Little is known of the clearance mechanism of blood in the joint and it is still controversial. In order to clarify the possible mechanism of the clearance, rabbits own venous blood was injected into their own right knee joints of twenty-four normal adult rabbits and the opposite left knee joints served as control. The animal were killed at 12 hours, 1, 2, 3, 4, 7, 14 and 21 days after intra-articular injection of autologous blood. For histological and histochemical studies, the fresh synovial tissues were obtained from infrapatellar regions. The sections were stained by the alcian-blue (pH 2.5) for mucopolysaccharides and methylgreen pyronin for ribonucleic acid (R.N.A.). And finally, for metachromasia the sections were stained with toluidine blue (pH 2.5). In hematoxylin-eosin stained preparation, the synovial cells did not show any gross alterations in the early stages of experiment, but there was an increasing infiltreation of some inflammatory cells into the synovial and subsynovial tissues. Many erythrocytes were found lying free between the synovial cells, in the synovial matrix and subsynovial tissues. Any synovial change that shows a patchy thickening of the synovium due to increase in both the size and number of synovial cells and villous proliferation, became marked at the fourth day after experiment. On the seventh day villous proliferation were still seen but persist in an attenuated form. These changes converted to nearly normal from two weeks after experiment. With methyl-green pyronin stain for R.N.A., the synovial cell showed a definite increase in number in pyroninophilic granules and in intensity of staining reaction at two days of hemarthrosis and these findings were seen even in the third week specimens. After 12 hours of experiment, the synovial cells and the matrix showed a quite clear positive reaction with alcine-blue. And these changes showed a most strong positive reactions at 24 hours of experiment. But after 24 hours the synovial cells gradually showed a decreasing tendensy in intensity of staining reaction to alcian-blue. Since the fourth day of experiment the synovial and subsynovial tissues were closer to normal with alcian-blue. Toluidine blue gave only faint metachromasia to the very rarely in the deeper layer of synovium. We confirmed some of the injected erythrocytes escaped from the joint into the synovium and were cleared from the joint, and blood cells are clears from the joint by phagocytosis of synovial cells. It is suggested that these changes correlates with various histological and metabolic changes of the synovial membrane following a experimental hemarthrosis.
Adult ; Animals ; Blood Cells ; Deception ; Erythrocytes ; Glycosaminoglycans ; Hemarthrosis ; Humans ; Injections, Intra-Articular ; Joints ; Knee Joint ; Knee ; Phagocytosis ; Rabbits ; RNA ; Synovial Membrane ; Tolonium Chloride ; United Nations

Sjogren-Larsson syndrome is a rare autosomal recessive neurocutaneous disorder due to a deficiency of the fatty aldehyde dehydrogenase. It consists of ichthyosis, spastic di- or quardriplegia and mental retardation. We report a case of a 9-year-old boy who was suspected to have Sjogren-Larsson syndrome. He had congenital ichthyosis, spastic diplegia and mental retardation. In addition, there was macular degeneration on the fundus. His neurological symptoms were improved after selective posterior rhizotomy and rehabilitation therapy. However, the dermatological problem did not subside with conservative treatment.
Aldehyde Dehydrogenase ; Cerebral Palsy ; Child ; Humans ; Ichthyosis ; Intellectual Disability ; Macular Degeneration ; Male ; Muscle Spasticity ; Neurocutaneous Syndromes ; Rehabilitation ; Rhizotomy ; Sjogren-Larsson Syndrome*

BACKGROUND: Long-term phototherapy can induce the changes of photoaging and it is reported that there is an increased chance of cutaneous squamous cell carcinomas in patients exposed to large amounts of UV radiation. OBJECTIVE: The main objective was to investigate the degree of photoaging and the presence of p53 mutations in normal skin in patients undergoing long-term phototherapy. METHOD: We performed hematoxylin-eosin and special stains, p53 and p21 immunohistochemical stains and polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP) on the normal skin of patients subject to long-term UV therapy. RESULT: 1. The typical features of photoaging were not observed in patients undergoing long-term UV therapy. 2. In p53 immunohistochemical staining performed at 1 week after cessation of long-term PUVA treatment, the patient group with a culmulated UV dosage of more than 1,000J/cm2 demonstrated an increased number of p53 positive epidermal cells compared to exposed as well as unexposed normal skins. 3. The patterns of p21 immunohistochemical staining performed at 1 week after cessation of long-term PUVA and UVB treatments were similar to that of p53 immunohistochemical staining performed at 1 week after cessation of phototherapy. 4. In p53 immunohistochemical staining performed at 4 months after cessation of UV treatment, the number of p53 positive epidermal cells decreased significantly compared to that of p53 positive epidermal cells found at 1 week after cessation of UV treatment. 5. The mutation of p53 genes was not found in PCR-SSCP analysis of biopsied skins done at 1 week after cessation of long-term PUVA and UVB treatment. CONCLUSION: Long-term phototherapy did not induce the typical changes of photoaging and p53 overexpression in the epidermis of UV treated skin was a reactive process. Therefore, UV therapy can be a relatively safe treatment modality, although a closer observation for cutaneous malignancy is warrented in the patients whose cumulated UV dosage is much higher than 1,000J/cm2.
Aging* ; Carcinoma, Squamous Cell ; Coloring Agents ; Epidermis ; Genes, p53 ; Humans* ; Phototherapy ; Skin*

BACKGROUND: The endothelial expresson and upregulation of ICAM-1 and epidermal keratinocyte expression of ICAM-1 are well documented in psoriasis. ICAM-1 mediates the adhesion and trafficking of circulating activated skin-seeking CD45RO+ memory CD4+ T lymphocytes from the vessel into the dermis and epidermis of psoriatic skin by binding to its ligand LFA-1(lymphocyte function-associated antigen-1) expressed on lymphocyte membranes. OBJECTIVE: The purpose of this study was to investigate the expression of ICAM-1 in vascular endothelium and keratinocyte of psoriatic skin and the difference of ICAM-1 expression between early and fully developed psoriatic lesions. METHODS: We have studied the expression of ICAM-1 in twelve psoriatic patients who had not been treated for psoriatic lesions for 1 month and three normal human skin samples by immunohistochemical staining using monoclonal antibody against ICAM-1. RESULTS: Immunohistochemical staining revealed anti-ICAM-1 antibody positively stained only in the subpapillary endothelial cells of normal skin. But in all psoriatic lesions studied, anti- ICAM-1 antibody was stained positively in the endothelium of papillary and subpapillary plexus, and in fully developed psoriatic lesions, anti-ICAM-1 antibody was stained focally in epidermal keratinocytes. CONCLUSION: The results suggest that ICAM-1 expression on papillary microvessels and keratinocytes may play an important role in the transendothelial and transepidermal migration of lymphocytes from the vessel into the dermis and epidermis of psoriatic skin.
Dermis ; Endothelial Cells ; Endothelium ; Endothelium, Vascular* ; Epidermis ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes* ; Lymphocytes ; Membranes ; Memory ; Microvessels ; Psoriasis ; Skin* ; T-Lymphocytes ; Up-Regulation

Giant cell tumor is a relatively uncommon neoplasm with high rate of local recurrence following curettage and bone graft. The histologic grading was not proven useful in predictiog outcome. Histologically benign giant cell tumor may metastasize. We report a case of histologically benign giant cell tumor occurred at left distai femur with local recurrences and multiple pulmonary metastases which was proven by percutaneous needle aspiration lung biopsy. Recurred local lesion was treated by curettage and filling with methylmethacrylate and pulmonary metastases was treated with adriamycine and dacarbazine.
Biopsy ; Curettage ; Dacarbazine ; Doxorubicin ; Femur ; Giant Cell Tumors ; Giant Cells ; Lung ; Methylmethacrylate ; Needles ; Neoplasm Metastasis ; Recurrence ; Transplants

Deep wound infection is a serious surgical complication. The majority of patients with pyogenic spondylodiscitis can be treated non-surgically with antibiotics and immobilization. However, although surgical management of pyogenic spondylodiscitis continues to evolve, no consensus has yet been reached regarding the best surgical approaches and techniques. Anterior lumbar interbody fusion (ALIF) followed by percutaneous pedicle screw fixation (PPF) is an effective surgical option for treating postoperative pyogenic spondylodiscitis (PPS). In this report, we describe a case of PPS in a 64-year-old man who underwent ALIF with PPF.
Anti-Bacterial Agents ; Consensus ; Discitis ; Humans ; Immobilization ; Middle Aged ; Wound Infection

No abstract available.
Nail-Patella Syndrome*

OBJECTIVE: The purpose of this study is to assess the factors related to the outcome of 84 patients who underwent surgery for anterior communicating Artery(ACoA) aneurysms. METHODS: The authors review 84 patients who were undertaken from January 1998 to May 2004. In the management of ACoA aneurysms, the outcome was based on several factors: Clinical condition, Distribution of hemorrhage, Time between aneurysmal rupture and surgery, Direction and shape of the aneurysm. RESULTS: The incidence rate of the ACoA aneurysm was 35%. Seventy four patients were classified as those having a good recovery, but 5 patients suffered from some morbidity and 5 patients died. The rate of good outcome for the patients with Hunt and Hess grade was as follows 100% in grade I, 95% in grade II, 80% in grade III, IV and V. The rate of good outcome for the patients with Fisher grade was as follows 98% in grade I, II and 81% in grade III, IV. Nineteen of 22 patients who underwent early surgery were rated as good, while twenty six of 30 patients for whom surgery was delayed showed a favorable result. The unfavorable outcomes were also attributed by vasospasm or other medical problems. CONCLUSION: For further improvement of the overall surgical outcome: First, early surgical intervention is recommended for good grade patients. Second, active management of poor grade patients should be scrutinized with early surgery. Third, it is also important to step up the effort to minimize the risk of medical complications to enhance surgical results on top of the mainstay of prevention efforts for vasospasm and rebleeding.
Aneurysm ; Hemorrhage ; Humans ; Incidence ; Intracranial Aneurysm* ; Rupture

Bullous pemphigoid(BP) is a bullous disease in elderly people characterized by subepidermal bullae on erythematous and normal skin. Peripheral blood easinophilia have been reported in the patients with BP, and blood eosinophilia may be related to disease activity and severity in BP. We report a 70-year old man BP. He showed peripheral blood eosinophilia, and was treated successfully with a combination of low dose steroids & tetracycline-niacinamide(T-N) therapy. The eosinophil counts fell to normal levels as the skin lesion cleared.
Aged ; Eosinophilia ; Eosinophils ; Humans ; Pemphigoid, Bullous* ; Skin ; Steroids

BACKGROUND: Previous studies have demonstrated the pathogenetic role and expression of TGF-beta in psoriatic lesion. Transforming growth factor s are a family of growth factors with inhibitory effects on epithelial cell proliferation. Their effects are mediated by two interacting receptors, of which type I receptor mediates signal transduction after interaction with type II receptor carrying the TGF ligand. OBJECTIVE: The purpose of this study was to investigate the relationship between development of psoriasis and expression of TGF-beta receptors in psoriatic lesion. METHODS: We have studied the expression of TGF-beta type I and type II receptors in psoriatic lesions of 30 psoriatic patients who had not been treated for 1 month, 5 non-lesional psoriatic skin, and 3 normal human skin by immunohistochemical staining using polyclonal rabit antisera. RESULTS: 1. Immunohistochemical analysis revealed an intense immunoreactivity for TGF-beta type I and type II receptors in the basal and also suprabasal layer of normal epidermis and non-lesional psoriatic skin. 2. Almost all psoriatic lesions studied lacked detectable immunoreactivity of either receptor in the epidermis. CONCLUSION: We suggest the lack of TGF-beta - mediated growth inhibition by down regulation of TGF-beta receptor expression may play an important role in the pathogenesis of psoriasis.
Down-Regulation ; Epidermis* ; Epithelial Cells ; Humans ; Immune Sera ; Intercellular Signaling Peptides and Proteins ; Psoriasis ; Receptors, Transforming Growth Factor beta ; Signal Transduction ; Skin ; Transforming Growth Factor beta ; Transforming Growth Factors