Calciphylaxsis is a rare and life-threatening condition of progressive cutaneous necrosis secondary to calcification of small and medium-sized blood vessels. It is seen almost exclusively in patients with end-stage renal disease, in a setting of secondary hyperparathyroidism and hypercalcemia resulting in metastatic vascular calcification, We experienced a case of calciphylaxsis manifested with chara- cteristic cutaneous lesions that began as tender violaceous livedoid discolorations and subsequent ulceration on the proximal aspect of the extremities and on the lower part of the abdomen. Histologically, calcification is found in small and medium-sized blood vessels in the deep dermis and subcutaneous tissue. The patient had been treated for hypercalcemia, not complicating renal failure, but the cause of hypercalcemia was not found. However, the hypercalcemia was contolled and the skin lesions also improved after oral prednisolone therapy. Our case is a rare presentation of calciphylaxsis in the absence of renal failure, reversibly improved.
Abdomen ; Blood Vessels ; Dermis ; Extremities ; Humans ; Hypercalcemia ; Hyperparathyroidism, Secondary ; Kidney Failure, Chronic ; Necrosis ; Prednisolone ; Renal Insufficiency ; Skin ; Subcutaneous Tissue ; Ulcer ; Vascular Calcification

This study was aimed to examine whether biological characteristics of the cancer cell lines have any correlation with distinctive movement of the reconstituted basement membrane in modified Boyden chamber. The in vitro model consists of a chamber and basement membrane filter. Matrigel was applied on the upper surface of the filter and type IV collagen, fibronectin and laminin were also applied to the lower surface of the filter, respectively. The cancer invasiveness was measured by the number of the moved cells through basement membrane differing in component, thickness and incubation time. For chemoattractant study, serum free medium, medium supplemented with 10% fetal bovine serum and medium supplemented with 10% fetal bovine serum and 0.1% bovine serum albumin were used. The invaded cancer cells were counted under high-power field microscope and the morphologic feature of invading cancer cells on reconstituted basement membrane was examined with scanning electron microscopy. The effects of the tissue inhibitor of metalloproteinase-2 (TIMP-2) and wild type tumor necrosis factor-alpha (wTNF-a) on invasiveness of three prostate cancer cell lines (hormone intermediate sensitive ALVA 101, and hormone refractory ALVA 41 and PPC-1) were investigated. The rate of movement of the cancer was reduced increasing thickness of the matrigel but increased in proportion to the incubation time (p<0.05). The components applied on the lower surface of the filter did not affect cancer cell invasiveness (p>0.05). TIMP-2 reduced the invasiveness of three kinds of cancer cell line at both the high and low concentration, indicating that this agent interferes the movement of the cells. Furthermore, this result suggests that TIMP-2 might repress metal-dependent enzymes, which are thought to elicit the invasiveness of the cancer cells. The wTNF-a did not show any effects on the invasiveness of three cell lines. The additive chemoattractant effect of 0.1% bovine serum albumin was not observed and serum free medium also did not induce the cancer cell invasion across the reconstituted basement membrane. The migration of the ALVA 41 and PPC-1 were more than the ALVA 101. The scanning electron microscopic examination showed the figures of migration of cancer cells through the pores on filter, supporting our experiments are performed in validness. The effect of protease inhibitor was distinct in different cancer cell lines studied. From this experiment, we conclude that the rate of movement of both ALVA 41 and PPC-1 cells with shorter doubling time and the hormone refractory was faster than that of ALVA 101 cells with longer doubling time and the hormone sensitive, suggesting biological characteristics of the cells are implicated in degree of cancer cell invasiveness and their malignancies.
Basement Membrane* ; Cell Line ; Collagen Type IV ; Fibronectins ; Laminin ; Microscopy, Electron, Scanning ; Population Characteristics ; Prostate* ; Prostatic Neoplasms* ; Protease Inhibitors ; Serum Albumin, Bovine ; Tissue Inhibitor of Metalloproteinase-2 ; Tumor Necrosis Factor-alpha

Apocrine poroma is a benign cutaneous adnexal neoplasm differentiating in the direction of sebaceous and apocrine glands, and follicular germs. The clinical appearance of apocrine poroma is not distinctive, and the histologic finding is similar to that of eccrine poroma, which is typified by proliferation of poroid and luminal cells in continuity with the epidermis. But sebaceous, apocrine or follicular differentiation may also be found in the case of apocrine poroma. We herein report a case of apocrine poroma on the scalp. This case exhibited apocrine and sebaceous differentiation, and connection to an adjacent follicular epithelium.
Apocrine Glands ; Epidermis ; Epithelium ; Phenobarbital ; Poroma* ; Scalp

No abstract available.
Erythema Multiforme* ; Erythema* ; Lymphoma*

Plexiform neurofibroma is considered to be pathognomic of neurofibromatosis type 1 (NF1). Herein we report a solitary plexiform neurofibroma which is not associated with NF1. A 61-year-old man presented with asymptomatic skin colored nodules on the medial side of his left great toe. No other abnormalities were found in his personal or family history. Clinically, the tumor was simulating the appearance of mucous cysts. Microscopically,it was a plexiform neurofibroma located in the dermis which seemed to originate from small superficial nerves. This case would seem to confirm that the superficial form of plexiform neurofibroma involving small nerves in the dermis or subcutis is not necessarily pathognomic for NF1.
Dermis ; Humans ; Middle Aged ; Neurofibroma, Plexiform* ; Neurofibromatosis 1 ; Skin ; Toes

OBJECTIVES: The present study aims to investigate the effects of physical illness on depression in North Korean Defectors. METHODS: One hundred forty-four North Korean Defectors(20 males, 124 females) and 376 South Koreans 133 males, 243 females) in Incheon Metropolitan areas participated the present study. Face-to-face interview was conducted for demographic information including presence of physical illnesses. To investigate depressive symptoms, all participants were required to complete the Center for Epidemiologic Studies-Depression scale (CES-D). RESULTS: After controlling gender, age, marital status, educational year, employment status and physical illness, North Korean Defectors showed higher CES-D score than South Koreans(beta=0.449, p<0.001). Within North Korean Defectors, the presence of physical illnesses independently was related to higher CES-D score(beta=0.243, p<0.001). However, within South Koreans, the presence of physical illnesses did not significantly predict CES-D score. North Korean Defectors with physical illness have higher CES-D score than North Korean Defectors without physical illness(26.8+/-13.8 versus 19.7+/-12.7). However, there was no significant differences of CES-D score between South Koreans with physical illness and South Koreans without physical illness(10.3+/-9.8 versus 9.3+/-8.8). CONCLUSION: Compared to South Koreans, North Korean Defector showed higher depressive symptoms independently from gender, age, education, employment, marriage. In addition, only North Korean Defectors showed the relationship between depression and physical illness. Our study suggests that depression should be assessed when North Korean Defectors have physical illness.
Depression ; Employment ; Humans ; Male ; Marital Status ; Marriage

Open tracheostomy has been indicated for patients who require prolonged mechanical ventilation or respiratory care in order to avoid lots of complications during long-term endotracheal intubation. Because there are a number of disadvantages and serious complications in standard open tracheostomy, a simpler, safe and minimally invasive procedure such as percutaneous dilatational tracheostomy (PDT) and translaryngeal tracheostomy (TLT) were introduced as an appropriate procedure that can be administered at bedside. In terms of prevention of complications, minimal invasive tracheostomy techniques are more advisable for post open heart surgery patients. After two failed attempts at respirator weaning, we experienced a successful TLT for a 71-year-old male patient with intractable post CABG pneumonia post-op 15 days in an intensive care unit. During and post-TLT courses were not eventful. The cannula was removed 2 weeks after TLT and the patient was subsequently discharged to ward.
Aged ; Catheters ; Heart* ; Humans ; Intensive Care Units ; Intubation, Intratracheal ; Male ; Pneumonia ; Respiration, Artificial ; Thoracic Surgery* ; Tracheostomy* ; Ventilator Weaning

A 38-year-old woman was presented with a dark brown plaque on the abdomen. Clinically, the tumor was simulating the appearance of dysplastic nevus. Microscopically, the cells of the stratum malphighii lay in a disordered pattern. Many cells in the epidermis were atypical and melanin pigment was mainly in the basal layer of the epidermis and the upper dermis. Diagnosis of pigmented Bowen's disease was made. Pigmented Bowen's disease is rarely found at body sites other than the anogenital area.
Abdomen ; Adult ; Bowen's Disease* ; Dermis ; Diagnosis ; Dysplastic Nevus Syndrome ; Epidermis ; Female ; Humans ; Melanins

Mixed tumor of the skin (chondroid syringoma) is a rare benign tumor composed of epithelial elements intermingled with myxoid or cartilagenous stroma which is not separated by basement membrane. It had been believed to originate from the eccrine gland but recently, it was described to be of apocrine gland origin in case of showing apparent apocrine secretion. We report on a 63-year-old man with a tumor on the right upper eyelid showing typical microscopic features of mixed tumor of the skin. Many apocrine decapitation secretions were seen in tubular structures and follicular differentiations were also seen, which represents the common origin of folliculo-sebaceous-apocrine unit.
Adenoma, Pleomorphic ; Apocrine Glands ; Basement Membrane ; Decapitation ; Eccrine Glands ; Eyelids ; Humans ; Middle Aged ; Skin

Blue nevus is a benign melanocytic neoplasm and represents itself usually as a solitary blue or blue-black papule. It rarely occurs as multiple lesions grouped in a circumscribed area. How-ever, non-grouped disseminated blue nevi are exceedingly rare. We report a patient with acquired multiple blue nevi that was distributed over the entire body discretely and showed an increase in the number of the nevi without any causal factors.
Humans ; Nevus ; Nevus, Blue*