A 66-year-old female patient had a firm, non-tender, dome shaped mass on the scalp. The lesion had enlarged slowly for 2 years, and measured about 4 × 6 cm. The histologic finding of the skin biopsy specimen demonstrated an infiltration of immature plasma cells in the dermis, which express monoclonal cytoplasmic lambda light chain by immunohistochemical stainings, and staging work-up after the biopsy revealed no evidence of disease in other foci. The mass on the scalp was treated successfully by radiation therapy, with the diagnosis of primary cutaneous plasmacytoma.
Aged ; Biopsy ; Cytoplasm ; Dermis ; Diagnosis ; Female ; Humans ; Plasma Cells ; Plasmacytoma* ; Scalp ; Skin

OBJECTIVE: To evaluate the effect of IL-10 on development of collagen-induced arthritis, on humoral and cellular immunity and on the endogenous production of IL-10 in DBA/1J mice. METHODS: DBA/1J mice were immunized with chicken type II collagen in Freund s complete adjuvant. Murine recombinant IL-10 was given intraperitoneally twice a week from the day of second immunization (week 3) in doses of 0.002ug, 0. 02ug and 0. 2ug for 3 different groups, respectively. Dexamethasone was injected in one group to suppress the arthritis development and this group was used as negative control group. Levels of anti-collagen antibodies, serum IL-10 and stimulation indices of splenic monocytes to collagen were measured at the end of study. RESULTS: The 0. 02ug IL-10 and 0. 2ug IL-10 treated groups developed earlier and more severe arthritis (week 6 and 8) compared to that of the control group while the 0. 002ug IL-10 group has shown similar course to the control group in terms of incidence and severity of arthritis, At week 10, all groups with or without IL-10 injections developed arthritis with similar degree of severity while dexamethasone group showed far less incidence and severity of arthritis. The serum levels of anti-collagen antibody, IL-10 and spleen monocyte stimulation indices to collagen antigen showed no difference among control group, IL-10 injected groups and dexamethasone injected group. CONCLUSION: This study shows IL-10 could worsen the arthritis in CIA with the dosage used in this study without significant influence on the level of anti-collagen antibodies or stimulation indices of spenic monocyte to collagen.
Animals ; Antibodies ; Arthritis ; Arthritis, Experimental* ; Chickens ; Collagen ; Collagen Type II ; Dexamethasone ; Immunity, Cellular ; Immunization ; Incidence ; Interleukin-10* ; Mice ; Monocytes ; Spleen

OBJECTIVE: The standard vocabularies need to cover a diverse and enriched field of medical content, thereby facilitating semantic information retrieval, clinical decision support and efficient care delivery. SNOMED-CT(Systematized Nomenclature of Human and Veterinary Medicine-Clinical Term) is a comprehensive and precise clinical reference terminology that provides unsurpassed clinical content and expressivity for clinical documentation and reporting. To investigate whether the SNOMED-CT can serve this function in Seoul National University Hospital(SNUH) environment, we evaluated the coverage of SNOMED-CT as compared with clinical terms in the discharge summary at SNUH. METHODS: We tested for discordance of clinical terms between SNUH discharge summary and those from SNOMED-CT. We extracted 9,554 concepts from 1,000 discharge summaries. From these concepts, we obtained 3,545 unique concepts which are normalized to map with SNOMED-CT. These normalized terms are mapped to concepts of SNOMED-CT with semi-automatic method. RESULTS: We found a degree of concordance between SNOMED-CT and the clinical terms used in the discharge summary. Approximately, 89% of medical terms in the discharge summary are matched and 11% of the concepts are not mapped to those of SNOMED-CT. CONCLUSION: Through this study, we confirmed that SNOMED-CT is appropriate reference terminology in SNUH environment.
Humans ; Information Storage and Retrieval ; Semantics ; Seoul ; Vocabulary

To determine effects of the direction of the rotational work shifting on the circadian rhythm and adaptation of physiological and psychological components were investigated with nursing students. Two groups of seven volunteers participated as experimental subjects, and eight nursing students participated as a control group. The directions of rotation work shift were as follows : CW(clockwise)-shift system rotation in the direction of day shift(3 lays), evening shift(3days), off duty(1day) and night shift(5days). and CCW(counterclockwise)-shift system rotation in the reverse direction. Urinary free cortisol and 17-hydroxycorticoster oids in the urine were measured by the solid-phase radioimmunoassay and the colorimetry methods, re spectively. Plasma melatonin was measured by radioimmunoassay. The urinary free cotisol rhythm changed to ir-regular on the evening and night shift in the CCW shift system, whereas the rhythm seems to adapt on night shift in the CW shift system. The daily rhythms of urinary 17-OHCS indicate that they are well synchronized to shift work. These results show that the rotation of shift in the CW direction is more acceptable in terms of the adaptation of hormonal rhythms. These results indicate that the CCW rotation of shift work makes it more difficult for the workers to adapt on a physiological level, and has many more negative effects on nurses when compared with the CW rotation. Thus, a clockwise rotating shift systern seems to be more desirable for the optimal health and performance of nurses.
Circadian Rhythm* ; Colorimetry ; Humans ; Hydrocortisone* ; Melatonin ; Plasma ; Radioimmunoassay ; Students, Nursing ; Volunteers

A 31-year-old woman with surgically proven spinal extradural granulocytic sarcoma was examined with magnetic resonance (MR) imaging. This patient had no evidence of systemic leukemia. The signal intensities of the mass on T1-weighted and gradient echo images were higher than those of spinal cord, which were different from iso-intensity of cases reported by other authors.
Adult ; Female ; Humans ; Leukemia ; Magnetic Resonance Imaging* ; Sarcoma, Myeloid* ; Spinal Cord

BACKGROUND: Recently, it has been suggested that autoantibodis face of melanocytes are prevent in the sera of vitiligo patients. However, these autoantibodies exist, whether they are specific for vitiligo a vitiligo patients possess them. In addition, the specificity of the iti lecular weight of the antigen are all unsolved areas demanding further. OBJECTIVE: To investigate the possible role of autoimmune microvitiligo, this study was designed to verify the presence of auto and vitiligo antigen from the surface of melanocytes, the specificity of gene specific antigens on the sunever, it is not known whether ents, and what percentage of goantigen and the exact moier research. anisms in the development of bodies in vitiligo patients, the utoantibodies and vitiligo anti. METHODS: Indirect immuvofluorescent microscopy, flow cytoriiety, and ELISA was done to compare the reactions between melanocytes and sera. SDS-PAC island immunoblotting were used for the identification of vitiligo antigen. RESULTS: Vitiligo sera showed more prominent fluorescence and higher optical density on the surface of melanocytes than normal sera. Forty-four percent of vitiligo sera was directed to melanocytic surface antigen with a molecular weight of 65kDa. The sition assay using rabbit antimelanocytic antibody showed an inhibition of the reaction betw er vitiligo sera and melanocytes in ELISA and immunoblotting. CONCLUSION: A surface antigen of 65kd was identified from melanocytes and 44.4% of the vitiligo sera showed positive reactions to this antigen.
Antigens, Surface ; Autoantibodies* ; Enzyme-Linked Immunosorbent Assay ; Fluorescence ; Humans ; Immunoblotting ; Melanocytes* ; Microscopy ; Molecular Weight ; Sensitivity and Specificity ; Vitiligo*

Vitiligo is a disease in which melanocytes are selectively destroyed. The disease is thought to be an autoimmune process being there are antibodies to pigment cells in the sera of patients and animals with vitiligo. In the present study, sera from vitiligo patients were examined for reactivity with the human melanoma cell line, SK-Mel-28, by Western blot analysis of solubilized membrane antigens of these cells to identify the pigment cell antigens defined by antibodies in the patients with vitiligo. Antibody reactivity to human melanoma cells (SK-Mel-28) was investigated in 14 patients with vitiligo, and 16 with normal control individuals. Antibodies to the 116-113, 60, 40 KD antigens were associated with vitiligo being present in 79%, 86%, and 43% respectively of the patients with vitiligo, but in only 6%, 38% and 6% of the normal controls. In contrast, antibodies to the 160-155, 78 and 64 KD antigens were equally common in vitiligo and in normal individuals. The results suggest that autoreactivity to pigment cells occurs more commonly in patients with vitiligo than in the normal control and high autoreactivity to pigment cells in the vitiligo sera might be an impertinent epiphemenon to destroyed pigment cell.
Antibodies, Neoplasm/*blood ; Antigens, Neoplasm/immunology ; Autoantibodies/blood ; Blotting, Western ; Human ; Melanoma/*immunology ; Vitiligo/*immunology

OBJECTIVES: Lipocortin-1 (LC-1), a member of annexin family of calcium-binding proteins induced by corticosteroid, originally evoked interest as one of the secondary messengers in the antiinflammatory action of corticosteroid, But the exact mechanism of LC-1 responsible for antiinflammatory effect is still unclear. We investigated the potential role of LC-1 in the effect of corticosteroid on amelioration of collagen induced arthritis (CIA) in mice. METHODS: Four groups of DBA/1j mice were immunized by intradermal injection of 5mg/kg of type 2 collagen with complete Freunds adjuvant which was boostered on day 21 and 42. Group 1 received no treatment and group 2 received 1mg/kg dexamethasone intraperitoneally twice weekly from day 21. Group 3 and 4 were treated with 50 and 0.5microgram/kg of anti LC-1 monoclonal antibody subcutaneously and dexamethasone from day 21 twice weekly, respectively. The prevalence of arthritis and arthritis score were assessed twice weekly. At week 10, we measured serum anticollagen antibody levels and splenic mononuclear cell stimulation indices (SI) to collagen. RESULT: CIA started to develop after 4 weeks of collagen treatment in all groups. All mice of group 1 developed arthritis by the 9 week. Treatment with dexamethasone markedly inhibited arthritis development (P<0.05). Cotreatment of anti LC-1 monoclonal antibody and dexamethasone abolished the antiinflammatory effect of dexamethasone (P<0.05). But there was no significant difference in the serum levels of anticollagen antibody or splenic mononuclear cell SI among the groups. CONCLUSION: These findings support the hypothesis that LC-1 is involved, at least in part, in the antiinflammatory actions of corticosteroid in chronic inflammation, although the mechanism of which is unclear.
Animals ; Arthritis* ; Calcium-Binding Proteins ; Collagen* ; Dexamethasone ; Freund's Adjuvant ; Humans ; Inflammation ; Injections, Intradermal ; Mice ; Prevalence

BACKGROUND: Epidermal grafting using cryotherapy for recipient sites is in widespread use. However the peripheral hypopigmented haloes that occur around the recipient sites require prolon gation of the treatment period. OBJECTIVE: We used a CO2 laser to remove the epidermis of the recipient sites for betteri results. METHODS: We treated lie localized vitiligo patients with CO2 laser to remove t.he epidermis and grafted suction blister rooves. We observed repigmentation and complications 1 month later. RESULTS & CONCLUSIONS : The superiority of this method is demonstrated by the fact 1) all prodedures can be completed on the day of operation 2) the incidence of hypertrophic scar and peripheral hypopigmented halos can be observed.The problems of this method are 1) uneven repigmentation of recipient. sites 2) hyperpigrnentation of recipient sites
Blister ; Cicatrix, Hypertrophic ; Cryotherapy ; Epidermis* ; Humans ; Incidence ; Lasers, Gas* ; Suction ; Transplants* ; Vitiligo*

BACKGROUND: Proximal humerus fracture is considered to be the third most common fracture for patients aged 65 years or older. Conservative treatment has been known to treat most of humerus fracture. However, fractures with severe displacement or dislocation may require surgical treatment. Intramedullary fibular allograft with a locking plate is frequently used in patients accompanying medial metaphyseal disruption. In this study, author intends to evaluate clinical and imaging results based on patients who underwent surgical treatment using fibular allograft with a locking plate. METHODS: This study is conducted prospectively at Wonju Severance Christian Hospital, targeting patients who previously underwent surgical treatment using open reduction and intramedullary fibular allograft with a locking plate between 2011 and 2015. A total of 26 patients were evaluated on the following: postoperational clinical assessment measuring Constant score, American Shoulder and Elbow Society (ASES) score, and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Postoperational imaging assessments are evaluated via measuring the neck-shaft angle. The study subject were Neer classification type 3, 4 proximal humerus fracture cases with disrupted medial hinge and having cortical comminution in the region of the surgical neck. RESULTS: The average period of progression was 22.5 months, and the average age of patients was 72.6 years. At the final follow-up, the average Constant, average ASES, and average DASH scores were 80.1, 78.5, and 20.6 respectively. The average neck-shaft angle was 127.5°. CONCLUSIONS: In conclusion, fibular allograft augmentation with a locking plate showed satisfying results in both clinical and imaging studies.