A 3-year-old-male had the appearance of red urine at birth and developed recurrent bullae in sun-exposed area of the skin, erythrodontia, alopecia, splenomegaly and hemolytic anemia, We observed coral red fluorescence of the teeth and urine under Wood's light and detected excessive excretion of the uroporphyrin in the urine and coproporphyrin in the stool wlth inreased porphyrin in the blood. Fluorescence of erythrocyte was demonstrated by:fluoreacence microscopy. Histologic findings showed subepidermal bulla with PAS-positive hyaline deposits around the blood vessels and revealed IgG deposits in the wall of blood vessels and dermo-epidermal junction by direct immunofluorescence.
Alopecia ; Anemia, Hemolytic ; Anthozoa ; Blood Vessels ; Erythrocytes ; Fluorescence ; Fluorescent Antibody Technique, Direct ; Hyalin ; Immunoglobulin G ; Microscopy ; Parturition ; Porphyria, Erythropoietic* ; Porphyrias ; Skin ; Splenomegaly ; Tooth

A 50-year-old woman with lupus erythematosus profundus of about a year's duration was reported. The patient had no history of discoid lupus erythematosus or systemic lupus erythematosus. Dermatologic examination revealed two, firm, freely movable, well demarcated, subcutaneous plaques, with mildly erythematous overlying skin, measuring 2 x 2 cm (right), 5 x 5 cm (left), was present on the both deltoid region. Histopathologically, this showed panniculitis. Diret immunofluorescence studies showed IgG and IgM deposition on the dermoepidermal junction.
Female ; Fluorescent Antibody Technique ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Lupus Erythematosus, Discoid ; Lupus Erythematosus, Systemic ; Middle Aged ; Panniculitis ; Panniculitis, Lupus Erythematosus* ; Skin

The CD44 protein has a functional domain for binding hyaluronic acid, maintaining the integrity and structure of the epithelium. The purpose of this study is to evaluate the presence and comparison of distribution of CD44 in human and rabbit corneas using immunohistochemical staining method. Immunostaining for CD44 was observed in the epithelium, endothelium and human stromal keratocytes. In particular, the strong positive deposition for CD44 can be seen in basal and limbal layers of the epithelium and in the endothelium. Immunodeposits for CD44 in rabbit cornea were detected in superficial parts of the epithelium, while they were localized in deep stromal keratocytes and the endothelium. In conjunctival tissue, immunostaining for CD44 was found in the epithelium, connective tissue, and vascular endothelium in human specimen but was faintly demonstrated only in the extracellular matrix of connective tissue in the rabbit conjunctiva. No immunostaining for CD44 was seen in control case. Our results suggest that CD44 protein can be seen both in human and rabbit corneas. However, there was different distribution of CD44 between two specimens.
Conjunctiva ; Connective Tissue ; Cornea* ; Endothelium ; Endothelium, Vascular ; Epithelium ; Extracellular Matrix ; Humans* ; Hyaluronic Acid

An alkali burn of the cornea severely damages not only the epithelium but also the underlying keratocytes and endothelium, the extracellular matrix is thought to play an important role in burn wound healing of the cornea. The glycoprotein CD44 of extracellular matrix has been implicated in biological cell behavior, including lymphocyte binding to endothelial venules, embryonic development cell migration, cell differentiation, and tumor metastasis. The purpose of this study is to investigate the presence and distribution of CD44 in wound healing using immunohistochemical staining method after alkali burning of rabbit cornea. 2 hour after burn, there was no immunodeposit for CD44 at keratocytes and endothelial cells at denuded epithelial burn area. 4 hours postburn, the epithelial cell gradually migrated over the burn area from the peripheral unburn area and immunodepositive staining of the keratocytes was observed at the margin of burn site. 24 hours postburn, immunopositive reaction for CD44 at adjacent alkali burn area was more strongly labeled, but the peripheral epithelial response of unburn area was faintly labeled by them. 48 hours postburn, immunopositive reaction gradually shifted from the border portion of alkali burn to the center portion of burn site. On days 7, the epithelium was completely reepithelized over the burn area and 3 weeks postburn, immunostaining were demonstrated the entire layer of burn site. The recovering time of the nornal immunostaing for CD44 of the rabbit cornea from the alkali burn was taken about 7 weeks. Our results suggest that the CD44 protein can be seen in proliferating in the epithelial cells, the keratocytes end endothelial cells, and is thought to play an important role in wound healing of the alkali burn cornea.
Alkalies* ; Burns* ; Cell Differentiation ; Cell Movement ; Cornea ; Embryonic Development ; Endothelial Cells ; Endothelium ; Epithelial Cells ; Epithelium ; Extracellular Matrix ; Female ; Glycoproteins ; Lymphocytes ; Neoplasm Metastasis ; Pregnancy ; Venules ; Wound Healing* ; Wounds and Injuries*

PURPOSE: The purpose of this study is to help diagnosis migraine and tension-type headache in children with chronic recurrent headache by comparing clinical characteristics of migraine and tension-type headache. METHODS: We performed a clinical analysis of 89 children diagnosed as migraine and/or tension-type headache by using international headache society classification with the aid of Prenky's criteria of migraine and Jay's category of tension-type headache. RESULTS: The diagnosed group consisted of 39 children with migraine, 40 tension-type headache cases and coexisting migraine and tension-type headache in 10 cases. In the location of the headache, the incidence of temporal area was significantly higher in the migraine than in tension-type headache(P<0.001) and the incidence of occipital area was significantly higher in the tension-type headache than in migraine(P<0.01). In migraine, 27 cases(69.2%) had pulsating headache which was significantly higher than in the tension-type headache(P<0.001). In tension-type headache, 18 cases(45.0%) had dull headaches which were significantly higher than in migraine(P<0.01). Nausea, vomiting, dizziness, relief of headache after sleep, photophobia, and visual disturbance among associated symptoms with headache were significantly higher in migraine than tension-type headache(P<0.05). The incidence of family history of headache in migraine(71.8 %) was higher than in the tension-type headache(40.0%)(P<0.01). CONCLUSION: Diagnostic criteria are significant in diagnosis of migraine and tension-type headache. The characteristics of headache are overlapped in both headache types and there are differences of expression for headache in children, so there is a problem in diagnosing of headache type. The international Headache Society Classifications are useful for children, but there are problems that diagnostic criteria are too strictly applied to children.
Child* ; Classification ; Diagnosis ; Dizziness ; Headache ; Humans ; Incidence ; Migraine Disorders* ; Nausea ; Photophobia ; Tension-Type Headache* ; Vomiting

No abstract available.
Animals ; Calcaneus* ; Muscle, Skeletal* ; Rats* ; Tenotomy*

BACKGROUND: Functional dyspepsia (FD) is a commonly encountered disturbance of gut function and has been shown to be associated with psychological disturbance such as depression and anxiety. Of particular importance to clinicians are the relationship between anger, alexithymia, and depression. In this study, we investigated anger, alexithymia, and depression in patients with functional dyspepsia. METHODS: Thirty patients who visited Wonkwang University Hospital from January 2001 to June 2001, were diagnosed with functional dyspepsia by a gastroenterologist and compared with 37 healthy control group. Medical investigation of FD including gastrofiberscopy, esophageal manometry, and ambulatory 24-hours intraesophageal reflux test were negative. All subjects were evaluated for depression, anxiety, anger and anger expression, and alexithymia. The measures included Beck Depression Inventory (BDI), Spielberger State-Trait Anxiety Inventory (STAI), Spielberger State-Trait Anger Expression Scale (STAXI), and Toronto Alexithymia Scale (TAS). RESULTS: The FD patients reported significantly more symptoms of depression, more difficulty describing feeling to others in TAS, less anger-in and anger-out expression in STAXI than the control subjects. Depressive symptoms in FD were positively correlated with state anxiety, trait anxiety, alexithymia, state anger, trait anger, and anger-in expression. In multiple regression model, state anger and trait anxiety together accounted for 69.1% of the depression in FD. CONCLUSION: The FD patients reported more depressive symptoms, and the depressive symptoms were related to anxiety, anger and anger-in, and alexithymia. These finding lend support that FD is a syndrome in which biopsychosocial process and affect dysregulation may play a role in features of FD.
Affective Symptoms* ; Anger* ; Anxiety ; Depression* ; Dyspepsia* ; Humans ; Manometry

Although adenosine (Ado) is being recently recognized as a potent inducer of apoptosis, molecular mechanism of apoptosis by Ado remains to be elucidated. In this study we observed that c-Myc was rapidly down-regulated in the apoptosis in human promyelocytic leukemia HL-60 cells treated with Ado. To establish the molecular and biochemical mechanisms of apoptosis, we tested the specific effects of several antagonists of Ado receptors or inhibitors of Ado transporter on the induction of apoptosis. Treatment of dipyridamole (DPD), an Ado transport inhibitor, effectively suppressed both c-Myc reduction and DNA fragmentation, suggesting that the induction of apoptosis and down-regulation of c-Myc is mediated by active Ado transporter. It was another evidence supporting the entrance of Ado into cells undergoing apoptosis that Ado cytotoxicity was potentiated by a addition of methylation cycle intermediates. These results suggest that the active Ado transporter-mediated Ado entrance into HL-60 cells leads to the induction of apoptosis through down-regulation of c-Myc.
Adenosine* ; Apoptosis* ; Dipyridamole ; DNA Fragmentation ; Down-Regulation* ; HL-60 Cells* ; Humans ; Leukemia ; Methylation

STUDY DESIGN: A literature review on the radiologic findings of pelvic parameters for treatment of spinal deformity OBJECTIVES: This review examines sagittal spine alignment, pelvic parameters, and methods for assessing alignment, and examines the relationships among all of these parameters to understand spinal deformity. SUMMARY OF LITERATURE REVIEW: Understanding the main pelvic and sagittal spinal parameters and recognizing their correlation is imperative in the diagnosis and treatment of various spinal disorders. MATERIALS AND METHODS: Review of the literature. RESULTS: As spinal and pelvic parameters tend to have a strong correlation, it is essential to measure not only spinal parameters but also pelvic parameters in analyzing sagittal balance. Degenerative changes have the potential to greatly disrupt the normal curvature of the spine, leading to sagittal malalignment. Analysis of sagittal balance is crucial to optimizing the management of spinal diseases. Improvement in surgical outcomes may be achieved through better understanding of radiographic spino-pelvic parameters and their association with deformity. CONCLUSIONS: Understanding spinal and pelvic parameters raises awareness of the relationship among alignment and balance, the soft tissue envelope, and compensatory mechanisms, which will, in turn, provide a more comprehensive understanding of the nature of spinal deformity and the modalities with which it is treated.
Congenital Abnormalities ; Diagnosis ; Spinal Diseases ; Spine

OBJECTIVE: Obturator neuropathy is a rare condition. Many neurosurgeons are unfamiliar with the obturator nerve anatomy. The purpose of this study was to define obturator nerve landmarks around the obturator foramen. METHODS: Fourteen cadavers were studied bilaterally to measure the distances from the nerve root to relevant anatomical landmarks near the obturator nerve, including the anterior superior iliac spine (ASIS), the pubic tubercle, the inguinal ligament, the femoral artery, and the adductor longus. RESULTS: The obturator nerve exits the obturator foramen and travels infero-medially between the adductors longus and brevis. The median distances from the obturator nerve exit zone (ONEZ) to the ASIS and pubic tubercle were 114 mm and 30 mm, respectively. The median horizontal and vertical distances between the pubic tubercle and the ONEZ were 17 mm and 27 mm, respectively. The shortest median distance from the ONEZ to the inguinal ligament was 19 mm. The median inguinal ligament lengths from the ASIS and the median pubic tubercle to the shortest point were 103 mm and 24 mm, respectively. The median obturator nerve lengths between the ONEZ and the adductor longus and femoral artery were 41 mm and 28 mm, respectively. CONCLUSION: The obturator nerve exits the foramen 17 mm and 27 mm on the horizontal and sagittal planes, respectively, from the pubic tubercle below the pectineus muscle. The shallowest area is approximately one-fifth medially from the inguinal ligament. This study will help improve the accuracy of obturator nerve surgeries to better establish therapeutic plans and decrease complications.
Cadaver ; Femoral Artery ; Ligaments ; Obturator Nerve* ; Spine