OBJECTIVE: Angiogenesis is a critical factor in the progression of solid tumors. The mechanisms responsible for angiogenesis in cervical neoplasia, however, are not well defined. Our study was aimed to determine the expression of VEGF(Vascular Endothelial Growth Factor), its receptor(KDR), and TGF-beta1(Transforming Growth Factor-beta1) in cervical neoplasia, to determine the role of these angiogenic factors in preinvasive(dysplastic) process and the progression of cervical cancer and to investigate the progression of angiogenesis in the transition from normal cervix to invasive squamous cell carcinoma of the uterine cervix. METHODS: The cervical lesions of 76 patients were punch biopsied and paraffin embedded. Among these, 5 were normal cervix, 36 were cervical intraepithelial lesion I-III, and the other 35 were invasive squamous cell carcinomas. The tissues were immunostained with antiVEGF, antiKDR, and antiTGF-beta1 polyclonal antibody. RESULTS: The expression of VEGF, KDR, and TGF-beta1 in CIN III was stronger than those of CIN I(p<0.01). Their expression were not significantly different among the each staged cervical cancers(p>0.01). CONCLUSIONS: These observations suggest that VEGF, KDR, and TGF-beta1 are important angiogenic factors in cervical neoplasia, especially in an early event to neoplastic transformation of cervical tissues, but these angiogenic factors are not associated with the progression of cervical cancer.
Angiogenesis Inducing Agents ; Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Humans ; Paraffin ; Phosphotransferases* ; Transforming Growth Factor beta1 ; Uterine Cervical Neoplasms ; Vascular Endothelial Growth Factor A*

BACKGROUND: TSH stimulates both the adenyl cyclase and phospholipase C (PLC) pathways by binding to a single cell surface receptor that is coupled to G protein, and we examined crosstalk between these two signaling pathways. METHODS: FRTL-5 rat thyroid cells were grown in 6H medium, then incubated with 5H medium before the stimulation. Then cells were incubated for 24 hours with 5H mix containing 1 mCi/L myo-(2-N-3H) inositol. After pretreatment of 100 microM Rp-cAMP, 100 microM forskolin, 50 nM staurosporine, or 100 nM PMA (phorbol-12-myristate-13-acetate), TSH were added in different experiments. After 30 min at 37 degrees C, cells were disrupted and IP formation was determined. RESULTS: Stimulation with 100 microU/mL TSH resulted in a 1.65 fold increase in IP generation. In pursuing the possibility that the two post-receptor events might be linked in some way, we examined the effect of exogenously administrated Rp-cAMP, protein kinase A antagonist, and forskolin, a direct stimulant of protein kinase A, on IP generation achieved at a dose of 100 microU/mL TSH. The pretreatment of 100 M Rp-cAMP at a concentration sufficient to inhibit protein kinase A enhanced TSH-induced IP production. This effect of Rp-cAMP was dose-dependent. Forskolin attenuatedTSH-stimulated increases in phosphatidylinositide turnover. PMA, a protein kinase C (PKC) activator and staurosporine, a PKC inhibitor did not affect TSH-induced IP generation. CONCLUSION: These data suggested that activation of adenylate cyclase/cAMP post-receptor signalling casacde, which results in the protien kinase A activation, has an inhibitory effect on IP turnover activated by TSH.
Adenylyl Cyclases ; Animals ; Colforsin ; Cyclic AMP-Dependent Protein Kinases ; GTP-Binding Proteins ; Inositol ; Phosphotransferases ; Protein Kinase C ; Rats ; Receptors, Thyrotropin* ; Signal Transduction* ; Staurosporine ; Thyroid Gland ; Type C Phospholipases

Pimecrolimus cream 1% has shown to be effective in patients with a variety of inflammatory cutaneous disorders. And it might be a useful modality in the treatment of seborrheic dermatitis. This prospective study was aimed at assessing the efficacy and tolerability of pimecrolimus cream 1% in the treatment of facial seborrheic dermatitis. Twenty patients were instructed to apply pimecrolimus cream 1% for 4 consecutive weeks. Assessment of the disease severity was performed at baseline and at week 1, 2, and 4. Clinical assessments of erythema, scaling, and pruritus were measured using a 4-point scale (0-3). Global assessments of the disease severity by patients and investigators were performed at each visit. Mean clinical scores of erythema, scaling, and pruritus significantly improved by 87.4%, 91.9%, and 91.5% respectively at week 4 (p<0.001). Improvements in the global assessment of disease severity determined by patients and investigators also showed excellent results. No specific adverse events other than transient burning and tingling sensations were noted. The relapse of facial seborrheic dermatitis was mostly observed between 3 to 8 weeks after the discontinuation of pimecrolimus. We suggest that the topical application of pimecrolimus cream 1% can be an effective and safe alternative for treatment of facial seborrheic dermatitis.
Adult ; Aged ; Dermatitis, Seborrheic/*drug therapy ; Erythema/drug therapy ; Face ; Female ; Follow-Up Studies ; Humans ; Korea ; Male ; Middle Aged ; Severity of Illness Index ; Tacrolimus/*analogs & derivatives/therapeutic use ; Time Factors ; Treatment Outcome

No abstract available.
Biopsy* ; Brain* ; Protons*

BACKGROUND: Drug rash with eosinophilia and systemic symptoms (DRESS), previously named drug `hypersensitivity syndrome', is a subset of severe drug eruption with quite distinct clinical presentations. Perhaps because of its relatively late onset and variable presentations, the diagnosis of DRESS may be delayed. OBJECTIVE: This study was designed to determine the incidence and investigate the causative drugs and clinical characteristics of DRESS. METHOD: We retrospectively reviewed the clinical features and laboratory findings of DRESS in 795 drug eruption patients who had visited Pusan National University Hospital over the last 10 years (1995-2004). RESULTS: 1. Of 795 drug eruption patients, 14 (1.76%) received a diagnosis of DRESS. 2. The average age of onset was 44.5 years and there was no significant difference according to sex. 3. The most common causative agent of DRESS was carbamazepine (50%), followed by allopurinol, captopril, phenytoin and antituberculous medications. 4. DRESS developed 2-10 weeks after administration of the causative agent, and the average latent period was 4.6 weeks.
Age of Onset ; Allopurinol ; Busan ; Captopril ; Carbamazepine ; Diagnosis ; Drug Eruptions* ; Eosinophilia* ; Exanthema* ; Humans ; Incidence ; Phenytoin ; Retrospective Studies

Eosinophilic, polymorphic, and pruritic eruption associated with radiotherapy (EPPER) is a disorder characterized by polymorphic papules, vesicles, and excoriations accompanied by a local or general itching sensation which can occur in cancer patients treated with radiotherapy. Histopathologic findings include a superficial and deep perivascular lymphohistiocytic infiltration with eosinophils. Most cases have occurred in patients with cervical cancer. To date, only one case of EPPER associated with breast cancer has been reported. We report a case of EPPER in a patient with breast cancer, who presented with eosinophilic, polymorphic, pruritic skin lesions in and around the irradiated left breast.
Breast Neoplasms* ; Breast* ; Eosinophils* ; Humans ; Pruritus ; Radiotherapy* ; Sensation ; Skin ; Uterine Cervical Neoplasms

Familial multiple lipomatosis is a rare hereditary disorder with a proposed autosomal dominant inheritance. Clinically, multiple well-circumscribed, encapsulated lipomas occur on the extremities and trunk. Familial multiple lipomatosis is often confused with multiple symmetric lipomatosis, which is a condition involving a diffuse fatty infiltration around the neck and shoulders. We report two cases of familial multiple lipomatosis with typical clinical features and familial history. To the best of our knowledge, these are the first cases of familial multiple lipomatosis in Korea.
Extremities ; Korea ; Lipoma ; Lipomatosis* ; Lipomatosis, Multiple Symmetrical ; Neck ; Shoulder ; Wills

BACKGROUND: Although serum thyroglobulin (Tg) has been proved to be a good tumor marker in the follow-up of the well differentiated thyroid cancer, some patients show low detectable Tg with negative 131I scan. In the present study, we tried to determine the lowest level of serum Tg which suggests requirement of aggressive work-up for the recurrent or metastatic thyroid cancer. METHODS: Serum Tg levels were measured in 102 patients with well differentiated thyroid cancer who had underwent thyroidectomy followed by 131I ablative therapy. Of 102 patients, 44 patients had no remnant thyroid tissue, while 58 patients had remnant thyroid. Serum Tg levels were measured while TSH-suppressive dose of T4 was administered (on T4 therapy) and then T4 was discontinued for 4 weeks to increase serum TSH level (off T4 therapy), then serum Tg levels were analyzed in relation to the presence or absence of recurrent or metastatic thyroid cancer, assessed by I scan and operation with reference to the physical examination, chest X-ray and thyroid ultrasonogram. RESULTS: Of 102 patients, 16 patients were found to have recurrent or matastatic thyroid cancer. Among them, 10 patients didnt have any remnant thyroid, while 6 patients had remnant thyroid. Serum Tg was undetectable on T4 therapy in 6 patients, but rose higher than 30 ng/mL off T4 therapy in 2 patients, while Tg remained undetectable in other 4 patients. In all 10 patients whoseTg levels were higher than 1 ng/mL. on T4 therapy, Tg rose higher than 30 ng/mL off T4 therapy. The best cut-off value of serum Tg which suggests recurrent or metastatic disease in patients without remnant thyroid was 3 ng/mL on T therapy (sensitivity 60%, specificity 91%, accuracy 84%) and 30 ng/mL off T4 therapy (sensitivity 80%, specificity 75%, accuracy 77%). In patients with remnant thyroid, cut-off value of serum Tg could not be determined because of the low sensitivity and specificity. CONCLUSION: In patients with well differentiated thyroid cancer who have no remnant thyroid, serum Tg level lower than 3 ng/mL on T4 therapy can warrant following-up of patients only with such clinical measures only such as physical examination and thyroid ultrasonogram. However, patients with Tg level of 3 ng/mL or more requires Tg measurements off T4 therapy and 131I scan to evaluate the possibility of recurrent or metastatic thyroid cancer.
Follow-Up Studies ; Humans ; Physical Examination ; Sensitivity and Specificity ; Thorax ; Thyroglobulin* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Ultrasonography

Granuloma annulare (GA) is a benign granulomatous disease. Although its etiology is not well understood, there are some reports about GA occurring after specific conditions such as sunburn, a tuberculin test, insect bites, viral diseases and trauma. Especially, in case of the auricular region which is vulnerable to trauma, it seems that GA has some relation with trauma. In 1992, Mills and Chetty proposed that repetitive minor trauma may be an important cause of auricular GA. Among the 5 cases of auricular GA that have been reported in the English literatures, 3 cases are assumed to be associated with repetitive minor trauma. Herein, we report on two cases of auricular GA that were thought to be associated with repetitive minor trauma.
Granuloma ; Granuloma Annulare ; Insect Bites and Stings ; Sunburn ; Tuberculin Test ; Virus Diseases

BACKGROUND: Diphenylcycloprophenone (DPCP) topical immunotherapy is usually safe and well-tolerated in the treatment of extensive alopecia areata, but some side effects can be problematic to both the physician and the patient. OBJECTIVE: The purpose of this study was to investigate the type and frequency of side effects to DPCP and theirrelation with therapeutic response during DPCP immunotherapy. METHODS: Eighty patients with alopeica areata (>25% of scalp hair), alopecia totalis, and alopecia universalis were treated with DPCP immunotherapy. After sensitization with 2% DPCP, progressively higher concentrations beginning at 0.00001% were applied with an interval of 1 to 2 weeks. During the follow-up period, the onset time and types of side effect and therapeutic response were recorded. RESULTS: Clinically, side effects were experienced by 58.8% of patients and were as follows; dermatitis at the application site (30.0%), dermatitis on a remote site (23.8%), generalized pruritus (13.8%), lymphadenopathy (11.3%), urticaria (8.8%), hyperpigmentation (6.3%), dermographism (2.5%) and vitiligo-like hypopigmentation (1.3%), in order of frequency. There were no serious adverse effects in any of the patients. The patients with better therapeutic response had more side effects than the ones with poor response. Of the many side effects, only lymphadenopathy had any statistical significance with regards to correlation of therapeutic effects and side effects of DPCP. CONCLUSION: DPCP topical immunotherapy in extensive alopecia areata appears to be safe without significant side effects. By noting the common side effects during each treatment period and the side effects which may be sign of better therapeutic response, we think that the patients' compliance and the therapeutic response can be increased.
Alopecia Areata* ; Alopecia* ; Compliance ; Dermatitis ; Follow-Up Studies ; Humans ; Hyperpigmentation ; Hypopigmentation ; Immunotherapy* ; Lymphatic Diseases ; Pruritus ; Scalp ; Urticaria