Bleomycin, a tumoricidal antibiotic agent, may produce unusual cutaneous manifestations such as pigmentation scleroderma, and gangrene. We report a case of the development of linear streaky pigmentation and cutaneous scleroderma in a patient treated with bleomycin for choriocarcinoma of undescented testis. The patient was 45-year-old male presented with linear brown and slate gray streaking over the trunk and extremities after three cycles of chemotherapy(bleomycin, etoposide, cisplatine). After the fourth cycle of the same chemotherapy, 18 weeks after initiation of bleomycin, the development of cutaneous scleroderma-like conditions was observed involving the same sites. Histopathologic examination showed increased basal pigmentation and thick collagen bundles through the entire dermis, extending to the subcutis. Herein, we describe a case of streaky pigmentation and scleroderma in association with bleomycin anticancer chemotherapy simultaneously in a patient.
Bleomycin* ; Choriocarcinoma ; Collagen ; Dermis ; Drug Therapy ; Etoposide ; Extremities ; Female ; Gangrene ; Humans ; Hyperpigmentation ; Male ; Middle Aged ; Pigmentation* ; Pregnancy ; Testis

No abstract available.
Thyroid Diseases* ; Thyroid Gland*

BACKGROUND: Superoxide disrnutase(SOD) provides a protective defease mechanism against potential cytotoxicity of superoxide radical in the aerobic organism. Although human skin is constantly at risk for developing acute and chronic changes by ultraviolet radiation and phototoxic reactions with exogenous and endogenously procluced photosensitizing molecules, studies in SOD in the human skin are rare. OBJECTIVE: We measured the level of SOD activities in the scar tissues and the normal human skin specimens. This study was to investigate changes of SOD activity by age, sex, and regional differences of SOD activities in the scar issues and the normal skin. METHODS: Aut,hors assayed the level of SOD activit,ies in 32 scar tissues(male 8, female 24) and 11 normal human skin specimens(male 8, female 3), which were obtaine 3 from face/neck(17 and 3 specimens), forearm(only 4 scar tissues), trunk(10 and 8 specimens), and lower extremity(only 1 scar tissue). RESULTS: First, activities of total SOD, Cu, Zn-SOD, and Mn-SOL ere 18.93+5.49, 16.97+55.31, and 1.96+0.90 units/mg proteiii respectively in the scar tissues. Second activities of total SOD, Cu, Zn-SOD, and Mn-SOD were 17.27+7.09, 13.82+6.44, and 3.45+1.07 units/mg protein respectively in the normal skin. Third, the changes of total SOD, Cu, Zn-SOD, and Mn-SOD activities by age and sex were similar each other and three were no significant, differneces between age groups in total, Cu, Zn- SOD, and Mn-SOD activities. Fourth, in sun exposed area and unexposed area there were no significant differences in the scar tissues in SOD activities. But, SOD activite.(total, Cu, Zn, and Mn-SOD) in face/neck were higher than those in trunk and lower extremity in tae normal skin(P<0.05). CONCLUSION: These findings suggest that there are no differences in the intrinsic SOD activities by age and sex in the mature scar tissues and the normal skin. Differences between exposed and unexposed area in the normal skin are due to the induction of exogenous SOD activity by sun-light generation of superoxide radicals. In wound, increased production of leukocyte derived superoxide radicals is the main factor of increased level of SOD activity.
Cicatrix* ; Female ; Humans ; Leukocytes ; Lower Extremity ; Skin ; Solar System ; Superoxide Dismutase* ; Superoxides* ; Wounds and Injuries

Acoustic stimulation test(AST), is currently being used as an alternative tool of nonstress test (NST). However, there are no standard guideline for analysis of AST. Computerized numerical analysis of AST would be helpful for development of diagnostic criteria of AST. Fifty-one normal pre-term pregnancies entered to this study after conventional 20-minutes NST and 10-minutes AST. Acoustic stimulations were performed using Fetal Acoustic Stimulator (Model 146, Corometrics, US). We analyzed the FHR response after acoustic stimulation using our on-line computerized FHR analysis system, HYFM-I & II software. The changes of loss of signal, baseline FHR, variability, number of fetal movements, and number of FHR accelerations were analyzed numerically. The loss of signal was increased about 2 fold(122.61%). The baseline FHR was increased from 144.57bpm to 156.81bpm(8.5%) after acoustic stimulation. Number of fetal movements was increased about 2 fold(from 2.1 to 4.12/10 minutes). FHR variability was also increased from 17.81 bpm to 26.37 bpm. After AST, number of FHR accelaration was increased 55.47%(10sec 10bpm) and 68.42%(15sec 15bpm), respectively. In this study, we acrumulated elemental FHR data using computerized system after AST. These data would be helpful in the accurate analysis of AST and also enable us to develop the objective interpretation system for AST.
Acceleration ; Acoustic Stimulation* ; Acoustics* ; Female ; Fetal Heart* ; Fetal Movement ; Heart Rate, Fetal* ; Pregnancy ; Pregnancy*

Cutaneous absorption of ultraviolet B(UVB) in the skin occurs primarily in keratinocyte, causing DNA and protein damage. p53 tumor suppressor gene appeared in the epidermis after UVB irradiation, and the wild type has been known to be responsible for apoptosis and plays an important role in excluding abnormal cells with significant DNA damage. While p53 has been implicated in both DNA repair and apoptosis, it is unclear whether the p53 protein is involved in both of these processes within the same cell. Therefore, UVB-induced apoptosis and changes in p53 expression were studied in cultured normal human keratinocyte to determine that the cellular response to UVB induced DNA damage(DNA repair or apoptosis) correlated with p53 expression. The cultured normal human keratinocytes were irradiated with the doses of UVB(25-150 mJ/cm2) and incubated for various times(3, 6, 12, 24 hour) after radiation. At UVB doses of 100 and 150 mJ/cm2, acridine orange/ethidium bromide(Ao/Eb) staining-positive cells and TUNEL (TdT mediated dUTP-biotin nick end labeling) staining-positive cells increased significantly after 3 hours and 6 hours postirradiation respectively. Twelve hour postirradiation, staining-positive cells increased at each level of UVB-radiation exposure. These results suggest that there were significant influences of UVB doses and time course after irradiation to the number of Ao/Eb and TUNEL staining-positive cells. To determine whether all Ao/Eb and TUNEL-positive cells were actually undergoing apoptosis, cellular DNA was extracted from keratinocytes at 12 hours after UVB irradiation and seperated by electrophoresis on an 2.5% agarose gel to detect the internucleosomal DNA fragmentation(DNA ladder). 'DNA ladder' occurred at every dose of UVB 12 hour after irradiation, but did not appear early after irradiation, suggesting that whether Ao/Eb and TUNEL-positive cells observed early after irradiation were not undergoing apoptosis. Activation of p53 and the response to DNA damage is not observed universally, but is dependent on tissue specificity, species specificity and type of genotoxic damage. To correlate p53 level with UVB-induced apoptosis at the dose of 100mJ/cm2 UVB, p53 levels were determined by western blot analysis. The accumulation of p53 protein was apparent after 6 hours postirradiation, and UVB irradiation caused a dramatic increase in p53 levels at 12 and 24 hours. These results demonstrate that p53 is required for UVB-induced apoptosis in cultured normal human keratinocyte and p53 has a time-dependent effect in the initiation of apoptosis. In this study, the results indicated that a low dose(25mJ/cm2) of UVB irradiation could induce apoptosis in human keratinocyte in vitro and UVB exerts a time-dependent effect on inducing apoptosis. And the results also give support to increasing evidence that p53 may play a role in UVB-induced DNA damage and the induction of apoptosis in cultured normal human keratinocyte and that p53 is involved in the decision process which determines the fate of keratinocyte after UVB -induced DNA damage.
Absorption ; Apoptosis* ; Blotting, Western ; DNA ; DNA Damage ; DNA Repair ; Electrophoresis ; Epidermis ; Genes, Tumor Suppressor ; Humans* ; In Situ Nick-End Labeling ; Keratinocytes* ; Organ Specificity ; Sepharose ; Skin ; Species Specificity

Diffuse leiomyomatosis of the esophagus is a rare condition and usually extends from the mid-esophagus to the proximal third of the stomach. Macroscopically, there is a marked diffuse thickening of the esophageal wall, with or without nodularity, predominantly affecting the circular muscle coat. Microscopically, the disorder is characterized by the loss of the normal orientation of the smooth muscle fibers of all three layers. We report a case in a 37-year-old woman which was incidentally discovered at exploratory thoracotomy.
Female ; Humans

A 46-year-old male patient had recurrent episodes of generalized pruritic wheals during hemodialysis. He has experienced urticaria during hemodialysis whenever he used a capillary dialyser sterilized by ethylene oxide(EO, Polysulfone-) gas which is used to sterilize hemodialysers and other medical equipment. On the other hand, capillary dialyser sterilized by Gamma ray (Hemophad) has not evoked urticaria. Although the presence of EO-specific antibodies was not detected, urticarial rash never developed when the equipment was switched to a gamma-sterilized one. We herein report a case referred to ethylene oxide induced cutaneous hypersensitivity during hemodialysis.
Antibodies ; Capillaries ; Ethylene Oxide ; Exanthema ; Gamma Rays ; Hand ; Humans ; Hypersensitivity* ; Kidneys, Artificial ; Male ; Middle Aged ; Renal Dialysis* ; Urticaria

BACKGROUND: The effects of intralesional recombinant alpha-2 interferon(IFN) in the treatment of basal cell carcinoma(BCC) and actinic keratosis(AK) would be of value in selected patients. OBJECTIVE: Our purpose is to evaluate the differences of cellular immune reactions between the responded and the unresponded cases treated with IFN. METHODS: We treated five patients with BCC and two patients with AK with the intralesional injection of recombinant alpha-2 IFN. We performed immunohistochemical stainings with paraffin-embedded specimens from the pretreated and posttreated skin lesions. RESULTS: Four patients(three with BCC and one with AK) were healed and three patients showed improvement after treatment. In immunohistochemical stainings, there was an increased number of T cells in the dermal infiltrate of the responded cases but not in the unresponded cases. CONCLUSION: Intralesional IFN may induce T cell-mediated immune response at the site of the tumor by immune modulation.
Actins* ; Carcinoma, Basal Cell* ; Humans ; Injections, Intralesional* ; Interferons* ; Keratosis, Actinic* ; Skin ; T-Lymphocytes

No abstract available.
Female ; Humans ; Middle Aged* ; Myofibroblasts

No abstract available.
Anal Canal* ; Paget Disease, Extramammary* ; Radiotherapy* ; Vulva*