Relapsed Brucellosis Presenting as Neurobrucellosis with Cerebral Vasculitis in a Patient Previously Diagnosed with Brucellar Spondylitis: A Case Report / 감염과화학요법

Brucellosis is a multisystem disease with various clinical symptoms. Neurobrucellosis is a rare but serious manifestation of brucellosis. A 60-year-old man with a previous diagnosis of brucellar spondylitis presented with sudden onset of aphasia and numbness of the right upper extremity. Cerebral angiography showed diffuse narrowing and dilatation on the distal branches of both the anterior cerebral artery (ACA) and the left middle cerebral artery (MCA) which indicated cerebral vasculitis, and the patient's Brucella agglutinin titer was 1:1280. After combined antimicrobial and steroid therapy was started, the patient's condition improved significantly, and he was discharged after 1 month. Antimicrobial therapy was continued for 16 months on an outpatient basis, and the last Brucella agglutinin titer was 1:40. To our knowledge, this is the first case of relapsed neurobrucellosis with vasculitis in Korea to have been treated successfully.

Thrombotic Complications during Interventional Lung Assist: Case Series / 결핵및호흡기질환

Interventional lung assist (iLA) effectively reduces CO2 retention and allows protective ventilation in cases of life-threatening hypercapnia. Despite the clinical efficacy of iLA, there are a few major limitations associated with the use of this approach, such as bleeding, thrombosis, and catheter-related limb ischemia. We presented two cases in which thrombotic complications developed during iLA. We demonstrated the two possible causes of thrombotic complications during iLA; stasis due to low blood flow and inadequate anticoagulation.

A Case of Choledochocele with High-Grade Dysplasia / 대한내과학회지

A type III choledochal cyst, known as a choledochocele, is rare. It is defined as cystic dilatation of the distal common bile duct, protruding into the duodenal lumen. Surgical treatment of a choledochocele remains controversial because it has a low incidence for malignancy compared with other choledochal cysts. While there have been few reported cases of choledochocele with malignancy, here we report our experience of a choledochocele with high-grade dysplasia and provide a literature review of the field.

An Outbreak of Acute Febrile Reaction Developed after the Administration of Teicoplanin / 감염과화학요법

An outbreak of acute febrile reaction which developed after the administration of teicoplanin was identified in seven patients. Fever, with hypotension in some, developed during or soon after infusion and persisted for several hours. Laboratory abnormalities including leukocytosis and elevation of liver enzymes and creatine phosphokinase in serum were observed for two or three days. Contamination of the drug with endotoxins was identified.

An Outbreak of Acute Febrile Reaction Developed after the Administration of Teicoplanin / 감염과화학요법

An outbreak of acute febrile reaction which developed after the administration of teicoplanin was identified in seven patients. Fever, with hypotension in some, developed during or soon after infusion and persisted for several hours. Laboratory abnormalities including leukocytosis and elevation of liver enzymes and creatine phosphokinase in serum were observed for two or three days. Contamination of the drug with endotoxins was identified.

Assessment of Chromosomal Analyses of 1,180 Cases Suspected of Chromosomal Aberrations

PURPOSE: We have performed this study to obtain reference data for the distribution of chromosomal aberrations in Korea. METHODS: We analyzed 1,180 chromosomal study cases from Kwang ju Christian Hospital during the past 25 years. 756 cases suspected of characteristic chromosomal aberration syndromes and 424 cases with hermaphroditism, mild sexual abnormalities, multiple anomalies, or mental and growth retardation were included. RESULTS: The male to female ratio of autosomal aberration syndromes was 1.2 : 1. 78.6% of autosomal aberrations were diagnosed under 1 year of age, whereas 89.8% of sex chromosomal aberrations were diagnosed over 12 years of age. Among 1,180 cases, 612 ones had chromosomal aberrations(51.9%) : 590 of 756 cases suspected of chromosomal aberration syndromes had aberrations(78.0%), whereas 22 of 424 showing the above other features had aberrations(5.2%). Autosomal aberrations appeared in 514 cases(83.8%) and sex chromosomal aberrations appeared in 98 cases(16.2%). The most frequently observed abberation in autosomal aberrations was Down syndrome, followed by E, D, B, A and C group aberrations. The most common abberation in sex chromosomal aberrations was Turner syndrome, followed by Klinefelter syndrome and Fragile X syndrome. CONCLUSION: It is of vital importance that patients suspected of chromosomal aberrations undergo chromosomal analysis. Further advanced chromosomal staining and molecular genetic methods will raise the detection rate of chromosomal aberrations.

A Case of Malignant Clear Cell Hidradenoma / 대한피부과학회지

Malignant clear cell hidradenomas are rare tumors originating from the eccrine sweat gland. Usually, they are malignant from their inception, but some develop from benign nodular hidradenomas. Although there is insufficient evidence in the literature, the recurrence rate may be estimated at about 50%, and the metastasis rate is about 60%, including regional nodes, bone, viscera, and the skin. We report a case of malignant clear cell hidradenoma in a 63-year-old woman, who had a 3-year history of asymptomatic pea sized hard solitary nodules on the right forearm. Despite repetitive surgical excisions, the lesions were recurred 5 times. To our best knowledge this is the first case of malignant clear cell hidradenoma in the Korean dermatologic literature.

Differential Expression of Peroxiredoxin Isotypes in Cultured Cells from Human and Rat Skin / 대한피부과학회지

BACKGROUND: Peroxiredoxin(Prx) is a novel peroxidase family to remove hydrogen peroxide using thioredoxin system, which is consisted of thioredoxin, thioredoxin reductase and NADPH. Several enzymatic antioxidants, such as superoxide dismutase, catalase and peroxidases are known to be present in the normal skin. But very little is known on the expression of Prx in the normal skin. OBJECTIVE: The aim of this study was to evaluate the expression of Prx isotypes in the normal human and rat skin, and thus to understand the role of Prx in the skin. MATERIALS AND METHODS: In this study, expression of 5 isotypes of Prx was evaluated in the primary cultures of keratinocytes and fibroblasts from human and rat, HaCaT cells and A431 cells by Western blot analysis. Also, immunohistochemical study for Prx I-IV expression was performed in the rat fibroblasts. RESULTS: Western blot analysis provided strong signals for Prx I, II and III with the cell extracts of cultured cells from the human and rat. The signals for Prx IV were weakly positive in hK, A431, hF and rF. The signals for Prx VI were positive in human cells, but were negative in rat cells. The finding were also identified in the intact skin. From immunocytochemical study for Prx I-IV, they were stained positively as a reticulated pattern in the cytoplasm of rF without isotype-specific difference. The positive reaction was strong in perinuclear cytoplasm. CONCLUSIONS: This study shows that Prx is ubiquitously expressed in the normal human and rat skin with an isotype-specific expression by species and cell types.

Four cases of Stevens-Johnson Syndrome associated with Methazolamide Treatment / 대한피부과학회지

Methazolamide is a carbonic anhydrase inhibitor commonly used for lowering intraocular pressure in glaucoma and other ophthalmologic diseases. Carbonic anhydrase inhibitors are sulfonamide derivatives that are known to cause many adverse side effects, including dermatologic reactions. Recently, Stevens-Johnson syndrome (SJS) associated with methazolamide treatment has been reported in Japanese and Japanese Americans, and it suggested a relationship between genetic background and methazolamide-induced SJS. We report four cases of SJS induced by methazolamide. Methazolamide should be prescribed with caution in patients of Japanese or Korean descent.

A Case of Laryngeal Ductal Cyst Who has History of Endotracheal Intubation / 소아알레르기및호흡기학회지

Laryngeal cysts can be classified into saccular (24%) or ductal (75%) cysts. In infants who have undergone intubation, ductal cysts are occasionally seen in the subglottic region. These cysts are caused by irritation and obstruction of mucous gland ducts. A 20-month-old infant admitted to our department due to inspiratory stridor, wheezing, and dyspnea. She was born prematurely and had a past history of endotracheal intubation with ventilator of 9 days because of respiratory distress syndrome. At 31 days of age, she was intubated again for 5 days because of pneumonia. She had admitted our hospital repeatedly at 7, 8, 16, and 17 months because of inspiratory stridor, wheezing, cough and dyspnea and she was diagnosed as asthmatic bronchitis. But symptoms developed again, she readmitted. A lateral X-ray film of the neck and neck spiral CT revealed a 6x5 mm sized homogeneous mass in the posterior wall of the subglottic region causing airway obstruction. A laryngoscopy was performed and showed a 4x5 mm sized cystic mass in the subglottic region. Endoscopic resection was done by Nd : Yag laser. The postoperative course was satisfactory. Histologic examination showed a ductal cyst, lined with ciliated cuboidal epithelium. This subglottic ductal cyst was believed to be a late complication of endotracheal intubation.

A Case of Kimura's Disease Probably Associated with Pregnancy / 대한피부과학회지

We report a case of Kimura's disease in a 28-year-old female who had recurring and aggravated original lesions that have been diagnosed as Kimura's disease during each of her pregnancies. She was presented with a palm-sized deep indurated plaque on her right thigh and a coin-sized subcutaneous nodule on her left post auricular area during her first pregnancy. Three months postpartum the lesions had decreased to approximately half their original size. This event recurred and was aggravated during her second and third pregnancies. This case is very interesting in supporting the pathogenic role of hormonal changes in the pathogenesis of Kimura's disease.

A Favre-Racouchot Syndrome Developed on the Applied area of Topical Corticosteroid / 대한피부과학회지

Favre-Racouchot syndrome, also known as nodular elastosis with cysts and comedones, typically presents with large black open comedones, furrows, and nodules in the periorbital region and over the malar eminence. The pathogenesis of Favre-Racouchot syndrome is still uncertain. However it has been postulated that damage from ultraviolet radiation, combined with some unknown host predisposition, leads to the degeneration of the supporting dermal connective tissue. We report a case of Favre-Racouchot syndrome that developed on the applied area of topical corticosteroid for a preceding post-herpetic neuralgia lesion. This case is unique to suggest that the catabolic effect of corticosteroid is superimposed on the UV-induced degeneration of dermal connective tissue as a pathogenic mechanism of Favre-Racouchot syndrome.

A Case of Extensive Kerion Celsi due to Microsporum canis in an Aged Woman / 대한의진균학회지

Kerion celsi, a severe inflammatory type of tinea capitis, which occurs chiefly in children between the ages of 4 and 14 years. We report a case of kerion celsi occuring in an elderly woman. She is a 67-year old wonman, presented with inflammatory, boggy mass studded with broken hairs, and oozing purulent materials from follicular orifices on the parietal scalp, which had been extending over almost entire scalp for 2 weeks. Kerin celsi caused by M. canin with atypical microscopic findings of the colony on the Sabouraud's dextrose agar was diagnosed by PCR analysis using PAPD method. This case is reported with two interesting facts: Kerion celsi is occuring rarely in old persons; Clinically kerion celsi progessed rapidly after onset in this case.