BACKGROUND: The changes in lipid composition during epidermal differentiation has been reported in human and animal models. Because of the difficulties in getting adeguate specimens from human subjects, the authors used easily obtainable circumcised prepuce for lipid analysis. OBJECTIVE: To investigate the changes in lipid composition duriig cornification of the epidermis, the lipid compositions of whole epidermis and stratum corneum were analyzed by thin layer chromatography(TLC). METHODS: From circumcied prepuce whole epidermis and stratum orneum were separated by 10mM EDTA(ethylene diamine tatraacetate) in PBS(phosphate-buffered saline) or heat(60C), and 0.5% trypsin in PBS respectively. Lipids were extracted with methanolctloroform-HO mixture(4:2:1.6, v/ v, Bligh-Dyer solvent), TLC was performed and lipid composition was quantitated by photodensitometer. RESULTS: In the composition of stratum corneum lipids, sphingoliids were the highest(33.3+2.9%) followed by cholesterol, free fatty acids and cholesterol esters in cleceasing order, there were small percentages of triglycerides, cholesterol sulfate and squalene. CONCLUSION: In this study the lipid composition of epidermis was similar to that of stratum corneum rather than those of previous reports on epidermal lipids, which may indicate the regional characteristics of epidermal/stratum orneum lipids in hyperkeratotic prepuie.
Cholesterol ; Cholesterol Esters ; Epidermis* ; Fatty Acids, Nonesterified ; Humans ; Models, Animal ; Squalene ; Triglycerides ; Trypsin

Blue rubber bleb nevus syndrome is a rare disease of cutaneous hemangioma of a variant of the carvenous type which is clinically characterized by multiple, protuberant, dark blue, generally soft, rubbery, and compressible cutaneous masses usually associated with similar lesions of the gastrointestinal tract. Most cases are sporadic, although autosomal dominant inheritance has been described. We report herein a cases of blue rubber bleb nevus syndrome in a 49-year-old, who had multiple, dark blue, slightly tender, easily compressible vascular tumors on the face, right postauricular area, tongue, neck, and right had and foot, measuring from 0.5 to 1.0 cm in diameter. Endoscopic examination also revealed several similar lesions on the upper third of the esophagus. Biopsy specimen from the lesion of the neck showed irregularly dilated vessels containing red blood cells and fibrinous material. The vascular space was lined by a single layer of flattened endothelial cells.
Biopsy ; Blister* ; Endothelial Cells ; Erythrocytes ; Esophagus ; Fibrin ; Foot ; Gastrointestinal Tract ; Hemangioma ; Humans ; Middle Aged ; Neck ; Nevus* ; Rare Diseases ; Rubber* ; Tongue ; Wills

No abstract available.

We report a case of infantile acute hemorrhagic edema in a 15-month-old boy. The patient showed multiple, bean to walnut-sized, red to purple-colored, indurated purpura with a cockade pattern on the face, earlobes, and extremities. Edema of the hands, feet, and earlobes was also observed. Laboratory examinations showed thrombocytosis, decreased serum CH50, and ketone in the urine. A skin biopsy taken from indurated purpura on the lower leg exhibited findings of acute leukocytoclastic vasculitis. Direct immunofluorescence examination showed deposition of IgM along the dermo-epidermal junction and C3 in the dermal vessel walls. With-out specific management except for fluid therapy to correct dehydration, the skin lesions cleared completely in 2 weeks, and recurrence has not observed.
Biopsy ; Dehydration ; Edema* ; Extremities ; Fluid Therapy ; Fluorescent Antibody Technique, Direct ; Foot ; Hand ; Humans ; Immunoglobulin M ; Infant ; Leg ; Male ; Purpura ; Recurrence ; Skin ; Thrombocytosis ; Vasculitis

This is a case of synovial chondromatosis involving the left knee joint of a forty one year old man. Chief complaints were gradual development of pain and limitation of knee joint motion of about 10 years duration. K-ray study revealed a single radio-opaque loose body filling the joint cavity. This body, measuring about 3×2×2cm, was removed surgically and found to have a pedicle from the synovial membrane, consisting of fat and fibrous tissue. The diagnosis of synovial chondromatosis was confirmed by pathological study. The postoperative course was uneventful and three months after the operation, the range of motion of the affected knee joint was good.
Chondromatosis, Synovial ; Diagnosis ; Joints ; Knee Joint ; Knee ; Range of Motion, Articular ; Synovial Membrane

Over 60 different types of human papillomavirus (HPV) have been identified, and they are classified into high and low risk groups based on the risk for malignant progression of HPV associated lesions. HPVs belonging to a high risk group have been shown to express two major transforming proteins, E6 and E7. With respect to the transforming activity of these proteins, many investigators have reported the location of these proteins in the cell, but their results are still controversial. In the present study, HPV type 16 E6 or E7 open reading frame (ORF) proteins were expressed and localized in human epidermal keratinocytes (RHEK-1) using the vaccinia virus as an expression vector. Immunofluorescence detection using monoclonal antibodies against E6 or E7 ORF proteins revealed that E6 or E7 proteins of HPV type 16 were located in the cytoplasm of RHEK-1 cells. These results suggest that E6 and E7 proteins bind to the tumor suppressor counterparts, thereby preventing transport of these proteins into the nucleus. These antioncogene products that fail to be rapidly transported out of the cytosol may be degraded by certain proteases such as the ubiquitin dependent system. In this way, the precise function of antioncogene products in the regulation of cell growth could be destroyed, and abnormal cell growth could occur.
Animal ; Base Sequence ; Cell Line ; Fluorescent Antibody Technique ; Haplorhini ; Human ; Keratinocytes/metabolism ; Molecular Sequence Data ; Oncogene Proteins, Viral/*biosynthesis ; Open Reading Frames/*physiology ; Papillomavirus, Human/*chemistry ; Plaque Assay ; Polymerase Chain Reaction ; Recombinant Proteins/biosynthesis ; Support, Non-U.S. Gov't ; Vaccinia virus/genetics

No abstract available.
Empty Sella Syndrome ; Hypoglycemia ; Insulin ; Receptor, Insulin

BACKGROUND: Anemia in chronic renal failure plays an important rolr in increasing morbidity of dialysis patients. The causes of the anemia are multifactorial. With using of erythropoietin(EPO), most of uremia-induced anemia can be overcome. However, about 10% of renal failure patients shows EPO-resistant anemia. Hyporesponsiveness to EPO has been realted to many factors: iron deficiency, aluminum intoxication, inflammations, malignancies and secondary hyperparathyroidism. So I evailuated the improvement of EPO responsiveness after correction of above several factors. MATERIALS AND METHODS: Seventy-two patients on hemodialysis over 6 months were treated with intravenous ascorbic acid(IVAA, 300 mg t.i.w. for 12 weeks). After administration of IVAA for 12 weeks,patients were classified into several groups according to iron status, serum aluminum levels and i-PTH levels. Indivisualized treatments were performed; increased iron supplement for absolute iron deficiency, active vitamin D3 for secondary hyperparathyroidism and desferrioxamine(DFO, 5 mg/kg t.i.w.) for aluminum intoxication or hyperferritinemia. RESULTS: 1) Results of IVAA therapy for 12 weeks on all patients(n=72) Hemoglobin levels at 2,4,6 week were significantly elevated compared to baseline. but those of hemoglobin at 8, 10, 12 week were not significantly different. 2) Result of IVAA therapy for 20 weeks on patients with 100 microgram/1< or =ferritin<500 microgram/1 and transferrin saturation(Tsat) below 30%(n=30) After treatment of IVAA for 12 weeks, patients were evaluated the response of therapy according to iron status. Patient with 100 microgram/1< or =ferritin?500 microgram/1 and Tsat below 30% showed the most effective response. These patients were treated further for 8 weeks. Hemoglobin levels at 2, 4 week were significantly increased compared to baseline with significantly reduced doses of EPO at 2, 4, 10, 12, 16, 20 week. Concomitantly significantly improvement of Tsat at 2, 6, 16, 20 week compared to baseline were identified. 3) Result of IVAA therapy for 12 weeks followed by DFO therapy for 8 weeks on patients with serume aluminum above 4 microgram/1(n=12) Hemoglobin levels were not significantly increased during IVAA therapy for 12 weeks but dosages of EPO were significantly decreased at 2, 4, 6, 8 week during DFO therapy compared to pre-treatment status. CONCLUSION: IVAA can be helpful for the treatment of the anemia caused by functional iron deficiency and can reduce the dosage of EPO for anemia correction. And administration of low dose DFO, in cases of increased serum aluminum level, can reduce the requirment of EPO.
Aluminum ; Anemia ; Ascorbic Acid ; Cholecalciferol ; Deferoxamine ; Dialysis ; Erythropoietin* ; Humans ; Hyperparathyroidism, Secondary ; Inflammation ; Iron ; Kidney Failure, Chronic ; Renal Dialysis* ; Renal Insufficiency ; Transferrin

OBJECTIVE: To investigate an appropriate depth of needle insertion during trigger point injection into the rhomboid major muscle. METHODS: Sixty-two patients who visited our department with shoulder or upper back pain participated in this study. The distance between the skin and the rhomboid major muscle (SM) and the distance between the skin and rib (SB) were measured using ultrasonography. The subjects were divided into 3 groups according to BMI: BMI less than 23 kg/m2 (underweight or normal group); 23 kg/m2 or more to less than 25 kg/m2 (overweight group); and 25 kg/m2 or more (obese group). The mean+/-standard deviation (SD) of SM and SB of each group were calculated. A range between mean+1 SD of SM and the mean-1 SD of SB was defined as a safe margin. RESULTS: The underweight or normal group's SM, SB, and the safe margin were 1.2+/-0.2, 2.1+/-0.4, and 1.4 to 1.7 cm, respectively. The overweight group's SM and SB were 1.4+/-0.2 and 2.4+/-0.9 cm, respectively. The safe margin could not be calculated for this group. The obese group's SM, SB, and the safe margin were 1.8+/-0.3, 2.7+/-0.5, and 2.1 to 2.2 cm, respectively. CONCLUSION: This study will help us to set the standard depth of safe needle insertion into the rhomboid major muscle in an effective manner without causing any complications.
Back Pain ; Humans ; Muscles ; Needles* ; Overweight ; Pneumothorax ; Ribs ; Shoulder ; Skin ; Superficial Back Muscles* ; Thinness ; Trigger Points* ; Ultrasonography

BACKGROUND: Polyethylene glycol(PEG) has been the most widely used colonic lavage solution. But large volume and salty taste of PEG solution is a problem which can lead to the noncompliance and the poor bowel cleansing. Recent reports have suggested that sodium phosphate solution of much smaller volume is more effective in colon cleansing ability and more easier to complete. Therefore, this study was designed to compare two solutions for colonoscopy and to determine the differences in either patient compliance or cleansing ability. METHOD: Eighty-two patients were randomized to take either oral sodium phosphate solution or 2 liter of PEG solution. Patient's discomfort and tolerance during ingestion was asessed by questionnaire and one colonoscopist who did not know the type of solution, assessed colonic preparation status. RESULTS: Among 25 patients experiencing two separate colonoscopies with PEG solution and sodium phosphate solution respectively, 19(76%) patients preferred sodium phosphate solution. Sodium phosphate solution was found to be easier to take. Sodium phosphate caused thirst more frequently(p=0.013) than PEG solution. Particulate stool and water retention status were similar in two groups. Gas bubble formation that disturbs luminal observation was more frequently found in sodium phosphate preparation group(P=0.00). Sodium phosphate was more effective in right colon cleansing ability than PEG preparation(P=0.04). The Colonoscopist assessed sodium phosphate as "good" in 47.2% vs 58.6% after PEG preparation as a whole, but there was no statistical difference. CONSLUSION: Sodium Phosphate solution is better tolerated and more easier to take than PEG solution. Gas bubble formation is a correctable problem, but right colonic cleansing effect is not. Our results showed that sodium phosphate is likely to be more effective in colonic cleansing effect comparing to polyethylene glycol solution.
Colon ; Colonoscopy ; Eating ; Humans ; Patient Compliance ; Phenobarbital ; Polyethylene Glycols* ; Polyethylene* ; Surveys and Questionnaires ; Sodium* ; Therapeutic Irrigation ; Thirst ; Water