BACKGROUND: Although immunophenotyping of leukemias has improved diagnostic accuracy and reproducibility, it has also caused diagnostic confusion regarding the lineage of leukemic cells. So far, lots of papers about acute leukemias with coexpression of another lineage markers with different technical methodologies and different criteria have been published in Korea and other countries. The authors investigated the frequency and immunophenotypic characteristics of the leukemias with aberrant lineage markers from data obtained at Korea University Hospital by a retrospective study. METHODS: From Jan. 1993 to Feb. 1996, 179 leukemias had been requested for immunophenotypig and 28 cases among them with unusual immunophenotypes were retrieved according to their immunophenotyping results. For the final diagnosis all the slides stained with Wright-Giemsa, peroxidase, Periodic-Acid Schiff, Sudan black B, and nonspecific esterase were re-examined, and all the flow cytometric results were reanalyzed. RESULTS: Among 28 cases, 3 cases(10%) were acute biphenotypic leukemias(BP) one with B lymphoid and myeloid markers and the other two with T lymphoid and myeloid markers. One case of intralineage bilinear acute leukemia(ILBL) with two separate populations of megakaryocytic cells and monocytic cells was noted. 6 cases(21%) were acute myeloblastic leukemias expressing lymphoid associated markers(Ly+AMLs; CD19) and 8 cases(28%) were myeloid antigen-positive acute lymphoblastic leukemias(My+ALLs, four with CD13+ and three with CD33+ and one with blastic transformation of chronic myelogeneous leukemia). Because of the change in diagnostic criteria, lymphocyte contamination, or low setting of negative control, 10 cases (36%) were not included to be of unusual immunophenotypes. CONCLUSIONS: Frequency of acute hybrid leukemia was 2.2 % of all leukemias. Ly+AMLs was 3.4%, and My+ALL was 4.4%. In conclusion, first, quality control of the flow cytometry and careful interpretation especially in terms of positive cut-off value and gating, are needed. Secondly, national guidelines for the criteria of the hybrid leukemia and My+ALLs and Ly+AMLs are necessary for the elucidation of the prognostic implication of those leukemias.
Carboxylesterase ; Diagnosis ; Flow Cytometry ; Immunophenotyping ; Korea ; Leukemia* ; Leukemia, Myeloid, Acute ; Lymphocytes ; Peroxidase ; Quality Control ; Retrospective Studies ; Sudan

We report a case of atrophoderma vermiculata with an unusual location. Besides symmetrical small pitted macules and linear atrophic depressions on both cheeks, there were unilateral atrophic depressed macules on the forehead, the right popliteal fossa and left up-per arm in our case. The histopathologic findings of these lesions showed a slight degree of epidermal atrophy with follicular pluggings and flattened rete ridges. In the dermis, there were mild perivascular in-filtrations of mononuclear cells. In addition, we could find out no pilosebaceous unit and other adnexal structures were diminished in number.
Arm ; Atrophy ; Cheek ; Depression ; Dermis ; Forehead

Marjolins ulcer is a special type of skin malignancy arising from previous scar site. We report two cases of Marjolins ulcer arising from chronic deg enerating burn scar. A 65-year-old male had a 9 x 15cm sized ulcer on his right popliteal fossa. He had a history of burn when he was seventeen years old and an ulcerati 1g tumor developed at the site of burn scar about 1 year ago. The ulcer became progressively penlarged in size and also painful. Skin biopsy revealed squamous cell carcinoma and,subsequently Above-Knee amputation was done. Another 54-year-old male had a painful coin sized ulcer on his right popliteal fossa where he had burn at the age of thirty-four. The ulcer was developed at the site of burn scar about 2months ago. The pathologic diagnosis was squamous cell carcinoma. He was recommended to get his leg amputated, but it was refused.
Aged ; Amputation ; Biopsy ; Burns ; Carcinoma, Squamous Cell ; Cicatrix ; Diagnosis ; Humans ; Leg ; Male ; Middle Aged ; Numismatics ; Skin ; Ulcer*

Trichoepithelioma, a tumor of the hair follicle, is usually seen as multiple lesions, but occasionally appears as a single tumor. Multiple trichoepithelioma is a dominant hereditary skin conditions whereas solitary trichoepithelioma is not hereditary and is growing tumor, usually seen in adults. A case of 56 year old housewife with solitary trichoepithelioma was reported. The skin lesion appeased as a firm, skin colored papule and the size was 0.5cm in diameter on right side of nose. Shaving biopsy was done and showed a high degree of differentiation toward hair structure and horn cyst that the keratinization is abrupt and complete. The methood of treatment is a surgical excision and electrodesiccation but remain a scar due to surgical trauma. And so, we used a 5-fluorouracil ointment instead of surgical excision and electrodesiccation, The skin lesion on nose was cured completely as a result of 5-FU ointment application without any scar formation cosmetically.
Adult ; Animals ; Biopsy ; Cicatrix ; Fluorouracil* ; Hair ; Hair Follicle ; Horns ; Humans ; Middle Aged ; Nose ; Skin

A 54-year-old woman with severe bullous pemphigoid (BP) associated with insulin dependent diabetes mellitus (DM), who showed unresponsiveness to conventional therapy with corticosteroids in combination of either cyclosporme or dapsone, was successfully treated with plasmapheresis followed each time by 3 successive days of pulse therapy of cyclophosphamide (500mg, intravenously). After six times of plasmapheresis, anti-basement membrane zone (BMZ) antibody titer decreased from 1:1280 to 1:40 and no new lesions developed at all. In severe refractory BP patients with uncontrolled DM, plasmapheresis is one of the valuable treatment modalities for a short period and the need for corticosteroids thus avoiding corticosteroid induced side effects. Herein we report a case of BP with uncontrolled DM who showed an excellent response to a low dose of corticosteroid and 150 mg oral azathioprine following plasmapheresis and cyclophosphamide pulse therapy.
Adrenal Cortex Hormones ; Azathioprine ; Cyclophosphamide* ; Dapsone ; Diabetes Mellitus ; Female ; Humans ; Insulin ; Membranes ; Middle Aged ; Pemphigoid, Bullous* ; Plasmapheresis*

No abstract available.
Lichens*

We present a case of onychogryphosis of both great toe nails associated with onychomycosis of all toe nails occurring in a 90-year-old female patient. She also had senile dementia. Affected nail plates were thickened, increased in length, and curved like the horn of a ram. The nail plates were removed surgically form the nail bed. Direct microscopic examination revealed many hyphae with potassium hydroxide. Trichophyton rnbrum was isolated from the culture in Sabouraud glucose agar media. On histopathologic examination, we found many hyphae in the nail plate. We suggest an onychomycosis as one of the causes of onychogryphosis.
Agar ; Aged, 80 and over ; Alzheimer Disease ; Animals ; Female ; Glucose ; Horns ; Humans ; Hyphae ; Onychomycosis* ; Potassium ; Toes ; Trichophyton

The purpose of this study is to evaluate the stress distribution in the bone around dental implants supporting mandibular overdenture according to the number of implant and the type of attachment. Two or four implants were placed in an edentulous mandibular model and three dimensional photoelastic stress analysis was carried out to measure the fringe order around the implant supporting structure and also to calculate principle stress components at cervical area of each implant. The attachments tested were rigid and resilient type of Dolder bar, Round bar, Hader bar and Dal-Ro attachment. The results were as follows; 1. In 2-implant supported overdenture using Round bar, Hader bar, and Dal-Ro attachment, compressive stress pattern was observed on the supporting structure of implant on loaded side, while tensile stress pattern in unloaded side. 2. In 2-implant supported overdenture using Dolder bar, the rigid Dolder bar shared the occlusal loads between 2 implants in a more favorable manner than was exhibited by the resilient type, while the resilient type placed a more stress on the distocervical area of the implant on the loaded side. But compressive stress pattern was observed in both the loaded and unloaded sides in either case. 3. In 2-implant supported overdenture, rigid and resilient type of Dolder bar exhibited more cross arch involvement than the Round bar, Hader bar, or Dal-Ro attachment. 4. In 4-implant supported overdenture using resilient Dolder bar and Hader bar, stress turned out to be distributed evenly among the implants between loaded and unloaded side, but ther was no reduction in the magnitude of the stress in the surrounding structure of implant contratry to 2-implant supported overdenture.. 5. The stress pattern at cervical area of implant was different with the number of implant or the type of attachment but the overload, harmful to surrounding structure of implant, was not observed.
Dental Implants ; Denture, Overlay*

A 63 year-old man was admatted to our hospital because of dulI epigastralgia. Upper G-I series reveaied the generalized thickened, tortuous mucosal folds in the stomach and duodenal bulb, Two ovold large pits on the antrum were observed endoscopically, Tha relevant literatures on the subject were reviewed.
Humans ; Middle Aged ; Pylorus* ; Stomach

No abstract available.
Diagnosis*