BACKGROUND: The cornified cell envelope (CE) is a unique structure found in the terminal differentiation of the skin. The precursor proteins of the CE are composed of many candidate structural proteins, among which invalucrin and filaggrin are important ones to participate in the complicated process of forming, the complex structure. OBJECTIVE: The purpose of this study was to evaluate the usefulness of expression of involucrin and filaggrin as markers of terminal differentiation in various skin disorders including tumors. METHODS: Immunohistochemical studies were performed in the formalin-fixed, paraffin-embedded skin samples of non-tumors (41 cases) and tumors (43 cases).
Skin*

No abstract available.

We reviewed 7 cases of congenital mesoblastic nephroma (4 cases of classical mesoblastic nephroma (CMN) and 3 cases of atypical mesoblastic nephroma (AMN)) using immuno-histochemical and flow cytometric study. Results are as follows. 1) The mean tumor size was 5 (3 to 7cm)cm in CMN and 9 (7 to 10cm)cm in AMN. The AMN revealed hemorrhage and necrosis in two Of three cases. A case of AMN showed cystic change without hemorrhage and necrosis. Mitotic count ranged in 0~4/10HPF in CMN and 20-35/10HPF in AMN. 2) Immunohistochemistry for vimentin was all positive. Actin, desmin were weakly positive in CMN, but negative in AMN. The findings were consistent with myofibroblastic differentiation in CMN and AMN was considered to be the less differentiated form of CMN. 3) Flow cytometiic analysis showed diploidy in two of two CMNs and two of three AMNs. Only one AMN showed aneuploidy with DNA index of 1.41. %SG2M were 8.1 and 15.9 (mean 12.0) in CMN and 16.9, 32.9 and 19.3 (mean 22.9) in AMN, respectively. We concluded that AMN should be distinguished from CMN, clinicopathologically.

Objectives: This study was aimed to assess the usefulness of the quantitative assessment of clock drawing test (CDT) combined with the Mini-Mental State Examination (MMSE) compared to that of the Montreal Cognitive Assessment (MoCA) or the MMSE alone for screening of dementia in Parkinson disease (PD) in patients with a low educational level. Methods: A representative sample of 91 PD patients was administered MMSE, MoCA and CDT. The discriminative validity of the MMSE, MoCA, and a MMSE+CDT combination for dementia screening was determined by estimating the sensitivity and specificity of each test and by testing integrated discrimination improvement (IDI). Results: The mean age and educational years were 69.0 (years) and 7.3 in the study population. The best screening cut-off points for the MMSE, MoCA, and MMSE+CDT were 25/26, 21/22 and 41/42. In a group of patients with educational years ≤6,
Dementia

The co-occurrence of multiple sclerosis and peripheral demyelinating neuropathy is rare. It has been disputed whether these are pathologically related or coincidental findings. We report a 36-year-old woman who presented with diplopia, right facial palsy and left-sided weakness. Brain magnetic resonance imaging showed a lesion indicative of central demyelinating disease. Nerve conduction studies revealed peripheral multifocal demyelinating neuropathies. We suggest that the central and the peripheral lesions may be continua of a demyelinating process.
Adult ; Brain ; Demyelinating Diseases ; Diplopia ; Facial Paralysis ; Female ; Humans ; Magnetic Resonance Imaging ; Multiple Sclerosis ; Neural Conduction

PURPOSE: To determine the extent to which magnetic resonance(MR) imaging findings can help differentiate between tuberculous arthritis (TA) and rheumatoid arthritis(RA). MATERIALS AND METHODS: This study involved sixteen patients with pathologically proven arthritis of the knee. In eight patients(mean age, 29.6 years; M:F=4:4) this was of the tuberculous variety, while eight (mean age, 47.5 years; M:F=2:6) suffered from the rheumatoid variety, which was monoarticular. For 14 patients, contrast enhancement studies were available. We retrospectively analyzed MR findings according to the demonstrated pattern of synovial thickening (regular and even, or irregular and nodular), bone erosion or abscess,bone marrow(BM) edema, the sites at which bursae were present, para-articular mass formation, and lymphadenopathy. RESULTS: In five of eight TA cases (62.5 %), irregular and nodular enhanced synovial thickening was present, while in six of eight RA cases (75%), thickening was regular and even. Bone erosions or subarticular abscesses were found in six TA cases (75%) and small erosions in three cases (37.5%) of RA. BM edema surrounding the erosion was found in four cases of TA (50%) and two of RA (25 %). In TA, edema was more extensive. In both TA and RA, all suprapatella bursae were distended while popliteal bursae were present in two cases of TA(25 %) and four of RA (50%). Para-articular masses with rim like enhancement were found in six cases of TA (75%) and in one case of RA (12.5 %). In particular, para-articular lymphadenopathy was seen in six cases of TA(75%), but not in RA. CONCLUSION: MR findings of irregular and nodular synovial thickening, extensive bone erosion, extensive BM edema, particular, para-articular abscess formation and ymphadenopathy, may help differentiate tuberculous arthritis of the knee from the rhumatoid variety.
Abscess ; Arthritis* ; Arthritis, Rheumatoid* ; Diagnosis, Differential* ; Edema ; Humans ; Knee* ; Lymphatic Diseases ; Magnetic Resonance Imaging* ; Retrospective Studies

Multiple system atrophy (MSA) is an idiopathic neurodegenerative disorder involving many neuronal structures. It is a heterogeneous system disorder affecting extrapyramidal, cerebellar and autonomic nervous system. Only a minority of MSA patients are diagnosed before reaching the full blown stage. Its autonomic features like orthostatic hypotension, vocal cord paralysis are directly related to mortality. Up to now, rehabilitation of MSA patients had been rarely reported. Early, proper diagnosis and comprehensive rehabilitation for their heterogeneous clinical features are important. We experienced 54 year old hemiplegic paient who overlaps MSA. He showed some improvement in ADL and cerebellar symptoms after comprehensive rehabilitation programs.
Activities of Daily Living ; Autonomic Nervous System ; Diagnosis ; Humans ; Hypotension, Orthostatic ; Middle Aged ; Mortality ; Multiple System Atrophy* ; Neurodegenerative Diseases ; Neurons ; Rehabilitation ; Stroke* ; Vocal Cord Paralysis

OBJECTIVE: The purpose of this study is to evaluate the role of cold knife conization in the diagnosis and management of cervical neoplasia. METHODS: Cold knife conization was performed in total 163 patients from January 1992 to December 2003. The results of PAP smear and colposcopy-directed biopsy were compared with the pathologic diagnosis of conization. And we evaluated the rate of positive margin and the presence of residual lesion. And then, we reviewed the pregnancy outcome after conization. RESULTS: The rate of agreement between PAP cytology and conization was 45.4%, and the rate of agreement between colposcopy-directed biopsy and conization was 65.6%. Hysterectomy was done in 102 patients (62.6%). The positive rate of resection margin was 19.6%. The incidence of residual lesion after conization was 31.2% in margin (+) and 1.4% in margin (-). We evaluated 7 cases of pregnancy after conization. CONCLUSION: Cervical conization as surgical treatment was effective in cervical neoplasia patients, especially young patients, with continuous follow-up.
Biopsy ; Conization* ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Incidence ; Pregnancy ; Pregnancy Outcome

BACKGROUND: The purpose of this study was to find additional effects of intrathecal nalbuphine 1 mg to morphine 0.1 mg for pain relief during a cesarean section. METHODS: Sixty healthy patients at full term who were scheduled for an elective cesarean delivery with spinal anesthesia were enrolled in the study. They received 0.5% bupivacaine 10 mg with either morphine 0.1 mg (group M), or nalbuphine 1 mg (group N), or morphine 0.1 mg nalbuphine 1 mg (group M + N). Analgesic effects were evaluated by a verbal rating scale on the duration of complete analgesia (time from the intrathecal injection to the first pain report), effective analgesia (time from the intrathecal injection to the first analgesic request), and cumulative doses of additional analgesics. Hemodynamic changes and adverse effects were also observed. RESULTS: The duration of complete analgesia increased significantly in group M, compared with group N and group M + N. Effective analgesia was longer in group M and group M + N, compared with group N. The incidence of pruritus was significantly lower in group N, compared with group M and M + N. The incidence of nausea and vomiting was the same among all groups. CONCLUSIONS: We concluded that intrathecal addition of nalbuphine 1mg to morphine 0.1 mg during spinal anesthesia for a cesarean delivery reinforced intraoperaitive analgesia compared with intrathecal morphine 0.1 mg. However, it reduced the duration of complete analgesia and had no effect on the incidence of pruritus.
Analgesia ; Analgesics ; Anesthesia, Spinal ; Bupivacaine ; Cesarean Section* ; Female ; Hemodynamics ; Humans ; Incidence ; Injections, Spinal ; Morphine* ; Nalbuphine* ; Nausea ; Pregnancy ; Pruritus ; Vomiting

BACKGROUND: Nitric oxide synthase (NOS) is known to mediate ultraviolet B (UVB)-induced skin inflammation However, there is still ambiguity as to which NOS isotype mediates the process in vivo. Furthermore, contradictory results have been reported on which cell types respond to UVB irradiation in vitro. OBJECTIVE: This study was performed to evaluate the change of inducible NOS (iNOS) expression in vivo as a result of UVB radiation on the skin of a rat. METHOD: To examine the time-course change in iNOS expression in the rat skin, the rats were exposed to 400 ml/cm2 of UVB radiation, and skin samples were taken at various time intervals up to 48 h. iNOS expression on the skin of a rat was evaluated by both Western blot analysis and immunohistochemical staining. RESULTS: From Western blot analysis, UVB irradiation induced inducible NOS (iNOS) expression in the epidermis at 12-48 h postirradiation with a peak expression at 24 h. Immunohistochemical staining revealed that UVB-induced iNOS expression was localized to the epidermis and infiltrating inflammatory cells in the upper dermis of the rat. CONCLUSION: iNOS was induced by UVB irradiation on the skin of a rat, mainly in the epidermis. Therefore, iNOS is supposed to be one of the major mediators with regard to inducing an inflammatory response in UVB-irradiated rat skin in vivo.
Animals ; Blotting, Western ; Dermis ; Epidermis ; Inflammation ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II* ; Rats* ; Skin*