No abstract avaiable.
Glucose* ; Homeostasis*

1. A Case of osteosarcoma is reported which arose 8 years after synovima of the knee had been locally excised. The patient is a 51-year-old housewife who had received irradiation therapy upon her knee for 30 days post-operatively. Following irradiation, asymptomatic latent period lasted 8 years when mass appeared on the site, which was biopsied and diagnosed as osteosarcoma one year later. 2. This case generally suffices the McKennas criterias for irradiation-induced osteosarcoma, 3. It seems to be worthwhile to keep an eye upon the prognosis of this possible case of irradiation- induced osteosarcoma, which is largely reported to be very grave.
Humans ; Knee ; Middle Aged ; Osteosarcoma ; Prognosis ; Sarcoma, Synovial

Monocular gaze palsies which result from a supranuclear cerebral lesion are rare clinical manifestations. The prefrontal cortico-oculomotor pathways travel across the thalamus and mesodiencephalic junction terminating directly in oculomotor complexes. These pathways exist bilaterally and the contralateral oculomotor bundle exerts an inhibitory influence upon the oculomotor neurons, particularly those related to the medial rectus muscle. The acute disinhibition of these neurons by a posterior thalamic lesion results in a sustained but transient discharge of the medial rectus and tonic activation. Impairment of monocular projections in the contralateral posterior thalamus could result in a tonic activation of the medial rectus, analogous to the conjugate gaze deviation observed with a frontal lobe lesion. We describe two patients with an acute onset of esotropia and contralateral supranuclear lesions - thalamic hemorrhages.
Esotropia* ; Frontal Lobe ; Hemorrhage* ; Humans ; Intracranial Hemorrhages ; Neurons ; Paralysis ; Thalamus

BACKGROUND: Psoriasis is characterized by chronic recurrent erythematous skin plaques that exhibit epidermal hyperplasia, inflammatory cell accumulation and abnormalities of the papillary dermal vasculature. Psoriatic skin lesions show enlargement and increased tortuosity of cutaneous microvessels without formation of new vessel sprouts, that is, inflammatory angiogenesis. Placental growth factor (PlGF) and Tie-2 were reported to be up-regulated during inflammatory angiogenesis. Tazarotene is the first receptor-selective retinoid and its effects include normalizing keratinocyte differentiation, reducing keratinocyte proliferation and reducing inflammation. OBJECTIVE: Our study evaluated the clinical efficacy of topical tazarotene treatment and clarified histological changes and possible action mechanisms of this agent in respect of inflammatory angiogenesis. METHODS: We selected patients with symmetric psoriatic lesions and applied 0.1% tazarotene gel (Tazorac(R)) versus calcitriol 3 microgram/g gel (Silkis(R)) twice a day for 12 weeks with a right-left comparison. We grouped the patients with treatment modalities. Clinical efficacy, which was measured by the overall lesional assessment (OLA) scores, was assessed at each visit in 2 week' intervals until treatment closed. Skin biopsies were performed before the treatment started and again at 4 weeks and 12 weeks after treatment. Immunohistochemistry of PlGF, Tie-2 and factor-VIII was performed to elucidate the anti-angiogenetic effect of tazarotene. RESULTS: At the completion of 12 weeks of treatment, the OLA score of tazarotene-treated lesions was more reduced than that of calcitriol-treated lesions combined with phototherapy, it was more effective. Several histologic features such as epidermal hyperplasia, inflammatory cell infiltration and vessel dilation/tortousity were improved with decreased PlGF and Tie-2 expressions. CONCLUSION: These results indicate that tazarotene is an effective topical agent for psoriasis by blocking inflammatory angiogenesis.
Biopsy ; Calcitriol ; Humans ; Hyperplasia ; Immunohistochemistry ; Inflammation ; Keratinocytes ; Microvessels ; Phototherapy ; Psoriasis* ; Skin

No abstract available.
Ductus Arteriosus, Patent* ; Endarteritis*

A spontaneous dissecting Aneurysm of the posterior inferior cerebellar artery(PICA) is a very rare cause of subarachnoid hemorrhage(SAH) or ischemic stroke. We report a 53-year-old male patient with left PICA territory infarction due to the spontaneous dissection of the PICA. A Brain MRI revealed an infarction of the left PICA territory and an angiography showed spindle-shaped dilatations of the left PICA followed by an irregular luminal narrowing. An angiography taken 3 months later showed spontaneous resolution of the left PICA dissecting aneurysm. The management of the intracranial dissecting aneurysm is still controversial. Some authors recommend surgical approaches for the prevention of SAH while others present medical management. Our case showed spontaneous regression of the PICA dissecting aneurysm.
Aneurysm, Dissecting* ; Angiography ; Arteries* ; Brain ; Dilatation ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Phenobarbital ; Pica ; Stroke

Lichen planus is a chronic papulosquamous disease chracterized by various clinical manifestations of the skin and mucous membrane. Although its etiology is not fully understood, lichen planus has been associated with viral infection, autoimmune disease, psychologic factors, and medications. Both antigen-specific and non-specific mechanisms may be involved in the pathogenesis of lichen planus. The former includes antigen presentation by basal keratinocytes and antigen-specific keratinocyte killing by CD8+ cytotoxic T cells, the latter includes mast cell degranulation and matrix metalloproteinase activation. A large variety of topical and systemic therapies are available for the treatment of lichen planus. Also, topical pimecrolimus (Elidel(R) 0.1% cream) may be used because of its inhibitory effect on activated T cells and mast cell degranulation. Recently, it has been shown to be effective in the treatment of oral and genital lichen planus. But, its effect in cutaneous lichen planus has not been reported to date. We report on the successful use of topical pimecrolimus in the management of a generalized lichen planus patient.
Antigen Presentation ; Autoimmune Diseases ; Homicide ; Humans ; Keratinocytes ; Lichen Planus* ; Lichens* ; Mast Cells ; Mucous Membrane ; Skin ; T-Lymphocytes

Pigmented neurofibroma is a rare cutaneous tumor accounting for less than 1% of all neurofibroma. It is characterized histologically by the coexistence of scattered melanin-laden cells and benign spindle cells with neural differentiation. The origin of these tumors are unknown, and they show a storifom pattern. In our case, the patient had giant cafe au lait patches on the left trunk which had been present since birth, freckles on both axilla, and two dark-red colored plaques which had appeared 2 years ago. Histologic examination revealed pigmented neurofibromas showing the melanin-laden, pigmented cells within the upper dermis and plexiform neurofibromas in the subcutaneous tissue. We describe a case of pigmented neurofbroma in a 13-year-old male patient.
Adolescent ; Axilla ; Dermis ; Humans ; Male ; Melanosis ; Neurofibroma* ; Neurofibroma, Plexiform ; Parturition ; Subcutaneous Tissue

Aortoesophageal fistula is an uncommon and fatal complication after surgery of aortic aneurysm. A case of aortoesophageal fistula as a complication of synthetis patch aortoplasty for mycotic aneurysm of descending thoracic aorta is described. After 3 months since patch aortoplasty for mycotic aneurysm of descending thoracic aorta this patient visited the emergency room due to melena and hematemesis. After gastrofiberoscopy and computed tomography the patient was taken ot the operating room. The surgical intervention was performed in two steps. Median sternotomy and midline laparotomy were made. Hemashield's Dacron(16mm) bypass between ascending thoracic aorta and infra-renal abdominal aorta was established first. Through the posterolateral thoracotomy false aneurysm and previous Hemashield's Dacron patch of descending aorta were resected. The two ends of the aorta were sutured and esophageal fistula was repaired. The esophageal suture line and the stumps were covered with omental graft. Thirty months later the patient has had no difficulty referable to the aortic surgery.
Aneurysm, False ; Aneurysm, Infected* ; Aorta ; Aorta, Abdominal ; Aorta, Thoracic* ; Aortic Aneurysm ; Emergency Service, Hospital ; Esophageal Fistula ; Fistula* ; Hematemesis ; Humans ; Laparotomy ; Melena ; Operating Rooms ; Polyethylene Terephthalates ; Sternotomy ; Sutures ; Thoracotomy ; Transplants

Calvus, callus, plantar warts and piezogenic papules are well known to cause discomfort and disturbance of gait in ordinary physical and sports activities. Furthermore, calcifying aponeurotic fibroma, whose mass slowly grows on the palms and soles of children and young adults, leads to pain, disturbance of gait, and even to skeletal deformities. A 22-year-old woman noticed an elevated subcutaneous mass on the left plantar surface of her big toe, which was accompanied with pain, tenderness and gait disturbance. The histologic findings showed an ill-circumscribed fibroblastic proliferation with foci of calcification and chondroid differentiation. After total excision of the mass, the patient became free of the above symptoms and the lesion did not recur for 9 months.
Bony Callus ; Child ; Congenital Abnormalities ; Female ; Fibroblasts ; Fibroma* ; Gait* ; Humans ; Sports ; Toes ; Warts ; Young Adult