Vascular tissue presumed to be the most sensitive target tissue of the immune and toxic reactions. Most of the vasculitides can be directly or indirectly associated with immunopathogenic rnechanisms. In this regards, the purpose of the study is to understand imrnunopathogenic mechanism of various cutaneous vasculitides by comparing their immunopathologic patterns. Imrnunopathologic studies were carried out on the blood vessel of various skin diseases by means of the direct immunofluorescent technique using FITC conjugated rabbit antihurnan IgG, IgA, IgM, C3 C1q, C4 and fibrinogen)(F). The results obtained were as follows : 16 patients with leukocytoclastic vasculitis out of 19 showed deposition of irnmune complex in the small upper dermal vessels and had positive reaction for F, 8 for IgA, 5 for C3 and 2 for IgM. Of the 6 patients with chronic pigmented purpura studied, 2 had IgM, 3 had Ca and all of these had F in small upper or middle dermal vessels. Immunopathologic patterns of livedo vasculitis were similar to those of chronic pigmented purpurs, except mainly affected in upper dermis. Nodular vasculitis and Behqets syndrome had deposits of F, C and IgM in medium or large vessels of the middle or lower dermis. Simultaneously, Cs in 2 patients with nodular vnsculitis and IgM in one patient with Behqets syndrorne were also noted along the basement mernbrane zone. In a patient with pityriasis lichenoides et varioliformis acuta, IgM and F were noted on the samll upper dermal vessels. With these results, the immune complex mechanism could be closly related the pathogenesis of most of cutaneous vasculitis. And various clinical manifestations or expression of vasculitis appear to be dependent upon 1) type of imrnune reaction, 2) size of blood vessels, 3) location and depth of blood vessels, 4) extend of affected areas and 5) involvement of other organs.
Antigen-Antibody Complex ; Blood Vessels ; Dermis ; Fluorescein-5-isothiocyanate ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Pityriasis Lichenoides ; Purpura ; Skin Diseases ; Vasculitis*

PURPOSE: The purpose of this study is to analyze the effect of surgical treatment for painful varicocele. MATERIALS AND METHODS: We reviewed the records of 103 patients who had undergone varicocele ligation due to serious pain from January 1996 to December 1999 and followed up for one year. The average patient age was 21 (19-41) years. We analyzed the degree of varicocele, duration and aspects of pain, effects of surgical treatment and results according to surgical techniques. We classified the results into three aspects based on the relief of pain (complete, partial and no relief) and subjective symptoms. RESULTS: As for the degree of varicocele, 40 cases placed in grade II, and 63 in grade III. The nature of the pain was a sharp ache (33 cases), dragging pain (48 cases) and dull pain (22 cases). There was no statistical significance between the grade of varicocele and the degree of pain (p>0.05). Of the 103 patients, 81 (78.6%) experienced complete relief of pain and 10 (9.7%) had partial relief. Only 12 patients (11.6%) had persistent or worsened symptoms. The results for the postoperative de gree of pain relief according to duration of pain did not show any statistical significance (p>0.05), but those according to preoperative quality of pain showed statistical signi ficance (p<0.05). CONCLUSIONS: This study supports the conclusion that varicocele ligation is an effective treatment for painful varicocele.
Humans ; Ligation* ; Varicocele*

We report a case of congenital giant pigmented nevus with malignant melanoma of brain in a 14-year-old male patient. He had giant pigmented nevus on the back and neck, and multiple satellite lesions over the whole body since birth. One year prior to visit to our hospital, the patient suffered from various neurologie symptoms including headache, nausea, vomiting, seizure and right side motor weakness. Flistologic findings of skin lesions were benign nevocytic nevi. Computed tomogram of brain demonstrated increased densities in the both fronto-parietal leptameninges and brain parenchyme. Histologic findings of brain parenchyme by stereotaxic long needle biopsy showed the infiltration of melanin containing atypical melanocytes. There was no evidence of malignant melanoma at other organs. All of these findings suggested that origin of malignant melanoma of brain parenchyme was leptomeninges rather than skin.
Adolescent ; Biopsy, Needle ; Brain* ; Headache ; Humans ; Male ; Melanins ; Melanocytes ; Melanoma* ; Nausea ; Neck ; Nevus ; Nevus, Pigmented* ; Parturition ; Seizures ; Skin ; Vomiting

No abstract available.
Temporal Bone*

Between July 1994 and August 1995, 78 patients underwent coronary artery bypass graft at Seoul National University Hospital. Coronary angiogram was performed one year after coronary artery bypass graft in 49 patients(62.8%) for evaluation of the graft patency and analysis of the risk factors for graft occlusion. The patency rates of both the internal mammary artery and the radial artery grafts were 100%, although three internal mammary artery grafts(5.0%) were narrowed(string sign). And that of the saphenous vein grafts were 85.2%. Multivariate analysis for the preoperative, operative, and postoperative factors was done between the widely patent and the narrowed internal mammary artery graft groups, and between the patent and the occluded saphenous vein graft groups by the general linear models procedure. Patient's age(>or=60 years), postoperative intraaortic balloon pump insertion, bleeding, and acute renal failure were found to be the significant risk factors for internal mammary artery graft narrowing, and coronary artery size(<1.5 mm) was the significant risk factor for the saphenous vein graft occlusion (p<0.05). This study confirms that the arterial graft is superior to the vein graft at one-year patency rate, and suggests the risk factors for graft occlusion during the first postoperative year. Knowledge of this study may provide a basis for estimating the risk factors for graft occlusion, and thereby modifying surgical strategy and postoperative surveillance.
Acute Kidney Injury ; Coronary Angiography ; Coronary Artery Bypass* ; Coronary Vessels* ; Graft Occlusion, Vascular ; Hemorrhage ; Humans ; Linear Models ; Mammary Arteries ; Multivariate Analysis ; Radial Artery ; Risk Factors ; Saphenous Vein ; Seoul ; Transplants* ; Veins

No abstract available.

No abstract available.
Cystitis* ; Eosinophils* ; Urinary Bladder Calculi* ; Urinary Bladder*

We report a case of malignant melanorna, which showed dramatic effect by combination therapy of DTIC and BCG immunotherpy. The case was s 56-year-old female patient who had an asymptomatic dark brown colored walunt sized protruding tumor with ulceration of the medial aspect of lower one third of right leg for 1 year and palpable masses over the right popliteal fossa and inguinal area. Histologic fingings showed cellular mass composed of epithelioid cells with atypical nucleus, occasionally mitotic figure and numerous melanin granules scattered in the epidermo-dermal junction and papillary or reticular dermis. The mass was diagnosed nodular malignant melanoma which showed Clark level W with metastasis in 4th thoracic vertebra and lymph node. After surgical remove of the primary lesion, chemo-immunotherapy with combined DTIC and BCG was tried, and all the lesion were completely dissppeared. No evidence of recurrence either in primsry focus or other sites was observed up to one year and eight months.
Dacarbazine* ; Dermis ; Drug Therapy* ; Epithelioid Cells ; Female ; Humans ; Immunotherapy* ; Leg ; Lymph Nodes ; Melanins ; Melanoma* ; Middle Aged ; Mycobacterium bovis* ; Neoplasm Metastasis ; Recurrence ; Spine ; Ulcer

We report a case of sebaceous gland carcinoma occuring in a 55 year-old woman, which showed huge ulcerated tumor mass measuring 6X7 cm in size and orbital invasion on left lower eyelid without any evidence of metastases. She was treated with wide excision of the lesion and exenteration of the eyeball, and then grafted with skin and muscle. We obtained good result with surgical treatment until 8 months observation after surgical operation.
Eyelids* ; Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; Orbit ; Sebaceous Glands* ; Skin ; Transplants ; Ulcer

We report a case of sebaceous gland carcinoma occuring in a 55 year-old woman, which showed huge ulcerated tumor mass measuring 6X7 cm in size and orbital invasion on left lower eyelid without any evidence of metastases. She was treated with wide excision of the lesion and exenteration of the eyeball, and then grafted with skin and muscle. We obtained good result with surgical treatment until 8 months observation after surgical operation.
Eyelids* ; Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; Orbit ; Sebaceous Glands* ; Skin ; Transplants ; Ulcer