A 26-year-old male has experienced repeated pruritic and burning erythema and edema over the exposed areas of the skin, especially on the face and hands, after sunlight exposure. He stated that his father, three aunts, and three sisters had similar sunlight sensitivity. The face showed tiny whitish scars. And also there were hypopigmented scars on the dorsum of the hands. Characteristic laboratory findings were as followa: RBC, plasma and stool fluoresced coral red color under the Woods light. 100ml of the RBC contained 245 pg of protoporphyrin. On photosensitive test using sunlight for 60 rninutes, there developed painful sensation at 4 minutes and 40 seconds after exposure, erythema at 12 minutes after, and edema at 20 minutes after. Pathological findings of the specimen obtained from erythematous lesion of the forehead revealed hypergranulosis and acanthosis in the epidermis and perivascular thickening and hyalin deposit around the capillaries in the upper dermis. For treatment, avoidance of exposure to sunlight was recomrnended and symptomatic therapy was tried.
Adult ; Anthozoa ; Burns ; Capillaries ; Cicatrix ; Dermis ; Edema ; Epidermis ; Erythema ; Fathers ; Forehead ; Hand ; Humans ; Hyalin ; Male ; Plasma ; Protoporphyria, Erythropoietic* ; Sensation ; Siblings ; Skin ; Sunlight ; Wood

We presented here a case of an 80-year-old male patient who was, confirmed in the typical tumor stage of Mycosis fungoide by skin biopay. Relatively well-defined, brown-colored, round patches were found about 3 years ago on the chest, abdomen and inguinal area. He had received some treatment at several private clinics uder the impression of seborrheic dermatitis, paoriaais and eczematoid dermatitis. However, the skin manifestations were not improved t.ut rarther increased in eize, similarly to tinea corporis. Two months ago, firm nodules and tumors developecl a new on the lesinn sites, assoviated with intense pruritus and ulcerative tendency. We tried radiation therapy, but due to old age the patient chose to discontinurue.
Abdomen ; Aged, 80 and over ; Dermatitis ; Dermatitis, Seborrheic ; Humans ; Male ; Mycosis Fungoides* ; Pruritus ; Skin ; Skin Manifestations ; Thorax ; Tinea ; Ulcer

In the case of IIc type of early gastric cancer occuring from the area of ulcer sear, endoscopic differentiation between it and beoign ulcer scar is occasionally very difficult, due to the absence of characteristic malignant features. The presence of the irregular granular mucosal changes on the area of ulcer scar may be very helpful in the differential diagnosis between early gastric cancer and benign ulcer sear. And underetanding of the malignant cycle of early gaetric cancer is very important for the diagnosis of the depressed forms of early gastric cancer, We experienced and report a cases of IIc type of early gastric cancer diagnosed before operation by the endoscopic finding of irregular granular mucoeal changes on the area of ulcer scar and showing part of malignant cycle.
Cicatrix* ; Diagnosis ; Diagnosis, Differential ; Stomach Neoplasms* ; Ulcer*

No abstract available.
Uterus*

BACKGROUND: Recent reports suggest that Epstein-Barr virus (EBV) may play an important role in such a wide spectrum of human neoplasia. Recently, peripheral T cell lymphomas and particularly, angiocentric lymphomas (ACL), increasingly are reported to be associated with EBV.Nasal-type and nasal T/NK cell lymphoma (TNKL) have recently been reported to comprise most of ACLs. The prognosis of these tumors has been extremely poor. OBJECTIVE: The purpose of this study was to investigate EBV association in primary or secondary cutaneous T-cell lymphoproliferative disorders and to identify any prognostic association. METHODS: Thirty six patients with primary or secondary cutaneous T-cell lymphoproliferative (CTCL) disorders were examined to evaluate the presence of Epstein-Barr virus using in situ hybridization for EBV-encoded RNA (EBER). RESULTS: EBER was detected in tumor cells in one third of the total cases (13/36); 4/4 secondary skin lymphoma from nasal TNKL, 8/8 primary cutaneous nasal type TNKLs and 1/5 mycosis fungoides (MF).EBER was not detected in the following disease: 6 cases of anaplastic large cell lymphomas (ALCL) including 2 cases of probable NK-like T cell lineage, 3 lymphomatoid papulosis, 2 CD56 (-) T cell ACLs and 7 subcutaneous panniculitic T-cell lymphomas (SPTL) by Revised European-American Lymphoma (REAL) classification and recent concept of further classification into NK-cell lineage. One case of T-cell pseudolymphoma as a negative control was also negative in EBER. CONCLUSION: High incidence of EBV was observed in primary or secondary CTCLs in Koreans, with predilection for nasal and nasal type TNKL. In MFs, an erythrodermic MF with fatal outcome was associated with EBV and the EBV detection might reflect worse prognosis in MFs as seen in an aggressive course of nasal and nasal type TNKLs.
Cell Lineage ; Classification ; Fatal Outcome ; Herpesvirus 4, Human* ; Humans ; In Situ Hybridization ; Incidence ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Lymphomatoid Papulosis ; Lymphoproliferative Disorders* ; Mycosis Fungoides ; Prognosis ; Pseudolymphoma ; RNA* ; Skin ; T-Lymphocytes*

Cardiac manifestations of hypereosinophilic syndrome rarely include left ventricular thrombosis leading to peripheral emboli. And the cases of thrombectomy in patients with left ventricular thrombus and hypereosinophilic syndrome are extremely rare. Recently we experienced a 58-years-old woman with hypereosinophilic syndrome, the history of thalamic infarction and a huge thrombi in left ventricle. We report this case with literatures.
Female ; Heart Ventricles ; Humans ; Hypereosinophilic Syndrome* ; Infarction ; Thrombectomy ; Thrombosis*

BACKGROUND: CD4(+)CD25(high+)regulatory T cells (Tregs) are considered to be of vital importance for maintaining immunologic self-tolerance and preventing autoimmune diseases. These cells have been found to be deficient in skin lesions and in the peripheral blood of patients with psoriasis. OBJECTIVE: To investigate the role of Tregs in the pathogenesis of psoriasis and to evaluate the changes in Tregs in relation to the severity and the clinical course of psoriasis. METHODS: Immunohistochemistry (CD3, 4, 8, 79 and FOXP3) was performed in 22 psoriatic patients compared to 5 normal controls. Flow cytometry (CD3, 4, 8, 25 and FOXP3) was performed in 18 psoriatic patients and 8 normal volunteers and reverse transcriptase polymerase chain reaction (foxp3 mRNA) was performed in 8 psoriasis patients. RESULTS: An increase in the FOXP3(+) cell fraction was detected in the lesional psoriatic skin irrespective of the severity of psoriasis as compared with the normal skin. However, a decrease in FOXP3(+) cells was observed in the samples obtained from psoriasis of 'acute course'. FOXP3(+) Treg populations in the blood of the 'acute course' psoriasis was not different compared to that of 'chronic course' psoriasis and normal controls. CONCLUSION: The deficiency of FOXP3(+) Tregs in the lesional psoriatic skin might be responsible for the exacerbation of psoriasis.
Autoimmune Diseases ; Flow Cytometry ; Humans ; Immunohistochemistry ; Psoriasis ; Reverse Transcriptase Polymerase Chain Reaction ; Skin ; T-Lymphocytes ; T-Lymphocytes, Regulatory

While some fluoroquinolone antibiotics can cause QT prolongation and Torsades de Pointes (TdP), serious proarrhythmic effects from ofloxacin have not been reported. Here, we report a case of ofloxacin-induced Torsades de Pointes with abnormal ECG changes, mimicking acute myocardial infarction. A 68-year-old man developed syncope following hospital admission for the treatment of pulmonary tuberculosis. TdP and marked QT prolongation (QT=0.44 sec, QTc=0.62 sec) were noted, with no remarkable serum electrolyte abnormality. The QT prolongation was followed by ST segment elevation, mimicking acute myocardial infarction. After discontinuation of ofloxacin, the QT interval shortened to 0.336 sec (QTc=0.481 sec), with no recurrence of TdP, although the QT interval remained mildly elevated during the hospital course. From this case, we propose that care should be taken in the use of ofloxacin, especially in patients susceptible to TdP.
Aged ; Anti-Bacterial Agents ; Electrocardiography* ; Humans ; Myocardial Infarction* ; Ofloxacin ; Recurrence ; Syncope ; Torsades de Pointes* ; Tuberculosis, Pulmonary

BACKGROUNDS: There are recently increasing reported cases of patients with malignant lymphoma with unique characteristics, designated nasal-type T/natural killer (NK) cell lymphoma (NKTL), which usually expresses the NK cell marker and shows frequent extra-nodal involvement including skin and poor prognosis. The CD56+ NKTL can be divided into nasal and non-nasal types. Nasal and non-nasal (nasal type) CD56+ NKTL share the same pathologic features such as angiocentricity and necrosis. OBJECTIVE: We have studied clinicopathologic features of 5 cases of nasal CD56+ NKTL with cutaneous involvement to further elucidate the behaviour of nasal CD56+ NKTL. RESULTS: Clinically, the cutaneous lesions were variable. Four of the five cases died with rapidly progressive disease within 25 months. Histologically, variable sized pleomorphic lymphoid cells with or without prominent angiodestruction were observed. Severe necrosis was consistent features. The results of immunophenotypes(both CD56+ and CD3+) and TCR gene rearrangement study showed these 5 cases are of NK cell origin(4 cases) or NK-like T-cell origin (1 case). A firm association with Epstein-Barr virus (EBV) infection was confirmed in our study. CONCLUSION: Although the prognosis of nasal CD56+ NKTL was not so bad, higher stage of nasal CD56+ NKTL with cutaneous metastasis seemed to be very fatal. The term NKTL has to be further specified according to immunophenotypes such as CD56+ or true T-cell, NK-like T cell lymphoma since biologic behaviour of each subgroup can be different.
Genes, T-Cell Receptor ; Herpesvirus 4, Human ; Humans ; Killer Cells, Natural ; Lymphocytes ; Lymphoma* ; Lymphoma, T-Cell ; Necrosis ; Neoplasm Metastasis ; Prognosis ; Skin ; T-Lymphocytes

Though the 2009 worldwide influenza A (H1N1) pandemic has been declared to have ended, the influenza virus is expected to continue to circulate from some years as a seasonal influenza. A rapid antigen test (RAT) can aid in rapid diagnosis and allow for early antiviral treatment. We evaluated the clinical usefulness of RAT using SD Bioline Influenza Antigen Test(R) kit to detect the influenza virus, considering various factors. From August 1, 2009 to October 10, 2009, a total of 938 patients who visited the outpatient clinic at Korea University Guro Hospital with influenza-like illnesses were enrolled in the study. Throat or nasopharyngeal swab specimens were obtained from each of the patients. Using these specimens, we evaluated the influenza detection rate by rapid antigen test based on the real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) method. In comparison with rRT-PCR, the sensitivity and specificity of the RAT were 44.0% and 99.9%, respectively. The cyclic threshold values of RAT negative specimens were higher than RAT positive specimens (30.1+/-3.1 vs. 28.3+/-3.9, p=0.031). The sensitivity of the RAT kit was higher in patients who visited clinics within two days of symptom onset (60.4% vs. 11.1%, p=0.026). The results of this study show that the RAT cannot be recommended for general use in all patients with influenza-like illness because of its low sensitivity. The RAT may be used, only in the settings with limited diagnostic resources, for patients who visit a clinic within two days of symptom onset.
Antigens, Viral/genetics ; Humans ; Influenza A Virus, H1N1 Subtype/genetics/immunology/*isolation & purification ; Influenza, Human/*diagnosis/virology ; Reagent Kits, Diagnostic ; Reverse Transcriptase Polymerase Chain Reaction ; Sensitivity and Specificity ; Time Factors