A Clinical and Histologic Study of Pityriasis Rosea during the Last 5-Year Period / 대한피부과학회지

BACKGROUND: Pityriasis rosea is an acute inflammatory dermatosis with an unproven etiology. The typical clinical feature consists of an initial, single herald patch followed by the development of smaller, disseminated, papulosquamous and ovoid macules. OBJECTIVE: The aim of this study was to evaluate the clinical manifestations of pityriasis rosea. METHODS: We examined a total of 101 patients with pityriasis rosea who visited the Department of Dermatology in Chung-Ang University Medical Center from March of 2005 to February of 2010. RESULTS: There were 1.53 times more women (61 patients) than men (40 patients) among the study subjects. The age of onset varied from 4 years to 71 years with a mean age of 28.7 years and 60% of the cases were 20 years to 39 years old. The percentage of seasonal variation was 34% in winter, 24% in summer, 22% in spring and 21% in autumn. A herald patch was found in 43% and the main predilection sites were the trunk and the thigh. Secondary eruptions could be classified into the macular type (67%), papular type (30%), urticarial type (2%) and purpuric type (1%). They appeared on the back, the chest, the abdomen, the upper arms, the thighs, the neck, the forearm, the lower legs, the face, the hands and the feet. The histopathological findings of all the types of lesions were focal parakeratosis, intraepidermal vesicles and papillary dermal edema. As compared to the macular type, hyperkeratosis, parakeratosis and exocytosis of lymphocytes were less commonly observed in the papular type. CONCLUSION: Most of the study results were compatible with those of other previous studies. However, the number of patients with papular type pityriasis rosea was currently increasing.

A Clinical and Histologic Study of Pityriasis Rosea during the Last 5-Year Period / 대한피부과학회지

BACKGROUND: Pityriasis rosea is an acute inflammatory dermatosis with an unproven etiology. The typical clinical feature consists of an initial, single herald patch followed by the development of smaller, disseminated, papulosquamous and ovoid macules. OBJECTIVE: The aim of this study was to evaluate the clinical manifestations of pityriasis rosea. METHODS: We examined a total of 101 patients with pityriasis rosea who visited the Department of Dermatology in Chung-Ang University Medical Center from March of 2005 to February of 2010. RESULTS: There were 1.53 times more women (61 patients) than men (40 patients) among the study subjects. The age of onset varied from 4 years to 71 years with a mean age of 28.7 years and 60% of the cases were 20 years to 39 years old. The percentage of seasonal variation was 34% in winter, 24% in summer, 22% in spring and 21% in autumn. A herald patch was found in 43% and the main predilection sites were the trunk and the thigh. Secondary eruptions could be classified into the macular type (67%), papular type (30%), urticarial type (2%) and purpuric type (1%). They appeared on the back, the chest, the abdomen, the upper arms, the thighs, the neck, the forearm, the lower legs, the face, the hands and the feet. The histopathological findings of all the types of lesions were focal parakeratosis, intraepidermal vesicles and papillary dermal edema. As compared to the macular type, hyperkeratosis, parakeratosis and exocytosis of lymphocytes were less commonly observed in the papular type. CONCLUSION: Most of the study results were compatible with those of other previous studies. However, the number of patients with papular type pityriasis rosea was currently increasing.

A Histopathologic Study of the Pseudomembranes harvested during Revision Total Hip Arthroplasty / 대한정형외과학회잡지

PURPOSE: To analyze the results of the foreign body reaction to polyethylene, polymethylmethacrylate, and metal debris and effect on bone by comparing histopathologic finding of pseudomembrane (interface membrane) which was obtained from failed cemented or cementless THA by aseptic loosening. MATERIALS AND METHODS: Of total 50 cases, we analyzed results between 25 cases of cemented THA and 25 cases of cementless THA. Follow-up period between primary and revision THA was average 8 years 5 months. Tissue specimens were harvested, stained with Hematoxylin-Eosin, and examined by light microscope. Histologic study of various items was done. RESULTS: The fibrous membrane between bone-to-cement or bone-to-metal could be roughly divided into three distinct histological layers in cross section histopathology. These tissues were characterized by histiocytes, infiltration of foreign body giant cells and fibrosis in all specimens, and infiltration of lymphocytes and plasma cells was relatively rare, and aggregation of polymorphonuclear leukocytes was invisible. CONCLUSION: Although there were no significant differences in histologic findings between the regions of ten tissue specimens, there was significant difference between the degree of polyethylene or cement debris in numbers and the degree of foreign body reaction associated with increased infiltrations of giant cells, and foreign body reaction to polyethylene debris seems to be main cause of aseptic loosening of prosthesis.

Histologic Findings of Anterior Cruciate Ligament Reconstructed with Bone - Patella tendon - Bone Allograft - Prospective Study / 대한정형외과학회잡지

A variety of substitutes and numerous operative procedures have been described to stabilize the anterior cruciate ligament(ACL) deficient knee. OBJECTIVES: The purpose of this study has been to evaluated the remodelling process of bone-patef- lar tendon-bone(B-PTB) allograft(Tutoplast(r)) for ACL reconstruction by means of light microscopic(LM) and electron microscopic(EM) examinations from the biopsy specimens obtained at the time of second-look arthroscopy. The authors also have been grossly observed the width, vascularity, elasticity and stability of B-PTB allograft. MATERIALS AND METHODS: ACL reconstruction using B-PTB allograft was performed on 22 consecutive patients. Among them, 12 patients were reviewed and the average age at time of operation was 22.5 years ranging from 21 to 40 years. The second look arthroscopy was performed at 6 months, 12 months, 24 months in each of the 4 cases. The gross findings of allograft were observed, and biopsy was done by the method of Millonig. Results; The arthroscopic findings of the reconstructed ACL were partially covered with synovium and narrowed in diameter at 6 months follow up. At 12 months follow up after reconstruction, that grafted ligaments were covered with more synovial membrane, and observed the more thickness with normal strength similar to normal anterior cruciate ligament configuration. At 24 months, grafted ligaments were grossly similar to normal ACL. The LM findings demonstrated many fibroblasts with spindle shape nuclei and and hypercellularity at 6 months. At the 12 months, crimp pattern of collagen bundles and decreased hypercellularity observed. At 24 months, grafted ligament were similar to nomal ACL. The EM findings that fibroblasts were showed abundant cytoplasm which contained marked dilated rough endoplasmic reticulum(r-ER) and aggregates of microfilaments at 6 months. At 12 months, fibroblasts with folded nuclei and abundant cytoplasm were observed. At 24 months, demonstrated the fibroblasts with abundant cytoplasm and densely packed collagen fibrils. Collagen fibrils displayed parallel arrangement and characteristic cross striation with a periodicity. Scanning EM findings showed uniformly small diameter of collagen in the transeverse section. CONCLUSIONS: Gross & LM findings of B-PTB allograft were similar to that of normal ACL at 6 months, and at 12 months, postoperatively. But EM findings of B-PTB allograft were compared with the biopsy samples of normal ACLs, the allograft was still undergoing maturation 24 months postoperati vely.

Ileocolonoscopic and Histologic Studies in Ankylosing Spondylitis / 대한류마티스학회지

OBJECTIVE: To investigate the frequency of gut inflammation in the ankylosing spondylitis and the role of gut lesion in the pathogenesis of the ankylosing spondylitis. METHODS: Ileocolonoscopy and biopsy were performed in 24 patients with. ankylosing spondylitis. RESULTS: 1) Endoscopic lesions were observed in 7 patients(29.2%) of 24 patients and more often in the terminal ileum(6/7) than in the colon(I/7). Among 7 patients with endoscopic lesions, 5 patients were presented as juvenile chronic arthritis. 2) Histologic signs of gut inflammation were detected in 14 patients(58. 3%). Actue lesions were seen in 2 patients (8. 3%) and chronic lesions were seen in 12 patients (50%). 3) In 12 patients without the involvement of peripheral joints, acute lesion was not seen(0%), and chronic lesions were seen in 6 patients(50%). In 12 patients with the involvement of peripheral joints, acute lesions were seen in 2 patients (16.7%), and chronic lesions were seen in 6 patients(50%). Gut inflammations were more frequent in patients with the involvement of peripheral joints than in those without the involvement of peripheral joints. 4) In 12 patients without the administration of sulfasalazine, acute lesion was not seen(0%), and chronic lesions were seen in 7 patients(58.7%) In 12 patients with the administration of sulfasalazine, acute lesions were seen in 2 patients (16.7%), and chronic lesions were seen in 5 patients(41.6%). The frequency of gut lesions in patients without the administration of sulfasalazine was not different from that in patients with the administration. of sulfasalazine (p<0.05). CONCLUSION: Gut inflammation was frequently found in patients with ankylosing spondylitis. Chronic gut inflammation could play a role in the pathogenesis of the ankylosing spondylitis.