• Childhood Kidney Diseases
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• v.10 no.1
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• pp.40-44
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• 2006

[ $Henoch-Sch{\"{o}}nlein$ ] purpura(HSP) is a systemic small vessel vasculitis characterized by cutaneous purpura, arthritis, abdominal pain and nephritis. The characteristic rash of HSP consists of palpable purpura on the buttocks and lower extremities. Bullous lesions often appear in adults with HSP, whereas they are very rare in children with HSP. In this case report, the patient presented with arthralgia and abdominal pain and had hemorrhagic bullae as a prominent manifestation of the disease. The skin biopsy of the patient revealed typical leukocytoclastic vasculitis of dermal vessels and prominent IgA and fibrinogen deposits on capillary walls by direct immunofluorescence. We confirmed the diagnosis of HSP and observed improvement of clinical symptoms and signs within a few days after corticosteroid treatment. We therefore report a case with a review of the literature.

• Korean Journal of Community Nutrition
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• v.26 no.5
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• pp.396-407
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• 2021

Objectives: We examined the common allergenic foods, symptoms and management of food allergies in children attending the facilities registered at Center for Children's Foodservice Management in Gangdong-gu, Korea. Methods: The survey was conducted among the directors or head teachers of 186 children's food service facilities with 7,591 children in 2019. The questionnaire consisted of three parts, including general information about food service facilities, information related to food allergies and allergenic foods and symptoms in individual children. Results: The number of children with food allergy was 271 (3.6%), and the proportion decreased with the increase of age. There were 91 children (33.6%) with a medical certificate, and these children had a significantly higher number of allergenic foods and symptoms than those without a medical certificate. Allergenic food groups included meat, fish, eggs and legumes (59.1%), fruits (12.4%), milk and dairy products (8.9%), cereals (7.8%), vegetables (6.2%), processed foods (3.8%) and oils and sugars (1.9%). Eggs accounted for 22.1%, followed by peanut and tree nuts (18.6%), fruits (12.4%), milk and dairy products (8.9%), shellfish (8.6%), vegetables (6.2%), fish (5.7%), cereals (4.3%) and meat (1.1%). The common allergenic foods were eggs, peanuts, walnuts, kiwi, shrimp, milk, tomatoes, mackerel, blue-green fish, peaches, shellfish (clams and abalone), buckwheat, wheat and soybeans. The most common allergic symptoms were skin and mucous membrane symptoms, such as hives, rash, itching and oral angioedema. Meal management for children with food allergies showed different trends depending on the causative food. Conclusions: The objective diagnosis by an allergist should be done for food allergy management in children's catering facilities. A system for systematic meal management of causative foods should be prepared.

• Korean journal of dermatology
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• v.56 no.10
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• pp.594-602
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• 2018

Background: Acute generalized exanthematous pustulosis (AGEP) is typically a medication-induced acute febrile eruption. Few large-scale studies have reported clinical data regarding AGEP in Korea. Objective: This study analyzed the clinical and histopathological features of AGEP in Koreans to identify recent trends in this context. Methods: This study retrospectively reviewed 31 patients with AGEP. Age, sex, clinical features, etiologies, laboratory findings, histopathological features, and treatment outcomes were obtained from patients' medical records and photographs. Results: The mean age of onset was 43.6 years, and the male : female ratio was 2.1 : 1. All patients showed non-follicular tiny pustules and erythema. Fever was reported in 13 patients and neutrophilia in 17 patients. Medications were considered the most common etiological contributors. Twenty patients showed drug-induced AGEP, and 11 of 20 patients showed antibiotic-induced AGEP. Serum C-reactive protein and lactate dehydrogenase levels increased in 93.8% and 77.8% of the patients, respectively. Histopathologically, all patients showed subcorneal or intraepidermal pustules, followed by exocytosis and neutrophilic dermal infiltrate. Twenty-five patients improved within a mean period of 7.5 days after the onset of the skin rash. The percentage of women in the drug-induced AGEP group was significantly higher than that in the non-drug-induced AGEP group. Conclusion: This report describes a large-scale study that analyzed the clinical and histopathological features of AGEP in Koreans and seems to accurately reflect the recent trends in this context. Clinically, it is important to note that the percentage of women in the drug-induced AGEP group was higher than that in groups showing other etiologies of AGEP.

• Journal of Genetic Medicine
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• v.15 no.2
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• pp.92-96
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• 2018

Chronic mucocutaneous candidiasis (CMC) is characterized by increased susceptibility to chronic and recurrent infections of the skin, mucous membranes, and nails by Candida species. It is a primary immunodeficiency disorder that is difficult to diagnose because of its heterogeneous clinical manifestations and genetic background. A 20-month-old boy who did not grow in height for 3 months was diagnosed as having hypothyroidism and he had hepatitis which was found at 5 years old. He presented with persistent oral thrush and vesicles on the body, the cause of which could not be identified from laboratory findings. No microorganism was detected in the throat culture; however, the oral thrush persisted. Immunological tests showed that immunoglobulin (Ig) subclass IgG and cluster of differentiation (CD)3, CD4, and CD8 levels were within normal limits. We prescribed oral levothyroxine and fluconazole mouth rinse. The patient was examined using diagnostic exome sequencing at the age of 6 years, and a c.1162A>G (p.K388E) STAT1 gene mutation was identified. A diagnosis of CMC based on the STAT1 gene mutation was, thus, made. At the age of 8 years, the boy developed a malar-like rash on his face. We conducted tests for detection of antinuclear antibodies and anti-dsDNA antibodies, which showed positive results; therefore, systemic lupus erythematosus (SLE) was also suspected. Whole exome sequencing is important to diagnose rare diseases in children. A STAT1 gene mutation should be suspected in patients with chronic fungal infections with a thyroid disease and/or SLE.

• Korean Journal of Acupuncture
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• v.37 no.4
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• pp.253-261
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• 2020

Objectives : This study aimed to evaluate adverse outcome associated with acupotomy and compare it with that of acupuncture. Methods : We retrospectively analyzed the chart records of 71 patients who received acupotomy at Daemyung Korean medical clinic from January 7, 2020 to March 6, 2020. We divided the acupotomy treatment area into 10, including the head, hand, chest, knees, shoulders, low back, neck, upper extremities, thighs, and feet. Furthermore, we investigated the adverse effect of acupotomy on those areas after treatment. Data were analyzed using descriptive statistics, and frequency analysis. Results : 'Bruise of specific region' accounted for the largest portion with 29 cases, followed by 24 cases of 'feeling tired and sleepy' and 17 cases of 'itch'. There were 16 cases of 'sustained pain' at the area of treatment, 11 cases of 'fatigue', 5 cases of 'swelling', 5 cases of 'dizziness', 4 cases of 'hematoma'. There were 3 cases of 'vertigo' and 2 cases of 'parathesia' and 'wide bruises', 'headache', 'gastric discomfort', 'bleeding', and 'skin rash' each. There was one case each that experienced 'unclear pronunciation', 'nausea', 'abnormal sweating', 'vomiting' and 'emotional/psychological reactions'. Conclusions : Adverse outcomes associated with acupotomy were mostly 'bruise of specific region', 'feeling tired and sleepy', 'itch', 'sustatained pain', and 'fatigue'. However, no adverse outcome or irreversible damage that have a serious effect on the body were observed.

• Korean Journal of Head & Neck Oncology
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• v.38 no.2
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• pp.23-27
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• 2022

Systemic lupus erythematosus(SLE) is a multisystemic disorder of autoimmune etiology. SLE can occur commonly in young women, and the early symptoms include fever, myalgia, arthralgia, weight loss, lymphadenopathy and these nonspecific symptoms develop into skin rash, splenomegaly, serositis and encephalopathy. Diagnosis of SLE requires clinical and serologic criteria, and treatment choices are hydroxyquinolone and NSAIDs for mild disease, corticosteroids and immunosuppressant for severe disease. In lupus patient, the prevalence of lymphadenopathy is 12~59%. Although lymphadenopathy is common finding in SLE, it is hard to distinguish in early phase of SLE. A 38-year-old woman visited our hospital for cervical lymphadenopathy with polyarthritis and malaise. Multiple cervical lymph nodes enlargement was found on Neck CT, and serologic laboratory test including ANA, antiphospholipid antibody, and anti-dsDNA was positive. For excluding lymphoma, PET-CT and excisional biopsy were performed. The patient finally diagnosed with SLE, and got regular follow-up without complication.

• Korean Journal of Acupuncture
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• v.25 no.1
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• pp.85-97
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• 2008

Objectives : Moxibustion therapy is one of the most popular oriental treatments in Korea. In this study, we operate the in-depth interview for use of moxibustion therapy in Korea. Methods : Survey questions were developed based on consensus of acupuncture professors. The list of the Korean medical doctors with experiences more than 10 years is provided by the Association of the Korean Oriental Medicine. The in-depth interview was conducted in 30 Korean medical doctors who answered in the previous telephone survey that they use moxibustion therapy for more than 30 % of patients everyday. Interview survey with them were conducted by the well-trained interviewers of Korea Institute of Oriental Medicine in medical researcher from 22th May to 28th June 2007. Results : Korean medical doctors prefer to use the moxibustion with moxa stick (83.9%). The most common treatment disease was musculo-skeletal disorder (28.9%), gynecology (14.1%), digestive disorder (28.6%). The most common treatment area was the abdomen (35.3%), back (22.5%), lower extremity (15.8%) and upper extremity (16.9%). Indirect moxibustion’s was as frequent as 73.5% of moxibustion method. The most common instrument for treating was mini-moxa of manufactured goods (39.3%). Most Korean medical doctors (48.8%) took up the position that bring symptom relief following good treatment area. 'High preferences of patients' (32.7%) was one of moxibustion strong points but 'Lots of smell and smoke' (54.7%)' was a weak points. The most common side effects was the 'slight burn' (34.9%), 'skin rash' (22.5%), 'skin pruritus' (23.8%) Conclusions : This survey provides unique insight into the perception of the Korea medical doctor at moxibustion therapy. Future research needs to provide more in-depth insight into doctor views of the experience.

• Tuberculosis and Respiratory Diseases
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• v.57 no.1
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• pp.55-60
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• 2004

Anticonvulsant hypersensitivity syndrome (AHS) is an uncommon, but potentially fatal and mutilsystemic disorder that occurs after exposure to the arene oxide-producing anticonvulsants-carbamzepine, phenobarbital and phenytoin. The multisystemic reactions include fever, skin eruptions, lymphadenopathy, hematologic abnormality and hepatitis. The diagnosis of AHS is made by history of drug exposure and clinical course. No specific treatments are proved as benefit except discontinuing the offending drug and trying the steroids in some severe cases. We report a case of carbamazepine induced anticonvulsant hypersensitivity syndrome characterized by skin rash, eosinophilia, subcarinal lymphadenopathy and eosinophilic pneumonia. The patient was resolved completely after only discontinuing carbamazepine.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.8 no.1
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• pp.131-132
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• 1995

After studing of viewpoint of surgical disease in seven medical books related with Ju Dan Gye(朱丹溪) among four eminent physicians in the Jin and Yuan dynasties(金元四大家) I get conclsion as following. 1. Studied surgical diseases are total 40 kinds. 2. In 40 kinds surgical diseaes, case of having theory are 20 kinds, cases of having no theory and having only treatement by medicine are 20 kinds. 3. In therapy, cases that mainly use a method to eliminate pathogenic factors are 27 kinds; Acute mastitis(乳癰), Deep-seated mammary abscess(내巖), Acute appendicitis(陽癰), Bone cellulitis(附骨疽), Carbuncle of the lower abdomen near external genitalia(便毒), Leprosy(癩風), Macule(斑), Rash(疹), Urticaria(은疹), Scrofula(나역), Stagnant plegm(結核), Goiter andtumer(영유), Erysipelas(丹), Furuncle(정瘡), Scabies(疥瘡), Chancre(下疳瘡), Syphilitic skin disease(樣梅瘡), Incised wound (金瘡), Dermatopathy of lower limb and heel(脚足部瘡), Pemphigus(天疱瘡), Itching eruption due to blood-heat or wind heat(血風瘡), Dermatopathy of head(頭面瘡), Scald and burn(湯火瘡), Tetanus(破傷風) , Ecthyma(염瘡), Fistula(久漏瘡), Tinea(癬瘡), Cases that mainly use external therapy are 5 kinds; Rhagades of hand and foot(手足군裂), Vulvar ulceration(婦人陰瘡), Chilblain(凍瘡), Rabies(풍狗咬), Tinea capitis(白禿瘡), Cases that mainly use a reinforcing method are 4 kinds; Internal deep-rooted carbuncle(內疽), Pruritus and dryness of skin(皮膚乾燥), Anul fistula(漏瘡), Macule Caused by disorder of internal organ(內傷發斑), Cases that mainly use eliminating first and then reinforcing are 2 kinds; Pyogenic infection and ulcerous disease of slin( 疽瘡상癰疽瘡瘍), Lung abscess(肺癰), Case that mainly uses reinforcement and elimination in combination is only Haemorroid(痔瘡). Case divided into two groups that are reinforcing method and a method to eliminate pathogenic factor is only Trauma(打撲). Case that have no treatment by medicine is only Abscess of the scrotum(囊癰). 4. In 40 kinds surgical diseases, we can know that except a few important surgical diseases, Ju Dan Gye haven't distinguished viewpoint in many surgical diseases, because there are many cases that have no theory and have only simple treatment of medicine, and that mainly use a method to eliminate pathogenic factors and external therapy. 5. Representative theory of Ju Dan Gye, nourishing Yin and extinguishing fire(滋陰降火), has little effect on therapy of surgical disease. We need to try statistical division of internal and external remedy in the future, and by studing of surgical disase in medical books related with four eminent physicians in the Jin and Yuan dynasties, I think we can see their viewpoint of surgical disease.

• Archives of Plastic Surgery
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• v.34 no.1
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• pp.77-80
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• 2007

Purpose: Purpura fulminans is a rare but rapidly progressive, serious, often life-threatening disorder in childhood, which is complicated with septic shock or disseminated intravascular coagulopathy during acute infection. It occurs first as acute-onset petechial rash, and spreads rapidly into full thickness skin and soft tissue necrosis. In the past, it had high mortality rate, up to 80%, but recently, survival rate has increased due to early diagnosis, and rapid advancement of critical care and antibiotics. From our experiences of PF management, we would like to review the pathophysiology and suggest the surgical treatment guideline about meningococcal induced purpura fulminans. Methods: Two cases of purpura fulminans over the last 3 years were reviewed retrospectively about reconstructive management. After they were treated resuscitative management initially by the critical intensive care, reconstructive surgery was performed by plastic surgeon as soon as the patients were vitally and mentally stable. Results: There were 6 procedures in case 1, and 3 procedures in case 2. The mean delayed period from admission with sepsis to the first surgical debridement was 24 days and 42 days, respectively. Total hospitalization period was 103 days and 69 days, respectively. All of them were treated with debridement and split thickness skin graft, but delayed debridement was superior to early one in the point of preserving much more tissues. Conclusion: From our experience, we suggest that conservative therapy to the wounds appears to be the best tool in the initial vitally unstable period in order to preserve as much tissues and functions as possible if no active inflammation and compartment syndrome are detective.