A 63-year-old Korean man presented with generalized, asymptomatic, discrete papules and coalescent annular plaques for one year. Interestingly, the patient complained of conjunctival congestion, concurrently with aggravation of the skin lesion. Histopathologic findings of the skin lesion and conjunctiva revealed giant cells engulfing fragmented elastic fibers, and a diagnosis of actinic granuloma with ocular involvement was made. Ten months later, the patient revisited with a two-week history of bilateral temporal headache, neck pain, intermittent jaw claudication, and blurred vision. Biopsy of the temporal artery confirmed the clinical diagnosis of temporal arteritis. Both actinic granuloma and temporal arteritis show similar pathologic process, and this case supports the hypothesis that actinically degenerated elastic tissue is likely to be the antigenic basis of actinic granuloma of the skin and temporal arteritis.
Actins* ; Biopsy ; Conjunctiva ; Diagnosis ; Elastic Tissue ; Estrogens, Conjugated (USP) ; Giant Cell Arteritis* ; Giant Cells ; Granuloma* ; Headache ; Humans ; Jaw ; Middle Aged ; Neck Pain ; Skin ; Temporal Arteries

An alkali burn of the cornea severely damages not only the epithelium but also the underlying keratocytes and endothelium, the extracellular matrix is thought to play an important role in burn wound healing of the cornea. The glycoprotein CD44 of extracellular matrix has been implicated in biological cell behavior, including lymphocyte binding to endothelial venules, embryonic development cell migration, cell differentiation, and tumor metastasis. The purpose of this study is to investigate the presence and distribution of CD44 in wound healing using immunohistochemical staining method after alkali burning of rabbit cornea. 2 hour after burn, there was no immunodeposit for CD44 at keratocytes and endothelial cells at denuded epithelial burn area. 4 hours postburn, the epithelial cell gradually migrated over the burn area from the peripheral unburn area and immunodepositive staining of the keratocytes was observed at the margin of burn site. 24 hours postburn, immunopositive reaction for CD44 at adjacent alkali burn area was more strongly labeled, but the peripheral epithelial response of unburn area was faintly labeled by them. 48 hours postburn, immunopositive reaction gradually shifted from the border portion of alkali burn to the center portion of burn site. On days 7, the epithelium was completely reepithelized over the burn area and 3 weeks postburn, immunostaining were demonstrated the entire layer of burn site. The recovering time of the nornal immunostaing for CD44 of the rabbit cornea from the alkali burn was taken about 7 weeks. Our results suggest that the CD44 protein can be seen in proliferating in the epithelial cells, the keratocytes end endothelial cells, and is thought to play an important role in wound healing of the alkali burn cornea.
Alkalies* ; Burns* ; Cell Differentiation ; Cell Movement ; Cornea ; Embryonic Development ; Endothelial Cells ; Endothelium ; Epithelial Cells ; Epithelium ; Extracellular Matrix ; Female ; Glycoproteins ; Lymphocytes ; Neoplasm Metastasis ; Pregnancy ; Venules ; Wound Healing* ; Wounds and Injuries*

Palmar filiform hyperkeratosis is characterized by multiple, tiny, keratotic projections on the palms. This disease has been associated with various underlying benign or malignant diseases. We present 69 year-old-man with 8-year history of palmar filiform hyperkeratosis. After development of skin lesions, he was diagnosed as having rheumatoid arthritis, hypertension, chronic renal failure, multiple renal and hepatic cysts, and multiple adenomas in the stomach and colon, in turn. Histopathologic examination revealed a compact parakeratotic column on an absent or thin granular layer. Treatment with 15% salicylic acid ointment under occlusion was partially effective.
Adenoma ; Arthritis, Rheumatoid ; Colon ; Hypertension ; Kidney Failure, Chronic ; Salicylic Acid ; Skin ; Stomach

Angiomyolipoma is a benign tumor, almost exclusively of the kidney, that is often associated with tuberous sclerosis. Cutaneous location is extremely rare. We report a case of cutaneous angiomyolipoma which occurred on the retroauricular area. A 57-year-old man presented with an asymptomatic mass on the retroauricular area. Although the clinical similarity to an epidermal or pilar cyst was striking, the histopathologic picture was distinctive. The tumor was a well-circumscribed subcutaneous mass composed of a mixture of smooth muscle, vascular spaces, and mature fat covered by a thin fibrous membrane.
Angiomyolipoma* ; Epidermal Cyst ; Humans ; Kidney ; Membranes ; Middle Aged ; Muscle, Smooth, Vascular ; Strikes, Employee ; Tuberous Sclerosis

Pyoderma gangrenosum has been described in association with a wide variety of disorders, including Crohn's disease, ulcerative colitis, myeloproliferative disease, monoclonal gammopathy, and Behcet's disease. Herein, we report two cases of pyoderma gangrenosum associated with Crohn's disease. The first case was a 24-year-old female who presented with multiple, necrotizing ulcers on the scalp, which is a rarely affected site. The other case was a 30-year-old female who presented with erythema nodosum on the lower leg initially, and subsequent rapidly-progressive ulcerating lesions then developed at the previous biopsy and intravenous injection sites. In both cases, the colonoscopic findings were consistent with Crohn's disease. The lesions improved with a combined therapy of systemic steroids, sulfa drugs and topical 0.03% tacrolimus ointment.
Adult ; Biopsy ; Colitis, Ulcerative ; Crohn Disease* ; Erythema Nodosum ; Female ; Humans ; Injections, Intravenous ; Leg ; Paraproteinemias ; Pyoderma Gangrenosum* ; Pyoderma* ; Scalp ; Steroids ; Tacrolimus ; Ulcer ; Young Adult

No abstract available.
Female ; Humans ; Ovary*

CREST syndrome is an indolent form of systemic sclerosis and refers to the manifestations of calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly and telangiectasias. We report a typical case of CREST syndrome in a 67-year-old woman, who presented with extensive, hard, calcified nodules and plaques on her shins, fingers, pelvis, and shoulder.
Aged ; Calcinosis* ; CREST Syndrome* ; Esophageal Motility Disorders ; Female ; Fingers ; Humans ; Pelvis ; Scleroderma, Systemic ; Shoulder ; Telangiectasis

No abstract available.

Epileptic seizures of nystagmoid character with the fast -beat to the opposite side of the epileptogenic focus have been described as oculoclonic seizures and epileptic nystagmus. Epileptic nystagmus, especially horizontal, most commonly results from seizure activity involving the occipital cortex, although participation of adjoining portions of the parietal and temporal cortex is possible. The frequency of ictal nystagmus was less than 10% of patients with occipital lobe epilepsy. Although forty-six cases were already reported at the litherature, there was no report in korea. We reported a 20-year old patient who had history of recurrent paroxysmal attacks of epileptic nystagniu, associated with oscillopsia and followed by episodic bilateral blindness and eyelid flutter. Standard and extra occipital electrodes visualized more exact left occipital foci at the videomonitored EEG examination when the patient showed epileptic nystagmus. The ictal Brain SPECT, with the use of 99mTc-HMPAO also localized the seizures to left occipital lobe.
Blindness ; Brain ; Electrodes ; Electroencephalography ; Epilepsies, Partial* ; Epilepsy ; Eyelids ; Humans ; Korea ; Occipital Lobe* ; Rabeprazole ; Seizures ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon ; Young Adult

OBJECTIVE: Type D personality can be regarded as a promising cardiovascular risk marker that has been repeatedly linked to relevant indicators of mental health, quality of life, morbidity, and mortality in cardiac patients. Heart rate variability (HRV) is a non-invasive technology that can provide information regarding a patient's sympathetic/parasympathetic balance and the control mechanisms of the autonomic systems in the cardiovascular system. As both type D personality and HRV are parameters related to the cardiovascular system, we assumed a relationship between type D personality and HRV. This study set out to identify the relationship between type D and HRV and the differences in HRV variables between type D and non-type D personalities. METHODS: Patients who visited Guro Community Mental Health Center from January 2011 to December 2012 were surveyed. They were evaluated using both the Korean version of the Type D Personality-14 for type D personality and HRV. During the survey, those who reported major cardiovascular disease that can affect heart rate variability were excluded from the study. RESULTS: Our analysis included 559 participants, 249 of whom were classified as type D personality. No significant differences were found in the HRV variables between the type D group and the non-type D group. There were also no clinically meaningful correlations between HRV variables and type D total/subscale scores when controlled for patient age. CONCLUSION: A relationship between HRV and type D personality was not identified using short-term HRV measurements in non-clinical patients with no definitive cardiovascular disease. Further studies using long-term HRV measurements in patients with cardiovascular disease are necessary to conclude an association between HRV and type D personality.
Cardiovascular Diseases ; Cardiovascular System ; Heart Rate* ; Humans ; Mental Health* ; Mortality ; Quality of Life ; Type D Personality*