BACKGROUND: The epidermal permeability barrier necessary for terrestrial life resides in the intercellular spaces of the stratum corneum and is composed of lipids. OBJECTIVE: Since strrtum corneum lipid may be important for the permeability barrier, we studied the differences and effects of experimentally altered barrier function using acetone and tape-stripping technique. METHODS: The permeability barrier of hairless mouse was disrupted by tape-stripping and acetone treatment and the recovery rate was assessed by histochemical staining, electron microscopic examination and lipid analysis. RESULTS: Although the transepidermal water loss recovered completely by 48 hours in both of the acute models, acetone treated samples seem to have on over-all better recovery rate than tape-stripped samples. The return of barrier function to normal in both tape-stripped and acetone-treated skin was accompanied by a comparable return of normal nile red and ruthenium tetroxide staining. The amount of lipid in stratum corneum paralleled both the return of barrier function towards normal and the extent of prior damage to the barrier in acetone treated skin, yet, the lipid synthesis in tape-stripped skin showed a slower return of lipid content. CONCLUSION: The difference in the recovery rate of the two acute models may be due to the fact that acetone mainly extracts intercellular lipids, whereas, tape-stripping has a prolonged effect by removal of comeocyte in addition to the intercellular lipids. This shows the importance of comeocytes as well as the intercellular lipid bilayer in the recovery of normal barrier function.
Acetone* ; Animals ; Extracellular Space ; Lipid Bilayers ; Mice ; Mice, Hairless ; Permeability ; Ruthenium ; Skin ; Water

OBJECTIVE: To evaluate the results of second-trimester maternal serum triple-marker screening test for Down syndrome and open neural tube defects in singleton pregnancies conceived from in vitro fertilization, the screen positive rates and triple-marker level of patients conceiving singleton pregnancies by IVF were compared to those of pregnancies conceived naturally. METHODS: Two hundred singleton pregnancies conceived by IVF and naturally conceived pregnancies who had done maternal serum screening test during the second trimester were analyzed from January 1995 to April 1998. RESULTS: One (0.5%) of the 200 cases of IVF singleton pregnancies had a positive result for Down syndrome compared with 1% of screen positive rate in the 200 cases of naturally conceived pregnancies. The median level of the triple markers were 0.92 multiples of the median(MoM) for alpha-fetoprotein(AFP), 1.44 MoM for unconjugated estriol(E3) and 0.87 MoM for human chorionic gonadotropin(hCG) respectively. CONCLUSION: The positive rate of triple test for Down syndrome and open neural tube defect in the two groups were significantly not different. As additional data are collected, corrected standards should be determined.
Chorion ; Down Syndrome ; Female ; Fertilization in Vitro* ; Humans ; Mass Screening* ; Neural Tube Defects ; Pregnancy Trimester, Second ; Pregnancy*

Coccidioidomycosis is a common infectious disease in southwestern North America, which is caused by the soil fungus, Coccidioides immitis. Due to the mobility of the modern population, increasing numbers of cases are being diagnosed outside the endemic areas. Moreover, diagnosis in non-endenmic areas may be delayed or confused due to its rarity. Here we report a case of pulmonary coccidioidomycisis in an immigrant. The patient presented with unexplained pulmonary symptoms. A history of recent travel to or immigration from an endemic area may suggest coccidioidomycosis. In addition an early tissue biopsy is helpful in establishing this diagnosis.
Bacterial Infections and Mycoses ; Biopsy ; Coccidioides ; Coccidioidomycosis* ; Communicable Diseases ; Diagnosis ; Emigrants and Immigrants* ; Emigration and Immigration ; Fungi ; Humans ; Mycoses ; North America ; Soil

A 25-year-old woman developed generalized urticaria and an anaphylactic syndrome of sudden onset while she was being treated for her decubitus ulcer with chlorhexidine antiseptic solution. Prick test with 0.5% chlorhexidine produced a wheal in a few minutes. A passive intradermal transfer test (PK test) to her mother was positive. These enabled us diagnose her as having an immunologic contact urticaria to chlorhexidine.
Adult ; Chlorhexidine* ; Female ; Humans ; Mothers ; Pressure Ulcer ; Urticaria*

Successful percutaneous transluminal angioplasty (PTA) of an internal mammary artery graft was performed in a 40 year old male patient who had recurrent angina soon after bypass surgery. Coronary angiography showed total occlusion of proximal portion of the left anterior descending artery and normal right coronary artery. Angiography of the left internal mammary artery graft revealed a tight stenosis (90% diameter narrowing) in the mammary artery at its insection into the left anterior descending artery.Angiography after the angioplasty demonstrated a widely patent graft (residual stenosis 10%) and translesional pressure gradient was 10 mmHg.
Adult ; Angiography ; Angioplasty* ; Arteries ; Constriction, Pathologic* ; Coronary Angiography ; Coronary Vessels ; Humans ; Insects ; Male ; Mammary Arteries* ; Transplants*

No abstract available.

Sweet's syndrome is an important cutaneous sign of underlying myeloproliferative disorder. The majority of cases have occurred with acute leukemia, primarily of the myelogenous type. We described a case of Sweet's syndrome in a patient with myelodysplastic syndrome that preceded acute myelogenous leukemia by 9 months.
Humans ; Leukemia ; Leukemia, Myeloid, Acute* ; Myelodysplastic Syndromes* ; Myeloproliferative Disorders ; Sweet Syndrome*

No abstract available.
Bone Diseases* ; Diagnosis, Differential* ; Humans ; Low Back Pain* ; Spine* ; Tomography, Emission-Computed, Single-Photon*

Stratum corneum lipids, which are enriched in sphingolipids, free fatty acids, and cholesterol, are required for epidermal barrier function. When the epidermal permeability barrier is perturbed, the transepidermal water loss returns to normal by 24-48 hours in parallel with the reappearance of stratum corneum lipids, derived from secreted lamellar bodis and accelerated lipid synthesis. Recent evidence shows that topical application of individual lipids interferes with barrier recovery while complete mixtures of cholesterol, fatty acids, and ceramides facilitate recovery after barrier disrupton. Metabolic imbalances and perturbed barrier function can be either the cause or the consequences of the pathobiology of scaling disease. Many skin diseases relating cornification and dryness are indeed related to abnormality of one or several combinations of lipids. Recently the cytokines which have changed during barrier recovery seem to be important in understanding of epidermal lipid homeostasis as well as barrier recovery.
Ceramides ; Cholesterol ; Cytokines ; Fatty Acids ; Fatty Acids, Nonesterified ; Homeostasis* ; Permeability ; Skin Diseases ; Sphingolipids ; Water

A 52-year-old man with multiple myeloma developed cutaneous nodules while being treated with melphalan and prednisolone. A biopsy specimen showed dermal infiltration by well differentiated plasma cells similar to those found on bone marrow biopsy. The use of peroxidase anti-peroxidase to demonstrate the monoclonality or polyclonality of the cytomplasmic immunoglohulins in the tumor cells revealed a positivity for IgG and 1 chain (ie, monotypic staining). Ultrastructurally, each plasmacytoma cell contained varyting amounts of rough endoplasmic reticulum and Golgi-apparatus. The cutnneous nodules completely disappeared after radiotherapy
Biopsy ; Bone Marrow ; Endoplasmic Reticulum, Rough ; Humans ; Immunoglobulin G ; Melphalan ; Middle Aged ; Multiple Myeloma* ; Peroxidase ; Plasma Cells ; Plasmacytoma* ; Prednisolone ; Radiotherapy