To investigate the heterogeneity of fibroblast proliferation rate depending on the depth of dermis in the psoriatic skin lesions, fibroblasts were obtained from the upper and lower dermis of the forearm skin lesions in 9 psoriatir, patients and of the comparable sites in 7 healthy persons respectively, and were cultured. The in vitro proliferation rates of the fibroblasts were calculated by measuring the efficiency af cell attachment, cell numbers on varying days of culture and the population doubling time during the 3rd passage of subculture. The results were as follows: 1, The efficiencies of cell attachment at 24 hours after seeding were not statistically different between the upper derrnal fibroblasts and the lower ones in both psoriatic skin lesions and normal skins. 2. By rneasuring the cell numbers and the population doubling times, the prolifeatior rate of the upper der mal fibroblasts was greater than that of the lower ones in both psoriatic skin lesions and normal skins and that the fibroblastic proliferation rate was significantly inereased in the psoriatic skin lesion compared to the normal skin.
Cell Count ; Dermis* ; Fibroblasts* ; Forearm ; Humans ; Population Characteristics ; Skin*

We herein present a case of bullous lichen planus in a 56-year-old female. She had had a generalized eruption of lichen planus with violaceus papules and plaques. many of which had been surmounted by vesicles and bullae. The histopathologic findings of a bulla revealed hyperkeratosis, irregular acanthosis, subepidermal bulla and upper dermal band-like cell infiltration. The patient had been treated with dapsone but the lesions had not been significantly improved.
Dapsone ; Female ; Humans ; Lichen Planus* ; Lichens* ; Middle Aged

We herein presented a case of persistent variant of Grovers disease in a 83-year old male. He had a rather extensive eruption of erythematous scaly papules, which had been profusely grouped but discretely distributed over 2 years or more. The histopathologic findings of two lesions in the same patient revealed mixture of various histologic patterns, patterns resembling Dariers disease, pemphigus vulgaris, Hailey-Hailey disease and spongiosis. The ultrastructural findings of Darier pattern should be essentially similar to those of Dariers disease and also be common to those observed in the early stages of other causes of focal acantholytic dyskeratosis. The patient had been treated with topical and intralesional steroid and oral 13-cis-isotretinoin, however, the lesions had been persisted only with partial improvement of clinical appearance and reduction of pruritus.
Aged, 80 and over ; Darier Disease ; Humans ; Male ; Pemphigus ; Pemphigus, Benign Familial ; Pruritus

We reviewed clinical records and histologic materials of 96 cases of metastatic skin cancer in Seoul National University Hospital from January 1973 to July 1986. The metastatic skin cancers of male were twice as many as that of female and they occurred most frequently in male at their fifties, female, forties. The most frequent primary cancers in men were carcinoma of the stomach, lung, colorectum and pancreas; in women, carcinoma of the breast, stomach, lung and uterine cervix. Cutaneous metastases from the carcinomas of the liver, uterine cervix and stomach which were many in Korea were smaller in number than that from the carcinomas of the lung and breast. Metastatic lesions were recognized before the primary tumor relatively often in carcinoma of the lung, pancreas and rarely in carcinoma of the uterine cervix, stomach. Though localizations of cutaneous metasta.sis were widespread over all body surfaces, regional areas of primary tumor were predisposed to metastasis. Metastatic carcinoma usually produced nonspecific nodules in the skin. Less commonly, some lesions of metastasis showed inflammatory or sclerotic plaque. The histologic findinga of cutaneous metastases generally mimicked that of primary tumors; nevertheless, in most instances, it was not possible to recognize the original tumor from a histologic examination of metastatic skin cancer and it was possible to classify the metastatic carcinoma only as an adenocarcinoma, a squamous cell carcinoma or an undifferntiated carcinoma.
Adenocarcinoma ; Breast ; Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Humans ; Korea ; Liver ; Lung ; Male ; Neoplasm Metastasis* ; Pancreas ; Seoul ; Skin ; Skin Neoplasms ; Stomach

No abstract available.
Laurence-Moon Syndrome*

No abstract available.
Laurence-Moon Syndrome*

Hepatolithiasis is said to exist when stones are present in the right or the left hepatic ducts or their tributaries. Although it is a pathophysiologically benign disease, it causes frequently serious problems-recurrent cholangitis, liver abscess, obstructive jaundice, liver cirrhosis, and sepsis - and has challenged surgeons. Until recently, its fundamental pathogenetic mechanisms have not been elucidated, but bile duct stenosis, bile stasis, and secondary infection are considered as important pathogenetic factors. Therefore, the ultimate goal of the treatment is directed to the correction of these factors. We were retrospectively reviewed 119 cases of patients with hepatolithiasis treated by various surgical methods from Jul. 1989 to Dec. 1996 at the Department of Surgery of Maryknoll Hospital, Pusan. There were 72 women and 47 men, and the mean age was 45.5 years. Thirty-nine patients (32.8%) had previous histories of operations related to biliary stone diseases - cholecystectomy (n=13), T-tube choledocholithotomy (n=21), choledochoduodenostomy (n=9), Roux-en-Y choledochojejunostomy (n=6), and transduodenal sphincteroplasty (n=1). Operative procedures were 24 (20.2%) lithotomy, 60 (50.4%) drainages, and 35 (29.4%) hepatectomies and determined by the location of the stones, the general condition of the patient, and the anatomical change (stenosis or cystic dilatation) in intrahepatic duct. Postoperative complications occurred in 33 (27.7%) patients : wound infection (n=23), atelectasis (n=5), intra-abdominal bile collection (n=3), choledochocutaneous fistula (n=2), hemobilia (n=1), and adhesive ileus (n=1). Residual stones were detected in 39 (32.7%) patients by T-tube cholangiography, ultrasonography, computed tomography. The instances of residual stones was the lowest (17.1%) for hepatectomy compared to 45.8% for a lithotomy and 39.3% for a drainage. The follow-up study showed symptom improvement in 91.5% of the patients with a hepatectomy compared to 58.3% for a lithotomy and 71.7% for a drainage which was statistically significant(P<0.05). Since incomplete stone removal in hepatolithiasis and presence of stenosis in intrahepatic duct frequently require a repeat operation or other invasive management, the authors conclude that a hepatectomy, as an initial treatment for hepatolithiasis, is a safe, satisfactory treatment where possible.
Adhesives ; Bile ; Bile Ducts ; Busan ; Cholangiography ; Cholangitis ; Cholecystectomy ; Choledochostomy ; Coinfection ; Constriction, Pathologic ; Drainage ; Female ; Fistula ; Follow-Up Studies ; Hemobilia ; Hepatectomy ; Hepatic Duct, Common ; Humans ; Ileus ; Jaundice, Obstructive ; Liver Abscess ; Liver Cirrhosis ; Male ; Postoperative Complications ; Pulmonary Atelectasis ; Retrospective Studies ; Sepsis ; Sphincterotomy, Transhepatic ; Surgical Procedures, Operative ; Ultrasonography ; Wound Infection

No abstract available.
Keratoacanthoma*

Tuberculosis of the duodenum is rare event in patients with pulmonary or intestinal tuberculoais. It is very difficult to diagnose duodenal tuberculosis because of inconaiatent symptoms and nonspecific duodenal lesioa. Although fiberoptic endoscopy has been used, there is the limitation of fiberoptic endoscopy ia diagnosingthis disease and the diagnoais require laparotomy with biopsy. Recently we experienced a case of duodenal tuberculosis with duodenoscopic findings of the submucosal tumor of duaidenum. We report a case with review of literatures.
Biopsy ; Duodenum* ; Endoscopy ; Humans ; Laparotomy ; Tuberculosis*

BACKGROUND: It is important to evaluate the patient presenting with non-traumatic chest pain in emergency department, and it is also difficult to classify appropriately. The purpose of this study is to predict probability of acute myocardial infarction(AMI) and assess the group for low probability of AMI that is target for observation-unit of chest pain in emergency department. METHODS: A prospective, clinical study was performed from March 1998 to August 1998 at the department of emergency medicine, Ewha Womans University Mokdong hospital. We classified high-probability group and low-probability group of AMI according to Goldman's algorithm and then compared with the final diagnosis. RESULTS: The study included 218 patients. 84 patients(39%) was the high-probability group and 134 patients(61%) was the low-probability group of AMI. As compared with final diagnosis, AMI was 47 patients(56%) among the high-probability group and 1 patient(0.7%) among the low-probability group. We observed sensitivity of 98%, specificity of 78% in predicting AMI. CONCLUSION: The classification according to Goldman's algorithm may be useful predictor of AMI and improve triage for emergency department patient with chest pain. It is also helpful for management of observation-unit of chest pain in emergency department.
Chest Pain* ; Classification ; Diagnosis ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Female ; Humans ; Prospective Studies ; Sensitivity and Specificity ; Thorax* ; Triage