BACKGROUND: In autoimmune bullous dermatoses, such as pemphigus and bullous pemphigoid, variations in the expression of the antigen in different body locations are recognized. OBJECTIVE: The degree of expession of epidermolysis bullosa acquisita (EBA) antigen in different sites on the body surface was estimated from the highest dilution factor of EBA sera that gave a positive reaction at a site by indirect immunofluorescence (IF). METHODS: Two sera, obtained from EBA patients with inflammatory and mechanobullous skin lesions, having antihody titers of 160 against the dermal component of the NaCl split skin, were used by indirect IF techniques with 20 specimens (2 from each of 10 locations) of normal human skin from different sites. These 20 skin samples were obtained from 10 healthy adults (1-3 from each individual). RESULTS: The greatest expression of the antigen was in the skin taken from the upper back with the titer of 160. EBA antigen was least recognized in skin specimens from the inner thigh and calf. Skin from the scalp, abdomen, and anterior chest and others demonstrated intermediate degrees of expression. CONCLUSION: There was some moderate degree of variation in the expression of EBA antigens in skin samples obtained from different locations on the body. It seems however that there is not any positive correlation between the degree of expression of EBA antigen in each location and predilection sites (possibly the trunk) of clinical lesions in EBA.
Abdomen ; Adult ; Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa* ; Fluorescent Antibody Technique, Indirect ; Humans ; Pemphigoid, Bullous ; Pemphigus ; Scalp ; Skin ; Skin Diseases, Vesiculobullous ; Thigh ; Thorax

BACKGROUND: There is increasing concern in many countries about the problem of drug-resistant tuberculosis. Prevalence of primary drug-resistant tuberculosis is the optimal epidemiological indicator for long term monitoring of national tuberculosis control program. Our purpose was The purpose of our study is to assess clinical characteristics and socioeconomic status of patients with drug-resistant tuberculosis. METHODS: We studied 68 cases with durg-resistant Mycobacterium tuberculosis infection diagnosed at the Ewha Womans University Mokdong Hospital from March, 1995 to February, 2000. RESULTS: Patients with primary drug-resistant tuberculosis(PDR) were younger(39.6±16.3 years vs. 48.2±16.5 years; p<0.05), had more population of less than more were under the age of 40 years aged-group(62.9% vs. 36.4%; p<0.05) and were more highly educated than those with acquired drug-resistant tuberculosis(ADR)(38.9% vs. 11.1%; p<0.05). In patients with ADR, the rates of familial history of tuberculosis and living in a rented house residence in a rented house were increased higher than compared with to those of patients with PDR. Patients with ADR had more involved lobes(2.0±0.8 vs. 1.4±0.7; p<0.01) and longer treatment duration than those with PDR(18.3±7.2 months vs. 10.6±6.3 months; p<0.05). Patients with ADR showed larger numbers of resistant were resistant to more number of drugs, lower hospitalization rate and higher rate of self-interruption of medication than those with PDR. In patients with PDR, mono-drug resistance was increased, whereas poly-and multi-drug resistances were decreased compared with those with ADR. Resistance to isoniazid was the highest among antituberculosis drugs, and resistance to isoniazid in patients with ADR was higher than that in patients with PDR(90.9% vs. 71.4%; p<0.05). CONCLUSIONS: Patients with ADR were more likely to include more population be of lower socioeconomic class, and patients with PDR seem seemed to be young and socially active population. For control of drug-resistant Mycobacterium tuberculosis infection, proper isolation and prevention of patient with drug-resistant tuberculosis are needed.
Female ; Hospitalization ; Humans ; Isoniazid ; Mycobacterium tuberculosis ; Prevalence ; Social Class ; Tuberculosis ; Tuberculosis, Multidrug-Resistant*

We describe five patiens with autoimmune bullous der matosis who presented cutaneous lesions localized on the face. In these patients iuumunopathologically confirmed diagnoses were penphigus erythematosus, bullous pemphigoid, cicatricial pernphigoid(Brunsting-Perry variant), epidemic lysis bullosa acquisita and bullous systemic lupus erythematosus in each. Except, for the case of pemphigus erythematosus, facelimited cutnious lesions can be seen rarely with these imrnunobullous diseases. We suggest that some external, in malfactors such as UV light and photosensitivity might be regarded as the precipitating factors fo the clinical rnanifestations of those skin lesions, and which should be included in the differential diingosis of vesiculobullous diseases involving the face.
Diagnosis ; Humans ; Lupus Erythematosus, Systemic ; Pemphigoid, Bullous ; Pemphigus ; Precipitating Factors ; Skin ; Ultraviolet Rays

To investigate the involvement of expression of the Fragile Histidine Triad(FH1T) gene product in the process of carcinogenesis and progression in cervical carcinoma, we examined its expression by immunohistochemical method in 15 cervical invasive carcinomas, 10 low grade cervical intraepithelial neoplasias(CINs) and 30 high grade CINs(CMI and III). We detected expression of FHIT gene product in 4 of 15(27%) of invasive carcinomas, 3 of 10(30%) low grade CIN and 7 of 30(23%) of high grade CIN, while we detected expression of FHIT gene product in 28 of 45(62%) normal and metaplastic epithelium near the tumor. Thesc data indicate that loss of expression of FH1T gene product has some role in the early tumorigenesis of uterine cervical carcinoma, but not the consequence of the pregression of the tumor.
Carcinogenesis ; Epithelium ; Histidine* ; Immunohistochemistry

Gall bladder wall varices are unusual manifestations of protal hypertention. Authors report 4 cases of gall bladder wall varices which were easily detected in IV bolus CT. All of our cases showed main portal vein obstruction but preserved intrahepatic portal flows with development of cavernous transformation. We could easily identify tortous and tubular structures with strong contrast enhancement in the gall bladder wall, compatible with gall bladder wall varices, at the early phase of IV bolus CT. Comparing with Doppler sonography, IV bolus CT is an easy and useful method for detection of gall bladder wall varices even in case of no prior information for portal vein abnormality.
Diagnosis* ; Methods ; Portal Vein ; Urinary Bladder* ; Varicose Veins

Backgraund : Most of the inflammatory bullous lesions in bullous pamphigoid(BP) and epidermolysis bullosa acquisite(EBA) demonstrate similar clinical and histological features. However, the specificities of the autoantibodiea reactive to the dermo-epidermal junction antigeins are different. In these two bullouk dermat loses, there are no remarkable differences in symptomaiology, there are no unique predilection sites for the lesions and they do not usually leave scars after nvolution. Considering these similarities, dermatologists could encounter some clinical confuiion in maling a provisional diagnosis. OBJECTIVE: Authors examined three patients of BP with classic inflammatory bullous eruptions and threa patients of EBA with inflammatory bullous lesions to see if here were any differences in the morphology of the immuno-fluorescence(IF) pattern. METHODS: For direct IF of vertical or semi-vertical sections, perilasional skin was obtained in each patient for indirect IF of horizontal or semi-horizonta1 sections, Ig(bound substrates were prepared from all these autoantibody-positive individuals. All specimens veri; observed at 200/400-magnification fields through an ordinary fluorescence microscopy. RESULTS: Patterns of fluorescence observed by direct IF were characterized as thin-linear in BP and thick/coarse-linear in EBA along the basement membrane zone. On the horizontal section preparations in indirect IF, the patterns of fluorescence were clean-linear in E3P hnd more fluffy-linear in EBA at the dermoepidermal junction, These patterns could be recognized aim/larly in the fields of both 200 and 400-magnification, however each minor differences were not easy to distinguish each other. CONCLUSION: The above findings of subtle differences in the pattern of IF may provide some suggestions to the examiners for the need of differential diagnosis in theae riseases.
Basement Membrane ; Blister ; Cicatrix ; Diagnosis ; Diagnosis, Differential ; Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa* ; Fluorescence* ; Humans ; Male ; Microscopy, Fluorescence ; Pemphigoid, Bullous* ; Skin

Backgraund : Most of the inflammatory bullous lesions in bullous pamphigoid(BP) and epidermolysis bullosa acquisite(EBA) demonstrate similar clinical and histological features. However, the specificities of the autoantibodiea reactive to the dermo-epidermal junction antigeins are different. In these two bullouk dermat loses, there are no remarkable differences in symptomaiology, there are no unique predilection sites for the lesions and they do not usually leave scars after nvolution. Considering these similarities, dermatologists could encounter some clinical confuiion in maling a provisional diagnosis. OBJECTIVE: Authors examined three patients of BP with classic inflammatory bullous eruptions and threa patients of EBA with inflammatory bullous lesions to see if here were any differences in the morphology of the immuno-fluorescence(IF) pattern. METHODS: For direct IF of vertical or semi-vertical sections, perilasional skin was obtained in each patient for indirect IF of horizontal or semi-horizonta1 sections, Ig(bound substrates were prepared from all these autoantibody-positive individuals. All specimens veri; observed at 200/400-magnification fields through an ordinary fluorescence microscopy. RESULTS: Patterns of fluorescence observed by direct IF were characterized as thin-linear in BP and thick/coarse-linear in EBA along the basement membrane zone. On the horizontal section preparations in indirect IF, the patterns of fluorescence were clean-linear in E3P hnd more fluffy-linear in EBA at the dermoepidermal junction, These patterns could be recognized aim/larly in the fields of both 200 and 400-magnification, however each minor differences were not easy to distinguish each other. CONCLUSION: The above findings of subtle differences in the pattern of IF may provide some suggestions to the examiners for the need of differential diagnosis in theae riseases.
Basement Membrane ; Blister ; Cicatrix ; Diagnosis ; Diagnosis, Differential ; Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa* ; Fluorescence* ; Humans ; Male ; Microscopy, Fluorescence ; Pemphigoid, Bullous* ; Skin

Early diagnosis and treatment of congenital dislocation of the hip is the only means of obtaining good results with consistent regularity. But a large number of congenital dislocation of the hip remain undiagnosed before the child begins to walk. One hundred and nine cases of congenital dislocation of the hip had been clinically diagnosed and 48 cases of them were treated conservatively or operatively at Department of Orthopedic Surgery, College of Medicine, Seoul National University from January, 1965 through September, 1975 with following results. 1. Among 109 cases of congenital dislocation of the hip, 48 cases were admitted and treated. In recent 10 years the number of the out-patient was increasing. 2. The preponderance of female to male (4:1) was found. 3. The age ranged between 3 months and 24 years, and 46 cases (42%) between 12 and 24 months. 4. In most cases the chief complaint was limping. 5. The associated congenital anomalies were observed in 3 cases of the series, comprising two cases of arthrogryposis multiplex congenita and one case of hydrocephalus. 6. The scetabular index was increased in affected hip. 7. The ratio of unilateral cases to bilateral ones was 100: 9, and right to left was 47: 53. 8. Closed reduction was satisfactory in 25 cases under 2 years of age. 9. Open reduction was necessary in 18 cases of failed closed reduction and 5 cases of redislocation. 10. Eleven cases of Salter's operation, 4 cases of Pembertons operation, 2 cases of Colonnas operation, and 8 cases of derotational osteotomy were performed to increase the stability of the hip joint.
Arthrogryposis ; Child ; Dislocations ; Early Diagnosis ; Female ; Hip Joint ; Hip ; Humans ; Hydrocephalus ; Male ; Orthopedics ; Osteotomy ; Outpatients ; Seoul

Fracture of intercondylar eminerce of the tibia indicate probable alteration of the cruciate ligament stability in the knee and occur from hyperextension injury of the knee and violent internal rotation of the tibia. Fracture of intercondylar eminence of the tibia has been classified by Meyer and Mckeever(1959, 1970) according to the degree of displacment and this classification is important as it pertains to the proper selection of treatment. The author studied 24 cases in 24 patients of fracture of the intercondylar eminerce of the tibia at the Department of Orthopedic Surgery of Severance Hospital during a 10 year period from Januaary, 1975 until December, 1984. The aim of this study was to find out incidence, cause and associated injury of the fracture of the intercondylar eminece of the tibia and was to asses the comparative results of the conservative and surgical treatment. The result of this study ase as follows ; 1. There is a predisposition for make in a ration of 3:1 and there is no age preponderance in occurance. 2.Majority of cause of injury was traffic accident(62.5%). 3.Isolated fracture of intercondylar eminence of the tibia was 15 cases (62.5%) associated knee joint injury shows 9 cases (37.5%). Among the associated knee joint injury, rupure of medial collateral ligament was 4 cases(44.4%), rupture of medial meniscus was 3 cases(33.3%) and rupture of lateral colateral ligament was 2 cases (22.2%). 4.By Meyer and Mckeever's classification, Type 2(41.7%) fracture of intercondylar eminence of the tibia was most common, and then Type 1(37.5%) and Type 3(20.8%) occured in order of frequency. 5. Type 1 and Type 2 fracture of the intercondylar eminence of the tibia resulted in good prognosis with only conservative treatment, and open reduction is not indicated. 6. Type 3 fracture of the intercondylar eminence of the tibia can be treated with conservative treatment if there is no associated injury of the knee joint.
Classification ; Clinical Study ; Collateral Ligaments ; Equidae ; Humans ; Incidence ; Knee ; Knee Joint ; Ligaments ; Menisci, Tibial ; Orthopedics ; Prognosis ; Rupture ; Tibia

PURPOSE: To obtain the useful information about tumor behavior of hepatocellular carcinoma by analyzing the recurrence pattern after curative resection. MATERIALS AND METHODS: Forty-two patients who underwent curative resection of hepatocellular carcinoma were analyzed. Based on the firstly detected radiologic recurrence, we classified recurrence patterns into three types, type I;marginal recurrence, type II;intrahepatic nodular(multiple, single) and type III;extrahepatic. We also analyzed its duration of recurrence after curative resection. RESULTS: Eighteen patients showed no radiologic recurrence during follow-up period(mean 19.2 months). Twenty-four patients showed radiologic recurrence at 29 sites and its mean duration was 11.0 months. Recurrence patterns were seven cases in type I, 14 cases in type II(multiple 11, single three), eight cases in type III including two omental, two extrahepatic lymph node, two brain, one spine, and one intracranial metastasis. Among the extrahepatic recurrences, five cases showed only distant metastasis without hepatic recurrence. Mean duration of recurrence according to the site was 16.0 months in type I, 12.6 months in type II, 12.3 months in type III. Among 20 patients with single site recurrence, type 11(9.0 months) was earlier than type 1(10.3 months). CONCLUSION: lntrahepatic recurrence is more common than extrahepatic recurrence. Intrahepatic nodular, especially multinodular recurrence, is more common than marginal recurrence. Intrahepatic recurrence has tendency to develope earlier metastain earlier than marginal recurrence.
Brain ; Carcinoma, Hepatocellular* ; Follow-Up Studies ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence* ; Spine