No abstract available.
Granuloma* ; Subphrenic Abscess*

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 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

Apoptosis is a host defense mechanism that the cell uses to limit production of infectious virus. Although many viruses can induce apoptosis in infected cells, large DNA viruses, such as poxviruses, herpesviruses and adenoviruses, usually exhibit the ability to suppress the induction of apoptosis in the infected cells. Several publications have attested to the ability of herpesviruses to protect cells against apoptosis. We investigated the ability of the virus to protect cells in continuous cultivation from apoptosis induced by the virus itself. The gamma herpesvirus alcelaphine herpesvirus 1 (AlHV-1) has been shown to harbor genes with antiapoptotic potentialities. However, here we have demonstrated that productive infection of adherent, permissive cell lines by AlHV-1 resulted in a cytopathic effect characterized by induction of apoptosis. This phenomenon was confirmed using different techniques to detect apoptosis and using different virus strains and cell lines. Therefore, despite the presence of antiapoptotic genes in its genome, AlHV-1 could complete its cycle of productive infection while inducing apoptosis of infected cells. This finding might have implications for the pathobiology of AlHV-1 and other gamma herpesviruses in vivo.
Adenoviridae ; Apoptosis ; Cell Line* ; DNA Viruses ; Genome ; Herpesviridae ; Poxviridae

A 26-year-old Korean man had an erythematous scaly plaque on his right thigh for fifteen years. He was diagnosed with chronic eczema and treated with topical steroid, but no clinical improvement was obtained for 15 years. Laboratory studies including complete blood cell count, urinalysis, liver and renal function test, and peripheral blood smear were normal. A biopsy specimen showed hyperkeratosis, acanthosis, and mononuclear cellular infiltration in the epidermis. These cells had a perinuclear halo and showed a Pautrier's microabscess like configuration. In the dermis, there was a band like infiltration of inflammatory cells. Infiltrates of the epidermis were negative for leukocyte common antigen(CD45) and positive for Pan T cell(CD45RO). He was treated with topical PUVA twice a week for twelve weeks. Clinical and pathological improvements were obtained. We propose PUVA may be a useful therapeutic modality to treat Woringer Kolopp disease.
Adult ; Biopsy ; Blood Cell Count ; Dermis ; Eczema ; Epidermis ; Humans ; Leukocytes ; Liver ; Pagetoid Reticulosis* ; Thigh ; Urinalysis

We report the clinical evolution of two male patients with generalized granulama annulare(GGA) who were controlled with hydroxychloroquine. In the first case, a 3-year-old boy was treated with systemic steroid, and in the second case, a 68-year-old man was treated with prednisolone, niacin, and retinoic acid. But, remission and recurrence of the skin lesions were repeated. A good clinieal response was achieved in both cases after administration of hydroxychloroquine without side effects or any signs of recurrence. Hydroxychloroquine may be helpful to treat the GGA that have side effects to the systemic corticosteroid or resistence to other therapeutic modalities.
Aged ; Child, Preschool ; Granuloma Annulare* ; Granuloma* ; Humans ; Hydroxychloroquine* ; Male ; Niacin ; Prednisolone ; Recurrence ; Skin ; Tretinoin

No abstract available.
Adult* ; Cerebral Infarction* ; Humans ; Polycythemia Vera* ; Polycythemia*

Three parameters (lumbar lordosis, lumbosacral and sacral inclination angle) were measured on 512 normal plain lateral radiographs of lumbosacral spine and the patterns of change during aging were studied. The following results were obtained. 1. The lumbar lordosis angle showed a tendency to increase with age. But a brief decrease was observed after the 6th decade in both sexes, between the 2(nd) and 3(rd) decades in males, and between the 3(rd) and 4(th) decades in females. The lumbar spines of females were generally more lordotic than those of males. 2. The lumbosacral angle appeared to increase with age. The angle in males showed a decline between the 2nd and 4th decades while the angle in females decreased after the 6th decade. Males usually had greater angles than females. 3. The sacral inclination angle continued to increase until the 6th decade, after which a decrease was noted. The angle in females was generally greater than that in males. These results showed that all three angles varied with age, and the pattern of change differed between male and female.
Aging* ; Animals ; Female ; Humans ; Lordosis* ; Male ; Spine

No abstract available.
Humans ; Nystagmus, Pathologic ; Reflex, Vestibulo-Ocular* ; Wernicke Encephalopathy*

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