Scar sarcoidosis is a rarely encountering variant of cutaneous sarcoidosis and its pathogenesis is still unknown. When inactive scars that have been quiescent for years develop a red or purple hue with induration, we should doubt whether they become infiltrated with sarcoid granuloma or not. We report herein a 45-year-old patient with recurrent scar sarcoid, who shows indurated plaques on the right chin and raised serum level of angiotensin converting enzyme, although there was no evidence of systemic involvement. She was treated with oral doxycycline of moderate doses and skin lesions were cleared after 9 months of treatment.
Chin ; Cicatrix* ; Doxycycline ; Granuloma ; Humans ; Middle Aged ; Peptidyl-Dipeptidase A ; Sarcoidosis* ; Skin

No abstract available.
Infant, Newborn ; Meconium Aspiration Syndrome* ; Meconium* ; Mortality ; Suction*

Vistamycin is a new type of aminoglycoside antibiotics and similar to Kanamycin in its antibacterial spectrum. Vistamycin is especially effective in ophthalmic field due to high penetration into the ocular tissue. In this study, the patients were divided into three groups. 1. 13 cases of ocular infectious diseases such as hordeolum and dacryocystitis. They have received intramuscular injections. 2. 32 cases receiving intramuscular injection for prophylaxis of postoperative infection. 3. 5 cases receiving topical application of 1% Vistamycin eye-drops. Group 1 and 2 were treated with intramuscular injection of Vistamycin 1.0 G.per day for 2 to 10 days. The results were summerized as follows: (1) Group 1 showed good response to Vistamycin with about 77% of efficacy rate. (2) None of group 2 developed postoperative infection. (3) The efficacy rate of group 3 was about 80%.
Anti-Bacterial Agents ; Communicable Diseases ; Dacryocystitis ; Hordeolum ; Humans ; Injections, Intramuscular ; Kanamycin ; Ophthalmology*

PURPOSE: To report a case of bilateral peripheral ulcerative keratitis after cataract extraction with a clear corneal incision in a patient with rheumatoid arthritis. CASE SUMMARY: A 67-year-old woman was referred to our clinic with bilateral ocular pain and visual disturbances, 10 days after a cataract extraction in her right eye. The patient had undergone a cataract extraction with clear corneal incision in the left eye and the same procedure was performed in the right eye after 1 week. During the surgery, hyphema occurred because of the iris damage by the phacoemulsification tip. Slit lamp examination showed bilateral peripheral ulcerative keratitis around the incision site and diffused corneal edema. Topical instillation and systemic administration of antibiotic agents were given as treatment but the patient showed no improvement. Corneal culture and smear were performed and showed a negative result. Because the patient was previously diagnosed with rheumatoid arthritis and showed the characteristic finger deformity, she was diagnosed with a sterile peripheral ulcerative keratitis and was treated with oral steroid, sulfasalazine, and steroid eye drop. After 1 month of treatment, epithelial thinning of the cornea and peripheral corneal ulcer stopped progressing and showed corneal re-epithelization. CONCLUSIONS: Because peripheral ulcerative keratitis after cataract extraction with clear corneal incision can occur in a patient with rheumatoid arthritis, caution is necessary to minimize damage by careful manipulation during the operation and requires special attention in preoperative and postoperative management.
Arthritis, Rheumatoid ; Cataract ; Cataract Extraction ; Congenital Abnormalities ; Cornea ; Corneal Edema ; Corneal Ulcer ; Eye ; Female ; Fingers ; Humans ; Hyphema ; Iris ; Phacoemulsification ; Sulfasalazine ; Ulcer

A retrospecive clinical observation was done on 325 cases of hypertension admitted to Department of internal Medicine of Seoul Red Cross Hospital from January, 1979 to December, 1982. The following results have been obtained. 1) The observed patients were 157 males and 168 females, and the prevalence rate of malignant hypertension among 325 hypertensions was 16 cases (4.9 percent). Among 16 cases of malignant hypertension 9 cases were male and 7 cases were female. Most frequently in 50, 60 and 40 years of age in this order each sex. 2) The average admitted dates are 7 days. 27 cases (8.3percent) were readmitted above 2 times after one discharged. 3) The most freqeuntly observed duration of Known hypertension 37.9 percent was 6-10 years and the next frequently observed duration 37.4 percent was 3-5 years. 4) The highest percentage of malignant hypertension had systolic blood pressure between 190-209mmHg and diastolic blood pressure between 150-169mmHg. 5) The highest percentage of seasonal number was spring (31.1 percent) and the next autumn, summer, winter in this order and the prevalence rates of hypertention are increased average 1.9% of each year. 6) The 78.5 percent of the patients were found that their blood pressure were abnormaly high when they were examined with related symptoms on admission, and they major symptorms were headache and dizziness. 7) The physical examination on admission, tachycardia (56percent), tachypnea (15.1percent), semicoma to coma (12.9 percent) in this order. 8) The status of treatment in hypertension on admission was as follows; imtermittent treatment 54.5 percent, no treatment 31 percent and continuous treatment 14.5 percent in this order. 9) In the chest X-ray on admission, the most frequent finding was cardiomegaly, and normal finding was the next frequency. The pulmonary Tbc was noted in 12.6 percent. 10) According to the degree of fundoscopic abnormality by K-W classification stage III was 68.8 percent and stage IV was 31.2 percent. 11) Electrocardiogram abnormalities were 44.9 percent, and 87.5 percent of malignant hypertension revealed electrocardiographic abnormalities and left ventricle hypertrophy was observed in 70.5 percent. 12) Hypercholesterolemia 78 percent, Hypernatremia 69.8 percent, Hypokalemia 22.8 percent, serum chloride 34.5 percent (<95m Eg/l), BUN 53.8 percent (>20mg/dl) and creatinine 45.8 percent (>3mg/dl) on admission. 13) Proteinuria was observed in 87.5 percent of malignant hypertension. 14) Marked improved for clinically was 24 percent and mortality rate was 5.2 percent, most common cause of death are cardiovascular accident (64.7percent) and renal failure (23.5percent).
Blood Pressure ; Cardiomegaly ; Cause of Death ; Classification ; Coma ; Creatinine ; Dizziness ; Electrocardiography ; Female ; Headache ; Heart Ventricles ; Humans ; Hypercholesterolemia ; Hypernatremia ; Hypertension ; Hypertension, Malignant ; Hypertrophy ; Hypokalemia ; Internal Medicine ; Male ; Mortality ; Physical Examination ; Prevalence ; Proteinuria ; Red Cross ; Renal Insufficiency ; Seasons ; Seoul ; Tachycardia ; Tachypnea ; Thorax

BACKGROUND: After referral system had been established, patients wishing to consult with a specialist with 'self- referral' in mind is increasing in university hospital family medicine clinics. This study was conducted to know whether those by self-referral to a specialist in a university hospital could benefit from family physician's consultation or not. METHODS: Three hundred and sixty patients were serially assigned to either 'simple referral' group provided with a referral note without consultation or 'referral after consultation' group with consultation from a family physician. Patient satisfaction was rated by using questionnaires with 5-point Likert scale. RESULTS: Patients in the 'simple referral' group were more satisfied with the whole process of family physicians' consultation compared to the 'referral after practice' group in both the appropriateness and patient satisfaction of the consultation (both, P<0.001). Males, longer encounter time, and shorter waiting time were significantly influenced patient satisfaction compared to each counterpart. CONCLUSION: Patients who want only a referral note from a family physician in a university hospital may received some benefit from the coordination and comprehensive care by a family physician. Health delivery system should be rectified according to the consideration of the role of the primary care physician such as a family physician.
Humans ; Male ; Patient Satisfaction ; Physicians, Family ; Physicians, Primary Care ; Referral and Consultation ; Specialization ; Surveys and Questionnaires

BACKGROUND: Although the topical application of glycolic acid (GA) could possibly exert some effects on the normal epidermal permeability function, the exact effects and its mechanism of action have not been well documented. OBJECTIVE: This study was conducted to investigate the effects of GA on the expression of epidermal cytokines and to clarify its chelation effect on the epidermal calcium ions, which are known to control the secretion of lamellar bodies. METHODS: After topical application of 70% GA aqueous solution on the flank of hairless mice, the expression of epidermal IL-1alpha and TNF-alpha was assessed and the change of epidermal calcium ions was evaluated. RESULTS: The results could be summarized as the following: (1) real time reverse transcriptase polymerase chain reaction and immunohistochemical staining studies showed increases in mRNA and protein expression of epidermal IL-1alpha and TNF-alpha; (2) the GA reduced intracellular calcium ion concentrations in vitro and resulted in the loss of epidermal calcium gradient in vivo. CONCLUSION: These results suggest that, like iontophoresis or sonophoresis, GA could influence the skin's barrier homeostasis, possibly by lowering the epidermal calcium ions.
Animals ; Calcium* ; Cytokines* ; Homeostasis ; Ions ; Iontophoresis ; Mice ; Mice, Hairless* ; Permeability ; Reverse Transcriptase Polymerase Chain Reaction ; RNA, Messenger ; Tumor Necrosis Factor-alpha

When 6 or more Cafe-au-lait spots(CALS) tend to be randomly and widely distributed, we must rule out neurofibromatosis(NF). Nevus depigmentosus is a congenital nonprogressive hypopigmented patch that shows histologically decreased pigmentation while CALS shows increased pigmentation. We report a case of a 16-month-old girl showing generalized multiple cafe-au-lait spots with segmental nevus depigmentosus and capillary hemangioma on her right upper back. A possible explanation for the co-occurrence of CALS and nevus depigmentosus could be the concept of mosaicism.
Cafe-au-Lait Spots* ; Female ; Hemangioma* ; Hemangioma, Capillary ; Humans ; Infant ; Mosaicism ; Nevus* ; Pigmentation

BACKGROUND: The Rx Imola (Randox, UK) is newly released bench top - fully automated analyzer based on Window XP software with high-throughput (640 tests per hour with ISE) and continuous random access. We evaluated the performance of Rx Imola for the routine chemistry. METHODS: Repeatability (within-day precision), between-day precision, within-device precision, linearity, recovery rates and correlation were evaluated for 19 items including AST, ALT, ALP, GGT, total bilirubin, calcium, phosphorus, albumin, total protein, BUN, creatinine, glucose, amylase, total cholesterol, triglyceride, HDL, LDH, CK and uric acid. Commercialized quality control materials and patient's sera were used. For correlation study, 747-100 (HITACHI, Japan) and VITROS 950 (Ortho-Clinical Diagnostics, USA) were used as comparative analyzers. RESULTS: Coefficients of variation (CVs) of all items in repeatability and between-day precision study were below 5%. The linearities were statistically acceptable (R2>0.99) for all items. The recovery rates ranged from 95.7 to 105.3%. The comparison study showed high correlation between Rx Imola and 747-100 or VITROS 950. Correlation coefficients of all items were above 0.99 except HDL and albumin. CONCLUSIONS: This study showed satisfactory results in precision, linearity, recovery rates and comparison studies of Rx Imola. It was expected to be useful for routine chemistry analysis and back up, because of high performance, easy handling and small size.
Amylases ; Bilirubin ; Calcium ; Chemistry* ; Cholesterol ; Creatinine ; Glucose ; Phosphorus ; Quality Control ; Statistics as Topic ; Triglycerides ; Uric Acid

We report a rare case of giant vascular eccrine spiradenoma (GVES) which developed in 56-yr-old Korean woman. It is a rare variant of eccrine spiradenoma (ES), which might be mistaken for angiomatous lesions in view of its florid vascularity and hemorrhagic features. Histogenesis of GVES is not clearly elucidated although it is known that ES presumably originates in the eccrine glands. To clarify the histogenesis of GVES, immunohistochemical stainings using various monoclonal antibodies were also performed. The tumor was composed of three types of cells, namely pale epithelial cells, small basal cells, and myoepithelial cells. Therefore, we conclude that GVES originated from eccrine gland and mainly differentiates toward secretory portion of secretory coil.
Actins/analysis ; Adenoma, Sweat Gland/blood supply/metabolism/*pathology ; Biological Markers/analysis ; CA-15-3 Antigen/analysis ; Eccrine Glands/blood supply/chemistry/*pathology ; Female ; Humans ; Immunohistochemistry ; Keratin/analysis ; Korea ; Membrane Proteins/analysis ; Middle Aged ; Muscle, Smooth/chemistry ; Sweat Gland Neoplasms/blood supply/metabolism/*pathology