Granuloma pyogenicum is a benign vascular tumor, usually about 0.5 to 2cm in diameter. It occurs as a single lesion with few exceptions and consists of pedunulated nodule with a dull red or slightly purplish color. We observed a 29-year old man who had multiple satellite recurrences in the scapular region which developed after excision of a single lesion of granuloma pyogenicum. Histapathologic findings showed many newly formed capillaries that had prominant endothelial cells and showed varying degrees of dilation without appearance of epiderrnal collarette sign. The lesions were much improved by X-ray irradiation.
Adult ; Capillaries ; Endothelial Cells ; Granuloma* ; Granuloma, Pyogenic* ; Humans ; Recurrence ; Shoulder*

We report a case of drug eruption and liver damage due to diaminodiphenyl suIfone(DDS) ingestion in a 17-year-old female. This patient had taken DDS for 20 days, 100mg-200mg daily to treat an unknown skin disease. Thereafter, she had generalized erythematous eruption on whole body, icteric sclera and fever. Liver function test showed abnormality (SGOT 514 unit, SGPT 710 unit, alkarine phosphotase 4. 3 B.U., total biIirubin 7. Oml/dl, direct bilirubin 4. 8mg/dl). The adverse reactiions to DDS are gastrointestinal intolerance, hemolytic, anemia, methemoglobinemia, agranulocytoais, hepatitis, neuritis, psychosis and a skin rash described as a fixed drug eruption, erythema multiforme, exfoliative dermatitis and toxic epidermal necrolysis. In Korea, DDS has been used for the treatment of skin diseases of various types for a long time without prescription, especially in rural areas. This trend is a significant sociomediical problem in Korea.
Adolescent ; Alanine Transaminase ; Anemia ; Bilirubin ; Dermatitis, Exfoliative ; Drug Eruptions* ; Eating ; Erythema Multiforme ; Exanthema ; Female ; Fever ; Hepatitis ; Humans ; Korea ; Liver Function Tests ; Liver* ; Methemoglobinemia ; Neuritis ; Prescriptions ; Psychotic Disorders ; Sclera ; Skin Diseases ; Stevens-Johnson Syndrome

BACKGROUND: The high level of susceptibility of patients with liver cirrhosis (LC) to septicemic infection is thought to be due to decreased reticuloendothelial function and irnpairment of several components of cell mediated and humoral immunity. It is well known that LC may cause many characteristic skin changes including jaundice, spider angioma, palmar erythema, xanthelasrna and nail changes such as clubbing and white nails. OBJECTIVE AND METHODS: During a 7 month period frorn April to October 1995, 100 patients who had been diagnosed as having LC were evaluated for the duration of their LC, the associated diseases they had apart from LC and various skin manifestations. Also, we performed the tuberculin test in 20 patients with LC and evaluated the correlation of the tuberculin test with severity of LC divided into 3 groups according to the Childs classification. RESULTS: The results are summarized as follows ; 1. The most frequent duration of LC was under 5 years (74%). 2. The most common associated disease of patients with LC was upper GI bleeding including esophageal varix (24 cases). Also, diabetes mellitus (13 cases) and hepatic coma (11 cases) were observed. 3. Jaundice (82 cases) was the most frequent skin rnanifestation of patients with LC. In addition, vascular changes (81 cases) and various nail changes (69 cases) were observed. Onychomychosis was the most common nail change of patients with LC. 4. 60% of the patients who were given the tuberculin test showed anergy, and the frequency of anergy increased in proport on to the severity of LC. However, it was not significant statistically (p> 0.05 ). CONCLUSIONS: Some of the skin manifestations help in the diagnosis of LC. Also, increased frequency of tuberculin test anergy in proportion to the severity of LC is thought to be related to decreased cell mediated immunity, although statistically it is not significant.
Child ; Classification ; Diabetes Mellitus ; Diagnosis ; Erythema ; Esophageal and Gastric Varices ; Hemangioma ; Hemorrhage ; Hepatic Encephalopathy ; Humans ; Immunity, Cellular ; Immunity, Humoral ; Jaundice ; Liver Cirrhosis* ; Liver* ; Skin Manifestations* ; Skin* ; Spiders ; Tuberculin Test

BACKGROUND: Generally, there are few problems in the diagnosis of Paget's disease(PD) using the H&E stain. However, the differentiation of PD from the clonal type of Bowens disease and superficial spreading melanoma in situ that shows pagetoid spreading of tumor cells, may present diagnostic difficulties. In addition, the specia1 stains used for demonstrating the presenee of Pagets cells, such as PAS and mucicarmim, are non-specific and not always sensitive. So, inenunohistochemical stains with monoclonal antibodies against various antigens may be helpful for differentiating PD from ather morphologically similar skin lesions. OBJECTIVE: The purpose of this study was to investigate the diagnostic accuracy of immunohisto- chemical staining for diagnostic use in PD. METHODS: Immunohistochemical stains used in the biotin streptavidin amplificxl technique with monoclonal antibodies to several low rnolecular weight cytokeratin(CK)s, EMA and CEA, were performed on formalin-fixed, paraffin-embedded tissue. Twelve cases of PD(10 cases of extranmmmary PD and 2 cases of mammary PD), five cases of superficial spreading melanoma in situ and five cases of Bowens disease were investigated. RESULTS: The results were as follows. 1. Positive reactions with variable intensity using CK7, CKS, CK19 were seen in all cases(100%) of PD and the. staining intensity tor CK7 or CK19 was stronger than that of CKS. 2. Of the 12 cases of PD, both CK18 and CAM5.2 staining showed positivity in 11 cases(92%). 3. EMA and CEA staining showed positivity in 10(83%) and 9(75%) of 12 cases, respectively. 4. Some Pagets cells were negative for CK8, CK18 and EMA, although other positive cells were observed in the same sections. 5. All antigens were consistently negative in all cases of Bowens disease and superficial spreading melanoma in situ. CONCLUSION: The results show that moaoclonal antibodies to low molecular weight CKs are more sensitive than EMA or CEA in the demonstration of Pagets cells. Moreover, among the low molecular weight CK series, CK7 and CK19 are most useful for their high sensitivity and intensity.
Antibodies ; Antibodies, Monoclonal ; Biotin ; Bowen's Disease ; Coloring Agents ; Diagnosis ; Melanoma ; Molecular Weight ; Skin ; Streptavidin

Infantile myofibromatosis is an uncornmon, benign, self-limiting, localized or generalized process, probably of hamartomatous origin, which consists to a large degree of cells having the characteristics of myofibroblasts and sometimes of pericytes. Both solitary and multicentric forms occur. Most lesions are present at birth or in early infancy, and some are familial in origin. A female newborn presented with a firm, round, red colored, 3 x 3 cm sized tumor with central necrosis on the left chest. Histological examination revealed well-circumscribed nodules consisting of short bundles of plump, spindle shaped cells displaying staining characteristics intermediate between fibroblasts and smooth muscle cells. The tumor was immunoreactive for actin but did not stain for desmin. A Follow-up examination at the age of 3 months revealed a moderate degree of spontaneous regressior of the lesion.
Actins ; Desmin ; Female ; Fibroblasts ; Follow-Up Studies ; Humans ; Infant, Newborn ; Myocytes, Smooth Muscle ; Myofibroblasts ; Myofibromatosis* ; Necrosis ; Parturition ; Pericytes ; Thorax

From January 1974 to December 1990, 54 patients with stage D2 carcinoma of the prostate. androgen deprivation therapy was initiated in 50 and no treatment in 4. The analyzed prognostic factors were age. urinary retention, bone pain, Karnofsky performance index. serum acid and alkaline phosphatase, anemia. Gleason`s sum, and EOD grading system (new EOD grade and EOD score). The 1. 3 and 5-year survival rates were 66.1 %, 40.1% and 21.6 %, respectively. Mean follow-up was 22 months ranging from 1 to 80 months. Evaluation of response to endocrine therapy in 42 evaluable patients based on NPCP criteria, 6 (15%) showed stabilization of disease with mean duration of 23 months, 8 (19%) partial response with mean duration of 28.4 months and 28 (66%) progression with mean duration of 12.1 months. Forty five patients with bone metastasis who received androgen deprivation therapy had their pretreatment bone scans reviewed using a semi-quantitative grading system based upon the extent of disease (EOD) observed on the bone scan. Using Soloway's 4 grade system, the survival of patients in categories between EOD grade 2 and S didn`t differ from each other. Based on Saitt new EOD 3 grade system, the survival in etch new EOD categories significantly differed from each other (p<0.05). When EOD score system was used employing ALP to overcome the false positive findings and inactive metastatic lesion. the mean survival of patients in EOD score system was improved from 59.8% to 60.4 %. Using the stepwise Cox regression procedure with 7 candidate factors. only two factors (anemia. EOD score) were statistically significant (p<0.1). We conclude anemia and EOD score are two most important prognosticators of the analyzed factors.
Alkaline Phosphatase ; Anemia ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Prostate ; Prostatic Neoplasms ; Survival Rate ; Urinary Retention

OBJECTIVES: The purpose of this study was to get help in order to diagnose orthopaedic disease, measure its activity and determine treatment plan by measuring the beta-glucuronidase activity in urine, serum and joint fluid. METHODS: The beta-glucuronidase activity was determined in the serum, urine and joint fluid of the patients with degenerative arthritis, rheumatoid arthritis, osteomyelitis and osteogenic sarcoma, and some other disease to study the change of the enzyme activity. These values of each specimen were calculated by standard curve and treated by statistical analysis. RESULTS: The results obtained were summarized as follows. 1. The beta-glucuronidase activity in the serum, urine and joint fluid was increased in patients with degenerative arthritis, rheumatoid arthritis, osteomyelitis and osteogenic sarcoma etc. 2. The increased beta-glucuronidase activity in the serum and joint fluid of each disease does not show a specific finding about respective disease, but the increased beta-glucuronidase activity was statistically significant in the urine of all disease groups(male:p=0. 0041, female:p=0. 0001). CONCLUSIONS: On the basis of these results, it was suggested that beta-glucuronidase activity was affected by the orthopaedic disease and differed according to each specimen.
Arthritis, Rheumatoid ; Glucuronidase* ; Humans ; Joints ; Osteoarthritis ; Osteomyelitis ; Osteosarcoma

Acute myocardial infarction after a bee sting is a very rare process. Among proposed mechanisms, vasospasm of the coronary artery is the most probable mechanism. Many mediators are included in the venom of wasps, and those mediators have vasoconstrictive properties and may constrict the coronary artery. Furthemore, those mediators have thrombogenic properties that lead to thrombogenesis in the coronary artery and aggravate myocardial ischemia. Epinephrine, commonly used in the management of anaphylactic shock, may further aggravate myocardial ischemia. We experienced two cases of acute myocardial infarction after a bee sting. In the first case, we could find no underlying abnormalities of the coronary vessel because the patient died during coronary angiography. In the second case, the electrocardiogram showed inferior wall myocardial infarction, but only mild stenosis of the right coronary artery was seen in coronary angiography.
Anaphylaxis ; Bees* ; Bites and Stings* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Electrocardiography ; Epinephrine ; Humans ; Inferior Wall Myocardial Infarction ; Myocardial Infarction* ; Myocardial Ischemia ; Venoms ; Wasps

No abstract available.

VUR is usually diagnosed by standard voiding cystourethrography(VCU). However, we are sometimes puzzled not being able to find VUR on VCU in the group of patients in whom VUR is highly suspected from accompanying obvious clinical, urographic and endoscopic features. For the purpose of detecting this type of VUR or 'subclinical VUR, VCU was performed after subcutaneous injection of bethanechol chloride in 3 patients who were highly suspected of VUR and two were diagnosed as subclinical VUR . Case 1 was diagnosed left VUR(grade II ) and case 2 was diagnosed right VUR(grade II) on VCU after' subcutaneous injection of bethanechol chloride. Both underwent unilateral ureteroneocystostomy and are on follow-up. Bethanechol chloride induced voiding cystourethrography is suggested to be a highly method to detect subclinical vesicoureteral reflux.
Bethanechol* ; Follow-Up Studies ; Humans ; Injections, Subcutaneous ; Vesico-Ureteral Reflux*