Cheilitis granulomatosa is one of the rare dermatoses which is characterized by a sudden onset and a progressive course termination in chronic enlargement of the lips Usually, enlargement of lip is the only symtom without ulceration, fissurign or scaling. It may be considered a part of the Melkersson-Rosenthal syndrome and the etiology is still unknown. A 35 year old female with the clinlcal symptoms of cheilitis granulomatosa is presented; the diagnosis was confirmed by histopathologic study.
Adult ; Diagnosis ; Female ; Humans ; Lip ; Melkersson-Rosenthal Syndrome ; Skin Diseases ; Ulcer

No abstract available.
Humans ; Infant, Newborn* ; Mass Screening*

Certain angiographic patterns outlining the morphologic characteristics of vessels and defining the lesion-specific characteristics have recently been shown to greatly influence the likelihood of a successful dilation. In 1988, ACC/AHA Subcommitte on percutaneous transluminal coronary angioplasty proposed the lesion-specific classification as a guide for estimating the likelihood of a successful procedure as well as the the likelihood of developing abrupt vessel closure. To determine the lesion-specific predictors for successful dilation and complications after percutaneous transluminal coronary angioplasty, nine angiographic charateristics of 200 lesions in 164 patients who underwent coronary angiplasty between May, 1983 and September, 1989 were analyzed. 1) Successful dilation, defined as a reduction in stenosis diameter to less than 50% without acute myocardial infarction or emergency coronary artery bypass graft, occurred in 175 of 212 lesions(82.5%). 2) Successful dilation occurred in 13 of 15 type A lesions(86.6%), 148 of 178 type B lesions(83.1%) and 3 of 7 type C lesions(42.8%)(p<0.05 for A or B vs C). 3) Acute closure syndrome occurred in none of type A lesions, 6 of type B lesions(3.4%), 2 of type C lesions(28.5%)(p<0.005 for A or B vs C). 4) multivariate analysis showed that lesion-specific characteristic predictors for successful dilation were length of lesion(p<0.05) and accessibility(p<0.05) ; for ischemic events were major branch involvement(p<0.05) and eccentricity(p<0.05); for acute closure syndrome were accessibility(p<0.05) and eccentricity(p<0.05). 5) Procedural predictors for ischemic events were coronary artery dissection(p<0.01), post-PTCA diameter stenosis(p<0.05) and balloon/artery diameter ratio(p<0.01) ; For acute closure syndrome was coronary artery dissection(p<0.005). In this analysis, we found that angiographic lesion-specific characteristics related very importantly to procedural success and were able to define three major independent lesionspecific risk factors whose presence beforehand decreased the likelihood of successful dilation and increased the likelihood of acute closure. In the absence of any of these risk factors, the risk of acute closure is very small. Thus, identification of these factors and their associate risk should improve patients selection and better define the role of coronary angioplasty in the management fo patients with coronary artery disease.
Angioplasty ; Angioplasty, Balloon, Coronary* ; Classification ; Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Vessels ; Emergencies ; Humans ; Multivariate Analysis ; Myocardial Infarction ; Risk Factors ; Transplants

Torsion of the fallopian tube is an uncommon cause for acute low abdominal pain in female that is difficult to diagnose. Because it has no pathognomonic clinical symptoms or laboratory findings, a high index of suspicion is important when there is history of pelvic pathologic conditions or surgery. The early diagnosis and surgical treatment of the disease are mandatory to preserve oviduct.
Abdominal Pain ; Adolescent* ; Animals ; Early Diagnosis ; Fallopian Tubes* ; Female ; Humans ; Oviducts

Buschke-Lowenstein (B-L) tumor occurs in penis associated with human papillomavirus (HPV). It appears as a exophytic cauliflower-like mass that may be foul smelling and sometimes ulcerated. B-L tumor is predominantly associated with HPV 6, 11 and rarely 16, 18. Because HPV 6, 11 are usually isolated from benign lesions, it has been hypothesized that other cofactors such as immunosuppression, poor hygiene, lack of circumcision, and chronic irritation may be involved. In addition, genomic alternation or subtle amino-acid changes in the HPV 6 E7 protein may play a role in enhancing oncogenic properties of the low-risk virus, HPV 6. We present a case of B-L tumor with squamous cell carcinoma that showed HPV 6 positive and altered p53.
Buschke-Lowenstein Tumor* ; Carcinoma, Squamous Cell* ; Circumcision, Male ; Female ; Human papillomavirus 6 ; Humans ; Hygiene ; Immunosuppression ; Male ; Penis ; Smell ; Ulcer

Vitiligo is an acquired, progressive depigmenting disorder of unknown etiology. In this study, to clarify pathogenesis of vitiligo, the marginal skin of actively spreading and stable vitiligo was examined using ICAM-1, HLA-DR, CD4 and CD8 monoclonal antibodies. In immunohistochemical study, ICAM-1 was expressed in four of five epidermis in active lesions, but not in stable lesion. Dermal ICAM-1 was also expressed in all active and stable lesions. HLA-DR was also expressed in all active epidermis in active lesions, but two of five epidermis in stable lesion. Dermal HLA-DR was also expressed in all active and stable lesion. CD4 lymphocytes were expressed more strongly in active lesion, but CD8 lymphocytes were not different in both lesions. There was no significant difference of degree of positivity with CD4 and CD8 in normal control specimens. In conclusion, we think that ICAM-1 and HLA-DR expression, cytokines released from keratinocytes, melanocytes or lymphocytes and infiltration of activated T-lymphocytes play an important role in disease activity.
Antigens, CD4/metabolism ; Antigens, CD8/metabolism ; Comparative Study ; HLA-DR Antigens/metabolism ; Human ; Immunohistochemistry ; Intercellular Adhesion Molecule-1/metabolism ; Skin/immunology ; Vitiligo/*immunology

Seborrheic keratosis, a benign tumor is more common in the elderly and composed of epidermal keratinocytes. Seborrheric keratoses are very common in white races and are often of little concern to the patient, being accepted as a harmless and inevitable consequence of aging. This tumor was classified into six histopathological types by Lever; acanthotic, hyperkeratotic, adenoid, irritated, clonal, and melanoacanthoma. In 1978 Tagami and Yamada reported a rare acantholytic variant of seborrheic keratosis. We are reporting a case with seborrheic keratosis showing focal acantholysis.
Acantholysis* ; Adenoids ; Aged ; Aging ; Continental Population Groups ; Humans ; Keratinocytes ; Keratosis ; Keratosis, Seborrheic*

BACKGROUND: There have been only a few electron microscopic studies after laser treatment of pigmented skin lesions. OBJECTIVE: The purpose was to investigate the pathologic, immunohistochemical, and electron microscopic changes following Q-switched alexandrite laser treatment of pigmented skin lesions. METHODS: Three patients with acquired bilateral nevus of Ota-like macules, and 2 patients with cafeau lait macule were irradiated with Q-switched alexandrite laser. Forty biopsies were taken before and immediately after laser treatment. Hematoxylin-eosin, Fontana-Masson, and gp100 staining were performed for the evaluation of the histopathologic and immunohistochemical findings of the specimens. Electron microscopic findings were also evaluated. RESULTS: Histopathologically, suprabasilar separations were observed immediately after laser treatment. Vacuolar alterations of pigment-containing cells were frequently found in the epidermis and/or in the dermis. Fontana-Masson and gp100 staining positivity changed to negative or decreased in the epidermis immediately after laser treatment, while they changed to negative in the dermis. Ultrastructurally, epidermal pigment-containing cells frequently showed severe vacuolar changes in the cytoplasm, pyknotic nuclei, and vacuolated and/or fragmented melanosomes immediately after laser treatment. Dermal melanocytes frequently revealed vacuolated and/or fragmented melanosomes immediately after laser treatment. CONCLUSION: Histopathologic, immunohistochemical, and electron microscopic examination of pigmented skin lesions immediately after Q-switched alexandrite laser treatment demonstrated vacuolated or fragmented melanosomes and vacuolar alteration of pigment-containing cells in the epidermis and/or in the dermis, which suggested selective photothermolysis of melanosomes.
Biopsy ; Cytoplasm ; Dermis ; Epidermis ; Humans ; Lasers, Solid-State* ; Melanocytes ; Melanosomes ; Nevus ; Skin*

BACKGROUND: Microemulsion propofol produces more frequent and severe pain upon injection than lipid emulsion propofol. This study examined the analgesic effect of lidocaine-premixed microemulsion propofol in patients pretreated with remifentanil. The induction of anesthesia with this combination was compared with microemulsion propofol accompanied with either remifentanil or lidocaine. METHODS: One hundred twenty patients aged between 20-65 years old were allocated randomly into one of three groups (n = 40, in each). The patients in the remifentanil group received remifentanil 0.5 microgram/kg IV for 30 seconds before a microemulsion propofol injection. The patients in the lidocaine group received propofol 2 mg/kg premixed with 40 mg lidocaine over a 60 second period. The patients in the combination group received both remifentanil and lidocaine. RESULTS: There was a significantly lower incidence of microemulsion propofol injection pain (severity 2 or more) in the combination group (12.5%) than in the remifentanil and lidocaine groups (90% and 65%, respectively, P < 0.05). The incidence of moderate pain disappeared completely in the combination group (0%) compared to that in the remifentanil and lidocaine group (32.5% and 20%, respectively, P < 0.05). Severe pain did not appear in any of the three groups. There were no complications on the injection site in the lidocaine alone and combination groups. CONCLUSIONS: The combination of microemulsion propofol premixed with lidocaine after a pretreatment with remifentanil was more effective in reducing the incidence of pain upon the injection of microemulsion propofol than either treatment alone.
Aged ; Anesthesia ; Anesthetics, Intravenous ; Humans ; Incidence ; Lidocaine ; Piperidines ; Propofol

Arteriovenous malformation is a vascular anomaly due to the hamartomatous proliferation of the subpapillary vascular plexus which exhibits multiple arteriovenus shunts. Various tumors can be developed in the port-wine stain, such as, pyogenic granuloma, basal cell carcinoma, squamous cell carcinoma, tufted angioma, giant proliferative hemangioma, and lymphangioma circumscriptum. We report a case of arteriovenous malformation arising in the port-wine stain. The pathogenesis of development of arteriovenous malformation in the port-wine stain is still unknown, but may be related to localized exaggerations of ectasia.
Arteriovenous Malformations* ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dilatation, Pathologic ; Granuloma, Pyogenic ; Hemangioma ; Lymphangioma ; Port-Wine Stain*