BACKGROUND: CD44 is a family of glycoproteins involved in cell to cell and cell to matrix interactions. Overexpression of CD44v6(variant exon 6) form has been reported in several malignant tumors such as stomach cancer, uterine cervical cancer, colorectal cancer, breast cancer and keratinocytic skin tumors, such as, basal cell carcinoma and squamous cell carcinoma. However, CD44 expression in cutaneous T cell lymphoma has not been investigated thoroughly. OBJECTIVE: The purpose of this study is to examine whether there is any difference in the expression of CD44s & CD44v6 between mycosis fungoides(MF), angiocentric T cell lymphoma, subcutaneous panniculitic T cell lymphoma, Ki lymphoma and unspecified peripheral T cell lymphoma. We also evaluated the statistical significance between the expression of CD44v6 and systemic involvement of the diseases. METHODS: Routine paraffin sections of formalin-fixed 33 tissues (11 MF, 8 angiocentric T cell lymphoma, 5 subcutaneous panniculitic T cell lymphoma, 2 Ki lymphoma, 1 unspecified peripheral T cell lymphoma, 2 psoriasis, 2 lichen planus, 2 erythema nodosum) were labeled with anti-CD44 monoclonal antibody using a avidin-biotin-peroxidase complex. Normal skin served as the negative control. RESULTS: 1. Eccrine glands, hair follicles and the epidermis, except the cornified layer, showed positive staining for CD44s. In inflammatory skin diseases, it showed positive staining for CD44s, however CD44v4/5 and CD44v6 stainings were negative. 2. All(4 out of 4) of the tumor stages of MF showed positive CD44s staining, and 3 out of 4 showed positive CD44v6 staining(p=0.024). However, none of them expressed CD44v4/5. 3. All 8 cases of angiocentric T cell lymphoma were positively stained for CD44s, but not for CD44v4/5. In contrast to other peripheral T cell lymphoma, CD44v6 was expressed in 3 out of 8 cases of angiocentric T cell lymphoma. In subcutaneous T cell lymphoma, only the CD44s was expressed, and Ki lymphoma was positively stained for CD44s and negatively stained for CD44v4/5 and CD44v6. 4. In CD44v6 positive angiocentric T cell lymphoma (3 out of 8) and CD44v6 positive tumor stages of MF (3 out of 4), 5 out of 6 patients had systemic involvement suggesting a statistical significance between CD44v6 expression and patient's systemic involvement(p=0.015). CONCLUSION: These results suggest that CD44v6 may serve as a useful prognostic marker in the tumor stage of mycosis fungoides and angiocentric T cell lymphomas.
Breast Neoplasms ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Colorectal Neoplasms ; Eccrine Glands ; Epidermis ; Erythema ; Exons ; Glycoproteins ; Hair Follicle ; Humans ; Lichen Planus ; Lymphoma ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Cutaneous* ; Lymphoma, T-Cell, Peripheral ; Mycosis Fungoides ; Paraffin ; Psoriasis ; Skin ; Skin Diseases ; Stomach Neoplasms ; Uterine Cervical Neoplasms

The number of patients with tinea corporis diagnosed on the clinical findings and KOH examination was 1,709 during the five yea.rs between January 1976 and December 1980, representing l.5% of the total dermatologic out-patients of 105,267 examined at Chilgok Catholic Dermatological Clinic, Daegu, Korea. The annual number of patients with tinea corporis was 84 (0.47% of the total outpatients) in 1976,115 (0.6%) in 1977, and 263 (1.30%) in 1980, but the figure increased markedly in 1976 reaching 616 (2.51%) and 631 (2.89%) in 1980. Of the 1,709 patients, males numbered 793 and females 916. Although the age of peak incidence was in the third decade in both sexes, males outnumbered females slightly before age 19 and, as age advanced, female predominance became marked. The seasonal distribution of patients was interesting: in summer between June and September when the climate is very humid and hot, the incidence was markedly high. From the 1, 709 patients, 1,293 organisms composms of 6 species were isolated and identified. The species isolated were, in order of decreasing frequency, Trichophyton rubrum (622 organisms, 48. 1% of total organisms isolated), T. mentagrophytes (486 organisms, 36. 2%), Microsporum canis (147 organisms, 11. 4%), Epidermophyton floccosurn (29 organisms, 2.2%), M. gypseum (23 organisrns, l.8%) and T. ferrugineum (4 organisms, 0. 3%).
Climate ; Daegu ; Epidermophyton ; Female ; Humans ; Incidence ; Korea ; Male ; Microsporum ; Outpatients ; Seasons ; Tinea* ; Trichophyton

This study was undertaken to evaluate the clinical usefulness of magnetic motor evoked potential (MEP) in the diagnosis of stroke and predicting the motor improvement following stroke. The cortical, cervical and lumbar stimulations were performed in the case of 24 healthy controls and 24 to a target muscle between after transcranial stimulation and after cervical or lumbar stimulation. There was no case showing no response in controls. But in 11 out of 24 ischemic patients, we could not get cortical MEP. Mean CMCT of abductor pollicis brevis muscle was not significantly different in controls and stroke patients in whom MEPs were recorded. There were significant differences between mean CMCT of normal controls and that of stroke patients showing MEPs in AH Muscle. MEP Results from testing the stroke patients were correlated with site of lesion, degree of motor weakness and motor improvement after 1 to 2 months. These results suggest that magnetic MEP is easy and useful in electrophysiological test of central motor pathway and is useful indicator for representing the motor weakness and predicting the motor outcome in acute ischemic stroke patients.
Diagnosis ; Evoked Potentials, Motor* ; Humans ; Stroke*

We report two cases of acquired fibrokeratoma which occurred on the nose and the elbow. A 0.5 cm sized, dome-shaped normal skin colored nodule was found on the nose of a 70-year-old man and a pedunculated, normal skin colored nodule was found on right elbow of on 18-year-old man. Histopathologic findings showed marked hyperkeratosis and acanthosis in epidermis and thick collagen bundles and dilated thin-walled capillaries were predominantly oriented in the direction of longitudinal axis of the tumor. To our knowledge, acquired fibrokeratoma occurring on the nose and the elbow was not reported.
Adolescent ; Aged ; Axis, Cervical Vertebra ; Capillaries ; Collagen ; Elbow ; Epidermis ; Humans ; Nose ; Skin

In general, the long head of the biceps brachii originates from the superior glenoid labrum and the supraglenoid tubercle, crosses the rotator cuff interval, and extends into the bicipital groove. However, rare anatomic variations of the origins of the long head have been reported in the past. In this report, we review the clinical history, radiologic findings, and arthroscopic identifications of 3 anatomic variants of the biceps tendon long head. As the detection of long head of biceps tendon pathology during preoperative radiologic assessment can be difficult without prior knowledge, surgeons should be aware of such possible anatomic variations.
Anatomic Variation ; Head* ; Pathology ; Rotator Cuff ; Shoulder ; Tendons

BACKGROUND: This study compared the clinical and radiological outcomes of the single calcar screw plate and Polarus nail techniques for the treatment of the proximal humerus fractures. METHODS: Seventy-two patients diagnosed with displaced proximal humerus fracture were enrolled for the study. Of these, 50 patients underwent the locking plate surgery with a single calcar screw (plate group), whereas 22 patients underwent the Polarus nail surgery (nail group). The plate group was further divided into plate 1 group (with medial support), and plate 2 group (without medial support). The radiological and functional results of both groups were compared to the nail group. RESULTS: The α angle 1 year after surgery was significantly different between plate 1 and plate 2, and plate 2 and nail groups (p=0.041, p=0.043, respectively). The ratio that does not satisfy the reference value of γ angle was 2.8% in plate 1, 7.1% in plate 2 and 22.7% in nail group (p=0.007); there was a significant difference between plate 1 and nail group, and plate 2 and nail group (p=0.014, p=0.033, respectively). CONCLUSIONS: No significant differences were observed in the clinical results between locking plate and Polarus nail. However, in the plate 2 group and nail group, the rate of failure to maintain reduction during the 1-year period after surgery was statistically and significantly higher than the plate 1 group (level of evidence: level IV, case series, treatment study).
Humans ; Humeral Fractures ; Humerus* ; Reference Values

Hyperkeratosis of the nipple and areola is a rare condition. We report a case of hyperkeratosis of the nipple and areola occurrinp in man with no underlying endocrirop thy or synthetic estrogenic drug therapy. The patient was not associated with epidermal nevus orichthyosis and so fitted into the nevoid form of hyperkeratosis of the nipple and areola. The clinical appearance and histological findings of the lesion were the same as those reported before. He showed a slight improvement in the color and hyperkeratcsis of the nipple and areola with 6 months use of a topical keratolytic agent and corticosteroid crearn.
Drug Therapy ; Estrogens ; Humans ; Nevus ; Nipples*

We report a case of atypical eruption due to chemotherapeutic agent in a 60-year-old man who presented with asymptomatic, erythematous, 0.5cm in diameter, confluent, and elevated papules and plaques confined to the face. The patient was previously diagnosed with small cell carcinoma of the lung with liver metastasis. Two months after the diagnosis, a first course of chemotherapy including etoposide was started. Five days after starting the chemotherapy, the patient developed a facial eruption. Histopathologic examination demonstrated increased epidermal mitotic figures, cells in metaphase arrest, basal cell layer hyperpigmentation, prominent dyskeratosis, and squamous atypia. The most distinctive histologic feature was the presence of starburst cells, which are markedly enlarged pale staining keratinocytes containing small basophilic fragments of nuclear debris haphazardly scattered throughout the cytoplasm in a starburst pattern.
Basophils ; Carcinoma, Small Cell ; Cytoplasm ; Diagnosis ; Drug Therapy ; Etoposide ; Humans ; Hyperpigmentation ; Keratinocytes ; Liver ; Lung ; Metaphase ; Middle Aged ; Neoplasm Metastasis

Mucosal melanosis such as labial and vulvar pigmented macules is common as well as cosmetically disfiguring benign pigmented lesions. Until the recent development of laser treatments, it was impossible to remove a mucosal melanosis without leaving a scar. The Q-switched Alexandrite laser, which has a wavelength of 755 nm and a short pulse duration of 100 nanoseconds, has been used for the treatment of dermal pigmentary disorders such as Nevus of Ota and tattoos. We treated two patients with labial melanosis by the Q-switched Alexandrite laser using a 2,4 mm spot size and energy fluences of 4.5 to 7 J/cm2. Their mucosal pigmentations were completely cleared without adverse sequelae or recurrence after one session of the treatment. We report that Q-switched Alexandrite laser might be a highly effective and safe modality for the treatment of mucosal melanosis and suggest it as the treatment of choice.
Cicatrix ; Humans ; Lasers, Solid-State* ; Lip* ; Melanosis* ; Nevus of Ota ; Pigmentation ; Recurrence

Two cases of clear cell syringoma are reported in the women who were 39 ad 54 years old, respectively. They had had asymptomatic, ricegrain-sized skin colored to yellowish pink papules on the face, particularly on he lower eyelid for several years. Interestingly, both of them had suffered from diabetes mellitus for more than a decade and been placed on irregular antidiabetic medications. Routine laboratory findings in the elder patient(case 2), unfortunately not checked in the younger patient(cases 1) due to her refusal, were within normal limits except marked glucosuria. Histologic examination revealed numerous various-sized, well-defined tumor nests composed largely of clear cells with polygonal cellular boundary and eccentric nucleus. Special stain with Periodic acid-Schiff disclosed existance of glycogen in the clear cells, but other special stains such as alcian blue showed negative findings. Electron microscopic examination of the elder patient revealed many multivesicular bodies suggestive of lysosomes, and numerous droplets of glycogen dispersed between them in villi-rich periluminal cell.
Alcian Blue ; Coloring Agents ; Diabetes Mellitus ; Disulfiram ; Eyelids ; Female ; Glycogen ; Humans ; Lysosomes ; Middle Aged ; Multivesicular Bodies ; Skin ; Syringoma*