We experienced a 40-year-old female patient who had vegetating plaques, erosions and a few vesicles on the external genitalia and the oral mucasa, assoeiated with pulmonary tuberculosis. On the skin biopsy specimen of the vegetating plaque, it showed acanthoais, papillomatosis, downward proliferation of the epidermis and eosinophilic microabacess in the epidermis. Direct immunofluorescence of the perilesional skin revealed deposition of IgG, Cq, Cs and C on the intercellular substance of the epidermis. Indirect immunofluorescence disclosed IgCi auto antibody(1: 320) positive to the inter ellular substance of the normal human back skin. The skin lesion had impraved with dapsone therapy.
Adult ; Biopsy ; Dapsone ; Eosinophils ; Epidermis ; Female ; Fluorescent Antibody Technique, Direct ; Fluorescent Antibody Technique, Indirect ; Genitalia ; Humans ; Immunoglobulin G ; Papilloma ; Pemphigus* ; Skin ; Tuberculosis, Pulmonary

A total of 39 malignant melanoma cases diagnosed at Chonnam National University Hospital for past 10 years from 1980 to April, 1990 were included for the clinicopathologic study. Among the 29 primary cutaneous melanomas, 18 cases(62.1 % ) occurred on the hands and the feet, especially on the heel. The average age of the patients was 54.3 years at the time of diagnosis and the male to female ratio was 1 to 1,4. Acral lentiginous melanoma was the most common (62.1% ) histopathologic type and the invasion level c)f 22 cases(78.4% ) was over 1.50mm by Rreslows thickness.
Diagnosis ; Female ; Foot ; Hand ; Heel ; Humans ; Jeollanam-do ; Male ; Melanoma

A large body of evidence indicates that Helicobacter pylori is involved in the pathogenesis of chronic gastritis and peptic ulcers. Several techniques are currently used for detecting H. pylori. Recently the immunohistochemical method was introduced for rapid detection of H. pylori. To compare the result of the immunohistochemical method with those obtained by microbiologic methods, we glean formalin fixed, paraffin embbeded gastric and duodenal biopsy specimens from 85 patients with upper gastrointestinal symptoms. We set fifty cases which H. pylori was cultivated and identified by Gram stain as Group I, and thirty-five cases without H. pylori in Gram stain and culture as Group II. The results were as follows. 1) The sensitivity and the specificity of immunohistochemical method were 94% and 80% compared with the microbiologic method. Positive and negative predictive value of the immunohistochemical method were respectively 87% and 90%. However, in seven cases of Group II, H. pylori were identified by immunohistichemical method. 2) Immunohistochemical staining exhibited bacteria that were present in the mucus layer, the surface of the gastric mucosa and metaplastic gastric epithelium in duodenum. With reference to the distribution and density of H. pylori in Group I and II, a significant correlation existed between microbiologic results and bacterial load of the biopsy specimen (p<0.01). 3) Chronic inflammation of gastric biopsies were seen in all 45 H. pylori-positive cases(100%) and 16 out of 19 H. pylori-negative cases(84%). The degree of chronic inflammation was more severe in positive cases than negative cases. Activity of inflammation was seen 98% of H. pylori-positive cases and 16% of H. pylori-negative cases. Intestinal metaplasia was seen 40% of H. pylori-positive cases and 58% of H. pylori-negative cases. Lymphoid follicles and aggregates were seen in 47%(27 cases) of H. pylori-positive cases. Among 47%, cases with lymphoid follicles were 9%(4 cases) and cases with lymphoid aggregates were 38%(17 cases). In H. pylori-negative cases, lymphoid follicles and aggregates were seen in 16%(3 cases). It is possible to obtain samples from most of the individuals who underwent the endoscopy in Korea. And this method is simple, rapid and sensitive. We conclude that the immunohistochemical method is another useful diagnostic tool for detection of Helicobacter pylori.
Predictive Value of Tests ; Biopsy

We performed an immunohistochemical study, using bioti-navidin system to clarify the pattern of carcinoembryonic antigen(CEA)immunoreactivity in various tumors of the skin, according to its histogenetic origin. Positive reaction was observed in syringorna, eccrine spiradenoma, eccrine angiomatous hamartoma, eccrine carcinoma, syringocystadenoma papilliferum, metastatic breast carcinoma and mammary Pagets disease. But in epithelial tumors, metastatic skin cancer from maxillary sinus, tumors derived from pilar and sebaceous gland structure, mesenchymal tumors and neuroectodermal tumors, CEA was not observed. These results suggest that immunohistochemical study for CEA could be used as an adjunct for the differential diagnosis of sweat gland tumors from others, especially pilar structure and sebaceous-gland-derived tumors, for the detection of the histogenesis of metastatic tumors, and for the diagnosis of Pagets clisease.
Breast Neoplasms ; Carcinoembryonic Antigen* ; Diagnosis ; Diagnosis, Differential ; Hamartoma ; Maxillary Sinus ; Neuroectodermal Tumors ; Paget's Disease, Mammary ; Sebaceous Glands ; Skin Neoplasms ; Skin* ; Sweat Glands

A 25-year-old female visited the clinic with abdominal pain and poor oral intake. She was diagnosed with Crohn’s disease and had a history of using infliximab for 4 years. She had no previous operative history. Magnetic resonance enterography demonstrated the progression of a penetrating complication that involved the distal ileum and complex entero-enteric fistula between the terminal ileum and sigmoid colon. Surgery was conducted using the da Vinci SP surgical system. In the operative field, severe adhesion was observed between the terminal ileum, adjacent ileum, cecum, and the sigmoid colon. After adhesiolysis of the small bowel and right colon was performed, the fistula tract between the sigmoid colon and terminal ileum was identified and resected. Then, simultaneous ileocecectomy and anterior resection was performed. The operation was completed without any intraoperative complications and patient’s recovery was uneventful. She was discharged postoperatively, after 8 days.

Recurrent colonic perforation in patients already having colostomy is extremely rare and only a few cases had been reported. Herein, we report 2 cases of recurrent colonic perforation at the proximal part of the colostomy in geriatric patients resulting from different causes, which might be caused by stercoral perforation and recurrent colonic ischemia, respectively. Based on our experience, surgeons should consider correcting chronic constipation even in patients who already have a colostomy.Additionally, transverse colostomy should be considered as a surgical treatment in patients with sigmoid colostomy for recurrent perforation due to colonic ischemia.

No abstract available.

PURPOSE: Recent developments in the polymerase chain reaction (PCR) technology have brought an extraordinary opportunity for the rapid detection of Mycobacterium Tuberculosis in clinical specimens for the diagnosis of tuberculosis. In this study, the efficacy of PCR was evaluated for detection of mycobacterial tuberculosis in urine. MATERIALS AND METHODS: 115 patients that attended the urology clinic between July 2000 and July 2003, with symptoms suggestive of genitourinary tuberculosis, were evaluated. The male to female patient ratio was 69 to 46, with a mean age of 54.2 (range 19 to 82) years. The results obtained from PCR were compared with those obtained from standard microbiological methods, acid-fast bacilli (AFB) stain and culturing. RESULTS: A total of 11 cases were confirmed as genitourinary tuberculosis, and 2 were positive on both PCR and AFB staining, and 4 and 2 cases were positive only in PCR and AFB stain, respectively, and one case on AFB staining was negative, but positive in both PCR and AFB culturing. The sensitivity of PCR, AFB staining and culturing were 63.6, 36.4 and 9.1%, respectively. CONCLUSIONS: We conclude that PCR is a rapid and sensitive method for the early diagnosis of tuberculosis.
Diagnosis ; Early Diagnosis ; Female ; Humans ; Male ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction* ; Tuberculosis ; Urology

Endothelin(ET), is the most potent endogenous vasoconstrictor. Myocardial ischemia and chemical stimuli including calcium ionophores are known to release ET-1. Recently, halothane has been shown to block calcium channel. Thus, halothane might attenuate coronary endothelial ET-1 production during myocardial ischemia-reperfusion. To test this hypothesis, we measured plasma ET-1 level continuously in open chest dogs subjected to 15 min of left anterior coronary arterial occlusion and 1 hour of reperfusion during fentanly(n=8) or halothane(n=7) anesthesia. The results were as follows. I) Baseline ET-1 levels of both femoral artery and great cardiac vein in the halothane group were lower than in the fentanly group(NS). 2) ET-1 level of femoral artery and great coronary vein in both halothane and fentanyl group remained unchanged 10 min into ischemia. 3) Coronary blood flow increased by 325, 250% in the halothane group and by 315, 258% in the fentanly group 2, 5 min into reperfusion, respectively. 4) ET-1 production increased from baseline of -2.9+/-1.7 pg/min to 66.0+/-21.5(p<0.05), 20.8+/-5.1 (p<0.01), 13.2+/-6.2(p<0.05) pg/min 5, 15, 30 min into reperfusion, respectively in the fentanyl group, but it remained unchanged from baseline of 0.8+/-3.1 pg/min in the halothane group. These findings suggest that ET-1 production or release is diminished by halothane during myocardial ischemia-reperfusion. Thus, halothane provides an advantage over fentanyl in patients with myocarial ischemic episodes.
Analgesics ; Anesthesia* ; Anesthetics ; Animals ; Calcium Channels ; Calcium Ionophores ; Coronary Vessels ; Dogs* ; Endothelin-1* ; Endothelins ; Femoral Artery ; Fentanyl* ; Halothane* ; Humans ; Ischemia ; Myocardial Ischemia ; Plasma ; Reperfusion ; Thorax ; Veins

PURPOSE: We wanted to determine the correlation between the renal length as measured on two dimensional (2D) ultrasonography (US) and the renal parenchymal volume as measured with a new three-dimensional (3D) volume probe ultrasound system. We also wanted to determine the correlation between the renal length or renal parenchymal volume and the glomerular filtration rate (GFR) in patients with glomerulopathy. MATERIALS AND METHODS: From July 2007 to December 2007, 26 patients who were pathologically confirmed to have glomerulopathy by biopsy were enrolled. Renal length was measured with 2D US and the renal parenchymal volume was measured with 3D US just prior to biopsy. The GFR was obtained from the electronic medical records. Pearson's correlation coefficients were used to analyze the correlation between the renal length and the renal parenchymal volume, the correlation between the renal length and the GFR and the correlation between the renal parenchymal volume and the GFR. RESULTS: The renal length and the renal parenchymal volume showed strong positive correlation (r = 0.850, p = 0.0001). The correlation coefficient between the renal length and the GFR was 0.623 (p = 0.0007) and the correlation coefficient between the renal volume and the GFR was 0.590 (p = 0.0015). Both the renal length and renal parenchymal volume showed apparently positive correlations with the GFR in glomerulopathy patients. CONCLUSION: The renal length showed strong positive correlations with the renal parenchymal volume. Both the renal length and the renal parenchymal volume showed apparently positive correlations with the GFR in glomerulopathy patients. In glomerulopathy patients, the renal dimensions measured by ultrasound can reflect the status of the GFR, and the measurement of the 2D renal length could be sufficient for follow up. Further studies are needed to evaluate the role of 3D US for assessing patients with renal disease.
Biopsy ; Electronic Health Records ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Kidney