From August to November 1985 244 bacteriologically proven male uncomplirated goncicoccal urethritis patients at the VD clinic of Choong-Ku Public Health Center form August to November 1985 were divided into group A and group B according to a random number sheet. In group A, treated with kanamycin 2.Ogm, im plus benzyl penicillin-G 5 mega units, im plus probenecid, 1.Ogm, PO; 112 of 121 patients were followed and 10 patients (8.9%) failed to be recovered. In group B, treated with kanamycin, 2,Ogm, im plus trimethoprim-sulfamethoxazole, 9 tahlets, PO; 112 of l23 patients were followed and 7(6.3%) failed. There is no sign.ificant difference between the two groups (p>0. 05) The failure rates in PPNG urethritis were 14.3% and 8.0% in group A and group B respectively. There is a signficant difference in failure rate between the two groups (P<0.05). It is suggested that, because of high rate of PPNG among circulating N.gonorrhoeae, the combinatioin regimen of kanamycin and trime.thoprim-sulfamethoxazole may be used as a first line treatrnent regimen for uncomplicated gonococcal urethritis.
Gonorrhea* ; Humans ; Kanamycin* ; Male ; Penicillin G* ; Penicillins* ; Probenecid* ; Public Health ; Trimethoprim, Sulfamethoxazole Drug Combination* ; Urethritis

Epithelioid hemangiomo, is belong to a group of unusual vascular proliferation accompanying prominent eosinophilic infiltration. It is usually classificed as a subset of angiolymphoid hyperplasia with eosinophilia despite of its peculiar endothelial morphology(i.e., vacuolization and hobnail appearance etc.). Histopathologically, the lesion was characterized by exuberant. proliferation of capillaries, epithelioid-appearing erdothelial cell, endothelial cytoplasmic vacuolization, solid sheets of endothelial cells, massive eosinophilic infiltration and lymphoreticular hyperplasia. The lesions are most common in he head-neck region and are characterized by single or multiple smooth-top papules or plnqu s of varying colors. We report two cases of epithelioid hemangioma occurring on the left auricle and scalp. The chiet complaints were pruritus and they have been early bleeding even in trivial trauma. Microscopically, the lesions were consisted of a prolifration of small to medium-sized blood vessels surraunded by inflammatory infiltrates predominantly composed of lymphocytes, histiocytes and eosinophils. The vessels were lined by epithelioid-appearing endothelial cells haveing enlarged round nuclei and abundant easinophilic or clear cytoplasm. Some vessels showed luminal obliteration by proliferating epithelioid endothelial cells. Occasionally, blood vessels were lined by hobnailor scallop-shaped endothelial cells. In immunohistochemical finolings, the epithelioid endothelial cells or proliferated capillaries were immunoreactive to factor VII-related antigen and negative to lysozyme.
Angiolymphoid Hyperplasia with Eosinophilia ; Blood Vessels ; Capillaries ; Cytoplasm ; Endothelial Cells ; Eosinophils ; Hemangioma* ; Hemorrhage ; Histiocytes ; Hyperplasia ; Lymphocytes ; Muramidase ; Phenobarbital ; Pruritus ; Scalp

BACKGROUND: Apoptosis is a highly selective form of cell suicide with characteristic morphologieal and biochemical features, including chromatin condensation, formation of apoptotic bodies, and DNA fragmentation by the activation of endonucleases. Various cytokines and physical or chemical factors can provoke apoptotic changes in the skin. OBJECTIVE: We investigated the cytotoxic effects with epidermal cytokines and their combinations, K+ ionophores, protein synthesis inhibitor(emetine), inhibitor of endogenous endonuclease(aurintricarboxylic acid, ATA), sodium azide, and retinoic acid witp human epithelial tumor cell lines(A431 cells) to examine the degree of induction of apoptosis in the epidermal keratinocytes. METHODS: Induction of apoptosis was measured in cultured human keratinocytes, keratinocyte cell lines(A-431, HaCat, KB cells), cultured human melanocytes and malignant melanoma cell lines(SK-28, SK-30) using a mixture of ethidium bromide and acridine orange, DNA agarose gel electrophoresis and TUNEL staining. RESULTS: l. In the A-431 cells, (1 to a certain degree, the combination of IFN-gamma and TNF-alpha could only induce apoptosis. Q2 most of K+ ionophores were observed to induce necrosis rather than apoptosis. Q3 emetine, a protein synthesis blocker, was found to induce apoptosis in a dose-dependent pattern. Q4 sodium azide at a concentration of 1% .induced apoptosis rather than necrosis. Q5 retinoic acid inhibit the beuvericin induced apoptosis. 2. In human keratinocytes, Ql more resistant in the induction of apoptosis than any cultured keratinocyte cell lines p aurintricarboxylic acid(ATA)-an endonuclease inhibitor, could inhibit UV induced apoptosis 3. In human keratinocytes and cultured keratinocyte cell lines, c-PAF inhibit the beauvericin induced apoptosis. 4. Human melanocytes is very resistant for the induction of apoptosis by beauvericin. 5. In the melanocytes and melanoma cell lines, sodium azide and beauvericin induced necrosis rather than apoptosis. CONCLUSIONS: The epidermis is continuously exposed to toxic factors which might induce cell death. With the above results, the induction of appeared to be rather resistant, epidermal cell apoptosis which may reflect the existence of some endogenous protective mechanisms in the epidermis to survive at certain toxic environments; melanocytes showed high expression of bcl-2 protein which could play a role in endogenous defense against toxic environments of the epidermis.
Acridine Orange ; Apoptosis* ; Cell Death ; Cell Line ; Chromatin ; Cytokines ; DNA ; DNA Fragmentation ; Electrophoresis, Agar Gel ; Emetine ; Endonucleases ; Epidermis ; Ethidium ; Humans ; In Situ Nick-End Labeling ; Ionophores ; Keratinocytes ; Melanocytes ; Melanoma ; Necrosis ; Skin ; Sodium Azide ; Suicide ; Tretinoin ; Tumor Necrosis Factor-alpha

Anti-T cell monoclonal antibodies(OKT series. OKT4a, OKTSA, OKT)1) immunoperoxidase technique study for the presence of T cells in cutaneous lesions from four patients with erythema multiforme showed that most dermal and epidermal lymphoid cells were reactive with monoclonal antibodies to anti-pan T cell (l3KT11) in this semiquantitative assay. In the dermis most of the perivascular lirmphoid infiltrates were reactive with anti-helper/inducer T cell antibody, but in the epidermis and in the derrnopidermal interface the predominant cells were identified as suppressor/cytotoxic T cells. The histologic and immunopathologic changes in erythema multiforme appear to be due in part to cellular immune rnechanisms with the lyrnphocyte as the predominant effector cell. But complex interplays with other humoral immune mechanisms might be in work for the development of erythema multiforme.
Antibodies, Monoclonal ; Dermis ; Epidermis ; Erythema Multiforme* ; Erythema* ; Humans ; Immunoenzyme Techniques ; Lymphocytes ; T-Lymphocytes*

Reticulated pigrnented anomalies of the flexures is a pigmentary disorder bearing genetic back ground, also known as Dowling Degos disease or dark dot disease. It is characterized reticulated brownish black macules on the flexural areas with the histological features of filiform pigmented epidermal downward proliferation and the presence of intraepidermal keratin containing cysts. We report 34-year-old housewife who showed brawnish black reticulated macules on her axillae, anterior neck and genitocural folds. Pigmented comedones were also found at the marginal areas of the axillae. Biopsy specimen revealed the presence of intraepidermal keratin containing cysts and basilar hyperpigmentation.
Adult ; Axilla ; Biopsy ; Humans ; Hyperpigmentation ; Malignant Atrophic Papulosis ; Neck ; Pigmentation

A 48-year-old male patient had white to ivory colored patches on brown colored bases over the right side of his back for 8 years without accompanying pruritus or pain. Six months prior to the onset of his skin eruption, he received acupuncture for the relief of right sided back pain for 1 month. Histopathologic examination of the white patches showed follicular plugging, epidermal atrophy, focal hydropic degeneration of basal cells, lymphedema of papillary dermis, thickened homogenization of collagen fibers; consistent with findings previously reported in lichen sclerosus et atrophicus. We report this case to document the occurence in an acupuncture site and stress the unusual clinical manifestation of a zosteriform distribution.
Acupuncture ; Atrophy ; Back Pain ; Collagen ; Dermis ; Humans ; Lichen Sclerosus et Atrophicus* ; Lichens* ; Lymphedema ; Male ; Middle Aged ; Pruritus ; Skin

BACKGROUND: The Fas antigen is a cell surface molecule that mediates apoptosis in many cell types. Matsues group indicated that keratinocytes constitutively express the Fas antigen and apoptosis was induced only on pretreatment with interferon-r (IFN-y) in cultured normal human keratinocytes (NHK). OBJECTIVE: We undertook this study to determine the induction of apoptosis by Fas antibody alone and/or in combination with IFN y, IL-1a in normal human keratinocytes (NHK) and transitional epithelioma cell lines (KB cell) which had lower levels of intracellular IL-1 receptor antago- nists (IL-1ra ). METHODS: We used cultured NHK and KB cells. Each cell was treated with IFN-r, IL-la and Fas antibody for induction of apoptosis. For quantifying the apoptosis, index fluorescent DNA- binding dyes were used. Result: Fas antibody alone could induce apoptosis not only in KB cells but also in NHK cells. The combination of Fas antibody and IFN-r enhanced the induction of apoptosis in NHK and KB cells. The IL-la alone could induce apoptosis only in KB cells which had relatively small amounts of IL-1ra compared to NHK. CONCLUSION: Our result may indicate that Fas antigen in human keratinocytes can regulate normal epidermal cellular differentiation and proliferation.
Antigens, CD95 ; Apoptosis* ; Carcinoma ; Cell Line ; Coloring Agents ; Humans* ; Interleukin 1 Receptor Antagonist Protein ; Interleukin-1 ; Interleukin-1alpha ; KB Cells* ; Keratinocytes*

We report a case of Hunter' s syndrome with characteristic nodules on the upper back. The patient was a 7-year-old Korean boy who presented with ivory-colored papules and nodules on both sides of the scapula, pectoral regions and lateral aspects of the upper arms. These lesione are regarded as pathognomonic cutaneous markers for Hunter s syndrome. He also presented with truncal hypertrichosis, retarded growth, short neck, round face, claw like contractures of hands, multiple joint contractures, and a clear cornea. Severely elevated glycosaminoglycan levels were present in the patient s urine samples. The patient s 5-year-old brother had similar clinical features.
Animals ; Arm ; Child ; Child, Preschool ; Contracture ; Cornea ; Hand ; Hoof and Claw ; Humans ; Hypertrichosis ; Joints ; Male ; Mucopolysaccharidosis II* ; Neck ; Scapula ; Siblings

No abstract available.
Cushing Syndrome* ; Female ; Immunization, Passive* ; Pemphigoid Gestationis*

The clinical use of topical antimicrobial substances is common in clean wounds as well as contaminated and chronic wounds. This use is based on the observation that the reduction of superficial bacterial contamination promotes wound healing. While the antibacterial efficacy of topical antimicrobials has been well documented, their effects on living tissue and the process of wound healing remain controversial. Recently, there have been several trials to detect the toxicity of various antimicrobial materials by using cultured fibroblasts and keratinocytes. In this study the cytotoxicity of several commonly used antimicrobials and the cytotoxic concentrations of antimicrobials on cultured human keratinocytes and fibroblasts were compared using 3 different METHODS: 1) the MTT method showing the ability of the cells to clear the cytotoxic agents, 2) LDH release indicating damage of cell membrane, and 3) tritiated thymidine incorporation measuring DNA synthesis. In the MTT method all topical antimicrobials in their usual clinical concentration showed cytotoxicity on both keratinocytes and fibroblasts by suppressing cell proliferation. Keratinocytes were more sensitive to certain antibiotics. When the 50% inhibition concentration (IC50) of topical antimicrobials were compared, the cytotoxicity to keratinocyte was, in the decreasing order, chlorhexidine, hydrogen peroxide, povidone iodine, sulfadiazine, fusidic acid, ethanol. Gentamicin and bacitracin. The cytotoxicity to fibroblasts was, in decreasing order, chiorhexidine, hydrogen peroxide, povidone iodine, fusidic acid, ethanol, sulfadiazine, bacitracin, and gentamicin. Most of the antimicrobials tested increased LDH release by keratinocyte in IC50.Chlorhexidine, hydrogen peroxide and povidone iodine showed statistically significant increase in LDH release. The tritiated thymidine incorporation study showed the order of cytotoxicity to keratinocyte in IC50 of each antimicrobials was similar to that of the MTT method. Tritiated thymidined incorporation, however, appeared to be a more sensitive method in detecting cytotoxicity than MTT because the IC50 was lower in the former. In conclusion, all topical antimicrobials are cytotoxic to keratinocytes and fibroblast in their usual concentration. Because of their cytotoxicity it is suggested that one should use topical antimicrobials in a dilution of up to 1 : 1,000 of commonly used concentration for a short period only especially when applied directly on a skin graft or wounds without a protective barrier. Bacitracin or gentamicin appear to be less cytotoxic among all the antimicrobials tested.
Anti-Bacterial Agents ; Bacitracin ; Cell Membrane ; Cell Proliferation ; Chlorhexidine ; Cytotoxins ; DNA ; Ethanol ; Fibroblasts* ; Fusidic Acid ; Gentamicins ; Humans* ; Hydrogen Peroxide ; Inhibitory Concentration 50 ; Keratinocytes* ; Povidone-Iodine ; Skin ; Sulfadiazine ; Thymidine ; Transplants ; Wound Healing ; Wounds and Injuries