No abstract available.
Granuloma* ; Subphrenic Abscess*

BACKGROUND: The pathogenesis of confluent and reticulated papillomatosis(CRP) is still unknown, although many theories have been suggested. It is stressed that abnormal host response to colonization of pityrosporum orbiculare might play a role in the pathogenesis of CRP, but is not completely understood. Frequently, we have observed bacterial colonies in the stratum corneum and, especially, within the hair follicles from biopsy specimens of patients with CRP. In addition, successful treatment for CRP with minocycline, a derivative of tetracyclines, has been reported continuously. OBJECTIVE: The purpose of this study was to document the possible association of bacterial factors in the pathogenesis of CRP and to elucidate the effectiveness of minocycline. METHODS: We performed Brown and Brenn gram staining in 12 biopsy specimens, bacterial cultures, identification of microorganisms and antibiotics sensitivity testing including minocycline. We administered oral minocycline with an initial dose of 100mg per day for 1 to 3 months and a maintenance dose 50mg per day for I to 2 months, then evaluated the response of treatment. RESULTS: 1. On Brown and Brenn staining, the gram positive bacterial colonies that stained dark bluish or nearly black were observed within the infundibulum of hair follicles in 10 out of 12 biopsy specimens(83.3%) and on the keratotic invagination of stratum corneum in 11 out of 12 biopsy specimens(91.7%). 2. Histological features of regions where bacterial colonies were observed showed, hyperkeratosis and keratotic invagination on the stratum corneum in all cases. Hyperkeratosis(66.7%), parakeratosis(16.7%), inflammatory cell infiltration(25.0%), perifollicular fibrosis(33.3%), and abnormal keratin in sebaceous ducts(50.0%) were shown in hair follicles. 3. In anaerobic cultures, no bacteria was grown. In aerobic cultures, staphylococcus species were identified in 6 cases, streptococcus viridans in one case, sternotrophomonas maltophilia in one case. In the susceptibiliity test, minocycline was sensitive in 7 from 8 cases. 4. The therapeutic response to minocycline was observed within one month in all cases, and the time to clear the lesions was 1/2 month in 2 cases, 1 month in 4 cases, 2 months in 5 cases, 3 months in one case, respectively. CONCLUSION: Form these results, we suggest that bacterial factors may play an important role in the pathogenesis of CRP and that the action mechanism of minocycline in the treatment of CRP may be due to antibacterial effects.
Anti-Bacterial Agents ; Bacteria* ; Biopsy ; Colon ; Hair Follicle ; Humans ; Malassezia ; Minocycline ; Papilloma* ; Staphylococcus ; Tetracyclines ; Viridans Streptococci

A 34-year-old man visited our hospital with alopecia areata on the occipital scalp, which began to develop two months prior to his visit. He was sensitized with 0.2% diphenylcyclopropenone(DPCP) in acetone that was applied to the inner side of his right arm. Two weeks after sensitization, we applied DPCP on his bald lesion once weekly for skin challenge. Following the third application of DPCP, polycyclic erythematous target-like lesions developed around the sensitized area. A clinical diagnosis of erythema multiforme was made. Histologically, the target-like lesion showed few eosinophilic dyskeratosis, exocytosis, and hydropic de-generation of basal layer in the epidermis, and mononuclear infiltration around superficial blood vessels in the dermis. We report herein a rare case of erythema multiforme following topical application of DPCP in the treatment of alopecia areata. This complication must be noted because of the wide-spread and frequent use of DPCP in dermatotherapeutic fields.
Acetone ; Adult ; Alopecia Areata ; Arm ; Blood Vessels ; Dermis ; Diagnosis ; Eosinophils ; Epidermis ; Erythema Multiforme* ; Erythema* ; Exocytosis ; Humans ; Scalp ; Skin

BACKGROUND: The self-inflating bag-valve resuscitator is an useful breathing support equipment in the cardiopulmonary resuscitation, the transportation of patients who required ventilation assist, or respiratory therapy. The inspiratory oxygen concentration (FiO2) or tidal volume (VT) delivered to the patient depends on various conditions during bag-valve ventilation. METHODS: During bag-valve ventilation without a reservoir at oxygen flow rates of 10 l/min, we evaluated fifty six volunteers to determine the FiO2 and VT at ventilatory frequencies of 10, 12 and 15 cycles per minute and to observe the effect of hand size and grasp power on FiO2 and VT in two-hand compression methods. RESULT: The FiO2 at frequency of 10 cycles/min were 50.1% and it was higher than other ventilatory frequencies. However, the VT was not statistically different among the changes of ventilatory frequency. In the change of VT according to characteristics of the hand, the operator's hand size exerted influence on VT(larger vs. smaller ; 942ml vs. 885ml, p<0.05), but the grasp power of the hand did not significantly affect. Separate analyses with size or grasp power of the hand failed to reveal significant differences of the FiO2. CONCLUSION: The results suggest that a slowing of ventilatory frequency within the allowable ranges for adequate gas exchange increase the FiO2 during bag-valve ventilation without reservoir, and that hand size may exert influence on the VT without FiO2 changes but grasp power may not be a contributing factor to the VT or FiO2 changes.
Cardiopulmonary Resuscitation ; Hand Strength ; Hand* ; Humans ; Oxygen* ; Respiration ; Respiratory Therapy ; Tidal Volume* ; Transportation of Patients ; Ventilation* ; Volunteers

No abstract available.
Priapism*

No abstract available.
Priapism*

Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of probable autoimmune etiology. The MR images of patients with clinically suspected ADEM were retrospectively reviewed. The clinical symptoms occurred 5 days to 1 month after viral upper respiratory infection (4) and Coxsakie viral infection(1). The symptoms had begun with fever(3), headache(3), sore throat(1), and drowsy mental state (1), which progressed with monophasic course to altered mental change(2), extremity weakness(2), seizure(1) and/or cerebellary symptom(I) MRI findings of ADEM showed patchy(4), nonhemorrhagic(5), asymmetric(5) high signal intensity lesions on T2-weighted images. The number of the lesions was mostly multiple(4). The lesions mainly involved the brain stem(3) and subcortical white matter(3). Follow-up MR images of 13 days to 20 days after high dose steroid therapy showed marked improvement in two of three, which well correlated with clinical manifestations. MR findin of multiple, patchy, nonhemorrhagic and asymmetric lesions in subcortical white matter and brain stem on T2-weighted images seem to be characteristic features of ADEM, but nonspecific. Therefore, clinical correlation is required in evaluating ADEM.
Brain ; Brain Stem ; Demyelinating Diseases ; Encephalomyelitis, Acute Disseminated ; Extremities ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies ; White Matter

Laser microdissection (LMD) is an important method for obtaining pure cell samples for genetic and proteomic analysis. In general, immunohistochemistry (IHC) and in situ hybridization (ISH) are useful techniques for targeting virus-specific cell populations. However, until now, there have been no IHC and ISH methods available for detecting ovine herpesvirus (OvHV-2). Previous reports have strongly suggested that lytic replication might occur in the respiratory epithelial cells of OvHV-2 infected animals. The aim of the present study was to confirm respiratory epithelial cells as the susceptible cells for the OvHV-2 by using LMD as an alternative method for localizing viral distribution. The microdissection of target cells by LMD was performed using paraffin-embedded tissues from 5 sheep with high viral copies, which were suspected as the status of reactive lytic replication, and 3 sheep with low viral copies, which were suspected as the status of latent infection. Then, OvHV-2-specific polymerase chain reaction (PCR) and real-time PCR were conducted with the extracted DNAs from the microdissected cells. Our results first demonstrate that OvHV-2 DNAs can be detected in the respiratory epithelial cells of high shedder reactive animals, from which inflammatory cells infected latently by OvHV-2 was excluded. These findings indicate that respiratory epithelial cells are susceptible to OvHV-2 and may be associated with its replication in a natural host. Also, in this study, LMD showed the possibility of wide application for the sensitive localization of low copy viral sequences within specific phenotype cells in the investigation of the role of viruses in a variety of clinical conditions.
Animals ; DNA ; Epithelial Cells ; Immunohistochemistry ; In Situ Hybridization ; Microdissection* ; Phenotype ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Sheep

No abstract available.
Statistics as Topic*

BACKGROUND: Repair of superior labral anterior to posterior (SLAP) lesion in patients older than 40 years is controversial. The purpose of this study was to evaluate clinical outcomes of arthroscopic repair of SLAP lesions between younger and older patient groups. METHODS: We reviewed 50 patients with isolated type II SLAP lesions who underwent arthroscopic repair. Patients were divided into 2 groups: group 1 included 20 patients aged <40 years, and group 2 included 30 patients aged > or =40 years. Functional outcome at the final follow-up was assessed using a visual analog scale for pain and satisfaction, American Shoulder and Elbow Surgeons form, Constant score, University of California at Los Angeles score, and periodic change in range of motion (ROM). Anatomical outcome was evaluated using computed tomography (CT) arthrography at least 1 year after surgery. RESULTS: No significant differences in functional scores or postoperative ROM were observed between the 2 groups. In group 2, later recovery of ROM (forward flexion, p=0.025; internal rotation, p=0.034) and lower satisfaction score (p=0.06) were observed for atraumatic patients (n=16) compared to patients with traumatic injury (n=14). Fifteen patients in group 1 (15/17, 88%) and 21 patients in group 2 (21/26, 81%) demonstrated a healed labrum on postoperative CT arthrography, and this difference was not significant. CONCLUSIONS: The results of this study suggest that arthroscopic repair of type II SLAP lesions can yield good functional and anatomical outcomes regardless of age, if patient selection is adequate. However, the delay in ROM recovery and lower satisfaction, particularly in older patients without traumatic injury, should be considered.
Arthrography ; Arthroscopy ; California ; Elbow ; Follow-Up Studies ; Humans ; Patient Selection ; Range of Motion, Articular ; Shoulder ; Visual Analog Scale