The complement system is known to be involved in the pathogenesis of the skin lesions in pernphigus vulgaris, bullous pemphigoid, dermatitis herpetiformis, epidermolysis bullosa acquisita, and systemic lupus erythematosus. Authors examined the skin specimens of each disease cases, who did not show any evidence of complement deficiency, to determine the deposition of complement components(C4, C3, Chb-9) and their inhibitors(C4bp, Factor H, S-protein) by modified direct immunofluorescence. We also looked at the staining pattern and localization, for further insights of their pathobiologic contributions in each disease. The findings of deposits of complement components up to C9, as well as inhibitor proteins at the primary histopathologic sites, in the majority of those cases, may indicate that the complement system, to certain extent, involves the inflamrnatory reactions in these diseases. The co-localization of C5b-9 and S-protein could be regarded as the consequence of in situ formation of SC5b-9 complexs or as the result of non-lytic adsorbed complexes of fluid phase SC5b-9. The pathologic role of the complement seems to depend mostly on the complement-fixing biologic property and the amount of the tissue bound immune complexes, which are often heterogeneous to different diseases and among different patients.
Antigen-Antibody Complex ; Complement Factor H ; Complement Membrane Attack Complex ; Complement System Proteins* ; Dermatitis Herpetiformis ; Epidermolysis Bullosa Acquisita ; Fluorescent Antibody Technique, Direct ; Humans ; Lupus Erythematosus, Systemic ; Pemphigoid, Bullous ; Skin ; Skin Diseases*

Dermatomyositis* ; Skin*

Bullous pemphigoid is a chronic and relatively benign subepidermal blistering disease and is generally considered not to be a sulfa-responsive dermatosis. As a rule, bullous dermatosis that excellently responded to sulfapyridine and sulfones was considered by some to be diagnostic of dermstitis herpetiformia. In 1977, Person and Rogers described 6 cases of bullous pemphigoid responded to sulfapyridine and sulfones. These sulfa-responsive cases were younger than ordinary bullous pemphigoid patients and the histopathologic findings showed prevalence of the neutrophilic infiltration. In this report, the patient who diagnosed as bullous pemphigoid by immunofluorescent studies has younger onset (38 years of age) than usual bullous pemphigoid and histopatbologic findings showed dense neutrophilic infiltrations. The patient was treated with 100-200mg of DDS for 2 months and the skin lesions completely disappeared.
Blister ; Humans ; Neutrophils ; Pemphigoid, Bullous* ; Prevalence ; Skin ; Skin Diseases ; Sulfapyridine ; Sulfones

Pachydermodactyly is a rare, distinct form of digital fibromatosis characterized by acquired, asymptomatic, bulbous swellings on the back and side of the proximal phalanges or proximal interphalangeal joint areas of fingers. It occurs mostly in men. There have been many cases treated with intralesional injection of corticosteroids, however, only a few by surgical excision. We report a case of pachydermodactyly, involving both fingers, in a young female. She was treated with surgical excision and recovered, with no sign of sequelae, during a follow-up period of 6 months.
Adrenal Cortex Hormones ; Female ; Fibroma ; Fingers ; Follow-Up Studies ; Humans ; Injections, Intralesional ; Joints ; Male

Pachydermodactyly is a rare, distinct form of digital fibromatosis characterized by acquired, asymptomatic, bulbous swellings on the back and side of the proximal phalanges or proximal interphalangeal joint areas of fingers. It occurs mostly in men. There have been many cases treated with intralesional injection of corticosteroids, however, only a few by surgical excision. We report a case of pachydermodactyly, involving both fingers, in a young female. She was treated with surgical excision and recovered, with no sign of sequelae, during a follow-up period of 6 months.
Adrenal Cortex Hormones ; Female ; Fibroma ; Fingers ; Follow-Up Studies ; Humans ; Injections, Intralesional ; Joints ; Male

Gastrointestinal cytomegalovirus(CMV) infection in adults is observed as a part of a generalized or localized infection in patients who are immunocompromized. We report a case of CMV infection of the small intestine. The patient is a 34 year-old woman who has complained of palpable purpura in the lower extremities and buttocks, and arthralgia of large joints. The skin biopsy showed fibrinoid necrosis and neutrophils with leukocytoclasis, which findings are compatible with hypersensitivity angiitis. The patient received steroid and cyclophosphamide. During the follow-up period, generalized edema and bloody stool were detected. Resected specimen of small bowel has multiple aphthous ulcer. Microscopically, cytomegalic cells are observed along the endothelial cells and mesenchymal cells. In situ hybridization using DNA probes against CMV revealed positive staining in the cytomegalic inclusions in vascular endothelial and mesenchymal cells.
Adult ; Male ; Female ; Humans ; Biopsy

In order to observe the responses of the periodintal tissue on the tension side following the experimental tooth movement, 35 Guinea pigs were divided into the control group (5 animals) and 6 experimental groups (3 movement groups and 3 retention groups) consisting of each 5 animals. The experimental tooth movement of Guinea pig's upper incisors installing open helical loop were carried out by rendering continuous force: 5g (1st groups) 35g (2nd groups), 100g (3rd groups), respectively for 7 days. 3 mocement groups (15 animals) were sacrificed soon after the continuous force, and 3 retention groups (15 animals) were sacrificed after the retention period of another 7 days. The following results were obtained from the observation of the surrounding tissues of teeth on the tension side through light microscopy any transmission electron microscopy. 1. The vessel walls in th experimental groups were thinner than those of the control group, the number of blood vessel had the tendency to increase. The greater the strong force applied to each group, the more the destruction of cells and fibers was found and the more the number of the red bloof cell of vessel outside appeared. 2. New collagen fibers were produced from fibroblasts in the 1st groups (light force), but were produced rather less in the 2nd groups (medium force) and the 3rd groups (heavy force). 3. In the forming patterns of the new alveolar bone of the 3rd groups (heavy force), the bone trabeculae were formed towards the direction of the force to be applied, but the new alveolar bone in the 1st groups (light force) was produced evenly throughout the all surfaces of the alveolar bone rather than the patterns of bone trabeculae ; therefore, the patterns of new alveolar bone were observed differently according to the magnitude of the force applied. 4. In the retention group, it was observed that the collagen fibers were produced from the osteoblasts in the marginal areas of the periodontal ligaments being widely opened and were deposited on the alveolar bone surface but the production of collagen fibers from the osteoblasts in the other area of the periodontal ligaments was almost ceased, and a rest line on the new alveolar bone surface was found.
Animals ; Blood Vessels ; Collagen ; Fibroblasts ; Guinea ; Guinea Pigs ; Incisor ; Microscopy ; Microscopy, Electron, Transmission ; Osteoblasts ; Periodontal Ligament ; Tooth Movement* ; Tooth*

Objective: This study aimed to evaluate the diagnostic value of combining the quantitative parameters of shear waveelastography (SWE) and superb microvascular imaging (SMI) to breast ultrasound (US) to differentiate between benign andmalignant breast masses. Materials and Methods: A total of 200 pathologically confirmed breast lesions in 192 patients were retrospectively reviewedusing breast US with B-mode imaging, SWE, and SMI. Breast masses were assessed based on the breast imaging reporting anddata system (BI-RADS) and quantitative parameters using the maximum elasticity (Emax) and ratio (Eratio) in SWE and thevascular index in SMI (SMIVI). The area under the receiver operating characteristic curve (AUC) value, sensitivity, specificity,accuracy, negative predictive value, and positive predictive value of B-mode alone versus the combination of B-mode US withSWE or SMI of both parameters in differentiating between benign and malignant breast masses was compared, respectively.Hypothetical performances of selective downgrading of BI-RADS category 4a (set 1) and both upgrading of category 3 anddowngrading of category 4a (set 2) were calculated. Results: Emax with a cutoff value of 86.45 kPa had the highest AUC value compared to Eratio of 3.57 or SMIVI of 3.35%. Inset 1, the combination of B-mode with Emax or SMIVI had a significantly higher AUC value (0.829 and 0.778, respectively)than B-mode alone (0.719) (p< 0.001 and p= 0.047, respectively). B-mode US with the addition of Emax, Eratio, and SMIVIhad the best diagnostic performance of AUC value (0.849). The accuracy and specificity increased significantly from 68.0%to 84.0% (p< 0.001) and from 46.1% to 79.1% (p< 0.001), respectively, and the sensitivity decreased from 97.6% to 90.6%without statistical loss (p= 0.199). Conclusion Combining all quantitative values of SWE and SMI with B-mode US improved the diagnostic performance indifferentiating between benign and malignant breast lesions.

BACKGROUND: Microalbuminuria in type 2 diabetes is a predictor of development of clinical nephropathy and cardiovascular disease. But, it has been reported that reduced glomerular filtration rate (GFR) may occur in some normoalbuminuric diabetic patients. The aim of this study was to identify whether decreased GFR without microalbuminuria is to predict diabetic vascular complications. METHODS: Between January 1998 and February 2001, 73 patients with type 2 diabetes who visited Yeungnam university medical center were divided into 5 groups according to initial GFR ranges: group 1 (GFR < 30 mL/min), group 2 (30 < or = GFR < 60 mL/min), group 3 (60 < or = GFR < 90 mL/min), group 4 (90 < or = GFR < 125 mL/min), group 5 (125 mL/min < or = GFR). They were examined for microvascular and macrovascular complications initially and after 4 years. RESULTS: Decreased GFR had a negative correlation with age (r = -0.472, P = 0.001). Decreased GFR without microalbuminuria had a significant correlation with development of diabetic nephropathy (P = 0.016) after 4 years. There were no significant correlation with the prevalence of diabetic retinopathy, peripheral neuropathy, and macrovacular disease. But, our study showed that coronary artery disease had an increasing tendency with decreased GFR without statistical significance (P = 0.085). CONCLUSIONS: Our data suggest that reduced GFR, independent of albuminuria, may be an important predictor of diabetic nephropathy and coronary artery disease to some extent. So we recommend that not only the microalbuminuria, but also the decrease in GFR should be evaluated at the follow-up of patients with type 2 diabetes.
Academic Medical Centers ; Albuminuria ; Cardiovascular Diseases ; Coronary Artery Disease ; Diabetic Nephropathies ; Diabetic Retinopathy ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Peripheral Nervous System Diseases ; Prevalence

A 45-year-old woman presented with a six-month history of Hailey-Hailey disease, which was recalcitrant to many dermatologic therapies including systemic antibiotics, dapsone, and topical corticosteroids. We precribed tacrolimus (0.1%) ointment for application to the lesions twice a day and examined weekly for the efficacy; the lesions were much improved after 6 weeks of treatment.
Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Dapsone ; Female ; Humans ; Middle Aged ; Pemphigus, Benign Familial* ; Tacrolimus*