The coexistence of the variants of porokeratosis is very rare. We report a case of coexistence of linear porokeratosis with disseminated superficial actinic porokeratosis (DSAP). A 43-year-old wornan first noticed a brownish papule on the left side of groin in early infancy. She developed multiple discrete or confluent keratotic plaques in linear fashion on the left lower extrernity and trunk in childhood. These leaions became pruritic in summer. Two years ago, she developed multiple scattered small annular lesions on the face and forearms. Her family history showed no abnormalities. Biopsy specimene from the groin and trunk showed eornoid lamella.
Adult ; Biopsy ; Forearm ; Groin ; Humans ; Porokeratosis*

BACKGROUND: Although the main features of psoriasis consist of abnormal epidermal proliferation and T cell infiltration, which of these is the initial abnormality has been a longstanding unresolved question. Recently there has been definite evidence that activated T cells produce the cytokines that induce keratinocyte abnormalities. OBJECTIVE: We investigated the distributions and relative numbers of T lymphocyte subpopulations, that is, CD4+ and CD8+ T cells, to verify the more important T cell subtype and its infiltrating site in the formation of psoriatic lesions. METHODS: Paired psoriatic lesional and non-lesional skin tissues were obtained from eight typical psoriatic patients. Immunohistochemical staining was done on the frozen sections using a labelled streptavidin-biotin peroxidase complex method with DAKO LSAB kit. The primary antibodies used in this study were monoclonal or polyclonal antibodies against CD3, CD4, CD8, HLA-DR, and ICAM-1. RESULTS: In lesional psoriatic skin, the epidermis was mainly infiltrated by CD8+ T cells. There were little or no T cells in non-lesional epidermis. In both lesional and non-lesional dermis, CD4+ T cells were the main ones. In lesional skin, anti-ICAM-1 antibody positively stained diffusely in the endothelial cells of papillary and subpapillary plexuses and focally in epidermal keratinocytes, but in non-lesional skin only the endothelial cells in the subpapillary plexus were stained. There were many HLA-DR+T lymphocytes in lesional and non-lesional dermis. In the epidermis, HLA DR was detected only in lesional keratinocytes and T lymphocytes. CONCLUSION: These results suggest (1) participation of activated epidermal CD8+ T lymphocytes in the formation of psoriatic plaques, and (2) a pathogenetic role of ICAM-1 expression on papillary microvessels.
Antibodies ; Cytokines ; Dermis ; Endothelial Cells ; Epidermis ; Frozen Sections ; HLA-DR Antigens ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes ; Lymphocyte Subsets* ; Lymphocytes* ; Microvessels ; Peroxidase ; Psoriasis ; Skin* ; T-Lymphocytes

The skin lesions of leprosy have a great similarity to various other lesions. Fasal has called it the great imitator. Sometimes these skin lesions can b misdiagnosed because the physician does not consider leprosy. We reported a case of early lepromatous leprosy in 42 year old male. His skin lesions were similar to secondary syphilid. There were no sensory changes on the skin lesions and no enlargement of the peripheral nerves. Numerous AFB(+) bacilli from the skin smear confirmed our diagnosis of leprosy.
Adult ; Diagnosis ; Humans ; Leprosy ; Leprosy, Lepromatous* ; Male ; Peripheral Nerves ; Skin Manifestations* ; Skin* ; Syphilis, Cutaneous

No abstract available.

The authors wish to retract this article due to duplicate publication.

No abstract available.
Humans* ; Idiopathic Pulmonary Fibrosis*

Pulmonary artery sling is a rare congenital cardiovascular anomaly which presents clinical obstructive symptoms and signs of trachea, right main bronchus and esophagus due to left pulmonary artery abnormaly arises from proximal part of right pulmonary artery. Aberrant left pulmonary artery courses to the right above right main bronchus and then turns to the left, and courses to between the anterior of the esophagus and the posterior aspect of trachea. One of important clinical significances of the pulmonary artery sling is associated with intracardiac anomalies, and with tracheal stenosis and bronchomalacia due to press tracheobronchial tree by the aberrant pulmonary artery. It has been thought that embryological malconnection between the pulmonary artery bud from left sixth arch and the pulmonary posterior branchial plexus in the left lung bud. We had experienced 21 months old male infant with left pulmonary artery sling associated with persistent left superior vena cava and dextropostioned heart. The heart seems to move to right hemithorax due to hypoplasia or segmental atelectasis of right lung.
Bronchi ; Bronchomalacia ; Esophagus ; Heart* ; Humans ; Infant ; Lung ; Male ; Pulmonary Artery* ; Pulmonary Atelectasis ; Trachea ; Tracheal Stenosis ; Vena Cava, Superior*

We have recently managed a patient, 31-year-old male, who has been in the state of inferior paraparesis due to cervical disc herniation. The centrally herniated disc material was removed through the posterior approach to the lesion under the general anesthesia in left lateral position. Two days after the operation with removal of herniated disc at C5-6interspace, the subject developed quadriparesis and difficulty in urination in which the weakness of upper extremities were more severe that of the lower extremities. The signs developed postoperatively were very much compatible with those of central cord syndrome, There was improving after the removal of the hematoma and of additional herniated material at second operation which was forced to be done due to development of central cord syndrome in severe degree following the primary surgery. Recovery from neurological dysfunction in order of good and better improvement was of leg, arm, voiding and finger.
Adult ; Anesthesia, General ; Arm ; Central Cord Syndrome* ; Fingers ; Hematoma ; Humans ; Intervertebral Disc Displacement ; Leg ; Lower Extremity ; Male ; Paraparesis ; Quadriplegia ; Upper Extremity ; Urination

BACKGROUND: Many non-invasive, continuous-monitoring blood culture systems have introduced technology that reduces the time and labor. There is a report that terminal subculture is necessary to decrease false negative. The purpose of this study is to evaluate the terminal subcultures for blood cultures monitored by VITAL system and to determine the clinical significance of positive blood cultures not detected by VITAL system. METHODS: From June to August 1996, a total of 3,988 blood culture bottles were processed by VITAL system and terminal subcultures were performed on consecutive 5 day blood culture. Any culture that was instrument positive but negative upon terminal subculture was considered to be false positive. Any culture that was instrument negative but positive upon terminal subculture was considered to be false negative. And false negative were categorized into minor and major errors. RESULTS: Two-hundred and nineteen (5.5%) out of 3,988 blood culture bottles were signaled as positive by VITAL system. Twenty-four bottles out of 219 were VITAL positive but negative upon terminal subcultures (false positive rate, 0.8%). And seven of the 3,988 terminal subcultures were false negative (0.2%). Four out of seven were major error and three were minor error. The isolates of major error bottles were Staphylococcus spp. and minor error bottles were Escherichia coli and Candida tropicalis. These isolates were clinically significant pathogens, but there were no changes on antimicrobial chemotherapy after reporting the positive blood culture reports. CONCLUSIONS: These results suggest that using VITAL system, terminal subculture of 5 day instrument-negative blood culture bottles is not necessary and the VITAL system provides for the rapid and convenient tool for detecting bacteremia.
Bacteremia ; Candida tropicalis ; Drug Therapy ; Escherichia coli ; Staphylococcus

BACKGROUND: Korea is an endemic area of viral hepatitis B with a rate of 5~10% carrier state. Therefore, hepatitis B vaccination is performed nationwide. But 5~15% of healthy individuals fail to respond adequately to the vaccine and an approved guideline for the nonresponders has not been developed yet. This study is designed to identify risk factors for those who lack anti-HBs after hepatitis B vaccination and to document the results of a double-dose revaccination in such nonresponders to the primary vaccination. METHODS: From Feb. 1996 to Aug, 1997, we assessed 51 healthy subjects(HBs Ag negative, anti-HBs negative, anti-HBc negative and a normal LFT). All subjects were vaccinated with Hepavax- B, 1.0ml, 24 by a rapid schedule(0, 1, and 2 months) and 27 by a standard schedule(0, 1, and 6 months). Anti-HBs titers were evaluated 3 months after the third vaccine and assessed the nonre-sponders (anti-HBs titer<2mIu/ml) and the hyporesponders(2~10mK/ml). All 13 nonresponders were revaccinated with 2ml of Hepavax-B 3 months after the primary vaccination. Anti-HBs titers were evaluated 1 month later. RESULTS: The differences in age(p<0.01) and smoking amount(p<0.05) between the responders and the hypo and the nonresponders were statistically significant. There were more males and higher body mass index in the hypo and the nonresponders but not statistically significant. The seroconversion rate after the double-dose vaccination was 92.3%(12/13) with an average titer of 5K08mlU/ ml(1-132.4mIU/ml). CONCLUSIONS: Increase in age and smoking amount were the risk factors of the nonresponders after the primary vaccination. Most of the hypo and the nonresponders to the primary vaccination responded adequately to the double-dose revaccination.
Body Mass Index ; Carrier State ; Hepatitis B* ; Hepatitis* ; Humans ; Immunization, Secondary* ; Korea ; Male ; Risk Factors* ; Smoke ; Smoking ; Vaccination