A 26-year-old man presented with a 7-month history of hyperkeratotic skin lesions on both elbows and heels. He also had marked subungal hyperkeratosis and splinter hemorrhage on the finger and toe nails. A biopsy specimen from the elbow revealed lichenoid re-actions with areas of epidermal atrophy with alternating acanthosis and foci of parakeratosis. We made a diagnosis of keratosis lichenoides chronica based on the characteristic clinicopathologic findings. We have treated the patient with etretinate, but only the skin lesions on the elbows and heels responded to treatment.
Acitretin ; Adult ; Atrophy ; Biopsy ; Diagnosis ; Elbow ; Etretinate ; Fingers ; Heel ; Hemorrhage ; Humans ; Keratosis* ; Nails, Malformed* ; Parakeratosis ; Skin ; Toes

This study was carried out to survey the prevalence of Helicobacter pylori infection and the incidence of vacuolating toxin producing H. pylori from the gastric biopsy specimens of patients with 178 gastritis, 57 gastric ulcer, 455 gastric cancer and 44 healthy person in Pusan, Korea. Further aim of this study was to evaluate the effect of ginseng extract, sofalcone, ginsenosides (F1, Rb3, Re, Rgl), sangwha, green, arrowroot, ginger, and jujube tea on the activity and production of vacuolating toxin by H. pylori in vitro. The isolation rates of H. pylori by culture method from gastric biopsy specimens were 34.1% in healthy person, 42.1% in gastritis, 36.8% in gastric ulcer, and 39.3% in gastric cancer. The isolation rates of vacuolating toxin producing H. pylori from gastric biopsy specimens were 80% in healthy person, 82.7% in gastritis, 81% in gastric ulcer, and 83.8% in gastric cancer. The growth of H. pylori was not influenced by the addition of 10 ug/ml or 100 ug/ml of Ginseng extract and 10 ug/ml of sofalcone in the medium, but the production of vaculating toxin of H. pylori was significantly inhibited by the addition of 100 ug/ml of Ginseng extract and sofalcone. The activity of vacuolating toxin in the culture supernatant of H. pylori was significantly diminished (1/2-1/16 compared to control) by the addition of 10 mg/ml of sangwha, green, arrowroot, and ginger tea, and 1 ug/ml of ginsenosides F1, Rb3, Re, and Rgl. These results suggest that the isolation rates of vacuolating toxin producing H. pylori were significantly higher than that of the foreign reports. Ginseng extract and sofalcone have direct inhibitory effect on the activity of vacuolating toxin production by H. pylori without considerable growth inhibition and sangwha, green, arrowroot, and ginger tea have direct inhibitory effect on the activity of vacuolating toxin of H. pylori.
Biopsy ; Busan ; Gastritis ; Ginger ; Ginsenosides ; Helicobacter pylori* ; Helicobacter* ; Humans ; Incidence ; Korea ; Marantaceae ; Panax* ; Prevalence ; Stomach Neoplasms ; Stomach Ulcer ; Tea ; Ziziphus

No abstract available.
Dilatation* ; Urethra*

In the present study, we investigated the differences in the levels of expression of virulence factors between blood isolates of Candida albicans and commensal strain isolated from the oral cavities of health volunteers, and correlations between virulence factors. Blood isolates of 33 and commenal isolates of 71 were characterized by putative virulence factors such as proteinase production (PROT), an ability to adhere to epithelial cells (ADH), cell surface hydrophobicity (CSH), phospholipase production (PLASE), and hyphal transition (GERM). In PROT, ADH, CSH, and PLASE, the means of expression of blood isolates were higher compared with those of commensal isolates, however statistical significance was only shown in CSH (p=0.036). On the contrary, mean expression of GERM of blood isolates was lower than that of commensal isolates. Of relationships between virulence factors, although a negative correlation of PROT with CSH was obtained, the correlation was relatively low (r=-0.316, p=0.001). These results suggest that higher expression of CSH is a more distinguishing character in virulent blood isolates of C. albicans and that the expression of virulence factors are independent.
Candida albicans* ; Candida* ; Epithelial Cells ; Healthy Volunteers* ; Hydrophobic and Hydrophilic Interactions ; Phospholipases ; Virulence Factors ; Virulence* ; Volunteers

A 13-year-old girl developed rice to nut-sized, bluish to slate-gray colored, depressed patches in a zosteriform distribution along the right side of her upper back and arm without any symptoms. Microscopically, the lesions showed a normal-appearing epidermis, dermis, and subcutaneous fat tissue except for a thinning of collagen fibers and widening of intervals between them in the lower dermis. There have been no changes to the skin lesions during the last 2 years.
Adolescent ; Arm ; Collagen ; Dermis ; Epidermis ; Female ; Humans ; Skin ; Subcutaneous Fat

70 cases free fiap were performed from March 1978 to July 1985. The donor fiap were dorsalis pedis flap in 34 cases, groin flap in 8 cases, osteocutaeous flap in 3 cases, gracilis flap in 17 cases, and latissimus dorsi flap in 8 cases respectively. The success rate was 90% in total including partial success. The causes of failure were 2 cases infection necrosis, and 1 case kinking of drain vessel. The gracilis and latissimus dorsi myocutaneous flap were very satisfactory method for the reconstruction of the upper extremity flexion power, especially in the case of Volkmann's ischemic contracture. The neurovascular dorsalis pedis flap was regarded as excellent method for the heel pad reconstruction, and tactile sensation reconstruction of the hand.
Free Tissue Flaps ; Groin ; Hand ; Heel ; Humans ; Ischemic Contracture ; Methods ; Microsurgery ; Myocutaneous Flap ; Necrosis ; Sensation ; Superficial Back Muscles ; Tissue Donors ; Upper Extremity

Staphylococcal cassette chromosome mec (SCCmec) type and coagulase serotype are important epidemiologic factors in methicillin-resistant Staphylococcus aureus (MRSA). To investigate correlation between SCCmec type and coagulase serotype of MRSA, we analyzed SCCmec types of MRSA strains isolated from clinical sources and compared the results to coagulase serotypes and antimicrobial susceptibility patterns. A total of 108 MRSA isolates were classified into four SCCmec types: II (55.6%), IV (21.3%) III (13.0%) and IIIA (8.3%), and five coagulase serotypes: II (54.6%), IV (21.3%), V (18.5%) and VII (2.8%). All of coagulase type II, IV and V strains belonged to SCCmec type II, III/IIIA and IV, respectively. SCCmec types II, III and IIIA were multidrug resistant, whereas SCCmec type IV strains were non-multidrug resistant except beta-lactams and erythromycin. The data provide that there is a significant correlation between SCCmec types and phenotypic characteristic of coagulase serotypes.
beta-Lactams ; Coagulase ; Epidemiologic Factors ; Erythromycin ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus

Rahnella aquatilis, an infrequently isolated gram-negative rod, is the only species of the genus Rahnella within the Enterobacteriaceae family. The organism's natural habitat is water, from which most isolates have been recoverd. Infecions in humans have only occasionally been reported, especially in immunocompromised patients. We reort a case of bacteremia caused by this organism in a hemodialysis patient.
Bacteremia* ; Ecosystem ; Enterobacteriaceae ; Humans ; Immunocompromised Host ; Rahnella* ; Renal Dialysis*

Popliteal artery injury in blunt trauma of knee joint is not common but poses high rate of amputation due to anatomical characteristics or delayed diagnosis and treatment. The aim of the present study is to review the authors' experiences with this condition and identify factors contributing to disability. We reviewed 7 cases of popliteal artery injury in trauma around knee. Injury mechanism, type of vessel damage, associated injuries, mangled extremity severity scores (MESS), ischemic time and additional treatments were analyzed. Tibial fracture, distal femoral fracture and serious soft tissue defect were combined. Mean MESS was 9.9 point and mean time of revascularization was 7.1 hours. Transfemoral amputation was performed in 2 cases due to vascular insufficiency and devastating infection, and 4 patients were able to walk without any support at the last follow up. Age, the severity of soft tissue injury, ischemic time and MESS are thought to be related to prognosis, and young patients with short ischemic time show best results, but authors experienced one exceptional case. We have to consider multiple factors related to the prognosis in popliteal artery injury with fractures around knee, and careful decision is needed regarding to early amputation.
Amputation ; Delayed Diagnosis ; Extremities ; Femoral Fractures ; Follow-Up Studies ; Glycosaminoglycans ; Humans ; Knee ; Knee Joint ; Popliteal Artery ; Prognosis ; Soft Tissue Injuries ; Tibial Fractures

Graft-versus-host disease can develop in immunosuppressed individuals who receive blood product transfusions that contain imrnunocompetent lymphocytes. We report a case of transfusion-associated graft-versus-host disease(TA-GVHD) that developed in a patient with acute lymphocytic leukemia who were undergoing therapy. The groups at risk for development of TA-GVHD, the clinical presentation and course, and methods of diagnosis are summarized. Prevention of TA-CVHD is possible by irradiation of blood products given to patients at risk, but problems remain in determining the groups that warrant such measures. We should be aware of the risk of developing TA-GVHD after routine blood transfusion, especially in areas where the population's HLA types are rather homogeneous.
Blood Transfusion ; Diagnosis ; Graft vs Host Disease ; Humans ; Leukemia* ; Lymphocytes ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Transplants*