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

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

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

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

Lentigo maligna melanoma and lentigo maligna are typically located on photo-exposed sites such as the head and neck, with the cheek being the most common site. Since lentigo maligna melanoma and lentigo maligna are found predominantly on such cosmetically-sensitive areas, it is critical to determine the exact histologic margin for maximal sparing of tissue and complete extirpation of the tumor. Since Mohs micrographic surgery has been recommended for tumors on cosmetically-sensitive locations where the tumor margin is indistinct, it appears to be a reasonable treatment modality for this type of tumor. We describe a case of lentigo maligna melanoma on the cheek, which was resected with Mohs micrographic surgery.
Cheek ; Head ; Hutchinson's Melanotic Freckle* ; Lentigo* ; Melanoma* ; Mohs Surgery* ; Neck

Nicolau syndrome or embolia cutis medicamentosa is an acute necrotic condition of skin that follows intramuscular injection of drugs. A 36-year-old man developed a painful, purpuric and erythematous patch on his left buttock following an intramuscular injection of diclofenac sodium. Histologically, the patch lesion displayed epidermal necrosis, dermal degeneration, and vascular thrombosis. We report a rare case of Nicolau syndrome following intramuscular injection of diclofenac sodium. In our case, the patient was successfully treated by surgical excision with primary closure.
Adult ; Buttocks ; Diclofenac ; Humans ; Injections, Intramuscular ; Necrosis ; Skin ; Thrombosis

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

Clear cell acanthoma is a rare, benign, epidermal tumor. These tumors usually present as solitary lesions, often localized on the lower legs of middle aged or elderly individuals. Pigmented clear cell acanthoma, a variant of clear cell acanthoma, presents as macroscopically visible brown to black-colored, flat or dome-shaped, sharply-dermacated papules or nodules. Histopathologic findings in these tumors reveal markedly epidermal hyperplasia, with exception of the cells in the basal layer. Also, most of the epithelium showed pallor and slight enlargement. With these pigmented type tumors, dermal melanophages are often noticeable on low-power magnification, plus increased melanocytes with melanin granules in the epidermis. A 41-year-old man presented with a 7-year history of a 1.2x0.8cm sized, black plaque on the right inner thigh. The histologic findings revealed the typical features of pigmented clear cell acanthoma.
Acanthoma* ; Adult ; Aged ; Epidermis ; Epithelium ; Humans ; Hyperplasia ; Leg ; Melanins ; Melanocytes ; Middle Aged ; Pallor ; Thigh

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