고정약진의 임상 및 병리조직학적 고찰

류지호 ( Ji Ho Ryou ),김진환 ( Jin Hwan Kim ),이무형 ( Mu Hyoung Lee ) 대한피부과학회 1998 대한피부과학회지 Vol.36 No.1

Background: Fixed drug eruptions(FDE) are a cutaneous reaction characterized by one or more circumscribed lesions that recur at the same site in response to a given medication. Objective: The purpose of this study was to find the clinical and histopathological characteristics of FDE and to compare early FDE with late FDE histopathologically. Method: We clinically investigated 54 cases of FDE that visited the department of dermatology at the Kyunghee medical center from January 1993 to December 1996. Among them, 31 patients had skin biopsies and were evaluated histopathologically on the basis of duration. Results .' The results were summarized as follows: 1. Development of FDE did not show any difference according to sex and was evenly distributed over all the ages. 2. The latent periods of FDE were diverse in appearance from 30 minutes to 10 days, but mostly, the skin lesions erupted within 4S hours. 3. The most common skin lesions were erythematous macules. 4. Distribution of the lesions came out as solitary : 20.4%, multiple : 79.6%. S3.7% of the multiple lesions were localized to a part of body, and 16.3% were distributed over the whole body. 5. The areas in which the eruptions developed were (in descending order): upper extremity(37.0%), hand(31.5%), trunk(24.1%), face(24.1%). 6. In most cases(68.6%), the size and the number of lesions were greater in recurrente, rather than in first attacks. 7. The histopathological findings commonly showed perivascular mononuclear cell(MNC) infiltration (100%), pigmentary incontinence(77.4%), basal hydrophic degeneration(71.0%), eosinophil infiltration in dermis(61.3%), etc. 8. The epidermal histopathological findings such as spongiosis, exocytosis of MNC, basal hydrophic degeneration, keratinocyte necrosis and subepidermal vesicles could be seen more frequently in early lesions than in late ones. Conclusion : In our study, we were able to obtain meaningful results based on data from the combination of clinical and histopathological investigations. This study may give help to understand the characteristics of fixed drug eruptions and to plan future studies. (Korean J Dermatol 1998;36(1): 30-36)

봉소염의 임상 및 병리조직학적 고찰

황선욱,박상만,박성욱,왕한영 인제대학교 2000 仁濟醫學 Vol.21 No.2

Objectives: Cellulitis is relatively common infectious disease of soft tissue. Recently, some authors claimed that cellulitis should be caused not by bacterial invasion and proliferation but by exaggerated host immune responses to pathogens. However, few studies have been done on the histopathological features, which represent these host immune responses, of cellulitis. Therefore the author evaluated clinical and histopathological features of cellulites and investigated relationships between clinical factors and histopathological features. Mateials and Methods: 25 cases of cellulitis in 23 patients were analyzed. The author surveyed medical record review and investigated patients' medical history, physical findings, bacterial culture findings and histopathological evaluation. Histopathological evaluation was performed based on Hematoxylin & Eosin stained samples. Special and immunohistochemical stains using Gram, neutrophil elastase, UCHL-1, L-26, lysozyme were also performed. Results: The results are as follows. 1. Clinical characteristics The male: female ratio of the patients were 1:1.2, and average age was 47.3 years. Male patients were distributed through all age groups. 76.9% of the female patients was over forties. Lower leg was the most common site of infection. All patients complained of erythema, pain, local heat sensation and tenderness. Fever was detected in 41.7% of cases. The most common source of infection was skin trauma caused by external stimuli, and systemic diseases such as diabetes mellitus and hypertension. On bacterial cultures using skin tissue or blood, only 4 cases found to have definitive organisms among 22 patients and all of them were identified as Staphylococcus aureus. 2. Histopathological characteristics Epidermal necrosis was found in 3 cases. Lymphocyte was the most common inflammatory cell and 96% of the specimens showed moderate to severe degree of infiltrates. In 60% of cases, infiltrates were confined mainly to dermal area. All the specimens showed variable range of vasculopathies but there were no relationship between the degree of vasculopathies and tissue edema. The inflammatory infiltrates showed variable features according to the duration of the disease. The biopsy specimens performed within 2 days after onset showed neutrophils(75%) as a predominant inflammatory cell. Also, specimens within 2-4 days showed neutrophil or mixed infix trace up to 75%. Lymphocyte(77.8% ) was the most commonly found inflammatory cell in the specimens 4 days after disease onset. Neither fever nor leukocytosis correlates with the nature of inflammatory infiltrates. Conclusion: This study revealed that the histopathological features of cellulitis consist of variable infiltrates of inflammatory cells, vasculopathies and edema. The most important influencing factor on this variety of histopathology was the duration of the disease. The early specimens usually showed infiltrates predominantly composed of neutrophils and the late ones showed lymphocytes. So when histopathological evaluations of cellulitis is performed, clinical duration should be considered. The histopathological findings of this study was not enough to find the specific characteristics to il-lustrate the pathogenesis of cellulitis. Further evaluations including many cellulites patients are needed to define the histopathological characteristics of cellulitis.

개 파보바이러스장염의 감염일령에 따른 병변의 병리조직학적 및 면역조직화학적 관찰

구자록,서일복,임창형,Ku, Ja-Iok,Seo, Il-bok,Lim, Chang-hyeong 대한수의학회 1994 大韓獸醫學會誌 Vol.34 No.3

Ninety seven cases of histopathologically diagnosed spontaneous canine parvovirus enteritis(CPE) were studied gross pathologically, histopathologically, immunohistochemically, to investigate histopathological types of small intestinal lesions, and antigen distributions in each pattern related to the infected age. And also, reliability of histopathological method in diagnosis of CPE was inspected with immunohistochemistry. The results were as follows : 1. Age-related occurring ratio in histopathologically diagnosed CPE was 53.6% in 4-8 weeks, 26.8% in 9-15 weeks, 8.25 in 16-19 weeks and 11.3% in 20-45 weeks of the clog age. 2. In histopathologic classification based on patterns of villi/crypts lesions of small intestine(jejunum), the ratio of A type (initial phase of necrosis of crypt epithelia, desquamated epithelial cells in the dilated lumen of the crypt) was 20.6%; the ratio of B type(middle phase of atrophy and fission of the villi, collapse of the mucosa, loss of normal crypt structure) was 62.9%, and C type(regenerative phase of the crypt architecture) was 16.5%. 3. The ratio of A, B, C type in 4-8 weeks old, respectively, was 23.5%, 61.5%, 15.4%; in 9-15 weeks old was 19.2%, 65.4%, 15.3% in 16-19 weeks old was 25.0%, 75.0%, 0.0%; and in 20-45 weeks old was 9.0%, 54.5%, 36.4%. 4. The antigen distribution in the nuclei of the crypt epithelial cells was higher than of the cytoplasm and numerous desquamated epithelial cells in dialated crypts in A type; The antigen cytoplasm and numerous desquamated epithelial cells in dialated crypts in A type; The antigen distribution in the nuclei of the collapsed crypt epithelial cells was not higher than that of the cytoplasm, crypts were lined by and filled with released viral antigens from the destructed epithelial cells in B type; and its distribution was also higher than in the epithelial cells adjacent to the tips of the villi, but it was not reacted in the regenerative crypt epithelial cells in C type. 5. Immunohistochemically detected antigen ratio in the small intestine of histopathologically diagnosed CPE was 94.6%, and this result indicates that histopathological diagnosis is very reliable method in diagnosis of CPE.

The relationship between the clinico-histologic subtypes of actinic keratosis and the efficacy of ablative fractional laser-assisted photodynamic therapy: a five year retrospective analysis

( Yeo-rye Cho ),( Jung-hwan Kim ),( Ho-jin Kim ),( Jeong-wan Seo ),( Ki-ho Kim ),( Ki-hoon Song ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2

Background: Actinic keratosis(AK) has various clinical and histopathological subtypes and it is needed to compare the efficacy of ablative fractional laser-assisted photodynamic therapy (AFL-PDT) in each subtypes for optimal treatment. Objectives: The aim of this study is to investigate the difference in the complete remission(CR) of the AFL-PDT according to the clinical and histopathological subtypes of AK. Methods: We evaluated the clinical and histopathological subtypes of AK in 133 patients who were treated by same protocol of AFL-PDT. Total 851 facial AK lesions were classified by clinical subtypes and 178 lesions that underwent biopsy were classified by histopathological subtypes. We assessed CR after a year of every lesions and investigate the relationship between clinical or histopathological and CR rate. Results: In clinical subtypes, erythematous type showed highest CR(91.3%) rate and cutaneous horn(56.2%) or hypertrophic type(72.5%) showed relatively lower CR rate. In histopathological subtypes, atrophic type(89.2%) showed highest CR rate and Bowenoid type(70.7%) showed lowest CR rate. Conclusion: The efficacy of AFL-PDT in the treatment of AK revealed to be different depending on the clinical and the histopathological types. The AK lesions of erythematous type in clinical subtypes and atrophic type in histopathologic subtypes showed higher CR rate. Therefore, it can be helpful to investigate the type of AK before AFL-PDT to predict treatment outcome and make treatment strategy.

Correlation of Habits and Clinical Findings with Histopathological Diagnosis in Oral Submucosal Fibrosis Patients

Ara, Syeda Arshiya,Arora, Vini,Zakaullah, Syed,Raheel, Syed Ahmed,Rampure, Prakash,Ashraf, Sajna Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.12

Background: Oral submucosal fibrosis (OSMF) is one of the most prevalent premalignant conditions in India which is easy to diagnose but difficult to manage. At present it is considered as irreversible and incurable. It has also been referred to as an epidemic in India. Aims and Objectives: To correlate the frequency and duration of habits with clinical staging, functional staging and histopathological grading and to correlate the clinical and functional staging with histopathological grading. Materials and Methods: The study included a total of 90 subjects, 80 with OSMF in the experimental group and 10 patients in the control group. Patient personal history was recorded with chewing habits, including frequency and duration of chewing. The site of keeping the quid, time duration and whether he/she swallows it or spits it were also noted. Clinical staging was done on the presence of palpable fibrous bands. Functional staging was accomplished by measuring mouth opening. Incisional biopsy was done for all the patients for histopathological examination. Histopathological grading was according to Pindborg and Sirsat. Results: The experimental group comprised 71 males and 9 females, the majority of which were in the age group of 21-30 years. Correlation of habits with clinical staging, functional staging and histopathological grading were significant (p<0.05). Clinical and functional staging did not correlate with histopathological grading, but the correlation of clinical and functional staging was highly significant (p<0.01). Conclusions: The widespread habit of chewing gutkha is a major risk factor for OSMF, especially in the younger age group. In this study, it was found that with increase in the duration and frequency of the habit the severity of the disease increased.

Helicobacter pylori에 의한 만성위염의 항균요법 후 위십이지장점막의 병리조직학적 변화

최명범(Myoung Bum Choi),김윤옥(Yoon Ok Kim),조윤경(Yoon Kyung Cho),신선경(Sun Kyeong Sin),김송자(Song Ja Kim),우향옥(Hyang Ok Woo),김미령(Mi Ryeung Kim),김승환(Seung Hwan Kim),윤희상(Hee Shang Youn),고경혁(Gyung Hyuck Ko),박철근(Cheo 대한소화기학회 1997 대한소화기학회지 Vol.29 No.1

N/A Background; We examined the histopathological changes of the gastroduodenal mucosa after chemotherapy against Helicobacter pylori to evaluate what happened to them, because most of patients with chronic gastritis who received the triple chemotberapy felt improvement of upper gastrointestinal symptoms in spite of its 45% clearance rate of Helicobacter pylori in our previous study. Methods; Gastric and duodenal mucosal biopsy specimens were obtained before and 2-4 weeks after the triple chemotherapy. Helicobacter pylori colonization was evaluated with urease test and histopatho]ogical examinations including hematoxy]in-eosin and Warthin-Starry silver staining. Histopathological grading of gastric and duodenal mucosa was done according to the Sydney Syste and Whitehead's criteria, respectively. Resu)ts; Decreasing pathological grades of Helicobacrer pylori density, gastric neutrophil infiltration and chronic inflammatory cell infiltration was observed in 100%, 100% and 57.6% of 26 Helicobacter pylori-cleared patients after chemotherapy, respectively. And we a]so observed the decreasing pathological grades of Helicobacter pylori density, gastric neutrophil infiltration and chronic inflammatory cell infiltration in 70.8%, 63.6% and 29.4% of 34 Helicobacter pylori-persisted patients after chemotherapy, respectively. The histopathological changes of neutrophil and chronic inflamrnatory cell infiltration after chemotherapy were correlated with the histopathological changes of Helicobacter pylori density. Chronic inflammatory cell infiltration of duodenal mucosa was decreased only in 8.6% of patients after chemotherapy. Conclusions; After chemotherapy, the histopathological grades of Helicobacter pylori density, neutrophil infiltration and chronic inflammatory cell infiltration of gastric mucosa were decreased in both Helicobacter pylori-cleared and persisted groups. (Korean J Gastroenterol 1997;29:41 - 52)

Helicobacter pylori에 의한 만성위염의 항균요법 후 위 십이지장점막의 병리조직학적 변화

최명범,김윤옥,조윤경,신선경,김송자,우향옥,김미령,김승한,윤희상 大韓消化器病學會 1997 大韓消化器病學會誌 Vol.29 No.1

흰쥐 좌골신경에 신경파괴제 주입 후 초래되는 하지 운동과 신경조직학적 변화

전재규(Jae Kyu Cheun),송선옥(Sun Ok Song),정성원(Sung Won Jung) 대한통증학회 2001 The Korean Journal of Pain Vol.14 No.1

N/A Background: This study was undertaken to observe the functional changes of the hind limb and histopathological changes in the sciatic nerve after an injection of alcohol or phenol, which are commonly used neurolytic agents, highlighting the time of recovery. Methods: Forty-eight Sprague-Dawley rats weighing 200-300g were used for the experiment. Histopathological changes under the electron microscope, were observed in the distal part of the sciatic nerve, into which O. 1 ml of alcohol or phenol was injected. This was severed in 3 rats of each group at 10 minutes, 1 hour, 24 hours, 3 days, 1, 2, 4 and 6 weeks later. The functional changes in the hind limbs were observed for 6 weeks by noting their walking pattern. Results: Following the injection of alcohol or phenol into the right sciatic nerve, the right hind limb showed a severe pronounced motor weakness and obvious gait changes. About 2 weeks later, gradual improvement of gait changes began, and after 6 weeks, the motor weakness and gait changes were no longer perceptible in both groups. The findings of any histopathological change were similar in both alcohol or phenol groups. At 10 minutes after injection, destructive lesions were confined to the immyelinated fibers and the myelin sheath of small the myelinated fibers. On the 3rd day and at 1 week, pathologic changes in axonal fibers and Schwann cells were in being phagocytized in spite of myelin restitution. From 2 to 4 weeks, axonal regeneration and remyelination appeared at the same time a myelin disintegration and axonolysis. At 6 weeks, neural regeneration was similar to that of the contralateral control group. Conclusions: These results suggest that functional and histopathological changes, after injection of neurolytics into the peripheral nerves, are quite similar in both alcohol and phenol groups. The progression of functional and histopathological changes become more obvious according to the time interval following the injection. Consequently, side effects that develop following the use of alcohol or phenol may begin to improve around the time that nerve regeneration occurs, i.e., two to four weeks later.

Surgical treatment of highly vascular intra-cranial meningioma and efficacy of pre-operative embolization : its clinical and histopathological findings

Lee, Sun-Il,Sim, Jae Hong 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

Introduction: Most meningiomas are begin and curable lesions. Therefore, the best of available treatment is complete surgical resection, Pre-operative embolization of highly vascular meningiomas should be an effcient technique for facilitating their surgical removal by decreasing blood loss, shortening surgical resection time and decreasing surgical complication and for the reducing tumor recurrence by producing necrosis at the site of dural attatchment although some controversy exists to the value of the embolization of convexity meningiomas. To evaluate the clinical efficacy and safety of pre-surgical devascularization of meningiomas, we reviewed the operative and histopathological findings which were subjected to pre-operative embolization. Materials and Methods: For the last 10 years, we have treated 245 meningiomas, of which 153 patients were operated by conventional microsurgical technique and 92 patients were treated by Gamma Knife radiosurgically. Among them, 35 meningiomas (12 men, 23 women) underwent superwent superselective embolization with 150∼250 microns PVA(polyvynil alcohol) particles. We compared the degree of surgical resectability between the group of patients in whom embolization was performed and the group not performed and analyzed the histopathological findings according to time interval after embolization to operation. Results: 25 cases(71%) were totally resected including dural attachment site without significant operative difficulties and intra-operative blood loss, post-operative complications. 8cases(23%) were subtotally resected. The histopathological findings included coagulative necrosis(54%), florid ischemic change, hyaline arteriosclerosis, many macrophage which contained PVA particles. However, vascular recanalization was not seen until 7 days after embolization. Conclusion: Pre-operative embolization of meningiomas should be done with the superselective technique whenever feasible and it is recommendableto operate within 7days after embolization significant operative difficulties and intra-operative blood loss, post-operative complications, 8cases(23%) were subtotally resected. The histopathological findings included coagulative necrosis(54%), florid ischemic change, hyaline arterioscleroses, many macrephage which contained PVA particles. However, vascular recanalization was not seen until 7 days after embolization. Conclusion: Pre-operative embolization of meningiomas should be done with the superselective technique whenever feasible and it is recommendableto operate within 7 days after embolization.

압박성 탈모증의 임상 및 횡단 절편 병리조직학적 연구

윤태영(Tae Young Yoon) 대한피부과학회 2001 대한피부과학회지 Vol.39 No.12

N/A Background:Pressure alopecia(PA), also referred to as postoperative pressure-induced alopecia, is seen most often after prolonged pressure on the scalp during general anesthesia, with the head fixed in one position. It may also occur in chronically ill persons after prolonged bed rest in one position, which causes persistent pressure on one part of the scalp. It probably arises due to pressure-induced ischemia. Although a few clinical studies of PA have been reported, extensive histopathological study of transverse section has not been performed. Objective:The purpose of this study was to investigate the clinical features and histopathological characteristics of transverse section in PA in order to find differential points from other alopecic diseases. Methods:Enrolled in this study was a total of 12 patients confirmed as PA at the Chungbuk National University Hospital from 1991 to 2001. The hospital charts and transverse sections of histopathological slides were reviewed. Results 1. The male and female ratio was 3:1. The mean age of the patients was 37.7 years. The mean ages of male and female patients were 34.7 and 46.7 years, respectively. 2. Most commonly involved sites were the parietooccipital area(8 cases). Temporoparietal area(4 cases) was followed. Signs and symptoms including pain, tenderness, erythema, swelling or numbness were present in seven cases. Five cases presented no signs or symptoms. The clinical appearance of alopecic patches varied mimicking alopecia areata or trichotillomania very closely. The mean operation time was 6.8 hours(from 2 to 11) and the mean postoperation onset time was 14.7 days(from 9 to 25). The hair regrowth was apparent 14.3 weeks in average(from 10 to 24) after operation. All cases were recovered within 6 months without any treatment. 3. Histopathological examination showed nearly all catagen stage of hair follicles, incontinent melanin pigment(12 cases), a perifollicular inflammatory infiltrate(3 cases including follicular infundibulum level in 2 cases and inferior segment level in 1 case), fat necrosis and a foamy macrophage infiltrate(5 cases), and vascular thrombosis(2 cases). (Korean J Dermatol 2001;39(12):1370~1376) Conclusion:The clinical appearance of PA varied mimicking alopecia areata or trichotillomania very closely. Histopathological findings could be similar to those of alopecia areata, but PA could be differentiated from alopecia areata by nearly all hair follicles in catagen stages, fat necrosis and a foamy macrophage infiltrate, vascular thrombosis, and the absence of a peribulbar lymphocytic infiltrate. The dermatologist should be aware of these characteristic findings of PA to avoid misdiagnosis and unnecessary additional treatments.