Romberg syndrome is a rare disease and characterized by unilaeril atrophy of the skin, subcutaneous tissue and the underlying structure of half the face. The lesion does not usually cross the midline of the scalp. Roriberg syndrome is sometimes mildsnosed as linear scleroderma, although they differ widely in their clinical and histological apperance. A 13-year-old boy was present with a one year history of idefined atrophic patch on the left side of face and neck. We involved skin was not bound down to the underlying structure. The history revealed no prcvious trauma or disease, He had no abnormal neurologic finding. Computerized tomography demonstrated a diminished subcutaneouat volume and also decreased thickness of back muscle is the left side face from cheek to neck.
Adolescent ; Atrophy ; Back Muscles ; Cheek ; Humans ; Male ; Neck ; Neurologic Manifestations ; Rare Diseases ; Scalp ; Scleroderma, Localized ; Skin ; Subcutaneous Tissue

A 63-year-old man had a huge verrucous protruding mass over the suprasternal area. The lesion enlarged rapidly over 3 mooths, and measured about 10×8 cm. The histologic finding of the biopsy specimen showed nests of squamous epithelium with central keratinization, infiltrating the dermis. The neoplasm was treated successfully with surgical excision.
Biopsy ; Dermis ; Epithelium ; Humans ; Keratoacanthoma* ; Middle Aged

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.

BACKGROUND: The aim of this study was to compare the cardiovascular changes followed by laryngoscopy with the McCoy laryngoscope blade with those followed by laryngoscopy with the Macintosh laryngoscope blade. METHODS: Forty eight patients were randomly divided into two groups. Following induction with fentanyl 2 mcg/kg and thiopental 5 mg/kg, and muscle relaxation with vecuronium 0.1 mg/kg, the vocal cords were visualized with either the McCoy or the Macintosh laryngoscope blade, then tracheal intubation was performed. Heart rate and arterial blood pressure were measured just before and after laryngoscopy, and 1, 3 and 5 min later. RESULTS: There was a significant increase in both heart rate and arterial blood pressure after tracheal intubation using the Macintosh laryngoscope. Also, use of the McCoy blade resulted in a significant increase in both heart rate and arterial blood pressure. CONCLUSIONS: There was no significant difference on arterial pressure and heart rate to laryngoscopy and tracheal intubation with either the McCoy blade or the Macintosh.
Arterial Pressure ; Blood Pressure* ; Fentanyl ; Heart Rate* ; Heart* ; Humans ; Intubation* ; Laryngoscopes* ; Laryngoscopy ; Muscle Relaxation ; Thiopental ; Vecuronium Bromide ; Vocal Cords

Purpose: To assess the impact of toxoplasma immunoglobulin G (IgG) titers on the diagnosis of active ocular toxoplasmosis. Methods: We retrospectively analyzed the medical records of patients tested for toxoplasma IgG at our uveitis clinic. Active ocular toxoplasmosis was clinically diagnosed based on wide-angle fundus photography and disease progression. Patients with IgG titers ≥ 30 IU/mL were classified as seropositive-high titer, those with IgG titers of 1.6-30 IU/mL as seropositive-low titer, and the remaining patients as seronegative. We compared the proportion of active ocular toxoplasmosis among these groups. Additionally, we evaluated the sensitivity and specificity of each titer and attempted to determine an ideal reference titer for toxoplasma IgG in diagnosing active ocular toxoplasmosis. Results: Out of 824 patients, 86 (10.4%), 88 (10.7%), and 650 (78.9%) were categorized as seropositive-high titer, seropositivelow titer, and seronegative, respectively. Among these patients, 34 in the seropositive-high titer group and 2 in the seropositive- low titer group were clinically diagnosed with active ocular toxoplasmosis. The false-positive rate was significantly different between the groups, being 60.5% in the seropositive-high titer group and 97.7% in the seropositive-low titer group (p < 0.001). The receiver operating characteristic curve indicated that 37.70 IU/mL could be an ideal reference titer for diagnosing ocular toxoplasmosis. Conclusions The false-positive rate was notably lower (60.5%) in patients with IgG titers ≥ 30 IU/mL compared to those with titers of 1.6-30 IU/mL (97.7%). Therefore, not only the presence of IgG but also the level of titer appears to be important in diagnosing ocular toxoplasmosis.

PURPOSE: Peroxisome proliferator-activated receptor gamma (PPARgamma) has become a potential target for the prevention and treatment of human cancers. PPARgamma ligands inhibit cell proliferation of estrogen receptoralpha(ERalpha)-positive breast cancer cells. However, it has recently been shown that ERalpha-negatively inhibits PPARgamma signaling in breast cancer cells, indicating that PPARgamma ligand may be more useful for treating ERalpha-negative breast cancer cells compared to ERalpha-positive breast cancer cells. In this study, we attempted to elucidate the role of PPARg in ERalpha-negative breast cancer cells. METHODS: The effect of PPARgamma ligand on the growth of MDA-MB-231 cells was measured by MTT assay and flow cytometric analysis. TUNEL staining and Hoechst 33342 fluorescent staining were used to observe the effects of PPARgamma ligand on cell apoptosis. The regulatory proteins of the cell cycle were measured by Western blot. RESULTS: The treatment of MDA-MB-231 human breast cancer cells with the PPARgamma ligand, trgoglitazone, was shown to induce inhibition of cell growth in a dose-dependent manner. Cell cycle analysis showed a G1 arrest in MDA-MB-231 cells exposed to troglitazone. The apoptotic effect by troglitazone demonstrated that apoptotic cells were elevated from 2.5-fold of the control level at 10 mM, to 3.1-fold at 50micrometer and to 3.5-fold at 75 mM of troglitazone. Moreover, troglitazone treatment dose-dependently caused a marked decrease in the pRb, cyclin D1, cyclin D2, cyclin D3, cdk2, Cdk4 and Cdk6 expressions and there was a significant increase in the p21 and p27 expressions. CONCLUSION: These results indicate that trgoglitazone induces cell-cycle G1 arrest and apoptosis in ERalpha-negative MDA-MB-231 breast cancer cells. Collectively, this paper shows that PPARgamma ligand is an important player as a member of the chemotherapeutic candidates for treating ERalpha-negative breast cancer.
Apoptosis* ; Blotting, Western ; Breast Neoplasms* ; Breast* ; Cell Cycle ; Cell Proliferation ; Cyclin D1 ; Cyclin D2 ; Cyclin D3 ; Estrogens ; Humans ; In Situ Nick-End Labeling ; Ligands ; Peroxisomes* ; PPAR gamma*

PURPOSE: iNOS expression in vascular smooth muscle cells (VSMC) causes the development of septic shock, and multiple organ dysfunction syndrome (MODS). For the inhibition of iNOS expression, glucocorticoids are known to inhibit iNOS expression but immunosuppression decreases its clinical availability. Recently, aspirin was reported to inhibit iNOS expression, but the mechanism and effectiveness are still unclear. In this investigation, on aspirin, several non steroidal antiinflammatory drugs (NSAIDs) were applied to clarify the inhibitory mechanism of iNOS expression and NO production in lipopolysaccharide (LPS) treated VSMCs. METHOD: VSMCs were primarily cultured from rat aorta and confirmed by immunocytochemistry of anti-smooth muscle myosin antibody. LPS, an inducer of iNOS, and NSAIDs, such as aspirin, indomethacin, ketoprofen sodium salicylate and acetaminophen were used. The concentrations of nitrite in culture media following the addition of LPS with a 1-hour pretreatment of NSAIDs were measured by spectrophotometry with griess reaction. Western blot and RT-PCR for iNOS protein and iNOS mRNA, respectively, were performed. RESULT: Acetaminophen had no effect on the inhibition of nitrite production. NSAIDs, especially ketoprofen and sodium salicylate, showed a significant inhibitory effect on nitrite production. In their mechanism, all the NSAIDs in present study inhibited iNOS mRNA and protein expression. CONCLUSION: These results suggest that the inhibitory mechanism on iNOS expression of NSAIDs is due to the inhibition of iNOS mRNA expression and subsequent inhibition of iNOS protein expression.
Acetaminophen* ; Animals ; Anti-Inflammatory Agents, Non-Steroidal* ; Aorta ; Aspirin ; Blotting, Western ; Culture Media ; Glucocorticoids ; Immunohistochemistry ; Immunosuppression ; Indomethacin ; Ketoprofen ; Multiple Organ Failure ; Muscle, Smooth, Vascular* ; Myosins ; Rats ; RNA, Messenger ; Shock, Septic ; Sodium Salicylate ; Spectrophotometry

The effectiveness of operative and non-operative management for postoperative adhesive ileus in children has been discussed. This study reviews the clinical characteristics and the treatment consequences of adhesive ileus in our institution, Department of Surgery of Chunbuk National University Hospital, retrospectively. A total of 62 cases of post-operative small bowel obstruction treated between January 1975 and December 1998 under the 15 years of age are included in this study. The patients were divided into two groups, operative (n=26) and non-operative (n=36) groups. The prevalent age was between 11 and 15 years (28 cases; 45.2%), and the most common previous operation was appendectomy (28 cases; 45.2%). The most common operative procedures were adhesiolysis (17 cases; 65.4%). The interval between admission and operation was 1 day in 11 cases (42.3%). The most common site of adhesion was the ileum in 13 cases (50.0%) and band constriction was the most frequent pattern (8 cases; 30.8%). Intestinal resection was significantly high in delayed operations of more than four days, in the patients with three or more classical signs of strangulation (fever, tachycardia, leukocytosis, abdominal pain, rebound tenderness), and in the cases of complete obstruction on plain abdomen film (p < 0.05). In conclusion, operation should be considered in cases with three or more signs of strangulation, no clinical improvement for over four days of conservative treatment, and signs of complete obstruction on plain abdomen film during the observation periods.
Abdomen ; Abdominal Pain ; Adhesives* ; Appendectomy ; Child* ; Constriction ; Humans ; Ileum ; Ileus* ; Leukocytosis ; Retrospective Studies ; Surgical Procedures, Operative ; Tachycardia

BACKGROUND: Facial involvement of psoriasis requires a different approach than that used for typical plaque psoriasis on other skin areas. Calcitriol ointment may improve lesions on the face without atrophy or other local side effects associated with the use of topical corticosteroids. OBJECTIVE: Our purpose was to determine the efficacy and tolerability of calcitriol 3 microgram/g ointment for the treatment of facial psoriasis. METHODS: In the psoriasis clinic of Seoul National University Hospital, a total of 53 patients were treated with calcitriol 3 microgram/g for 8 weeks. Efficacy was evaluated by an investigator's assessment of the area and a severity index score of facial psoriasis at the 2nd, 4th, and 8th week. Global assessment was also determined at the 8th week. RESULTS: A total of 10 patients discontinued prematurely from the study, due to disappearing during follow-up treatment (n=9) and combined use of topical corticosteroids (n=1). The remaining patients showed the following response to treatment; excellent (n=10), good (n=14), fair (n=11), and poor (n=8). After 8 weeks of treatment with calcitriol ointment, clinical improvement was achieved in 81.4% of the patients. Among them, 55.8% showed excellent (23.3%) or good effect (32.5%) with calcitriol ointment. Five patients (11.6%) showed a local adverse reaction such as erythema, exfoliation, or an itching sensation, and 2 patients discontinued treatment due to adverse reactions. However, no patient showed telangiectasia, skin atrophy, or systemic side effects. CONCLUSION: Our results suggest that calcitriol ointment is an effective and tolerable agent for treatment of psoriasis on the face.
Adrenal Cortex Hormones ; Atrophy ; Calcitriol* ; Erythema ; Follow-Up Studies ; Humans ; Pruritus ; Psoriasis* ; Sensation ; Seoul ; Skin ; Telangiectasis