No abstract available.
Blood Pressure* ; Humans ; Infant, Newborn*

Acute necrotizing encephalopathy is a recently established disease entity, proposed by Mizuguchi et al in 1995, that shows a characteristic symmetric and multifocal involvement of both thalamus, brainstem tegmentum, cerebral periventricular white matter, and cerebellar medulla. It is known to be prevalent in Japan and other Far Ease countries. The etiology of the acute necrotizing encephalopathy remains unknown. The typical course of acute necrotizing encephalopathy is the development of the irreversible neurologic symptoms related to brain lesions. The diagnosis can be made on the basis of the combination of a typical clinical profile and characteristic radiologic findings. We experienced a first case of acute necrotizing encephalopathy in a 9 month old boy in Korea. We report this case with the brief review of related literatures.
Brain ; Brain Stem ; Diagnosis ; Humans ; Infant ; Japan ; Korea ; Male ; Neurologic Manifestations ; Thalamus

No abstract available.
Blood Pressure* ; Humans ; Infant, Newborn*

Skeletal muscle involvement has been well documented and muscular symptoms are common in patients with polyarteritis nodosa (PAN). However, the level of muscle enzyme is uncommonly elevated and overt rhabdomyolysis is very rare. We report a case of PAN presenting as rhabdomyolysis. A 22-year-old man was admitted because of fever, severe myalgia and swelling in all extremities. Laboratory investigations showed markedly increased levels of serum creatine kinase and myoglobin. There was diffusely increased muscular uptake in bone scan. Muscle biopsy from the right deltoid revealed vasculitis involving medium-sized vessel with ischemic necrosis of muscle. On angiography, saccular aneurysms were found in multiple arterities. Therapy with methylprednisolone pulse therapy and cyclophosphamide was followed by improvement of his symptoms.
Aneurysm ; Angiography ; Biopsy ; Creatine Kinase ; Cyclophosphamide ; Extremities ; Fever ; Humans ; Methylprednisolone ; Muscle, Skeletal ; Myalgia ; Myoglobin ; Necrosis ; Polyarteritis Nodosa* ; Rhabdomyolysis* ; Vasculitis ; Young Adult

We recently encountered an interesting case of acute inferior ST segment elevation myocardial infarction (STEMI). This patient had a rare anatomic variation, single coronary artery. The right coronary artery originate from the left circumflex proper artery, not from aorta, was totally obstructed with thrombi. Though it took more time to figure out the patient's coronary anatomy and the culprit lesion, we successfully performed primary percutaneous coronary intervention within the guideline-recommended time period. We performed left coronary angiography at the beginning. This strategy could be helpful in determining the culprit lesion and preventing unnecessary procedural delay in acute inferior STEMI.
Anatomic Variation ; Aorta ; Arteries ; Coronary Angiography ; Coronary Vessel Anomalies ; Coronary Vessels* ; Humans ; Myocardial Infarction* ; Percutaneous Coronary Intervention

No abstract available.
Sepsis*

BACKGROUND: Pilomatricoma (PM) is benign follicular tumor composed of the basophilic cells, transitional cells, shadow cells, squamoid cells and keratin filaments/amorphous debris. At present, PM is assumed to differentiate toward hair-forming cells of hair follicles but definite direction is not clear. OBJECTIVES: This study was made in order to investigate the pathways of cell differentiation associated with sudden keratinization in PM. METHODS: In the present study, 19 cases of human PM was histopathologically examined and classified into 4 groups according to the chronological stages. RESULTS: In the chronological stages according to Kaddu's classification, there were 2 cases of early lesion, 6 cases of fully developed lesion, 7 cases of early regressive lesion and 4 cases of late regressive lesion. The basophilic cells changed into the shadow cells or amorphous debris through the transitional cells moving toward the exterior of the PM, as well as toward the interior. As keratinization occurs, some inner basophilic cells which had been located in marginal areas of keratinization lost their tight cell-cell bonding. These cells showed edematous/vesicular and squamoid changes. High molecular weight cytokeratin was expressed in a linear pattern in some early and fully developed lesions. There were fewer layers of basophilic cells between the stroma and squamoid cells/amorphous debris than between the stroma and shadow cells. Ki-67 was expressed strongly both basal and overlying basophilic cells. Apoptotic bodies were detected in most transitional cell layers and some amorphous debris zones. CONCLUSIONS: The present study suggests dual pathways of cell differentiation in PMs. In the sudden keratinization pathway, the basophilic cells, transtional cells, shadow cells, and squamoid cells are suddenly keratinized, and the basophilic cells become early the transitional cells or squamoid cells. Cytoplasmic expressions of Ki-67 and cytokeratin in the basophilic cells show that the basophilic cells differentiate toward the innermost layer of the outer root sheath cells.
Apoptosis ; Basophils ; Cell Differentiation ; Classification ; Cytoplasm ; Hair Follicle ; Humans ; Keratins* ; Molecular Weight ; Pilomatrixoma*

Despite numerous therapeutic options the treatment of verruca vulgaris remains difficult and various treatment modalities are accompanied with substantial pain, tissue destruction and frequent recurrence. Recently imiquimod has been successfully used as topical immune response modifier for the treatment of external anogenital warts with less pain, destruction and fewer recurrent rate. We observed a case of verruca vulgaris on the left palm and the left second toe in a 57-year-old man. He had been treated with keratolytic agent and CO2 laser with little effect. So we tried to treat him with 5% imiquimod cream which was self-applied to the lesions and achieved complete clearance after 4 weeks of the therapy.
Humans ; Lasers, Gas ; Middle Aged ; Nociceptive Pain ; Recurrence ; Toes ; Warts*

We have experienced a case of squamous cell carcinoma of lung mixed with malignant lymphoma. The patient was a 19-years-old male. He was a non-smoker. Right pneumonectomy was done. We could not find any evidences of metastasis. The postoperative course was uneventful. The tissue diagnosis was confirmed by immunohistochemical method. The lymphoma recurred at 3 months after operation and the patient was dead at 5 months after operation because of respiratory failure
Carcinoma, Squamous Cell* ; Diagnosis ; Humans ; Lung* ; Lymphoma* ; Male ; Neoplasm Metastasis ; Pneumonectomy ; Respiratory Insufficiency

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome associated with anticonvulsant drugs is a rare but potentially life-threatening disease that occurs in response to arene oxide producing anticonvulsant such as phenytoin and carbamazepine. There have been many reports of cross reactivity among the anticonvulsants upon first exposure to the offending drugs. However, there has been few data describing the development of DRESS syndrome after switching medication from previously well-tolerated phenytoin to carbamazepine, and the induction of hypersensitivity to phenytoin by DRESS to carbamazepine. We experienced a case of a 40-yr-old man who had uncontrolled seizure that led to the change of medication from the long-term used phenytoin to carbamazepine. He developed DRESS syndrome after changing the drugs. We stopped carbamazepine and restored phenytoin for seizure control, but his clinical manifestations progressively worsened and he recovered only when both drugs were discontinued. Patch tests with several anticonvulsants showed positive reactions to both carbamazepine and phenytoin. Our case suggests that hypersensitivity to a previously tolerated anticonvulsant can be induced by DRESS to another anticonvulsant, and that the patch test may be a useful method for detecting cross-reactive drugs in anticonvulsant-associated DRESS syndrome.
Syndrome ; Skin/drug effects/immunology/pathology ; Phenytoin/immunology ; Male ; Humans ; Drug Hypersensitivity/*immunology ; Drug Eruptions/etiology/*immunology ; Carbamazepine/*adverse effects ; Anticonvulsants/adverse effects ; Adult