Prurigo pigmentosa is a chror ic pruritic inflammatory dermatosis characterized by erythematous papules in a reticulated pattern that resolve leaving a reticulated, mottled hyperpigmentation and rapidly response to dapsone therapy. Most cases that have been reported are from Japan. We report two cases of prurigo pigmentosa in a 21 year-old female and a 23-year-old female. Histopathologic findings of erythematous papules showed exocytosis, spongiosis, liquefaction degeneration of basal cell layer and perivascular lymphohistiocytic infiltration on the upper dermis. We treated them with dapsone, 100mg daily, which resulted in a remarkable regression of the ery thematous papules and improvenien of pruritus.
Dapsone ; Dermis ; Exocytosis ; Female ; Humans ; Hyperpigmentation ; Japan ; Prurigo* ; Pruritus ; Skin Diseases ; Young Adult

To determine the incidence, clinical characteristics and coronary angiographic findings of postinfarction angina, clinical course and coronary angiogram were studied in 45 patients with acute myocardial infarction. During a mean follow-up period of 12 weeks, 17 patients(37.8%) developed angina. Of 5 patients with postinfarction angina within 1 week of infarction, 2 patients died during hospitalization, whereas all 12 patients with postinfarction angina which occured more than 1 week after acute myocardial infarction were discharge alive. The frequency of stenosis over 90% and multivessel disease by coronary angiography were 51.7% and 64.7% respectively in patients with postinfarction angina, and 25%, 28.5% respectively in patients without postinfarction angina.
Constriction, Pathologic ; Coronary Angiography ; Follow-Up Studies ; Hospitalization ; Humans ; Incidence ; Infarction ; Myocardial Infarction

Painful nociceptive informations are well known to be transferred from nociceptors through spinal dorsal horn not only in different pathways but also in diverse nature depending on the type of noxious stimuli. There have been some controversies about the role of neuropeptide somatostatin in the transmission of the nociceptive information to the dorsal horn cells of the spinal cord. We performed the study in order to elucidate the effects of somatostatin on transmission of noxious stimuli in the spinal dorsal horn, comparing with those of morphine. Using carbon-filamented microelectrode, the single cell activities of wide dynamic range(WDR) neuron were recorded extracellularly at the lumbosacral enlargement of the spinal cord in cats after noxious mechanical(squeeze), thermal(heat lamp), and cold(dry ice) stimulation to the receptive field. The sciatic nerve was stimulated electrically to evoke, A4-fiber and C-fiber each other. Data were compiled into single pass time histograms or postsimulus time histograms. Twenty micro-gram of somatostatin was injected intravenously to study the changes of single cell activities in 20 minutes, which were compared with the effects of morphine(2m/kg). Then naloxone was administrated(0.1mg/kg) to know whether it antagonized the effects of somatostatin and morphine And those finding were also observed in inverted WDR cells. In WDR cell, somatostain decreased the cellular responses to noxious heat stimuli in 6cell(n=9), but increased those to cold stimuli in 4 cells(n=6). And the responses to noxious mechanical stimuli were so diverse that they were slightly increased in 7 cells(164%), decreased in 5 cells, and were not changed in 6 cells(n=18). A-response, the response to peripheral Ad-afferent activation, showed a tendency to be facilitated(n=6/9), while C-response had a slightly depressed tendency(n=4/9). Morphine strongly suppressed the responses of dorsal horn neurons to noxious heat(n=9/13), cold(n=2/2), mechanical stimuli(n=16/19) and electrical A-response(n=7/10), C-response(n=6/7). Following subsequent injection of naloxone, the effects of morphine on noxious stimuli evoked response were fully reversed but those of somatostatin were not antagonized. There was significant difference between the reversal effects of naloxone on morphine and somatostatin(p<0.05). From the above results it is concluded that somatostatin suppresses the transmission of nociceptive heat stimuli, especially via C-fiber, while facilitates that of nociceptive mechanical and cold stimuli via Adelta-fiber in spinal dorsal horn cells. Also the somatostatin appears to have different nociceptive mechanism from morphine.
Animals ; Cats* ; Horns ; Hot Temperature ; Microelectrodes ; Morphine* ; Naloxone ; Neurons ; Neuropeptides ; Nociceptors ; Peripheral Nerves* ; Posterior Horn Cells* ; Sciatic Nerve ; Somatostatin* ; Spinal Cord

To investigate the effect of bile acid on gastric mucosa, we performed biologic test using Sprague-Dawley rat. Mixture solution of TDCA 15mM and Hcl of pH 3 was given into stomach to one group and HCl of pH 3 was given into stomach to another group. The significant gastric mucosal change was vasodilation and edema, that was disappeared progressively. These findings suggest the bile acid and damage gastric mucosa.
Animals ; Bile* ; Edema ; Gastric Mucosa ; Hydrogen-Ion Concentration ; Rats ; Rats, Sprague-Dawley ; Stomach ; Vasodilation

BACKGROUND AND PURPOSE: Cavernous angiomas are frequently encountered in patients with intractable partial epilepsies. Cavernous angioma can make highly epileptogenic foci and dual pathology. Although it is generally thought that the epileptogenic activity originated in neuronal populations adjacent to the lesion, little is known as to the exact location of the epilepsies on electophysiologic, clinical and pathologic view. We investigated nine intractable epilepsy patients with cavernous angioma regarding relation of EEG, semiology and pathology to verify where are the epileptogenic foci in cavernous angioma. METHODS: We included 9 intractable epilepsy patients with cavernous angioma who had been were undergone video-EEG monitoring. They were aged from 15 to 49 years(average:36.7+15.7)and had cavernous angioma in temporal, frontal lobe, or multiple areas(temporal:7, frontal:1, multiple:1 patients). Four patients had invasive EEG study including subdural and/or depth electrodes. Six patients had undergone epilepsy surgery. We analyzed seizure history, semiology of their seizures, interictal and ictal EEG. To know dual pathology, MRI including hippocampal volumetry, invasive EEG, and pathology were studied. RESULTS: Four patients had multiple auras. Eight patients had complex partial seizures and one had right foot clonic seizure, which were related with the location of cavernous angioma. In scalp EEG, ictal recording showed definite EEG changes, but 3 patients had no definite EEG change in some seizures. In invasive EEG with subdural and/or depth electrodes , interictal spikes were more frequently detected than scalp EEG and ictal EEG revealed not only 3 different ictal onset zones in 3 patients but also EEG seizures without clinical events in 3 patients. Regarding dual pathology, mesial temporal involvement was detected in 2 patients in MRI. Among 6 surgery patients 4 patients including 3 patients with normal hippocampus in MRI had hippocampal or dentate gyral change in pathology. Among 4 patients with invasive ictal EEG, 3 patients including 1 patient with normal hippocampus in MRI and pathology had mesial temporal involvement in ictal onset zones. CONCLUSION: Cavernous angiomas can make multiple epileptogenic foci around themselves and often dual pathology of hippocampus, which can be easily detected by invasive ictal EEG but not by imaging and even by pathology. And the foci can have frequent EEG seizures, which do not make clinical events. Precise localization of epileptogenic foci in cavernous angioma were needed to have good medical and surgical treatments.
Electrodes ; Electroencephalography ; Epilepsies, Partial ; Epilepsy ; Foot ; Frontal Lobe ; Hemangioma, Cavernous* ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Neurons ; Pathology ; Scalp ; Seizures

Orbital infarction syndrome is a rare complication of neurosurgical procedures. The authors recently experienced two patients suffered from acute proptosis, ophthalmoplegia, and blindness developed immediately after surgery for ruptured anterior communicating artery aneurysms. Both patients underwent standard frontotemporal craniotomies to clip their aneurysms. Retinal and choroidal nonperfusion, and ophthalmoplegia, which suggested hypoperfusion of the ophthalmic artery and its branches, consistent with the orbital infarction. We report two cases of orbital infarction syndrome and discuss possible mechanism with literature review.
Aneurysm ; Blindness ; Choroid ; Craniotomy ; Exophthalmos ; Humans ; Infarction* ; Intracranial Aneurysm* ; Neurosurgical Procedures ; Ophthalmic Artery ; Ophthalmoplegia ; Orbit* ; Retinaldehyde

PURPOSE: This study was undertaken to show the clinical results of combined radiotherapy and hyperthermia in primary hepatoma. MATERIALS AND METHODS: Between December 1989 and March 1993, 50 patients with hepatomas were treated by combined radiotherapy and hyperthermia. Among them, we analyzed retrospectively 33 patients who received the complete course of treatment. The ages of the patients ranged from 36 to 75(mean age: 55.5 years). Twenty-six patients (78.8%) were men, and 7 (21.2%) were women. According to Child's classification, nine patients (27.3%) were A group, 9 (27.3%) were B group, 15 (45.4%) were C group. Radiation therapy was done by a 6 MV and 15 MV linear accelerator. Patients were treated with daily fractions of 150-180 cGy to doses of 2550 cGy - 4950 cGy (median: 3000 cGy). Local hyperthermia was done by 8 MHz RF capacitive heating device (Cancermia. Green Cross Co., Korea), 50-60 min/session, 1-2 sessions/wk, and 8.5 sessions (median number)/patients. We analyzed the prognostic factors including age, sex, tumor type, Child's classification, a-fetoprotein, liver cirrhosis, ascites, portal vein invasion, esophageal varix, number of hyperthermia, chemotherapy, total bilirubin level, Karnofsky performance status. RESULTS: The overall 1-year survival was 24.2%, with a mean survival of 10 months. Of 33 patients, tumor regression (PR+MR) was seen in 30.4%, no response was seen in 52.2%, 17.4% patient was progressed. In patients who had tumor regression, the overall 1-year survival was 42.1% with a mean survival of 14 months. Factors influencing the survival were sex (p=0.05), tumor type (p=0.0248), Child's classification (p=0.0001), liver cirrhosis (p=0.0108), ascites (p=0.0009), and Karnofsky performance status (p=0.0028). Complications developed in 28 patients, including 18 hot pain, 5 fat necrosis, 3 transient fever, 2 nausea and vomiting. CONCLUSION: In this study, the results suggests that combined radiotherapy and hyperthermia may improve the survival rate of hepatoma.
Ascites ; Bilirubin ; Carcinoma, Hepatocellular* ; Classification ; Drug Therapy ; Esophageal and Gastric Varices ; Fat Necrosis ; Female ; Fever* ; Heating ; Hot Temperature ; Humans ; Hyperthermia, Induced ; Karnofsky Performance Status ; Liver Cirrhosis ; Male ; Nausea ; Particle Accelerators ; Portal Vein ; Radiotherapy* ; Retrospective Studies ; Survival Rate ; Vomiting