We report herein a case of tuberculosis cutis orificialis in a 50-year-old man. He suffered from well demarcated, 2x5cm sized, slightly tender, pus discharging, perianal ulcer with bluish edges for 3 months. The biopsy specimen from the ulcer revealed tuberculoid structure with Langhans giant cells in the deep dermis and a few acid-fast bacilli. AFB cultures from the sputum, pus, and tissue were successful. Intradermal test with PPD showed positive result. Chest roentgenographic findings disclosed advanced pulmonary tuberculosis. Almost complete healing of the perianal ulcers occurred following 2 months of therapy using antituberculosis drugs.
Biopsy ; Dermis ; Giant Cells, Langhans ; Humans ; Intradermal Tests ; Middle Aged ; Sputum ; Suppuration ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer

Ichthyosis hystrix is characterized by extensive bilateral systemic involvement of thick hyperkeratotic verrucous papules forming confluent plaques or linear arrangement and is currently classified into a systematized epidermal nevi, which was once conaidered as an extreme variant of congenital ichthyosiform erythroderma. Here is presented a case with typical clinical features and characteristic histopathologic findings of epidermolytic hyperkeratosis. Our patient exhibited no skeletal or CNS abnormalities reported to be associated with this condition. Marked improvement was obtained with oral administration of etretinate.
Acitretin* ; Administration, Oral ; Eating ; Etretinate* ; Flushing ; Humans ; Hyperkeratosis, Epidermolytic ; Hypertrophy ; Ichthyosiform Erythroderma, Congenital ; Ichthyosis* ; Mandible ; Nevus ; Porcupines* ; Sclerosis ; Sweat ; Sweating ; Sweating, Gustatory* ; Young Adult

BACKGROUND: Few studies have demonstrated an enhanced skin responsiveness to opiates in atopic subjects. OBJECTIVE: To determine whether the skin response to morphine is increased in atopics and to assess the clinical usefulness of morphine skin prick test in diagnosis of allergic diseases. METHOD: Allergy skin prick tests were performed using 55 common allergens, histamine, and morphine in 158 patients with allergic diseases. RESULTS: Wheal and flare sizes for morphine (1mg/mL) were significantly related to and smaller than those for histamine (1mg/mL). Although the proportion of subjects with allergic rhinitis and the level of serum total IgE were not different between responders (wheal >- 2mm) and nonresponders to morphine, the positive response rate to allergens was significantly lower in nonresponders. The flare sizes for morphine were significantly higher in positive allergen test group (A/H ratio >- 0.5). Among positive allergen test group, the subjects with atopy score >- 5 showed a larger flare size for morphine than those with atopy score < 5 while the sizes for histamine were not different. CONCLUSION: Morphine skin prick test is helpful for detecting false negative responses to allergens, and morphine skin test responses are increased in highly atopic patients probably due to enhanced mast cell releasability.
Allergens ; Diagnosis* ; Histamine ; Humans ; Hypersensitivity ; Immunoglobulin E ; Mast Cells ; Morphine* ; Rhinitis ; Skin Tests ; Skin*

We report herein a 53-year-old male patient with a large condyloma acuminaturn of 16 months duration on his penis. Clinically, an approximat;ely 3.5 X 2.0 Cm sized, asyrnptomatic, verrucous-surfaced, papilloma was present on his prepuce and glans. Elistological examination disclosed hyperkeratosis, marked acanthosis, papillomatosis, vacuolated upper malphigian cells, dilated capillaries, and mononuclear infiltrntes in the upper dermis. Trial of DNCB immunotherapy showed a dramatic effect on tumor regression.
Capillaries ; Dermis ; Dinitrochlorobenzene* ; Humans ; Immunotherapy ; Male ; Middle Aged ; Papilloma ; Penis

l6-year-old male and 48-year-old female with systemic lupus erythematosus (SLE) and renal disease presented with vesiculobullous eruptions during severe attack of the disease. They showed hypocomplementernia, and high ANA titers. Histopathologic findings revealed subepidermal blister and leukocytoclastic vasculitis, Direct immunofluorescence demonstratedlinear deposits of IgG, IgA and lgM at the dermoepidermal junction. The vesiculobullous eruption of SLE may be an important marker reflecting disease activity and prognosis.
Blister ; Female ; Fluorescent Antibody Technique, Direct ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Lupus Erythematosus, Systemic* ; Male ; Middle Aged ; Prognosis ; Vasculitis

Ultrastructural study was taken in a 48 year old male farmer with colloid milium. Electrcn microscopically, colloid was mainly composed of protofilaments, amorphous substance and degenerating collagens surrounded by halos. Colloidal filaments were curved and branched at their ends. Fibroblasts near the colloid island contained amorphous materials and protofilaments idnitical to that of colloid materials, Thus we suggest that. colloid milium may be produced by the abnormal fibroblasts or may be derived from actiinically damaged collagen fibers.
Collagen ; Colloids* ; Fibroblasts ; Humans ; Male ; Middle Aged

No abstract available.
Fingers* ; Toes*

No abstract available.
Urolithiasis*

Idiopathic osteonecrosis of the femoral head is an important and unresolved problem in orthopaedic surgery. Generally the progressive collapse of the femoral head and ultimate osteoarthritis of the hip will ensue requiring joint replacement. But longterm results of total hip joint replacement surgery are unfavorable especially in young patients. Therefore, if alternatives to the toal joint replacement are to be effective, they must be applied especially in young patients with osteonecrosis of the femoral head. Recently we attempted the vascular-pedicled iliac bone graft (VPIBG), using the deep circumflex iliac vessel as a vascular pedicle, in 13 hips of 10 patients with idiopathic osteonecrosis of the femoral head and followed up 9–19 months after operation. Aims of this procedure are to decompress the femoral head hence allowing better circulation, to revitalize the dead head by insertion of live bleeding bone and to give a mechanical support preventing further collapse of the femoral head. Though more follow up studies are required, the preliminary results seen during 9–19 months after surgery are encouraging enough to be reported.
Bone Transplantation ; Follow-Up Studies ; Head ; Hemorrhage ; Hip ; Hip Joint ; Humans ; Joints ; Osteoarthritis ; Osteonecrosis ; Transplants

Total hip replacement for adults with severe acetabular dysplasia presents a difficult problem because deficient bone stock and soft tissue contractures usually prevent sitting at the normal anatomic level. The rationales of high hip center are due to high failure rate of bulk structural weight bearing graft, good short-term result of hemispherical cementless acetabular component in revision surgery, high hip center but not lateral which does not adversely affect the biomechanics of the hip, and intimate apposition with viable host bone. We represented the short-term results of 21 total hip replacements with proximal placement of the acetabular cup than the anatomical position that is normally used. The mean duration of follow up was 18 months(range, 12-58 months) and the mean age of the patient was fifty-one years(range, thirty to sixty-seven years). Most of these hips had a major deficiency or defect of the acetabular bone stock. They had an aver- age Harris hip score of 47 points preoperatively and 90 points postoperatively. Roentgenographic measurements showed that the mean change in the height of the center of the hip postoperatively was only +6.6 millimeters and the mean change of horizontal location of them was 10 millimeters medial to the preoperative position. Postoperative complications included calcar fracture(1 case), trochanteric bursitis(1 case), postop- erative dislocation(1 case) and one case of radiological loosening of the acetabular component. The center of the hip in THR is not a crucial parameter with regard to the long-term stability of acetabular component, so our recommendation is to place the acetabular component at a more proximal but not lateral position if strong bone stock is available. But future studies of high hip center need to address femoral component longevity.
Acetabulum ; Adult ; Arthroplasty, Replacement, Hip ; Contracture ; Femur ; Follow-Up Studies ; Hip Joint ; Hip ; Humans ; Longevity ; Osteoarthritis ; Postoperative Complications ; Transplants ; Weight-Bearing