Lichenoid keratosis (LK), a lichen planus-like keratosis, is a rather frequent skin disorder that has some histological features similar to lichen planus. However, the classification system for LK has not been settled. We report two cases of LK and propose a new classification for LK correlating with clinicohistopathological findings.
Actins* ; Classification ; Keratosis* ; Lichen Planus ; Lichens ; Skin

Indeterminate cell proliferations are rarely described in dermatology literature. Indeterminate cells are characterized by positivity for S-100 protein and CD-la, but are distinguished from Langerhans cells by the absence of Birbeck granules. We present a case of congenital indeterminate cell histiocytoma in a 6-day-old male infant. A Skin examination revealed a solitary, erythematous, 6*6cm, superficially crusted, dome shaped papule on his forehead. A Histopathologic examination showed a dense cellular infiltrate in the dermis, below the atrophic epidermis. Frequently, the nucleus demonstrated a single cleft or crease like the shape of a kidney. These cells showed positivity for S-100 protein. Birbeck granules were not found on electron microscopic examination.
Dermatology ; Dermis ; Epidermis ; Forehead ; Histiocytoma* ; Humans ; Infant ; Kidney ; Langerhans Cells ; Male ; S100 Proteins ; Skin

Winkelmann granuloma is a very rare disorder characterized by histologic findings of perhaps[ic] infiltration, collagen degeneration, and granulomatous inflammation, which usually show palisading features. A number of diseases, especially systemic immunoreactive diseases, are associated with this disorder. We describe a focal neutrophilic necrosis : type of Winkelmann granuloma associated with hypothy- roidism and rheumatoid arthritis.
Arthritis, Rheumatoid* ; Collagen ; Granuloma* ; Hypothyroidism* ; Inflammation ; Necrosis ; Neutrophils

OBJECTIVE: The presence of an intracerebral hematoma from a ruptured aneurysm is a negative predictive factor and it is associated with high morbidity and mortality rates even though clot evacuation followed by the neck clipping is performed. Endovascular coil embolization is a useful alternative procedure to reduce the surgical morbidity and mortality rates. We report here on our experiences with the alternative option of endovascular coil placement followed by craniotomy for clot evacuation. MATERIALS AND METHODS: Among 312 patients who were admitted with intracerebral subarachnoid hemorrhage during the recent three years, 119 cases were treated via the endovascular approach. Nine cases were suspected to show aneurysmal intracerebral hemorrhage (ICH) on CT scan and they underwent emergency cerebral angiograms. We performed immediate coil embolization at the same session of angiographic examination, and this was followed by clot evacuation. RESULTS: Seven cases showed to have ruptured middle cerebral artery (MCA) aneurysms and two cases had internal carotid artery aneurysms. The clinical status on admission was Hunt-Hess grade (HHG) IV in seven patients and HHG III in two. Surgical evacuation of the clot was done immediately after the endovascular coil placement. The treatment results were a Glasgow Outcome Scale score of good recovery and moderate disability in six patients (66.7%). No mortality was recorded and no procedural morbidity was incurred by both the endovascular and direct craniotomy procedures. CONCLUSION: The results indicate that the coil embolization followed by clot evacuation for the patients with aneurysmal ICH may be a less invasive and quite a valuable alternative treatment for this patient group, and this warrants further investigation.
Treatment Outcome ; Tomography, X-Ray Computed ; Retrospective Studies ; Middle Aged ; Male ; Intracranial Aneurysm/radiography/*therapy ; Humans ; Hematoma/radiography/*therapy ; Female ; Embolization, Therapeutic/*methods ; Drainage/*methods ; Cerebral Angiography ; Aneurysm, Ruptured/radiography/*therapy ; Adult

Relapsing polychondritis is a rare systemic disorder characterized by recurrent inflammation of cartilaginous structures, the eye, the audiovestibular and cardiovascular systems. Skin lesions, found in 17% to 38% of cases, include leukocytoclastic vasculitis, livedo reticularis, erythema nodosum, erythema multiforme, keratoderma blenorrhagicum, psoriasis, polyarteritis nodosa, thrombophlebitis and other various conditions. We report a 65-year old man with relapsing polychondritis and associated thrombophlebitis. The patient was treated with oral dapsone and systemic steroid with complete resolution of symptoms. However, the patient died of severe intractable pneumonia.
Aged ; Cardiovascular System ; Dapsone ; Erythema Multiforme ; Erythema Nodosum ; Humans ; Inflammation ; Livedo Reticularis ; Pneumonia ; Polyarteritis Nodosa ; Polychondritis, Relapsing* ; Psoriasis ; Skin ; Thrombophlebitis* ; Vasculitis

PURPOSE: A significant proportion of patients with cough variant asthma (CVA) eventually develops asthma. The aim of this study was to investigate the relationship between bronchial hyperresponsiveness (BHR) and development of asthma in preschool children with CVA. METHODS: We reviewed the medical records of children aged 5 to 7 years who presented with chronic cough and had regular check-up by the school age. All children had methacholine bronchial challenge test (MBCT) at preschool age with a modified auscultation method. The end-point was defined as the appearance of wheezing and/or oxygen desaturation. Positive BHR was defined as end-point concentration (EPC)< or =8 mg/mL. MBCT was performed at the school age with spirometric method. Positive BHR was defined as PC20< or =8 mg/mL. We collected information on the development of wheezing or dyspnoea from the medical records. RESULTS: Thirty-six children with CVA were analyzed. During follow-up (2.1+/-0.9 years), 9/36 children developed wheezing or dyspnoea (group A), and 27/36 children did not (group B). EPC (geometric mean, 95% confidence interval) was significantly lower in group A than group B (1.59 mg/mL, 0.93 to 2.70 mg/mL vs. 3.43 mg/mL, 2.34 to 5.03 mg/mL; P=0.02, respectively). The prevalence of positive BHR at school age was significantly higher in group A than group B (77.8% vs. 22.2%, P<0.01). CONCLUSION: These results suggest that the increase and the persistence of BHR may have an important role in the development of asthma during the course of CVA in preschool children.
Aged ; Asthma ; Auscultation ; Bronchial Provocation Tests ; Child ; Child, Preschool ; Cough ; Follow-Up Studies ; Humans ; Medical Records ; Methacholine Chloride ; Oxygen ; Phosphorylcholine ; Prevalence ; Respiratory Sounds

We report here on a rare case of carotid artery angioplasty and stenting in a patient with spontaneous recanalization after complete occlusion of the proximal internal carotid artery (ICA). The patient initially showed severe stenosis at the left proximal ICA on MR angiography (MRA). Digital subtraction angiography (DSA) performed three days after MRA showed complete occlusion of the proximal ICA. The follow-up DSA after four weeks showed recanalization of the ICA, and then carotid artery stenting was successfully performed. There has been no neurologic complication during more than one year follow-up.
*Stents ; Recurrence ; Middle Aged ; Male ; Magnetic Resonance Angiography ; Humans ; Carotid Stenosis/*therapy ; *Carotid Artery, Internal ; Angioplasty, Balloon

Peritoneal calcifying fibrous tumor is a rare tumor in the peritoneal cavity. In this case, plain radiography showed multiple conglomerated calcifications and several separate calcifications scattered in the lower abdomen and pelvic cavity. CT showed several well-circumscribed masses with a group of conglomerated nodular calcifications in their centers, and these were surrounded by three bands with different attenuation. Ultrasonography showed a well-circumscribed mass with strong posterior shadowing from its anterior surface and hyperechoic calcifications in its center. The histopathological diagnosis was calcifying fibrous tumor. The mass was well circumscribed and non-encapsulated and it was mainly composed of hyalinized fibrosclerotic tissue and dystrophic calcification with no inflammatory cells. We report here on a case of peritoneal calcifying fibrous tumor, along with a review of the relevant literature.
Abdomen ; Hyalin ; Peritoneal Cavity ; Peritoneum ; Shadowing (Histology) ; Tomography, X-Ray Computed

PURPOSE: To investigate the caspase-3 expression in the acinar and ductal cells of rat submandibular glands after the irradiation of various doses. MATERIALS AND METHODS: The male Sprague-Dawley rats weighing approximately 250 gm were used for this study. The experimental group was irradiated with a single absorbed dose of 2, 5, 10, and 15 Gy on the head and neck region. The rats were sacrificed on the 1st, 3rd, 7th, 14th, 21st, and 28th day after irradiation. The specimens including the submandibular gland were sectioned and observed using histopathological and immunohistochemical methods. RESULTS: The local destruction of the acinar and ductal cells and the karyopyknotic nuclei of the acinar cells were observed in the 2 Gy and 5 Gy irradiation groups later than in the 10 Gy and 15 Gy irradiation groups. And the expression of caspase-3 was prominent only in the ductal cells in the 2 Gy and 5 Gy irradiation groups. CONCLUSION: This experiment suggests that radiation-induced apoptosis in the ductal cells of rat submandibular glands was induced by a low dose radiation associated with the activation of caspase-3 and radiation-induced necrosis was induced by a high dose radiation.
Acinar Cells ; Animals ; Apoptosis ; Caspase 3* ; Head ; Humans ; Male ; Neck ; Necrosis ; Rats* ; Rats, Sprague-Dawley ; Submandibular Gland*

PURPOSE: The bronchodilator response (BDR) is frequently measured to assess the severity of asthma and to help facilitate therapeutic decisions, as well as to confirm the diagnosis. Few reports are available on the impact of atopy, one of the most important risk factors for childhood asthma, on the BDR. METHODS: The medical records of 207 asthmatic children (174 with atopic asthma and 33 with non-atopic asthma) were retrospectively reviewed. At the time of asthma diagnosis, the subjects underwent blood tests, bronchial provocation tests, and spirometry before and 15 minutes after inhalation of 4 puffs of salbutamol. We compared the mean BDR levels between the children with atopic and non-atopic asthma, then determined the correlations between the BDR and serum markers of eosinophilic inflammation. RESULTS: While the mean pre-bronchodilator FEV1 was not different between children with atopic and non-atopic asthma, atopic asthmatics had a higher mean BDR than non-atopic asthmatics (9.12+/-5.69% vs. 6.93+/-3.80%, P =0.03). There were weak, but significant correlations between the BDR and the serum markers of eosinophilic inflammation (total immunoglobulin E, r =0.192, P =0.01; total eosinophil count, r =0.192, P =0.01; eosinophil cationic protein, r =0.200, P <0.01). CONCLUSION: Asthmatic children had different mean levels of BDR based on atopic status at the time of asthma diagnosis. When the BDR was assessed to aid therapeutic decisions, the presence of atopy should be taken into consideration in children with asthma.
Albuterol ; Asthma ; Biomarkers ; Bronchial Provocation Tests ; Child ; Eosinophil Cationic Protein ; Eosinophils ; Hematologic Tests ; Humans ; Immunoglobulin E ; Immunoglobulins ; Inflammation ; Inhalation ; Medical Records ; Retrospective Studies ; Risk Factors ; Spirometry