Pemphigus is a rare, blistering autoimmune disease in which the action of antibodies is now well established. The most effective therapy is the administration of cortioseroids. Prior to the use of steroids, it was commonly fatal. Since the availability of corticosteroidsnortality has been markedly reduced. However prolonged administration of steroids may be difficult to sustain because of severe side effects. For these, other sdjuvant therapies were considered. Such as immunosuppresive drugs, gold, dapsone, plasmapheresis and intralesional injection of corticosteroid. Of these, immunosuppressive therapies are most commonly used. Recently cyclosporine which was for human organ transplantation is used in dermatology. Cyclosporine is a potent immunosupprc save agent with no appreciable effect on bone marrow and a selective inhibition to helper T cells. In our case, cyclosporine was administrated to the patient who had suffered from severe pemphigis vulgaris for 3 years without responding to treatment. We gave cyclosporine 400mg and prednisolon, 90mg per day. But we found a sudden increase of the RUN/Cr level and a shut down of the renal funtion. Therefore we discontinued cyclosporine and treated acute renal failure. However the renal damag e was irreversible and two days later the patient died.
Acute Kidney Injury* ; Antibodies ; Autoimmune Diseases ; Blister ; Bone Marrow ; Cyclosporine ; Dapsone ; Dermatology ; Humans ; Injections, Intralesional ; Organ Transplantation ; Pemphigus* ; Plasmapheresis ; Steroids ; T-Lymphocytes, Helper-Inducer ; Transplants

Authors experienced a 13-day-old boy who had suffered from walnut sized hard erythematous nodules on left axilla, anterior and posterior aspect of the neck which began to develop 9 days after birth. Histopathologic findings revealed subcutaneous fat necrosis and needle-shaped cleft in several fat cells. The skin lesions spontaneously resolved at 2 months of age. The clinical pattern, the skin manifestations, and the histologic appearance of the lesions were diagnostic of subcutaneous fat necrosis of newborn.
Adipocytes ; Axilla ; Humans ; Infant, Newborn* ; Juglans ; Male ; Neck ; Necrosis* ; Parturition ; Skin ; Skin Manifestations ; Subcutaneous Fat*

Syndromal acanthosis nigricans is associated with cellular resistance to the action of insulin and other endocrinopathies. In the insulin resistant state, increased insulin binds to the receptors of insulin-like growth factors (IGFs). IGFs are growth prompting peptides, which act as direct mitogens on cells containing the receptors. Through these actions, increased cellular growth and metabolism cause the skin lesions of acanthosis nigricans. Hyperandrogenism is also found in syndromal acanthosis nigricans patients. When associated with insulin resistance, these states are proportionally related. Increased insulin prompts the synthesis of androgen and conversely, increased androgen elevates the insulin resistance. We present three cases of syndromal acanthosis nigricans with hyperpigmented skin lesions and obesity. Laboratory findings demonstrated normal fasting blood suga levels with increased insulin and C-peptide levels and decreased insulin receptors. The oral glucose tolerance test was normal. We suggest that these patients were in an insulin resistant state. Skin biopsies from the axilla in all three cases showed hyperkeratosis, irregular acanthosis and upward projection of dermal papillae as finger like fashion. Thus all three cases represent syndromal acanthosis nigricans associated with an insulin resistant state based on clinical, histopathological, and laboratory findings. The three patients were treated with dietary control.
Acanthosis Nigricans* ; Axilla ; Biopsy ; C-Peptide ; Fasting ; Fingers ; Glucose Tolerance Test ; Humans ; Hyperandrogenism ; Insulin Resistance* ; Insulin* ; Metabolism ; Mitogens ; Obesity ; Peptides ; Receptor, Insulin ; Skin ; Somatomedins

The epidermis, which is composed mainly of keratinocyt;es, undergoes continual proliferation and differentiation, To study keratinocyte differentiation, it is necessary to separate the keratinocytes at their sucessive stages of maturation. We separate the keratinocytes by layers by using Percoll and obtain the relatively pure fractions of basal cells, spinous cells, and granular cells, 76. 8%, 67. 2%, 30%. respectively.
Epidermis ; Humans* ; Keratinocytes

We report a case of ureteral migration of a surgical clip after partial nephrectomy in which the clip was misdiagnosed as a ureteral stone. A 37-year-old woman had undergone laparoscopic partial nephrectomy of right renal cell carcinoma at another hospital 2 years previously. Postoperatively, she had gradually acquired lower urinary tract symptoms. Then, she complained of sudden right flank pain for a week. A plain X-ray and enhanced abdominopelvic computed tomography scan were performed. A 0.5 cmx1.0 cm right upper ureteral opacity with borderline hydronephrosis was seen but could not be found on the X-ray. Ureteroscopy revealed a medium-sized Hem-o-Lok clip on the right upper ureter that was removed with a stone basket. We concluded that a Hem-o-Lok clip used for collecting system sealing had migrated to the ureter and had been misdiagnosed as a ureteral stone on a computed tomography scan.
Carcinoma, Renal Cell ; Female ; Flank Pain ; Humans ; Hydronephrosis ; Lower Urinary Tract Symptoms ; Nephrectomy ; Surgical Instruments ; Ureter ; Ureteral Calculi ; Ureteroscopy

No abstract available.
Adenoma, Pleomorphic*

Paraganglioma is a benign tumor arising in the paraganglion system scattered throughout the body, but its cytopathologic findings arenot well known. We experienced a case of paraganglioma of carotid body diagnosed by fine needle aspiration. The patient was a 30 year-old female who suffered from the left neck mass for 3 years. The mass was 3x3crn in size without pulsation or bruit. Cytologically, the smear revealed aggregated and singly scattered tumor cells having abundant pale cytoplasm and indistinct cell borders. Their nuclei were round to oval, but enlarged nuclei were occasionally observed. The nuclear membrane was smooth with fine clumping of chromatin. Differentiation from metastatic follicular carcinoma of the thyroid gland was difficult.
Adult ; Biopsy, Fine-Needle ; Carotid Body ; Chromatin ; Cytoplasm ; Female ; Glomerulosclerosis, Focal Segmental* ; Humans ; Neck ; Nephrotic Syndrome* ; Nuclear Envelope ; Paraganglioma ; Thyroid Gland

Fox-Fordyce disease is a chronic pruritic papular eiruption, usually appearing in women and presenting a strict localization to the areas bearing apocrine sweat glands. More than 90g, of the cases were seen in women, the majority being in the age group of 13 to 35 years. The present report deals with unusual case of 14-year-old boy who developed Fox-Fordyce disease 6 years ago. To our knowledge, it is extremely rare case in Korea.
Adolescent ; Female ; Fox-Fordyce Disease* ; Humans ; Korea ; Male ; Sweat Glands

A clinical observation on the nephrectomized 114 patients in the department of Urology, Han Gang Sung Sim Hospital, during the period from January, 1972 to December, 1979 was presented with brief review of the literature. The result were as follows: 1. The total number of in-patients during above period was estimated to 1492. and nephrectomies were performed in the 114 of the 913 urologic operations. (12.4%) 2. The age distribution ranged from 1 year to 66 years with the most common age groups in the 4 th decades. (22.8%) 3. The ratio of male to female was 1.2 to 1. 4. Among the symptoms on admission, hematuria was in 82 cases (71.9%), flank pain in 74 cases (64.9%), and urinary frequency in 46 cases. (40.4%) 5. The causative diseases of the operated kidney showed the highest in renal tuberculosis (30.7%), renal tumor (18.4%), calculous disease (17.5%). renal injury (14.9%) and hydronephrosis (10.5%) by sequence. 6. Flank approach with 1 rib resection was the most frequently used in 52 of 114 cases. 7. Postoperative complications were seen with 3 cases of wound infection, 2 cases of wound dehiscence, 2 cases of atelectasis, 1 case of pneumonia, and 1 case of paralytic ileus. 8. 110 cases (96%) were discharged within 2 weeks after surgery.
Age Distribution ; Female ; Flank Pain ; Hematuria ; Humans ; Hydronephrosis ; Intestinal Pseudo-Obstruction ; Kidney ; Male ; Nephrectomy ; Pneumonia ; Postoperative Complications ; Pulmonary Atelectasis ; Ribs ; Tuberculosis ; Tuberculosis, Renal ; Urology ; Wound Infection ; Wounds and Injuries

Recently we experienced 10 cases of posterior urethral injury associated with pelvic fracture. Of these patients 5 underwent primary realignment with perineal traction on the prostate (Selikowitz method), and the other 5 underwent immediate cystostomy and delayed urethroplasty (Johanson method). Comparison of the post-operative complications didn`t appear to show significant differences in the 2 groups, although the numbers were small. But patients who performed immediate cystostomy and delayed urethroplasty showed some disadvantages of the long period of treatment, high charges, often multiple hard procedures and the long time of operation. Therefore in the initial management of posterior urethral injury, we think it better to take primary realignment in Korean socioeconomic circumstances, if the patient is not in the high risk.
Cystostomy ; Humans ; Prostate ; Traction