Mycobacteriosis cutis is largely classified to localized forms and exanthematous forms and it is subdivded into five diseases in detail, each. They are 1) primary tuberculous complex, 2) lupus vulgaris, 3) tuberculous verrucosa cutis 4) scrofulo derma, and 5) tuberculosis cutis orificialis in localized ferms and 1) tuberculous miliaris disseminata, 2) lupus miliaris disserninaia faciei, 3) papulonecrotic tuberculid, 4) lichen scrofulosorom and 5) ervthema induratum in exanthematous forms.Rich(1944) insisted on that, the pathogenesis of cutaneous tuberuculosis was essen tially the sarne as that for tuberculosis in general. He said that aII forms of cutaneous tuberculosis were produced by the local action of the bacilus of tuberculosis. In the formerly termed true tuberculosis such as lupus vulgaris, the microorganisrns were found in varing numbers in the lesions, and animal inoculations of tissue were successful, In other forms represented by the tuberculids, the bacillus of tuberculosis was found only in the earilest stages before the true clinical and histological picture had developed, Its short lived existence in this forms was explained by the allergic statc of the tissues and this fact exnlained the failure to find the microorganisms in the lesions, or reproduced the affection by inoculations in animals, in cases sufficiently developed to be recognizable clinically and histologically. The other generally accepted view is that the mycobacteriosis cutis, especially the types in the category of tuberculids are caused by the hematogenous dissemination of tubercle bacilli from a focus, often extrapulmonary in location, into the skin, where they are rapidly destoryed. spiet and Roeckie(1960) agreed with above menitioned plausible theories with the background of their hypothesis, that was the skin was hyperegic, And Miescher(1951) also insisted that, skin had a decreased immunologic resistance. But according to Flegel(1957), if the skin was in a state of hyperegic reaction, the focus from which the dissemination was taking place was also should be in a hyperegic state and vice versa should be right, And moreover, Suizberger(1940) declared that whenever microorganisms or their products were being overcome or neutralized by local lmmunologic reactions, tubercles or tubercles or tuberculoid structures had a tendency to appear. So the theories of different immunologic state between the skin and focus were discarded. After that many authors proposed three factors against a tuberculous etiology of tuberculids. First, inoculation of tissue from lesion into guinea pigs and culturing of such tissue have given no evidence for tuberculosis. Second, active tuberculosis occurs no greater frequency in patients with tuberculids than in the general population. Third, tuberculids does not respond to antituberculous treatment but responds to the adminiatration of corticosteroids. According to Eberhartinger(1963), Schneider and Undeutsch(1965), in erytbema induraturn the primary event is a vasculitis of subcutaneous arteries and veins. And any fat necrosis following vascular damage can develop a tubereuloid appea- rance. Lever(1967) declared with self confidence that it was a relic of the times- when a tuberculoid histology was tantamount to tuberculosis. In this condition we decided to clarify that whether the mycobacteriosis cutis, especially the disease in the category of tuberculids, could be originated from mycobacteria tuberculosis in fact or not. Eleven patients, whose clinical diagnosis were skin tuberculosis or very similar to those diseases such as erythema. nodosum, were biopsied by 5mm puncher after 2% procaine injection on their two of skin lesions, the early one for the culture of tubercle bacilli and the oId one for histopathological study, on the O.P.D. of dermatologic department in Severance Hospital. Those biopsied material of early lesion was digested with proper amount of 4% NaOH and fragmented in tissue grinder about 10 minutes. After that, it was centrifuged in rotating speed of 3,500 r.p.m. for 30minutes, and neutralized by 8% HCl after adding phenol red drop by drop. Again it was centrifuged by same as previous method and its supernatant was discarded. The remnants of precipitin was inoculated on Ogawa's nutrient tuberculous media in incubator at 37C. Finally the acid-fast tubercle bacilli have been grown on the Ogawa's media three months after its first inoculation. The inoculation material was biopsied from the patient of eighteen year-old girl, whose clinical and histopathological diagnosis was erythema induratum. From the result of this study, we got the strong confidence that in spite of many authors powerful countertheories and the extremely poor harvesting of its culture, the erythema induratum can be or in evidently caused from mycobacterium tuberculosis. It may be early days yet to say that erythema induratum is originated fromtubercle bacilli but it is considered to be a truth in Korea, with the result of this study.
Adrenal Cortex Hormones ; Animals ; Arteries ; Bacillus ; Diagnosis ; Erythema ; Erythema Induratum ; Fat Necrosis ; Female ; Guinea Pigs ; Humans ; Incubators ; Korea ; Lichens ; Lupus Vulgaris ; Mycobacterium tuberculosis ; Phenolsulfonphthalein ; Procaine ; Skin* ; Tuberculosis ; Tuberculosis, Cutaneous* ; Vasculitis ; Veins

A case of malignant melanoma developed from giant congenital pigmented nevus in a seven year old girl was reported. Since the identification of benign juvenile melanoma, the distinct rarity of true cutaneous malignant melanoma in infants and children has become generally recognized. In giant congenital pigmented nevus, the malignant melanoma as a rule arises deep in the dermis. In this case, the histopathologic finding shows no junctional activity in epidermodermal juction other than ordinary nevocellular nevi, but some nevus cell nests and mild inflammatary cell infiltration in the upper dermis. And in the deep dermis, well marginated but not encapsuIated huge tumor mass, in which variable sized, pleomorphic, several vigorous mitotic figures in predominantly cuboidal cells and bizarre giant cells, which was thought to be developed from giant congenital pigmented nevus. The few recorded cases of fatal cutaneous malignant melanoma in early life are of two types: those arising in giant congenital pigmented nevi and ordinary small nevi, de novo including small nevus. The former account for between 22% and 40% of the total. This case is one of the reported 20 cases in the world.
Child ; Dermis ; Female ; Giant Cells ; Humans ; Infant ; Melanoma* ; Nevus ; Nevus, Pigmented*

The clinical findings in the Vogt-Koyanagi-Harada syndrome ae reviewed and eight cases reported emphasizing the cutaneaus changes. The syndrome consists of symptoms of poliosis, vitiligo, alopecia, meningeal irritation sign, nontraumatic uveitis, and dysacousia. Meningeal or ocular symptons usually appear first, but in some patients thc cutanious changes have been observed beforc the uveitis. The etiology rernains unsettied, but an allergic mechanism or a virus infection is favaveci by most observers. Early diagnosis is important because ocular mobidity can be reduced significantly in some patients if treated in the early stages. During the course of treatment of our patients, corticosteroid is appeared to be the most effective drug for this uncertain etiologic syndrome and this fact may eventually support. the theory nf autoimmue mechanisn. The daily does of corticosteroid is prednisolone 60mg and the duration of administration is from 15 days to 2 months, after that the dose is graclually decreased in relation with the degree of symptoms. The ophthalrnologic symptoms were markedly improved 10 days after the administvation of prednisolonc. The purpose of this report is to emphasize the cutaneous findings in this syndrome, to point out that the cutaneous manifestations may lead to establishing tne diagnosis and on the basis of that, those patients can be received prompt, suitable treatment to avoid the grave ocular morbidity.
Alopecia ; Diagnosis ; Dronabinol ; Early Diagnosis ; Humans ; Prednisolone ; Uveitis ; Uveomeningoencephalitic Syndrome ; Vitiligo

No abstract available.
Female ; Humans ; Osteoporosis* ; Uterine Prolapse*

Functional paraganglioma of the mediastinum is an uncommon tumor of the paraganglion system that causes symptoms and signs of episodic catecholamine release. It has not been reported in Korea. We experienced a case of a 17 years old man with a history of diaphoresis and paroxysmal hypertension refractory to therapy since 14 years old. Urinary execretion of catecholamine and its metabolites were elevated. Computed tomography(CT) scan revealed high density mass located on the posterior mediastinum in the area of the right fifth intercostal space. At thoracotomy, a 3X3X4cm sized lesion was resected and confirmed as a paraganglioma.
Adolescent ; Humans ; Hypertension* ; Korea ; Mediastinum* ; Paraganglioma* ; Pheochromocytoma ; Thoracotomy

No abstract available.
Classification* ; Risk Factors* ; Trophoblastic Neoplasms* ; Trophoblasts*

In order to produce a stable denture for severe alveolar bone loss area, it is not only important that .0a suitable occlusion is established but also to consider compatibility with the surrounding muscle to form a suitable polished surfaces. Neutral zone is defined as a potential area where the neuromuscular system of the tongue, cheeks and lips is balanced can be determined through the neutral zone impression technique. And if artificial teeth are aligned within the neutral zone and the polished surface follows the anatomical form of the dynamic muscle, higher stability and retention of the denture may be obtained through coordination with the surrounding muscle tissue. This case is being reported since the concept of the neutral zone was applied to a patient with severely atrophic residual alveolar ridge and the result was clinically satisfactory in both function and aesthetics.
Alveolar Bone Loss ; Alveolar Process ; Cheek ; Denture, Complete ; Dentures ; Esthetics ; Humans ; Lip ; Rehabilitation ; Tongue ; Tooth, Artificial

Tonsillar lymphangiomatous polyp is an uncommon hamartomatous lesion that generally arises from the tonsillar surface. Due to the uncommon clinical and pathological features of these polyps, pathologist and clinician may experience difficulty in correctly classifying them. Although this is a rare clinical and pathologic entity for pathologists and clinicians, the diagnosis is not so difficult if one has a bit of experience about that. Recently, we experienced a 37-year-old women with a pale lymphangiomatous polyp of 3x1.5 cm size, which was treated by tonsillectomy. We report this case with a review of literature.
Adult ; Female ; Humans ; Isothiocyanates ; Palatine Tonsil ; Polyps ; Tonsillectomy

Syphilis, a chronic systemic infection caused by Treponema pallidum, is usually sexually transmitted and characterized by episodes of active disease interrupted by a latent period. After an incubation period of averaging 2-6 weeks, a primary syphilis with a firm, non-tender chancre appears, often associated with regional lymphadenopathy. Secondary syphilis shows localized or diffuse mucocutaneous lesions and generalized non-tender lymphadenopathy. In about onethird of untreated cases, the tertiary stage appears, characterized by progressive destructive mucocutaneous, musculoskeletal or parenchymal lesions, aortitis or symptomatic central nervous system diseases. Without serological testing, the precise diagnosis is very difficult. In fact, it has often been called the great imitator because it was often confused with other disease. We report a very unusual case of luetic lymphadenitis presented as a solitary submandibular mass.
Aortitis ; Central Nervous System Diseases ; Chancre ; Lymphadenitis ; Lymphatic Diseases ; Neck ; Serologic Tests ; Syphilis ; Treponema pallidum

Diploic arteriovenous fistulas (AVFs) or intraosseous dural AVFs are rare arteriovenous shunts. A diploic AVF is formed between a meningeal artery and an intraosseous diploic vein or the transosseous emissary vein, and the nidus is located exclusively within the bone. Currently, endovascular embolization with a transvenous approach is considered the treatment of choice for most dural AVFs. However, in the absence of an accessible venous channel, an alternate treatment approach should be considered. Herein, we report a case of a diploic AVF that was treated using embolization with transosseous direct cannulation.