Squamous cell carcinoma(SCC) is a recognized late complication of chronic discoid lupus erythematosus(CDLE). There are many case reports of SCC in white patients with chronic DLE. However, it is uncommon in blacks and Asians. The etiology of squamous cell carcinoma is multifactorial. The predisposing factors for the development of SCC in these patients include actinic keratosis, Bowen's disease, burn scars, arsenic keratosis, and chronic discoid lupus erythematosus. Of these causes, SCC developing in the lesions of CDLE is very rare. We report a patient who has been evaluated for ten years with a diagnosis of discoid lupus erythematosus and has squamous cell carcinoma.
African Continental Ancestry Group ; Arsenic ; Asian Continental Ancestry Group ; Bowen's Disease ; Burns ; Carcinoma, Squamous Cell* ; Causality ; Cicatrix ; Diagnosis ; Humans ; Keratosis ; Keratosis, Actinic ; Lupus Erythematosus, Discoid*

In humans, the major stimulus for cutaneous pigmentation is ultraviolet radiation. Little is known about the mechanism underlying this response, in part, because of the complexity of the interactions involving the whole epidermis. The present stucy was undertake to evaluate the effects of a single exposure of UVB on cultured normal melanocytes. Melanocytes were exposed to UVB from 5.1 mJ/cm to 203 mJ/cm. The results were as follows : 1. The main morphologic changes in UVB-exposed groups w re larger sized cells, more blunted dendrites, and shorter dendrites than in the control group. These cells increased sized according to the increased doses of VVB, but above 101.5 mJ/cm, the melanocytes shrunk and were destroyed. 2. From 20.3 mJ/cm of UVB, the proliferation of melanocyte was decreased, Especially, there was statistical!y significant difference above 50.8 mJ/cm (p<0.05, p<0.01). 3. The antiproliferativo effect increased with the passage of tirie after UVB exposure. So, cell count could not be done in 101.5 mJ/cm and 203 mJ/cm on the third day, and in 50.8 mJ/cm, 101.5 m J/cm and 203 mJ/cm on the seventh day. 4. Statistically the melanin content per well was significantl dicreased to 11-28% of each control group with dose above 50.8 mJ/cm (p<0.05, p<0.01). The melanin content per cell was increased to 107-128% of each control group when doses were below 20.3 mJ/cm and decreased to 49-79% of each control group when above 0.8 mJ/cm on the third day, but there was no statistically significant difference. In summary, when melarocytes were exposed to UVB, morphclogic changes progressed to cell differentiation. The results also suggested that a low or dose of UVB has an antiproliferative arid mild melanogenic effect, and a higher dose of UVB has a direct cytotoxic effect.
Cell Count ; Cell Differentiation ; Dendrites ; Epidermis ; Humans ; Melanins ; Melanocytes* ; Pigmentation

Benign symmetric lipomat,osis is a rare disease of undetermined cause characterized by symmetric deposits of adipose tissue o:n the neck, upper trunk and abdomen. We report three cases of kienign symmetric lipomatosis, one of which is associated with alcoholic liver disease and the patient complained of a diffieulties in neck motion, All of them are about sixty year old men with history of frequent alcohol consumption. In histopathologic findings, the reticular dermis was completcly replaced by mature fat cells and there was a slight increase in vascular and fibrous elements.
Abdomen ; Adipocytes ; Adipose Tissue ; Alcohol Drinking ; Dermis ; Humans ; Lipomatosis* ; Liver Diseases, Alcoholic ; Male ; Neck ; Rare Diseases

No abstract available.
Epinephrine* ; Heart Arrest*

BACKGROUND: Adie's tonic pupil consists of mydriasis, accommodation defect, decreased light reflex, and tonic near reflex. When tonic pupil is combined with hypo- or areflexia, it is called Holmes-Adie syndrome. CASE: Fifty-two-year-old and 37-year-old female patients showed unilateral dilated irregular pupil, decreased light reflex, and decreased or absent DTR. When 0.125% pilocarpine was dropped on the dilated pupil, the pupil was constricted after pilocarpine application. Somatosensory evoked potentials were within normal ranges, and H-reflex responses were absent or delayed.
Adie Syndrome* ; Adult ; Evoked Potentials, Somatosensory ; Female ; H-Reflex ; Humans ; Mydriasis ; Pilocarpine ; Pupil ; Reference Values ; Reflex ; Tonic Pupil

Wilson's disease is an autosomal recessive disorder resulting from an excessive accumulation of copper in the liver, cornea, kidneys, and in the basal ganglia of the brain. The prominent speech disturbances of Wilson's disease include monopitch, monoloudness, slow rate, low pitch, delayed in initiating speech and rarely palilalia. A19-year-old woman developed palilalia which was characterized by compulsive repetition of a phrase with increasing rapidity and with a decrescendo of voice volume. Although she had been suffering from liver cirrhosis for the past 8 months, the palilalia was the only neurological sign at initial examination. She showed a low serum ceruloplasmin, low serum copper, increased urinary copper excretion, and Kayser-Fleischer rings. Brain magnetic resonance images showed high signals in the bilateral basal ganglia in T2-weighted images, and slight cortical atrophy.
Atrophy ; Basal Ganglia ; Brain ; Ceruloplasmin ; Copper ; Cornea ; Female ; Hepatolenticular Degeneration* ; Humans ; Kidney ; Liver ; Liver Cirrhosis ; Voice

Among 73 patients with possible and definite tuberculous meningitis, 14 cases showed a sudden unexpected polymorphonuclear (PMN) CSF pleocytosis during treatment. Patients with superimposed bacterial meningitis were excluded. Eleven patients(15. 1%) matched inclusion criteria. The intervals between the onset of the treatment and the onset of the PMN CSF pleocytosis were 7-54 days(mean 17.2+ 14.4 days). The mean duration of PMN CSF pleocytosis was 14.2+12.4 days. A PMN CSF pleocytosis may develop occasionally weeks or months after the start of the treatment for tuberculous meningitis. Though the cause is uncertain, we suggest that probably its cause is superimposed acute meningeal inflanunation by the release of Mycobacterium from tuberculomas or.delayed Jarisch-Herxheimer reaction.
Humans ; Leukocytosis* ; Meningitis, Bacterial ; Mycobacterium ; Tuberculoma ; Tuberculosis, Meningeal*

BACKGROUND & OBJECTIVES: Hypertensive encephalopathy is an acute neurologic syndrome characterized by abrupt and marked elevation of blood pressure, headache, vomiting, seizure, visual disturbance, and altered mental status. This syndrome may occur as a complication of toxemia, renal artery stenosis and acute glomerulonephritis. We report 4 young patients with occipital lobe seizure, as a presenting sign of hypertensive encephatopathy, whose brain MRI and perfusion scans showed lesions on bilateral occipital lobes. Case : Four young patients experienced moderate to severe headache, visual illusion, generalized seizure, and loss of sight for a few days. Their systolic blood pressure was 150-170mmHg and diastolic blood pressure 100-120mmHg. Three patients had proteinuria and hematuria as the results of acute glomerulonephritis. CSF findings were within normal limits. EEG showed intermittent generali,ed or bilateral temporoparietooccipital slowings in all patients and continuous parietooccipital slowings in one patient. Brain MRI man showed hyperintensity signal in T2WI and hypointensity signal in TlWl on bilateral occipital lobes and SPECT scan showed normal perfusion three patients and increased perfusion on occipital areas in one patient. They were treated with antihypertemsive agents and anticonvulsants (phenobarbital or valporic acid) for 2-10 months. Seizure was well controlled and didn't recur though discontinuing anticonvulsant. CONCLUSION: In young age, acute hypertension may cause clinically occipital lobe seizure and radiologically bilateral occipital lobe lesions.
Adolescent* ; Anticonvulsants ; Blood Pressure ; Brain ; Electroencephalography ; Glomerulonephritis ; Headache ; Hematuria ; Humans ; Hypertension ; Hypertensive Encephalopathy* ; Illusions ; Magnetic Resonance Imaging ; Occipital Lobe* ; Perfusion ; Proteinuria ; Renal Artery Obstruction ; Seizures* ; Tomography, Emission-Computed, Single-Photon ; Toxemia ; Vomiting

Pilomatricoma is a benign tumor derived from the hair matrix. Pilomatricoma-like changes have been described in epidermal cysts in Gardner's syndrome. Apart from this association, a cyst can arise from various portions of a hair follicle, and combine to form a hybrid cyst. Follicular hybrid cyst is an interesting pathologic phenomenon, and needs to be explained for their pathogenesis. We present a case in which a pilomatricoma was situated in the immediate vicinity of an epidermal cyst. Histopathologic findings showed that one part of the cyst had a feature of an epidermal cyst, and the other part had a feature of a pilomatricoma.
Chimera ; Epidermal Cyst ; Gardner Syndrome ; Hair ; Hair Follicle ; Pilomatrixoma

No abstract available.
Contusions*