The term halo congenital nevus is a condition in which halo formation is associated with congenital melanocytic nevus. The regression of congenital melanocytic nevi is usually accompanied by the halo phenomenon and this is considered to be a rare event, although this may be underestimated. We describe here a 9-year-old boy with verrucous congenital nevus surrounded by a depigmented halo on the right upper arm. Histologically, the nevus lesion revealed a dense lymphocytic infiltration in the upper dermis intermingled with some remnants of nevus cell nests. Most of the infiltrating cells were CD8+ T lymphocytes. At the edge of the lesion, corresponding to the area of the halo, neither melanocytes nor melanin were found in any significant amounts.
Arm ; Child ; Dermis ; Humans ; Melanins ; Melanocytes ; Nevus ; Nevus, Pigmented ; T-Lymphocytes

An atypical clinical form of pityriasis versicolor has been infrequently reported, in which cutaneous atrophy is associated with individual pityriasis versicolor lesions. The pathogenesis of this atrophy remains unclear, but is believed to be a delayed-type hypersensitivity reaction to antigens derived from the Malassezia species. A 60-year-old man presented with multiple, slightly scaly, and depressed maculopatches or plaques on the trunk and extremities. Our microscopic examination of the skin scrapings on a KOH preparation revealed numerous short hyphae and spores. The patient was treated daily with 200 mg of itraconazole in combination with topical antifungals, achieving clinical improvement and mycological recovery, which was confirmed upon follow-up 1 month later. This is the first case report of atrophying pityriasis versicolor in Korea. It needs to be differentiated from other atrophying disorders of the skin.
Atrophy ; Extremities ; Follow-Up Studies ; Humans ; Hypersensitivity ; Hyphae ; Itraconazole ; Korea ; Malassezia ; Middle Aged ; Pityriasis ; Skin ; Spores ; Tinea Versicolor

PURPOSE: The cross-protection of 7-valent pneumococcal conjugate vaccine (PCV7) against vaccine-related serotypes has been controversial. We investigated the serological properties of cross-protective antibodies against vaccine-related serotypes 6A, 6C, and 19A induced in young children aged 12-23 months after booster immunization of PCV7. METHODS: IgG and IgM antibody concentrations and opsonic index (OI) against vaccine serotypes 6B and 19F and vaccine-related serotypes 6A, 6C, and 19A were measured by ELISA and opsonophagocytic killing assay (OPA) in 4 selected immunesera. The serological properties and antigenic specificity of protective antibodies were determined by IgM depletion of immunesera, OPA, and competitive OPA against serogroup 6 and 19 pneumococci. RESULTS: Compared to pre-IgM depleted immunesera, OI of IgM-depleted immunesera against 6B and 19F decreased and OI against 6A, 6C, and 19A decreased, too. In competition OPA, free 6B and 19F polysaccharide completely inhibited the immune protection against vaccine-related serotypes 6A, 6C, and 19A as well as vaccine types 6B and 19F. CONCLUSIONS: The booster immunization of PCV7 certainly induced cross-protective antibodies against vaccine-related serotypes 6A, 6C, and 19A with both IgG and IgM isotypes. Furthermore, IgM antibodies are more highly contributed to opsonophagocytic activity against vaccine-related serotypes as well as most of vaccine types than do IgG antibodies. Further studies are needed for the more immunized sera in the children as well as adults.
Adult ; Aged ; Antibodies ; Child ; Cross Protection ; Enzyme-Linked Immunosorbent Assay ; Epitopes ; Homicide ; Humans ; Immunization ; Immunization, Secondary ; Immunoglobulin G ; Immunoglobulin M ; Pneumococcal Vaccines ; Streptococcus pneumoniae ; Heptavalent Pneumococcal Conjugate Vaccine

No abstract available.
Cerebral Hemorrhage* ; Mucormycosis*

BACKGROUND: There has been a change in the causes of aortic stenosis when comparence of rheumatioc aortic stenosis in recent year. Therefore, we studied the etiology factor of pure aortic stenosis. METHODS: The gross surgical pathologic features of the aortic valves were reviewed in 92 patients with pure aotic stenosis whom underwent aortic valve replacement at Yonsei University, Cardiovascular center between July 1989 and June 1994. RESULTS: The three most frequent causes were 1) calcification of congenital bicuspid valve in 30%, 2) degenerative calcification of aortic valve in 22%, 3) rheumatioc valvular change in 48%. The mean age at the time of aortic valve replacement for the entire series of patients was 54.4 years. The range of age was from 18 years to 77 years. Males predominated for degenerative disease and congenital bicuspid valves, but there were reversed rheumatic origin. One or more complications occured in 17% of patients undergoing operation. The surgical mortality was 3.3%. CONCLUSION: Our data suggest that more common cause of aortic stenosis is non-rheumatic disease rather than rheumatinc origin.
Adult* ; Aortic Valve ; Aortic Valve Stenosis ; Constriction, Pathologic* ; Humans ; Male ; Mitral Valve ; Mortality

No abstract available.
Diabetes Mellitus* ; Tuberculosis*

No abstract available.
Arteriovenous Fistula* ; Cyanosis*

Purpose: In the present study, an atypical case of multiple evanescent white dot syndrome (MEWDS) was reported, which thewhite dots of acute phase and the pigmented patches of recovery phase appeared on different location.Case summary: A seventeen years old male with no previous medical history was presented with decreased visual acuity of hisleft eye. On the first visit, his maximum corrected vision was 1.0 in right eye and 0.5 in left eye. The white dots with blurry marginwere noted at the nasal retina on fundus exam. Fundus autofluorescence photography, fluorescein angiography and indocyaninegreen angiography all showed typical foundings of MEWDS. Gradually the vision improved up to 1.0 with maximumcorrection in six weeks, with normalized ellipsoid zone contour. However, multiple panretinal pigmented patches appeared diffusely,not only at nasal, where the previous white spots were noted, but also at temporal. The patient was followed up withoutany medication. Finally, the pigmented lesions were disappeared spontaneously. Conclusions During the recovery phase of MEWDS, multiple pigmentations may appear in different part of the retina, where thewhite dots were not presented. However, they were disappeared with recovery of clinical symptoms gradually without anytreatment.

PURPOSE: To evaluate non-alcoholic fatty pancreas disease severity on ultrasound (US-determined NAFPD) as a risk factor for coronary heart disease (CHD) and to evaluate its predictive value for intermediate/high CHD risk compared with US-determined non-alcoholic fatty liver disease (US-determined NAFLD) severity. MATERIALS AND METHODS: A retrospective analysis of 544 young adults, aged 18–40 years, was performed. NAFPD and NAFLD were classified as absent, mild, moderate, and severe. CHD risk was calculated using the Framingham Risk Score (FRS). Correlation, multivariate logistic regression, and receiver operating characteristic curve analyses were used to compare the predictive performance. RESULTS: FRS increased with increasing US-determined NAFPD severity (r = 0.624, p < 0.001), with a concomitant increase in the odds ratio for intermediate/high CHD risk. There was no difference between the predictive performance of US-determined NAFLD and NAFPD severities for intermediate/high CHD risk (p = 0.17). The combination of US-determined NAFPD and NAFLD severities significantly improved the differentiation between intermediate and high CHD risk (predictive value, 0.807; p < 0.001). CONCLUSION US-determined NAFPD severity was well-correlated with FRS and associated with the prevalence of intermediate/high CHD risk. The combination of US-determined NAFPD and NAFLD severities may be useful for predicting CHD risk.

PURPOSE: To determine the efficacy and safety of oral propranolol as a first-line treatment for superficially located infantile hemangioma (IH) and propose an assessment tool to measure treatment response. METHODS: Patients with superficial IH under 1 year of age were prospectively recruited between May 2012 and December 2013 at the Department of Pediatrics of Chungbuk National University Hospital. Propranolol was administered to 12 infants (median age, 3.8 months) while monitoring cardiovascular and adverse metabolic effects. If a patient showed no adverse events, the dosage was gradually increased up to 3 mg/kg/day and maintained for 1 year. We used our own scoring system to assess treatment response using parameters like change in color, and longest diameter, and thickness of the IH. RESULTS: Eleven out of 12 patients completed the protocol with consistent improvement of hemangiomas during therapy. Patients on propranolol showed a more than 50% involution in the first 3 months, with additional steady involution until 1 year. Patients with the highest scores at 1 month maintained their score and showed better responses until treatment termination. The patient with the lowest score at 1 month did not show any further regression and stopped propranolol treatment 4 months after initiation. In two children with recurrences after successful therapeutic regression, propranolol was effective after being reintroduced. Propranolol treatment was not interrupted in any patient due to adverse events. CONCLUSION: Oral propranolol at 3 mg/kg/day showed a consistent, rapid, and therapeutic effect on superficial IHs without significant adverse events.
Child ; Chungcheongbuk-do ; Hemangioma* ; Humans ; Infant ; Pediatrics ; Propranolol* ; Prospective Studies* ; Recurrence