BACKGROUND: Diabetes mellitus is a heterogeneous group of disorders characterized by high serum glucose levels and by disturbances of carbohydrate and lipid metabolism. There are many cutaneous signs of this common endocrinopathy, such as nercobiosis lipoidica diabeticorum, diabetic bullosis, shin spot, diabetic pruritus, etc. OBJECTIVE: In this study, we investigated whether extracellular matrix gene expression in cultured skin fibroblast is influenced by insulin and Insulin-like growth factor-I(IGF-I). METHOD: Total RNA was isolated from insulin or IGF-I treated human skin fibroblasts. The Northern blot and slot-blot hybridization were then conducted. RESULTS: The mRNA levels of pro α1(I) collagen, pro α1(I11) collagen, fibronectin in insulin and IGF-I treated normal skin fibroblasts increased compared with untreated normal skin fibroblasts. CONCLUSION: Our results show that insulin and IGF-I stimulate collagen formation in normal skin fibroblast at physiological concentrations. Therefore, these demonstrate that insulin can modulate the expression of extracellular matrix gene.
Blood Glucose ; Blotting, Northern ; Collagen ; Diabetes Mellitus ; Extracellular Matrix* ; Fibroblasts* ; Fibronectins ; Gene Expression ; Humans ; Insulin* ; Insulin-Like Growth Factor I ; Lipid Metabolism ; Methods ; Pruritus ; RNA ; RNA, Messenger ; Skin*

T-cell lymphomas primarily involving subcutaneous tissue and minicking panniculitis have rarely been described. In addition, some cases may have been orviously reported as malignant histiocytosis. Some of the affected patients have developed a hemohagocytic syndrome. A 44-year-old wornan showed multiple, recurrent, ill-defined, sarble sized, erythematous, tender subcutnaeous nodules on the trunk and extremities. Histopathological findings levealed the infiltration of hyperchrorriatiatypical large lymphocytes and nurnerous beanbag-like cells in the subcutaneous fat. The infitrted cells were positively stained with Leucocyte common antigen, UCHL-1 antigen, Lysozyme, that ot with CD20. Bone marrow biopsy showed mild erythreid hyperplasia and erythorophagocytic. hitiocytes. These histopathological features were consistent with cutnaeous T cell lymphoma involvnig the subcutaneous tissue.
Adult ; Biopsy ; Bone Marrow ; Extremities ; Histiocytic Sarcoma ; Humans ; Hyperplasia ; Lymphocytes ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Cutaneous* ; Muramidase ; Panniculitis ; Subcutaneous Fat ; Subcutaneous Tissue*

BACKGROUND: A clinical study of rosacea has never been reported in Korea. OBJECTIVE: The purpose of this study was to elucidate the clinical observations of rosncea. METHODS: During a 5-year-period from Jan. 1990 to Dec. 1994, 133 patients were evaluated with regard to age, sex, location of skin lesions, clinical type, duration, and precipitating factors. RESULTS AND CONCLUSIONS: 1. Of the 7,787 cases amongst outpatients, 133 cases(1.7% ) were dignosed with rosacea. Of there 46 were male patients and 87 females, giving a sex ratio of 1:1.9 in favor of females. 2. The most common type of rosacea was vascular rosacea(60.2%) 3. The average duration of rosacea was 3.4 years. 4. Rosacea afflict persons aged 40-49 most frequently. 5. The predilection sites of the rosacea were : cheek(42.9%), nose(23.3%), entire face(11.3%), cheek & nose(9%), zygomatic area(6.8%), extra-facial area(3.8%), forehead(2.9%). 6, The aggravating factors of rosacea were : unknown cause(32.3%), coffee & tea(18%), alcohol(13.5%), emotional stress(10.5%), sun exposure(9.8%), multi-factoral(7.5%), drugs(steroids)4.6%).
Cheek ; Coffee ; Female ; Humans ; Korea ; Male ; Outpatients ; Precipitating Factors ; Rosacea* ; Sex Ratio ; Skin ; Solar System

OBJECTIVE: Telomerase is an RNA-dependent DNA polymerase that synthesizes TTAGGG telomeric DNA. It has been detected in a variety of human malignancies, suggesting that it's activity may play a role in the tumorigenic process. Also, maintenance of telomerase activity is associated with increased resistance to apoptosis. Caspase-3 activation has been found to be essential components of the apoptotic pathway. METHODS: To determine whether telomerase is involved in carcinogenesis of uterine cervix and to analyze the relationship between telomerase RNA and caspase-3 expression according to cervical cancer stage, we performed in situ hybridization for telomerase RNA and immunohistochemistry for caspase-3. The materials were 10 normal cervical tissues, 12 low grade intraepithelial lesions (LSIL), 20 high grade intraepithelial lesions (HSIL), 17 microinvasive carcinomas, 19 invasive carcinomas. RESULTS: Telomerase RNA was weakly expressed in a few basal cells of normal squamous epithelium in uterine cervix. But, high expression rate was noted in squamous intraepithelial lesions and invasive carcinoma groups. Expression of telomerase RNA was demonstrated 5 (41.6%) of LSIL, 7 (35.0%) of HSIL, 6 (35.2%) of microinvasive carcinoma, and 11 (57.8%) of invasive carcinoma. Expression of caspase-3 was demonstrated 0% of LSIL, 13 (65.0%) of HSIL, 13 (76.4%) of microinvasive carcinoma, and 7 (36.8%) of invasive carcinoma. Relationship between telomerase RNA and caspase-3 expression according to stage was not seen. Telomerase RNA and caspase-3 expression showed weakly inverse correlation in invasive carcinoma group. Telomerase RNA and caspase-3 expression was not correlated with clinico-pathologic factors, including stage, tumor differentiation, invasion depth, and lymph node metastasis (p>0.05). But, weak correlation between telomerase RNA expression and tumor size was noted (p=0.05). CONCLUSION: These data indicate telomerase might be involved in carcinogenesis of uterine cervix. Distinct relationship between telomerase RNA and caspase-3 was not seen according to stage. Expression of telomerase RNA and caspase-3 had no correlation with clinico-pathologic factors.
Apoptosis ; Carcinogenesis ; Caspase 3* ; Cervix Uteri ; DNA ; Epithelium ; Female ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Lymph Nodes ; Neoplasm Metastasis ; RNA* ; RNA-Directed DNA Polymerase ; Telomerase* ; Uterine Cervical Neoplasms

We report a patient who developed a Barrett,s esophageal ulcer 10 years after esophagomyotomy for achalasia. A-59-year-old female was admitted to the hospital with dysphagia for 2 months. In 1982, she had undergone a modified Heller esophagomyotomy for achalsia. After esophagogram, esophageal manometry, 24hr esophageal pH monitoring, esophagoscophy achalasia and Barrett,s esophageal ulcer was diagnosed. So, she had been treated with omeprazole and sucralfate and has been followed up in a asymtomatic state currently. In Barrett,s esophagus, there is a metaplasia of the normal stratified squamous mucosa to columnar epithelium, caused by the reflux of acid. It appears in approximately 10% of patients with chronic gastroesophageal reflux and is associated with increased probability of adenocarcinoma of the esophagus. Among the predis- posing factors of gastroesophageal reflux, there is treatment of esophageal achalsia by forceful dilatation or by the esophagomyotomy. The resultant ralaxation of lower esophageal sphinter, combined with deficient propulsive esophageal peristalsis, predisposed to gastroesophageal reflux. Actually an increased incidence of gastroesophageal reflux, esophagitis and stricture are well-known complications after esophagomyotomy. But in spite of higher risk of gastroesophageal reflux after esophagomyotomy the development of Barrett,s mucosa has been rarely reported and only recently recognized. Diagnosis of Barrett,s esophagus in such patients is difficult and the cumulative effects of achalasia and Barrett's esophagus predispose these patient to higher risk of developing esophageal carcinoma. So, high index of awareness and regular endoscopic surveillance are required.
Adenocarcinoma ; Barrett Esophagus ; Constriction, Pathologic ; Deglutition Disorders ; Diagnosis ; Dilatation ; Epithelium ; Esophageal Achalasia* ; Esophageal pH Monitoring ; Esophagitis ; Esophagus ; Female ; Gastroesophageal Reflux ; Humans ; Incidence ; Manometry ; Metaplasia ; Mucous Membrane ; Omeprazole ; Peristalsis ; Sucralfate ; Ulcer*

Ecthyma Gangrenosum is a rapidly progressing skin infection charact,erized by edema, hemorragic bullae and necrosis. Ecthyma Gangrenosum occurs almost exclusively in severely imrnunocompromised patients during the course of pseudomanas aeruginosa septisemia. A 5 month-old boy was transferred to our department because of multiple well defined central necrotic black-colored large erythematous bullae. In the bacterial cultures of skin, stool and liver aspiration fluid, Pseudomonas aeruginosa was grown. In the abdominal ultrasonogram and computed tomogram, the multiple liver abscess, hepatomegaly and ascites were shown on both hepatic lobes. Herein we report a case of ecthyma gangrenosum associated with liver abscess.
Ascites ; Ecthyma* ; Edema ; Hepatomegaly ; Humans ; Infant ; Liver Abscess* ; Liver* ; Male ; Necrosis ; Pseudomonas aeruginosa ; Skin ; Ultrasonography

Pregnancy associated breast cancer is defined as breast cancer diagnosed during pregnancy or in the 12 months postpartum. The incidence is one of the most common carcinomas and approximately 1 in 3,000 pregnancies in the United States. Pregnant women are at a higher risk of presenting with more advanced disease than nonpregnant women since small lumps cannot be easily detected due to the natural tenderness and engorgement of the breasts during pregnancy and lactation. Average diagnosis delays of 5 to 7 months are reported. The prognosis is thought not to be significantly different from non-pregnancy associated breast cancer, except in cases where a delay in diagnosis is associated with more advanced disease. Therefore breast cancer is no evidence to implicate pregnancy or lactation in either the etiology and the progression. The strategies for therapeutic management of breast cancer associated pregnancy are mainly dependent on early diagnosis and the stage with gestational age. We experienced a patient who underwent a modified radical mastectomy and adjuvant chemotherapy due to rapid growing breast cancer in pregnant. We report this case with a brief review of literature.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Diagnosis ; Early Diagnosis ; Female ; Gestational Age ; Humans ; Incidence ; Lactation ; Mastectomy, Modified Radical ; Postpartum Period ; Pregnancy* ; Pregnant Women ; Prognosis ; United States

The occurrence of Non-Hodgkin's lymphoma (NHL) during pregnancy is very rare and this malignancy is most commonly associated with aggressive histology and dissemination. Treatment in pregnant women with low-grade lymphoma may be delayed until after delivery but women with an aggressive lymphoma must have a immediate initiation of standard chemotherapy whether to have a therapeutic abortion or not. A-32-year-old woman with NHL stage IIb complicating pregnancy is presented. The diagnosis was made aggressive lymphoma. The baby weighting 1,830 gm was delivered by normal spontaneous vaginal delivery. Following delivery, the patient received combination chemotherapy with cyclophosphamide, adriamycin, vincristine, prednisone regimen but magnetic resonance imaging undertaken during follow-up showed leptomeningeal involvement, indicating poor prognosis. She wanted discharge ten months later from disseminated disease. We experienced a case of rapid growing Non-Hodgkin's lymphoma developed on anterior mediastineum that diagnosed during pregnancy and treated following delivery. We report this case with a brief review of literature.
Abortion, Therapeutic ; Cyclophosphamide ; Diagnosis ; Doxorubicin ; Drug Therapy ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Magnetic Resonance Imaging ; Prednisone ; Pregnancy* ; Pregnant Women ; Prognosis ; Vincristine

Cutaneous metastases from Internal carcinomas are relatively rare. We report a case of cutaneous metastasis believed t.o originate from primary lung carcinoma in a 69-year-old male patient. The patient presented with localized well defined multiple variable sized, hard eryt,hematous papules, nodules and pustules on the right chest, back and upper arm. Biopsy specimens from the nodules upper chest revealed scatt,ered islands of tumor cells and fi brosis of the dermis. To evaluate the role of p53 protein in the development of skin tumors, we examed p53 expres sion at protein level by imnunoperoxidase stain using monoclonal antimouse human p53 antibody on paraffin embeded tissues The patient died after four months from the appearance of cutaneous lesions.
Aged ; Arm ; Biopsy ; Dermis ; Humans ; Islands ; Lung ; Male ; Neoplasm Metastasis ; Paraffin ; Skin ; Thorax

OBJECTIVE: We compared the impact of chemotherapy-induced nausea and vomiting (CINV) on patients of an aprepitant regimen with an ondansetron regimen, for antiemetic efficacy after highly emetogenic chemotherapy (HEC). METHODS: The study was performed prospective on 61 patients who is diagnosed initially the gynecological cancer during chemotherapy at Gospel hospital of Kosin university between March 2007 and October 2007. The study was divided according to an aprepitant/ondansetron regimen. The efficacy of controlling acute (during the 24 hours after chemotherapy) /delayed (day 2 days thought 5) nausea, vomiting and adverse effects were compared. Statistical analysis was performed using the chi-square test. RESULTS: The efficacy of controlling nausea with an aprepitant regimen and an ondansetron regimen was 86.7%, 83.9% in acute periods (Pvalue= 0.742) and 99%, 83.9% in delayed periods (P-value=0.083), respectively. The efficacy of controlling vomiting with an aprepitant regimen and an ondansetron regimen was 93.3%, 90.3% in acute periods (P-value=0.809) and 96.7%, 83.9% in delayed periods (Pvalue= 0.034), respectively. The efficacy of controlling delayed vomiting with an aprepitant regimen reported significantly. The common adverse effects in both groups were not significantly. CONCLUSION: The regimen including aprepitant was superior in preventing CINV as compared with a regimen in which both ondansetron and dexamethasone were given delayed periods in patients receiving chemotherapy
Dexamethasone ; Humans ; Morpholines ; Nausea ; Ondansetron ; Prospective Studies ; Vomiting