We experienced 53-year-old male patient, who had an eczematous verrucous plaque measuring 6 x 4cm in diameter on the nasal bridge for 4 months. On physical examination, there was no abnormality except of palpable bean sized nodule on the left side of chin for 2 months. The overlying skin of the nodule is a quite normal appearance. The skin biopsy of the nodule showed the charact.eristic a.rrangement of the infiltrate in three zones. And the result of fungus culture of the thin tissue slice on Sabouraud media diagnosed fungal infection due to Sporotherix .schenkii. The treatment began with oral ketoconazole for 4 weeks, and the medication was interrupted for 2 weeks, because of no favorable effectiveness. On his revisit, a chain of painless nodules along lymphatics palpated on the right side of his f ace. We changed the therapy into saturated solution of potassium iodide(KI) with 0.25ml(5 drops) orally there times a day and was gradually increased administration of KI, And no side effects were noted. The patient was treated for a. total of 18 weeks, which included 6 weeks of treatment following clinical resolution.
Biopsy ; Chin ; Fungi ; Humans ; Ketoconazole ; Male ; Middle Aged ; Physical Examination ; Potassium ; Skin ; Sporotrichosis*

The present study was designed to measure the activity of purine nucleosiae phosphorylase(PNPase) in sera and lymphocytes af peripheral blood from patients with allergie contact dermstitis and drug eruption since PNPase activities are known to be decreased in cell-mediated immune deficieney diseases. The PNPase activities in sera and lymphocytes of normal subjects were (7.2 +1.05) * 105 unit/L of sera and (1.85+0.38) unit/102 lymphocytes, respectively. In allergic contact dermatitis, the PNPase activities in sera and lymphocytes of patients were (3.9+0.78) *105 unit/L of aera and (0.69+0.23) uoit/102 lymphocyteis, which were signifieantly lower than those of normal subjects. There were no differences in PNPase activities of sera and lymphocytes between drug eruption patients and normal subjects. From these results, it is suggested that the lowered PNPase aetivity in allergie contact dermatitis might be associated with abnormal lymphocytes differentiation or activation or some other unknown mechanism, since lowered PNPase activity in allergic contact dermatitis is in contrast to the generally accepted concept that enhanced status of CMI in ACD will lead to the increase in PWPase activity.
Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Drug Eruptions* ; Humans ; Lymphocytes* ; Purine-Nucleoside Phosphorylase*

We present a case of fibroepithelioma in a 67 year-old male patient. He was admitted e,t Dey4. of Orthopedic Gurgery due to the trochanteric fracture of the femur. And he was eonsulted to our Department for evaluating the deformity of the left foot. Once he had worked as a miner, he have been suffered from multiple injuries of the left f t, The leeions beeame purulent discharge and crust. He found verrucous lesions at the site. On his visit, we found multiple dark brown verrucoua papules at dorsum of the left foot, d we psrformed the skin biopsy of the lesions. Histopathologic findinga showed a proliferation of long, brsnching and anastomosing skin of loid cells embedded within an edematous fibrous stroma.
Aged ; Biopsy ; Congenital Abnormalities ; Femur ; Foot ; Humans ; Male ; Multiple Trauma ; Orthopedics ; Skin

Thanatophoric dysplasia is the most common lethal congenital chondrodysplasia with characteristic features of narrow thorax, short rib, severe platyspondyly, short bowed limbs and skull deformity, etc. It is not a hereditary disorder and there is usually no family history of dysplasia. We experienced a case of thanatophoric dysplasia at 38 weeks of gestation with antenatal sonographic and abdominal radiographic findings of small thorax, short bowed extremities with surrounding thickened soft tissues and marked platyspondyly. Soon atter delivery, the baby died and post-mortem radiographs showed the characteristic findings of thanatophoric dysplasia.
Congenital Abnormalities ; Extremities ; Humans ; Pregnancy ; Ribs ; Skull ; Thanatophoric Dysplasia* ; Thorax ; Ultrasonography

OBJECTIVES: This study was conducted in order to understand the cellular events associated with silica-induced pathogenesis of the rat lung. METHODS: Silicosis was induced by an intratracheal instillation of 50 mg of silica (SiO2, 0.15 - 10 micrometer) suspended in 500 microliter of a sterile saline solution in Sprague-Dawley rats weighing 200g. Silicotic nodules were excised from the rat lungs 4 weeks after silica instillation, then boiled for 4 days at 110 degrees in solution containing 2% SDS, 10 M urea and 40 mM DTT. The insoluble cellular encapsulates were electrophoresed on 4-12 % gradient SDS-PAGE, and the amino acid composition was analyzed. Affinity chromatographies of the homogenate supernatants of the control lung, silicotic nodule, and normal rat plasma were performed using rabbit IgG, anti-rat, cross-linked protein from the silicotic nodule. The amounts of N epsilon-(gamma-glutamyl) lysine cross-linked in the control lungs and silicotic nodules were determined using HPLC analysis. RESULTS: The remaining cross-linked protein was insoluble in the 10 M urea and 40 mM sulfhydryl reagents even under prolonged boiling conditions. The encapsulate revealed the retention of silica particles within the protein whose amino acid composition showed a high percentage of alanine, leucine and glycine. A 46 KDa protein was identified as a cross-linked protein in the silicotic nodule by affinity chromatography. The level of N epsilon-(gamma-glutamyl) lysine dipeptide in the nodule digest was prominently increased compared with that in the control lung. CONCLUSIONS: Transglutaminase (TGase)-catalyzed cross-linking appears to be involved in the silicotic nodule formation, and the 46 KDa protein may be cross-linked to itself and other extracellular matrix proteins during fibrosis and the formation of eventually insoluble nodule.
Alanine ; Animals ; Chromatography ; Chromatography, Affinity ; Chromatography, High Pressure Liquid ; Electrophoresis, Polyacrylamide Gel ; Extracellular Matrix Proteins ; Fibrosis ; Glycine ; Immunoglobulin G ; Leucine ; Lung* ; Lysine ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Silicon Dioxide ; Silicosis ; Sodium Chloride ; Sulfhydryl Reagents ; Urea

OBJECTIVES: This study was performed to examine the immunohistochemical distribution of TGase 1, 2, 3, coagulation factor XIII and N epsilon-(gamma-glutamyl) lysine cross-link in the silicotic nodules formed after an intratracheal instillation of the silica. METHODS: The immunohistochemical examinations used antibodies against TGase 1, 2, 3, coagulation factor XIII and N epsilon-(gamma-glutamyl) lysine isopeptide in the silicotic nodules induced after an intratracheal instillation of 50 mg of size fractionated, crystalline silica. RESULTS: A high level of TGase 3 was related to the severity of fibrosis in silicotic nodules and extracellular coagulation factor XIII was detected around the nodules. Expressions of both membrane-bound TGase 1 and TGase 2 were barely detected in the nodules although high expressions were detected in the intact lung. Formation of N epsilon-(gamma-glutamyl) lysine cross-links was increased in severe fibrotic nodules. CONCLUSIONS: TGase 3 might contribute to the eventual stone-like fibrosis via formation of N epsilon-(gamma-glutamyl) lysine cross-links. Futhermore, coagulation factor XIII plays a role in the formation of a provisional matrix which results in fibrogenesis during silicotic nodule formation.
Antibodies ; Blood Coagulation Factors* ; Crystallins ; Factor XIII* ; Fibrosis ; Immunohistochemistry* ; Lung ; Lysine* ; Plasma* ; Silicon Dioxide

OBJECTIVES: In an attempt to identify the demographic characteristics and the factors influencing long-term hospitalization of chronically mentally-ill patients, a survey on the chronically mentally-ill patients who had been staying longer than 1 year in mental health facilities was conducted. METHODS: Checklist including some demographic data that were regarded as independent variables was applied to 3,477 subjects through administration system of Pusan Metropolitan City. Statistical analyse were done using distribution-free, non-parametric tests. RESULTS: 1)Subjects who had been staying longer than 1 year were 70.7% of the total inpatients of mental health facilities, and median duration of their hospitalization was 5.5 years. 2)In mental hospitals and asylums, the ratio of chronically mentally-ill subjects to the total inpatients in each facilitiy was 46.3% and 95.1%, respectively. 3)All of the 10 independent variables had an influence on the hospitalization duration. CONCLUSIONS: These results indicated that many indirect, extramedical factors had an influence the long-term hospitalization of chronically mentally-ill patients, and it is likely to reflect the underdevelopment of mental health services in Korea.
Busan ; Checklist ; Hospitalization ; Hospitals, Psychiatric ; Humans ; Inpatients ; Korea ; Mental Health Services ; Mental Health*

A membrane glycoprotein CD4 functions as a co-receptor of a T lymphocyte. The co-receptor function has been attributed to a protein tyrosine kinase, p56lck, which is activated upon CD4 binding to MHC molecule. In this study, we present evidences that one of the pathways through which CD4 transmits its signal is cytoskeleton association of p56lck tyrosine kinase as well as CD4 itself. Cytoskeletal association of both proteins is inhibited by a tyrosine kinase inhibitor, genistein, indicating that tyrosine protein kinase activation is important for cytoskeletal association of CD4 and p56lck. Cytoskeletal association of these proteins by CD4 cross-linking is not affected by inhibitors of protein kinase C nor PI3-kinase. Taken together, these results suggest that CD4 cross-linking activates a tyrosine kinase which then induces the simultaneous association of CD4 and p56lck with cytoskeleton.
Antigens, CD4/metabolism* ; Antigens, CD4/drug effects ; Cross-Linking Reagents ; Cytoskeleton/metabolism* ; Down-Regulation (Physiology) ; Enzyme Inhibitors/pharmacology ; Flow Cytometry ; Genistein/pharmacology ; Human ; Lymphocyte Specific Protein Tyrosine Kinase p56(lck)/metabolism* ; Lymphocyte Specific Protein Tyrosine Kinase p56(lck)/antagonists & inhibitors ; Phosphorylation/drug effects ; Protein Binding ; Tetradecanoylphorbol Acetate/pharmacology ; Tumor Cells, Cultured ; Tyrosine/metabolism

PURPOSE: To assess the efficacy of ancillary CT findings other than the obstructive lesion per se for the differential diagnosis of extrahepatic biliary obstruction. MATERIALS AND METHODS:CT findings of 49 patients with extrahepatic bile duct obstruction(22 benign and 27 malignant lesions) were assessed with emphasis on the patterns of ductal dilatation, contrast enhancement, and diffuse thickening of the extrahepatic ductal wall. Degree of central and peripheral intrahepratic ductal dilatation was graded by comparing with the adjacent portal radicles and hepatic parenchymal thickeness. RESULTS: Diffuse circumferential thickening and contrast enhancement of the extrahepatic ductal wall were more frequent in benign cases, but only thickening was statistically significant(p < 0.01). Peripheral intrahepatic ducts were more severely dilated by malignant causes(p < 0.01). With the same degrees of extrahepatic and central ductal dilatations, peripheral intrahepatic ducts were more severely dilated in malignant than in benign cases. CONCLUSION: These results may help to interpret the CT findings of extrahepatic biliary obstruction, particularly when the cause of biliary obstruction is uncertain.
Bile Ducts, Extrahepatic ; Diagnosis, Differential ; Dilatation* ; Humans

BACKGROUND/AIMS: This study sought to evaluate the diagnostic value of salivary gland ultrasonography in primary Sjogren's syndrome with anti-Ro/SS-A antibody. The secondary goal was to assess the relationship between the grade of parenchymal inhomogeneity and the anti-Ro/SS-A antibody titer or clinical manifestations. METHODS: The parotid and submandibular glands were examined ultrasonographically in 30 patients having primary Sjogren's syndrome with anti-Ro/SS-A antibody and 30 control subjects with no evidence of Sjogren's syndrome. The ultrasonographic definition of parenchymal inhomogeneity of the salivary glands was blurred glandular borders, multiple hyperechoic bands, and hypoechoic areas. The parenchymal inhomogeneity of the glands was categorized into four grades. RESULTS: Parenchymal inhomogeneity of the parotid gland was seen in 25 (83.3%) patients with primary Sjogren's syndrome and 2 (6.7%) control subjects. Of these cases, the submandibular gland showed parenchymal inhomogeneity in 24 (80%) patients with primary Sjogren's syndrome and 2 (6.7%) control subjects. The sensitivity and specificity of parenchymal inhomogeneity of the parotid gland were 83.3% and 93.3%, respectively, and 80% and 93.3% for the submandibular gland. The grade of ultrasonographic parenchymal inhomogeneity was related to a diagnosis of Sjogren's syndrome (p<0.001) and the time of dissolution of the wafer, but had no relationship with the anti-Ro/SS-A antibody titer. A high degree of interobserver agreement was found in the assessment of parenchymal abnormalities of the salivary gland (parotid gland: kappa=0.859; submandibular gland: kappa=0.837). CONCLUSIONS: Salivary gland ultrasonography is a useful method for visualizing glandular structural changes and making a diagnosis of primary Sjogren's syndrome.
Humans ; Parotid Gland ; Salivary Glands ; Sensitivity and Specificity ; Sjogren's Syndrome ; Submandibular Gland