Lymph nodes, one of peripheral lymphoid organs, are the sites, where the lymphocytes receive their initial instructions for producing effector functioning resulting in humoral or cell-mediated immunity. Each lymph node consists of an outer cortex in which there are aggregates of cells constituting the follicles, B-cell areas. Some follicles have central areas called germinal centers, which stain lightly. Germinal centers are B lymphoblast cell areas arising eccentrically in primary lymphoid follicles in response to T-cell dependent antigenic stimulation and are the generally accepted sites of generation of memory B cells and undergoing isotype switching and somatic mutation. We observed the morphologic, cellular, protein and molecular events arising in mouse popliteal lymph nodes in response to T-cell dependent antigenic stimulation. In this study mice were immunized into footpads with TNP-chicken ovalbumin. The germinal center formation in primary follicles of popliteal lymph nodes was first observed 6 days after immunization and germinal centers persisted until 24 days of immunization. Lymph node cells were stained with PE-labeled anti-B220 antibody and/or FITC labeled PNA and analyzed by using FACScan. B cells (B220(+) cell) in lymph node increased after 3 days and peaked between 6 and 18 days after immunization. The proportion of germinal center B cells (B220, PNA(high) cells) among lymph node B cells was low (2%) before immunization but increased at day 6 (9%) and reached the peak (30%) at day 18. The expression of IgG1 productive mRNAs and germline transcripts were observed by using RT-PCR. The expression of IgG1 productive mRNA was detected at day 10 and continued until 24 days after immunization. The expression of IgG1 germline transcripts was observed 10 days after immunization and rapidly declined over the next one week. IgG1 anti-TNP antibody, main isotype of anti-TNP antibodies, was first detected at day 14 and reached the peak level 24 days after immunization. Taken these data together, we can conclude that the first immunological event observed from mouse popliteal lymph node in response to T-cell dependent antigenic stimulation is the increase in the number of B cells, and this event is followed by appearance of germinal center B cells and at the same time by the formation of germinal center in primary lymphoid follicles. Once the germinal center is formed, the process of isotype switching to IgG1 occurs in lymph node and antigen-specific IgG1 antibody is produced.
Animals ; Antibodies ; B-Lymphocytes ; Fluorescein-5-isothiocyanate ; Germinal Center ; Immunity, Cellular ; Immunization ; Immunoglobulin Class Switching ; Immunoglobulin G ; Immunoglobulins* ; Lymph Nodes* ; Lymphocytes ; Memory ; Mice ; Ovalbumin ; RNA, Messenger ; T-Lymphocytes

We report herein two cases of leukemia cutis. One case is a 54-year-old woman who came to our department with complaints of a solitary ulcerating nodule on her left leg that had been present for 2 months since prior to her visit. Through histopathological studies, the diagnosis of myelocytic leukemia cutis was made before the final diagnosis of acute myelocytic leukemia was made by hematological studies. When combined chemotherapy was finished, she was in a partial remission state and the nodule disappeared after 1 month of chemotherapy. The other case is a 77-year-old man having multiple infiltrative nodules on the right forearm and right thigh for 1 month prior his visit. He was diagnosed as having leukemia cutis for his skin lesions histopathologically. This was redefined as chronic myelomonocytic leukemia of the myelodysplastic syndrome with blastic transfor- mation by hematological examination. He developed septicemia and died 3 weeks after the dermato- logical diagnosis.
Aged ; Diagnosis ; Drug Therapy ; Female ; Forearm ; Humans ; Leg ; Leukemia* ; Leukemia, Myeloid ; Leukemia, Myeloid, Acute ; Leukemia, Myelomonocytic, Chronic ; Logic ; Middle Aged ; Myelodysplastic Syndromes ; Sepsis ; Skin ; Thigh ; Ulcer

Herein we report a case of subungual osteochondroma in a male patient. Although there have been several reports about cases of subungual exostosis in Korea, a case of subungual osteochondroma had not been reported until now. Osteochcndromas are clearly different disease entities from exastosis in that they have diagnostic hyaline cartilaginous caps instead of the fibrocartilages in subungual exostosis. Additioaally, subungual osteochondroma is a very rare type having an incidence rate of less than 1% among all osteochondromas. Our patient was an 18-year-old male with a solitary woody mass on his right great toe that was painfuL A surgical excisional biopsy following a nail plate avulsion showed the characteristic hyaline cattilaginous caps enclosing bony trabecula connected with the inferior cortical bone.
Adolescent ; Biopsy ; Exostoses ; Humans ; Hyalin ; Incidence ; Korea ; Male ; Osteochondroma* ; Toes

BACKGROUND: Although there are varied etiological factors in the pathogenesis of psoriasis, recent data where viral hepatitis is more frequently found in psoriasis patients than in the normal population, suggests the possibility that some kinds of viral antigens may participate as causative factors of psoriasis. Hepatitis C virus(HCV) in particular, which has been proven to be associated with many dermatoses such as porphyria cutanea tarda, lichen planus and vasculitis, is currently suspected as a possible pathogen in psoriasis. OBJECTIVE: This study was conducted to estimate the prevalence of viral hepatitis infection among psoriasis patients in Korea where it is known to be endemic. Additionally, we analysed the relationship between the clinical severity of psoriasis and viral hepatitis according to the serotypes. METHODS: In this study, we looked for the presence of HCV, HBV, HAV, HDV and HEV infection in 65 enrolled psoriasis patients and 98 non-psoriatic patients by enzyme immunoasay, recombinant immunoblotting, radioimmunoassay and reverse transcription polymerase chain reactions. RESULTS: 1. We found a higher prevalence of viral hepatitis in the psoriasis group(70.8%) than the control group(45.9%). 2. 10.7% of patients were shown to be infected with HCV in the psoriasis group, in comparison with 2% in the control group. Also 52.7% of psoriatic patients were positive to HBV markers as HBcAb and HBsAg in comparison with 38.8% in the control group. 3. There was a statistically significant correlative relationship between the clinical severity of psoriasis and the presence of viral hepatitis. 4. We could establish a significant association among higher titers of ALT, positivity of HBcAb and HBsAg, and HCV hepatitis in psoriatic patients. CONCLUSION: Psoriatic patients had a higher prevalence of viral hepatitis than normal controls. Also psoriatic patients with viral hepatitis showed relatively different clinical features and labaratory results in comparison with those without it.
Antigens, Viral ; Hepatitis B Surface Antigens ; Hepatitis C ; Hepatitis* ; Humans ; Immunoblotting ; Korea ; Lichen Planus ; Polymerase Chain Reaction ; Porphyria Cutanea Tarda ; Prevalence ; Psoriasis* ; Radioimmunoassay ; Reverse Transcription ; Skin Diseases ; Vasculitis

We herein report a case of Spitz nevus which occurred in a 6-year-old girl with acute lymphocytic leukemia. The lesion was a well delimited, symmetric, 1.0 * 1.0cm sized, dome-shaped light pinkish nodule with a shiny surface on her forehead. The histopathological findings of the excisional biopsy specimen revealed mild epidermal hyperplasia ; numerous uniform nests of spindle cells and epitheloid cells with sparce pigmentation along the dermoepidermal junction; colloid body-like eosinophilic globules ; multinucleated giant nevus cells in the epidermis and edema in the upper dermis. Since the complete excision of her lesion was accomplished, there have been no new lesions over the past year.
Biopsy ; Child ; Colloids ; Dermis ; Edema ; Eosinophils ; Epidermis ; Female ; Forehead ; Humans ; Hyperplasia ; Nevus ; Nevus, Epithelioid and Spindle Cell* ; Pigmentation ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

Pemphgus vulgaris (PV), Bullus pemphigoid (BP), and Epidermolysis bullous acqusita (EBA) are autoimmune bullous dermatoses, characterized by circulating IgG autoantibodies. These antibodies react with antigens located at the intercellular substance (ICS) of epidermis, basement membrane zone (BMZ), and subepidermal anchoring fibril zone (AFZ), respectively. The subclass distribution of IgG autoantibodies, and the properties and degrees of complement fixing activities of these autoantibodies in each of the above diseases have not been well understood. Indirect immunofluorescence and in vitro complement stainings were performed for the titration of subclasses of IgG antibodies and for the immunofluorescence staining reactivities of complement components C3, C4, C5b-9, H, C4bp, and S. Each serum specimen from five cases of PV, five cases of BP. and three cases of EBA was tested. The findings of multistep technique with monoclonal and polyclonal antibodies are as follows : All four subclasses of IgG antibodies were identified at the antigenic sites in these group, however there were some differences in the antibodies titers. In PV and BP the dominant subclass of highest antibody titer was IgG1 and/or IgG4. In EBA only IgG4 was dominant in all three cases. The results of complement component stainings, in most of the cases of PV, showed positive for C3 and C4 but were negative for the other components or inhibitor proteins at the ICS of epidermis. In BP most of the cases revealed positive staining reactivities at the BMZ for C3, C4, C5b-9, H, and C4bp-9 with no staining reactivities for the inhibitor proteins No significant relevancy was found between the titers of complement fixing IgG subclasses and the numbers of positive complement staining reactivities for complement components. The results suggest that the complement system may contribute more strongly to the formation of bullous lesions in BP and EBA than in PV.
Antibodies ; Autoantibodies ; Basement Membrane ; Blister ; Complement Membrane Attack Complex ; Complement System Proteins ; Epidermis ; Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa* ; Fluorescent Antibody Technique ; Fluorescent Antibody Technique, Indirect ; Immunoglobulin G ; Pemphigoid, Bullous* ; Pemphigus* ; Skin Diseases, Vesiculobullous

The delayed blanch is one of the most discussed but undecided facets of atopic dermatitis as yet. At present, they favor the theory that delayed blanch is due to vasoconstriction, but it is not obvious whether this is due to "true" vasoconstriction or to the blood vessels being narrowed by the surrounding exudative edema, resulted from vasodilatation and increased capillary per meability. We compared cutaneous response of severe atopic dermatitis with that of age matched non-atopic individuals after intradermal injection of acetylcholine by means of naked eye and laser Doppler flowmeter examination, control group showed flare and wheals while at,opy group resulted in delayed blanch in addition to flare and whealing. The results of laser Doppler flowmeter examination revealed that, as compared to baseline, atopy group showed statistically significantly increase in spite of delayed blanch. We suggested that the delayed blanch may be not due ta va.soconstriction but due to the vasadilatation and aceumulation of edema fluid.
Acetylcholine ; Blood Vessels ; Capillaries ; Dermatitis, Atopic* ; Edema ; Flowmeters ; Injections, Intradermal ; Vasoconstriction ; Vasodilation

We used skeletal scintigraphy which had a high sensivity in the diagnosis of acute fractures in clinically suspected scaphoid fracture to elevate diagnostic accuracy, and then evaluated the results. From February 1993 to April 1994, twenty patients with a clinical suspicion of a scaphoid fracture in spite of normal skeletal films had been examined with skeletal scinigraphy of the wrist Sensitivity was 100%, specificity 30.8%, positive predictable value 43.8%, and negative predictable value 100%. The patients with positive scintigraphy and normal x-ray were free from symptoms in 4-6 weeks in spite of no treatment. In conclusions, Skeletal scintigraphy is of major importance in carpal trauma to rule out scaphoid fracture. Information obtained through scintigraphy often proved a prerequisite both for the retrospective identification of the fracture and for repeat directed skeletal view. The lesions in the distal radius and other carpal bones may clinically mimic a scaphoid fracture. and the authors feel to need further specific diagnostic tools such as MRI in cases with carpal injuries and scinitigraphic uptake indicative of a fracture when even skeletal views turn out normal. However, scintigraphy doesn't seem to be a guide of trament in these patients.
Carpal Bones ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Radionuclide Imaging ; Radius ; Retrospective Studies ; Sensitivity and Specificity ; Wrist

Anterior plate fixation of the cervical spine enhance anterior grafting technique and provide good primary stability to allow early mobilization without significant external support. This facilitastes nursing and shortens rehabilitation time. Although these advantages, the screw technique is risky and time-consuming since purchasing of posterior cortex is needed for obtatining maximum stability. The authors have tried to a technique of purchasing only near cortex. The objectives of this study were review of the result of this technique and the determining the factor influencing screw loosening. One hundred and five screws used in twenty-one patients for conventional cervical plate fixation from September 1990 to February 1994 were reviewed. Average age was forty-two years old ranged from nineteen to sixty-five. Patients with trauma were six and degenerative diseases were fifteen. Two screws were inserted in C3 bodies, ten in C4, thirty-two in C5, thirty-four in C6, ten in C7, two in Tl and fifteen in grafted bone. Twenty-four screws(16%) in six patients(28.6%) were loosened. Usually the first loosening was noted at about one month after operation. The incidence of loosening was significantly higher in lower cervical region(p < 0.001) and older age(p < 0.05). The disease entity or sex were not significant factor. This technique showed high rate of screw loosening especially in older age group or lower cervical lesion. We think the indication of this technique should be limited in young patient with upper cervical lesion.
Early Ambulation ; Humans ; Incidence ; Nursing ; Rehabilitation ; Spine ; Transplants

We herein present a case of a 2-year-old girl with non-Hodgkin's lymphoma(NHL) of the lymphoblastic type involving cutaneous sites at the time of diagnosis. The histological finding was typical of lymphoblastic lymphoma. However, immunophenotypically, this lymphoma was not of the T-cell or B-cell type, although the vast majority of lymphoblastic lymphomas involving the skin are usually of the pre-B cell or T-ce11 type. Until now, there have been few reports of non-T, non-B primary cutaneous lymphoblastic lymphoma expressing surface CD10 and CD56 antigens as in this case.
Antigens, CD56 ; B-Lymphocytes ; Child, Preschool ; Diagnosis ; Female ; Humans ; Lymphoma ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Precursor Cells, B-Lymphoid ; Skin ; T-Lymphocytes