BACKGROUND: Pemphigus are chronic autoimmune blistering disorcers characterized by acantholysis. In addition to pemphigus vulgaris(PV), the major clinical variarts are pemphigus foliaceus(PF), paraneoplastic pemphigus(PNP) and drug-induced pemphigus(DP). Detection of pemphigus antigen is important for differential diagnosis as well as research work. Most investigators have identified pemphigus antigens by means of immunoprecipitation using metabolically radiolabeled cultured keratinocytes. However, immunorepitation is generally more expensive, hazardous and time-consuming than immunoblotting. Therefore, establishment of the immunoblotting as a standard technique for the detection of the pemphig us antigens is desirable. OBJECTIVE: To characterized pemphigus antigens by an immunobloting analysis of human epidermal extract and by indirect itnmunofluroscence study using human of cultured keratinocytes as a substraie. METHOD: We performed imrnunoblotting analysis af sera from patieiits with PV, PF, PNP and DP with human epidermal extract as a source of antigen. Indirect immunof uorescence study was also performed using human keratinocytes cultured in high or low calcium media for detection of pemphigus antigens. RESULTS: In an immunoblotting analysis, all(9/9) PV sera showed secific reactivities with a 130-KD protein and all(5/5) FF sera showed reactivities with a 150-KK protein, which is most likely desmoglein 1. Furthermore, one of nine PV serum also reacted with a 150-KD protein, which seems to be the identical antigen detected in PF. All PNP(3/3) sera showed reactivities with two protein bands, 210KD and 190KD. In our indirect imrnunofluorescence study using culltured human keratinocytes as a substrate, when keratinocytes were grown in low calcium media, no pimphigus antigens could be detected. However, when grown in high calciurn media, pemphigus vulga ris and paraneoplastic pernphigus antigens were present t the cell-cell contact areas with a puncta;e pattern, whereas pemphigus foliaceus antigen was not, presint in keratinocytes even when cultured in high calcium media. CONCLUSION: Our results suggests (1) immunoblotting analysis is a reliable technique for defining pemphigus antigen and could be a valuable tool for the differentiation of PV, PF and PNP and(2) PF antigen rnay not be expresseden cultured keratinocytes.
Acantholysis ; Blister ; Calcium ; Desmoglein 1 ; Diagnosis, Differential ; Fluorescent Antibody Technique, Indirect* ; Humans ; Immunoblotting ; Immunoprecipitation ; Keratinocytes* ; Pemphigus* ; Research Personnel

No abstract available.
Giant Cell Tumors* ; Giant Cells* ; Tendons*

PURPOSE: To quantify the cardiac dose reduction during breathing adapted radiotherapy using Real-time Position Management (RPM) system in the treatment of left-sided breast cancer. MATERIALS AND METHODS: Twenty-two patients with left-sided breast cancer underwent CT scans during breathing maneuvers including free breathing (FB), deep inspiration breath-hold (DIBH), and end inspiration breath-hold (EIBH). The RPM system was used to monitor respiratory motion, and the in-house self respiration monitoring (SRM) system was used for visual feedback. For each scan, treatment plans were generated and dosimetric parameters from DIBH and EIBH plans were compared to those of FB plans. RESULTS: All patients completed CT scans with different breathing maneuvers. When compared with FB plans, DIBH plans demonstrated significant reductions in irradiated heart volume and the heart V25, with the relative reduction of 71% and 70%, respectively (p < 0.001). EIBH plans also resulted in significantly smaller irradiated heart volume and lower heart V25 than FB plans, with the relative reduction of 39% and 37%, respectively (p = 0.002). Despite of significant expansion of lung volume using inspiration breath-hold, there were no significant differences in left lung V25 among the three plans. CONCLUSION: In comparison with FB, both DIBH and EIBH plans demonstrated a significant reduction of radiation dose to the heart. In the training course, SRM system was useful and effective in terms of positional reproducibility and patient compliance.
Breast Neoplasms* ; Cardiac Volume ; Feedback, Sensory ; Heart ; Humans ; Lung ; Patient Compliance ; Radiotherapy* ; Respiration* ; Tomography, X-Ray Computed

We reviewed the clinical epidermiologic features and skin biopaies of 23 patients who were diagonosed with sparganosis. Clinically, the parasites were obtained from the lesions and confirmed histopathologically. The purpose of this study was to evaluate the elinical, epidemiological, and histopathological charaeteristics of sparganosis. The results are summurized as follows : 1. There were no difference between male (48%) and female (52%) patients. 2. Age distribution, at first visit, were variable, ranging from 7 to 75, with the mean age of 40 years-old. 3. Duration of symptoms were variable, ranging from 10 years to 15 years, with a mean duration of 3 years. 4. Frequency of clinical features were as follows; movable or fixed subcutaneous nodule (16 cases), subcutaneous nodule with pain & focal warmth t.o touch (6 cases), seizure (I case). 5. Number of parasites per lesion were single lesion with single, parasite (21 cases), single lesion with two parasites (2 cases) and three parasites (3 case). 6. Frequency of location of lesion were abdominal wall (8 cases), thigh (4 cases), breast (3 cases), scrotum (3 cases), arm (3 cases), buttoek (1 cases), ciiest wall (1 case), brain (1 case). 7. The histological change of the affected tissue were characterized as follows ; 1) necrotizing and granulomatous tissue with or without parasif os in the lesions. 2) some cases were associated with marked fibrosis or formation of lymphoid follicles. 3) There were many lympho-histocytes, eosinophils, giant cel1s and some plasma cells near the lesions.
Abdominal Wall ; Adult ; Age Distribution ; Arm ; Brain ; Breast ; Eosinophils ; Female ; Fibrosis ; Humans ; Male ; Parasites ; Plasma Cells ; Scrotum ; Seizures ; Skin ; Sparganosis* ; Thigh

No abstract available.
Glomerulonephritis*

Subungual exostosis is a bony outgrowth occuring on the distal phalanx beneath the nail. This report concerns a case of subungual exostosis, accompanied with overlying myrmecia which developed in a 18-years-old man. Confirmatory X-ray showed a bony exostosis arising from the dorso-medial aspect of the distal end of the distal phalanx of the right great toe. The purpose of this artiicle is to direct attention to subungual existosis, the diagnosis of which may often be unsuspected in dermatology
Dermatology ; Diagnosis ; Exostoses* ; Toes

Subungual exostosis is a bony outgrowth occuring on the distal phalanx beneath the nail. This report concerns a case of subungual exostosis, accompanied with overlying myrmecia which developed in a 18-years-old man. Confirmatory X-ray showed a bony exostosis arising from the dorso-medial aspect of the distal end of the distal phalanx of the right great toe. The purpose of this artiicle is to direct attention to subungual existosis, the diagnosis of which may often be unsuspected in dermatology
Dermatology ; Diagnosis ; Exostoses* ; Toes

No abstract available.

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Humans ; Statistics as Topic*

Neurocutaneous melanosis is a rare congenital syndrome characterized by the presence of large or multiple congenital pigmented nevi and a benign or maigrant pigment cell tumor of the leptomeninges. The s ndrome is thought to represent an erroi in the morphogenesis of the embryonal neuroectoderm. Even in the absence of melanorra, symptomatic neurocut.aneous melanosis has extremely poor prognosis. We report a case of neiirocutaneous melanosis in 38-year-old male. He was noted at birth to have a giant pigmented nevus on the bathing trunk area. He presneted with severe headache. Brain CT sca n was performed and 4 x 4cm sized well demarcated contrast enhanced mass was seeii in the right frontal lobe. Histopathologically, the tumor was composed of malignant melanoma cells. Multiple skin biopsies werperformed on the giant pigmented nevus and small nevi. All of the specimens revealed patterns typical of cornpound nevi. Dermatologists following patients with large or multiple congenial pigmented nevi should be aware of this condition to aid in prompt diagnosis.
Adult ; Baths ; Biopsy ; Brain ; Diagnosis ; Frontal Lobe ; Headache ; Humans ; Male ; Melanoma ; Melanosis* ; Morphogenesis ; Neural Plate ; Nevus ; Nevus, Pigmented ; Parturition ; Prognosis ; Skin