Persistent trigeminal artery is an embryonic remnant of the anastomotic channel linking the internal carotid artery and the basilar artery. Cases of vertebrobasilar insufficiency caused by the persistent trigeminal artery with internal carotid artery stenosis has been described previously, but vertebrobasilar insufficiency entirely due to in situ stenosis of the persistent trigeminal artery has not been reported. A 71-year-old man presented with frequent dizzy episodes. The brain MRI showed no parenchymal lesions. MR angiography showed poor visualization of vertebrobasilar system. He was diagnosed as having vertebrobasilar insufficiency. Cerebral angiography revealed that there was complete occlusion at the vertebrobasilar junction, and the basilar artery was supplied by the persistent trigeminal artery which had severe stenosis at its origin. There was no stenosis of the internal carotid artery of both sides. We believe that this is the first report of vertebrobasilar insufficiency due to stenosed persistent trigeminal artery, without internal carotid artery stenosis.

PURPOSE: To report two cases of tsutsugamushi disease, showing ocular manifestations with eschars on the lower eyelids. METHODS: Two patients who have tsutsugamushi disease with ocular manifestations were examined by standard ophthalmic procedures. Eschars were observed in both patients on the medial canthal lower lid. Conjunctival injection and episcleral vessel dilations were also observed in both patients. One patient had limbal vasculitis with pannus. RESULTS: It is possible that eschars, which are the pathognomonic sign in tsutsugamushi disease, can occur on the eyelid, as well as on the axilla, perineum, abdomen, and extremities, which have been commonly observed sites. Ocular manifestations, including conjunctival injection, episcleral vessel dilation, or limbitis may be observed. These conditions may respond well to treatment with 0.1% Fluorometholone.
Abdomen ; Axilla ; Extremities ; Eyelids* ; Fluorometholone ; Humans ; Perineum ; Scrub Typhus* ; Vasculitis

PURPOSE: To evaluate the early ERG (electroretinogram) changes in N-methyl-N-nitrosourea (MNU)-induced retinal degeneration in rats. METHODS: Thirty-six 6-week-old male rats were injected intraperitoneally with 60mg/kg MNU and divided into 6 groups. Histology and ERG were recorded for the rats of each group before treatment and at 3, 6, 12, 18, and 24 hours after MNU injection. Promptly after the ERG recording, rats were sacrificed and the eyeballs prepared for histologic sectioning. The Tdt-mediated dUTP-digoxigenin nick end labeling (TUNEL) method was used to detect photoreceptor cell death. RESULTS: The first decreases of ERG responses were noticed maximally at 3 hours after the treatment. Thereafter, the amplitude of the responses was partially recovered at 12 hours post-treatment. The second decrease of ERG amplitudes was observed in the 18-hour recordings, and those changes progressed to 24 hours after the treatment. In the histologic findings, TUNEL (+) cells in the Outer Nuclear Layer (ONL) were not detected at 3 hours after MNU injection, but were initially noticed at 6 hours post-injection. CONCLUSIONS: The first decreases of ERG amplitudes proceeded the appearance of TUNEL (+) cells in ONL, and these electrophysiological changes seemed to not be related to photoreceptor cell death. We propose that electrophysiological changes observed might be related to the MNU-induced activity enhancement of guanylate cyclase in the phototransduction pathway. We also show that photoreceptor cell death in the MNU-induced retinal degeneration model occurs at 6 hours after the treatment, which is earlier than the results of previous reports.
Animals ; Guanylate Cyclase ; Humans ; In Situ Nick-End Labeling ; Light Signal Transduction ; Male ; Methylnitrosourea ; Photoreceptor Cells ; Rats* ; Retinal Degeneration* ; Retinaldehyde*

Eccrine poroma is a benign neoplasm, whicn is thought to originate from the eccrine sweat gland. Previous studies suggest that these are primarily lesions of the hairless acral surface. We report a clinicopathological case of a 30-year-old man who presented with a 2.0 by 1.2 cm sized, unusual scalp lesion, which proved to be an eccrine poroma. There has been no local recurrence in the 4 months since complete excision.
Adult ; Humans ; Poroma* ; Recurrence ; Scalp* ; Sweat Glands

BACKGROUND: Human skin is exposed to various environmental stresses, such as heat, cold, and ultraviolet (UV) radiation. Heat shock proteins (HSPs) induced by temperature elevations, as a physiologic response to mediate repair mechanisms and reduce cellular damage. OBJECTIVE: The purpose of this study was to investigate the induction of HSPs in human skin cells after UV exposure. METHODS: We performed immunoblotting using a specific monoclonal antibody to the HSP70 family, one of the best-conserved stress proteins in humans, with cultured normal human keratinocytes, A431 cells, human melanocytes, SK30 cells, and human dermal fibroblasts (HDF). RESULTS: Our results indicated that high expression of HSP70 in the unstressed state was noted in epidermal cells, including normal human keratinocytes, A431 cells, human melanocytes, and SK30 cells, but epidermal cells showed no additional up-regulation of HSP70 after UV irradiation. On the other hand, HDF expressed very small amounts of HSP70 at baseline, but significantly higher amounts of HSP70 after UV exposure. CONCLUSION: These findings suggest that constitutive expression of HSP70 in epidermal cells may be an important mechanism for protection of the human epidermis from environmental stresses, such as sunlight exposure.
Cold Temperature ; Epidermis ; Fibroblasts ; Hand ; Heat-Shock Proteins ; Hot Temperature ; HSP70 Heat-Shock Proteins ; Humans ; Immunoblotting ; Keratinocytes ; Melanocytes ; Skin ; Sunlight ; Up-Regulation

BACKGROUND: Pemphigus vulgaris is an autoimmune bullous dermatoses of skin and mucosa characterized by loss of adhesion between keratinocytes, a process known as acantholysis. Apoptosis, programmed cell death, may participate in pathogenesis of intercellular detachment and loss of cell-matrix interaction. OBJECTIVE: This study was designed to investigate the induction of apoptosis in the pemphigus lesional epidermis and to elucidate the mechanism of apoptosis induced by pemphigus sera. METHODS: Hoechst 33342 staining was performed to determine the induction of apoptosis in the pemphigus lesional epidermis. In addition, we used HaCaT cells treated with pemphigus sera and analyzed the expression of caspase-3, caspase-8, caspase-9 and bcl-2, bcl-xL, bax, bak by the RT-PCR method. RESULTS: In Hoechst 33342 staining, typical findings of apoptosis were observed in the pemphigus lesional epidermis showing acantholysis. RT-PCR showed the upregulation of caspase group (caspase-3, caspase-8, caspase-9), the downregulation of antiapoptotic bcl-2 family (bcl-2, bcl-xL) and the upregulation of proapoptotic bcl-2 family (bax, bak). CONCLUSION: These results suggest that apoptosis may be associated with acantholysis of pemphigus lesional epidermis and may play an important role in the pathogenesis of pemphigus.
Acantholysis ; Apoptosis* ; Caspase 3 ; Caspase 8 ; Caspase 9 ; Cell Death ; Down-Regulation ; Epidermis ; Humans ; Keratinocytes ; Mucous Membrane ; Pemphigus* ; Skin ; Skin Diseases, Vesiculobullous ; Up-Regulation

Laugier-Hunziker syndrome (LHS) is a rare acquired benign macular hyperpigmentation of the lips and oral mucosa which is often associated with longitudinal melanonychia. LHS is known to be an entirely benign condition with no systemic manifestations, which requires patient reassurance as the only intervention. The significance of this condition is due to its inclusion in differential diagnoses of pigmentary disorders of the oral mucosa, especially Peutz-Jeghers syndrome. We report a case of Laugier-Hunziker syndrome in a 66-year-old woman who presented with longitudinal pigmented bands on her fingernails and multiple, pigmented macules on the lip and tongue.
Aged ; Diagnosis, Differential ; Female ; Humans ; Hyperpigmentation ; Lip ; Mouth Mucosa ; Nails ; Peutz-Jeghers Syndrome ; Tongue

BACKGROUND: Functional MRI is a new neuroimaging method that detects focal blood flow change associated with neural activation. This study aimed at improving it for use as a clinical test. METHODS: We separated image reconstruction from scan acquisition as an off-line process, systematized post-processing stages, and employed SPM96 package for statistical analysis. Tasks easy enough for most neurological patients were designed for activation of motor, somatosensory, visual, and language areas. From twenty consecutive patients admitted to neurology wards, frequency of expected activation and inactivation among defined regions of interest was obtained as a measure of sensitivity and quasi-specificity. RESULTS: It took about 4 minutes for data acquisition per task condition. Thus within half an hour all four tasks were tested in cooperative patients. Post-processing took about an hour per task condition, using PC-based analysis packages. Sensitivity and quasi-specificity were about 70% and 90%, respectively. CONCLUSIONS: Our newly developed method shortened the time for fMRI acquisition and systematized post-scan analysis. Data obtained from patients showed acceptable reliability for clinical use, but further research and improvement should be necessary.
Humans ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging* ; Neuroimaging ; Neurology

BACKGROUND: Intracerebral hemorrhage (ICH) is associated with a considerable proportion of stroke and head injuries, but except for supportive care, there is no medical therapy available. Transplantation of human neural stem cells (NSCs) can be used to reduce behavioral deficit in experimental ischemic infarct model. However, effect of stem cell transplantation in experimental intracerebral hemorrhage (ICH) is unknown. We hypothesized that NSCs could migrate and differentiate into neurons or glial cells, and improve functional outcome in ICH. METHODS: Experimental ICH was made by intrastriatal administration of bacterial collagenase in adult rats. Animals were randomized to receive intravenously either immortalized Lac-Z positive human NSCs (5x1 06 in 500microL, n=15) or same volume of saline (n=12) on the following day. Animals were evaluated for 8 weeks after surgery with behavioral test battery. After 8 weeks, animals were sacrificed and the brains were sectioned. Transplanted NSCs were detected by X-gal histochemistry or beta-gal immunohistochemistry, and differentiation of grafted NSCs were evaluated by double labeling of GFAP, NeuN, or neurofilament. RESULTS: Transplanted NSCs migrated to the side of peri-hematomal areas, and differentiated into neurons and astrocytes. NSCs injection group showed improved performances on rotarod test after 2 weeks and on limb placing test after 5 weeks compared with control group (p<0.05) and these effect persisted up to 8 weeks. CONCLUSIONS: Intravenously injected NSCs enter rat brain with ICH, and differentiate into astrocytes or neuronal cell, which lead to functional recovery. These findings show the possibility that NSCs can be used to reduce neurological deficits in the experimental ICH.
Adult ; Animals ; Astrocytes ; Brain ; Cerebral Hemorrhage* ; Collagenases ; Craniocerebral Trauma ; Extremities ; Humans* ; Immunohistochemistry ; Neural Stem Cells* ; Neuroglia ; Neurons ; Rats ; Rotarod Performance Test ; Stem Cell Transplantation ; Stroke ; Transplants

Nevoid basal cell carcinoma syndrome is inherited as an autosomal dominant trait with variable expressivity. This is characterized by multiple basal cell carcinomas, skeletal abnormalities, ectopic calcification, palmoplantar pits, central nervous system abnormalities, and multiple odontogenic keratocysts of the jaw. We report a case of nevoid basal cell carcinoma syndrome occurring in 14 year old girl, she had multiple basal cell carcinomas, spina bifida in the cervical vertebrae, forked ribs, hypertelorism, ectopic calcification of falx cerebri, palmoplantar pits, medulloblastoma, meningioma and sclerosing stromal tumor of the ovary. Her father had the same clinical features.
Adolescent ; Basal Cell Nevus Syndrome* ; Carcinoma, Basal Cell ; Central Nervous System ; Cervical Vertebrae ; Fathers ; Female ; Humans ; Hypertelorism ; Jaw ; Medulloblastoma ; Meningioma* ; Odontogenic Cysts ; Ovary* ; Ribs ; Spinal Dysraphism