T Cell's Sense of Self: a Role of Self-Recognition in Shaping Functional Competence of Naïve T Cells

Post-thymic naïve T cells constitute a key cellular arm of adaptive immunity, with a well-known characteristic of the specificity and robustness of responses to cognate foreign antigens which is presented as a form of antigen-derived peptides bound to major histocompatibility complex (MHC) molecules by antigen-presenting cells (APCs). In a steady state, however, these cells are resting, quiescent in their activity, but must keep full ranges of functional integrity to mount rapid and robust immunity to cope with various infectious pathogens at any time and space. Such unique property of resting naïve T cells is not acquired in a default manner but rather requires an active mechanism. Although our understanding of exactly how this process occurs and what factors are involved remains incomplete, a particular role of self-recognition by T cells has grown greatly in recent years. In this brief review, we discuss recent data on how the interaction of T cells with self-peptide MHC ligands regulates their functional responsiveness and propose that variable strength of self-reactivity imposes distinctly different levels of functional competence and heterogeneity.

A Case of Simultaneous Presentation of Closed and Open Type of Congenital Cholesteatoma / 대한이비인후과학회지

Congenital cholesteatoma of the middle ear classically presents as a white retrotympanic middle ear mass. In spite of many theories on congenital cholesteatoma, its pathogenesis is still unclear. There are two distinct pathologic types of congenital cholesteatoma, closed and open type. The closed cystic form can be easily removed, but the open type has a tendency to make strong contact with the middle ear mucosa and to infiltrate into the surrounding structures. We report a rare case which presented both open and closed types of congenital cholesteatoma.

A Case of Fungal Nasal Septal Abscess in the Immunocompromised Patient / 대한이비인후과학회지

Nasal septal abscess is the result of trauma to the nose with septal hematoma and subsequent infection. Proper management of a nasal septal abscess requires prompt diagnosis, adequate surgical drainage, and antibiotics to prevent the potentially dangerous spread of infection and the development of severe functional and cosmetic sequelae. In the immunocompromised patient, nasal septal abscess can occur without trauma and can rapidly progress to a state of life threatening complication. We had experienced a case of fungal nasal septal abscess without antecedent trauma in immunocompromised kidney transplantation patient. Through prompt incision and drainage and appropriate antifungal agent, the infection was resolved without complication. In the immunocompromised patients, it is important to recognize the potential for the immunocompromised condition to influence the development of septal abscess and the alternate pathogens like fungus.

The Effect of Single Estrogen and Continuous Combined Estrogen + Progestin on Lipid Profile and Bone Mineral Density in Premenopausal Hysterectomised and Natural Menopausal Women / 대한산부인과학회잡지

No abstract available.

A Case of Metastatic Choriocarcinoma with Uterine Perforation following Term Pregnancy / 대한부인종양콜포스코피학회잡지

Gestational trophoblastic tumor is one of the curable disease, but metastatic trophoblastic tumor still shows high mortality rate because of resistance to the chemotherapy. Choriocarcinoma may occur after an any type of human pregnancy. The incidence of choriocarcinoma following term pregnancy is very uncommon, and such tumor appears to follow a more aggressive course with more extensive metastatic spread and is less responsive to chemotherapy resulting in a poorer prognosis. Choriocarcinoma presenting as postpartum hemorrhage, and spontaneous tumor perforation with intra-abdominal hemorrhage is even rarer, requiring emergency laparotomy. We had experienced one case of metastatic choriocarcinoma following term pregnancy that required emergency total abdominal hysterectomy due to uterine perforation and hemorrhage. So, we report this case with brief review of literatures.

A Case of Pseudomyxoma Peritonei with Primary Borderline Mucinous Tumors of the Ovary and Appendix / 대한산부인과학회잡지

Pseudomyxoma peritonei is a poorly understood condition characterized by mucinous ascites and multifocal peritoneal mucinous tumors. Pseudomyxoma peritonei is most commonly associated with mucinous tumors of the ovary and appendix. When two lesions are morphologically similar, it is difficult to determine whether one reflects a metastasis or whether the tumors are independent. Many studies concluded that most cases in which both the appendix and ovary were involved were primary appendiceal tumor with secondary involvement of the ovary, but we have experienced one case of pseudomyxoma peritonei originated from independent primary borderline mucinous tumors of the ovary and appendix. So we report this case with the brief review of literatures

A Case of Alopecia Neoplastica Metastasis from Breast Carcinoma / 대한피부과학회지

Breast cancer is a common cancer in women and the most common primary tumor metastatic to the skin. Cutaneous metastasis from breast cancer occurs predominently through lymphatic dissemination. Alopecia neoplastica is rare and probably caused by the hematogenous spread of the internal carcinoma. It has diagnostic importance because it may be the first sign of an undiscovered internal malignancy. We report a case of a 40-year-old female who showed alopecia neoplastia secondary to an invasive intraductal carcinoma of the breast.

Occupational Dermatoses in Metalworking Fluid Exposed Workers . ( II ) Allergic Contact Dermatitis / 대한피부과학회지

BACKGROUND: Skin contact with metalworking fluid(MWF) remains a frequent cause of occupational dermatitis. However, no precise data is available about sensitization in metalworkers exposed to MWF in Korea. OBJECTIVES: The purpose of this study was to evaluate the prevalence of contact sensitivity among metalwokers who handle MWFs and to investigate the suitability of a screening test with MWFs being actually used in metalworkers. METHODS: An epidemiological study was performed using a'questionnaire in 771 workers in 9 derpartments of a motor company. 278 out of 771 workers had actual contact with MWF. Patch tests were performed in 73 metalworkers who had suspected dermatits in relation to exposure of MWF, which was selected via interviews and dermatologic examinations. Patch tests were included with a routine series of common components of MWF(materials obtained from Chemotechnique, Sweden), a solvent series and several dilutions of various crude MWFs(8 species) RESULTS: Contact sensitization was established in 14 metalworkers(5% of 278). Sensitising substances were biocide(6 cases), corrosion inhibitors(2 cases), emulsifiers(2 cases), biostatic substances(1 cses) and others(4 cases). Therefore 10 out of 14 metalworkers had true occupational allergic contact dermatitis. 10 out of 73 screening patch tests showed positive reactions to MWF elements, and 9 people who were positive to MWF elements showed positive reactions to crude MWF, but 1 person did not. CONCLUSION: The prevalence of occupational allergic contact dermatitis(3.5% of 278) was low. The screening patch test by crude MWFs actually used in metalworkers may give false negatives. Therefore for the purpose of diagnosis of allergic contact dermatitis, we need a process of patch tests with MWF elements.

A Case of Type IIa Hyperlipoproteinemia with Xanthoma Planum , Xanthoma Tendinosum and Xanthoma Tuberosum / 대한피부과학회지

We report a case of a 59 year-old female with hyperlipoproteinernia who had xanthoma tuberosum, xanthoma tendinosurn and xanthoma planum. Yellowish nodules appeared on the right elbow 26 years ago and the lesions gradually increased in size and spread to the elbow, hand, knee, foot and achilles tendon. Except for the skin lesion, she was normal on physical examination. The laboratory findings showed that the serum cholesterol, beta lipoprotein and total lipid were increased. The beta band was rnarkedly elevated on electrophoresis, which suggested type IIa hyperlipoproteinemia. Histopathological findings shc wed many aggregates of foam cells and foreign body giant cells were seen in the dermis.

A Study on the Effect of Symptoms to Diagnosis Interval on the Cancer Survival / 한국역학회지

For many years, members of medical profession have believed that the shorter symptoms to diagnosis interval(SDI) might be related to early stages and that the prompt treatments might improve survival rates in cancer patients. But this notion has been challenged by many researches for many years. This study was conducted to investigate the effects of SDI on the cancer survival for 221 stomach cancer cases, 106 lung cancer cases, 74 liver cancer cases and 59 cervix cancer cases. These cancer cases are registered ones in Kanghwa Cancer Registery Program from 1987 to 1991. Relationships among SDI, stages of cancers, operation rates, and survival were analysed. Results are as follows: 1. SDI was not related to stages of cancer. There were no difference in the distribution of stages among five SDI subgroups. 2. This data did not support that SDI affects the survival of stomach cancer patients. The cancer stages did affect survival in stomach cancer patients though. 3. Our data did not support that SDI affects cancer survival. A Cox proportional hazard model showed that SDI does not play a important role in cancer survival controlling age, gender, stage and other variables in the model. Further studies are highly expected to clarify the relationships between SDI and cancer survivals. Researches with bigger sample size and more sophisticated variables would be needed.

A Study of Occupational Dermatoses in metal Workers / 대한피부과학회지

No abstract available.

A study on dermatologic diseases of workers exposed to cutting oil / 예방의학회지

We investigated the 1,004 workers who worked in a automobile factory to study the epidemiologic characterist of dermatoses due to cutting oils. Among the workers, 667(66.4%) answered the questionnaire. They are belong to 5 departments of the factory-the Engine-Work(86), Power train Assembly(17). We measured the oil mist concentration in air of the departments and examined the workers who had dermatologic symptoms. The results were follows; 1) Oil mist concentration; Of all measured points(52), 9 points(17.2%) exceeded 5mg/m3-the time-weighed PEL- and one department had a upper confidence limit(95%) higher than 5mg/m3. 2) Dermatologists examined 213 workers. 172 of them complained any skin symptoms at that time-itching(32.5%), papule(21.6%), scale(15.7%), vesicle(12.5%) in order. The abnormal skin site found by dermatologist were palm(29.3%), finger & nail(24.6%), forearm(16.2%), back of hand(8.4%) in order. 3) As the result of physical examination, we found that 160 workers had skin diseases. Contact dermatitis was the most common; 69 workers had contact dermatitis alone(43.1%), 11 had contact dermatitis with acne(6.9%), 10 had contact dermatitis with folliculitis(6.3%), 1 had contact dermatitis with acne & folliculitis, and 1 had contact dermatitis with abnormal pigmentation. Others were folliculitis(9 workers, 5.6%), acne(8, 5.0%), folliculitis & acne(2, 1.2%), keratosis(1, 0.6%), abnormal pigmentation(1, 0.6%), and non-specific hand eczema(47, 29.3%). 4) The prevalence of any skin diseases was 34.0 per 100 in cutting oil users, and 13.3 per 100 in non-users. Especially, the prevalence of contact dermatitis was 23.0 per 100 in cutting oil users and 4.3 per 100 in non-users. 5) We tried patch test(standard series, oil series, organic solvents) on 49 patients to differentiate allergic contact dermatitis from irritant contact dermatitis and found 20 were positive. 6) In a multivariate analysis(independent=age, tenure, kinds of cutting oil), the risk of skin diseases was higher in the water-based cutting oil user and both oil user than non-user or neat oil user(odds ratio were 2.16 and 2.78, respectively). And the risk of contact dermatitis was much higher at the same groups(odds ratio were 5.16 and 6.82, respectively).

A Case of Darier' s Disease Treated by the Combined Treatment with Oral Etretinate and Topical Tretinoin Cream / 대한피부과학회지

We report a case of Dariers disease which showed a more effective result using a combined treatment with oral etretinate and topical tretinoin cream than treatment with oral etretinate alone in a 17-year old male patient. Oral etretinate 40mg was given daily and topical therapy with tretinoin cream was applied to lesions of neck and face. Two weeks later, lesions of neck and face showed good improvement compared with the not applied lesions. Topical therapy was then extended to other lesions. Six weeks after treatment, there was a marked improvement. Three months after treatment, most of lesions were nearly gon.

A Case of Papillary Adenoma of the Nipple Showing Histopathologic Findings of Syringocystadenoma Papilliferum / 대한피부과학회지

A 24-year-old woman was seen for evaluation of an skin lesion on thiright nipple. Examination revealed a solitary 1.5 x 1cm-sized, erythematous, oozing, eroded andruted, verrucous nodule on the right nipple. A small amount of serous discharge was found but there was no pain or tenderness. Histopathologic findings showed cystic invaginations extending down vard from the epidermis and papillary projections extending into the lumina of the invagination. Pupiae were lined by two rows of cells. In stroma, there were marked inflammatory infiltrates containing any plasma cells. The overlying dermis showed an adenomatous growth pattern with a prolifertion of round, oval or irregular shaped ducts and fibrotic stroma.

A Case of Syphilid Simulating Purpura Annylaris Telangiectodes / 대한피부과학회지

The skin manifestations of secondary syphilis, termed syphilid, show macular, papular and papulosquamous rashes in most cases, but may show lots of other clinical findings. We report a case of syphitid simulating purpura annulsris telangieitodes in 25-year-old male who had a history of genital ulcer 2 months ago. The skin lesion showed diffuse erythematous, 1-3 cm sized, telangiectatic annular patchea and purpuric plaques on both lower extremities and discrete papulosquamous rashes on both soles. The results of the serologic test for syphili was found to be reactive to 32 dilution in serum VDRL test and positive in serum TPHA test. Histovathologically, we could observe the obscuring of dermoepidermal juction, coat-sleeve-like perivascular infiltrate composed of mononuclear cells and a few plasma cells, and endothelial swellings. Afte the treatment with benzathine penicillin G, the titer of serurn VDRL test was decreased abruptly to 4 dilution and the skin lesions disappeared completely.

A Case of Systemic Candidiasis with Skin Manifestations Simulating Varicella

No abstract available.

A case of Bart's syndrome / 대한피부과학회지

Barts syndrome was desrribed by Bart(Bart et al, 1966) with hereditary congenital localized absence of skin from the lovrer legs associated with blistering of the sun and mouth and nail abnormalities. A newborn girl presented with a congenital localized absence of skn over both shins & dorsa of both feet which were covered with the thin, translucent, brown red glistening membranes. A number of blisters were seen on the back, thighs upper extremities, and both 2rd toe nails were absent. Electron microscopic examination of defected skin revealed dermo-epidermal . paration with focal disruption of basal lamina.

A histopathologic study of syphilid / 대한피부과학회지

BACKGROUND: The differentiation of syphilids from other skin decreases is frequently difficult due to considerable variations of clinical and histologic pattern. The most common histologic changes in secondary syphilis are swelling & proliferation of endothelial cells and the presence of a perivascular infiltrate containing plasmia cells. But often, these findings are absert or inconspicuous. OBJECTIVE: We examined the histopathologic findings of secondary syphilis in relation to the clinical types of the skin lesion. MEHTODS: 36 biopsy specimens from twenty-nine serologically and clinically confirmed cases of secondary syphilis (15 macules, 8 papules, 2 condylomata latas and 11 papulosquamous lesions) were examined. RESULTS: The histopath,ologic findings of secondary syphilis showed comparative differences according to the clinical types of the skin lesion. The plasms cell infltrates were absent or sparse in 14 csses(39%) and the plasma cell infiltration was significantly correhted with the age of skin lesions(p=0.02197). Vascular changes were seen in 32 cases (89%), but the incidence of endothelial proliferation was less(25%). CONCLUSION: This study demonstrates the histopathologic findirigs of secondary syphilis in accordance to the clinical morphology of the eruption and thus, help to differentiate syphilids from other skin diseases.