Impetigo herpetiformis is a rare pustular eruption that may be seen in late pregnancy. It is associated with severe maternal and fetal complications in case of misdiagnosis and delayed treatment. The patient was a 25-years-old multigravida with psoriasis in her past history. At 20weeks gestation, she had been developed erythematous scaly annular patchs with papules and pustules on inner thigh. At 37weeks' gestation, the patient was suffered from a severely pruritic pustular rash with fever and leukocytosis. The skin of the affected areas was biopsied and showed intraepidermal pustular abscess with a neutrophilic infiltrate. Treatment commenced with intravenous fluids, antibiotics, systemic prednisone, steroid creams, and phototherapy(UVB) under the careful fetal well being monitoring. Cesarean section was done due to fetal distress, and a normal healthy male infant was delivered, following which the patient's condition improved rapidly.
Abscess ; Anti-Bacterial Agents ; Cesarean Section ; Diagnostic Errors ; Exanthema ; Female ; Fetal Distress ; Fever ; Humans ; Impetigo* ; Infant ; Leukocytosis ; Male ; Neutrophils ; Prednisone ; Pregnancy* ; Psoriasis ; Skin ; Thigh

Cutaneous horns of the penis are rare. We report a case associated with squamous cell carcinoma in a 56-year-old male. A gradually enlarging nodule had been on the glans penis for four years. He had suffered from an erythematous crusted tumor mass and horny excrescence on the glans penis which recurred and was aggravated after excision of the nodule seven months ago. Histopathologic findings of the lesions showed characteristic findings of squamous cell carcinoma and cutaneous horn. In situ DNA hybridization for human papillomavirus types 6, 11, 16, 18, 32, and 33 were all negative. The tumor mass were surgically excised and we have not found any sign of recurrence since then.
Animals ; Carcinoma, Squamous Cell* ; DNA ; Epithelial Cells* ; Horns* ; Humans ; Male ; Middle Aged ; Penis* ; Recurrence

Pretibial myxedema, which consists of localized cutaneous accumulations of acid mucopolysaccharides, oceurs in a few patients with hyperthyroidi';m after its correction by surgery or radioactive iodine therapy. We report a case of pretibial myxedema with exophthalmos in a 36 year old male. He has suffered from hyperthyroidism with bilateral pretibial myxedema for a period of 4 years. He was treated with a subtotal thyroidectomy and excision of both pletibia lesions 1 year ago. The lesions recurred on t,he left pretibial area, as a 11 X 16cm sized, non pitting, non tender, swollen, brownish plaque. The histopathologic findings showed epidermal hyperkeratosis and a considerable arnount of mucin in the mid-dermis. We treat.ed him with intralesional injection of triamcinolone acetonide with marked improvement.
Adult ; Exophthalmos ; Glycosaminoglycans ; Humans ; Hyperthyroidism ; Injections, Intralesional ; Iodine ; Male ; Mucins ; Myxedema* ; Thyroidectomy ; Triamcinolone Acetonide

No abstract available.
Humans

No abstract available.
Occupational Diseases*

No abstract available.

Giant cell tumor is a predominantly benign condition but often the tumor is locally aggressive and tends to have high rate of recurrence and it can evolve into a malignant tumor. Thus the lesions have a practically difficult therapeutic problem for the orthopaedic surgeon and any method of treatment has not been satisfied. Between March 1984 and March 1993, clinical observation was carried out on 22 cases of giant cell tumor of bone to analyse the recurrence rate and functional evaluation of the joint according to the treatment methods, pathological grade and cortical destruction. The mean follow-up time was 75. 2 months. The recurrence rate of the intralesional excision group was 54.5% and that of the wide excision group was 9%, There was no relationship between the pathologic grade and recurrence rate. There was no recurrent case in the grade I cortical destruction but almost all of recurrence was occurred in the grade I or II cortical destruction. The functional result of the giant cell tumor occurred around the knee joint was that the mean ratings in the intralesional excision group were 79% and in the wide excision group were 51%. In conclusion, to achieve better joint function and less recurrence rate, intralesional or marginal excision with heat using bone cement or with chemical cauterization using phenol and alcohol can be used for cases of radiological grade I or II, and wide excision for grade III.
Cautery ; Follow-Up Studies ; Giant Cell Tumor of Bone ; Giant Cell Tumors ; Giant Cells ; Hot Temperature ; Joints ; Knee Joint ; Methods ; Phenol ; Recurrence

Leukemia cutis are clinically divided into the specific and nonspecific types. The former demon strates a malignant cell infiltrate on histopathologic examination. We report a case of leukemia cutis in a 29-year old female which developed specific cutanous manifestations previous to peripheral blood abnormalities, She had suffered from several discrete, bean to walnut sized, tender, erythematous patches and nodules on the trunk for 3 months and these gradually spread to the right cheek and upper arm. Atypical lymphocytes and incesassed lymphoblasts were notifced on a peripheral blood smear and bone marrow aspiration. A bone marrow biopsy revealed compact marrow finding, and increased celluarity. The histopathlogic findings showed diffuse dermal and subcutaneous infiltration of atypical lymphocytes. An immunohistochemical study with kappa, lamda, and leukocyte common antigen(LCA) revealed lymphoid malignancy, T-cell type. We treated her with various combined chemotherapy for 2 year, but her skin lesions were not inproved.
Adult ; Arm ; Biopsy ; Bone Marrow ; Cheek ; Drug Therapy ; Female ; Humans ; Juglans ; Leukemia* ; Leukocytes ; Lymphocytes ; Skin ; T-Lymphocytes

BACKGROUND: Recently, Doppler echocardiography has been widely used to evaluate left ventricular(LV) diastolic filling. However, There are only limited date about the influence of LV systolic function on the pattern of left ventricular diastolic filling. METHODS: To evaluate the changes of Doppler echocardiographic parameters of left ventricular filling induced by variations in left ventricular systolic function in dilated cardiomyopathy(DC) with heart failure(HF), 25 patients(M : F=14 : 11) with DC and HF, and 21 age-matched normal subjects(M : F=13 : 8) were examined by ECG, phonocardiography and echocardiography. From the Doppler recording, A2D(time from second heart sound to the onset of early diastolic mitral flow), peak velocity at early diastole(E) and late diastole(A), ratio of E to A velocity(E/A) and flow velocity integral(FVI) were measured. RESULTS: In 22 patients with DC and HF without mitral regurgitation(MR), A2D was significantly prolonged(119.5+/-12.7 vs 92.4+/-14.1msec, p<0.01), and early diastolic peak velocity and E/A velocity ratio were decreased as compared with the normal subjects(E=0.39+/-0.08 vs 0.57+/-0.12m/sec, p<0.01, E/A : 0.87+/-0.19 vs 1.33+/-0.19 vs 1.33+/-0.18, p<0.05). There were significant correlations between A2D and FVI(r=+0.73, p<0.01), and between E/A velocity ratio and FVI(r=-0.78, p<0.01). However, in 3 patients with MR, A2D(88.7+/-12.1msec), E(0.56+/-0.05m/sec), and E/A(1.32+/-0.12) were similar to those in normal subjects, despite of decreased FVI(12.0+/-0.9cm). CONCLUSIONS: These data show that a change of left ventricular systolic function in patients without MR may influence a diastolic filling pattern of left ventricle but not in patient with MR, and suggest that MR masks left ventricular distolic filling abnormalities.
Cardiomyopathy, Dilated* ; Echocardiography ; Echocardiography, Doppler* ; Electrocardiography ; Heart ; Heart Sounds ; Heart Ventricles ; Humans ; Masks ; Phonocardiography ; Ventricular Function, Left*

PURPOSE: Nitric oxide (NO) is synthesized from the amino acid L-arginine by nitric oxide synthase (NOS) which exists as three isoforms, the calcium-dependent endothelial NOS and neuronal NOS, and a calcium-independent inducible NOS. NO has been studied in a variety of human cancers and is implicated in both tumor promotion and inhibition. NO cause p53 mutation in human cells and mutations of p53 are the most common genetic abnormality yet found in human cancers. Aims of this study is to investigate the correlation of iNOS and p53 expression in colorectal cancer, and to evaluate its clinicopathological siginificance with the expression of these proteins. METHODS: 125 patients, who received curative resection of colorectal cancer from 1992 to 1996, were analyzed retrospectively. The monoclonal antibody to the iNOS (Transduction Laboratories.), the monoclonal antibody to the mutant p53 (Dako Co.) were used for the immunohistochemical analysis. Normal colorectal tissue were assayed in 45 cases. The relationship between mutant p53 and iNOS was investigated. RESULTS: When iNOS expression were detected in specimens, positive rate of mutant p53 were 72.4%. When mutant p53 expression were detected in specimens, positive rate of iNOS expression were 65.8%(P<0.05). Positive rate of iNOS, mutant p53 in tumor size were 51%, 56% below 4 cm and 60%, 63% in 4~8 cm and 47%, 67% above 8 cm. Positive rate of iNOS, mutant p53 in Dukes' stage were55%, 55% in stage B and 56%, 67% in stage C. Positive rate of iNOS, mutant p53 in histologic differentiation were 55%, 55% in well-differentiation and 61%, 66% in moderate differentiation and 35%, 48% in poor-differentiation. There was no difference in each Dukes stage between iNOS expression or p53 mutation and postop five year survival rate. Positive rate of iNOS, mutant p53 in normal tissue were 22%, 32%. CONCLUSION: The prevalence of iNOS expression and p53 mutation has been found in exceeding 50% of cases. There was a significant correlation between iNOS expression and p53 mutation in colorectal cancer. No correlation was found between iNOS expression or p53 mutation and clinicopathologic parameters.
Arginine ; Colorectal Neoplasms* ; Humans ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; Prevalence ; Protein Isoforms ; Retrospective Studies ; Survival Rate