BACKGROUND: Primary targit injured from the immunologic mechanism of alopecia areata is not definitely confirmed although alopecia areata is regarded as a disease occuring from certain im munologic process. Recently, par ticular interest has been focused on the follicular keratinocytes which show morphologic and anigenic alterations in active lesions. Another important point is the subclinical state hypothesi. It is based upon the observation that the patterns of T lymphocytes infiltration and ultrastructural changes of dermal papilla cells are nearly identical in active lesions and in non-lesional areas of alopecia areata. OBJECTIVE: The purpose of this study is to determine and to compare the aberrant expression of HLA-DR, CD1 and ICAM-1 on the follicular keratinocytes from the active alopecia areata lesion, stationary lesion and non-lesional scalp. METHODS: We performed a n immunohistochemical study, using the streptavidin system to compare the patterns of HLA-DR, CD1 and ICAM-1 immunoreactivity in the follicular keratinocytes in five active alopecia lesions two stationary lesions and non-lesional scalp specimens among four active and two stationary patients, and two normal control scalp specimens. RESULTS: In the active aloecia lesions, the HLA-DR and ICAM-1 immunoreactivity was observed in some patients while CD1 immunoreactivity was observed in all the patients. In the sta tionary alopecia lesions, none of the HLA-DR or CD1 or ICAM-1 immunoreactivity was observed as was the case in the norrial control scalp specimens. In the non-lesional normal scalp specimens, the HLA-DR, CD1 and ICAM-1 immunoreactivity showed nearly the same patterns as those in the acute alopecia leions. CONCLUSION: The aberrant antigenic alterations, especially CD1 expression of follicular keratinocytes are likely to be asociated with the active progress of alopecia areata lesions. These antigenic alterations were also observed in non-lesional scalp as well as alopecia areata lesions in the very similar patterns.
Alopecia Areata* ; Alopecia* ; HLA-DR Antigens ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes* ; Scalp* ; Streptavidin ; T-Lymphocytes

Nodular pseudosarcornatous fasciitis is a benign, fibrohlastic proliferative disease. This case report is one of a hard nodule which a 35-year-old male suddenly discovered on his right forearm 10 days prior to being aeen. The nodule showed characteristic histological findings of nodular pseudosarcomatous fasciitis.
Adult ; Fasciitis* ; Forearm ; Humans ; Male

No abstract available.
Amlodipine* ; Humans ; Hypertension*

No abstract available.
Doxazosin* ; Hypertension*

No abstract available.
Humans ; Hypercholesterolemia* ; Lovastatin*

No abstract available.
Biopsy* ; Child* ; Humans

Telangiectasia is characterized by permanently dilated small vessels usually arising from the suprapapillary plexus of venule capillaries, or arterioles. It may be etvlogically divided into the primary and secondary types. Rosacea, varicose vein, prolonged sun xvsure, radiation, and physical trauma may be the causes of secondary telangiectasia. We report herein a case of secondary telangiectasia associated which operation for a femur fracture.
Arterioles ; Capillaries ; Femur ; Rosacea ; Solar System ; Telangiectasis* ; Varicose Veins ; Venules

A 70-year-old woman with Parkinson disease was admitted to the emergency department with altered consciousness, fever and convulsive movements without experiencing withdrawal from antiparkinsonian medication. Six hours after the emergency department visit, the patient had a hyperpyrexia (>40℃) and a systolic blood pressure of 40 mmHg. There was no evidence of bacterial infection based on extensive workups. The patient was discharged without aggravation of Parkinson disease symptoms after treatment that included administration of dantrolene sodium, enforcement of continuous renal replacement therapy and cooling blankets. Malignant syndrome should be suspected if high fever occurs in Parkinson disease patients without evidence of a definitive infection.
Aged ; Bacterial Infections ; Blood Pressure ; Consciousness ; Dantrolene ; Dehydration ; Emergency Service, Hospital ; Female ; Fever ; Humans ; Parkinson Disease* ; Renal Replacement Therapy

The central venous catheter(Quinton) was replaced in the right atrium for chemotherapy and blood sampling to a eight-year old girl with acute lymphoblastic leukemia. The catheter was flushed with heparin two times daily and the chemotherapeutic drug regimens by CCSG-105 protocol were vincristine, prednisone, L-asparaginase, daunomycin, methotrexate, cyclophosphamide, cytosine arabinoside, 6-mercaptopurine and adriamycin. On day 31 of catheterization, the lumen for blood sampling was blocked. From day 60 of catheterization, anorexia, nausea, vomiting, abdominal distension and tachypnea were developed. Echocardiogram, lung scan, pulmonary function test(PFT), arterial blood gas analysis (ABGA) were done. Two cemtimeters in diameter of thrombosis was found in the right atrium on echocardiogram. The lung scan showed slight decrease in uptake of Tc-99m on the whole lung fields. Restrictive ventratory impairment on PFT and decreased PaO2(48 mmHg) on ABGA were found. To lysis of thromboembolism, urokinase(4,400 IU/kg for initial 10 minutes and the 4,400 IU/kg for 12 hours) was injected intravenously and aspirin(30 mg/kg/d, po) was given. The thrombosis was disappeared from the atrium on echocardiogram and PaO2 was increased up to 97 mmHg temporary. The catheter was removed but total haziness on the right middle and lower lobes were developed after 5 days. The same dose of urokinase was injected just infront of the embolism through Pitfall catheter for 8 days intermittently as results of pulmonary angiography. Symptoms and PaO2 were alleviated and the lung was expanded with mild atelectasis on day 55 of the first fibrinolytic enzyme therapy. Although the frequent complications of central venous catheter are catheter occlusion and infection, we have to check the development of thromboembolism with echocardiogram periodically or in case of unexplained respiratory symptoms.
6-Mercaptopurine ; Angiography ; Anorexia ; Blood Gas Analysis ; Catheterization ; Catheters ; Central Venous Catheters* ; Cyclophosphamide ; Cytarabine ; Daunorubicin ; Doxorubicin ; Drug Therapy ; Embolism ; Enzyme Therapy ; Female ; Heart Atria ; Heparin ; Humans ; Lung ; Methotrexate ; Nausea ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prednisone ; Pulmonary Atelectasis ; Tachypnea ; Thromboembolism* ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Vincristine ; Vomiting

We performed tendon transfer with a microvascular free flap for recovery of handicapped function and reconstruction for the skin and soft tissue loss. We review the clinical data of 11 children who underwent these operation due to injured foot by pedestrian car accident from January, 1986 to June, l994. The mean age of patients was 5.6 years old (3-8). Five cases underwent tendon transfer and microvascular free flap simultaneously. Another 6 cases underwent operations separately. The time interval between tendon trasnfer and microvascular free flap was average 5.8 months (2-15 months). The duration between initial trauma and tendon transfer was average 9.6 months (2-21 months). The anterior tibial tendon was used in 6 cases. Among these, the technique of splitting the anterior tibial tendon was used in 5 cases. The posterior tibial tendon was used in 3 cases and the extensor digitorum longus tendon of the foot in 2 cases. Insertion sites of tendon transfer were the cuboid bone in 3 cases, the 3rd cuneiform bone in 3 cases, the 2nd cuneiform bone in I case, the base of 4th metatarsal bone in I case, and the remnant of the extensor hallucis longus in 3 cases. The duration of follow-up was average 29.9 months (12-102 months). The clinical results were analyzed by Srinivasan criteria. Nine cases were excellent and 2 cases were good. The postoperative complications were loosening of the tranferred tendon in 2 cases, plantar flexion contracture in l case, mild flat foot deformity in I case and hypertrophic scar in 2 cases. So we recommend the tendon transfer with a microvascular free flap in the case of injured foot of children combined with nerve injury and extensive loss of skin, soft tissue and tendon.
Child* ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Contracture ; Disabled Persons ; Flatfoot ; Follow-Up Studies ; Foot* ; Free Tissue Flaps* ; Humans ; Metatarsal Bones ; Postoperative Complications ; Skin ; Tarsal Bones ; Tendon Transfer* ; Tendons*