A 38-year-old male patient visited our clinic complaining of three skin lesions on the scalp. There were yellowish to brownish, waxy, non-tender, walnut-sized nodules. Hematoxylin and eosin staining revealed amorphous pinkish material deposits in the dermis. The Congo red stain and Dylon stain under polarizing microscopy showed yellow-green birefringence and the immunoglobulin-lambda light chain stain showed a positive reaction. An electron microscopic examination revealed filaments with uniform diameter(6 to 10nm) that were straight and neither branched nor anastomosed. Based on the clinical, histopathological, immunohistochemical and electron microscopical findings, the skin lesions were diagnosed as nodular amyloidosis.
Adult ; Amyloidosis* ; Birefringence ; Congo Red ; Dermis ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Male ; Microscopy ; Scalp ; Skin

Sepsis refers to the systemic response to serious infection. Patients with sepsis usually manifest fever, tachycardia, tachypnea, leukocytosis, and a localized site of infection. Methicillin-resistant Staphylococcus aureus(MRSA) is a gram-positive, nonmotile, aerobic, catalase- positive coccus, which is resistant to all the B -lactam antibiotics. Cutaneous manifestations in sepsis are maculopapules, nodules, petechiae, ecchymoses, purpurae, pustules, vesiculobullae, hemorrhagic bullae and ulcers. When MRSA is identified in blood cultures and skin tissue cultures, the skin lesions can be considered as cutaneous manifestations in sepsis caused by MRSA. We report two cases with erythematous pustules, petechiae, hemorrhagic bullae and maculopapules caused by MRSA sepsis. MRSA grew in blood cultures and skin tissue cultures.
Anti-Bacterial Agents ; Ecchymosis ; Fever ; Humans ; Leukocytosis ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Purpura ; Sepsis* ; Skin ; Staphylococcus ; Tachycardia ; Tachypnea ; Ulcer

No abstract available.
Lymphoma, Large-Cell, Anaplastic*

We report a case of subcutaneous panniculitic T-cell lymphoma (SPTCL) which occurred in a 10-year-old Korean girl. Her disease presented as multiple erythematous subcutaneous nodules on the right cheek, left chest, abdomen, left flank, both calves, and left shin with systemic symptoms. She had a protracted course of multiple erythematous subcutaneous nodules for 2 months often with spiking fever. Histopathologic findings for the subcutaneous nodules revealed lobular panniculitis-like findings composed of atypical small, bland lymphocytes and histiocytes. Characteristically, atypical lymphocytes rimmed individual fat cells in a lace-like pattern and some histiocytes occasionally phagocytosed WBCs. Bone marrow findings revealed increased phagocytic histiocytes with engulfed hematopoietic cell. The immunophenotypic studies showed CD45RO (UCHLl)+, CD20-, CD4-, CD8+ and CD56+ (focal), lysozyme+, CD45 (LCA)+ and EBV-. She received three cycles of high-dose cyclophosphamide, adriamycin, vincristine, prednisolone (CHOP) and methotrexate, intrathecal methotrexate and one cycle of fludarabine, mitoxantrone and dexamethasone (FND) chemotherapy. She died of acute renal failure during multiple chemotherapy.
Abdomen ; Acute Kidney Injury ; Adipocytes ; Bone Marrow ; Cheek ; Child* ; Cyclophosphamide ; Dexamethasone ; Doxorubicin ; Drug Therapy ; Female ; Fever ; Glycogen Storage Disease Type VI ; Histiocytes ; Humans ; Lymphocytes ; Lymphoma, T-Cell* ; Lymphoma, T-Cell, Cutaneous ; Methotrexate ; Mitoxantrone ; Prednisolone ; T-Lymphocytes* ; Thorax ; Vincristine

No abstract available.
Female ; Humans ; Ovary*

Chronic spinal epidural hematoma related to Kummell's disease is extremely rare. An 82-year-old woman who had been managed conservatively for seven weeks with the diagnosis of a multi-level osteoporotic compression fracture was transferred to our institute. Lumbar spine magnetic resonance images revealed vertebral body collapse with the formation of a cavitary lesion at L1, and a chronic spinal epidural hematoma extending from L1 to L3. Because of intractable back pain, a percutaneous vertebroplasty was performed. The pain improved dramatically and follow-up magnetic resonance imaging obtained three days after the procedure showed a nearly complete resolution of the hematoma. Here, we present the rare case of a chronic spinal epidural hematoma associated with Kummell's disease and discuss the possible mechanism.
Aged, 80 and over ; Back Pain ; Female ; Follow-Up Studies ; Fractures, Compression ; Hematoma ; Hematoma, Epidural, Spinal ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Spine ; Vertebroplasty

BACKGROUND: Incohorenet lamps or pulsed/continuous wave lasers have effectively been used for photodynamic therapy (PDT). OBJECTIVE: To assess the safety and efficacy of the various light sources, such as halogen, xenon arc, and the 585nm pulsed dye laser, in photodynamic therapy for treatment of actinic keratosis. METHODS: PDT, using 5-aminolaevulinic acid (5-ALA), was used on 18 patients who had been diagnosed with actinic keratoses. A single treatment consisting of a topical application of 20% 5-aminolaevulinic acid for 4 hours, followed by halogen, xenon arch lamp and the 585nm pulsed dye laser was administered. RESULTS: Of the 227 lesions, 95/106 (89.6%), 68/77 (88.3%), and 39/44 (88.6%) lesions showed complete response to the halogen lamp, xenon arc lamp, and 595nm dye laser respectively, and 10/106 (9.4%), 9/77 (11.7%), and 5/44 (11.4%) lesions showed partial response to the above, respectively. Only one lesion (1.0%) showed no response to the halogen lamp. In all cases, cosmetic outcome was excellent, and anatomical function was preserved. Topical 5-ALA based PDT is an effective and useful treatment modality for various premalignant diseases, to the halogen lamp, xenon arc lamp, or 585nm pulsed dye laser were used. CONCLUSIONS: Treatment of actinic keratosis with various light sources, following topical application of 5-ALA is effective. However, advantages of the laser treatment may include recovery times, excellent postreatment cosmesis, and high efficacy rate.
Actins* ; Humans ; Keratosis, Actinic* ; Lasers, Dye* ; Photochemotherapy* ; Xenon

This article consists of a clinical analysis of 171 cases of intussusception treated at the Department of General Surgery and Pediatrics of Pusan Adventist Hospital, during a five year period from Jan. 1991 to Dec. 1995. The results were as follows ; 1) On the age and sex distribution, the age incidence under 1 year old was the most common(73.1%), and male to female ratio was 1.48 : 1. 2) The seasonal variation was Autumn(35.1%), Spring(32.1%), Summer(19.9%), and Winter(12.9%). 3) On the hematologic laboratory finding, 68% were revealed leukocytosis above 10,000/mm3 in serum. 4) In etiology, idiopathic type was common(98.5%), and Meckel's diverticulum was rare(1.5%). 5) The frequent Symptoms and signs were abdominal pain and irritability(84.2%), bloody stool(83.6%), vomiting(80.7%), palpable abdominal mass(48.5%). 6) On comparison of barium reduction to methods of the operation in relation to duration of symptoms, within 12 hours was 81.4% : 15.7% and above 24 hours was 49% : 51% 7) The common anatomical type of intussusception was ileo-colic type (36.9%), and the common types of bowel resection were ileoileo type and ileoileocolic type(80%). 8) The methods of the operation were manual reduction(53.8%), bowel resection(30.8%), and spontaneous reduction(15.4%). 9) Postoperative complications occurred in 10 cases ; febrile convulsion 3 cases, wound infection 2 cases, and wound dehiscence, intestinal obstruction, pulmonary complication each 1 case. 10) The overall recurrence rate was 5.3% (8 cases); 6.6% (7 cases) were after barium reduction, and 1.5% (1 case) was after manual reduction.
Abdominal Pain ; Barium ; Busan ; Child* ; Female ; Humans ; Incidence ; Infant* ; Intestinal Obstruction ; Intussusception* ; Leukocytosis ; Male ; Meckel Diverticulum ; Pediatrics ; Postoperative Complications ; Recurrence ; Seasons ; Seizures ; Seizures, Febrile ; Sex Distribution ; Wound Infection ; Wounds and Injuries

Teramethylammonium(TMA) in one of the synthetic compounds of nicotine that act at ganglionic site. The major action of TMA consists of initial stimulation followed by a more persistent depression of all autonomic ganglia by binding to a cholinergic receptor. It is well believed that the level of membrane potential in arterial smooth muscle is an important regulator of tension development. Depolarization and hyperpolarization by only few millivolts results in significant changes in tension. In general, the agents of vascular smooth muscle induce vascular relaxaion. The present study was undertaken to elucidate the effect of TMA on vascular contractility in the isolated rabbit thoracic aorta with or without endothelial cell, and mechanisms involved in the change of vascular contractility by TMA. The results obtained are summarized as follows ; 1) In the presence of endothelial cell, TMA induced a relaxtion of the aorta precontracted with norepinephrine but induced a contraction in the aorta without endothelial cells, indicating that in the rabbit aorta, relaxations produced by TMA were the endothelium-dependent. 2) The addition of inhibitor such as methylene blue, hemoglobin, hydroquinone and p-bromophenacyl bromide during the TMA-induced relaxation reversed the contractile tension to a level similar to or higher than that before the addition of TMA in rabbit thoracic aorta.This relaxation effect of TMA suggest that the TMA-inducdd relaxation in rabbit aorta is due to the release of endotheline derived relaxing factor(EDRF). 3) Relaxation induced by TMA was antagonized by atropine and thus the TMA does seem to act on the muscarinic receptors. 4) TMA reduced the norepinephrine-induced Ca++ influx into rabbit smooth muscle membrane. From the above results, it may be concluded that TMA-induced vacular relaxation in rabbit aorta is due to the release of EDRF. Mechanism involved in the relaxation induced by TMA may be the stimulation of soluble guanylate cyclase and increased tissue cGMP concentrations.
Aorta ; Aorta, Thoracic* ; Atropine ; Depression ; Endothelial Cells ; Endothelins ; Endothelium ; Endothelium-Dependent Relaxing Factors* ; Ganglia, Autonomic ; Ganglion Cysts ; Guanylate Cyclase ; Membrane Potentials ; Membranes ; Methylene Blue ; Muscle, Smooth ; Muscle, Smooth, Vascular ; Nicotine ; Norepinephrine ; Receptors, Muscarinic ; Relaxation

No abstract available.