BACKGROUND: The differentiation of syphilids from other skin decreases is frequently difficult due to considerable variations of clinical and histologic pattern. The most common histologic changes in secondary syphilis are swelling & proliferation of endothelial cells and the presence of a perivascular infiltrate containing plasmia cells. But often, these findings are absert or inconspicuous. OBJECTIVE: We examined the histopathologic findings of secondary syphilis in relation to the clinical types of the skin lesion. MEHTODS: 36 biopsy specimens from twenty-nine serologically and clinically confirmed cases of secondary syphilis (15 macules, 8 papules, 2 condylomata latas and 11 papulosquamous lesions) were examined. RESULTS: The histopath,ologic findings of secondary syphilis showed comparative differences according to the clinical types of the skin lesion. The plasms cell infltrates were absent or sparse in 14 csses(39%) and the plasma cell infiltration was significantly correhted with the age of skin lesions(p=0.02197). Vascular changes were seen in 32 cases (89%), but the incidence of endothelial proliferation was less(25%). CONCLUSION: This study demonstrates the histopathologic findirigs of secondary syphilis in accordance to the clinical morphology of the eruption and thus, help to differentiate syphilids from other skin diseases.
Biopsy ; Endothelial Cells ; Incidence ; Plasma Cells ; Skin ; Skin Diseases ; Syphilis ; Syphilis, Cutaneous*

No abstract available.
Lichens* ; Mucinosis, Follicular*

PURPOSE: We compared the clinicopathologic effects of TTT between pigmented and albino rabbits. METHODS: TTT was delivered using infrared diode laser at 810 nm(Iris Medical Instrument, Mountain Veiw, CA, USA) and applied with spot size of 3 mm, duration of 60 seconds. At 1 week and 4 weeks after TTT, fundus photographs and simultaneous FAG/ICG angiogram were taken with SLO(Scanning Laser Ophthalmolscopy, Rodenstock, Munish, Germany). Light and electron microscopic examination were performed. RESULTS: In pigmented rabbits, visible funduscopic change was visible even with minimal power setting(100 mW). Obliteration of choroidal vessels was observed on ICG angiogram. In microscopic examination, entire layers of neural retina, retinal pigment epithelial cells, and deep choroid were severely damaged at the center of treated fields. Whereas, in albino rabbits fundus changes were not observed at any power setting. However, focal thrombosis at margin of lesion was identified on ICG angiogram after power of 300 mW. In microscopic examination, tissue damage was developed up to 600 mW and the lesion extended into the superficial choroid posteriorly and outer neural retina anterioly. CONCLUSIONS: The effect of TTT was increased with fundus pigmentation. Clinically we should adjust TTT power setting according to the amount of melanin pigmentation in the fundus.
Choroid ; Epithelial Cells ; Lasers, Semiconductor ; Melanins ; Pigmentation ; Rabbits ; Retina* ; Retinaldehyde ; Thrombosis

BACKGROUND:CAVI, Cardio Ankle Vascular Index, has been proposed as an independent marker of arterial stiffness regardless of the blood pressure. We measured the CAVI of hemodynamically unstable patients on maintenance hemodialysis and at the same time measured other pulse pressure-related parameters in order to study their correlations with each other. METHODS:We studied 85 patients undergoing maintenance hemodialysis over 3 months. We categorized patients into 4 subgroups: Diabetes+Hypotension (N= 12), Diabetes+Normal blood pressure (N=16), Non- diabetes+Hypotension (N=15), and Non-diabetes+Normal blood pressure (N=42). Using automatic waveform analyzer, we measured CAVI and pulse pressure- related markers twice, before and after the hemodialysis session, and observed the change. RESULTS:After the dialysis, CAVI did not change despite the decreased mean blood pressure. Yet both brachial and ankle pulse pressure dropped significantly (4.34+/-15.22 mmHg, 11.50+/-20.65 mmHg, p<0.01). PEP (Pre-Ejection Period) on the other hand, remarkably increased (12. 13+/-22.18 msec) while ET (Ejection Time) showed considerable decrease (35.86+/-45.68 msec), and PEP/ ET ratio increased as well. Predialysis CAVI was significantly higher in Diabetes group than in Non-diabetes (11.02+/-2.33 vs. 8.20+/-1.87, p<0.001). However, no significant difference of CAVI was observed between Hypotension and Normal blood pressure groups. Diabetes+Hypotension Group displayed reduction in CAVI after dialysis with marginal significance (0.68+/-1.07, p=0.05) whilst PEP, ET and PEP/ET ratio showed no significant change compared to other groups. CONCLUSION:CAVI, a newly developed marker of arterial stiffness, is expected to be useful in prediction of the cardio-vascular risk and prognosis of patients undergoing hemodialysis.
Ankle ; Blood Pressure ; Dialysis ; Hand ; Humans ; Hypotension ; Prognosis ; Renal Dialysis* ; Vascular Stiffness

Subgenus classification of Acanthamoeba remains uncertain. Twenty-three reference strains of Acanthamoeba including 18 (neo)type-strains were subjected for classification at the subgenus level by riboprinting. PCR/RFLP analysis of 18S rRNA gene (rDNA). On the dendrogram reconstructed on the basis of riboprint analyses, two type-strains (A. astronyxis and A. tubiashi) of morphological group 1 diverged early from the other strains and were quite distinct from each other. Four type-strains of morphological group 3, A. culbertsoni, A. palestinensis, A. healyi were considered taxonomically valid, but A. pustulosa was regarded as an invalid synonym of A. palestinensis. Strains of morphological group 2 were classified into 6 subgroups. Among them, A. griffini which has an intron in its 18S rDNA was the most divergent from the remaining strains. Acanthamoeba castellanii Castellani, A. quina Vil3, A. lugdunensis L3a, A. polyphaga Jones, A. triangularis SH621, and A. castellanii Ma strains belonged to a subgroup, A. castellanii complex. However, A. quina and A. lugdunensis were regarded as synonyms of A. castellanii. The Chang strain could be regarded as A. hatchetti. Acanthamoeba mauritaniensis, A. divionensis, A. paradivionensis could be considered as synonyms of A. rhysodes. Neff strain was regarded as A. polyphaga rather than as A. castellanii. It is likely that riboprinting can be applied for rapid identification of Acanthamoeba isolated from the clinical specimens and environments.
Acanthamoeba/genetics ; Acanthamoeba/classification* ; Animal ; DNA, Protozoan/analysis ; Polymerase Chain Reaction/methods* ; Polymorphism, Restriction Fragment Length* ; RNA, Protozoan/genetics ; RNA, Protozoan/analysis* ; RNA, Ribosomal, 18S/genetics ; RNA, Ribosomal, 18S/analysis*

BACKGROUND: Numerous environmental, physiological, and pathological factors, and some medications are known to influence the speed of nail growth. OBJECTIVE: Our purpose was to know the effect of topical antifungal drug, amorolfine, on the growth rate of nails. METHODS: First study was performed to patients with distal subungual onychomycosis affecting at least one side of great toe nail (64 cases). The growth rate of affected toe nails was memasured according to the treatment groups, oral itraconazole alone (21 cases), combination of oral itraconazole and amorolfine (23 cases), and amorolfine alone (20 cases). Also, the growth rate of toe nails in the controls who have tinea pedis without onychomycosis (22 cases) was measured. Another study was performed to healthy volunteers without onychomycosis, tinea pedis and any other dermatologic and systemic disease (21 cases). The growth rate of normal toe nails before and during application of amorolfine was measured. RESULTS: There was no statistically significant difference in the growth rate of affected toe nails between monotherapy group with oral itraconazole alone and combination therapy group with oral itraconazole and amorolfine in patients with onychomycosis (p>0.05). There was no statistically significant difference when comparing the growth rate of affected toe nails of patients with onychomycosis treated with amorolfine alone with that of normal toe nails of the controls (p>0.05). There was no statistically significant difference in the growth rate of normal toe nails between before and during application of amorolfine in healthy volunteers (p>0.05). CONCLUSION: Topical antifungal medication might not influence the growth rate of nails.
Healthy Volunteers ; Humans ; Itraconazole ; Nails* ; Onychomycosis ; Tinea Pedis ; Toes

The principal manifestation of poisoning induced by the alkaline substance is a corrosive effects in tissues. The alkalies combine with protein and fat of the tissue, causing deep penetrating injury and liquefactive necrosis of the organs. Liquid lye is the most frequently ingested form of corrosive agents and causes most of the deaths associated with corrosive agent ingestion. We have experienced 5 fatal cases which were accidentally administered liquid lye as soap-saline enema in the hospital during 30 days. the 3 cases of them were autopsied at this institute. At autopsy, the digestive tract including rectum, colon and small intestine revealed hemorrhagic necrosis with multiple area of perforation. Because these were the first proved cases that the liquid lye was used as enema solution, we report here.
Alkalies ; Autopsy ; Colon ; Corrosion ; Eating ; Enema* ; Gastrointestinal Tract ; Intestine, Small ; Lye* ; Necrosis ; Poisoning ; Rectum

About 5% of patients with SCLC have the ectopic production of ACTH. Ectopic ACTH production of SCLC is suspected when patients of SCLC have unexplained metabolic alkalosis and hypokalemia. Most patients lack the classic feature of Cushing's syndrome. According to the recent report, they have poor prognosis, which median survival is less than 4 months and associated with a high rate of complication during chemotherapy. Also a case of paraneoplastic CRH production with SCLC can mimic the ectopic ACTH syndrome hut it can be distinguished by immunohistochemistry or direct measurement of serum CRH level. We report here a case of small cell lung cancer associated with Cushing's syndrome of ectopic ACTH production. That is immunohistochemically provened by staining with ACTH.
ACTH Syndrome, Ectopic ; Adrenocorticotropic Hormone* ; Alkalosis ; Cushing Syndrome* ; Drug Therapy ; Humans ; Hypokalemia ; Immunohistochemistry ; Lung Neoplasms* ; Lung* ; Prognosis ; Small Cell Lung Carcinoma

No abstract available.
Endothelial Cells* ; Hantaan virus* ; Humans* ; Umbilical Veins*

PURPOSE: To compare the success rates of performing only silicone tube intubation versus carrying out both conjunctival resection and silicone tube intubation. METHODS: The subjects of this study involved 62 patients (96 eyes) between October 2015 and May 2017 who were diagnosed as having punctal stricture or nasolacrimal duct stenosis. Out of 96 eyes, 47 underwent only silicone tube intubation, and 49 underwent both silicone tube intubation and conjunctival resection. Three parameters were measured at 1, 3, and 6 months after the surgery: the area of the tear meniscus using RTVue-100 anterior segment optical coherence tomography, the height of the tear meniscus using a slit lamp microscope, and the subjective satisfaction of patients as a result of improved sympotms like epiphora. The surgery was considered successful when the patients' experienced the resolution of symptoms and reduction of the area and height of the tear meniscus. RESULTS: The area of the tear meniscus, height of the tear meniscus, and subjective satisfaction of patients was superior in the group that underwent both silicone tube intubation and conjunctival resection compared silicone tube intubation only. Based on these results, the success rate of the surgery was 68.9% in the group that underwent only silicone tube intubation and 78.7% in the group that underwent both silicone tube intubation and conjunctival resection. CONCLUSIONS: The resection of relaxed plica semilunares seems to increase the success rate of silicone tube intubation through the reduction of the area and height of the tear meniscus. Therefore, after determining the degree of conjunctivochalasis, if it was found to be severe, a combination with conjunctival resection was expected to increase the success rate of the surgery.
Constriction, Pathologic ; Humans ; Intubation* ; Lacrimal Apparatus Diseases* ; Nasolacrimal Duct ; Silicon* ; Silicones* ; Slit Lamp ; Tears ; Tomography, Optical Coherence