We describe four patients with herpes-associated erythema multiforme, who had clinical and histopathological features consistent with the so-called erythema multiforme minor. The appearance of lesions of herpes simplex were followed with intervals between 6 and 10 days by the recurrent developments of erythema multiforme several times in a year in each patient. Sinee herpes simplex virus infection is considered one of the major factors provocating erythema multiforme one may have to pay more attention to patient's history to define the nature of erythema multiforme.
Erythema Multiforme* ; Erythema* ; Herpes Simplex ; Humans ; Simplexvirus

Background: Insulin is known to act as second effector that provides potassium transfer from extracellular fluid to intracellular fluid, thus causing hypokalemia and arrythmia. We evaluated the effect of magnesium sulfate treatment on hemodynamics and serum potassium concentration, induced by continuous infusion of regular insulin solution in rabbits. Method: Twenty-four rabbits were divided into four groups for the experiment. Group I was given intravenouse injection of 5 ml of normal saline and continuous dripping of 7.5 U of RI. Group II was pretreated with 30 mg/kg of magnesium sulfate, followed by continuous dripping of 7.5 U of RI. Group III was given 5 ml of normal saline and 15 U of RI. And Group IV was administered 15 U of RI after 30 mg/kg of magnesium sulfate pretreatment. Venouse blood sampling was done before pretreatment, and after 5, 30, 60 and 120 minutes respectively. Heart rate and arterial blood pressure were taken at the same intervals. Result: 1) There was no significant change in serum potassium concentration in groups injected with 7.5 units of RI respectively (groups I and II), regardless of magnesium pretreatment. But in groups injected with 15 units of RI, the group that was not pretreated with magnesium (Groups III) showed a decrease in serum potassium concentration from 3.39+/-0.57 Eq/L to 2.29+/-0.71 mEq/L, while the concentration in the pretreated group (Group IV) decreased more significantly from 3.35+/-0.50 mEq/L to 1.81+/-0.41 mEq/L. 2) Pulse rate did not change significantly in groups that received continuous infusion of 7.5 units of RI (groups I and II) regardless of magnesium pretreatment, but increased significantly in groups injected with 15 units of RI (groups III and IV), pretreated or not. The pretreated group (group IV) had a more significant rise in pulse rate compared with the group that was not pretreated (group III). 3) In all of the groups, those pretreated with magnesium (groups II and IV) and those not pretreated (groups I and III), there was no significant change in systolic and diastolic blood pressures. Nor was arrhythmia detected. Conclusion: The above results indicate that while magnesium sulfate pretreatment at 30 mg/kg with insulin infusion affects serum potassium concentration, has an antiarrhythmic effect, and may induce tachycardia, it does not have any significant effect on blood pressure.
Arrhythmias, Cardiac ; Arterial Pressure ; Blood Pressure ; Extracellular Fluid ; Heart Rate ; Hemodynamics* ; Hypokalemia ; Insulin ; Intracellular Fluid ; Magnesium Sulfate ; Magnesium* ; Potassium* ; Rabbits* ; Tachycardia

A 56-year-old woman presenting a 10-year history of atrophic discoid patches with underlying subcutaneous nodules was seen. These skin lesions were distributed on the upper arms bilaterally. Biopsy specimens taken from the lesional skin showed epidermal and dermal changes consistent with the discoid lesions of the cutaneous lupus erythematosus. Deep dermis and subcutaneous fat tissue revealed sclerosis and fibrinoid alterations of the collagen and necrosis of fat cells, the features corresponding to the lupus ei ythematosus profundus. She had no laboratory evidences suspective of systemic lupus erythematosus or other connective tissue diseases. This patient with lupus erythernatosus profundus which cleveloped subsequent to the discoid lesion is consiclered to be a rarely encounteririg observation in lupus erythematosus.
Adipocytes ; Arm ; Biopsy ; Collagen ; Connective Tissue Diseases* ; Connective Tissue* ; Dermis ; Female ; Humans ; Lupus Erythematosus, Cutaneous ; Lupus Erythematosus, Systemic ; Middle Aged ; Necrosis ; Panniculitis, Lupus Erythematosus* ; Sclerosis ; Skin ; Subcutaneous Fat

No abstract available.
Humans

Anti-T cell monoclonal antibodies(OKT series. OKT4a, OKTSA, OKT)1) immunoperoxidase technique study for the presence of T cells in cutaneous lesions from four patients with erythema multiforme showed that most dermal and epidermal lymphoid cells were reactive with monoclonal antibodies to anti-pan T cell (l3KT11) in this semiquantitative assay. In the dermis most of the perivascular lirmphoid infiltrates were reactive with anti-helper/inducer T cell antibody, but in the epidermis and in the derrnopidermal interface the predominant cells were identified as suppressor/cytotoxic T cells. The histologic and immunopathologic changes in erythema multiforme appear to be due in part to cellular immune rnechanisms with the lyrnphocyte as the predominant effector cell. But complex interplays with other humoral immune mechanisms might be in work for the development of erythema multiforme.
Antibodies, Monoclonal ; Dermis ; Epidermis ; Erythema Multiforme* ; Erythema* ; Humans ; Immunoenzyme Techniques ; Lymphocytes ; T-Lymphocytes*

The clinical spectruni of epidermolysis bullosa acquisita(EBA) is much broader than originally thought. Although the full extent of the clinical presenation is still being defined, it is now known that EBA include the followings: a non-inflammatory mechanobullous condition equating wit,h classical EBA; an inflammatory vesiculosullous eruption mimicking bullous pernphigoid; and a mucosal-centered disease with sarring similar to cicatricial pemphigoid. Among the nine cases of EBA, aged between 34 to 70 year-old, seen in recent years, three patients had mechanobullous lesions with skin fragilities and scarrings; three patients had inflammatory bullous eruptions, and three other patient had combined features of mechanobullous/inflammatory bullous lesions. Mucous membrane lesions were recognized in sex cases, and the rnos! frequent site of involvement was the oral mucosae. According to observations of these patients episodes of inflammatory bullous eruptions appeared to be present in seven cases and have been considered as early sympoms of the disease. It has been noted, however, that in two cases lesions develop d as an non-inflammatory mechanobullous from thonset. Based on the ability of EBA to mimick bullous pemphigoid or cicatricial pernphogoid and the fact that such cases have perhaps been missed, we feel EBA is more common than past literature has suggested.
Aged ; Blister ; Cicatrix ; Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa* ; Humans ; Mouth Mucosa ; Mucous Membrane ; Pemphigoid, Benign Mucous Membrane ; Pemphigoid, Bullous ; Skin

The tricuspid valve is not a simple but a complex structure, tricuspid valve complex. This complex is composed of tricuspid orifice, annulus, valve leaflet, chordae tendineae and papillary muscles. There are flew articles about these structures. The authors studied tricuspid valve complex in 53 cases of normal korean adults, such as circumference of tricuspid annulus, the maximum diameter of the tricuspid orifice, height and breadth of the cusps, including commissures, the ratio of rough to clear zone, the number of scallops of posterior cusp, the number, length and pattern of arrangement of the several types of chordae, the number and morphological characteristics of papillary muscles.
Adult* ; Chordae Tendineae ; Heart* ; Humans ; Papillary Muscles ; Pectinidae ; Tricuspid Valve*

A case of benign lichenoid keratosis(BLK) developed in a 25-year-old female is presented. She had two erythematous plaques with slightly verrucous surfaces on the lips for 4 weeks. A biopsy specirnen taken from the periphery of the lesion revealed a focal parakeratosis, the absence of granular cells, and hydropic degeneration of the basal cells in the epidermis. The upper dermal infiltrate composed chiefly of lymphacytes intermingled with a few histiocytes was also seen. The direct immunofluorescent study showed depositions of a few cytoid bodies and fibrin around the areas of the dermoepidermal junction. These plaques on her lips, demonstrating lichenoid tissue changes, cleared in 8 weeks from the evalution, without any treatment.
Adult ; Biopsy ; Epidermis ; Female ; Fibrin ; Histiocytes ; Humans ; Keratosis* ; Lip ; Parakeratosis

Majocchi's disease is one of chronic vascular disorders of the skin, histologically showing capillaritis with lymphoid cell infiltration. Although the hypothesis of delayed type hypersensitivity reaction against foreign antigen is proposed as the mechanism producing this condition, there are much yet to be defined. We tried to examine the lesional skin of five patients with Majocchi's disease by the direct immunofluorescence with anti-human immunoglobulins, C 3, and fibrin. As a result we found the deposition of immunoglobulins (M, and G) in papillary blood vessels in four patients, and C 3 and fibrin were found in all five patients. C3 was also found at the dermoepidermal junction in three patients. These findings suggest the posssibility that antibody mediated immunologic processes may alsobe involved in the pathogenesis of this disorder. With this observation Majocchis disease could be considered as a chronic immune vasculitis.
Blood Vessels ; Fibrin ; Fluorescent Antibody Technique, Direct ; Humans ; Hypersensitivity ; Immunoglobulins ; Lymphocytes ; Skin ; Vasculitis

BACKGROUND: This study was conducted to compare the clinical and radiological outcomes of the locking hook plate fixation (HP) technique and the single tight rope (TR) technique applied for acute high-grade acromioclavicular (AC) joint separations. METHODS: Between 2009 and 2014, 135 consecutive patients with acute AC joint separation Rockwood types III, IV, and V were subjected to surgical reconstruction. One hundred fourteen patients (84.4%) were available for retrospective evaluation. Of them, 62 and 52 were treated using the single TR group and clavicular HP group techniques, respectively. The visual analogue scale, Constant, American Shoulder and Elbow Surgeons (ASES), and Taft scores were used for clinical assessment. Postoperative shoulder range of motion was also assessed. An anteroposterior radiograph of the coracoclavicular distance (CCD) was obtained to evaluate the radiographic signs of recurrence. RESULTS: The TR group patients had better Constant, ASES, and Taft scores than the HP group patients. The loss of reduction in terms of the CCD did not differ between groups. Subacromial osteolysis was observed in 34.6% of the cases in the HP group. However, there were no significant differences in the clinical outcomes between the patients with and without osteolysis in the HP group. Subcoracoid osteolysis, drill tunnel widening, and metal displacement were observed in 3.2%, 22.6%, and 4.8% of the cases in the TR group, respectively. CONCLUSIONS: The single TR technique was relatively more effective at treating acute high-grade AC joint injuries than the HP fixation technique (level of evidence: therapeutic; retrospective comparative study, Level III).
Acromioclavicular Joint* ; Dislocations* ; Elbow ; Humans ; Joints ; Osteolysis ; Range of Motion, Articular ; Recurrence ; Retrospective Studies ; Shoulder ; Surgeons