BACKGROUND: The relationship and differentiation among various dendritic cells of the dermis are unclear. Recently it has hecome possible to identify different subpopulat,ions of dermal dendritic cells using anti-CD34 and anti-factor XIIIa antibodies. OBJECTIVE: To elucidate which cell types the fibrous dermal turnors consist of we compared the staining patterns of these antibodies as well as of anti-Mac 387 antibody which are labeled as inflammatory cells of the monocyte-macrophage lineage. METHODS: Tumors studied included dermatofibrosarcoma protuberans(DFSP, n=2), dermato-fibroma(n=22), neurofibroma, n=27), acrochordon(n=15), keloid, hypertrophic scar(n=10), juvenile xanthogranuloma(n=1, and malignant fibrous histiocytoma (MFH, n=1). We performed immunoperoxidase staining(AUSC technique) with polyclonal anti FXIIIa antibody, monoclonal anti-CD34 antibody, and monoclonal anti-Mac 387 antibody on the formalin-fixed-paraffin-embedded tissue specimens of these fibrous tumors. The intensity of staining was graded as negative, weakly staining, or strongly stainiring. RESULTS: FXIIIa reactivity was strongly present in dendritic and spindle-shaped cells of all dermatofibromas and some nurofibromas(11 of 27 specimens), but absent from the other fibrous tumors. Among these tumors, one of the two DFSPs was uniquely expressed CD34. Dendritic and spindle-shaped cells within tiese tumors were MAC 387 negative. In inflammatory conditions, variable numbers of MAC 38 positive cells were observed, corresponding to histiocytes and mac-rophages, but the labeling of ipithelioid cells and multinucleated foreign body giant cells were variable. CONCLUSION: The findings of significant numbers of FXIIIa positive cells in dermal fibrous tumors studied suggest that thet may be diagnostic utility associated with the use of this antit)ody. In addition, CD 34 expression by the tumor cells can be an extremely useful marker in establishing a definitive diagnosis of IFSP.
Antibodies ; Dendritic Cells ; Dermatofibrosarcoma ; Dermis ; Diagnosis ; Factor XIIIa* ; Giant Cells, Foreign-Body ; Histiocytes ; Histiocytoma, Benign Fibrous ; Histiocytoma, Malignant Fibrous ; Keloid ; Langerhans Cells ; Neurofibroma

A 12-year-old girl presented with a 1-week duration of hair loss associated with splitting of the hair ends and whitish dots on the occipital hairs. On microscopic examination, a longitudinal splitting of the hair shaft with reconstitution of the normal hair distal to the fracture, nodular swellings, with the appearance of broomsticks pushed into one another, at the site of whitish swellings, and the flattening and twisting of the hair shaft around the long axis were demonstrated. Minor trauma to injury-prone hair is a common cause of hair shaft defects, however the reports with the combined conditions are insufficient in the literature. We describe a patient with central trichoptilosis associated with localized trichorrhexis nodosa and pili torti.
Axis, Cervical Vertebra ; Child ; Female ; Hair ; Humans

No abstract available.
Intracranial Aneurysm*

Clear cell sarcoma of tendons and aponeuroses is the term coined by Enzinger in 1965 to describe a rare but unique type of soft tisse neoplasm whose cells characteristically have the capacity to produce melanin. The authors experienced a case of 64-year old female who presented with a 6x5x4 cm sized mass deeply seated in the left popliteal fossa. The mass was firm and multinodular, and on cut section revealed patches of brown black pigmentation. Histologically the tumor was composed of round to fusiform cells with clear or pale eosinophilic cytoplasm that contained small amounts of glycogen, separated into compact nests or short fascicles by delicate septa of fibrous tissue. The brown black pigment seen in tumor cells and stroma was proven to be melanin by special stain, and ultrastructural examination showed melanosomes in varying stages of development dispersed freely in the cytoplasm or in the lysosomes. These findings strongly support the view that clear cell sarcoma is a tumor of neural crest origin rather than of tenosynovial mesenchyme origin, and is a soft tissue variant of malignant melanoma.
Female ; Humans

No abstract available.
Facial Paralysis* ; Humans ; Malocclusion*

No abstract available.
Enterotoxigenic Escherichia coli*

The use of hyperventilation technique to reduce intracranial pressure for surgical intervention of cerebral aneurysm has been well documented and most common in general practice. The decrease of blood flow with hyperventilation may aggravate pre-existing ischemic region. On this occasion it was suggested that cerebral intracellular metabolic acidosis may be accentuated so that its metabolic status could be measured from the analysis of cerebrospinal fluid gases. Hyperventilation can cause an increase in PH of cerebrospinal fluid due to the decrease of PCO but if hyperventilation is induced chronically, an elevated PH returns gradually to its previous normal value by loss of HCO, from the cerebrospinal fluid. Anesthesia was maintained with hyperventilation throughout the cerebral aneurysm surgery then cerebrospinal fluid and arterial blood gases were measured at regular intervals. PH in cerebrospinal fluid at 1 hour after hyperventilation revealed severe metabolic acidosis and arterial blood gases showed respiratory alkalosis. At 6 hours after hyperventilation the PH in cerebrospinal fluid in-creased markedly but the changes of HCO2were not significant from its control value and accord-ingly metabolic acidosis in cerebrospinal fluid was improved. It was suggested that compensatory mechanism for PH of cerebrospinal fluid to return to its low value by decreasing HCO2was shown. If such mechaniwm does not exist cerebrospinal fluid HCO2must he increased theoretically.
Acidosis ; Alkalosis, Respiratory ; Anesthesia ; Cerebrospinal Fluid ; Gases ; General Practice ; Hydrogen-Ion Concentration ; Hyperventilation* ; Intracranial Aneurysm* ; Intracranial Pressure ; Reference Values

Gram-negative sepsis is the most common setting in which the constellation of abnormalities in lung function, is clinically called the adult respiratory distress syndrome(ARDS). There is a considerable clinical interest in measuring pulmonary microvascular filtration pressure in patients with acute respiratory failure. Pulmonary capillary pressure(Pc) influences the rate of edema formation in the injured lung, and an understanding of how Pc is altered by the disease is important to improve our treatment of acute respiratory failure, We infuesd E. Coli endotox-in, 3 mg/kg, intravenously into anesthetized dogs and measured the hemodynamics and pulmonary capillary pressure, which was derived from the pressure transient recorded while the pulmonary artery catheter was rapidly wedged. Dogs were given fluids to restore cardiac filling pressure to baseline levels. This resulted in a low resistance shock in all animals. 3 hours after the endotxin infusion experimental ARDS developed. The data report that mean pulomanary artery pressure, pulmonary capillary pressure, and pulmonary vascular resistance(PVR) are increased in experimental ARDS(P<0.1), and there is uneuqal, variable partitoning of the PVR. The Gaar estimation of Pc and measured Pc were highly correlated(r=0.915). These data suggest that measuring Pc will alow the clinician to learn if vasoactive agents infused in the management of acute respiratory failure can reduce the microvascular filtration pressure. In this manner, clinicians may directly reduce the rate of edema formation in the acutely injured lung.
Adult ; Animals ; Arteries ; Capillaries* ; Catheters ; Dogs ; Edema ; Filtration ; Hemodynamics* ; Humans ; Lung ; Pulmonary Artery ; Respiratory Insufficiency ; Sepsis ; Shock ; Shock, Septic

Gram-negative sepsis is the most common setting in which the constellation of abnormalities in lung function, is clinically called the adult respiratory distress syndrome(ARDS). There is a considerable clinical interest in measuring pulmonary microvascular filtration pressure in patients with acute respiratory failure. Pulmonary capillary pressure(Pc) influences the rate of edema formation in the injured lung, and an understanding of how Pc is altered by the disease is important to improve our treatment of acute respiratory failure, We infuesd E. Coli endotox-in, 3 mg/kg, intravenously into anesthetized dogs and measured the hemodynamics and pulmonary capillary pressure, which was derived from the pressure transient recorded while the pulmonary artery catheter was rapidly wedged. Dogs were given fluids to restore cardiac filling pressure to baseline levels. This resulted in a low resistance shock in all animals. 3 hours after the endotxin infusion experimental ARDS developed. The data report that mean pulomanary artery pressure, pulmonary capillary pressure, and pulmonary vascular resistance(PVR) are increased in experimental ARDS(P<0.1), and there is uneuqal, variable partitoning of the PVR. The Gaar estimation of Pc and measured Pc were highly correlated(r=0.915). These data suggest that measuring Pc will alow the clinician to learn if vasoactive agents infused in the management of acute respiratory failure can reduce the microvascular filtration pressure. In this manner, clinicians may directly reduce the rate of edema formation in the acutely injured lung.
Adult ; Animals ; Arteries ; Capillaries* ; Catheters ; Dogs ; Edema ; Filtration ; Hemodynamics* ; Humans ; Lung ; Pulmonary Artery ; Respiratory Insufficiency ; Sepsis ; Shock ; Shock, Septic

Efforts from many different approaches have been made to cure Raynand's phenomenon, such as a dorsal sympathectomy, topical injection of nitroglycerin, phentolamin and procaine, and oral or parentral administration of various drugs. However, there has been no successful management proven yet. In recent years, it was reported that intra-arterial administration in normal subjects as well as patients with Raynaud's syndrome has demonstrated a significant rise in blood flow to the hands. We used intermittent stellate ganglion blocks in conjunction with intra-arterial injections of reserpine and procaine in 10 patients suffering from finger necrosis. The stellate ganglion block was performed in a paratracheal approach by injection of 1% lidocaine purposely mixed with adrenaline followed by the administration of reserpine 1mg and procaine 50mg through a butterfly needle inserted in the radial or brachial artery. The administration of reserpine and procaine was done only twice at intervals of 1 week because of the development of suspected arterisclerosis. The stellate ganglion block was carried out once a week for about 3 months, then once a month as needed for 6 to 12 months. AS the procedure was carried out and the necrotic tissue sloughed off, oozing appeared and new granulation tissue was observed. 5 out of 10 patients were healed completely and the rest improved considerably but were not followed to the end. We concluded that the intra-arterial administration of reserpine and procaine helped initiate and accelerate increasing blood flow to the hand and the stellate ganglion block continued to help revascularization by dilating the peripheral beds.
Brachial Artery ; Butterflies ; Epinephrine ; Fingers ; Granulation Tissue ; Hand ; Humans ; Injections, Intra-Arterial ; Lidocaine ; Necrosis ; Needles ; Nitroglycerin ; Procaine ; Reserpine* ; Stellate Ganglion* ; Sympathectomy