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*

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*

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

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

BACKGROUND: Dermatologic emergency patients who visit the emergency room increase in number every year. But there is no report about the statistical analysis of such visits. OBJECTIVES & METHODS: We reviewed 326 new dermatologic emergency patients who uisited the emergency room of Dongsan Medical Center in Taegu from 1986 to 1995 to study the age, sex, monthly and yearly distributior, arrival time, length of visit, prevalence of common dermatoses, admission rate and death rate. RESULTS: The results are summarized as follows: 1. Of 326 patients, there were 151 males and 175 females. The sex ratio of male to female was 1: 1.15. The number of patients increased with each year. 2. In age distribution, there were 23(7%) under 10;46(14%) between 11-20,55(17%) between 21-30;49(15% ) between 31-40;33(10%) between 41 50; 62(19% ) between 51-60 years,39(12% ) between 61-70 and 19(6%) between 71-80 years. 3. In monthly and arrival time distribution, the peak month incidence occurred in August(24 %), and the lowest incidence in December(1%). The peak incidence of arrival time occurred PM 6-12 hours and the lowest incidence AM 0-6 hour. 4. In the distribution about length nf visit, 73% of patients stayed more than 10 hours, 23% 5-10 hours and 4% less than 5 hours. 5. Of the most common derrnatoses, acute urticaria was seen in 124 cases(38%), and herpes zoster. in 94 cases (29%). In age distribution, acute urticaria was most preualent between the age of 0-30 and herpes zoster between 50-70. 6. The admission rate was 43%(140 cases). The death rate was 1.2%(3 cases). CONCLUSION: Our study of e nergency patients revealed that dermatologic emergency patients who visited the emergency room had increased in number every year and the distribution of patients is quite different from that of outpatients.
Age Distribution ; Daegu ; Emergencies* ; Emergency Service, Hospital* ; Female ; Herpes Zoster ; Humans ; Incidence ; Male ; Mortality ; Outpatients ; Prevalence ; Sex Ratio ; Skin Diseases ; Urticaria

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

PURPOSE: Radical gastrectomy is main treatment of gastric cancer. But the result is not satisfactory with surgery alone. Most of pattern of failure remain locoregional recurrence. To improve 5 year survival postoperative chemotherapy with or without radiotherapy has been used. We analyzed patients with stage III and IV stomach cancer who had radical operation and received postoperative radiation therapy combined with or without chemotherapy retrospectively. MATERIAL AND METHOD: From March 1985 to June 1993, 68 patients treated with curative resection and received postoperative adjuvant radiotherapy with 36Gy or more were evaluated. Median age was 60 years(range 28-66 yrs). Patients were followed from 3 to 133 months with median follow up of 48 months. Thirty seven patients had non signet ring adenocarcinoma, 29 signet ring cell, 2 other cell. Patients with stage IIIA, IIIB, IV disease were 19, 25 and 24 respectively. Chemotherapy was given to all patients except two. RESULTS: Five-year overall survival and disease-free survival rate were 36.6% and 33.6%, respectively. Prognostic factor affecting survival were assessed. High ratio of involved/dissected lymph node, signet ring histology showed poor prognosis with statistical significance. Presence of residual tumor after surgery, stageIV, split course of radiation therapy, age, number of involved lymph node, number of lymph node dissection and grade of tumor affected survival without statistical significance. Type of chemotherapy did not affect survival.Recurrence was documented in 34 patients. High recurrence was seen in omentum and peritoneum with 23.5%, and remnant stomach, anastomosis site, A-loop and E-loop had also high recurrence with 13.2%. In field locoregional recurrence was 20.7% and total distant metastases were 39.7%. Total intraabdominal failure was 47.1% and extraabdominal failure was 13.2%. Treatment toxicity was considered to be acceptable. 22.1% of patients had grade 3 and only 1 patient had grade 4 leukopenia. Six patients(8.8%) had weigh loss more than 10%. CONCLUSION: Treatment toxicity was acceptable with combined treatment with chemotherapy and radiotherapy. Locoregional recurrence was relatively low compared to distant failure with addition of irradiation. Peritoneal and omental seeding was high. Five-year surival was increased with combined modality. Radiation may eradicate minimal residual disease and improve survival. To evaluate role of radiation prospective randomized study employing chemotherapy alone and chemotherapy plus radiation is necessary. Futhermore to reduce intraabdominal failure, role of intraabdominal chemotherapy in addition to combined chemotherapy plus radiation has to be explored.
Adenocarcinoma ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Gastrectomy ; Gastric Stump ; Humans ; Leukopenia ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm, Residual ; Omentum ; Peritoneum ; Prognosis ; Radiotherapy* ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Stomach Neoplasms*