BACKGROUND: The endothelial expresson and upregulation of ICAM-1 and epidermal keratinocyte expression of ICAM-1 are well documented in psoriasis. ICAM-1 mediates the adhesion and trafficking of circulating activated skin-seeking CD45RO+ memory CD4+ T lymphocytes from the vessel into the dermis and epidermis of psoriatic skin by binding to its ligand LFA-1(lymphocyte function-associated antigen-1) expressed on lymphocyte membranes. OBJECTIVE: The purpose of this study was to investigate the expression of ICAM-1 in vascular endothelium and keratinocyte of psoriatic skin and the difference of ICAM-1 expression between early and fully developed psoriatic lesions. METHODS: We have studied the expression of ICAM-1 in twelve psoriatic patients who had not been treated for psoriatic lesions for 1 month and three normal human skin samples by immunohistochemical staining using monoclonal antibody against ICAM-1. RESULTS: Immunohistochemical staining revealed anti-ICAM-1 antibody positively stained only in the subpapillary endothelial cells of normal skin. But in all psoriatic lesions studied, anti- ICAM-1 antibody was stained positively in the endothelium of papillary and subpapillary plexus, and in fully developed psoriatic lesions, anti-ICAM-1 antibody was stained focally in epidermal keratinocytes. CONCLUSION: The results suggest that ICAM-1 expression on papillary microvessels and keratinocytes may play an important role in the transendothelial and transepidermal migration of lymphocytes from the vessel into the dermis and epidermis of psoriatic skin.
Dermis ; Endothelial Cells ; Endothelium ; Endothelium, Vascular* ; Epidermis ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes* ; Lymphocytes ; Membranes ; Memory ; Microvessels ; Psoriasis ; Skin* ; T-Lymphocytes ; Up-Regulation

The hereditary multiple osteochondromatosis is a hereditary disorder characterized by gradual development of numerous osteocartilagenous masses from the metaphyseal region of long bones. The abnormality is transmitted as an autosomal dominant trait and its etiology is unknown but many theories of pathogenesis have been advanced. Four members of a family with hereditary multiple osteochondromatosis who are much shorter in height are presented with a brief review of literatures.
Exostoses, Multiple Hereditary ; Humans

Bullous pemphigoid(BP) is a bullous disease in elderly people characterized by subepidermal bullae on erythematous and normal skin. Peripheral blood easinophilia have been reported in the patients with BP, and blood eosinophilia may be related to disease activity and severity in BP. We report a 70-year old man BP. He showed peripheral blood eosinophilia, and was treated successfully with a combination of low dose steroids & tetracycline-niacinamide(T-N) therapy. The eosinophil counts fell to normal levels as the skin lesion cleared.
Aged ; Eosinophilia ; Eosinophils ; Humans ; Pemphigoid, Bullous* ; Skin ; Steroids

An association between drug treatment for viral infections and severe cutaneous adverse reactions has been noted. We investigated six patients diagnosed with Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) after being prescribed acetaminophen for suspected viral illnesses. Multiplex analysis was performed to measure cytokine levels in sera before and after treatment. IL-2Rα levels significantly decreased during the convalescence phase. Although acetaminophen is relatively safe, the drug can trigger SJS/TEN in patients with suspected viral infections. T-cells and monocytes may be key components of the link between viral infection and acetaminophen-induced SJS/TEN.
Acetaminophen* ; Convalescence ; Humans ; Monocytes ; Stevens-Johnson Syndrome* ; T-Lymphocytes

PURPOSE: Despite modern medication, peptic ulcer, patients often require emergency surgery for complications of peptic ulcer disease, and the mortality due to a perforated peptic ulcer still remains high. This retrospective study was conducted to evaluate the risk factors associated with mortality in patients undergoing surgery for a perforated peptic ulcer. METHODS: Two hundred and four consecutive patients (mean age: 45.8 years; range: 15~0 years) who underwent emergency surgery for a perforated peptic ulcer at the National Medical Center, between January 1991 and December 2000, were reviewed. RESULTS: The overall mortality rate was 5.9%. A univariate analysis of multiple clinical variables revealed old age (> or =65 years), duration of symptoms (> or =24 hours), NSAIDs or steroid use, comorbid disease, shock on admission, low hemoglobin (<10 g/dl), higher BUN (> or =20 mg%), higher creatinine (> or =1.5 mg%), gastric ulcer and simple closure to be significantly associated with mortality. However, a multivariate analysis showed that shock on admission, comorbid disease and old age (> or =65 years) were independent predictors of mortality. CONCLUSION: Shock on admission, comorbid disease and old age should be considered as significant prognostic factors of emergency surgery for a perforated peptic ulcer, and a comorbid disease and age as non modifiable factors. For that reason, prompt resuscitation is considered as the most effective therapy for reducing the mortality due to peptic ulcer perforation.
Anti-Inflammatory Agents, Non-Steroidal ; Creatinine ; Emergencies* ; Humans ; Mortality* ; Multivariate Analysis ; Peptic Ulcer Perforation ; Peptic Ulcer* ; Resuscitation ; Retrospective Studies ; Risk Factors* ; Shock ; Stomach Ulcer

Annular elastolytic giant cell granuloma (AEGCG) is an inflammatory disorder characterized by the annular plaques with serpiginous raised borders on the sun-exposed area. Its pathologic finding shows the patchy granulomatous infiltration composed of multinucleated giant cells, histiocytes, lymphocytes and disappearance of the elastic fibers secondary to being engulfed by the giant cells. We report a case of AEGCG in a 59-year-old-male. He had several annular, erythematous plaques with raised borders on his dorsum of the hand, neck, back and the typical histologic features of AEGCG.
Elastic Tissue ; Giant Cells* ; Granuloma, Giant Cell* ; Hand ; Histiocytes ; Lymphocytes ; Neck

Carcinoembryonic antigen (CEA) has been studied in the field of gynecologic malignancy to determine whether it can be used as a tumor marker for early detection of recurrence or evaluation of therapeutic results. From January 1985 through December 1989, a total of 239 cervical cancer patients were entered for an analysis of plasma CEA level in the group with cervical cancer compared to the control group consisting of 65 normal healthy women and 18 women with benign gynecologic disease. Plasma CEA levels appear to be directly related with the tumor extension and as stages advance, the incidence of patients with abnormal plasma CEA levels is increased. Also, there seems to be a little higher incidence of abnormal CEA levels in patients with adenocarcinomas or adenosquamous carcinoma but not statistically significant because of small number of patients. When the patients developed recurrence, plasma CEA levels are markedly elevated in the majority, particularly in patients with hepatic metastases. In conclusion, serial plasma CEA checks could be used to detect recurrence during follow-up after treatment of cervical cancer.
Adenocarcinoma ; Carcinoembryonic Antigen ; Carcinoma, Adenosquamous ; Female ; Follow-Up Studies* ; Genital Diseases, Female ; Humans ; Incidence ; Neoplasm Metastasis ; Plasma* ; Recurrence ; Uterine Cervical Neoplasms

An intravenous pyogenic granuloma is a rare, benign, intravascular tumor, which arises from the vein wall and protrudes into the lumen. This is characterized by a lobular proliferation of capillaries similar to the more common cutaneous pyogenic granulomas. We report a case of intravenous pyogenic granuloma which showed lobular capillary proliferation in the perivenous connective tissue.
Capillaries ; Connective Tissue ; Granuloma, Pyogenic* ; Veins

BACKGROUND: Shiga toxin-producing Escherichia coli (STEC) was found in several serotypes of E coli including 0157 serotype. Sorbitol-MacConkey agar: may be useful for the detection of E. coli 0157, but is not helpful for the detection of sorbitol-fermenting STEC other than 0157. Moreover, some strains of E. colt 0157 can ferment sorbitol. In this study, in situ hybridization using DNA probe of shiga toxin was used for the isolation of STEC from the PCR-positive stool and -Sequenbe analysis of a part of shiga toxin gene was performed. METHODS: The stool was incubated in LB broth overnight and DNA was extracted from the culture fluid. Multiplex PCR was performed with primers for stxl and stx2 genes. Specimen showed PCR-positive was incubated on MacConkey agar and colonies were blotted with nitrocellulose membrane. Digoxigenin-labelled DNA probe for shiga toxin was made by PCR and the positive colonies were detected with anti-digoxigenin-alkaline phosphatase conjugate and nitroblue tetrazolium. Agglutination test with antisera was performed for the serotying and VTEC-RPLA kit was used for the toxin production. Sequence analysis of PCR products was performed with automatic sequence analyser. RESULTS: An stxl-negative, but stx2-positive PCR was observed in a three-year-old girl, who visited Kumi Hospital on July 19, 1999 complaining of vomiting and diarrhea. The positive colonies were isolated by in situ hybridization using stx2-specific DNA probe. The titers of stxl and stx2 by VTEC-RPLA test were negative and 1:64, respectively. Agglutination for the serotyping was not observed with all of the 0 antisera. 160-nucleotide sequence of stx2 of this isolate was identical with bacteriophage 933W (GenBank X07865), except for the change (T-C) of 957th nucleotide and amino acid sequence was identical each other. CONCLUSIONS: For the sensitive detection of STEC from the stool of patients with diarrhea, multiplex PCR is recommended with stxl- and stx2-specific primers. And in situ hybridization should be performed in PCR-positive specimen for the isolation of STEC. This method may be helpful for the detection of STEC as the causative microorganisms in food-borne outbreak.
Agar ; Agglutination ; Agglutination Tests ; Amino Acid Sequence ; Bacteriophages ; Collodion ; Diarrhea ; DNA ; Escherichia coli ; Female ; Gyeongsangbuk-do ; Humans ; Immune Sera ; In Situ Hybridization ; Membranes ; Multiplex Polymerase Chain Reaction ; Nitroblue Tetrazolium ; Polymerase Chain Reaction ; Sequence Analysis* ; Serotyping ; Shiga Toxin ; Shiga-Toxigenic Escherichia coli* ; Sorbitol ; Vomiting

BACKGROUND: Shiga toxin-producing Escherichia coli (STEC) was found in several serotypes of E coli including 0157 serotype. Sorbitol-MacConkey agar: may be useful for the detection of E. coli 0157, but is not helpful for the detection of sorbitol-fermenting STEC other than 0157. Moreover, some strains of E. colt 0157 can ferment sorbitol. In this study, in situ hybridization using DNA probe of shiga toxin was used for the isolation of STEC from the PCR-positive stool and -Sequenbe analysis of a part of shiga toxin gene was performed. METHODS: The stool was incubated in LB broth overnight and DNA was extracted from the culture fluid. Multiplex PCR was performed with primers for stxl and stx2 genes. Specimen showed PCR-positive was incubated on MacConkey agar and colonies were blotted with nitrocellulose membrane. Digoxigenin-labelled DNA probe for shiga toxin was made by PCR and the positive colonies were detected with anti-digoxigenin-alkaline phosphatase conjugate and nitroblue tetrazolium. Agglutination test with antisera was performed for the serotying and VTEC-RPLA kit was used for the toxin production. Sequence analysis of PCR products was performed with automatic sequence analyser. RESULTS: An stxl-negative, but stx2-positive PCR was observed in a three-year-old girl, who visited Kumi Hospital on July 19, 1999 complaining of vomiting and diarrhea. The positive colonies were isolated by in situ hybridization using stx2-specific DNA probe. The titers of stxl and stx2 by VTEC-RPLA test were negative and 1:64, respectively. Agglutination for the serotyping was not observed with all of the 0 antisera. 160-nucleotide sequence of stx2 of this isolate was identical with bacteriophage 933W (GenBank X07865), except for the change (T-C) of 957th nucleotide and amino acid sequence was identical each other. CONCLUSIONS: For the sensitive detection of STEC from the stool of patients with diarrhea, multiplex PCR is recommended with stxl- and stx2-specific primers. And in situ hybridization should be performed in PCR-positive specimen for the isolation of STEC. This method may be helpful for the detection of STEC as the causative microorganisms in food-borne outbreak.
Agar ; Agglutination ; Agglutination Tests ; Amino Acid Sequence ; Bacteriophages ; Collodion ; Diarrhea ; DNA ; Escherichia coli ; Female ; Gyeongsangbuk-do ; Humans ; Immune Sera ; In Situ Hybridization ; Membranes ; Multiplex Polymerase Chain Reaction ; Nitroblue Tetrazolium ; Polymerase Chain Reaction ; Sequence Analysis* ; Serotyping ; Shiga Toxin ; Shiga-Toxigenic Escherichia coli* ; Sorbitol ; Vomiting