Liesegang rings (LRs) are peculiar structure of periodic precipitation zones from supersaturated solution in colloidal system. LRs are formed by a process referred to as "the Liesegang phenomenon". Here we describe LRs in renal hemorrhagic cyst from the donor kidney of a 59-year-old man. His general condition was good. Abdominal ultrasonography revealed a simple cyst in the left kidney. After donor nephrectomy for renal transplantation, a 3x2 cm sized cyst containing the brownish necrotic fluid was noted in the upper pole of left kidney. Frozen section from the relatively thickened cystic wall was performed. During frozen section examination, round concentric rings with double-layered outer wall, striations and amorphous central nidus admixed with the foamy macrophages were found and the lesion was originally interpreted as xanthogranulomatous inflammation with unusual crystalline structures in the cytoplasm of macrophages or freely in the interstitium. Macrophages with calcium crystals or malakoplakia were also considered at that time. Additional specimen for the permanent sections showed a simple hemorrhagic renal cyst with areas of small or large aggregates of LRs along the cyst wall. Multiple round ring-like structures ranging from 11 to 42 micrometer in diameter had uniform, pale eosinophilic, radially striated double wall. Histochemical and immunohistochemical stainings for iron, calcium, mucopolysaccharide, amyloid, cytokeratin were negative in these structures. They were highlighted by CD68 immunostaining as well as PAS and Masson's trichrome stainings. Awareness of Liesegang phenomenon in cystic lesions will decrease the possibility of erroneous diagnosis as another type of pathologic process, such as parasitic worms or eggs.
Amyloid ; Calcium ; Colloids ; Crystallins ; Cytoplasm ; Diagnosis ; Eggs ; Eosinophils ; Frozen Sections ; Helminths ; Humans ; Inflammation ; Iron ; Keratins ; Kidney Transplantation ; Kidney* ; Macrophages ; Malacoplakia ; Middle Aged ; Nephrectomy ; Ovum ; Tissue Donors* ; Ultrasonography

BACKGROUND: The incidence and causative dermatophytes of tinea cruris has been changed with time. Although clinical and mycologic studies of whole dermatophytosis have been reported many times, there have been only a few studies about tinea cruris reported. OBJECTIVE: The purpose of this study was to investigate clinical and mycological features of tinea cruuis. METHODS: We evaluated the clinical and mycologic aspects of tinea cruris in 598 patients with tinea cruris from January 1985 to December 1997 in Yeungnam University Hospital. RESULTS: The incidence of tinea cruris was 20.8% of 2,878 total dermatophytoses. The ratio of male to female patients was 23.9:1. And most of them were in their twenties and thirties. Most(82.1%) of them involved both sites of the groin. Concurrent dermatophytic infections of tinea cruris were noted in 29.4% of the cases and the most common one was tinea pedis(22.4%). Three hundred and thirty eight dermatophytes were isolated from 598 patients with tinea cruris. They were Trichophyton(T.) rubrum(95.3%), T. mentagrophytes(4.4%), Epidermophyton floccosum(1.2%), Microsporum canis(0.9%). CONCLUSION: Tinea cruris is a male predominant dermatophytosis, the most common causative organism is T. rubrum, and tinea pedis seems to be an important reservoir.
Arthrodermataceae ; Epidermophyton ; Female ; Groin ; Humans ; Incidence ; Male ; Microsporum ; Tinea Pedis ; Tinea*

A Listeria monocytogenes infection is relatively rare in healthy adults. However, the chance of an infection increases almost 17 times in pregnancy due to changes in the immune function. A Listeria monocytogenes infection results in characteristic gross and microscopic features in the placenta, including multiple yellowish nodules showing microscopic intervillous abscess and intervillositis. We describe the placental findings of a Listeria monocytogenes infection that was complicated by maternal sepsis, myocarditis and congestive heart failure. The infection was discovered in the 34th week of a twin gestation in a 28 year-old woman. This case should emphasize the importance of this condition to pathologists. Antibiotic treatment was started based on the placental histologic findings before a maternal blood culture confirmed growth of Listeria monocytogenes. Both the mother and twin babies were healthy at the time of this report.
Abscess ; Adult ; Female ; Heart Failure ; Humans ; Listeria monocytogenes* ; Listeria* ; Mothers ; Myocarditis ; Placenta ; Pregnancy ; Pregnancy, Twin* ; Sepsis

Talus is an important structure of the ankle joint and its function is critical for ambulation and weight bearing. The talus fracture is rare, but the complications of fracture and dislocation are serious and resulting in avascular necrosis, osteoarthritis. So its treatment is carefully considered at initial status. Authors reviewed 11 cases of fracture and dislocation of the talus treated at Yeungnam university hospital from 1984 to 1991. The longest follow up was 8 years and shortest, 1 years. The results were as follows. 1. There were all males, the average age was 30 years old. 2. The most common cause was fall down (8 cases), and next traffic accident (2 cases), sports injury (1 case). 3. According to Marti-Weber classification, 1 case was type I, 1 in type II, 4 in type III and 5 in type IV. 4. The method of treatment were open reduction and internal fixation in 6 cases, the others were closed reduction in 5 cases. 5. Final results (by Hawkins grading system) were as follows, 3 cases were excellent, 4 cases were good, 1 case was fair and 3 cases were poor. 6. Complications were AVN in 2 cases, degenerative arthritis in 8 cases, malunion in 1 case. 7. The range of motion of the ankle joint was relatively preserved (74%), but in the subtalar joint it was decreased (43%)
Accidents, Traffic ; Ankle Joint ; Athletic Injuries ; Classification ; Dislocations ; Follow-Up Studies ; Humans ; Male ; Methods ; Necrosis ; Osteoarthritis ; Range of Motion, Articular ; Subtalar Joint ; Talus* ; Walking ; Weight-Bearing

Intestinal metaplasia (IM) have long been thought to play a role in the pathogenesis of gastric intestinal adenocarcinoma, but not in that of diffuse cancer. We studied 20 normal gastric mucosa, 90 IM, 39 atypia (dysplasia or adenoma), and 51 adenocarcinoma to evaluate the expression of p53, erb B2, and H-ras p21 proteins and to assess the correlation with IM (esp. type III IM, revealing positive HID-AB/PAS for sulfomucin). Positive rate of HID-AB staining revealed an increased trend in comparison between IM, atypia and adenocarcinoma. It was the highest in mucinous carcinoma, but it was not correlated with positive oncoprotein expressions. Positive rates of oncoproteins revealed increased trends in comparison between IM, dysplasia or adenoma and adenocarcinoma in c-erb B2 and p53 (P<0.01). The positive rates were highest in intestinal adenocarcinoma (50.0% and 54.2%, respectively). Rates were lowest in biopsy tissue of IM (4.4% and 8.7%, respectively). The expression of H-ras p21 was not significant in gastric carcinogenesis. There was no significant correlation between oncoproteins and other clinical parameters, such as depth of invasion, differentiation, size and nodal metastasis of the tumors. Therefore, we suggest that p53 and erb B2 may play a role in the carcinogenesis of gastric intestinal adenocarcinoma.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Adenoma ; Biopsy ; Carcinogenesis ; Gastric Mucosa ; Metaplasia* ; Neoplasm Metastasis ; Oncogene Proteins

The present study was designed to evaluate the efficiency of total lactate dehydrogenase, total creatine kinase, LD1/LD2 ratio, CK-MB and newly developed troponin T in acute myocardial infarction. The level of troponin T was 0.010.02 pg/L in 34 healthy person, but the peak vaule of acute myocardial infarction ranged in 4.7-24.2 pg/L. Total lactate dehydrogenase was peaked in 1 to 3 days after chest pain and then progressively decreased, but LD1/LD2 ratio was persistently higher than 1.0 for 10 days in most patients. Total creatine kinase and CK-MB were peaked in 1-2 days, and normalized in 3-4 days, so they, were useful in early diagnosis of acute myocardial infarction, but not for the late stages of acute myocardiz l infarction. Troponin T is early elevated and persistently high level for more than 10 days. Comparing with total lactate dehydrogenase, total creatine kinase, LD1/LD2 ratio and CK-MB, troponin-T test improves the efficiency of serodiagnostic method for the detection of ischemic myocardial damage.
Chest Pain ; Creatine Kinase ; Early Diagnosis ; Humans ; Infarction ; L-Lactate Dehydrogenase* ; Lactic Acid* ; Myocardial Infarction* ; Phosphotransferases* ; Troponin T* ; Troponin*

Major pathogenic Gramnegative organisms such as P. aeruginosa, Serratia species, E. coli, Enterobacter species which are isolated from the specimens in large medical centers are greatly resistant to the commonly used antibiotics. Gramnegative bacilli, which had been isolated in Yeungnam Uni rersity Hospital during the period from December 1992 to April 1993 and turned out to be resistant to the primary antibiotics susceptibility test for chloramphenicoi, ampicillin, eephaiothin,- geniamicitt, tetracyclin, amikin and tobramycin, were subjected to the secondary antibiotics susceptibility test for aztreonam, ceftazidime, ciprofloxacine, cefotaxime, cefamandole, piperacillin, ticarcillin and sulfamethoxazole trimethopime. Out of 315 tested organisms, 167 organisms (53%) were resistant to all secondary antibiotics in vitro. Antimicrobial activity of ceftazidime (37.1%), aztreonam (11. %), ciprofloxacine (7.9%) against Gram negative bacilli were slightly more active than other antibiotics tested, while cefamandole was not active to all the Gramnegative bacilli tested. According to the specimens, E. coli was the most frequently resistant organisms to the primary antibiotics from urine, A. baumanii, from respiratory system and wounds, and P. aeruginosa from various specimens. In summary, Gram negative bacilli resistant to the primarily applied antibiotics also were resistant to the secondary antibiotics. Rearrangement of the antibiotics disks for the antibiotic susceptibility test should be considered.
Amikacin ; Ampicillin ; Anti-Bacterial Agents* ; Aztreonam ; Cefamandole ; Cefotaxime ; Ceftazidime ; Ciprofloxacin ; Enterobacter ; Piperacillin ; Respiratory System ; Serratia ; Sulfamethoxazole ; Ticarcillin ; Tobramycin ; Wounds and Injuries

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KOH examination is a simple, rapid and diagnostic procedure to confirm dermatophytic infections. It is important to select a proper examination site of the lesion. To determinate the proper examination site of the lesion, mycologic studies were done with multiple specimens collected from the center, margin and out of margin of the ring-shaped dermatophytic skin lesion on the 58 patients. The results were as follows. Positive rate of KOH wet smear was 94.8% at the center and 100% at the margin of the lesions, 22.4% at the 1 cm and 5.2% at the 2 cm out of the lesions. The more hyphae were found in the lesion, the more hyphae were found out of the lesion. Culture was done on the Sabouraud's glucose agar from the highest KOH positive area and the positive culture was 48 strains (82.8%) of 58 patients. These findings suggested that the ring-shaped active margin was the best site to examine mycologic studies.
Agar ; Glucose ; Humans ; Hyphae ; Skin*

We observed a 51-year-old male, who developed depigmented patches on the lower abdomen after photochemotherapy(PUVA) of psoriasis without evidence of phototoxic reaction. The depigmented patches did not orginate from the sites of previous psoriatic lesions. Fontana-Masson stain of the biopsy specimen revealed nearly absent melanin pigments in the epidrmis of the hypopigmented patch, while lots of pigments were obsereved on the surrounding hyperpigmented area. Electron micrograph showed no melanocytes in the hypopigmented patch. Thus we report this case as having vitiliginous patches induced by photochemotherapy of psoriasis.
Abdomen ; Biopsy ; Humans ; Male ; Melanins ; Melanocytes ; Middle Aged ; Photochemotherapy* ; Psoriasis* ; Vitiligo