two days before admission, she was administered an intramuscular injection of dipyrone as antipyretics. She had a past history of previous sensitization of dipyrone. CBC revealed profound netropenia(total WBC 900/mm3, with 1% neutrophils, 88% lymphocytes, 10% atypical lymphocytes, 1% monocytes), but normal RBC and platelet count. Bone marrow examination showed hypocellularity(20%), decreased myeloid precusors, and M:E ratio of 1 : 2.5. The girl received subcutaneous G-CSF once daily for 3 days. G-CSF therapy resulted in a steep increase of neutrophil count, which was faster than the spontaneous recovery reported in the literature. G-CSF may be considered useful in the management of drug-induced agranulocytosis.
Acetaminophen ; Agranulocytosis* ; Antipyretics ; Bone Marrow Examination ; Chills ; Daejeon ; Dipyrone ; Female ; Fever ; Granulocyte Colony-Stimulating Factor ; Granulocytes* ; Humans ; Ibuprofen ; Injections, Intramuscular ; Lymphocytes ; Miocamycin ; Neutropenia ; Neutrophils ; Platelet Count

Drug-induced agranulocytosis is a potentially lethal disorder characterized by selective neutropenia. G-CSF has been utilized for its treatment. We report a case of acute agranulocytosis probably associated with injection of sulpyrine(dipyrone). A three-year old girl was admitted to Taejon St. Mary's Hospital following five days of fever and two days of chills and prostration. During this period, she had been treated at local clinics with oral acetaminophen, ibuprofen, and miokamycin. Two days before admission, she was administered an intramuscular injection of dipyrone as antipyretics. She had a past history of previous sensitization of dipyrone. CBC revealed profound netropenia(total WBC 900/mm3, with 1% neutrophils, 88% lymphocytes, 10% atypical lymphocytes, 1% monocytes), but normal RBC and platelet count. Bone marrow examination showed hypocellularity(20%), decreased myeloid precusors, and M:E ratio of 1 : 2.5. The girl received subcutaneous G-CSF once daily for 3 days. G-CSF therapy resulted in a steep increase of neutrophil count, which was faster than the spontaneous recovery reported in the literature. G-CSF may be considered useful in the management of drug-induced agranulocytosis.
Acetaminophen ; Agranulocytosis* ; Antipyretics ; Bone Marrow Examination ; Chills ; Daejeon ; Dipyrone ; Female ; Fever ; Granulocyte Colony-Stimulating Factor ; Granulocytes* ; Humans ; Ibuprofen ; Injections, Intramuscular ; Lymphocytes ; Miocamycin ; Neutropenia ; Neutrophils ; Platelet Count