Hypergammaglobulinemic purpura of Waldenstrom is characterized by recurrent episodes of petechiae, hypergammaglobulinemia, an elevated erythrocyte sedimentation rate, and the presence of rheumatoid factor, and leukocytoclastic vasculitis or mild lymphocytic perivasculitis. There is a primary type and a secondary type which is associated with other autoimmune diseases. We present a csae of a 48 year-old female with hypergammaglobulinemic purpura of Waldenstrom. She showed characteristic clinical, histopathological and laboratory findings consistent with hypergammaglobulinema purpura of Waldenstrom. Although there was a decrease in the Schimer test, we couldt den ostrate an association with Sjogrens syndrome. We think that this case may be a secondary type and needs a follow-up study.
Autoimmune Diseases ; Blood Sedimentation ; Female ; Follow-Up Studies ; Humans ; Hypergammaglobulinemia ; Middle Aged ; Purpura ; Purpura, Hyperglobulinemic* ; Rheumatoid Factor ; Sjogren's Syndrome ; Vasculitis

No abstract available.
Candidiasis, Cutaneous*

A case report of a 60 year-old man with lichen aureus of leg is presented. Clinically the solitary golden to purple colored patch consists of lichenoid papules, plsque, and mild petechiae around the lesion, and the histology reveals a dense and bandlike infiltrate hugging thepidermis. It consists of lymphocytes, histiocytes, eosinophils, and many extravasated erythrocytes and hemosiderin in dermis, but a few red cells and increased melanin pigment can also be seen in the epidermis. The eruption is mildly itchy and has been present 6 months.
Dermis ; Eosinophils ; Epidermis ; Erythrocytes ; Hemosiderin ; Histiocytes ; Humans ; Leg ; Lichens* ; Lymphocytes ; Melanins ; Middle Aged ; Purpura

No abstract available.
DNA Topoisomerases* ; DNA*

OBJECTIVE: This study was conducted to compare radiologic changes and clinical outcomes in adjacent level of percutaneous pedicle screws with those of conventional (open) pedicle screws. METHODS: From January 2007 to December 2009, 51 patients underwent L3-5 decompression and spinal fusion. Percutaneous pedicle screws were used in 22 patients, and open pedicle screws were used in the remaining patients. For estimation of instability, we performed measurements of change in the lordotic and adjacent segment angles. A retrospective evaluation of the patients' data and several assessment scales was conducted for determination of clinical outcomes. RESULTS: The radiological examinations revealed no significant differences, except the L2-3 sagittal angle change. The upper adjacent level angle change in the open group was larger than that in the percutaneous group. In the percutaneous group, the sagittal angle changed from 9.7+/-3.0degrees to 11.25+/-3.6degrees during the follow-up periods, and in the open group, the sagittal angle changed from 10.8+/-4.1degrees to 13.6+/-4.5degrees. Radiological instability was observed in 5 patients (17%) in the open group and in 2 patients (9%) in the percutaneous group. Both groups showed similar clinical outcomes. CONCLUSION: We suggest that open screws have a greater tendency to cause degenerative change in the upper segment than percutaneous screws. This may be because percutaneous screw fixation causes minimal injury to supporting structures and preserves adjacent facet joints.
Decompression ; Follow-Up Studies ; Humans ; Postoperative Complications ; Retrospective Studies ; Spinal Fusion ; Weights and Measures ; Zygapophyseal Joint

OBJECTIVE: This study was conducted to compare radiologic changes and clinical outcomes in adjacent level of percutaneous pedicle screws with those of conventional (open) pedicle screws. METHODS: From January 2007 to December 2009, 51 patients underwent L3-5 decompression and spinal fusion. Percutaneous pedicle screws were used in 22 patients, and open pedicle screws were used in the remaining patients. For estimation of instability, we performed measurements of change in the lordotic and adjacent segment angles. A retrospective evaluation of the patients' data and several assessment scales was conducted for determination of clinical outcomes. RESULTS: The radiological examinations revealed no significant differences, except the L2-3 sagittal angle change. The upper adjacent level angle change in the open group was larger than that in the percutaneous group. In the percutaneous group, the sagittal angle changed from 9.7+/-3.0degrees to 11.25+/-3.6degrees during the follow-up periods, and in the open group, the sagittal angle changed from 10.8+/-4.1degrees to 13.6+/-4.5degrees. Radiological instability was observed in 5 patients (17%) in the open group and in 2 patients (9%) in the percutaneous group. Both groups showed similar clinical outcomes. CONCLUSION: We suggest that open screws have a greater tendency to cause degenerative change in the upper segment than percutaneous screws. This may be because percutaneous screw fixation causes minimal injury to supporting structures and preserves adjacent facet joints.
Decompression ; Follow-Up Studies ; Humans ; Postoperative Complications ; Retrospective Studies ; Spinal Fusion ; Weights and Measures ; Zygapophyseal Joint

BACKGROUND: The incidence of cutaneous squamous cell carcinoma(SCC) has been increasing, but no analysis of the causative diseases of cutaneous SCC has been performed. OBJECTIVE: The purpose of this study was to investigate the causative disease of SCC. METHODS: Eighty-seven patients with cutaneous SCC were retrospectively studied. RESULTS: The possible causative diseases of cutaneous SCC were actinic keratosis(18 csaes), Bowen's disease(17 cases), actinic cheilitis(8 cases), burn scar(4 cases), arsenical keratosis(3 cases), xeroderma pigmentosum(3 cases), chronic discoid lupus erythematosus(2 cases), epidermodysplasia verruciformis(2 cases), leukoplakia(1 case), chronic radiodermatitis(1 cases), erythroplasia of Queyrat (1 case), osteomyelitis sinus(1 case), lichen planus(1 case), porokeratosis of Mibelli(1 case), and the other 21 cases were of unknown origin. CONCLUSION: The causative diseases of cutaneous SCC were related to sun-exposure, and chronic dermatoses.
Actins ; Burns ; Carcinoma, Squamous Cell* ; Erythroplasia ; Humans ; Ichthyosis ; Incidence ; Lichens ; Osteomyelitis ; Porokeratosis ; Retrospective Studies ; Skin Diseases

BACKGROUND: The incidence of cutaneous squamous cell carcinoma(SCC) has been increasing, but no analysis of the causative diseases of cutaneous SCC has been performed. OBJECTIVE: The purpose of this study was to investigate the causative disease of SCC. METHODS: Eighty-seven patients with cutaneous SCC were retrospectively studied. RESULTS: The possible causative diseases of cutaneous SCC were actinic keratosis(18 csaes), Bowen's disease(17 cases), actinic cheilitis(8 cases), burn scar(4 cases), arsenical keratosis(3 cases), xeroderma pigmentosum(3 cases), chronic discoid lupus erythematosus(2 cases), epidermodysplasia verruciformis(2 cases), leukoplakia(1 case), chronic radiodermatitis(1 cases), erythroplasia of Queyrat (1 case), osteomyelitis sinus(1 case), lichen planus(1 case), porokeratosis of Mibelli(1 case), and the other 21 cases were of unknown origin. CONCLUSION: The causative diseases of cutaneous SCC were related to sun-exposure, and chronic dermatoses.
Actins ; Burns ; Carcinoma, Squamous Cell* ; Erythroplasia ; Humans ; Ichthyosis ; Incidence ; Lichens ; Osteomyelitis ; Porokeratosis ; Retrospective Studies ; Skin Diseases

BACKGROUND: Familial benign chronic pemphigus is a rare autosomal dominant disorder characterized by persistently recurrent bullous and vesicular dermatitis of the sides of the neck, axillae, and apposing surfaces. Hailey and Hailey, Montes, and other some investigators reported the presence of bacteria in the lesions of familial benign chronic pemphigus, and suggested that bacteria was associated in the its pathogenesis. OBJECTIVE: The purpose of this study was to elucidate the association of bacteria in thepathogenesis of familial benign chronic pemphigus. METHODS: We performed Brown & Brenn Gram stain in 14 biopsy tissues, bacterial culture and sensitivity test in 10 cases, and decided the effective treatment methods in each case. RESULTS: 1. Man to woman ratio was 3.67: 1 and about 60% of patients were in their third and forth decades. The family history was found in 6 out of 14 cases(42.9%). 2. The lesions were predomiriantly distributed on the groins(85.7%), axillae(71.4%), neck(64.3 %), trunk(50.5%), antecubital fossa(214%). 3. In Brown & Brenn gram stain, the bacterial colonies in the stratum corneum were found in 12(85.7% ) out of 14 biopsy tissues. The cells and its keratohyaline granule in granular layer had blue or nealy black color in 13(92.9%) out of 14 cases. 4. In bacterial culture and sensitivity test, Staphylococcus aureus was identified in 7 cases(70.0 %), Staphylococcus hemolyticus, 2 cases(20.0%) and Streptococcus species, 1 case(10.0%). 5. The number of cases which showed effective response to antibiotics therapy was 8 (57.1%) out of 14 cases. CONCLUSION: These results suggest that bacteria or its toxin play a part of role in the production of lesions of familial benign chronic pemphigus and recurrent bacterial infection may cause recurring of this disease in the genetically predisposed persons.
Anti-Bacterial Agents ; Axilla ; Bacteria* ; Bacterial Infections ; Biopsy ; Dermatitis ; Female ; Humans ; Neck ; Pemphigus, Benign Familial* ; Research Personnel ; Staphylococcus ; Staphylococcus aureus ; Streptococcus

OBJECTIVE: Percutaneous pedicle screw fixation is one of treatment option in lumbar degenerative disease. The advantage of percutaneous pedicle screw fixation is to minimize iatrogenic injury of supporting structures in spine. This study compares clinical outcomes and radiologic changes in adjacent level of percutaneous pedicle screw fixation with those of open pedicle screw fixation. METHODS: Total 54 lumbar degenerative spine patients underwent screw fixation and interbody fusion after decompression. Percutaneous pedicle screw was used in 23 patients, other patients underwent open pedicle screw fixation. Patients' age, sex, diagnosis and, operative results were collected retrospectively. Clinical outcomes were measured by Visual Analogue Scale, Odom's criteria and Oswestry Disability Index. We measured lordotic angle and adjacent segment angle in follow-up radiologic study. RESULTS: Clinical outcomes showed no obvious differences in both percutaneous and open screw fixation groups. In radiologic finding, both groups revealed no significant differences in lordotic angles. On the other hand, L3-4 adjacent level angle change in open group was larger than in percutaneous group. The percutaneous group's sagittal angle changed from 10.2+/-2.4 to 11.6+/-2.7 in follow-up periods, and The open group's sagittal angle changed from 9.9+/-2.4 to 13.4+/-2.9. This difference has a statistical significance. But there is no significant difference in L5-S1 adjacent level angle change between two groups. CONCLUSION: We guess open screw fixation tend to make degenerative change in adjacent segment than percutaneous screw fixation. This suggestion may be related on minimal injury of supporting structures and preservation of adjacent facet joints in percutaneous screw fixation. But it can be confirmed through additional follow-up periods.
Decompression ; Follow-Up Studies ; Hand ; Humans ; Imidazoles ; Nitro Compounds ; Postoperative Complications ; Retrospective Studies ; Spinal Fusion ; Spine ; Zygapophyseal Joint