We reviewed 37 skin biopsies obtained from 35 patients with secondary syphilis during the period of 9 years from January 1980 to June 1988, which had been diagnosed by dark field examination, serologic tests for syphilis, and identification of spirochetes by immunoperoxidase method (avidin-biotin complex) in the skin biopsies. We investigated the histologic features of the skin lesions in secondary syphilis according to the types and patterns of inflammatory cell infiltration in the dermis, vascular reactions and epidermal changes. We matched these histologic findings with the clinical features of the skin lesions. The results were as follows; 1) The histologic patterns of dermal infiltrate in order of frequency were as follows; junctional pattern in 14 biopsies (38%), lichenoid pattern in 10 biopsies (27%), diffuse pattern in 5 biopsies (14%), patchy pattern in 3 biopsies (8%), normal pattern in 3 biopsies (8%) and undertermined in 2 biopsies (5%). 2) The dermal infiltration of plasma cells was found in 24 biopsies (65%). All the biopsies of diffues and lichenoid patterns, 7 biopsies of junctional and one biopsy of patchy pattern showed plasma cells but none in normal pattern. 3) Eosinophils were observed in the dermis in 11 biopsies (30%). There was no difference in incidence of eosinophils in the dermis among morphologic patterns. However, they were frequently seen in the dermis and epidermis of condyloma lata (4 of 7 biopsies). 4) The vascular changes in the dermis included endothelial cell swelling in 23 biopsies (62%), endothelial cell proliferation in 22 biopsies (60%) and vascular dilatation in 10 biopsies (27%). They were most commonly observed in the lichenoid pattern followed by diffuse and junctional patterns. Three cases showed lymphocytic vasculitis. 5) Epidermal changes were seen in all of the biopsies exocytosis, parakeratosis, hydropic change of basal cells, acanthosis, spongiosis, keratinocyte necrosis and hyperkeratosis in the order of frequency. 6) In relation to the clinical manifestations, junctional pattern (14 biopsies) consisted of 6 papulosquamous lesions, 5 macules and 3 papules. Lichenoid pattern (10 biopsies) consisted of 7 papulosquamous lesions and 3 papules. All the biopsies showing diffuse pattern (5 biopsies) appeared in condyloma lata. Patchy pattern (3 biopsies) consisted of 2 macules and 1 papule. All of the normal pattern (3 biopsies) appeared in macules. In conclusion, with dermal and epidermal changes, the acknowlegement of the 5 basic histologic patterns in secondary syphilis seems to be very helpful for the diagnosis of syphilis.
Incidence ; Biopsy

A patient had total occlusion of the left main coronary artery that was proved by coronary arteriography. Patients with total occlusion of the left main coronary artery have a varying clinical presentation and may have prolonged survival. In patients with good collaterals, left ventricular function may be preserved. This report reveiws the clinical and angiographic findings of a patient with occlusion of the left main coronary artery with symptoms of unstable angina pectoris but without congestive heart failure or EKG evidence of myocardial infarction.
Angina, Unstable ; Angiography ; Coronary Vessels* ; Electrocardiography ; Heart Failure ; Humans ; Myocardial Infarction ; Ventricular Function, Left

On histological examination, an epidermolytic hyperkeratosis was observed adjacent to follicular papules on the back of a 53-year-old man. It has been reported that incidental epidermolytic hyperkeratosis occur either within various lesion (epidermal neoplasm, melanocytic neoplasm, scars, and inflammatory conditions) or in the normal skin adjacent to the lesion. This patient participated in the Vietnam War for 2 years, and had had contact with defoliants. He was treated for multiple peripheral neuropathies and cerebral infarcts. In keratinocytes, 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD; Agent Orange) contained in defoliating agents is associated with altered patterns of keratinocyte differentiation. So, as a cause of incidental epidermolytic hyperkeratosis, defoliant contact could be suspected.
Cicatrix ; Humans ; Hyperkeratosis, Epidermolytic* ; Keratinocytes ; Middle Aged ; Peripheral Nervous System Diseases ; Skin* ; Tetrachlorodibenzodioxin ; Veterans* ; Vietnam*

We analysed 3,130 patients with simple renal cyst who were discovered in 27,216 men receiving routine ultrasound examination in our hospital. Incidence of simple renal cyst was 11.5% in all populations and ratio of male to female was 1.8: 1. Patients age ranged from 14 to 91 years (average age 63.8 years) and number of renal cysts were increased after fifth decade in both sexes. Size of cysts were increasing along with age. And 201 cases visiting Urology Department were examined on symptoms. Symptoms associated with simple renal cysts were : none( 77.6% ), pain ( 11.4% ), gross hematuria( 4.0% ) and epigastric discomfort( 3.0% ). Benign renal cysts were treated with percutaneous aspiration in 9 cases, percutaneous aspiration with sclerosing agent in 13 cases and only follow-up in asymptomatic 29 cases. All were followed by ultrasound from 6 to 38 months(average 27 months). Overall efficacy were 44.4% with aspiration and 92.2 % with combined therapy. Sclerosing therapy using 99% ethanol seems to be a safe and effective way to prevent reaccumulation of cystic fluid in symptomatic cases. But routine follow-up is sufficient in asymptomatic cases, since simple renal cysts increase slowly in size.
Ethanol ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Ultrasonography ; Urology

PURPOSE: To experimentally investigate the effect for muscle weakness after superior rectus Z-myotomy and histological changes. METHODS: Superior rectus muscle fibers of rabbits (16 rabbits, 32 eyes) were cut transversely with scissors across 75% of the muscle in two different positions on opposite sides. In group 1 (16 eyes), myotomies were performed at 2 and 7 mm from the muscle insertion (5 mm gap) and in group 2, performed at 2 and 5 mm (3 mm gap). The change of mark, eyeball position, and muscle tension after myotomy and 4 weeks postoperatively was evaluated, the location of the mark was examined, and muscle tissue biopsy was performed. RESULTS: After Z-myotomy, the marks of the two groups moved significantly posteriorly from insertion within groups (p<0.05), with no significant differences between groups (p=0.469). Eyeball positions of the two groups moved significantly inferiorly (p<0.05); the amount of position change of group 1 was greater than group 2 (p<0.05). When the globe was pulled in opposite directions for muscle action, the degree of change decreased with significant difference within groups (p<0.05), but there were no significant differences between groups (p=0.32). CONCLUSIONS: Z-myotomy of the superior rectus muscle affected the recession of eyeball position and weakened the muscle action. Muscle weakening affected by the different gaps between myotomies did not show consistent results.
Biopsy ; Muscle Tonus ; Muscle Weakness ; Muscles ; Rabbits

Although conventional barium study has been used for diagnosis of gastrointestinal lymphoma, CT is superior tobarium study in the evaluation of its extent and relationship to the bowel, lymph node enlargement, and distantmetastasis. The authors analyzed CT features of 21 cases of pathologically proven gastrointestinal lymphoma forrecent 5 years. The results were as follows: 1. In a total 21 cases of gastrointestinal lymphomas, 13 cases wereprimary gastrontestinal lymphoma and others were secondary. But there was no difference in CT featurs betweenthem. 2. Male predominates over female(17:4), and type age ranged from 5 to 73 years old, most common
Abdominal Pain ; Barium ; Colon ; Diagnosis ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Male ; Mesentery ; Methods ; Omentum

No abstract available.
Polycystic Kidney Diseases*

OBJECTIVES: The aim of this study is to confirm the clinical and histopathologic findings of ovarian tumors and determine the malignancy before operation. It will attribute to early diagnosis, determining direction of treatment and improving prognosis of malignant ovarian tumor. METHODS: Seven hundred sixty-five patients who had an operation for ovarian tumors in the department of Obstetrics and Gynecology of Gachon University Gil Medical Center from April 2007 to December 2009 were enrolled as subjects. A retrospective analysis of age, parity, menopausal status, preoperative CA 125, histology, ultrasound, and treatment method was done. RESULTS: 1. Among benign ovarian tumors, endometrial cyst (211 cases, 30.1%) was most common and had the highest preoperative CA 125 (76.07 U/mL). 2. Among borderline ovarian tumors, mucinous type (16 cases, 62.5%) was most common, but preoperative CA 125 was higher in serous type (144.38 U/mL) than mucinous type (82.59 U/mL). 3. Among malignant ovarian tumors, serous adenocarcinoma (14 cases, 29.8%) was most common, and undifferentiated carcinoma had the highest preoperative CA 125 (500.0 U/mL). 4. The preoperative CA 125 showed a tendency to increase in relation to stage in malignant ovarian tumors. 5. Age, preoperative CA 125, menopausal status and ultrasound finding were identified as discriminating factors for malignancy and relative risk of them were 7.19, 7.90, 5.56 and 61.43, respectively. CONCLUSION: Using the combination of age, menopausal status, preoperative CA 125 and ultrasound to diagnose ovarian tumors before the operation will be a help to early diagnosis and determining the treatment and improve prognosis.
Adenocarcinoma ; CA-125 Antigen ; Carcinoma ; Early Diagnosis ; Female ; Gynecology ; Humans ; Mucins ; Obstetrics ; Parity ; Prognosis ; Retrospective Studies

The transobturator tape (TOT) procedure is a relatively safer than tension-free vaginal tape (TVT) operation but it may cause vascular injury. Recently we experienced a case using uterine artery embolization for the patient with uterine artery bleeding after TOT.
Hemorrhage* ; Humans ; Suburethral Slings* ; Uterine Artery Embolization* ; Uterine Artery* ; Vascular System Injuries

Small bowel herniation after operative laparoscopy is an uncommon but serious complication that can result in bowel resection. Therefore, it is important to prevent and diagnose early. We experienced a case of small bowel herniation through trocar site and present with a brief review of literatures.
Laparoscopy ; Surgical Instruments