Subepiderral calcified nodules is a special form of idiopathic calcinosis circumscripta with its distinct clinical and histopathologic features, which was originally described by Winer(1952) as solitary congenital no3ular czlcification of the skin. Although the lesions are usually solitary and congenital, subs aquent investigators reported multiple lesions and later onset. Clinically, th. leions are small hard. yellowish-white warty nodules developed. usually on the face and mostly in children and histopathologically are subepidermal calcified mass with s cvn4ry epidermal changes. Although the pathogenesis is still unexplained, it s seems that the disease is not associated with any systemic or cutaneous disease or any biochemial abnormalities. We present a first recorded case of subepidermal calcified no3ules developed on the left the a Korasn female, aged 23, which has been present for 7 years. Shave biopsy showed typical histopathologic and histochemical features of the subpidermal calcified nodules. Literature were reviewed.
Biopsy ; Calcinosis ; Child ; Female ; Humans ; Research Personnel ; Skin

There have been reported some important findings in immunology of psoriasis, such as lower than normal level of IgM, defective humoral immune, responsiveness to newly administered antigens during cytotoxic drug therapy, lower than normal incidence of active sensitization with DNCB, prolonged skin heterograft survival and presence of anti-IgG antibody in peripheral lymphocytes. These findings are strongly suggestive of some humoral as well as cellular immunne dysfunction in patients with psoriasis. The present study was undertaken to evaluate the therapeutic effectiveness of BCG, a potent nonspecific immune stimulator, in patierts with psoriasis. Total 41 cases of more than 2 years' duration of illness and with widespread involvement and having had history of various previous treatment were slelcted at the Department of Dermatology, National Medical Center during October, 1973 and October, 1974, Liquid BCG(manufactured by NIH, Korea) was administered intradermally in a starting dose of 0.1 ml(0.01 mg in dry weight) weekly. The dosage of BCG was increased to 0.3 or 0.5ml after 3 or 5 injections and this dosage was maintained until some clinical changes were observed. The mean injection time to each patient was 20. 7.The results were as follows: 1. Eighteen cases showed no therapeutic response or aggravation of the lesions. 2. Six cases showed good therapeutic effect, resulting in only a few small lesions remained on elbows, knees or scalp areas. 3. Fourteen cases showed excellent therapeutic effect, that is complete disappearance of the lesions. During 2 to 6 months'follow up period, 7 cases showed relapse and the remainders are still under observation. The mechanism of influence of BCG on the clinical course of psoriatic patients is not determined, however, possible mechanism was discussed.
Allergy and Immunology ; Dermatology ; Dinitrochlorobenzene ; Drug Therapy ; Elbow ; Heterografts ; Humans ; Immunoglobulin M ; Incidence ; Knee ; Lymphocytes ; Mycobacterium bovis* ; Psoriasis* ; Recurrence ; Scalp ; Skin

Accidental vaccinia may occur either in a recently vaccinated person through autoinoculation by veticular fluid or in a person who is in close personal contact with a recently vaccinated person. Accidental vaccinia occurs most co@mmonly on the eyelid, lips, nose or vulva. An outbreak of similar lesions in a family is unusual. We presented a case of accidental vaccinia in a 29-year old married woman. She has been relatively well until 5 days prior to visit, when she began developed painful grouped papules with central umbilication around both mammary areolas and nipples and marked painful swelling of both axillary lymphnodes. Family history revealed that her baby has also suffered from vesicopustuIar eruptions on upper lip 10 days before her onset and her nephew had similar skin eruption on left index finger for the last 1 week. Contact tracing revealed her neighboring child who was smallpox vaccinated inoculated her baby and then she was contracted from her baby, so-called, third hand vaccinia. Physical examination was not remarkable and laboratory findings were within normal limit. The biopsy finding showed findings consistent with viral infection. After symptomatic treatment and daily dressing, the akin lesion has completly healed in about 2 weeks.
Adult ; Bandages ; Biopsy ; Child ; Contact Tracing ; Eyelids ; Female ; Fingers ; Hand ; Humans ; Lip ; Nipples ; Nose ; Physical Examination ; Skin ; Smallpox ; Vaccinia* ; Vulva

OBJECTIVE: Bacteroides fragilis, normal colonic inhabitant, is the most frequently isolated anaerobes in infected tissues, particularly in intraabdominal abscesses. In the acute infection model with abscesses, the response to B. fragilis infection is characterized by infiltration of neutrophils and macrophages. This study was designed to determine whether proinflammatory cytokines could be upregulated in peritoneal tissue of B. fragilis-infected mouse model. METHODS: After C57BL/6 mice were infected with abscess-inducing encapsulated B. fragilis, RNA was extracted from the intraperitoneal tissues. Cellular RNA was also extracted from mouse peritoneal macrophages (MPM) and human peripheral blood mononuclear cells (PBMC) after infection with B. fragilis. Expression of various cytokine mRNA was assessed using RT-PCR and standard RNA. Each cytokine protein was also measured by ELISA. RESULTS: B. fragilis-infected intraperitoneal tissues showed upregulated expression of IL-1u, IL-6 and TNFu mRNA. Expression of IL-1u and TNFu mRNA and protein was significantly higher in MPM or PBMC infected with B. fragilis than in those without infection. However, expression of IL-6 mRNA and protein was not increased in MPM or PBMC infected with B. fragilis compared with those without infection. CONCLUSION: These results suggest that the cytokines can be involved in immunopathologic reactions of the peritoneal tissue infected with B. jragilis.
Abscess ; Animals ; Bacteroides fragilis* ; Bacteroides* ; Colon ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-6 ; Macrophages ; Macrophages, Peritoneal ; Mice* ; Neutrophils ; RNA ; RNA, Messenger

The serodiagnostic test of syphilis employed with the greatest freguency in this country is the VDRL procedure which is one of the flocculation test utilizing cardiolipin-lecithin as an antigen. As well known, the immunologically nonspecific nature of this test relegates it only to screening test, so that all the sera displaying weakly reactive or reactive VDRL in the absence of definite evidence of present or past syphilis should be confirmed by using the specific treponemal antigen tests. However, there are only lirnited numbers of institutions at which the specific treponemal antigen tests are carried out, because the tests usually need quite coaiplicatnl technology and specifically trained personnel. The Treponema. pallidum hema.gglutination assay (TPHA) which was first described by Rathlev in 1965 and established as more improved and standardized procedure in serodia,gnosis of syphilis by Tornizaxva and Kasamatsu (1966) has been found to h as sensitive and specific as the technically more complicated Fluorescent treponemaI antibody absorption (FTA-ABS) or Treponema pallidum immobilization (TPI) po cedure by rnany investigators from different parts of the world during these 10 years. The TPHA has also been found to have definite advantage over the other tests because it is easy to perform and economic. The present authors felt. that the TPHA meight be the most reasonable method to be used in this country and decided to evaluate it in the serodiagnosis of problem cases. Sera from 516 presumed normal persons, 686 pregnant women ancl 1345 patients with various diseases other than syphilis were screened with the standard VDRL procedure as described and recommanded by USPHS. Out of these, 475 of t.he presumed normal persons, 646 of the pregnant women and 1243 of the patient group wit;h various diseases other than syphilis v;ere serologically nonreactive and 10, 12 and Rl sera from each of the above groups, respectively, were found to be true syphilitc with definite evidence of clinical signs or history of syphilis. Thirty-one out of the presumed normal persons, 28 out of the pregnant women and 71 out of the patient group with various diseases other than syphilis showed either weakly reactive or reactive VDRI, in undiluted sera without definite evidence of syphilis and these 130 sera from 130 persons were the subject of the present study. The TPHA was carried out on these 130 sera. according to the ma.nual MEA-TP instructed by National Institute of Health, Japan. The reagents used in this study rvere rnanufactured and supplied hy the Fujizoki Pharmaceutical Co. Ten (32.3%) out of the R1 sera from preaumed normal persons, 11 (39.4%) out of the 28 sera from pregna.nt women a.nd 28 (69.4%) out of the patient group with various disea ses other then syphilis showed reactive TPHA. Eighty-seven of the total 130 sera showed weakly reactive VDRL so called rough result and 19 (21.8%) Of these 87 sera showed reactive TPHA, while 30(69.8%) of the 43 sera which showed reactive VDRL were found to be TPHA reactive. These results arc in general agreement with those of other investigators confirmed by the more complicated FTA-ABS or TPI. The overall incidence of syphilis was 3.87%, 3.35% and 4.38% in presumed normal persons, in pregnant women and in patient group with various diseases other than syphilis respectively. Considering the relative lack of study concerning to the false positive reactions in this country, these results may be helpful to the clinician to rnake a cert.ain diagnostic decision when they meet such a patient whose VDRL is weakly reactive or reactive in the absence of definite evidence of syphilis. The authors concluded that: the MHA-TP technique is easy in performance, economic and highly specific in serodiagnosis and that this technique is highly recommanded in this country. * The authors thank Fujizoki Pharrnaceutical Company, Tokyo, Japan which provided the TPHA reagents used in this study.
Absorption ; Bezafibrate ; False Positive Reactions ; Female ; Flocculation Tests ; Humans ; Immobilization ; Incidence ; Indicators and Reagents ; Japan ; Mass Screening ; Pregnant Women ; Research Personnel ; Serologic Tests* ; Syphilis* ; Treponema ; Treponema pallidum ; United States Public Health Service

A case of multiple myeloma associated with adenocarcinoma of the stomach was review. A 59-year, old Korean man had been abmitted to St. Mary's Hospital in January 1984, with chief complaint of posterior neck pain, and intermittent headache for one year prior to amission. Osteo lytic punched-out lesions were noted on skull and other skeletal x-ray films. Bone marrow aspirates revealed diffuse infiltration of mature and immature plasma cells. Laboratory findings revealed anemia and Bence-Jones proteinuria. Immunoelectrophoresis revealed findings consistent with IgA-lamda type multiple myloma. Alkylating agents and steroids were tried with some clinical improvements. In August 1985, the patient revisited outpatient clinic with chief complaints of epigastric pain and neck mass. Endoscopic biopsy and excision biopsy of the cervical lymph node were performed. By microscopic examination, adenocarcinoma of the stomach and metastasis of multiple myeoma to the supraclavicular lymph nodes were confirmed. Subtotal gastrectomy was performed. By gross and microscopic revealed metastasis to the regional lymph nodes.
Male ; Humans ; Adenocarcinoma ; Biopsy ; Neoplasm Metastasis

Adenoid cystic carcinoma of the lung is histologically and ultrastructurally identical to the salivary gland tumor of the same name and is characterized by infiltrative growth, local recurrence, and usually a prolonged clinical course. We have recently experienced two cases of adenoid cystic carcinoma arising in the lung. Case 1 was a 59 year-old male who presented with cough, fever, and chill of 1.5 months' duration, and case 2 was a 61 year-old male who was incidentally found to have a 3 to 4 cm sized lobulated mass in the right upper lobe. After being worked up, both patients underwent right pneumonectomy. In case 1, a 3x2 cm sized tumor was located in the lower bronchus, partly elevating toward the lumen and partly infiltrating into regional lymph nodes and lung parenchyma showing grayish-white and solid cut surface. Case 2 was a 3.5x3.5 cm sized upper bronchial tumor resembling the former in appearance. Histologically, the tumors were composed of small round hyperchromatic cells, forming solid, cribriform, acinar, or tubular structures. Luminal spaces in tumor cell nests contained PAS-positive mucinous or hyaline material. Among the tumor cells, scattered islands of normal submucosal gland were noticed.
Male ; Humans

No abstract available.
Humans ; Nitroblue Tetrazolium* ; Skin* ; Tuberculosis, Cutaneous*

A clinical study was conducted to compare effectiveness of IV Globulin with that of steriod in childhood acute ITP. We carried out an experiment to 36 patients of acute ITP who recovered over 50.000/mm(3) of platelet count and not to recur in 6 months. Study group consist of 10 children who were treated with steriod only (Group A), 13 children who were treated with IV Globulin (0.4g/kg/d, 5 days, Group B), and 13 children combined with steroid (Group C) Study period was from January 1988 to December 1992, folllowing results were obtained. 1) There were no significant difference in sex ratio. age distribution, pretreatment hemoglobin level, platelet count and prolonged bleeding time among study groups. 2) The days which platelet count reached to 50.000/mm(3), 100,000/mm(3) were 3.7 days (Group A), 2.1 days (Group B), and 2.3 days (Group C), respectively (p<0.05). 3) Complete response rates within 4 weeks did not show significant difference (90% in Group A, 84.6% in Group B, 92.3% in Group C), the complete response rate within 1 week were significantly different among three group (44.4% in Group A, 90.9% in Group B, 83.3% in Group C)(p<0.05). In conclusion, it is more desirable for early treatment of a childhood ITP because IV Globulin is easy to normalize platelet count in a short time.
Age Distribution ; Bleeding Time ; Child ; Humans ; Platelet Count ; Sex Ratio

Herpes zoster is known to be more frequent and severe in patients during immunosuppressive treatment and various predisposing factors, such as Hodgkin's disease, advanced tumor stage, local X-ray irradiation, splenectomy and cutaneous anergy. This report presents the case of a 23-year-old woman who developed herpes zoater on two separate occasione during the treatment of systemic lupus erythematosus with immunosuppressive agents (corticosteroid and cyclophosphamide). In each occasion, it was involved by different and multiple dermatomes. Treatment with oral and intralesional corticosteroids administration proved to be beneficial without any complication, although some delayed recovery of the disease was noted.
Adrenal Cortex Hormones ; Causality ; Female ; Herpes Zoster* ; Hodgkin Disease ; Humans ; Immunosuppressive Agents ; Lupus Erythematosus, Systemic* ; Splenectomy ; Young Adult