Two cases of clear cell syringoma are reported in the women who were 39 ad 54 years old, respectively. They had had asymptomatic, ricegrain-sized skin colored to yellowish pink papules on the face, particularly on he lower eyelid for several years. Interestingly, both of them had suffered from diabetes mellitus for more than a decade and been placed on irregular antidiabetic medications. Routine laboratory findings in the elder patient(case 2), unfortunately not checked in the younger patient(cases 1) due to her refusal, were within normal limits except marked glucosuria. Histologic examination revealed numerous various-sized, well-defined tumor nests composed largely of clear cells with polygonal cellular boundary and eccentric nucleus. Special stain with Periodic acid-Schiff disclosed existance of glycogen in the clear cells, but other special stains such as alcian blue showed negative findings. Electron microscopic examination of the elder patient revealed many multivesicular bodies suggestive of lysosomes, and numerous droplets of glycogen dispersed between them in villi-rich periluminal cell.
Alcian Blue ; Coloring Agents ; Diabetes Mellitus ; Disulfiram ; Eyelids ; Female ; Glycogen ; Humans ; Lysosomes ; Middle Aged ; Multivesicular Bodies ; Skin ; Syringoma*

Addisons disease is the defieient production of glucocorticoid or mireralocorticoid or both, due to the destruction of the adrenal cor tex. We report a case of Addiaons disesse in a 26-year-old male who complained only of skin and oral mucosal hyperpigmentations without other constitutional symptorns, Physical examinations showed scanty pubic and axillary hsirs. On adrenocorticoid funtion study, the ACTH stimulstion test failed to rise the bassl plasme cortisol level and basal ACTH level was marked elevated st PM 6:00. Routine laboratory and other endocrinologic evaluations exhibited within normal limits. Radiologic findings showed negative on both cheet X-ray and abdominal MRI films. Gradisl disapperance of skin snd mucosal hyperpigmentation were noted following administration of phosiologic dose of corticosteriods. Almost normal appearance was obtaineg after 26 months treatment.
Addison Disease* ; Adrenocorticotropic Hormone ; Adult ; Humans ; Hydrocortisone ; Hyperpigmentation ; Magnetic Resonance Imaging ; Male ; Physical Examination ; Skin

Hyperkeratosis of the nipple and areola is a rare condition. We report a case of hyperkeratosis of the nipple and areola occurrinp in man with no underlying endocrirop thy or synthetic estrogenic drug therapy. The patient was not associated with epidermal nevus orichthyosis and so fitted into the nevoid form of hyperkeratosis of the nipple and areola. The clinical appearance and histological findings of the lesion were the same as those reported before. He showed a slight improvement in the color and hyperkeratcsis of the nipple and areola with 6 months use of a topical keratolytic agent and corticosteroid crearn.
Drug Therapy ; Estrogens ; Humans ; Nevus ; Nipples*

BACKGROUND: There have been a few reports suggesting involvement of neutrophil as well as eosinophil in inducing bronchoconstriction aft,er inhalation of TDI. OBJECTIVE: In order to observe the source of chemokines in TDI-induced asthma, this investigation was designed to determine whether IL-8 and RANTES could be produced by human bronchial epithelial cells and whether dexamethasone had any effects on their production. Materials and METHODS: We cultured Beas-2B, a bronchial epithelial cell line, with five concentrations of TDI-human serum albumin (HSA) conjugate and compared them with those having no conjugate. The levels of IL-8 and RANTES in the supernatant were measured by ELISA. To evaluate the effect of pro-inflammatory cytokines, cells were incubated with peripheral blood mononuclear cell (PBMC) culture supernatant, which was derived from PBMC culture of a TDI -induced asthmatic subject under exposure to TDI-HSA conjugate, and then compared to those without PBMC supernatant addition. To evaluate the effect of dexamethasone, four concentrations of dexamethasone were pre-incubated and the same steps were repeated. RESULTS: There was significant production of IL-8 from bronchial epithelial cells with addition of TDI-HSA conjugate in a dose-dependent manner (p<0.05, respectively), which was significantly augmented with additions of PBMC supernatant (p<0.05, respectively) at each concentration. RANTES production was negligible, however, it increased significantly with addition of PBMC supernatant and TDI-HSA conjugate in a dose response manner(p<0.05, respectively). Compared to the untreated sample, pre-treatment of dexamethasone induced remarkable inhibitions of IL-8 and RANTES production. CONCLUSION: These results suggest that IL-8 and RANTES released from bronchial epithelial cells may contribute to neutrophil and eosinophil recruitment occurring in TDI-induced airway.
Asthma ; Bronchoconstriction ; Chemokine CCL5* ; Chemokines ; Cytokines ; Dexamethasone ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Epithelial Cells* ; Humans ; Inhalation ; Interleukin-8 ; Neutrophils ; Serum Albumin ; Toluene 2,4-Diisocyanate* ; Toluene*

Five cases of complete visual loss related to papilledema were presented. The diagnoses of cases were an intracranial arachnoid cyst(1 case), brain tumors(3 cases) and benign intracranial hypertension(BIICP) followed by a minor head trauma(1 case). All cases had marked papilledema at admission and their range of age was from 4 to 27 years. The timings of visual loss were preadmission in 2 cases, during admission following removal of posterior fossa tumor(1 case) and revision of cysto-peritioneal shunt in a case of an arachnoid cyst(1 case), and during follow-up after conservative management of a minor head trauma(BIICP) in 1. Their visual function had not improved during the follow-up from 3 months to 9 years. Optic nerve sheath decompression should be considered in the case of BIICP for improving the vision. In cases who have well developed chronic papilledema, visual loss that is abrupt may be followed by cranial decompression. We stress neurosurgeons should predict a tragic outcome of visual loss during the management of cases who have well developed chronic papilledema, especially in children and young adult patients.
Arachnoid ; Brain ; Child ; Decompression ; Diagnosis ; Follow-Up Studies ; Head ; Humans ; Optic Nerve ; Papilledema ; Pseudotumor Cerebri ; Young Adult

BACKGROUND: We have recently reported that airway epithelial cells can produce RANTES and IL-8 in response to the stimulation of tubercle bacilli wuggesting a certain role of airway epithelial cells in the pathogenesis of pulmonary tuberculosis. The pathogenesis of tuberculosis is determined by several factors including phagocytosis, immunological response of host, and virulence of tubercle bacilli. Interestingly, there have been reports suggesting that difference in immunological response of host according to the virulence of tubercle bacilli may be related with the pathogenesis of tuberculosis. We, therfore, studied the expressions and productions of RANTES and IL-8 in airway epithelial cells in response to tubercle bacilli(H37Rv, virulent strain and H37Ra, avirulent strain), in order to elucidate the possible pathophysiology of pulmonary tuberculosis. METHODS: Peripheral blood monocytes were isolated from normal volunteers. Peripheral blood monocytes(OBM) were stimulated with LPS(10 micrograms/ml), H37Rv, or H37Ra(5X10(5) bacilli/well) along with normal control for 24 hours. A549 cells were stimulated with supernatants of cultured PBM for 24 hours. ELISA kit was used for the measurement of TNFalpha and IL-1beta production in supernatants of cultured PBM and for the measurement of RANTES and IL-8 in supernatants of cultured A549 cells. Northern blot analysis was used for the measurement of RANTES and IL-8 mRNA expression in cultured A549 cells. RESULTS: TNFalpha and IL-1beta productions were increased in cultured PBM stimulated with LPS or tubercle bacilli(H37Rv or H37Ra) compared with the control. There was, however, no difference in TNFalpha and IL-1beta production between cultured PBM stimulated with H37Rv and H37Ra. RANTES and IL-8 expressions and productions were also increased in cultured A549 cells stimulated with LPS or tubercle bacilli compared with the control. RANTES and IL-8 mRNA expressions were significantly increased in cultured A549 cells stimulated with H37Ra-conditioned media(CM) compared with A549 cells stimulated with H37Rv-CM (p<0.05). However, there was no difference in RANTES and IL-8 productions between A549 cells stimulated with H37Rv-CM and H37Ra-CM. CONCLUSION: Airway epithelial cells can produce the potent chemokines such as RANTES and IL-8, in response to the stimulation of tubercle bacilli. These results suggest that airway epithelial cells may play a certain role in the pathogenesis of pulmonary tuberculosis. However, the role of airway epithelial cells in the pathogenesis of tuberculosis according to the virulence of tubercle bacilli was not clear in this study.
Blotting, Northern ; Chemokine CCL5 ; Chemokines ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Healthy Volunteers ; Interleukin-8 ; Monocytes ; Phagocytosis ; RNA, Messenger ; Tuberculosis ; Tuberculosis, Pulmonary ; Tumor Necrosis Factor-alpha ; Virulence*

BACKGROUND: Rifampicin (RFP) is a key component of the antituberculous short-course chemotherapy and the RFP resistance is a marker of multi-drug resistant (MDR) tuberculosis. RpoB gene encodes the beta-subunit of RNA polymerase of M. tuberculosis which is the target of RFP. And the mutations of rpoB gene have been found in about 96% of rifampicin resistant clinical isolates of M. tuberculosis. So in order to find a rapid and clinically useful diagnostic method in identifying the REP resistance, we compared the PCR-line probe method with PCR-SSCP for the detection of the rpoB gene mutation in cultured M. tuberculosis. METHODS: 45 clinical isoLates were collected from patients who visited Sung Kyun Kwan University Hospital. The REP susceptibility test was referred to the referral laboratory of the Korean Tuberculosis Institute. 33 were rifampicin resistant and 12 were rifampicin susceptible. The susceptibility results were compared with the results of the PCR-SSCF and PCR-line probe method. RESULTS: We could find rpoB mutations in 27/33(81.8%) RFP-resistant strains by PCR-line probe method, and in 23/33(69.7%) by PCR-SSCP and there was no significant difference between two methods. There was no mutation in rifampicinn susceptible strains by both methods.: Comparison of PCR-line probe and PCR-SSCP methods for detection rifampicin resistance CONCLUSION: PCR-Iine probe method would be a rapid, sensitive and specific method for the detection of rifampicin resistant Mycobacterium tuberculosis.
DNA-Directed RNA Polymerases ; Drug Resistance ; Drug Therapy ; Humans ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymorphism, Single-Stranded Conformational ; Referral and Consultation ; Rifampin* ; Tuberculosis

No abstract available.
Blastocyst ; Coculture Techniques ; Fertilization ; Oocytes* ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval* ; Spermatozoa*

BACKGROUND: Liquid ventilation is associated with decreased inflammatory response in an injured lung. This study was performed to investigate if whether perfluorocarbon (PFC) can decrease chemokine expression in airway epithelial cells. METHODS : A549 cells were used for airway epithelial cells and perfluorodecalin for PFC. To expose cells to PFC, lower chamber of Transwell a plate was used. This study was performed in two parts. In the first part, we examined whether PFC could decrease chemokine expression in airway epithelial cells through inhibition of other inflammatory cells. Peripheral blood mononuclear cells (PBMC's) were isolated and stimulated with lipopolysaccharide (LPS, 10 mg/mL) for 24 hours with or without exposure to PFC. Then A549 cells were stimulated with conditioned media (CM) containing the culture supernatants of PBMC . After 24 hours, the expressions of interleukin-8 (IL-8) and RANTES were measured. In the second part of the study, we studied whether PFC could directly suppress chemokine expression in airway epithelial cells. A549 cells were stimulated for 24 hours with interleukin-1b and/or tumor necrosis factor-a with or without exposure to PFC (,)and then the chemokine expression was measured. Northern analysis was used to measure the mRNA expression (,) and ELISA was used for immunoreactive protein measurements in culture supernatant. RESULTS: 1. IL-8 and RANTES mRNA expression and immunoreactive protein production were increased significantly by CM from LPS-stimulated PBMC in A459 cells compared with CM from unstimulated PBCM(p<0.05) (,)but exposure of PFC had no significant effect on either mRNA expression immunoreactive protein expression. 2. IL-8 and RANTES mRNA expression and immunoreactive protein production were increased significantly by IL-1b and TNF-a in A549 cells(p<0.05)(,)but exposure of PFC had no significant effect on either mRNA expression or immunoreactive protein production. CONCLUSION: Decreased chemokine expression of airway epithelial cells may not be involved in decreased inflammatory response observed in liquid ventilation. Further studies on possible mechanisms of decreased inflammatory response are warranted.
Chemokine CCL5 ; Culture Media, Conditioned ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Inflammation ; Interleukin-8 ; Liquid Ventilation ; Lung ; Necrosis ; RNA, Messenger

BACKGROUND: Basal cell carcinoma(BCC) does not commonly occur in dark-skinned people, although it is the most common cancer of light-skinned people. So it has been known that incidence of BCC is lower than that of squamous cell carcinoma(SCC) in Asian and Africans. However, several recent Korean articles have reported the reversal of the ratio of SCC to BCC. There has been no report about BCC following a nationwide survey in Korea. OBJECTIVE: Our purpose was to confirm the trends in BCC and SCC, and to identify the clinical and histopathological characteristics of BCC. METHODS: A clinical and histopathological analysis was done retrospectively with patients diagnosed as BCC from the Department of Dermatology of 15 University Hospitals or General Hospitals during the last 20 years(1977-1996). Annual incidence of BCC was compared with that of SCC at the same situation. We compared the results with those in other races statistically. RESULTS: 1. Incidence of BCC was 0.16% compared with 0.11% of SCC. The increasing incidence of BCC was more pronounced than that of SCC, although they were increased gradually. 2. The male-female ratio was 1:1.07, and the most frequent age group was the 6th decade(30.1%). 95% of the patients were older than the age of 40 years with the mean age of 62.7 years. 3. The most commonly involved site was the face(84.9%), especially on the nose, cheek, and eyelids. 4. The most frequent histologic pattern was nodulocystic type(35.4%), followed by mixed(30.1%), infiltrative(9.3%), superficial(6.7%), micronodular(6.2%), adenoid(5.9%), metatypical(4.0%), morpheaform(2.1%), and fibroepithelioma type(0.3%). 5. Histologically, 45.3% of BCC contained pigment. The histologic pattern most frequently associated with pigmented BCC was mixed type(53.1%) followed by nodulocystic(51.2%), superficial(46.8%), micronodular(38.6%), and adenoid type(33.3%). 6. Overall recurrence rate was 6.3%. Morpheaform, infiltrative, and metatypical BCC have a high erincidence of recurrence(26.3%, 13.2%, 8.1%, respectively). Therapeutic modalities that showed high recurrence rate was 5-FU, curettage and electrodessication, and cryotherapy(33.3%, 28.6%, 16.8%, respectively). CONCLUSION: It was confirmed following a nationwide survey that increasing incidence of BCC was more pronounced than that of SCC since early 1980s and BCC was the most common skin cancer in Korea.
Adenoids ; Asian Continental Ancestry Group ; Carcinoma, Basal Cell* ; Cheek ; Continental Population Groups ; Curettage ; Dermatology ; Eyelids ; Fluorouracil ; Hospitals, General ; Hospitals, University ; Humans ; Incidence ; Korea ; Nose ; Recurrence ; Retrospective Studies ; Skin Neoplasms