Mesotherapy is a widely used technique of intradermal or subcutaneous microinjection of a drug or cocktail of drugs, at sites of the body with medical or aesthetic problems. Rare cutaneous side effects have been previously reported, including allergic reactions to the administered drugs or skin infections. We herein report a case of an immediate adverse reaction following mesotherapy. A 40-year-old woman was referred to our department with pruritic erythematous urticarial plaques at the sites of application of mesotherapy. She had been treated for abdominal liposis with one session of multiple subcutaneous injections of a drug mixture including aminophylline at a local clinic. After clinical recovery, a skin test using the same drugs was performed. A positive intradermal test was found with aminophylline and ethylenediamine that is an ingredient of aminophylline. These results support that the ethylenediamine component of aminophylline is identified as the etiologic agent.
Adult ; Aminophylline ; Ethylenediamines ; Female ; Humans ; Hypersensitivity ; Injections, Subcutaneous ; Intradermal Tests ; Mesotherapy ; Microinjections ; Skin ; Skin Tests ; Urticaria

BACKGROUND: It was reported that N,N,N'N'-tetrakis-[2-pyridylmethyl]-ethylenediamine (TPEN), a transition metal chelator, confers cardioprotection against myocardial ischemic injury. In this study, we investigated the effect of TPEN targeting reperfusion period in isolated rat hearts. METHODS: Langendorff perfused rat hearts were subjected to 30 min of regional ischemia and 2 h of reperfusion. Hearts were randomly assigned to either control (n = 9) or 10 micrometer of TPEN (n = 8) groups. TPEN was perfused for a period of 5 min before and 30 min after reperfusion. RESULTS: The ratio of infarct area/ischemic area (AN/AR) was significantly reduced in TPEN treated hearts (6.9 +/- 1.7%, P < 0.001) compared to control hearts (29.5 +/- 3.2%). Recovery of left ventricular developed pressure (LVDP), rate-pressure product (RPP), +dP/dt(max), and -dP/dt(min) in the control group after reperfusion were 53.8 +/- 6.2%, 51.0 +/- 6.3%, 51.9 +/- 5.7%, and 51.4 +/- 5.7%, respectively, of the baseline levels. In the TPEN group, LVDP, RPP, +dP/dt(max), and -dP/dt(min) returned to 58.5 +/- 4.6%, 54.8 +/- 6.4%, 61.7 +/- 4.9%, and 53.4 +/- 3.9%, respectively, of the baseline levels. There were no significant differences in the cardiodynamic variables between the two groups (P > 0.05). CONCLUSIONS: Pharmacological postconditioning with TPEN reduces myocardial infarction however, TPEN does not modify post-ischemic systolic dysfunction in isolated rat hearts.
Animals ; Ethylenediamines ; Heart ; Ischemia ; Myocardial Infarction ; Myocardial Stunning ; Rats ; Reperfusion ; Reperfusion Injury

Syphilid has been called the "great imitator" of skin disease, and it can have protean clinical manifestations and it may present with unusual lesions. Annular syphilid, which can mimic sarcoid, granuloma annulare, Sweet syndrome or tinea corporis, is a rare variant of syphilid. We report here on a case of annular syphilid that mimicked tinea corporis in a 29-year-old female who showed a three month history of multiple, pruritic, well-demarcated annular scaly erythematous patches with central clearing and an elevated border on the trunk and both upper extremities. Direct mycological examination and culture did not result in finding any fungal elements, and annular syphilid was confirmed according to the histopathologic and serologic findings. She and her boyfriend were treated with benzathine penicillin G, and the skin lesions disappeared completely.
Adult ; Ethylenediamines ; Female ; Granuloma Annulare ; Humans ; Hydrazines ; Penicillin G Benzathine ; Skin ; Skin Diseases ; Sweet Syndrome ; Syphilis, Cutaneous ; Tinea ; Upper Extremity

We experienced a rare case of solitary syphilitic osteomyelitis of the skull without any other clinical signs or symptoms of syphilis. A 20-year-old man was referred due to intermittent headache and mild tenderness at the right parietal area of the skull with a palpable coin-sized lesion of softened cortical bone. On radiological studies, the lesion was a radiolucent well enhanced mass (17 mm in diameter). The erythrocyte sedimentation rate (52 mm/h) and C-reactive protein (2.24 mg/dL) were elevated on admission. Serum venereal disease research laboratory (VDRL) and Treponema pallidum haemagglutination assay (TPHA) tests were positive. There were no clinical signs or symptoms of syphilis. After treatment with benzathine penicillin, we removed the lesion and performed cranioplasty. The pathologic finding of the skull lesion was fibrous proliferation with lymphoplasmocytic infiltration forming an osteolytic lesion. In addition, a spirochete was identified using the Warthin-starry stain. The polymerase chain reaction study showed a positive band for Treponema pallidum. Solitary osteomyelitis of the skull can be the initial presenting pathological lesion of syphilis.
Blood Sedimentation ; C-Reactive Protein ; Ethylenediamines ; Headache ; Humans ; Osteomyelitis ; Penicillin G Benzathine ; Polymerase Chain Reaction ; Sexually Transmitted Diseases ; Skull ; Spirochaetales ; Syphilis ; Treponema pallidum ; Young Adult

The aim of the present study was to investigate the effect of zinc deficiency on cardiomyocyte survival and the underlying mechanisms. Simulated zinc deficiency model was developed in H9c2 cardiac cells with zinc chelator N, N, N', N'-tetrakis (2-pyridylmethyl) ethylenediamine (TPEN). MTT assay was used to evaluate cell viability. Morphological changes of the cells were observed by optical microscope. Lacate dehydrogenase (LDH) levels of the cells were determined with LDH assay kit. Mitochondrial membrane potential (ΔΨ) was measured with confocal microscope using JC-1 dye. Intracellular reactive oxygen species (ROS) levels were determined by DCFH-DA staining. PD98059 (an inhibitor of ERK), SNAP, which can activate ERK, and the ROS scavenger, MPG, were respectively used to investigate mechanism of signal transduction. The phosphorylation of ERK was detected by Western blot. The results showed that TPEN significantly induced the cell morphological damage and the loss of ΔΨ, increased LDH leakage, and promoted ROS generation. In the H9c2 cells, TPEN significantly inhibited ERK phosphorylation and decreased cell viability, which was potentiated by PD98059, whereas both SNAP and MPG reversed the inhibitory effects of TPEN. These data suggest that zinc deficiency leads to the injury in H9c2 cardiac cells through down-regulating ERK pathway. Increased intracellular ROS may account for the effect of zinc deficiency.
Animals ; Cell Line ; Cell Survival ; Down-Regulation ; Ethylenediamines ; Fluoresceins ; Membrane Potential, Mitochondrial ; Myocytes, Cardiac ; Phosphorylation ; Rats ; Reactive Oxygen Species ; Signal Transduction ; Zinc

Syphilis, the "great imitator" of skin diseases, is a chronic systemic infectious disease with a waxing and waning course. Clinical manifestations of syphilis are variable in appearance and have been described for centuries. Especially, secondary syphilis is characterized by large diversity of presentation. They include macular, papular, papulosquamous, syphilis cornee, psoriasiform, annular en cockade, nodular, condylomata lata, malignant syphilis, mucosal lesions, loss of the hairs, and alteration of the nails. Nail involvement of syphilis includes changes on nail plate (syphilitic onychia) or periungual tissue (syphilitic paronychia). A 20-year-old man was presented with multiple erythematous broad eroded surfaced papules and macules on the scrotum and scaly exfoliated patch with erythematous swelling on the right thumb with onychodystrophy and mild tenderness on the nail. Serological screening for syphilis showed increased titer for VDRL (1:16) and TPHA (+). After intramuscular treatments with benzathine penicillin G, the skin lesions on the scrotum cleared within 1 month and the nail dystrophy showed slight improvement.
Communicable Diseases ; Cytochrome P-450 CYP1A1 ; Ethylenediamines ; Hair ; Humans ; Mass Screening ; Nails ; Penicillin G Benzathine ; Scrotum ; Skin ; Skin Diseases ; Syphilis ; Syphilis, Cutaneous ; Thumb ; Young Adult

Malignant syphilis (also known as lues maligna) is a rare dermatologic manifestation of syphilis and this is more commonly seen in patients with human immunodeficiency virus (HIV) infection. A 40-year-old man presented with general malaise and widespread cutaneous noduloulcerative lesions covered with lamellar crusts for 15 days. He had been diagnosed with HIV infection 6 years earlier, but had not regularly taken antiretroviral drugs. The syphilis serology showed a VDRL (venereal disease research laboratory) titer of 1 : 256 and a positive TPPA (treponema pallidum particle agglutination test) at presentation. Histologic exam showed the dense perivascular inflammatory infiltrates composed of lymphocytes, histiocysts and neurophils with some plasma cells in the underlying upper and reticular dermis. Obliterated blood vessels with eosinophilic materials were observed as an unusual histologic feature of syphilis. Based on the clinical, histological and serological findings, a diagnosis of malignant syphilis accompanied by acquired immune deficiency syndrome (AIDS) was made. The patient was treated with intramuscular benzathine penicillin G at 2.4 million units per week for 3 weeks, and the skin lesions completely healed with post-inflammatory hyperpigmentation. It is necessary to take into account this entity among the possible diagnoses in HIV-infected patients with cutaneous noduloulcerative lesions.
Acquired Immunodeficiency Syndrome ; Adult ; Agglutination ; Blood Vessels ; Dermis ; Eosinophils ; Ethylenediamines ; HIV ; HIV Infections ; Humans ; Hyperpigmentation ; Lymphocytes ; Penicillin G Benzathine ; Plasma Cells ; Skin ; Syphilis

BACKGROUND: Patients who are born without spleen or who have impaired splenic function due to disease or splenectomy become vulnerable to sepsis caused by bacteria. Overwhelming post-splenectomy infection (OPSI) occurs at an estimated incidence of 0.23-0.42% per year with a lifetime risk of 5%. The risk of OPSI with encapsulated bacteria is generally considered greatest in the first 2 years after splenectomy but the increased risk remains lifelong. Because vaccination doesn't completely protect against infection with encapsulated bacteria that prevent OPSI, use of prophylactic antibiotics are recommended for prevention of infection after splenectomy.METHODS: A retrospective review of 41 patients who underwent splenectomy from January 1990 to December 2012 in Inje University Busan Paik Hospital were identified through the medical records.RESULTS: Of 41 patients, 100% (41/41) were vaccinated in pneumococcal vaccines, 27% (11/41) were vaccinated in HIB vaccines. Prophylactic antibiotics (penicillin G benzathine IM every 4 weeks) were prescribed in 73% (30/41) of patients. We could not find any septic events.CONCLUSION: Because of the high mortality, the fulminant course, and the refractoriness to common treatment of overwhelming infections caused by encapsulated bacteria, prevention through vaccination and antibiotic prophylaxis is the basis of the management of patients who have had splenectomy or have hyposplenism. Prophylactic antibiotics using Penicillin G benzathine every 4 weeks is effective for preventing septic events in splenectomized patients. But further improvement in coverage of recommended vaccines and continuous prophylactic antibiotics after splenectomy is needed to reduce the risk of serious infection.
Anti-Bacterial Agents ; Antibiotic Prophylaxis ; Bacteria ; Ethylenediamines ; Haemophilus influenzae type b ; Humans ; Incidence ; Medical Records ; Mortality ; Penicillin G Benzathine ; Pneumococcal Vaccines ; Retrospective Studies ; Sepsis ; Spleen ; Splenectomy ; Vaccination ; Vaccines

OBJECTIVES: To investigate the clinical effect of Er:YAG laser combined with ethylenediamine tetra acetic acid (EDTA) on three-walled periodontal intrabony defects adjacent to implant sites. METHODS: A total of 30 patients with three-walled periodontal intrabony defects adjacent to implant sites were treated with the combination therapy. Patients with three-walled intrabony defects were divided into two groups according to the depth of the intrabony pocket between the implant and natural teeth. Evaluation of wound healing was performed 10 days after the operation, and bone augmentation was evaluated 6 months after the operation. RESULTS: Primary healing in group 1 was 92.31%, primary healing in group 2 was 82.35%. No significant difference was observed between the two groups ( CONCLUSIONS The effect of bone augmentation with combination therapy was more ideal in group 2 than in group 1. Implant placement with combination therapy may be a viable technique to reconstruct three-walled intrabony defects due to the space maintenance provided by implants and bone grafts and the good root surface biocompatibility provided by the Er:YAG laser and EDTA.
Acetic Acid ; Alveolar Bone Loss ; Dental Implants ; Ethylenediamines ; Follow-Up Studies ; Guided Tissue Regeneration, Periodontal ; Humans ; Lasers, Solid-State ; Periodontal Attachment Loss ; Treatment Outcome

Rheumatic fever is an acute inflammatory sequela following a group A, beta-hemolytic streptococcal infection. Rheumatic fever is characterized by polyarthritis, carditis, chorea, subcutaneous nodules, and erythema marginatum as the major diagnostic criteria. Rarely, advanced heart block may also occur. A 13-year-old boy was admitted to the Pediatric Department for evaluation and management of complete atrioventricular block. The patient had exertional dyspnea for 1 month. Based on the findings of mitral regurgitation, fever, elevated acute phase reactants, and a high antistreptolysin O titer, the patient was diagnosed with rheumatic fever. A benzathine penicillin injection was administered, as well as salicylate therapy. On the 5th day of hospitalization, the electrocardiogram revealed a normal sinus rhythm with a 1st degree atrioventricular block. After discharge, the electrocardiogram normalized with the monthly penicillin injections. Herein we report a case of complete atrioventricular block associated with rheumatic fever. The heart block resolved without specific cardiac treatment, other than a non-steroidal anti-inflammatory medication.
Acute-Phase Proteins ; Adolescent ; Antistreptolysin ; Arthritis ; Atrioventricular Block ; Chorea ; Dyspnea ; Electrocardiography ; Erythema ; Ethylenediamines ; Fever ; Heart Block ; Hospitalization ; Humans ; Mitral Valve Insufficiency ; Myocarditis ; Penicillin G Benzathine ; Penicillins ; Rheumatic Fever ; Streptococcal Infections