A 24-year old woman presented with hemorrhagic vesicles on her legs. She had taken sibutramine (Reductil(R), Abbott Labs., Seoul, South Korea) for 3 months and developed skin lesions the week before. A skin biopsy showed leukocytoclastic vasculitis with conspicuous eosinophilic infiltration of the tissue. These lesions showed improvement after discontinuation of sibutramine. However, 3 months later the skin lesions recurred on other sites on the lower extremities when the patient was rechallenged with the same drug for 2 weeks. Herein, we report the first case of necrotizing vasculitis induced by sibutramine.
Biopsy ; Cyclobutanes ; Eosinophils ; Female ; Humans ; Leg ; Lower Extremity ; Skin ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous

No abstract available.
Cleft Lip*

No abstract available.
Myocutaneous Flap* ; Pressure Ulcer*

PURPOSE: In the diagnosis of pediatric urinary tract infection(UTI), the use of invasive methods, such as voiding cystourethrography(VCUG), is controversial. A retrospective study was carried out to evaluate the necessity for VCUG in assessing pediatric UTI. MATERIALS AND METHODS: Between April 2000 and March 2002, 70 children (60 boys, 10 girls) with symptomatic UTI were evaluated. All patients were evaluated with renal ultrasonography(RUS), 99mTc-DMSA renal scintigraphy(DMSA renal scan) and VCUG. The results of the VCUG were compared with RUS and similar comparisons made between the results of the VCUG and DMSA renal scans. Patients with both normal a RUS and DMSA renal scan were then evaluated for the frequency and grade of vesicoureteral reflux(VUR) on the VCUG. RESULTS: The mean age at the initial evaluation was 7.95 months, ranging from 1 to 52 months. RUS and DMSA scan abnormalities were found in 38(54.3%) and 26(37.1%) children, respectively. Of the 22 patients with VUR confirmed by VCUG, 11(50.0%) had an abnormal RUS, and 12 (54.5%) patients had abnormal DMSA renal scans. Of the 19 patients with both a normal RUS and DMSA scan, 4(21.2%, 6 kidney-ureter unit) were found to have VUR on VCUG. CONCLUSIONS: This study illustrated that a considerable number of patients may have significant VUR, despite normal renal ultrasonography and DMSA scans. Therefore, VCUG remains important in assessing pediatric UTI.
Child* ; Diagnosis ; Humans ; Retrospective Studies ; Succimer ; Technetium Tc 99m Dimercaptosuccinic Acid ; Ultrasonography ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

Aplasia cutis congenita (ACC) is an uncommon condition which is characterized by congenital, localized or widespread absence of skin or scar formation. Lesions can be multiple and may occur on any body surface, although they are mostly seen on the scalp as a solitary lesion. ACC is most often a benign isolated defect; but it can be associated with other physical anomalies or malformation syndromes. Adams-Oliver syndrome is a distinct subtype in which distal limb reduction is found in association with a solitary scalp defect. There is no single underlying cause of ACC; it may reflect a disruption of intrauterine skin development. A 25 day-old boy was referred to our clinic with a thick hemorrhagic crust, and a surrounding hairless atrophic scar on the midline over the skull vertex. He also had hypoplasia of the left 2nd to 5th toes since birth. The rest of the physical examination as well as an ultrasound examination of the brain were normal. Herein we report a rare case of ACC of the scalp accompanied by distal limb hypoplasia, Adamson-Oliver syndrome.
Brain ; Cicatrix ; Ectodermal Dysplasia ; Extremities ; Limb Deformities, Congenital ; Parturition ; Physical Examination ; Scalp ; Scalp Dermatoses ; Skin ; Skull ; Toes

A 6-day-old infant presented with a deeply bluish cystic mass below the right medial canthus. She had been born healthy. Under the impression of a hemangioma brain computed tomography was conducted. As a result, a diagnosis of congenital dacryocystocele was made. We present this case to show that it is important for a dermatologist to correctly identify congenital dacryocystoceles and appropriately refer the infant to a pediatric ophthalmologist prior to performing invasive measures.
Brain ; Hemangioma ; Humans ; Infant

PURPOSE: To identify the relationship between dietary habits and childhood gastroesophageal reflux disease (GERD) in preschool children. METHODS: We performed a questionnaire study to analyze the relationship between dietary habits and GERD in 85 preschool children with GERD and 117 healthy children of the same age. RESULTS: Irregular and picky eating were more p–revalent in the GERD group than in the control group (odds ratio [OR], 4.14; 95% confidence interval [CI], 1.37–12.54 and OR, 4.96; 95% CI, 1.88–13.14, respectively). The snack preferences and the late night eating habits were significantly more prevalent in the GERD group than in the control group (OR, 3.83; 95% CI, 1.23–11.87 and OR, 9.51; 95% CI, 2.55–35.49, respectively). A preference for liquid foods was significantly more prevalent in the GERD group (OR, 9.51; 95% CI, 2.548–35.485). The dinner-to-bedtime interval was significantly shorter in the GERD group than in the control group (157.06±48.47 vs. 174.62±55.10, P=0.020). In addition, the time between dinner and bedtime was shorter than 3 hours in 47 children (55.3%) of the GERD group and 44 (37.6%) of the control group. This difference was statistical significance (P=0.015). CONCLUSION: Dietary habits such as picky and irregular eating, snack preference, a preference of liquid foods, late night eating, and a shorter dinner-to-bedtime interval had a significant correlation with GERD. Further large-scale studies are necessary to confirm our results.
Child ; Child, Preschool* ; Eating ; Food Habits* ; Gastroesophageal Reflux* ; Humans ; Meals ; Snacks

Onychomycosis is caused by dermatophytes usually, but some species of nondermatophytic molds and yeasts are also associated with invasion of nails. Aspergillus sydowii is a nondermatophytic mold which is opportunistic filamentous fungus in all environments. We report a case of onychomycosis caused by A. sydowii in a 65-year-old male. The patient showed yellowish discoloration with hyperkeratotic change on the distal and lateral portion of both great toenails. Direct microscopic examination of scraping on the potassium hydroxide preparation revealed dichotomous septate hyphae and repeated cultures on Sabouraud dextrose agar showed the same blue green velvety colonies. Biseriate phialides that cover entire vesicle with conidial structure resembling Penicillium were shown in the slide culture. The DNA sequence of internal transcribed spacer (ITS) region of clinical sample was 99% match to that of A. sydowii strain XWSFJJ1 (GenBank accession number FJ461692). We confirmed A. sydowii by KOH mount, colony, light microscopic morphology and DNA sequence analysis. The patient was treated with 250 mg oral terbinafine daily and topical 5% amorolfine nail lacquer for 3 months.
Agar ; Aged ; Arthrodermataceae ; Aspergillus* ; Base Sequence ; Fungi ; Glucose ; Humans ; Hyphae ; Lacquer ; Male ; Nails* ; Onychomycosis* ; Penicillium ; Potassium ; Sequence Analysis, DNA ; Yeasts

BACKGROUND: Subclinical thyroid dysfunction might influence a bone health. We evaluated whether subclinical hypothyroidism adversely affects bone health including bone mineral density (BMD), level of vitamin D, and bone turnover status in patients with hip fracture. METHODS: We evaluated 471 patients aged 50 years or older, who underwent hip fracture surgeries. BMD, level of vitamin D, bone turnover status, and one-year mortality were compared between subclinical hypothyroidism group and control group. RESULTS: BMD of femur and the level of 25-hydroxy-vitamin D (25-[OH]D) were similar in the two groups. There were no significant differences in bone turnover markers according to thyroid function. No significant differences were observed between the groups in utilization of intensive care unit (ICU), length of hospital stay, mobility, and one-year mortality. CONCLUSIONS: Subclinical hypothyroidism was not associated with reduced bone health, including BMD, the level of 25-(OH)D, and bone turnover marker.
Bone Density ; Femur ; Hip Fractures ; Hip* ; Humans ; Hypothyroidism* ; Intensive Care Units ; Length of Stay ; Mortality ; Thyroid Gland ; Vitamin D

No abstract available.
Dexamethasone* ; Humans ; Membranes* ; Rupture*