To identify the developmental characteristics of fetal skin, the expressions of cytokeratine (CK) and epidermal growth factor (EGFR) in fetal skin (12-24 weeks of gestation) were studied immunohistochemically, and the ultrastructure of epidermis was also observed. The Expressions of CK and EGFR were identified in labelled sterptoavidine biotin immunohistochemical method. Primary antibodies used monclonal mouse anti-human CK (DAKO-CK, MF116) and EGFR Ab-4 which is rabbit affinity-purified polyclonal antibody raised against the amino acid residues 1005-1016 (Onc Science). At 12 weeks of gestation the epidermis was composed basal layer and periderm and the cells of both layers were positively stained for CK and EGFR. At 16-18 weeks of gestation, epidermis was composed basal, intermediate, and periderm. The cells of basal layer and periderm were strongly positive for CK, but the cells of intermediate layer showed weak or negative reaction for CK. EGFR immunoreactivity was noted in cells of all three layers, though cells of basal layer were stained relatively weak. At 23-24 weeks of gestation, the epidermis thickened and appeared 6 or more cell layers. Epidermal cells except horny layer were stained positively for CK and EGFR. EGFR immunoreactivity in basal layer, however, was relatively weak compared to those in intermediate layers. Periderm always were reaction-positive for CK and EGFR. The hair follicles, mainly pre-germ stage, were negatively stained for CK and EGFR at 12 weeks of gestation. The hair follicles with various developing stages were positively stained at 16-18 weeks of gestation. At 24 weeks of gestation, inner sheath of hair shaft and sebaceous gland were strongly reacted for CK, but not reacted for EGFR. In electron microscopic study, epidermis was composed of two layers, basal layer and periderm at 12 weeks of gestation. The periderm was composed of basal, intermediate and periderm at 12 weeks of gestation. The periderm was composed of basal, intermediate and periderm layers at 16-18 weeks of gestation. Intermediate cells consisted of 2-3 layers of spinous cells. The granular cells appeared rarely in superficial cells of intermediate layers. At 23-24 weeks of gestation, epidermis consisted of basal, prickle, granular, and horny layers. Periderm cells were locally exfoliated from the hony layer. The results demonstrate the expression of CK and EGFR in skin of human fetus between 12 and 24 weeks of gestation, and suggest that full thickness of epidermis is formed by 24 weeks of gestation.
Animals ; Antibodies ; Biotin ; Epidermal Growth Factor ; Epidermis* ; Fetus* ; Hair ; Hair Follicle ; Humans* ; Keratins ; Methods ; Mice ; Pregnancy ; Receptor, Epidermal Growth Factor ; Sebaceous Glands ; Skin

BACKGROUND: The distribution of Malassezia yeasts on normal human skin was varied according to the age and race of the volunteers and the methodologies used. In Korea, most reports of Malassezia yeast distribution have relied on direct skin smears rather than culture methods. OBJECTIVE: The aim of this work was to perform a comprehensive survey of the distribution of Malassezia yeasts on normal human skin to provide a base line for a companion study of Malassezia yeasts in patients with various dermatoses. METHODS: Malassezia yeasts were cultured using the swabbing technique from the scalp, forehead, chest, upper back, upper arm and upper thigh in 137 subjects, infancy to 80 years of age. RESULTS: Malassezia yeasts were present in the lowest incidence(0-30%) on six sites of infants and present in 60.0-66.7% on the sebum-rich sites (scalp, forehead, chest, upper back) of children aged 1-9. Malassezia yeasts were present in 80.0-86.7% on the sebum-rich sites of the elderly group(over 60 years of age), about the same frequency as in the middle-aged groups. The population density of these organisms was significantly higher on the upper back than on the forehead, chest, upper arm and upper thigh in all age groups except the infant group and the group aged 1 to 9 (p<0.05). There were no regular quantitative variations in the distribution of Malassezia yeasts on a given site between age groups. On Leeming and Notman media, besides three morphotypes of Malassezia yeasts reported by Cunningham et al(1990), one additional type was identified. CONCLUSION: The results showed regional variations in the distribution of Malassezia yeasts in all ages except infancy and no regular age variations on a given site. Additionally, four colony types of Malassezia yeasts were found. The findings of our study coold help to investigate the role of Malassezia yeasts in related disorders.
Aged ; Arm ; Child ; Continental Population Groups ; Forehead ; Friends ; Humans* ; Infant ; Korea ; Malassezia* ; Population Density ; Scalp ; Skin Diseases ; Skin* ; Thigh ; Thorax ; Volunteers ; Yeasts*

BACKGROUND: Cutaneous vasculitis associated with viral hepatitis seems to occur as a hypersensitivity reaction against the circulating viral antigens. Hepatitis B virus(HBV)-encoded X antigen(HBxAg) is known to participate in the carcinogenesis of hepatocellular carcinoma(HCC) by the inactivation of p53. However, HBxAg has been found in chronic infiammatory lesions without the overexpression of p53. Accordingly, not only EBsAg and HBcAg but also HBxAg may be involved in HCC-associated cutaneous vasculitis, regardless of the alteration of p53. OBJECTIVE: This study was conducted to investigate the expression of HBV-encoded antigens in cutaneous vasculitis accompanied by HBV hepatopathy. Additionally, we have compared the expression of 3 HBV antigens and p53 between vasculitic patients with HCC and in others showing HCC-non-associated vasculitis. METHODS: Immunohistochemically, we examined the expression of HBsAg, HBcAg, and HBxAg in the tissue specimens taken from the vasculitic lesions of the 33 HBsAg-positive enrolled patients with cutaneous vasculitis proven by skin biopsy. RESULTS: 1. The immunohistochemical positivity rate to HBsAg in vasculitic patients with HBV hepatopathy was 66.7% overall. It was 90% in HCC-associated vasculitic subjects and 56.5% in the vasculitic subjects without HCC, respectively. 2. We found the expression of HBxAg in 80% of the vasculitic subjects showing HCC. The vasculitic patients without HCC showed 17,3% of the positivity rate to HBxAg. 3. We could not find the overexpression of p53 in the vasculitic tissue specimens of the HCC patients without the cutaneous metastasis from primary HCC. CONCLUSION: HBsAg, HBcAg and HBxAg may participate in the pathogenesis of cutaneous vasculitis with HBV hepatopathy, regardless of tumorigenesis.
Antigens, Viral ; Biopsy ; Carcinogenesis ; Hepatitis ; Hepatitis B ; Hepatitis B Core Antigens ; Hepatitis B Surface Antigens ; Humans* ; Hypersensitivity ; Malassezia* ; Neoplasm Metastasis ; Skin* ; Vasculitis ; Yeasts*

No abstract available.
Arthroplasty, Replacement, Hip* ; Venous Thromboembolism*

No abstract available.
Arthroplasty* ; Bone Resorption* ; Hip* ; Thigh*

There have been a few repots that serum immunoglobulins are increased in Perthes' disease suggesting possible immunological involvement in the pathophysiology of the disease. Joseph(1991) suggested that the raised IgM concentrations might be related to complications of Perthes' disease such as striking reduction of movement, fixed deformities and striking reduction of movement, fixed deformities and chondrolysis and that immunological mechanisms might be implicated in the mediation of some of the changes in Perthes' disease. More studies are necessary to prove the results. The purpose of this study is to detect if there is a true increase of serum immunoglobulins in Perthes' disease.
Congenital Abnormalities ; Immunoglobulin M ; Immunoglobulins ; Negotiating ; Strikes, Employee

BACKGROUND: Prevention of postherpetic neuralgia as well as management of the symptoms of the acute stage is an important therapeutic goal in the treatment of herpes zoster. Corticosteroid, acyclovir and sympathetic block have all been advocated as effective therapeutic tools for the treatment of the disease. OBJECTIVE: This study was conducted to evaluate the necessity of sympathetic block for prevention of postherpetic neuralgia in acute herpes zoster. METHODS: The author observed the duration and degree of pain and the incidence of postherpetic neuralgia in 54 patients with herpes zoster treated with three different therapeutic measures. Group A was treated with triamcinolone acetonide 80mg three times, acyclovir and sympathetic blockade, group B with triamcinolone acetonide 80mg three times and acyclovir, and group C with triamcinolone acetonide 40mg three times and acyclovir. RESULTS: 1. Addition of sympathetic blockade to corticosteroid and acyclovir therapy did not seem to reduce the duration of pain and incidence of postherpetic neuralgia. 2. The Incidence of postherpetic neuralgia was higher in the elderly, especially with underlying systemic disease including diabetes melitus, hypertension, etc. Al] the therapeutic measures could not completely prevent the development of postherpetic neuralgia in those patients. 3. Regarding corticosteroid dosage, daily triamcinolone acetonide 80mg for three consecutive days showed no better effect than daily 40mg for consecutive days. CONCLUSION: When herpes zoster was treated with proper dosages of corticosteroid and acyclovir in its acute stage, sympathetic block showed no additional beneficial effect.
Acyclovir ; Aged ; Herpes Zoster* ; Humans ; Hypertension ; Incidence ; Neuralgia, Postherpetic ; Triamcinolone Acetonide

BACKGROUND: Pancreatoduodenectomy is a standard operation for benign and malignant lesions of the periampullary area. Even though the complication and the mortality rates have markedly decreased owing to recent developments in surgical techniques and postoperative care, the complication rates still remain high. Especially, pancreatic leakage is the main cause of death today in a pancreatoduodenectomy, so surgical techniques dealing with this problem have emerged as a major issue. The usual techniques used have been the duct ligation method, the duct occlusion method, a pancreatojejunostomy, and a pancreatogastrostomy. However, a recent trend has been to maintain pancreato-enteric continuity. Thus, the authors used a pancreatojejunostomy with the duct-to-mucosa method to decrease the complications. METHODS: The authors retrospectively reviewed the medical records of 56 patients who had undergone a pancreatoduodenectomy between January 1987 and July 1997 by one surgeon. RESULTS: The male-to-female ratio was 1.4:1 and the mean age was 55.5 years (ranging from 25 to 77). A Whipple's operation was done in 44 cases, and a pylorus-preserving pancreatoduodenectomy was done in 12 cases. All the cases used a pancreatojejunostomy with the duct-to-mucosa method. No pancreatic leakage was observed in any of the 56 cases. The immediate postoperative complication rate was 28.6%, and there was one (1.8%) postoperative mortality due to adult respiratory distress syndrome. Six patients complained of minimal exocrine functional abnormality, but only one patient, who had suffered severe chronic pancreatitis preoperatively, routinely now takes a pancreatic enzyme. However, even after long-term follow up, no endocrine insufficiency has been detected. CONCLUSIONS: Through our experience, a pancreatojejunostomy with the duct-to-mucosa method is a secure and reasonable method and can be used for all patients undergoing a pancreatoduodenectomy.
Cause of Death ; Follow-Up Studies ; Humans ; Ligation ; Medical Records ; Mortality ; Pancreaticoduodenectomy* ; Pancreaticojejunostomy* ; Pancreatitis, Chronic ; Postoperative Care ; Postoperative Complications ; Respiratory Distress Syndrome, Adult ; Retrospective Studies

Carcinosarcomas of the female genital tract have generally been regarded as a type of sarcoma. Recent studies, however, suggest the tumor may be more closely related to carcinoma and may represent metaplastic carcinoma in histogenesis. We analyzed clinicopathologic and immunohistochemical features of 10 carcinosarcomas to evaluate the relative importance of the carcinomatous and sarcomatous components in metastasis and recurrence. The primary tumor originated in the uterine body in seven cases, the uterine cervix in two and the ovary in one. Patient,s ages ranged from 54 to 71 years (mean, 64). The most common symptom of the uterine mass was vaginal bleeding. The median survival time was 21 months following diagnosis in five cases. Surgico-pathologic FIGO stages of five patients who received an operation were stage III and IV, but clinical FIGO stage of three patients (60%) among them were I. Lymphovascular invasions were identified in seven areas; five vascular invasion lesions showed the carcinomatous component alone, one the sarcomatous component alone, and remained one admixture of both components. Metastatic and recurrent lesions to the paraaortic lymph node, ovary, pelvic wall, or vaginal vault showed characteristically carcinomatous component only. Immunohistochemically, positive reactions for cytokeratin and epithelial membrane antigen were noted in the sarcomatous component of five cases. Vimentin positivity was detected in carcinomatous component of three cases. We conclude that the dominant element in carcinosarcomas of the female genital tract is the carcinomatous component. The survival rate of carcinosarcoma is extremely poor. The surgico-pathologic stage is better indicator of survival than the clinical stage. Immunohistochemical findings suggest that carcinosarcoma may represent a metaplastic carcinoma in histogenesis.
Carcinosarcoma* ; Cervix Uteri ; Diagnosis ; Female* ; Humans ; Keratins ; Lymph Nodes ; Mucin-1 ; Neoplasm Metastasis ; Ovary ; Recurrence ; Sarcoma ; Survival Rate ; Uterine Hemorrhage ; Vimentin

Primary ovarian transitional cell carcinoma(TCC) is a recently described, distinct subtype of ovarian carcinoma resembling TCC of the urinary bladder. TCC differs from malignant Brenner tumor(MBT) by absence of benign or proliferative Brenner component and prominent stromal calcification. TCC also represents a high-stage tumor with more aggressive biologic behavior than MBT, but it has a relatively favorable response to chemotherapy. TCC may arise from the pluripotential surface epithelium of the ovary or from the cells with urothelial differentiation, rather than from a benign or proliferative Brenner tumor precursors. We report a case of pure form of primary TCC presenting as a left ovarian mass in 45-year-old woman.
Female ; Humans