We herein report a case of AIDS-related Kaposi's sarcoma (KS) in a 36-year-old male patient, who had a solitary nodular skin lesion on the left supraclavicular area. The histopathologic findings showed typical features of KS as spindle cell proliferation and vascular spaces lined with endothelial cells. The patient's serum was positive for antibodies to the human immunodeficiency virus (HIV) and he had opportunistic infection of Pneumocystis carinii pneumonia and pulmonary tuberculosis. The WBC count was 1,200/mm3 and CD4 count was 50/mm3 with decreased CD4/CD8 ratio to 0.06. He died due to an aggravated respiratory infection.
Adult ; Antibodies ; CD4 Lymphocyte Count ; Cell Proliferation ; Endothelial Cells ; HIV ; Humans ; Male ; Opportunistic Infections ; Pneumonia, Pneumocystis ; Sarcoma, Kaposi* ; Skin ; Tuberculosis, Pulmonary

BACKGROUND: Differential diagnosis of keratoacanthoma(KA) from squamous cell carcinoma(SCC) is often difficult, especially when SCC has KA-like features(KA-like SCC). A number of recent studies have been attempted to separate these two entities with the use of immunohistochemical stains. But the results were inconsistent and the studies with KA-like SCC are rarely reported. OBJECTIVES: The purpose of this study was to examine the expression patterns of p53 protein and Ki-67 antigen on KA and KA-like SCC using immunohistochemical staining method and to evaluate the usefulness of this method in distinguishing each other. METHODS: We performed immunoperoxidase staining(LSAB technique) using monoclonal antibody to p53 protein(PAb1801) and Ki-67 antigen(MIB1) on the formalin-fixed, paraffin-embedded biopsy specimens obtained from 12 patients with KA, 8 patient with KA-like SCC, and 10 patients with well-differentiated SCC. RESULTS: The results were as follows; 1) There was a significant difference in the p53 expression between KA(25%) and SCC group (KA-like SCC=88%, SCC=100%). 2) Mean Ki-67 labeling index was slightly higher for SCC group(KA-like SCC=30.72%, SCC= 31.23%) than for KA(25.30%), but this difference was not statistically significant. 3) In Ki-67 expression, KA showed more pheriperal basal pattern(91%), whereas SCC group showed more diffuse pattern(77%). CONCLUSION: Our results suggest that KA and SCC are distinct entities of different nature and that these immunohistochemical staining methods can be useful methods in differentiating KA-like SCC from KA.
Biopsy ; Carcinoma, Squamous Cell* ; Coloring Agents ; Diagnosis, Differential ; Humans ; Keratoacanthoma* ; Ki-67 Antigen*

BACKGROUND: Differential diagnosis of keratoacanthoma(KA) from squamous cell carcinoma(SCC) is often difficult, especially when SCC has KA-like features(KA-like SCC). A number of recent studies have been attempted to separate these two entities with the use of immunohistochemical stains. But the results were inconsistent and the studies with KA-like SCC are rarely reported. OBJECTIVES: The purpose of this study was to examine the expression patterns of p53 protein and Ki-67 antigen on KA and KA-like SCC using immunohistochemical staining method and to evaluate the usefulness of this method in distinguishing each other. METHODS: We performed immunoperoxidase staining(LSAB technique) using monoclonal antibody to p53 protein(PAb1801) and Ki-67 antigen(MIB1) on the formalin-fixed, paraffin-embedded biopsy specimens obtained from 12 patients with KA, 8 patient with KA-like SCC, and 10 patients with well-differentiated SCC. RESULTS: The results were as follows; 1) There was a significant difference in the p53 expression between KA(25%) and SCC group (KA-like SCC=88%, SCC=100%). 2) Mean Ki-67 labeling index was slightly higher for SCC group(KA-like SCC=30.72%, SCC= 31.23%) than for KA(25.30%), but this difference was not statistically significant. 3) In Ki-67 expression, KA showed more pheriperal basal pattern(91%), whereas SCC group showed more diffuse pattern(77%). CONCLUSION: Our results suggest that KA and SCC are distinct entities of different nature and that these immunohistochemical staining methods can be useful methods in differentiating KA-like SCC from KA.
Biopsy ; Carcinoma, Squamous Cell* ; Coloring Agents ; Diagnosis, Differential ; Humans ; Keratoacanthoma* ; Ki-67 Antigen*

BACKGROUND: To access the accuracy and clinical usefulness of microplate identification (ID) system for the identification of Enterobacteriaceae, we compared microplate ID system with API 20E(bioMerieux, Etoile, France). METHODS: Ninety-two cultures of Enterobacteriaceae and one isolate of Aeromonas species were simultaneously identified by microplate ID system and the API 20E. Twenty biochemical tests used in microplate ID system were lactose, sucrose, and H2S in Kligler's iron agar media; indole, sucrose, raffinose, arabinose, trehalose, adonitol, dulcitol, sorbitol, cellibiose, methy-red, phenylalanine deaminase, ornithine decarboxylase, lysine decarboxylase, arginine dihydrolase, urease, and citrate in microplate; and oxidase test. The identification was obtained by considering percent likelihood(% ID), modal frequency and ID score method. RESULTS: Among the 92 cultures of Enterobacteriaceae and one isolate of Aeromonas species, agreement rate of identification according to the % ID between microplate ID system and API 20E were 90.3% to the species level and 97.8% to the genus level. CONCLUSIONS: For the identification of clinical Enterobacteriaceae isolates, the microplate ID system compares favorably with API 20E in identification accuracy and have the advantage of costsaving and easy to use.
Aeromonas ; Agar ; Arabinose ; Arginine ; Citric Acid ; Enterobacteriaceae* ; Galactitol ; Iron ; Lactose ; Lysine ; Ornithine Decarboxylase ; Oxidoreductases ; Phenylalanine ; Raffinose ; Ribitol ; Sorbitol ; Sucrose ; Trehalose ; Urease

BACKGROUND: Granuloma annulare is a chronic skin disease of unknown origin, that can present itself with diverse clinical and histopathologic findings. But no clinicopathological studies has been reported yet in Korea. OBJECTIVE: Our purpose was to investigate the clinicopathological findings of each type of granuloma annulare. METHODS: We observed twenty two cases of granuloma annulare and examined their clinical manifestations and histopathological findings. RESULTS: The incidence showed a bimodal peak between 3 to 4 years and 49 to 51 years in age and females were affected twice as much as males. The lesions are commonly located on the distal portion of the extremities. In histopathologic findings, perforating type was observed in 13.6% and subcutaneous type in 18.2%. In collagen alteration, fragmentation and hyalinization were observed in 72.7% and 81.8% respectively. Most infiltrated cells were epithelioid cells. In vascular changes, endothelial swelling and occlusion of vessels were common findings and vasculitis was shown in 36.4%. CONCLUSION: There were not epidemiologic differences from the reported studies in western patients. But the clinical manifestation and the histopathologic findings were so varied that differential diagnosis is important in diagnosis of granuloma annulare. Immunological and immunohistochemical studies may be necessary for differential diagnosis and elucidating pathogenesis of granuloma annulare.
Collagen ; Diagnosis ; Diagnosis, Differential ; Epithelioid Cells ; Extremities ; Female ; Granuloma Annulare* ; Granuloma* ; Humans ; Hyalin ; Incidence ; Korea ; Male ; Skin Diseases ; Vasculitis

A purpose of present study is to provide basic information evaluating the utility of Magnetic Resonance imaging as a biological marker estimating manganese effects to central nervous system among welders, which is conducted by comparing urinary and blood manganese concentrations and signal intensities of brain MR images between exposed group and non-exposed group, evaluating the objectivity of subjective grading estimated by correlations between Pallidal signal intensity index (P. I) and subjective grades among exposed group, and comparing the difference of signal intensities according to presence of neurologic symptoms, signs and exposure variables among the exposed group. The exposed group is composed of 11 welders complaining severe symptoms or showing neurological signs, and the non-exposed group is composed of 5 patients who admitted a hospital. Urinary manganese concentrations and signal intensities in T1-weighted MR images among exposed group were higher than those of the non-exposed group significantly, which exhibits that increased signal intensities in T1-weighted MR image represent the effect of manganese exposure. P. Is among the exposed group revealed relatively high correlations with subjective grades ( gamma =0.63, p=0.037) , which suggests the objectivity of subjective grade. Signal intensity in globus pallidus was a suitable single variable representing the effect of manganese accumulation in C.N.S system appropriately, which was verified as follows ; Increased signal intensities among the exposed group had the highest frequency and intensity in the globus pallidus, and the P.I. had a relatively high correlation coefficient ( gamma 0.62, p=0.044) with total score of subjective grades. Signal intensity with subjective grading in globus pallidus represented very high correlation gamma =0.97, p=0.00) with total score of subjective grades, and had a similar correlation coefficient with many variables. It is hard to argue that signal intensities are markers representing pathologic change in C.N.S system or can be used as a diagnostic tool for manganese intoxication, because signal intensities had no difference between the exposed group and the non-exposed group according to presence of neurological signs.
Biological Markers ; Brain ; Central Nervous System ; Globus Pallidus ; Humans ; Magnetic Resonance Imaging* ; Male* ; Manganese ; Neurologic Manifestations

Erythropoietic protoporphyria(EPP) is an inherited inborn error of porphyrin metabolism caused by decreased activity of the enzyme ferrochelatase. EPP is characterized clinically by photosensitivity to visible light commencing in childhood, and biochemically by elevated red cell free protoporphyrin levels. We report herein a case of EPP which occurred in a 44-year-old man and his family. He had suffered from immediate photosensitivity since he was 4 years old. He was presented with burning, erythema, scars and waxy thickening of the sun-exposed skin. Red cell free protoporphyrin level was elevated and urinary porphyrins were normal. Histopathologically, homogeneous eosinophilic materials that stained with PAS were deposited in perivascular area of upper dermis. He was managed with light restriction and sunscreen.
Adult ; Burns ; Child, Preschool ; Cicatrix ; Dermis ; Eosinophils ; Erythema ; Ferrochelatase ; Humans ; Light ; Metabolism ; Porphyrins ; Protoporphyria, Erythropoietic* ; Skin

We report herein two cases of cutaneous mucinosis in a 59 and a 55 year-old woman which occurred by asymptomatic cystic nodule on the previous biopsy scar site respectively. The histopathologic findings revealed focal accumulation of mucin and proliferation of fibroblasts in the dermis. We suppose that trauma may cause these cases.
Biopsy ; Cicatrix* ; Dermis ; Female ; Fibroblasts ; Humans ; Middle Aged ; Mucinoses* ; Mucins

An increase in the dose of chemotherapy enhances the response of many experimental and clinical cancers, but the extent of chemotherapy dose escalation and repeated use is often limited by myelosuppression. The side effects of chemotherapy including bleeding and infection due to myelosuppression have resulted in delayed therapy and a reduction in the therapeutic dose, therefore it is necessary to overcome myelosuppression especially leukopenia in patients with gynecologic malignancies who recieved chemotherapy. This study is undertaken to investigate the clinical effects of rhG-CSF(recombinant human Granulocyte-colony stimulating factor) in 29 patients with gynecologic malignancy who recieved chemotherapy. It was given at a dose of 100 microgram bid/day subcutaneously until significantly increase of leukocyte count in leukopenic patient. The results showed, the rhG-CSF has significantly increased the number and function of leukocyte. The use of rhG-CSF was effective and useful to treat chemotherapy induced leukopenia and to accelerate the recovery from this complications.
Drug Therapy* ; Hemorrhage ; Humans* ; Leukocyte Count ; Leukocytes ; Leukopenia*

Pagetoid reticulosis(PR) is a rare lymphoproliferative disorder that has been divided into the localized and disseminated type. There has been ongoing debate about the nature of PR. Some authors have regarded PR as a variant of mycosis fungoides(MF). However recent reported cases suggest that PR may represent a spectrum of lymphoproliferative disorders that may not be related to MF. We report a case of a 65-year-old woman who had an erythematous plaque on the anterior chest, buttock and lower extremities for 2 years. Histologically there was dense infiltrate of predominantly CD8-/CD30+ atypical mononuclear cells in the epidermis that produce a pagetoid appearance. We believe this is the first reported case of disseminated pagetoid reticulosis in the Korean literature.
Aged ; Buttocks ; Epidermis ; Female ; Humans ; Lower Extremity ; Lymphoproliferative Disorders ; Pagetoid Reticulosis* ; Thorax