BACKGROUND: Pilomatricoma(Benign calcifying epithelioma of Malherbe) is a uncommon benign tumor with differentiation toward hair cortex cells. It commonly manifests itself as a firm, deep seated nodule with normal Overlying skin, However, anetodermic cutaneous changes have also been described in the literature since 1943. Although the authors hypothesized this phenomenon as a chronic mechanical irritation or a step of transepidermal elimination of the tumoral mass, distinctive elucidation of pathomechanism of it remained. OBJECTIVE: The purpose of this study was to characterize the clinical and histopathologic features of 25 cases with pilomatricoma and to elucidate pathomechanism of the anetodermic cutaneous changes through the comparison of the anetodermic pattern of overlying skin with the changes of the tumoral mass or collagen and elastic fibers in the dermis. METHODS: Twenty-five cases with pilomatricoa have been collected at Chunganam National University Hospital and Kongju Medical Center during 15 years and 5 years, respectively, And we studied the clinical and histopathological characteristics of patients and tried to reveal the relationship between the cutaneous manifestations and the histologic changes through the test for independence. RESULTS: 1. In the age distribution, the patients lesser than 30 years old was 23 cases(92%). The mean age was 18.9 years old. The ratio of males to females was 1 : 2.6. 2. The duration of lesions was from 2 months to 7 years, with the mean duration of 11 months. The predilection sites were arm(40%), face(28%), neck(12%), shoulder(8%), scalp(4%) and back(4%) in order. All lesions were hard in consistency, and were from bean to walnut sized. Clinically, 10 cases (40%) showed reddish discoloration and/or anetodermic cutaneous changes. 3. Histopathologically, the typical patterns of pilomatricoma were commonly located at the dermis (23 cases) and consisted of the shadow cells predominantly(21 cases). Calcium deposits(21 cases, 84%) were noted within the shadow cells. Eight cases(32%) had the tumoral maese demarcated with fibrous capsules, and the foreign body reaction with giant cells and chronic mononuclear cell infiltrations around the shadow cells ruptured the fibrous capsules in 17 cases(68%). 4. When we compared the relationship between the inflammatory cell infiltrations around the tumoral mass and the changes of dermal collagen and elastic fibers, we observed that the changes of dermal fibers and foreign body reaction and mononuolear cell infiltrations were statistically co-related. When compared the cutaneous changes with the inflammatory cell infiltrations of the tumoral masses, we could also reveal that the anetodermic cutaneous changes of the overlying skin might be influenced by the foreign body reactions with chronic mononulcer cell. Based on the status of foreing body reaction, the average of onset was inversely proportional to the average of age. CONCLUSION: Pilomatricomas are slowly growing, firm, deep seated benign tumor which occurs commonly on the arm, face and neck. However, they often showed the anetodermic changes on the overlying skin. Anetodermic cutaneous changes or discoloration may be correlated with the degree of foreign body reactions without the evidences of transepidermal elimination histopathologically.
Adult ; Age Distribution ; Arm ; Calcium ; Capsules ; Carcinoma ; Chungcheongnam-do ; Collagen ; Dermis ; Elastic Tissue ; Female ; Foreign Bodies ; Foreign-Body Reaction ; Giant Cells ; Hair ; Humans ; Juglans ; Male ; Neck ; Pilomatrixoma* ; Skin

We report a case of rosacea in a 65 year old female with a 14 year history of polycythemia vera. The patient suffered from several constitutional symptoms and signs suggestive of polycythemia vera. Six years prior to our initial examination, erythematous lesions were first noted on the center of the face. These lesions exhibited periodic improvement and exacerbation without specific treatment. Histopathologic examination of the facial lesions showed nodular infiltration of lymphocytes and histiocytes and dilation of blood vessels. On the basis of laboratory examination, the patient was diagnosed as polycythemia vera. The patient has received metronidazole, tetracycline, and topical steroids to control rosacea-like facial lesions. The treatment results were not significant. However, phlebotomy markedly improved the skin lesion. To our knowledge, there are no reports describing the clinical course of rosacea lesions following the treatment with phlebotomy.
Blood Vessels ; Female ; Histiocytes ; Humans ; Lymphocytes ; Metronidazole ; Phlebotomy ; Polycythemia Vera* ; Polycythemia* ; Rosacea* ; Skin ; Steroids ; Tetracycline

Infantile digital fibromatoais is a rare benign tumor on fingers and toes of infants and childhood characterized by fibroblaatic proliferation. A 6 months old male infant had a bean sized, flesh nodule on th left 3rd finger. The lesion was noted at 3 days after birth and surgically removed at 7 months old, However, a new lesion developed at the margin of the ald lesion 2 months later. The second patient was a 21 months old female who had two bean sized, flesh nodules on the right 4th snd 5th fingers. The lesion was first noted at 12 months and regressed spontaneously at 30 months without specific interventiona. Histopathological examination of the two cases showed eosinophiric ntracytoplasmic inclusion bodies, charateristic for infantile digital fibromatosis.
Female ; Fibroma* ; Fingers ; Humans ; Inclusion Bodies ; Infant ; Male ; Parturition ; Recurrence ; Toes

From April 2009 to October 2011, we surveyed the higher fungi in the Byeonsanbando National Park, Korea. In total, we identified 2 kingdoms, 3 divisions, 7 classes, 22 orders, 63 families, 149 genera, and 313 species (including 6 undocumented taxa: 2 families, 2 genera, and 2 species). Seventeen 17 orders, 49 families, 128 genera, and 286 species belonged to Basidiomycota; 7 orders, 9 families, 15 genera, and 21 species were of Ascomycota; and 4 orders, 5 families, 6 genera, and 6 species of primordial fungi. Among the Basidiomycota, Agaricomycetes were represented by 47 families, 126 genera, and 282 species. The most common fungi were Boletaceae (33 species), followed by Russulaceae (30), Agaricaceae (27), and Amanitaceae (24). Various species of most of the higher fungi occurred during periods with average temperatures of 23~24.9degrees C, maximum temperatures of 28~31.9degrees C, minimum temperatures of 22~23.9degrees C, > 82% relative humidity, and > 200 mm precipitation.
Agaricales ; Ascomycota ; Basidiomycota ; Fungi* ; Humans ; Humidity ; Korea

We collected and identified 5,721 ectomycorrhizal fruiting bodies (EcM) from Naejangsan National Park from June 2004 to 2013, belonging to 1 phylum, 1 class, 6 orders, 19 families, 40 genera, and 196 species. Of these, 2,249 individuals were identified as 89 species belonging to 11 genera in 7 families in the Agaricales; 1,511 were identified as 43 species belonging to 2 genera in 1 family in the Russulales; 1,132 were identified as 50 species belonging to 21 genera in 6 families in the Boletales; 793 were identified as 8 species belonging to 3 genera in 2 families in the Cantharellales; 29 were identified as 3 species belonging to 2 genera in 2 families in the Thelephorales; and 7 were identified as 3 species belonging to 1 genus in 1 family in the Gomphales. Thus, most of the EcMs identified belonged to the following 3 orders: Agaricales, Russulales, and Boletales. Russulaceae were most common (43 species), followed by Boletaceae (39 species), and Amanitaceae (27 species); most individuals were Russulaceae (1,511), followed by Hydnagiaceae (1,071) and Boletaceae (804). The monthly distribution showed that the greatest number of individuals and species of EcM, including the dominant ones, occur around July~September at an elevation of 200~299 m, diminishing markedly above 600 m. The greatest number of individuals and species, including the dominant ones, were collected in the period with average temperatures 25.0~26.9degrees C, lows of 21.0~22.9degrees C, and highs of 30.0~31.9degrees C, relative humidity > 76%, and rainfall > 400 mm.
Agaricales ; Fruit* ; Humans ; Humidity

The cause of primary spontaneous pneumothorax (PSP) is obvious. Recently, the FLCN mutation was suggested to be a causal factor in PSP. A 47-year-old Korean male patient with chief complaint of repetitive PSP had numerous emphysematous bullae and multiple large cysts based upon high resolution computer tomography. Here we report a case of PSP with an FLCN c.468_470delTTC mutation.
Blister ; Humans ; Male ; Middle Aged ; Pneumothorax ; Sequence Deletion

Aerococcus viridans, a catalase-negative gram-positive coccus rarely causing bacteremia, was isolated from blood cultures of a 52-yr-old man under the gran-ulocytopenic condition. The isolate showed the typical characteristics of A. viridans, i.e., tetrad arrangements in gram stain, positive pyrrolidonyl aminopeptidase (PYR) and negative leucine aminopeptidase (LAP) reactions, and no growth at 45 degrees C.The isolate was revealed to be highly resistant to penicillin, erythromycin, clindamycin, and ceftriaxone, although most strains of A. viridans isolated from the previously reported patients were susceptible to penicillin and other commonly used antibiotics. Even though A. viridans is rarely associated with human infections, it could be a potential causative agent of bacteremia, especially in immunocompromised patients.
Agranulocytosis/*complications/microbiology/physiopathology ; Bacteremia/*complications/microbiology/physiopathology ; Ceftriaxone/pharmacology ; Clindamycin/pharmacology ; *Drug Resistance, Multiple, Bacterial ; Erythromycin/pharmacology ; Gram-Positive Bacterial Infections/*complications/microbiology/physiopathology ; Humans ; Male ; Middle Aged ; Penicillins/*pharmacology ; Streptococcaceae/*drug effects/isolation & purification

No abstract available.
Lymphadenitis*

We analyzed the efficacy and toxicity of a modified Cancer and Leukemia Group B (CALGB) 19802 regimen in adult acute lymphoblastic leukemia (ALL). From February 2002 to August 2005, 25 adults with untreated ALL were enrolled in the study. Compared to the original regimen, the modified CALGB 19802 regimen consisted of a 4-drug induction (cyclophosphamide, daunorubicin, vincristine, and prednisone) instead of a 5-drug induction (L-asparaginase was added to the previous regimen). This was followed by high-dose methotrexate (1,000 mg/m(2)X3 days) and cytarabine (2,000 mg/m(2)X4 days) for the consolidation cycles. High-dose systemic and intrathecal methotrexate was given for central nervous system prophylaxis. Twentythree patients (92%) achieved a complete remission (CR), and two patients (8%) had refractory disease. With a median follow-up of 21.5 months, 10 patients (40%) were alive and continued to be in CR. The 3-yr probability of an event-free survival and the overall survival were 39.0% and 47.4%, respectively. Treatment related mortality and major grade 3 to 4 neurotoxicity occurred in 1 patient and 3 patients, respectively. The modified CALGB 19802 regimen demonstrated a high remission rate and a favorable survival rate.
Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Cyclophosphamide/*administration & dosage ; Daunorubicin/*administration & dosage ; Disease-Free Survival ; Female ; Humans ; Male ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/*drug therapy ; Prednisone/*administration & dosage ; Remission Induction ; Treatment Outcome ; Vincristine/*administration & dosage

BACKGROUND: The purpose of this study is to evaluate intercostal neuropathy after rib fracture and to determine the severity of intercostal neuropathy with using a numerical rating scale and according to the duration of pain and the body mass index. MATERIAL AND METHOD: We measured the positive sharp wave and fibrillation on the intercostal and paraspinal muscles in the thoracic region by performing needle electromyography in 47 patients who had intercostal neuralgia after rib fracture and who had needed daily analgesic for more than three months. RESULT: We diagnosed 11 cases as intercostal neuropathy among the 47 cases. Of the total 11 cases, 8 were male and 3 were female and they were most often of an active generation in the community. The common location of intercostal neuropathy was the intercostal space below the rib fracture and from the 7th to the 12th intercostal rib area. The incidence of intercostal neuropathy was significantly related with multiple rib fracture rather than single rib fracture. The symptoms observed were chest pain (90.9%), sensory change (81.8%), paresthesia and numbness (63.6%), back pain (27.2%) and muscle atrophy (18.2%). The numerical rating scale, the duration of pain and the body mass index showed no significant correlation with the severity of intercostal neuropathy. CONCLUSION: We concluded that the electrodiagnostic approach with considering the affecting factors and the clinical findings will be helpful for diagnosing and treating persistent intercostal neuralgic pain (more than 3 months) after rib fracture.
Back Pain ; Body Mass Index ; Chest Pain ; Electromagnetic Phenomena ; Electromyography ; Female ; Humans ; Hypesthesia ; Incidence ; Intercostal Nerves ; Male ; Muscles ; Muscular Atrophy ; Needles ; Neuralgia ; Paresthesia ; Rib Fractures ; Ribs