BACKGROUND: Histologic distinction between various fibrohistiocytic tumors of the skin may sometimes be difficult. Recently, several immunohistochemical markers of "histiocytes and "facultative fibroblasts" have been introduced and used for the study of some fibrohistiocytic tumors of the skin. OBJECTIVE: The purpose of this study is to determine whether immunostatining with MAC 387, antibodies to S-100 protein, factor Xllla(FXllla) and CD 34 allows distinction between various fibrohistiocytic tumors of the skin in formalin-fixed, paraffin-embedded specimens. METHODS: Paraffin-embedded specimens of dermatofibroma, keloid, hypertrophic scar, dermatofibrosarcoma protuberans(DFSP), neurofibroma, and juvenlie xanthogranuloma were investigated with MAC 387, antibodies to S-100 protein, CD 34 and FXllla using avidin-biotin -peroxidase complex method. RESULTS: In all fibrous dermatofibromas (n=26), 20-90% of constituent cells were positive for FXllla. Focal or diffuse CD 34 reactivity was present in DFSP (n=2). Weak reactivity for CD 34 and consistent labeling for S-100 protein were found in neurofibromas (n=5). Tumor cells showed negative for FXllla, CD 34 and S-100 protein in keloids (n=2), hypertrophic scars (n=6), and juvenile xanthogranulomas (n=5). MAC 387 did not label tumor cells of the fibrobistiocytic tumors we have studied. CONCLUSION: Immunostaining of paraffin-embedded specimens with antibodies to S-100 protein, FXllla and CD 34 may be useful in the differential diagnoses of fibrohistiocytic tumors of the skin.
Antibodies ; Cicatrix, Hypertrophic ; Dermatofibrosarcoma ; Diagnosis, Differential ; Histiocytoma, Benign Fibrous ; Keloid ; Methods ; Neurofibroma ; S100 Proteins ; Skin* ; Xanthogranuloma, Juvenile

Candidiasis is the most common fungal infection complicating the course of patients with hematologic malignant neoplasms. Although widespread organ involvement is characteristic of disseminated candidiasis, reports of skin are rare. Reports describing typical clinical and histopathological finding of cutaneous lesions are very important since it may enable a diagnosis of disseminated candidiasis to be made and thus antifungal therapy can be initiated earlier. A 50-year-old housewife was admitted with a 5-month history of fatigue and easy bruising. She was diagnosed as ha.ving acute myelocytic leukemia and treatment was begun with daunorubicin and cytosin, arabinoside. Eight days after the start of chemotherapy, she developed a fever and generalized tender well demacated erythematous to purplish papulonodular eruption. A biopsy specimen from the skin lesion showed perivascular mononuclear cell infiltration and spore and pseudohypae v,rere found within the dermis and subcutis in PAS stain. Cultures of one skin biopsy specimen and one of four blood sarnples grew Candida tropicalis. The patient was treated with intravenous amphotericin B for disseminated candidiasis. On the tenth day of antifun gal therapy, she developed cardiopulmonary arrest and died.
Amphotericin B ; Biopsy ; Candida tropicalis ; Candidiasis* ; Daunorubicin ; Dermis ; Diagnosis ; Drug Therapy ; Fatigue ; Fever ; Heart Arrest ; Humans ; Leukemia, Myeloid, Acute ; Middle Aged ; Skin Manifestations* ; Skin* ; Spores

No abstract available.
Graves Disease* ; Pregnancy*

BACKGROUND: It is a popular notion that cutaneous ageing includes two distinct phenomenon; true ageing, a universal presumably inevitable change attributable to the passage of time alone, and photoageing, changes attributable to chronic habitual sun exposure that are neither universal nor inevitable. Numerous investigations with experimental animals, in vitro skin models have been conducted, although, few histological studies to date have attempted to announce fundamental morphological changes with innate ageing. OBJECTIVE: We compared skin derived from the breast of old and young persons using light microscopy to discern structural changes in epidermal and dermal morphology with advancing age. METHODS: The histological, immunohistochemical studies were performed with normal skin sections of thirty donors who were diagnosed with breast cancer. They were classified into three age cohort groups; nine into group I (22 to 38), twelve into group II(40 to 52), and nine into group III(54 to 87). We chose the breast as an area that might closely resemble intrinsically aged skin. This region is relatively shielded from photoageing by its anatomical location. Analysis of data was performed using the Kruskal-Wallis and ANOVA test for dermal parameters based on a 5-point rating scale, and a simple regression test for a positive rate of immunoreactants. Results : 1. Light microscopic appearance of aged skin revealed a more flattened epidermis than young skin. There was no trend for an increase in epidermal melanin content per unit area on Fontana-Masson staining. There was an age-associated decrease in the Ki-67 positive rate(p<0.001), the density of Ki-67 positive cells declined approximately 1.16% per decade in photoprotected skin(p<0.001). The number of S-100 positive cells declined approximately 4.4/mm width along the dermo-epidermal juction per decade in photoprotected skin(p<0.001). The expression of differentiation markers(keratin 1, involucrin, filaggrin, loricrin) were not different among the three age cohort groups. 2. With advancing age, there was an attenuation in the number and diameter of elastic fibers in the papillary dermis and an increase in the number and straightness of the same fibers in the reticular dermis. The collagen fibers are arranged in sparse bundles in disarray, and/or aggregates of loosely woven, straight fibers in the aged skin. There was an apparent, age-related decrease in the stainability of ground substances in the papillary dermis on colloidal iron staining. Conclusions : Our data documents semi-quantitative differences among three groups in intrinsically aged breast skin and provide the framework for future research to evaluate the ageing process.
Animals ; Breast ; Breast Neoplasms ; Cohort Studies ; Collagen ; Colloids ; Dermis ; Elastic Tissue ; Epidermis ; Humans ; Iron ; Melanins ; Microscopy ; Skin* ; Solar System ; Tissue Donors

BACKGROUND: In the skin, it is often difficult to differentiate lymphomas from reactive lymphoid lesions by light microscopic examination. OBJECTIVE: Our purpose was to determine whether immunologic data obtained from mutine-processed specimens could be used to further objective morphologic interpretations. METHODS: We conducted an immunohistochcmical staining in 44 cases of benign and malignant cutaneous lymphoproliferative lesions using nine antibodies, including anti-CD3, UCHL1, MT1, MT2, L26, MB2, BerH2, 123C3, and MIB1. RESULTS: 1. Immunophenotyping with anti-CD3, UCHL1, MT1, L26, and MB2 was useful for the diagnosis of T cell or B cell lymphoma. However, these antibodies showed a lack of specificity for neoplastic cells, 2. Antibody to CD56, 123C3 showed positivity in 4 cases of angiocentric lymphoma, but negativity in 8 cases showing angiocentric lymphoma-like pathology. 3. Antibody to CD30, BerH2 showed positivity in all 6 cases of CD30 positive large cell lymphoma, but negativity in 6 cases showing diffuse lymphoma-like pathology. 4. Antibody to Ki-67, MIB1 showed positivity in more than 30% of infiltrating cells in 6 cases of angiocentric lymphoma, 4 cases of diffuse B cell lymphoma, and in more than 60% of infiltrating cells in 6 cases of CD30 positive large cell lymphoma. CONCLUSION: These observations suggest that immunostaining may provide useful adjunctive information in distinguishing benign from malignant cutaneous lymphoproliferations in paraffin sections.
Antibodies ; Diagnosis ; Immunophenotyping ; Lymphoma ; Lymphoma, B-Cell ; Paraffin ; Pathology ; Pseudolymphoma* ; Sensitivity and Specificity ; Skin

BACKGROUND: Neurofibiomat,osis type 1(NF-1) is a multisystemic disorder of genetic ori gin, affecting one in every 3000 to 4000 people. It is clinically important in the aspect of dermatology, pediatrics, orthopedic surgery, neurology, neurosurgery and ophthalmology. OBJECTIVE: The purpore of this study was to elucidate the clinical characteristics of NF-1 in Korean people. METHODS: We carried out a retrospective study on 112 patients which were compatible to the diagnostic criteria of Riccardi and Neurofibromatosis Conference Statement. The results were compared with other western studies. RESULTS: The age of onset, sex ratio, family history of neurofibromatosis, and clinica features of cafe-au-lait spot, neurofibroma, and axillary freckinings did not differed from western countries. However, some characterist,ics of NF 1(e.g. Lisch nodule) were not as sessed in the most of the cases and incomplete evaluations of the systemic diseases wen found. CONCLUSION: In this study t.he clinial features of NF-1 did not differ from western coun tries in many aspects. A more intensive evaluation of patient,s status is needed to manag; NF-1 patients appropritely.
Age of Onset ; Cafe-au-Lait Spots ; Dermatology ; Humans ; Neurofibroma ; Neurofibromatoses* ; Neurofibromatosis 1* ; Neurology ; Neurosurgery ; Ophthalmology ; Orthopedics ; Pediatrics ; Retrospective Studies ; Sex Ratio

BACKGROUND: A number of in vitro skin models have been developed for the purpose of the screening of cosmetics, pharmaceuticals, and environmental chemicals. To mimic the skin in vivo, a model should resemble morphologically and biochemically the parent, tissue. OBJECTIVE: The purpos of this study is to study the differentiation and organization of the artificial epidermis in comparsion with epidermis in vivo based on the expression of epidermal protein antigens and basement membrane components. METHODS: Human keratinocytes were cultured on deepidermidized dermis (RE-DED) or on fibroblast-populated collag-,n matrix (LSE). After 10 days culture, the sections of RE-DED and LSE were stained with hematoxylin and eosin. An immunohistochemical study was also performed with the sections of RE-DED and LSE using antibodies recognizing proliferating cell nuclear antigens (PCNA), epidermal growth factor receptor (EGFR), keratin 1, involucrin, filaggrin, loricrin, keratin 13, type IV collagen, and laminin. RESULTS: In both culture systems(RE-DED and LSE) a multilayered epidermis with a horny layer was observed. In the human epidermis reconstructed by both culture systems, differentiation markers appeared but with a topography slightly different from that of epidermis in vivo, and components of the basement membrane was also expressed. CONCLUSION: Our findings suggest the epidermis obtained in both culture systems(RE-DED and LSE) resembled in vivo epidermis morphologically and biochemically, although it was not the same.
Antibodies ; Antigens, Differentiation ; Basement Membrane* ; Collagen Type IV ; Dermis ; Eosine Yellowish-(YS) ; Epidermis* ; Hematoxylin ; Humans* ; Keratin-1 ; Keratin-13 ; Keratinocytes ; Laminin ; Mass Screening ; Parents ; Proliferating Cell Nuclear Antigen ; Receptor, Epidermal Growth Factor ; Skin

BACKGROUND: A number of in vitro skin models have been developed for the purpose of the screening of cosmetics, pharmaceuticals, and environmental chemicals. To mimic the skin in vivo, a model should resemble morphologically and biochemically the parent, tissue. OBJECTIVE: The purpos of this study is to study the differentiation and organization of the artificial epidermis in comparsion with epidermis in vivo based on the expression of epidermal protein antigens and basement membrane components. METHODS: Human keratinocytes were cultured on deepidermidized dermis (RE-DED) or on fibroblast-populated collag-,n matrix (LSE). After 10 days culture, the sections of RE-DED and LSE were stained with hematoxylin and eosin. An immunohistochemical study was also performed with the sections of RE-DED and LSE using antibodies recognizing proliferating cell nuclear antigens (PCNA), epidermal growth factor receptor (EGFR), keratin 1, involucrin, filaggrin, loricrin, keratin 13, type IV collagen, and laminin. RESULTS: In both culture systems(RE-DED and LSE) a multilayered epidermis with a horny layer was observed. In the human epidermis reconstructed by both culture systems, differentiation markers appeared but with a topography slightly different from that of epidermis in vivo, and components of the basement membrane was also expressed. CONCLUSION: Our findings suggest the epidermis obtained in both culture systems(RE-DED and LSE) resembled in vivo epidermis morphologically and biochemically, although it was not the same.
Antibodies ; Antigens, Differentiation ; Basement Membrane* ; Collagen Type IV ; Dermis ; Eosine Yellowish-(YS) ; Epidermis* ; Hematoxylin ; Humans* ; Keratin-1 ; Keratin-13 ; Keratinocytes ; Laminin ; Mass Screening ; Parents ; Proliferating Cell Nuclear Antigen ; Receptor, Epidermal Growth Factor ; Skin

Chronic pain is associated with disabling physical and emotional symptoms. Patients with chronic pain utilize more health services, have an impaired sense of well-being and frequently experience anxiety or depression. Unfortunately, treatment for chronic pain is not always correctly targeted, which leads to a reduced quality of life. Treatment of chronic pain involves a comprehensive approach using medication and functional rehabilitation. The usual approach for mild to moderate pain is to start with nonopioid analgesics. Also, trying antidepressant drugs for sleep loss and gabapentin for neuropathic pain or fibromyalgia is appropriate. For moderate to severe chronic pain, opioid analgesics can be used without any serious side effects if adequately used at the right dosage. It is important to provide guidance on the safe use of analgesics and other psychoactive drugs. Dosing of acetaminophen should be limited to avoid liver toxicity, and topical analgesics are preferred for focal pain. Full-dose nonsteroidal anti-inflammatory drugs should not be used for more than short periods, in order to avoid gastrointestinal, renal, and cardiovascular complications. Mechanisms of analgesia, drug selection, and recommendations for clinical usage for the management of chronic pain are reviewed in this paper.
Acetaminophen ; Amines ; Analgesia ; Analgesics ; Analgesics, Non-Narcotic ; Analgesics, Opioid ; Antidepressive Agents ; Anxiety ; Chronic Pain ; Cyclohexanecarboxylic Acids ; Depression ; Fibromyalgia ; gamma-Aminobutyric Acid ; Health Services ; Humans ; Liver ; Neuralgia ; Psychotropic Drugs ; Quality of Life

PURPOSE: Percutaneous needle aspiration biopsy under the imaging guidance in the diagnosis of intrathoracic diseases has become a standard practice. Core tissue obtained by automated gun biopsy(AGB) is believed to be more diagnostic than materials from fine needle aspiration(FNA) by many cytopathologists. The authors evauated the role of automated gun biopsy in localized pulmonary lesions with respect to the its accuracy and complications. MATERIALS AND METHODS: We performed 107 percutaneous biopsies in localized pulmonary lesions under fluoroscopic guidance among 107 patients:AGB using 18G or 20G was done in 81 patients, and both AGB and FNA was done in 26 patients. RESULTS: Biopsy samples sufficient for histologic diagnosis were obtained in 94(87.9%) of 107 patients, AG8 in 73(90.1%) of 81 patients and AGB and FNA in 21(80.8%) of 26 patients. 11 of 13 negative results were due to inadeguate specimen size for the histologic diagnosis or were composed of necrotic areas, and 2 of 13 negative results were obtained through nontarget tissue. 10 patients developed pneumothorax and 4 of them required chest tube insertion. Minimal hemoptysis was found in 3 patients. CONCLUSION: Percutaneous automated gun biopsy under fluoroscopic guidance was easy and simple method of obtaining specimens of good quality and quantity. It may be an useful procedure in the diagnosis of localized pulmonary lesions.
Biopsy* ; Biopsy, Needle ; Chest Tubes ; Diagnosis ; Hemoptysis ; Humans ; Needles ; Pneumothorax