We describe the case of a 45-year-old woman who had self-regressing livedo reticularis on the lower extremities. Examination of a biopsy specimen from the mottled area revealed myxomatous emboli in the deep dermal arterioles. Echocardiography showed a myxoma in the left atrium. After the tumor was surgically excised, the patient had no further evidence of the disorders during the 3-year period of follow-up. Livedo reticularis caused by an peripheral arterial embolism, which in turn was caused by the tumor fragments in our patient with left atrial myxoma, is considered to be unusual.
Arterioles ; Biopsy ; Echocardiography ; Embolism ; Female ; Follow-Up Studies ; Heart Atria ; Humans ; Livedo Reticularis* ; Lower Extremity ; Middle Aged ; Myxoma*

Syndromal acanthosis nigricans is associated with cellular resistance to the action of insulin and other endocrinopathies. In the insulin resistant state, increased insulin binds to the receptors of insulin-like growth factors (IGFs). IGFs are growth prompting peptides, which act as direct mitogens on cells containing the receptors. Through these actions, increased cellular growth and metabolism cause the skin lesions of acanthosis nigricans. Hyperandrogenism is also found in syndromal acanthosis nigricans patients. When associated with insulin resistance, these states are proportionally related. Increased insulin prompts the synthesis of androgen and conversely, increased androgen elevates the insulin resistance. We present three cases of syndromal acanthosis nigricans with hyperpigmented skin lesions and obesity. Laboratory findings demonstrated normal fasting blood suga levels with increased insulin and C-peptide levels and decreased insulin receptors. The oral glucose tolerance test was normal. We suggest that these patients were in an insulin resistant state. Skin biopsies from the axilla in all three cases showed hyperkeratosis, irregular acanthosis and upward projection of dermal papillae as finger like fashion. Thus all three cases represent syndromal acanthosis nigricans associated with an insulin resistant state based on clinical, histopathological, and laboratory findings. The three patients were treated with dietary control.
Acanthosis Nigricans* ; Axilla ; Biopsy ; C-Peptide ; Fasting ; Fingers ; Glucose Tolerance Test ; Humans ; Hyperandrogenism ; Insulin Resistance* ; Insulin* ; Metabolism ; Mitogens ; Obesity ; Peptides ; Receptor, Insulin ; Skin ; Somatomedins

Bowenoid papulosis is manifested by clinically the benign-appearing papules of anogenital region and histopathologically similar features of squamous cellurar inoma in situ in human. A cause is thought to be Human Papillomavirus infection, type 16. The treatment is mainly through conservative management but others are topical application of podophyllin, shave excision, local excision, cryotherapy, electrodessication, topical applcation of 5-FU ointment and subcutaneous injection of recombinant interferon gamma. We present a case of Howenoid papulosis treated with DNCB imriunotherapy. The patient, had multiple papules on the penis with mild pruitus. Histopatnologic findings showed crowding and irregular arrangement of the nucleic many of which are large, hyperchromatic, and pleomorphic. Dyskeratotic and multinucleated keratinocytes wire also present, as were atypical mitoses, scattered in epidermal layer. We treated him with DNCB immunotherapy. Initially he was sensitized with 2,000 ug/0.1ml and two weeks later he received 50 ug/0.1ml per every week. After 3 weeks, he had showed no improvement and we elevated the dose to 100 ug/0.1ml. He was improved after 6th trial and his skir. lesions were almostly disappeared at present.
Crowding ; Cryotherapy ; Dinitrochlorobenzene* ; Fluorouracil ; Humans ; Immunotherapy* ; Injections, Subcutaneous ; Interferons ; Keratinocytes ; Male ; Mitosis ; Papillomavirus Infections ; Penis ; Podophyllin

PURPOSE: Troglitazone (TRO) is a peroxisome proliferator-activated receptor gamma (PPARgamma) agonist. TRO has antiproliferative activity on many kinds of cancer cells via G1 arrest. TRO also increases Cu2+/Zn2+-superoxide dismutase (CuZnSOD) and catalase. Cell cycle, and SOD and catalase may affect on radiation sensitivity. We investigated the effect of TRO on radiation sensitivity in cancer cells in vitro. MATERIALS AND METHODS: Three human cervix cancer cell lines (HeLa, Me180, and SiHa) were used. The protein expressions of SOD and catalase, and catalase activities were measured at 2-10 microM of TRO for 24 hours. Cell cycle was evaluated with flow cytometry. Reactive oxygen species (ROS) was measured using 2',7'-dichlorofluorescin diacetate. Cell survival by radiation was measured with clonogenic assay. RESULTS: By 5 microM TRO for 24 hours, the mRNA, protein expression and activity of catalase were increased in all three cell lines. G0-G1 phase cells were increased in HeLa and Me180 by 5 microM TRO for 24 hours, but those were not increased in SiHa. By pretreatment with 5 microM TRO radiation sensitivity was increased in HeLa and Me180, but it was decreased in SiHa. In Me180, with 2 microM TRO which increased catalase but not increased G0-G1 cells, radiosensitization was not observed. ROS produced by radiation was decreased with TRO. CONCLUSION: TRO increases radiation sensitivity through G0-G1 arrest or decreases radiation sensitivity through catalase-mediated ROS scavenging according to TRO dose or cell types. The change of radiation sensitivity by combined with TRO is not dependent on the PPARgamma expression level.
Catalase ; Cell Cycle ; Cell Line ; Cell Survival ; Cervix Uteri ; Chromans ; Female ; Flow Cytometry ; Fluoresceins ; Humans ; PPAR gamma ; Radiation Tolerance ; Reactive Oxygen Species ; RNA, Messenger ; Thiazolidinediones ; Uterine Cervical Neoplasms

We studied the incidence and results of treatment of secondary hypertension in Yeungnam University Hospital. Nineteen hundred fifty patients with hypertension were included from march 1990 to march 1994. We analysed the prevalence of secondary hypertension and results of treatment. The incidence of secondary hypertension in Yeungnam University Hospital was six percent. The most common underlying causes of secondary hypertension was renal parenchymal disease. Patients with three forms of potentially reversible secondary hypertension, namely, renovascular hypertension, endocrine disease, exogenous hormone, were assed to determine whether surgery or withdrawal of the exogenous hormane had led to an improvement in blood pressure control. The incidence of secondary hypertension in Yeungnam University Hospital was low(6%), but some of these are curable. Thus it is very inportant that evaluate the secondary hypertension.
Blood Pressure ; Endocrine System Diseases ; Equidae ; Humans ; Hypertension* ; Hypertension, Renovascular ; Incidence ; Prevalence

PURPOSE: To analyze the optical coherence tomography (OCT) result at the area of hyperfluorescence by scanning laser ophthalmoscopy (SLO) in central serous chorioretinopathy. METHODS: We investigated sensory detachment, pigment epithelial detachment (PED), choroidal neovascularization (CNV), and retinal pigment epithelial atrophy using OCT in the area of hyperfluorescein by scanning laser ophthalmoscopy (SLO) in 29 eyes of 29 patients with CSC. RESULTS: Of 29 eyes, no specific finding was noted in 19 eyes. Small PED corresponding to the leaking point was noted in 3 eyes, large serous PED with leaking point in 2 eyes, hemorrhagic PED in 1 eye, subretinal precipitate and PED in 1 eye, and retinal pigment epithelial atrophy in 2 eyes. CONCLUSIONS: OCT provided intuitive and objective information on the pathophysiologic state of the retinal pigment epithelial layer at the area of hyperfluorescence by SLO in CSC.
Atrophy ; Central Serous Chorioretinopathy* ; Choroidal Neovascularization ; Humans ; Ophthalmoscopes* ; Ophthalmoscopy ; Retinaldehyde ; Tomography, Optical Coherence*

OBJECTIVE: Meningiomas represent 18-20% of all intracranial tumors and have a 20-50% 10-year recurrence rate, despite aggressive surgery and irradiation. Hydroxyurea, an inhibitor of ribonucleotide reductase, is known to inhibit meningioma cells by induction of apoptosis. We report the long-term follow-up result of hydroxyurea therapy in the patients with recurrent meningiomas. METHODS: Thirteen patients with recurrent WHO grade I or II meningioma were treated with hydroxyurea (1000 mg/m2/day orally divided twice per day) from June 1998 to February 2012. Nine female and 4 male, ranging in age from 32 to 83 years (median age 61.7 years), were included. Follow-up assessment included physical examination, computed tomography, and magnetic resonance imaging (MRI). Standard neuro-oncological response criteria (Macdonald criteria) were used to evaluate the follow-up MRI scans. The treatment was continued until there was objective disease progression or onset of unmanageable toxicity. RESULTS: Ten of the 13 patients (76.9%) showed stable disease after treatment, with time to progression ranging from 8 to 128 months (median 72.4 months; 6 patients still accruing time). However, there was no complete response or partial response in any patients. Three patients had progressive disease after 88, 89, 36 months, respectively. There was no severe (Grade III-IV) blood systemic disorders and no episodes of non-hematological side effects. CONCLUSION: This study showed that hydroxyurea is a modestly active agent against recurrent meningiomas and can induce long-term stabilization of disease in some patients. We think that hydroxyurea treatment is well tolerated and convenient, and could be considered as an alternative treatment option in patients with recurrent meningiomas prior to reoperation or radiotherapy.
Apoptosis ; Disease Progression ; Female ; Follow-Up Studies ; Humans ; Hydroxyurea ; Magnetic Resonance Imaging ; Male ; Meningioma ; Physical Examination ; Recurrence ; Reoperation ; Ribonucleotide Reductases

PURPOSE: E-cadherin(E-CD) is a family of Ca++-dependent intercellular adhesion molecules, plays essential roles in organogenesis and in the maintenance of normal structure and function. Decreased expression of E-CD correlates with tumor aggressiveness, advanced stage and metastasis. In renal cell carcinoma(RCC), however, this correlation is not well established and prevalence of negative expression of E-CD is higher than in other carcinomas. We focused our interest on E-CD expression in RCC and its clinicopathological implications. MATERIALS AND METHODS: Retrospectively, we reviewed 34 cases with RCC that were reclassified according to Mainz classification. Tumor stage, grade were determined according to the Robson method and Fuhrmann`s grading system. We detected E-CD expression in RCC by immunohistochemical staining and investigated the relationship between E-CD expression and clinicopathological features including prognosis. RESULTS: Thirty four cases of RCC were consisted of 21 cases(61%) of non-papillary clear cell type, 2 cases(6%) of chromophil type, 3 cases(9%) of spindle cell type and 8 cases(24%) of chromophobe type by Mainz classification. Especially, E-CD expression showed a strong positive reaction along the cell membranes in all 8 cases of chromophobe type. Our immunohistochemical study of E-CD expression in 34 RCC specimens showed 73% of positive expression and 27% of negative expression. Absence of E-CD expression was correlated with the high tumor stage and grade( stage & grade 3 or 4. p<0.05 in chi-squar test). All of metastatic cases showed a negative expression of E-CD. CONCLUSIONS: The differential expression of E-cadherin in renal cell carcinomas suggest that the tumor cell origin and differentiation. Especially, chromophobe cell type may have different biologic characteristics from other types of renal cell carcinoma. In this study, E-CD expression was seemed to be lost in RCC with a high stage and grade. In addition, preserved E-CD expression was associated with better prognosis than reduced E-CD expression.
Cadherins* ; Carcinoma, Renal Cell* ; Cell Adhesion Molecules ; Cell Membrane ; Classification ; Humans ; Neoplasm Metastasis ; Organogenesis ; Population Characteristics ; Prevalence ; Prognosis ; Retrospective Studies

The genome of Hantaan virus, the prototype of the hantavirus genus, is composed of three segmented, single stranded negative sense RNA genome. The 5' and 3' termini of the Hantaan virus RNA genome contain noncoding regions (NCRs) that are highly conserved and complementary to form panhandle stuctures. There are some reports that these NCRs seems to control gene expression and viral replication in influenza virus and vesicular stomatitis virus. In this study, we examined whether NCRs in Hantaan virus play a role in expression of the viral nucleocapsid protein (Np) and foreign (luciferase) gene. The 5' and/or 3' NCR-deleted mutants were constructed and analysed. The Np expression of 5' NCR-deleted clone, it showed 40% reduction. To investigate the role of NCR in foreign gene expression, the clones which are replaced ORF of Hantaan viral Np gene with that of luciferase gene were constructed. The results were similar to those of the experiments using Np gene. These results suggest that 3' NCR is more important than 5' NCR in protein expression. To find out a critical region of 3' NCR in more important than 5' NCR in protein expression. To find out a critical region of 3' NCR in protein expression, several clones with a deleted part of 3' NCR were constructed and analyzed. The deletion of the conserved region in 3' NCR showed 20~30% decrease in Np expression. However there were no change in luciferase activities between clones with or without non-conserved region of 3' NCR. These results suggest that the 3' NCR of Hantaan virus S genome, especially conserved region in 3' NCR, plays and important role in the expression of Hantaan viral Np and foreign genes.
Animals ; Clone Cells ; Ecthyma, Contagious ; Gene Expression ; Genome* ; Hantaan virus ; Hantavirus ; Luciferases ; Nucleocapsid Proteins* ; Nucleocapsid* ; Orthomyxoviridae ; RNA ; Vesicular Stomatitis

BACKGROUND: Staphylococcal scalded skin syndrome is a relatively uncommon but well described syndrome defined by clinical, microbiological and histological criteria. The spectrum of the disease in children includes not only a severe and acute exfoliative form(generalized form) but also a scarlatiniform eruption(abortive form) and bullous impetigo(localized form). OBJECTIVE: We performed the study to review the clinical, microbiological and histological features of staphylococcal scalded skin syndrome in Korean children. METHODS: We reviewed retrospectively medical records, clinical photographs, microbiologic results and histopathologic findings of 20 cases of staphylococcal scalded skin syndrome diagnosed at Hanyang University Kuri Hospital from February 1998 to November 2001. RESULTS: 1. Of the 20 patients, 13 were generalized type and 7 were abortive type and male to female sex ratio was 1:1.5. The mean age of onset was 3.2 years. 2. The ordinary cultures from the suspected sites of primary infection revealed methicillin-sensitive Staphylococcus aureus in 7 of the 18 patients, and methicillin-resistant Staphylococcus aureus in 6 of the 18 patients. The colonized sites were conjunctiva(23%), throat(23%), skin(23%), nasal cavity(23%) and ear(8%) in 13 cases. 3. Perioral crusting and fissuring was observed in all cases and the erythema was accentuated in the flexural areas. 4. Histopathologic findings of 11 cases showed intraepidermal cleavage, with splitting occuring beneath and within the stratum granulosum. In 6 of 8 generalized forms, several acantholytic epithelial cells were observed. 5. The coexisting diseases were variable, including atopic dermatitis(5 cases), polycystic kidney disease(1 case) and varicella(1 case). 6. All the patients were treated with first generation cephalosporin and vancomycin therapy without significant sequelae. CONCLUSION: There are no significant relation between clinical types of SSSS and causative organisms. Methicillin-resistant Staphylococcus aureus may induce generalized form and abortive form of staphylococcal scalded skin syndrome but should be confirmed by production of exfoliation in the new-born mouse assay.
Age of Onset ; Animals ; Child ; Colon ; Epithelial Cells ; Erythema ; Female ; Humans ; Male ; Medical Records ; Methicillin-Resistant Staphylococcus aureus ; Mice ; Polycystic Kidney Diseases ; Retrospective Studies ; Sex Ratio ; Staphylococcal Scalded Skin Syndrome* ; Staphylococcus aureus ; Vancomycin