Clinical Characteristics of Tinnitus in Elderly / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Tinnitus is commonly known to occur in the elderly, while presbytinnitus is not known as well. This study compared the clinical characteristics of tinnitus between the elderly and adults. SUBJECTS AND METHOD: This prospective case-control study enrolled 148 patients who had subjective tinnitus. Demographic data, otologic history, tinnitus questionnaires, the tinnitus handicap inventory (THI), a visual analogue scale, and audiological examinations were evaluated. RESULTS: The effect of tinnitus on the quality of life and the severity of tinnitus in the elderly were not different from those in adults. The elderly were more annoyed with the tinnitus than adults. The elderly had louder and longer tinnitus. Nevertheless, the elderly had a lower THI score. The effect of tinnitus on the quality of life was not correlated with tinnitus loudness, duration, or hearing threshold. In the elderly, the effect of tinnitus on the quality of life was correlated more with the emotional score of the THI than the other subscales of the THI. CONCLUSION: Tinnitus has a great effect on the quality of life of the elderly. This is related more to psychological factors than to otological factors.

Immunohistochemical Studies of Angiogenic Factors on Psoriatic Lesions / 대한피부과학회지

BACKGROUND: Psoriasis is a common chronic skin disorder characterized by hyperproliferation of the epidermis, inflammatory cell accumulation and increased tortuosity and dilatation of dermal papillary blood vessels. Angiogenesis plays a major role in the pathogenesis of psoriasis, however the mechanism responsible is largely unknown. Recently, some studies have identified several angiogenic factors from psoriatic epidermis, including interleukin (IL)-8, vascular endothelial growth factor (VEGF), and basic fibroblast growth factor (bFGF). OBJECTIVE: This study was aimed to elucidate the roles of VEGF and bFGF in the pathogenesis of psoriasis. METHODS: Immunohistochemical staining for VEGF and bFGF was carried out on skin samples of 15 psoriatic patients, plus 5 normal skin samples as a control. The psoriatic skins were divided into early and fully-developed stages, and differences in their expression between the stages were examined. RESULTS: The expressions of VEGF and bFGF on both epidermis and dermal structures were significantly higher in psoriatic lesional skin than in normal control skin. There was no significant differences between early and fully- developed psoriatic skin lesions. CONCLUSION: These results suggest that VEGF and bFGF may play significant roles in the pathogenesis of psoriasis.

Lupus Erythematosus Panniculitis with Xanthomatous Reaction / 대한피부과학회지

Xanthoma may or may not be associated with abnormal serum lipids. Normolipidemic xanthomas can occur in association with underlying lymphoproliferative disease, or they can result from lipid deposition with damaged or altered skin. A 56-year-old woman presented with multiple, yellowish to erythematous papules and plaques on the periocular area and forehead. She had no evidence or history of hyperlipidemia. The biopsy specimen of the forehead showed a diffuse histiocytic infiltrate with abundant bubbly cytoplasm, associated with lobular lymphocytic panniculitis and mucin deposition. Based on the clinical and histopathologic findings, we diagnosed this case as lupus erythematosus panniculitis with xanthomatous reaction. The patient was treated with low dose oral steroids and antimalarials, and her skin lesions were improved after 2 weeks.

Eosinophilic Pustular Folliculitis Successfully Treated with Indomethacin / 대한피부과학회지

Eosinophilic pustular folliculitis (EPF) is a rare dermatosis of unknown cause. It is characterized by recurrent crops of sterile, pruritic, follicular papulopustules on the face, trunk, and extremities. Although various treatments have been attempted for EPF, including systemic corticosteroid dapsone, cetrizine, UVB phototherapy, as well as cyclosporin, no uniformly effective treatment has been found. We describe a 20-year-old man with long standing EPF which was resistant to various treatments, but who responded dramatically to indomethacin.

Trichothiodystrophy with Cerebral Hypomyelination

No abstract available.

Familial Atrophoderma Vermiculata Associated with Epidermal Cysts

No abstract available.

A Case of Verrucous Carcinoma Occurring on the Face / 대한피부과학회지

Verrucous carcinoma is a low-grade squamous cell carcinoma. It usually occurs in the oral cavity, genital or palmoplantar area. A 55-year-old woman presented with an asymptomatic, erythematous, round, hyperkeratotic nodule, of 0.8cm in diameter, on the left cheek. A skin biopsy revealed a typical verrucous carcinoma. We report herein an unusual case of verrucous carcinoma occurring on the face.

Clinical and Histopathologic Studies of Lupus Erythematosus Panniculitis in Korea / 대한피부과학회지

BACKGROUND: Lupus erythematosus panniculitis (LEP), (or lupus erythematosus profundus), is an unusual variant of lupus erythematosus which primarily affects subcutaneous fat. LEP may occur with or without other manifestations of cutaneous or systemic lupus erythematosus. Only a few studies on the clinical and histopathologic manifestation of LEP have been conducted in Korea. OBJECTIVE: The purpose of this study was to investigate clinical, laboratory, and histopathologic features of LEP in Korean patients. METHOD: A total of 30 patients confirmed as having LEP at the Chungbuk National University Hospital between 1 July 1994 and 31 June 2004 were included in this study. The medical records and histopathologic findings were reviewed. RESULTS AND CONCLUSION: 1. LEP occurred predominantly in females, with the female to male ratio being 4: 1. The mean age at diagnosis was 38.5 years. 2. The most common clinical features were nodules or plaques, and 60% of the patients had pain or tenderness. Skin lesions affected the proximal arm area, face, trunk, scalp, and buttocks. In 26% of cases, LEP was associated with discoid lupus erythematosus (DLE), and 13% had evidence of mild systemic lupus erythematosus (SLE). The antinuclear antibody (ANA) was positive in 30% of cases. 3. The main histopathologic characteristics of LEP were predominant lymphocytic lobular panniculitis, hyaline necrosis, mucin deposit, and lymphoid aggregates. 4. Treatments included antimalarial drugs, systemic corticosteroids, intralesional corticosteroids, or topical potent corticosteroids under occlusion. They produced some improvement in most cases, however LEP exhibited a chronic nature with a high relapse rate.

Autoerythrocyte Sensitization Syndrome

No abstract available.

Sebaceous Carcinoma Arising from Nevus Sebaceus / 대한피부과학회지

Nevus sebaceus is a hamartoma of both epithelial and non-epithelial components, which that undergoes age-related change. It commonly affects the head and neck, particularly the scalp. In 10-20% of nevus sebaceus cases, secondary benign or malignant neoplasms such as syringocystadenoma papilliferum, trichoblastoma or basal cell carcinoma occur between 40-80 years of age. In only rare instances does a sebaceous carcinoma develop within a nevus sebaceus. To our knowledge, only 3 cases of sebaceous carcinoma in nevus sebaceus have been reported in the Korean dermatologic literature. We present a case of a sebaceous carcinoma arising from nevus sebaceus in a 46-year-old Korean man.

Neonatal Purpura Fulminans Due to Homozygous Protein C Deficiency

No abstract available.

Enterococcal Bacteremia in Children:A Review of Fifty Episodes in a Pediatric Hospital / 감염과화학요법

BACKGROUND: Episode of Enterococcal bacteremia has increasingly been reported for the past 15 years in USA, but there have been few systematic studies on its occurrence among Korean children. This study was carried out to determine the epidemiologic, clinical and laboratory characteristics of enterococcal bacteremia in Korean children. METHODS: Fifty episodes of enterococcal bacteremia among Korean children were retrospectively analyzed. Clinical and microbiological data were collected for all episodes of enterococcal bacteremia which occurried during 9-year period between November, 1992, and August, 2001 at the Seoul National University Children's Hospital. RESULTS: Significant underlying diseases were present in 47 (94%) episodes, including cardiac or abdominal surgery (44%), cardiac disease (30%), and chronic gastrointestinal disorders (16%). Thirty- eight (76%) episodes were nosocomial in origin, and 14 (28%) episodes were polymicrobial bacteremia. The source of bacteremia was identified in 16 (32%) episodes, intravascular device being the most common identifiable source. Of the 47 isolates identified at species level, 20 strains were Enterococcus faecium, 26 Enterococcus faecalis and one Enterococcus avium. Seventy-two percent of E. faecium cases were resistant to ampicillin. 36 cases (80%) had high-level resistance to gentamicin and sixteen cases (36%) to streptomycin. There was no strain resistant to vancomycin. Three clinical patterns were identified; self-limited bacteremia, 20%; low grade sepsis with favorable outcome after specific therapy, 42%; severe and prolonged infection, 30%; and unclassified, 8%. The overall mortality rate was 10.8%. CONCLUSION: Enterococcal bacteremia in children was usually nosocomial and comprised a heterogeneous group. The majority of cases occurred in children with serious underlying diseases. The frequency of high-level resistance to gentamicin in enterococcal isolates was high.

Enterococcal Bacteremia in Children:A Review of Fifty Episodes in a Pediatric Hospital / 감염과화학요법

BACKGROUND: Episode of Enterococcal bacteremia has increasingly been reported for the past 15 years in USA, but there have been few systematic studies on its occurrence among Korean children. This study was carried out to determine the epidemiologic, clinical and laboratory characteristics of enterococcal bacteremia in Korean children. METHODS: Fifty episodes of enterococcal bacteremia among Korean children were retrospectively analyzed. Clinical and microbiological data were collected for all episodes of enterococcal bacteremia which occurried during 9-year period between November, 1992, and August, 2001 at the Seoul National University Children's Hospital. RESULTS: Significant underlying diseases were present in 47 (94%) episodes, including cardiac or abdominal surgery (44%), cardiac disease (30%), and chronic gastrointestinal disorders (16%). Thirty- eight (76%) episodes were nosocomial in origin, and 14 (28%) episodes were polymicrobial bacteremia. The source of bacteremia was identified in 16 (32%) episodes, intravascular device being the most common identifiable source. Of the 47 isolates identified at species level, 20 strains were Enterococcus faecium, 26 Enterococcus faecalis and one Enterococcus avium. Seventy-two percent of E. faecium cases were resistant to ampicillin. 36 cases (80%) had high-level resistance to gentamicin and sixteen cases (36%) to streptomycin. There was no strain resistant to vancomycin. Three clinical patterns were identified; self-limited bacteremia, 20%; low grade sepsis with favorable outcome after specific therapy, 42%; severe and prolonged infection, 30%; and unclassified, 8%. The overall mortality rate was 10.8%. CONCLUSION: Enterococcal bacteremia in children was usually nosocomial and comprised a heterogeneous group. The majority of cases occurred in children with serious underlying diseases. The frequency of high-level resistance to gentamicin in enterococcal isolates was high.

Selective Spinal Cord Infarction on Gray Matter in a Child with Injured Unilateral Vertebral Artery: A case report

Several studies report varing incidence of spinal cord injury without radiologic abnormality (SCIWORA) from 21% to 66% in children. Fifty-five percentage of SCIWORA involves the cervical cord. The mechanisms of neural damage of SCIWORA include flexion, hyperextension, longitudinal distraction and ischemia. But spinal cord infarction related to vertebral arterial injury is rare. The authors report a case of selective spinal cord infarction on gray matter with unilateral vertebral artery injury after a minor trauma, in a 4-year-old boy. Neurological signs and symptoms developed 12 hours after the trauma. Initial postcontrast magnetic resonance imaging (MRI) showed an enhancement in the left vertebral artery. Follow up postcontrast MRI showed a selective signal change on the central gray matter and unilateral vertebral artery. We present this case with the review of literatures.

Neurobehavioral Tests in Workers Exposed to Ethylene Oxide / 대한산업의학회지

Ethylene oxide is widely used to sterilize heat-sensitive materials in hospital. Previous reports for neurotoxic effects of ethylene oxide have been described in animals and humans. To assess the exposure level and neurobehavioral effect of ethylene oxide, a cross-sectional study was performed to 27 nurses from central supply unit at hospital, exposed to ethylene oxide and 32 nurses as reference. Ethylene oxide was collected with using a personal air sampler and analyzed by gas chromatography for the determination of exposure level, and five items among Neurobehavioral Core Test Battery (NCTB) of World Health Organization, including Digit Span, Benton visual retention. Santa Ana dexterity, Digit Symbol and Simple reaction time, were administered to the exposed and reference group. The mean exposure level was 0.63 ppm in the exposed group and six subjects were exposed above the level of 1 ppm, which is currently regulated by the Korean Ministry of Labor. The results of neurobehavioral test in the exposed group showed significantly poorer performances in Digit Span forward and backward, Benton visual retention and Simple reaction time, comparing with the reference group. When the exposure level was divided into below and above the level of 1 ppm, there were significant differences in performance on Benton visual retentions, Digit Symbol and Simple reaction time. Also, Digit Span forward and backward showed significantly poorer performances below the level of 1 ppm, compared with reference group. Simple reaction time was still significantly delayed by the exposure level after controlling the confounding factors with multiple regression analysis. The results suggest that the periodic measurement of ethylene oxide in hospital and health care program is needed.

Safety and Immunogenicity of a Pseudomonas aeruginosa Outer Membrane Protein Vaccine(CFC-101) : a Phase I/IIa Clinical Trial / 감염

BACKGROUND: We developed a Pseudomonas aeruginosa outer membrane protein(OMP) vaccine, CFC-101, and the prophylactic efficacy of which has been demonstrated in animal models. In order to evaluate the safety and immunogenicity of the P. aeruginosa vaccine, we carried out a phase I/IIa clinical trial in healthy male volunteers. METHODS: Groups of eight volunteers, including two placebo subjects, were vaccinated intramuscularly with three doses of 0.25, 0.5 or 1.0 mg of the vaccine at one week intervals. Signs of systemic and local reactions observed after vaccination were recorded for each vaccinee for 5 days. Physical examinations were performed on days 0, 1, 7, 8, 14, 15, 21, and 42, and clinical laboratory tests were done on days 0, 3, and 21. Blood samples for assay of serum antibody levels were obtained up to 42 days after the first vaccination. RESULTS: The vaccine was generally well tolerated by all vaccinees, showing no significant side effects. In the three dosage groups, all vaccinees, except one receiving the 0.25 mg dose, showed significant elevation in serum IgG antibody titers against the vaccine proteins, indicating 100% seroconversion in 0.5 and 1.0 mg groups. The human antibodies induced by the vaccine were specific for P. aeruginosa OMPs, as confirmed by western blot analysis and immunoprecipitation assays. The capacity of the human antisera to enhance opsonophagocytic killing activity by polymorphonuclear leukocytes and to confer protection against P. aeruginosa infections indicates that the antibodies elicited by the vaccine have protective efficacy. CONCLUSION: We conclude that the P. aeruginosa OMP vaccine is safe and effective for human use and its optimal dose to be 0.5 or 1.0 mg.