Quality control survey was done on the plasma triglyceride determination of six laboratories and following results were obtained. 1) Coefficients of variation were less than 5% in 3 laboratories and over 10% in one laboratory. 2) High interlaboratory variation was inferred from the mean values ranging from 104.0~136. 4mg% (sample A) with enzyme method and 44.7~65.3 (Sample B) with acetylaceton method. 3) Establishment of normal plasma triglyceride level in Koreans and supervised quality control by the authority seemed to be urgent.
Plasma ; Quality Control ; Triglycerides*

We report a case of eosinophilic pustular folliculitis in a 42-year-old woman who had atypical clinical findings with moderately pruritic erythematous follicular papules and pustules on the face and neck. Histopathologically miny eosinophils and neutrophils infiltrated around the follicles, within the follicles and around tbe vessels. The follicular walls showed spongiosis. The differential count of eosinophils in seram was 1.9%. The patient responded well to systemic steroid and dapsone.
Adult ; Dapsone ; Eosinophils* ; Female ; Folliculitis* ; Humans ; Neck ; Neutrophils

BACKGROUND: Nitric oxide(NO) produced by activated macrophages through the action of iNOS is the key molecule in the killing mycobacterium. Prostaglandins produced by the action of COX-2, also, are the important mediators of inflammation and other pathophysiologic process. A complex relationship is emerging with regard to "cross-talk" between the NO and COX-2 pathways. OBJECTIVE: The purposes of this study were to investigate the expression of iNOS and COX-2 across the spectrum of leprosy in the paraffin-embedded skin lesions, to demonstrate the interaction between iNOS and COX-2 expression, and to demonstrate the differences in the cell types expressing the iNOS or COX-2. METHOD: In the paraffin-embedded skin lesions of 30 new cases of leprosy(TT, n=4; BT, n=4; BL, n=7; LL, n=15), iNOS and COX-2 expression were detected by using immunohistochemical staining. RESULTS: iNOS expression was 2.0-55.8%(mean 15.9%) and the level of expression of iNOS in TT(31.2%) and BT(32.6%) lesions was significantly higher than that of BL(11.1%) and LL(8.6%) lesions(p<0.05). COX-2 expression was 3.6-74.5%(mean 27.1%) and the level of expression of COX-2 in TT(59.2%) lesions was significantly higher than that of BT, BL and LL lesions(p<0.05). There was positive correlation between iNOS and COX-2 expression, that is, the lesions which expressed high level of iNOS also expressed COX-2 highly. The correlation was statistically significant(r=0.535, p<0.05). The overall level of COX-2 expression(27.1%) was higher than that of iNOS expression(15.9%), and when compared the expression of them across the spectrum of leprosy, COX-2 expressed higher than iNOS in TT and LL lesions. CONCLUSION: Both iNOS and COX-2 were expressed in all types of leprosy skin lesions and the level of iNOS expression in TT and BT lesions was significantly higher than that of BL and LL lesions. The level of expression of COX-2 in TT lesions was significantly higher than that of BT, BL and LL lesions. These results suggest that iNOS and COX-2 have important roles in anti-mycobacterial activities in leprosy lesions. The positive correlation between iNOS and COX-2 expression suggests that NO and COX-2 might interact synergistically or additively rather than suppress each other.
Homicide ; Humans ; Inflammation Mediators ; Leprosy* ; Macrophages ; Mycobacterium ; Prostaglandins ; Skin*

Angioma serpiginosum is a rare acquired naevoid disorder, characterized by minute red or purple punta that are frequently arranged in serpiginous patterns in the lower extremities and buttocks. It usually begins in childhood and is more common in females. Histopathologically, thin-walled capillaries in the dermal papillae and the superficial reticular dermis are widely dilated without extravasation of red blood cells. We report a case of angioma serpiginosum on the lateral aspect of the right arm along the lines of Blaschko in a 36-year-old woman.
Adult ; Arm ; Buttocks ; Capillaries ; Dermis ; Erythrocytes ; Female ; Hemangioma* ; Humans ; Lower Extremity

No abstract available.
Purpura, Thrombocytopenic, Idiopathic*

Lichen striatus is an uncommon nonspecific inflammatory cutaneous disease of unknown etiology occuring as unilateral and linear distribution on extremities and healing spontaneously within a few months to a year. Clinically it is composed of small licbenoid papules which tend to be grouped and coalesced to form either a continuous or an interrupted hypopigmented band and is not usually accompanied by any subjective symptoms. The principal histologic features are an infiltrate composed of lymphocytes and histiocytes around papillary vessels and usually also around, some of the deeper vessels and skin appendages and consequent secondary changes of the epidermis. We present the results of clinical and histopathologic observation in 19 patients with lichen striatus observed at Department of Dermatology, National Medical Center and Seoul National University Hospital during 4 years period from l972 to 1976 which would be the first recorded report on this rare disease in Korea. 1. Clinieal Observation.' Among the 19 patients, 10 were female and 9 were male; 15 were under 10 years of age and 4 were over 10 years of age. Duration of the eruption varied from 1 week to 4 years and average duration was 9.6 months at the time of the first visit. It was unilateral in all cases and affected the upper extremities in 9 and the lower extremities in 8 instances. The eruption extended onto the upper part of the trunk in 2 cases. Only 3 patients had a history of mild intermittent itching sensation. Characteristically, the eruption consisted of grouped, linear, slightly scaling flat polygonal papules with varying degrees of hypopigmentation, extending at least onethird of the length of an extremity. . Histopathologic observation: Skin biopsy was performed in 13 cases. The epiderrnal changes consist of mild diffuse hyperkeratosis (13 cases), focal parakeratosis (5 cases), varying degree of atrophy of malpighian layer (7 cases), mild acanthosis (2 cases), intercellular and intracellular edema (8 cases), exocytosih of lymphocytes (7 cases), focal basal cell disruption (11 cases), and dyskeratotic cells (colloid body) (2 cases). Dermal changes include mild to moderate perivaacular lymphocytic and histiocytic infiltrate rnostly on the level of papillary dermis. Also, there was chronic infIammatory cell infiltrate around hair follicle and sweat glands and ducts in 7 cases respectively, which seems to be peculiar in this disease. Overall histologic findings in our cases are generally consistent with those of the primary phase of the so-called lichenoid tissue reaction of Pinkus, The possible pathogenetic mechanism of the linear eruption and immunobiologic interpretation of the lichenoid tissue reaction were literally reviewed.
Atrophy ; Biopsy ; Dermatology ; Dermis ; Edema ; Epidermis ; Extremities ; Female ; Hair Follicle ; Histiocytes ; Humans ; Hypopigmentation ; Korea ; Lichens* ; Lower Extremity ; Lymphocytes ; Male ; Parakeratosis ; Pruritus ; Rare Diseases ; Sensation ; Seoul ; Skin ; Sweat Glands ; Upper Extremity

Background: Fine needle aspiration and biopsy(FNAB) has known the most accurate test(about 90%) in the preoperative evaluation of patients with a thyroid nodule. The false negative findings of thyroid cancer by FNAB are mainly due to the aspiration of cystic fluid in cystic degeneration of thyroid cancer and the ipossibility of differentiation between follicular adenoma and carcinoma by aspiration or FNAB because of the failure to evaluate the capsule invasion or angioinvasion of the tumor. Actually more than 80% of the nodules are found as benign nodules in aspiration or FNAB and the findings of follieular lesions are found about half of the samples tested, so limiting the cancer incidence in surgically resected samples up to 50% of the surgical resection. Sa reasonable guidelines to manage the benign nodules on aspiration or FNAB are needed which can select the maligna~nt nodules with false negative findings on aspiration or FNAB. We tried to evaluate whether the thyroxine suppression therapy can increase the malignancy rates on thyroidectomy, Methods: We treated the benign thyroid nodules in FNAB with thyroxine for 1 year and cornpared the nodule volume change before and after treatment (every 6 month) with ultrasonogram. We performed thyroidectomy on 1~7 thyroid nodules wbich showed less than 50% decrease of nodule volume after 1 year of thyroxine suppression therapy. Results: The results were as follows. 1) Of all 17 patients, surgical resection revealed malignant thyroid nodule(Group I) in 10 cases (58.82%, papillary cancer. 6 cases, follicular cancer: 4 cases) and benign thyroid nodule(Group II) in 7 cases(41.18%, follicular adenoma: 4 cases, adenomatous goiter: 3 cases). 2) Between group I and II, there was no significant differences in serum T, T and TSH levels before and after thyroxine suppression therapy. Also, there were no significant difference in TSH suppression % between group I and group II(5.60+5.39%, 14.64+11.48%, respectively). 3) Thyroid nodule volume decrease percent before and after thyroxi~ne therapy showed no significant difference between group I and group II (124.80+54.18% vs 159.42+79.82%, p>0.05). Conclusion: Our data suggested that the benign thyroid nodules on aspiration or FNAB which were not suppressed in volume after thyroixine therapy revealed more than 50% incidence of malignancy on surgical resection, so these nodules were highly reeommended to surgical exploration.
Adenoma ; Biopsy, Fine-Needle ; Goiter ; Humans ; Incidence ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy ; Thyroxine ; Ultrasonography

Proximal tibial osteotomy is a procedure usually employed for osteoarthritis of the knee with a predominant single compartment involvement accompanied by pain and angular deformity. It has as its objective the shift of the gravitational line of weight from an involved to a relatively uninvolved side of the knee. We studied the preoperative clinical status and postoperative results in twenty-two patients (twenty-four knees) who had had a proximal osteotomy for osteoarthritic varus deformity. The mean length of follow-up was 2.6years(Range, 6months to 4.8years). In the preoperative evaluation of the lesion, we used bone scintigraphy to estimate the range and extent of the osteoarthritic change. The scintigraphic results were more sensitive to simple x-ray finding in a disease process. The range of motion of the knee were improved after osteotomy, from 7.7degree-128 degree to 2.6 degree-135degree(5.1degree in flexion contracture and 7 degree in further flexion). Correction of the tibiofemoral angle was performed to the level that we had decided correction angle to 7 degree and 3 degree of overcorrection. The correltion of good clinical results and tibiofemoral angle was dependent on whether the postoperative tibiofemoral angle is more than 5 degree valgus or not.
Congenital Abnormalities ; Contracture ; Follow-Up Studies ; Humans ; Knee ; Osteoarthritis ; Osteotomy ; Radionuclide Imaging ; Range of Motion, Articular

We checked and analysed the clinical and radiological status of the upper extremities of 142 baseball player in childhood and adolescence. The results of this study were as follow:1. The oreder of frequency of pain locations in the upper extremities was elbow, shoulder, and then wrist joint. 2. There was colse relationship between elbow pain and career, but not in shoulder and wrist area. 3. The characteristics of shoulder or wrist pain were diffuse and vague nature, but elbow pain was located in medial aspect. 4. The cubitus valgus and limited elbow ROM in throwing side were found in pitchers or older careers. 5. All players showed cortiocotrabecular hypertrophy of humerus, and high incidence of medial epicondylar changes were noticed with career increased. 6. Main bony changes: Shoulder
Adolescent ; Baseball ; Elbow ; Epiphyses ; Growth Plate ; Humans ; Humerus ; Hypertrophy ; Incidence ; Joints ; Shoulder ; Upper Extremity ; Wrist ; Wrist Joint

BACKGROUND: Local bath-PUVA(LB-PUVA) therapy has been recently tried for the treatment of palmoplantar pustular psoriasis and chronic eczema with successful results. However it has not been reported that the effectiveness of LB-PUVA was compared with that of steroid treatment which is the most available treatment. OBJECTIVES: The purpose of this study was to assess the effectiveness, symptom-free interval, recurrence rate and side effects of local bath-PUVA(LB-PUVA) therapy in palmoplantar pustular psoriasis and dyshidrotic eczema which had been resistant to conventional treatments and to compare these results with those of the steroid treatment. METHODS: Twenty four patients with palmoplantar pustular psoriasis, dyshidrotic eczema and palmoplantar keratoderma were treated with local bath-PUVA and the control group of twenty patients with systemic and topical steroid. 1. Local bath-PUVA therapy After a 15-minute bath in 1mg/L of methoxsalen solution(0.0001%), the palms or soles or both were exposed immediately to UVA radiation by UV/PUVA200. The initial standard dose was 1.5 J/cm2, and the patients were treated three times a week. 2. Systemic and topical steroid therapy The patients treated with 10-15mg of oral prednisolone once a day and high-potency steroid(Dermovate ointment) to the lesion topically for 4-8 weeks. The efficacy, symptom-free interval and side effects were assessed for 6-12 months after termination of the treatments. RESULTS: The following results were obtained from this study. 1. In the objective study, severity scores before and after treatment significantly differed in palmoplantar pustular psoriasis treated with local bath-PUVA (p<0.001). 2. In the subjective study, steroid treatment was more effective than LB-PUVA treatment for dyshidrotic eczema and palmoplantar pustular psoriasis. 3. Remission period was significantly longer (mean 9.1+/-2.8 months vs. 5.2+/-3.1 months) and recurrence rate, lower (26.7% vs. 68.9%) after LB-PUVA treatment than after steroid treatment in palmoplantar pustular psorisis and dyshidrotic eczema. 4. One patient with palmoplantar keratoderma was effectively treated by LB-PUVA. CONCLUSION: Local bath-PUVA therapy can be used as an effective and safe treatment method of palmoplantar pustular psoriasis and possibly palmoplantar keratoderma.
Baths ; Eczema ; Eczema, Dyshidrotic* ; Humans ; Keratoderma, Palmoplantar ; Methoxsalen ; Prednisolone ; Psoriasis* ; Recurrence