Histoid leproma usually occur in pat.ients with lepromatous leproy who have had relapsed after being undcr treatment(usually sulfones) for a long time and who have shown variable improvement. A 56 year old female patient who had been suffering from lepromatous leprosy and had been treated which clapsone relatively regularly for approximately 28 years had a history of several shiny rice grain t.o peanut sized nodules on the face and right flank. Histopathologic examination of a specimen taken from a nodular lesian revealed a well circirmscrihed nodule composed mainly of spindle-shaped cells and epithe:ioi 1 cells on the upper and mid-levmis, and granuloma composed of epithelioid cells, multinucleated wait cells and foamy histiocytes on the lower dermis. In AFB stain, numerous acid-fast bacilli were scatt red dermis and epidermis, especially stratum corneum. This study opplied a polymease chain reaction(PCR) on sections of biopsy tissues and peripheral blood of pat.ient. Positive amplification of a 530 bp fragment was deteated not only in the lesion tissues but also in the per ipher al blood.
Biopsy ; Edible Grain ; Dermis ; Epidermis ; Epithelioid Cells ; Female ; Granuloma ; Histiocytes ; Humans ; Leprosy, Lepromatous ; Middle Aged ; Mycobacterium leprae* ; Mycobacterium* ; Polymerase Chain Reaction*

A 17-year-old woman had an extensive nevus comedonicus affecting the left sides of the breast, trunk, axilla, and upper extremity. Her condition was complicated by episodes of re-current cyst formation, secondary infection, and atrophic scars. We performed various therapeutic approaches include topical keratolytic agents, manual extraction of comedones, excision of smaller lesions, and systemic antibiotics but the response was unsatisfactory. We tried systemic isotretinoin and minocycline and the pustulation of the lesions was reduced. Herein we report a rare case of linearly arranged extensive nevus comedonicus.
Adolescent ; Anti-Bacterial Agents ; Axilla ; Breast ; Cicatrix ; Coinfection ; Female ; Humans ; Isotretinoin ; Keratolytic Agents ; Minocycline ; Nevus* ; Upper Extremity

Leukemia cutis is defined as infiltration of the skin by malignant leukocytes that have originated from the bone marrow. The cutaneous eruption of leukcmia may be divided into the specific and non-specific lesion (leukemid). These may occur separately or in combination. True leukemia infiltrations of the skin consist of nodular, diffuse, or plaque-like infiltrations with swelling, macules, papules, ecchymoses, palpable purpura, erythroderma, and ulceration. A 55-year-old man presented with multiple as mptomatic dark-brown nodules on the whole body with recurrent gingival bleeding. The patient developed seoticemia and died 6 months after the onset of the disease.
Bone Marrow ; Dermatitis, Exfoliative ; Ecchymosis ; Hemorrhage ; Humans ; Leukemia* ; Leukocytes ; Middle Aged ; Purpura ; Skin ; Ulcer

Squamous cell carcinoma of the lower lip can be developec by a number of underlying etiologic factors, the most outstanding of which is solar irracdiation, and is considerably more aggresive and has a much higher incidence of metastatic spread. Its early detection and effective treatment afford a high cure rate. Cryosurgery is a simple, efficient and effective method of treatment of skin cancer and is now a widely accepted modality for the treatment of these lesions. Two patients(67-year-old male and 57-year-old female) were presented with solitary or two masses on the lower lip without regional lymphadenopathy. These two cases showed clinical and histopathologic findings of squamous cell carcinoma. They were successfully treated by cryotherapy with liquid nitrogen without any significant side effects.
Carcinoma, Squamous Cell ; Cryosurgery ; Cryotherapy ; Humans ; Incidence ; Lip* ; Lymphatic Diseases ; Male ; Middle Aged ; Nitrogen* ; Skin Neoplasms

PURPOSE: We have evaluated the outcome of the operative treatment of Achilles tendon rupture and analyzed the prognostic factors related to the results. MATERIALS AND METHODS: Subjective assessment of symptoms, range of ankle motion and isokinetic ankle strength was performed on 50 patients during a 1-year follow up. We used a clinical scoring system reported by Leppilahti et al to evaluate the results. RESULTS: The overall results were excellent in 18 (36%), and good in 16 (32%), fair in 10 (20%), and poor in 6 (12%) cases. Lower activity level (P<0.001), presence of systemic disease (P<0.001), later return to physical exercise (P=0.044), and previous Achilles tendon symptoms (P=0.015) were associated with unsatisfactory strength results. An older age (P<0.001) and later return to strenuous activities (P=0.005) were associated with unsuccessful overall results. CONCLUSIONS: We think that a clinical scoring system, including subjective and objective assessment, is good protocol to find the prognostic factors related to the results after the operative treatment of Achilles tendon rupture. The patient group with poor prognostic factors present a challenge for rehabilitation.
Achilles Tendon* ; Ankle ; Exercise ; Follow-Up Studies ; Humans ; Rehabilitation ; Rupture*

This study was designed to investigate the effect of GABA and related substances on the spontaneous contraction of rat small intestine. The rats (Sprague-Dawley), weighing 200-250g, were sacrificed by cervical dislocation, and the small intestine was isolated. Longitudinal muscle strips from duodenum, jejunum and ileum were suspended in Biancani's isolated muscle chambers and myographied isometrically. GABA and muscimol, a GABA A receptor agonist relaxed the duodenum and jejunum significantly, but baclofen-induced relaxation in those muscle strips negligible. The effectiveness of GABA and muscimol in various regions were the greatest on duodenum, and greater on jejunum than on ileum The effect of GABA and muscimol was antagonized by bicuculline, a competitive GABA A receptor antagonist and picrotoxin, a noncompetitive GABA A receptor antagonist. Duodenal relaxation induced by GABA and muscimol was unaffected by hexamethonium, but was prevented by tetrodotoxin. These results suggest that GABA inhibit the contractility of smooth muscle with distinct regional difference of efficacy, and the site of inhibitory action is the GABA A receptor existing at the presynaptic membrane of postganglionic excitatory nerves.
Animals ; Bicuculline ; Dislocations ; Duodenum ; GABA-A Receptor Agonists ; GABA-A Receptor Antagonists ; gamma-Aminobutyric Acid* ; Hexamethonium ; Ileum ; Intestine, Small* ; Jejunum ; Membranes ; Muscimol ; Muscle, Smooth ; Picrotoxin ; Rats* ; Receptors, GABA-A ; Relaxation ; Tetrodotoxin

GABA is an inhibitory neurotransmitter in central nervous system and produce sedative, antianxiety and muscle relaxing effects via GABA(A) receptor or GABA(B) receptor. Recently it is known that GABA is widely distributed throughout peripheral organs and may play a physiological role in certain organ. The vas deferens is innervated by species-difference. These study, therefore, was performed to investigate the mode and the mechanism of action of GABA on the norepinephrine-, ATP- and electric stimulation-induced contraction of vas deferens of rat. Sprague-Dawley rats were sacrificed by cervical dislocation. The smooth muscle strips were isolated from the prostatic portion and were mounted in the isolated muscle bath. PSS in the bath was aerated with 95/5%-O₂/CO₂ at 33℃. Muscle tensions were measured by isometric tension transducer and were recorded by biological recording system. 1. GABA, muscimol, a GABA(A) agonist, and baclofen, a GABA(B) agonist inhibited the electric field stimulation (EFS, 0.2Hz, 1mSec, 80V, monophasic square wave)-induced contraction with a rank order of potency of GABA greater than baclofen greater than muscimol. 2. The inhibitory effect of GABA was antagonized by delta aminovaleric acid (DAVA), a GABA(B) antagonist, but not by bicuculline, a GABA(A) intagonist. 3. The inhibitory effect of baclofen was antagonized by DAVA, but the effect of muscimol was not antagonized by bicuculline. 4. Exogenous norepinephrine (NE) and ATP contracted muscle strip concentration dependently, but the effect of acetylcholine was negligible and GABA did not affect the NE-and ATP-induced contractions. 5. GABA, baclofen and muscimol did not affect basal tone, and GABA did not affect the NE-and ATP-induced contractions. 6. EFS-induced contraction was inclucling 2 distinctable components. The first phasic component was inhibited by beta gamma-methylene ATP (mATP), a desensitizing agent of APT receptor and the second tonic component was reduced by pretreatment of reserpine (3 mg/Kg, IP). 7. GABA inhibited the EFS-induced contraction of reserpinized strips, but not the mATP-treated strips. These results suggest that in the prostatic portion of the rat vas deferens, adrenergic and purinergic neurotransmissions are exist, and GABA inhibits the release of ATP via presynaptic GABA(B) receptor on the excitatory neurons.
Acetylcholine ; Adenosine Triphosphate ; Animals ; Baclofen ; Baths ; Bicuculline ; Central Nervous System ; Dislocations ; gamma-Aminobutyric Acid ; Muscimol ; Muscle, Smooth ; Neurons ; Neurotransmitter Agents ; Norepinephrine ; Rats* ; Rats, Sprague-Dawley ; Receptors, GABA-A ; Reserpine ; Transducers ; Vas Deferens*

To investigate the effect of diazepam on the contractility of the intestinal smooth muscle, longitudinal muscle strip isolated from rat ileum was prepared for myography in isolated organ bath. 1) Basal tone of ileal muscle was reduced by diazepam concentration-dependently. 2) Higher concentrations (30 and 100 microM) of diazepam inhibited (p<0.05, p<0.001) The carbachol-induced contraction in a concentration-dependent manner; but lower concentration of diazepam (10 microM) enhanced (p<0.05). 3) Histamine-induced contraction was inhibited by pretreatment with diazepam in a concentration-dependent manner. 4) Ca⁺⁺-induced tension recovery in calcium-free solution was inhibited in the presence of diazepam concentration-dependently. These results suggest diazepam reduces the contractility of the longitudinal muscle isolated from rat ileum via interference with influx of calcium into the muscle cells.
Animals ; Baths ; Calcium ; Carbachol* ; Diazepam* ; Ileum* ; Muscle Cells ; Muscle, Smooth ; Myography ; Rats*

BACKGROUND: Methods to detect and quanitify Mycobacterium leprae(M. leprae)are needed for studies involving the epidemiology, pathogenesis, and chemotherapy of leprosy. Serological assays and skin tests lack the sensitivity and specificity to serve as diagnostic tool for M. leprae infection. The polymerase chain reaction(PCR) based on the selective amplification of an 530-bp frangment of the gene encoding the proline-rich antigen of M. leprae was performed with sections of fixed or frozen biopsy samples from leprosy patients. OBJECTIVE: This study was done to investigate the applicability of PCR for the detection of low numbers of M. leprae in tissues and peripheral blood. METHODS: The PCR was used to amplify a 530-base-pair M. leprae DNA with the thermoxtable Taq DNA polymerase. RESULTS: The In frozen skin tissues and peripheral blood of leprosy patients. relatively high detection rates of PCR products was achieved by using direct gel analysis as well as Southern blot hybridization. CONCLUSION: These results suggest that PCR amplification for the detection of M. leprae may be useful for the epidemiologic study of large papulations as well as coinical astudies on the individual patients.
Biopsy ; Blotting, Southern ; DNA ; Drug Therapy ; Epidemiologic Studies ; Epidemiology ; Humans ; Leprosy ; Mycobacterium leprae* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Skin ; Skin Tests ; Taq Polymerase

In order to identify the relationship between the patient's age and the presence of another disease, and the postoperative complications and mortality, we reviewed the medical records of 6156 patients admitted to the Department of Surgery, Dae Jeon Eul Ji General Hospital, during the period from January 1991 through December 1995. There were 1546 geriatric patients(>65 years of age) and 4610 adult patients (age between 16 and 64). Six hundred sixty-five patients (43%) in the geriatric group had one or more concurrent diseases preoperatively, whereas 1127 patients (24.4%) in adult group did. Postoperative complications were more frequent in the geriatric group: 21.6% (310 patients) in the geriatric group vs 15.2%(217 patients) in the adult group. Geriatric patients who had more than one concurrent disease and who underwent an emergency operation showed a higher postoperative complication rate than those who had only one concurrent disease and who underwent elective surgery. The postoperative mortality was also higher in the geriatric group: 3.8%(48 patients) in the geriatric group vs 0.7% (32 patients) in the adult group. The most frequent cause of postoperative death in the geriatric group was sepsis. The geriatric patients who had a concurrent disease account for 16.4% of postoperative complications and 1.5% of the mortalities, whereas those who did not have any concurrent disease account for 2.67% and 0.2%, respectively. Among 1127 adult patients who had a concurrent disease, 124 (11.0%) had postoperative complications and 24 (2.2%) died postoperatively. In conclusion, the elderly patients more frequently had one or more concurrent diseases, and these patients had higher postoperative complication and mortality rates, especially after emergency operations. Accordingly, it is crucial for the surgeon to completely evaluate and manage any concurrent diseases in elderly patients preoperatively.
Adult ; Aged ; Daejeon ; Emergencies ; Hospitals, General ; Humans ; Medical Records ; Mortality ; Postoperative Complications ; Sepsis