BACKGROUND: Immunostaining to identify nuclear antigen provides a convenient way of assessing proliferative kinetics in hyperplastic/tumor tissue. OBJECTIVE: The object of this study is to find out whether there are any differences in the expression of proliferation related protein among psoriasis, basal cell carcinoma and squamous cell carcinoma by immunohistochemical evaluation on the PCNA (proliferative cell nuclear antigen) and Ki-67. METHODS: The detection of PCNA and Ki-67 were done by,immunohistochemical methods (avidin-biotin immunoperoxidase methods) using respective monoclonal antibodies in the paraffin embeded tissues from psoriasis (17 cases), basal cell carcinomas (15 cases) and squamous cell carcinomas (10 cases). RESULTS: The labelling indices of PCNA were 14.2±4.0% in psoriasis, 10.9±5.5% in basal cell cardinoma and 28.0±7.8% in squamous cell carcinoma, while the labelling indices of Ki-67 were 15.7±3.8% in psoriasis, 11.26.1% in basal cell carcinoma and 30.3±9.4% in squamous cell carcinoma. CONCLUSION: 1. Interpretation of Ki-67 staining was easier than that for PCNA, mainly because cell morphology was better preserved and the distinction between hyperplastic/tumor and nontumor cell was clear. 2. PCNA and Ki-67 counts had strong correlation to each other (r=0.979). 3. Our immunohistochemical results of PCNA and Ki-67 suggested that proliferative activity was more marked in psoriasis than basal cell carcinoma.
Antibodies, Monoclonal ; Carcinoma, Basal Cell* ; Carcinoma, Squamous Cell ; Kinetics ; Paraffin ; Proliferating Cell Nuclear Antigen* ; Psoriasis*

BACKGROUND: Juvenile myoclonic epilepsy(JME) is the most common idiopathic generalized epileptic syndrome which occurs mostly in the second decade of life. It is still frequently unrecognized and misdiagnosed. JME responds well to valproate, but is hardly controlled by other commonly used antiepileptic drug such as carbamazepine or phenytoin. We intended to Investigate the clinical symptoms and EEG findings of JME to support the diagnosis and treatment of JME. SUBJECTS AND METHODS: We retrospectively reviewed the medical record of 18 childrens with JME, from March 1991 to February 1997 We have analysed the clinical symptoms, seizure type, EEG findings including photosensitivity, and the effect of antiepileptic drug. RESULTS: 1) Seven patients were boys and eleven patients were girls(M : F=1 : 1.6). The seizure onset between 5 and 7 years of age were noted in 5 cases, that between 8 and 10 years in 5 cases, and in 8 cases seizures began after 11 years of age 2) Generalized convulsive seizures were noted in 16 cases(GTC 13, GC 2, GCTC 1), myoclonic seizures in 18 cases, absence seizures in 5 cases, and photoconvulsive seizures during video game were associated in 3 cases. 3) Epileptiform discharges at the diagnosis of JME were noted 12 cases(66.7%), and no epileptiform discharges were seen in 6 cases(33.3%). The background activities were normal in all cases. In all 12 cases that showed abnormal epileptiform discharge, generalized spike and wave discharges were obtained, and photosensitivies noted in 4 cases. 4) Follow up EEG obtained after treatment, showed normal EEG findings in 16 cases, and abnormal EEG findings were obtained in 2 cases. 5) Sixteen cases responded well to valproate monotherapy, and 2 other cases responded to valproate and ethosuximide combined therapy. In one case who received vigabatrin, the seizure was aggravated. 6) In 5 cases who discontinued antiepicoptic drug medication after 3 year seizure free duration, 3(60%) cases relapsed within 1 year, and 2(40%) cases remained seizure free for over 1 year. CONCLUSION: Juvenile myoclonic epilepsy is an epileptic syndrome with generalized convulsive seizure, myoclonic seizure, and absence seizure, and EEG findings showed generalized spike and wave discharge in 66.7%, and photosensitivity in 22.2%. JME responded well to valproate monotherapy or valproate and ethosuximide combined the rape, but not responded to other antiepileptic drugs.
Anticonvulsants ; Carbamazepine ; Child ; Diagnosis ; Electroencephalography ; Epilepsy, Absence ; Ethosuximide ; Follow-Up Studies ; Humans ; Medical Records ; Myoclonic Epilepsy, Juvenile* ; Phenytoin ; Rape ; Retrospective Studies ; Seizures ; Valproic Acid ; Video Games ; Vigabatrin

The term "fixed drug eruption" was coined by Louis Brocq in 1894 to describe a special type of reaction to antipyrine. It is now known that many drugs can cause a fixed drug eruption. Notorious offenders have included phenolphthalein, quinine and barbiturates. We present a case of multiple fixed drug eruption appearing in a 20 year-old male patient who has generalized slate-blue colored pigmentation on neck, trunk and extremities. The area of total pigmented skin lesions are over 50% of body surface. We could confirm the fixed drug eruption by positive phenobarbital provocation test.
Antipyrine ; Barbiturates ; Criminals ; Drug Eruptions* ; Extremities ; Humans ; Male ; Neck ; Numismatics ; Phenobarbital ; Phenolphthalein ; Pigmentation ; Quinine ; Skin ; Young Adult

Epidermolysis bullosa dystrophica is rare, chronic non-inflammtory mechanobullous disease of hereditary trait, which easily produces bullae by minor trauma or sponta neosly. A 1-day old male neonate presented wide spread vesicobullous minor, eruptions since birth. On examination, tense bullse were noted on the dorsa of the feet and right knei: area Which is usually serous but may be hemarrhagic tendeney. This was healed by the dropping of oxoline and wet betadine auze application along with the administration of vitamin E and phenytoin. We present a case of epidermolysis bullosa dystrophica that seems be a dominant type considering the presence of family history with histopathologic and electron microscopic findings.
Epidermolysis Bullosa Dystrophica* ; Epidermolysis Bullosa* ; Foot ; Humans ; Infant, Newborn ; Male ; Parturition ; Phenytoin ; Povidone-Iodine ; Transcutaneous Electric Nerve Stimulation ; Vitamin E ; Vitamins

Eosinophilic fasciitis is a syndrome which is characterized by scleroderma-like skin involvement, eosinophilia and hypergammaglobulinemia without significant systemic changes. The primary pathological alterations are thickening and inflammation of the deep fascia. The majority of the cases that have been reportecd respond to systemic corticosteroids. We describe a 19-year-old male patient with eosinophilic fasciitis. On physical examination, he showed tender, edematous, indurated and tight skin in the back and both lower legs, and the laboratory findings showed eosinophilia and mild hypergammaglobulinemia. He also had Raynaud phenomenon, mild dyspnea, abdominal pain, pulmonary function abnormalities and roentgenographic evidence of pulmonary fibrosis. Result of a biopsy showed sclerosis of dermia and intense infiltrations of eosinophils, lymphocytes and histiocytes and fibroais of panniculus and fascia. Treatment with systemic corticosteroids showed complete resolution of the skin lesions, but after withdrawal new scleroderma-like skin lesions developed in the dorsum of feet.
Abdominal Pain ; Adrenal Cortex Hormones ; Biopsy ; Dyspnea ; Eosinophilia ; Eosinophils ; Fascia ; Fasciitis* ; Foot ; Histiocytes ; Humans ; Hypergammaglobulinemia ; Inflammation ; Leg ; Lymphocytes ; Male ; Physical Examination ; Pulmonary Fibrosis ; Raynaud Disease ; Sclerosis ; Skin ; Young Adult

We report a case of inflammatory linear verrucous epidermal nevus which was treated with an aromatic analog of vitamin A acid, Ro 10-9359, with significant effect, The patient is a 17-year-old woman who has had linear verrucous patches involving the entire length of the extensor surface of the right arm, right scapular area and anterior upper part of the right chest with persistent itching sensation of 10 years' duration. The patient was treated with oral Ro 10-9359 75mg daily, and showed marked improvement of the skin lesions after seven days of treatment, but the patient was lost to follow up.
Adolescent ; Arm ; Etretinate ; Female ; Humans ; Lost to Follow-Up ; Nevus, Sebaceous of Jadassohn* ; Pruritus ; Sensation ; Skin ; Thorax ; Tretinoin

No abstract available.
Lung* ; Paragonimiasis* ; Perfusion*

A follow-up study was made of 26 knees of 21 patients who underwent arthroscopic synovectomy between October 1982 and August 1983 in Catholic Medical College and Center. The patient's ages ranged from 3 to 66 years of age. There were 14 female patients and 7 male patients in this series. The follow-up period of all patients was a minimum of twelve months to a maximum of 20 months. The average follow-up of the whole group was 16.8 months. The abnormal findings were rated from 0 to 4 according to Marmors rating system. Final clinical evaluations of the patients were done according to the modified criteria of Sledge et al. The results were as follows; 1. Rheumatoid Arthritis Of 14 knees, 3 joints(21.4%) were rated “excellent”, 6(42.9%) were “good”, and 5(35.7%) were “fair”. There was no case of “unimproved”. 2. Juvenile Rheumatoid Arthritis The results of all 5 knees were satisfactory. Of 5 knees, 4 joints(80%) were rated excellent and one joint (20%) was good. 3. There were 3 knees of osteoarthritis, 3 knees of chronic synovitis and one knee of pigmented villonodular synovitis. Their final results were all satisfactory. Three joints were rated excellent and the other 3 joints were good. 4. Of 26 knees, as a whole, 10 joints (38.5%) were rated “excellent”, 11 joints (42.3%) were “good”, 5 joints (19.2%) were “fair” and no joint was “unimproved”. There were 5 recurrences of active synovial disease in this series, and these patients all were “classic” rheumatoid arthritis. But surprisingly the average patient in this group of recurrence did well even after recurrence. These patients all had less pain and effusion than before operation. 5. The major cause of unsatisfactory results other than recurrence of synovitis were articular degeneration (joint space narrowing) and patellofemoral osteoarthritis (4 knees). 6. A good range of motion with the shortest rehabilitation period can be expected if alternate flexion and extension splints are applied on alternate days for less than a week following the surgery. In conclusion, one may state that the arthroscopic synovectomy is worth considering for the treatment of various kinds of synovitis of the knee joint and when the rheumatoid process follows a favourahle course.
Arthritis, Juvenile ; Arthritis, Rheumatoid ; Female ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Knee ; Male ; Osteoarthritis ; Range of Motion, Articular ; Recurrence ; Rehabilitation ; Splints ; Synovitis ; Synovitis, Pigmented Villonodular

The significance of the physical examination is controversial since Slocum and Larson first described the concept of rotatory instability of the knee. The findings of the physical examination of the 101 knees of 95 patients from 1982 to 1985 were compared with the operative findings. The results were as follows. 1. Valgus stress test a) The valgus stress test c the knee in extension was positive in 1) combined tear of medial collateral ligament, posterior oblique ligament, either anterior or posterior cruciate ligament, 2) avulsion fracture of medial collateral ligament and 3) extensive tear of medial capsular ligament. But the test was negative when the posterior oblique ligament was intact although the medial collateral ligament and the anterior cruciate ligament were torn. b) The valgus stress test c the knee in 30° flexion was positive in all cases of torn medial collateral ligament, But it was severer in cases of positive test in full extension. 2. The varus stress test in extension was positive when the anterior or posterior cruciate ligament was torn in addition to lateral collateral ligament and posterolateral capsule. 3. The Slocum test was negative, or positive only in neutral rotation in isolated tear of the anterior cruciate ligament. 4. The Ritchey-Lachman test was positive in all cases of torn anterior cruciate ligament. 5. The posterior drawer test could be positive in cases of intact posterior cruciate ligament. 6. The pivot shift test was negative in cases of torn medial collateral ligament and posterior oblique ligament although there was associated tear of the anterior cruciate ligament. 7. The flexion rotation drawer test was positive in all cases of torn anterior cruciate ligament although there was associated tear of the medial collateral ligament. The positive test didn't always mean anterolateral rotatory instability, 8. The reversed pivot shift test was positive in cases of posterolateral rotatory instability but it was negative in cases of associated tear of posteromedial capsule. 9. The drawback of external rotation drawer test was that it depended on subjective evaluation. 10. The rotation test was very good for the rotatory instability but it could not be used in bilateral injury and the anterolateral rotatory instability of isolated tear of anterior cruciate ligament.
Anterior Cruciate Ligament ; Collateral Ligaments ; Exercise Test ; Humans ; Knee ; Lateral Ligament, Ankle ; Ligaments ; Physical Examination ; Posterior Cruciate Ligament ; Tears

A retrospective study was made of the previous medical records of 32 infants with congenital syphilis borne from mothers with untreated syphilis at Severence Hospital, Yonsei University College of Medicine during the years 1,972 through 19g3, These infants had a VDRL titer higher than 1: 8 with reactive FTA-ABS test and were also subjected to radiologic examinations. Radiologic changes and clinical features were analyzed, The following results were obtained: Of the total of 32 infants with congenital syphilis under 5 months of age, those under 1 month of age, were the most common group numbering a total of twelve. Of 32 infants with congenital syphilis, twenty-nine(91%) showed skeletal changes upon radiologic examination, Among them the different sites of bone involvernent revealed that the femur(92%) was the most commonly affected bone, followed by the humerus(88%), tibia(81%,), fibula(80%), ulna(72%), radius (68%). Among the same 29 infants a study of the presence of various abnormal bone changes showed that periostitis was the most common, being involved in 83%, the others being metaphysitis and periostitis(72%), metaphysitis(66%). 3. Among the clinicaI features presented in the 32 infants with congenital syphilis, hepatomegaly was the most common(63%,), followed by erythema with desquamation(47%), pneumonia(38%), maulopapules(34%).
Erythema ; Fluorescent Treponemal Antibody-Absorption Test ; Hepatomegaly ; Humans ; Infant ; Medical Records ; Mothers ; Periostitis ; Radius ; Retrospective Studies ; Syphilis ; Syphilis, Congenital*