Inflammatory nodular vascular diseases of the legs have been classified as severah distinctive entities based on their minor clinical and pathological variations. They have so many common features which often make the differential diagnosis difficult or impossihIe that reevaluation of these diseases is one of the important problems in the dermatologic field. The author studied the clinical and pathological relationship of those diseases in 86 patients including 70 cases of erythema nodosum, 7 of erythema induratum, 3 of panniculitis, and 6 of nodular vasculitis. The results are as follows; l. Erythema nodosum, erythema induratum and nodular vasculitis are most common. In the spring and patient are most often in their twenties. 2. Common to all, females are more commonly affected than males. 3.Erythema nodosum, erythema induratum and nodular vasculitis reveal no definite difference in their clinical pictures and laboratory findings. 4. Erythema nodosum, erythema induratum and nodular vasculitis are founded to be assoeiated with mostly streptococcal infection and/or tuberculosis; panniculitis is associated mainly with streptococcal infection.5. In histopathological findings, tubercle formation and caseation necrosis are more marked in erythema induratum than in erythema nodosum and nodular vasculitis. 6. The panniculitis is characterized by inflammation of the small sized vessels in. subcutaneous tissues; Nodular vasculitis reveals its main lesion in the large sized. Vessels of lower dermis. In erythema nodosum and erythema induratum, small. And medium-sized vessels are involved in subcutaneous tissue.
Dermis ; Diagnosis, Differential ; Erythema Induratum ; Erythema Nodosum ; Female ; Humans ; Inflammation ; Leg* ; Male ; Necrosis ; Panniculitis ; Streptococcal Infections ; Subcutaneous Tissue ; Tuberculosis ; Vascular Diseases ; Vasculitis

No abstract available.
Korea*

No abstract available.
Schools, Medical*

No abstract available.
Brain Death* ; Brain*

Ehlers-Danlos syndrome, a heritable disorder of connective tissue by autosomal dominant mode, is very rare disease in this country. Authors described a typical case in 39 years old woman who had a daughter of 6 years old also affectect by this disorder. The patient had the characteristic hyperelasticity of the skin and hyperextensibility of the jonts especially at metacarpophalangeal joint of the hands. She also revealed hyperterolism and aortic insufficiency on X-ray and E.C.G. examination.
Adult ; Child ; Connective Tissue ; Ehlers-Danlos Syndrome ; Family Characteristics* ; Female ; Hand ; Humans ; Metacarpophalangeal Joint ; Nuclear Family ; Rare Diseases ; Skin

BACKGROUND: Although hypoxic pulmonary vasoconstriction (HPC) and hypoxic coronary vasodilatation (HCD) have been recognized by many researchers, the precise mechanism remains unknown. As isolated arteries will constrict or relax in vitro in response to hypoxia, the oxygen sensor/transduction mechanism must reside in the arterial smooth muscle, the endothelium, or both. Unfortunately, much of the current evidence is conflicting, especially concerning to the dependency of HPC and HCD on the endothelium and the role of the K+ channel. Therefore, this experiment was attempted to clarify the dependency of HPC and HCD on the endothelium and the role of the K+ channel on HPC and HCD. METHODS: HPC was investigated in isolated main pulmonary arteries precontracted with norepinephrine (NE). HCD was investigated in isolated left circumflex coronary artery precontracted with prostaglandin F2 alpha. Vascular rings were suspended for isometric tension recording in an organ chamber filled with Krebs-Henseleit solution. Hypoxia was induced by gassing the chamber with 95% N2 +5% CO2, which was maintained for 15 - 25 min. RESULTS: 1)Hypoxia elicited a vasoconstriction in NE-precontracted pulmonary arteries with endothelium, but a vasodilatation in PGF 2 alpha-precontracted coronary arteries with and without endothelium. There was no difference between the amplitude of the HPC and HCD induced by two consecutive hypoxic challenges and the effect of normoxic and hyperoxic control Krebs-Henseleit solution on subsequent response to hypoxia. 2)Inhibition of NO synthesis by the treatment with Nw-nitro-L-arginine reduced HPC in pulmonary arteries, but inhibition of the cyclooxygenase pathway by treatment with indomethacin had no effect on HPC and HCD, respectively. 3)Blockades of the TEA-sensitive K+ channel abolished HPC and HCD. 4)Apamin, a small conductance Ca2+/-activated K+ (KCa) channel blocker, and iberiotoxin, a large conductance KCa channel blocker, had no effect on the HCD. 5)Glibenclamide, an ATP-sensitive K+ (KATP) channel blocker, reduced HCD. 6)Cromakalim, an K(ATP) channel opener, relaxed the coronary artery precontracted with prostaglandin F2 alpha. The degree of relaxation by cromakalim was similar to that by hypoxia and glibenclamide reduced both hypoxia- and cromakalim-induced vasodilations. 7)Verapamil, a Ca2+ entry blocker, caffeine, a Ca2+ emptying drug; and ryanodine, an inhibitor of Ca2+ release from SR, reduced HPC, respectively. CONCLUSION: HPC is dependent on the endothelium and is considered to be induced by inhibition of the mechanisms of NO-dependent vasodilation while HCD is independent of the endothelium and is considered to be induced by activation of the K(ATP) channel.
Anoxia ; Arteries ; Caffeine ; Coronary Vessels ; Cromakalim ; Dinoprost ; Endothelium ; Glyburide ; Indomethacin ; Muscle, Smooth ; Norepinephrine ; Oxygen ; Prostaglandin-Endoperoxide Synthases ; Prostaglandins F ; Pulmonary Artery ; Relaxation ; Ryanodine ; Vasoconstriction* ; Vasodilation*

A pregnancy is considered postterm if it is beyond 294 days (42 complete weeks). Several investigators have demonstrated that postterm pregnancy may be accompanied by a rise in perinatal morbidity and/or mortality. Abnormalities such as meconium staining, cringenital anomalies, intrauterine growth retardation, postmaturity syndrome, fetal asphyxia have been reported in some cases of reduced amniotic fluid volume (oligohyramnios) which is commonly observed in postterm pregnancies. Amniotic fluid volume has been shown to decrease significantly as gestational age advances beyond term. Oligohydramnios has particular relevance to postterm pregnancies. Poor perinatal outcomes of oligohydramnios on postterm pregnancy have been reported by several authors. To date, however, the relationship between oligohydramnios in pastterm pregnancy and fetal outcome is debatable. The purpose of this clinical study was to evaluate the relationship between oligohydr- amnios and perinatal outcome in 64 cases of postterm pregnancies. Amniotic fluid index(AFI) values were measured semiweekly in 64 good dated, uncomplicated singleton pregnancies. AFI values were categorized into 2 groups. The group 1; patients whose final AFI value was above 5.0 cm; Group 2, patients whose AFI value fell below 5.0 cm. Adverse fetal outcome was defined by the presence of meconium staining, fetal heart rate decelerations, cesarean delivery for fetal distress, low Apgar score at 1 and 5 minutes, neonatal intensive care unit admission, and perinatal mortality. The fetal outcome was compared group 1 with group 2 and results obtained were as follows: 1. The incidence of oligohydramnios in postterm pregnancy was 54.7 %. The average diminution of amniotic fluid index was from 8.2 1.8 cm to 5.6+2.2 cm/week. 2. The incidence of meconium-staining in amniotic fluid was 40.6 % (Group 1: 20.7 %, Group 2: 57.1 %) and showed statistically significant difference between the two groups(p= 0.003). 3. The incidence of Apgar score less than 7 was 23.4% in 1 minute (Group 1: 13.8 %, Group 2: 31.4 %) and 4.7 % in 5 minutes(Group 1: 3.4%, Group 2: 5.7 %), respectively and showed no statistically significant difference between the two groups (p=0.140, p=1.000). 4. I'he incidence of cesarean delivery due to fetal distress was 12.5 % (Group 1: 6.9%, Group 2: 17.1 %) and showed no statistically significant difference between the two groups (p=0.275). 5. The incidence of admission to NICU was 12.5 % (Group 1: 6.9%, Group 2: 17.1 %) and showed no statistically significant difference between the two groups (p=0.275). Adverse fetal outcome was not uniformly observed in postterm pregnancies with oligohydramnios. Amniotic fluid index in oligohydramnios group as a single independent guide was not enough to predict fetal outcomes in postterm pregnancy without specific pathologic condition of fetus.
Amniotic Fluid* ; Apgar Score ; Asphyxia ; Deceleration ; Female ; Fetal Distress ; Fetal Growth Retardation ; Fetus ; Gestational Age ; Heart Rate, Fetal ; Humans ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Meconium ; Mortality ; Oligohydramnios ; Perinatal Mortality ; Pregnancy* ; Research Personnel

No abstract available.
Cartilage* ; Enophthalmos* ; Ribs* ; Transplants*

Backgraund : Most of the inflammatory bullous lesions in bullous pamphigoid(BP) and epidermolysis bullosa acquisite(EBA) demonstrate similar clinical and histological features. However, the specificities of the autoantibodiea reactive to the dermo-epidermal junction antigeins are different. In these two bullouk dermat loses, there are no remarkable differences in symptomaiology, there are no unique predilection sites for the lesions and they do not usually leave scars after nvolution. Considering these similarities, dermatologists could encounter some clinical confuiion in maling a provisional diagnosis. OBJECTIVE: Authors examined three patients of BP with classic inflammatory bullous eruptions and threa patients of EBA with inflammatory bullous lesions to see if here were any differences in the morphology of the immuno-fluorescence(IF) pattern. METHODS: For direct IF of vertical or semi-vertical sections, perilasional skin was obtained in each patient for indirect IF of horizontal or semi-horizonta1 sections, Ig(bound substrates were prepared from all these autoantibody-positive individuals. All specimens veri; observed at 200/400-magnification fields through an ordinary fluorescence microscopy. RESULTS: Patterns of fluorescence observed by direct IF were characterized as thin-linear in BP and thick/coarse-linear in EBA along the basement membrane zone. On the horizontal section preparations in indirect IF, the patterns of fluorescence were clean-linear in E3P hnd more fluffy-linear in EBA at the dermoepidermal junction, These patterns could be recognized aim/larly in the fields of both 200 and 400-magnification, however each minor differences were not easy to distinguish each other. CONCLUSION: The above findings of subtle differences in the pattern of IF may provide some suggestions to the examiners for the need of differential diagnosis in theae riseases.
Basement Membrane ; Blister ; Cicatrix ; Diagnosis ; Diagnosis, Differential ; Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa* ; Fluorescence* ; Humans ; Male ; Microscopy, Fluorescence ; Pemphigoid, Bullous* ; Skin

Backgraund : Most of the inflammatory bullous lesions in bullous pamphigoid(BP) and epidermolysis bullosa acquisite(EBA) demonstrate similar clinical and histological features. However, the specificities of the autoantibodiea reactive to the dermo-epidermal junction antigeins are different. In these two bullouk dermat loses, there are no remarkable differences in symptomaiology, there are no unique predilection sites for the lesions and they do not usually leave scars after nvolution. Considering these similarities, dermatologists could encounter some clinical confuiion in maling a provisional diagnosis. OBJECTIVE: Authors examined three patients of BP with classic inflammatory bullous eruptions and threa patients of EBA with inflammatory bullous lesions to see if here were any differences in the morphology of the immuno-fluorescence(IF) pattern. METHODS: For direct IF of vertical or semi-vertical sections, perilasional skin was obtained in each patient for indirect IF of horizontal or semi-horizonta1 sections, Ig(bound substrates were prepared from all these autoantibody-positive individuals. All specimens veri; observed at 200/400-magnification fields through an ordinary fluorescence microscopy. RESULTS: Patterns of fluorescence observed by direct IF were characterized as thin-linear in BP and thick/coarse-linear in EBA along the basement membrane zone. On the horizontal section preparations in indirect IF, the patterns of fluorescence were clean-linear in E3P hnd more fluffy-linear in EBA at the dermoepidermal junction, These patterns could be recognized aim/larly in the fields of both 200 and 400-magnification, however each minor differences were not easy to distinguish each other. CONCLUSION: The above findings of subtle differences in the pattern of IF may provide some suggestions to the examiners for the need of differential diagnosis in theae riseases.
Basement Membrane ; Blister ; Cicatrix ; Diagnosis ; Diagnosis, Differential ; Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa* ; Fluorescence* ; Humans ; Male ; Microscopy, Fluorescence ; Pemphigoid, Bullous* ; Skin