BACKGROUND: Dermatophytosis is sometimes difficult to diagnose deinitively if it has atypical clinical characteristics and mycological tests are negative. Histopathologic findings may be different depending upon the location and causative dermatophytes. OBJECTIVE: The purpose of the present study was to evaluate histopathologic characteristics nf dermatophytosis depending upon the areas of involvement. METHODS: We evaluated the clinical and histopathologic features of 32 cases of dermatophytosis which were diagnosed by skin biopsies at the Dermatology Department of branch hospitals of Catholic University Medical College from March 1985 to August, 1994. Histopathologic features were observed in three dilferent groups divided by location, area of terminal hair, areas of vellus hair and hairless areas. RESULTS: Epidermal changes including hyperkeratosis, parakeratos, acanthosis, spongiosis and neutrophilic exocytosis were frecuently observed in the three groups of Iermatophytosis. In 7 cases of tinea capitis and linea barbae, follicular and inflamma or changes of the deep dermis were important. Hyphae and spores were observed in 71%(5 cases) and 57%(4 cases) respectively, in the follicles. In 19 cases of tinea faciale, tiriea corporis and tinea cruris, change epidermis and superficial dermis as well as findings of follicular infundibulum were important. Herphae were observed in 84%(16 cases) and 53%(10 cases) in the stratum corneum and vellus hir follicle respectively, and in 3 cases the hyphae were observed only in the vellus hair follicle. Sandwich sign, known to be important clue of dermaliophytosis, was observed in only 5%(1 cacse, In 6 cases of tinea manus and linea pedis, hyphae and spores were rebserved in 100% (6 cases) and 33%(2 cases) respectively, in the stratum corneum. CONCLUSION: We consider tha histopathologic observations may of great help to diagnose some difficult cases of dermatophytosis and the presence of hyphae n .he vellus hair follicle may be a more frequent and important finding than the sandwich sign the dermatophytosis of the vellus hairy regions.
Arthrodermataceae ; Biopsy ; Dermatology ; Dermis ; Epidermis ; Exocytosis ; Hair ; Hair Follicle ; Hospitals, Satellite ; Hyphae ; Neutrophils ; Skin ; Spores ; Tinea Capitis ; Tinea*

Desmoplastic trichoepithelioma, a tumor of hair follicle, is usually seen as solitary lesions. Its clinical configuration is hard and annular, asympromatic, white or yellowish and varied in size from 3 to 8 mm, but the appearance of these lesion is not so distinctive to hair follicle tumors that the diagnosis is estabilished by the histopathologic findings. Microscopical findings of desmoplastic trichoepithelioma consist of narrow strands of tumor cells, horn cyst, desmoplastic stroma. We present here a case of desmoplastic trichoepitheliorna, which develops as 6 mm sised papule on the left cheek in a 57-year-old woman.
Animals ; Cheek ; Diagnosis ; Female ; Hair Follicle ; Horns ; Humans ; Middle Aged

Catecholamine-induced cardiomyopathy associated with neuroblastoma is rarely reported. We report a case of catecholamine-induced cardiomyopathy associated with neuroblastoma in a 33-month-old female that was treated with extracorporeal membrane oxygenation (ECMO). She was tentatively diagnosed with acute myocarditis and presented with hypertension. Because of rapid patient deterioration despite pharmacological treatments, ECMO was applied. ECMO can be helpful in cases of catecholamine-induced cardiomyopathy associated with neuroblastoma.
Cardiomyopathies* ; Catecholamines ; Child, Preschool ; Extracorporeal Membrane Oxygenation* ; Female ; Humans ; Hypertension ; Myocarditis ; Neuroblastoma*

We report herein a case of subcutaneous fat necrosis in an 1-month-old abandoned female neonate who had subcutaneous nodule on the right cheek and linear cord-like subcutaneous nodule on the right upper arm which has been evident from the second post-delivery day. Hiatopathologic findings revealed massive subcutaneous fat necroais with infiltration of foreign body giant cells and inflammatory cells. Calcigm was also deposited but no needle shaped cleft was formed in the fat cells. The akin lesion resolved spontaneously after 2 months.
Adipocytes ; Arm ; Cheek ; Female ; Giant Cells, Foreign-Body ; Humans ; Infant, Newborn* ; Necrosis* ; Needles ; Subcutaneous Fat*

Diaphragmatic hernia was found in a patient who had undergone transhiatal esophagectomy for early esophageal cancer. Chest X-ray was not helpful, but abdominal or chest computed tomography was useful for accurate diagnosis. Primary repair through thoracotomy was performed and was found to be feasible and effective. However, long-term follow-up is required because hernia recurrence is common.
Diagnosis ; Esophageal Neoplasms* ; Esophagectomy* ; Follow-Up Studies ; Hernia ; Hernia, Diaphragmatic* ; Humans ; Recurrence ; Thoracotomy ; Thorax

BACKGROUND: Xanthoma is an interesting disease entity that often indicates underlying lipid abnormalities. but, clinical studies about hyperlipopropeinemia in xanthoma were rarely present. OBJECTIVE: The purpose of this study is to observe the clinical and histopathologic features in xanthoma and to evaluate relationship between hyperlipoproteinemia and underlying xanthoma. METHOD: 57 cases of xanthoma were analyzed. In 35 cases, blood lipids including triglyceride, cholesterol and high density lipoprotein were analyzed. And clinical characterics of xanthoma and hyperlipoproteinemia were evaluated in 10 cases of our hyperlipoproteinemic patients confirmed by electrophoresis. RESULTS: The ratio between male and female was 1: 1.45 in xanthoma excluding xanthelasma and was 1: 1.86 in xanthelasma only. The mean age of each group was 28 years and 52 years. The incidence of each type, in descending order, was xanthelasma(35%), tuberous xanthoma(20%), eruptive xanthoma(14%), plane xanthoma(7%), tendinous xanthoma(2%), and unclassified(17.5%). The associated diseases, in descending order, were diabetes mellitus(9/15), fatty liver(2/15) etc. Among these, diabetes mellitus was the most common associated disease in hyperlipoproteinemia group(6/10). Histopathological features in 26 cases revealed lipid-laden foamy cells in all cases, and foreign body giant cells, fibrosis, cholesterol clefts in some cases. Among 35 cases, the rate of abnormal lipid profiles, in descending order, was xanthelasma(63.3%), eruptive xanthoma(62.5%), and tuberous xanthoma(38%). The frequent types of hyperlipoproteinemia in our cases, in descending order, are V(5/10), type IIa(3/10), IV(2/10). In previously reported hyperlipoproteinemia with xanthoma patients, the frequent types of xanthoma, are tuberous xanthoma(12/30), plane xanthoma(8/30), eruptive xanthoma(6/30), mixed type (2/30), and xanthelasma(1/30), and the frequent types of hyperlipoproteinemia in descending order are IIa (9/30), IV(8/30), V(4/30), IIb(3/30), III(3/30), unclassified(2/30), and I(1/30). CONCLUSION: The most common type of hyperlipoproteinemia in our cases and literatures is type IIa. but, recently type IV and type V are increasing and are associated with increased incidence of diabetes. The incidence of abnormal lipid profiles in xanthelasma is 63.3% and routine lipid profile study will be needed in the evaluation of xanthoma including xanthelasma.
Cholesterol ; Diabetes Mellitus ; Electrophoresis ; Female ; Fibrosis ; Giant Cells, Foreign-Body ; Humans ; Hyperlipoproteinemias* ; Incidence ; Lipoproteins ; Male ; Triglycerides ; Xanthomatosis*

Acute aortic dissection (AAD) during pregnancy can be fatal to both the pregnant mother and the baby, particularly in patients with the Marfan syndrome. We report a case of the modified Bentall procedure in surgery for AAD in a 31-year-old pregnant woman at 24 weeks of gestation with the Marfan syndrome. The patient recovered well after the operation, but unfortunately, the fetus could not be saved.
Adult ; Female ; Fetus ; Humans ; Marfan Syndrome* ; Mothers ; Pregnancy* ; Pregnant Women

Mediastinal paragangliomas are very rare neuroendocrine tumors. Complete resection is the standard treatment of a paraganglioma because of the tumor's potential malignancy and poor response to chemo- or radiotherapy. However, the highly vascular nature of the tumor and its characteristic anatomic location make complete resection difficult. We report a case of an anterior mediastinal paraganglioma, which was incidentally found on a chest computed tomography scan for chronic cough work-up of a 55-year-old woman. Complete resection was accomplished using video-assisted thoracoscopic surgery, and the patient recovered without any complications.
Cough ; Female ; Humans ; Mediastinal Neoplasms ; Middle Aged ; Neuroendocrine Tumors ; Paraganglioma* ; Radiotherapy ; Thoracic Surgery, Video-Assisted* ; Thorax

PURPOSE: To date, paraquat poisoning has almost universally resulted in unfavorable outcomes, and it has become a big issue in clinical toxicology. Current efforts to overcome its toxicity have focused on drugs with anti-oxidant capacity such as ascorbic acid in order to combat over-production of reactive oxygen species (ROS) by paraquat radicals, which are mainly induced by NADPH-cytochrome P450 reductase. Unfortunately, this strategy of treatment has not yielded satisfactory results. In search of a new approach to cope with PQ toxicity, we developed an in vitro culture model of cells resistant to lethal doses of PQ, and we then investigated resistance mechanisms using DNA microarray technology, a tool for simultaneously measuring a number of gene expression changes. METHODS: This experiment was conducted in vitro using the hepatocelluar carcinoma cell line (HepG2) to assay xenobitotics metabolism. We induced resistant of these cells to up to 100 uM PQ by treating with escalating doses of PQ for about 5 months. Cytotoxicity was studied using the MTT method, and optical density was measured at 540 nm using an ELISA reader. We examined morphological changes in cells after drug treatment using an inverted microscope, and we investigated gene expression profiles in control and resistant cells by use of DNA microarray. RESULTS: Results of MTT assays indicated that resistant cells showed relatively high survivals against a 100 mM dose, but that the control group had zero percents of survival at a 1 mM dose. In the comparing gene expression levels between the control group and the resistant group, 6,717 genes found to be differentially expressed. In the analysis of anti-apoptosis genes in particular, the resistant group showed more expression of genes with anti-apoptotic functions than did the control group. In examining the expression of cytochrome P450 genes related to xenobiotic metabolism and PQ radical induction, expression of the cytochrome P450 1B1 gene was significantly higher in the resistant group than in the control group. CONCLUSION: Although cytochrome P450 is known to be responsible for redox cycling of PQ as an electron transferor, this study suggest that up-regulation of the cytochrome P450 1B1 gene can corelate with PQ resistance. Therefore, induction of cytochrome P450 1B1 can be a new therapeutic approach to reduce PQ toxicity through actual PQ degradation, rather than simply through neutralization of ROS.
Ascorbic Acid ; Cell Line ; Cytochrome P-450 Enzyme System ; DNA ; Electrons ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; Hep G2 Cells ; NADPH-Ferrihemoprotein Reductase ; Oligonucleotide Array Sequence Analysis ; Oxidation-Reduction ; Paraquat ; Phosphatidylethanolamines ; Reactive Oxygen Species ; Toxicology ; Transcriptome ; Up-Regulation

PURPOSE: To report a case of keratoconjunctivitis induced by Dieffenbachia plant sap. CASE SUMMARY: A 44-year-old woman presented with severe ocular pain and decreased visual acuity which developed after she accidentally got Dieffenbachia plant sap in her left eye. During her initial evaluation, visual acuity was 0.4 in her left eye. On slit lamp examination, we found that she had moderate injection of the conjunctiva, an epithelial defect, and fine needle-like blue crystals in the stromal layer of the cornea. The patient was treated with topical steroids and antibiotics. We checked the treatment response using a regular slit lamp examination. Six days after the injury, all of the findings which were observed on the first day had resolved except the needle-like blue crystals in the stromal layer of the cornea. These gradually disappeared from the cornea 11 days after the accident. After six weeks, the crystals in the stromal layer had completely resolved. She maintained good visual acuity during this time. There was no opacity noted in her cornea. CONCLUSIONS: We experienced a case of keratoconjunctivitis induced by Dieffenbachia plant sap. This sap caused severe ocular pain and a reversible decrease in visual acuity when in contact with the eye.
Adult ; Anti-Bacterial Agents ; Conjunctiva ; Cornea ; Eye ; Female ; Humans ; Keratoconjunctivitis ; Plants ; Steroids ; Visual Acuity