Familial benign pemphigus(Hailey-Hailey disease) is a rare hereditary dermatosis that begins in the 2nd or 3rd decade of life. The skin lesion is characterized by a localized, recurrent eruption of small vesicles on an erythematous base. During its course there are remissions and exacerbations. It seldom begins in early childhood or after the age of 50. The main treatment modalities are conservative ones. A 59-year-old woman with familial benign chronic pemphigus presented with a 10 year history of generalized pruritic recurrent skin lesions on her neck, axilla, inguinal, antecubital, and trunk area. Physical examination showed moist, macerated, fissured and scaly patches on an erythematous base in the axillae, groins, neck, antecubital, and trunk. A biopsy specimen showed extensive suprabasal separation containing acantholytic cells.
Axilla ; Biopsy ; Female ; Groin ; Humans ; Middle Aged ; Neck ; Pemphigus* ; Pemphigus, Benign Familial ; Physical Examination ; Skin ; Skin Diseases

No abstract available.
Pneumocephalus*

Acquired perforating disease(APD) is characterized by hyperkeratotic papules with transepidermal elimination of degenerated material and is associated with renal disease and/or diabetes. Particular attention has been directed to transepidermal elimination because the articles on perforating diseases among patients with chronic renal failure and/or diabetes have been increasingly reported. We describe four patients with chronic renal failure and/or diabetes whose skin biopsy specimens showed transepidermal elimination.
Biopsy ; Humans ; Kidney Failure, Chronic* ; Skin

BACKGROUND: Preservation of antigen determinants while retaining morphological detail is prerequisite for high quality immunohistochemistry. Conventional formalin fixation and paraffin embedding procedures are useful in preserving tissue architecture and cytologic detail. However, they destroy the antigenicity of many proteins is tissue samples. On the other hand, fresh frozen section preserve the antigenicity of most proteins, but vield poor morphological preservation. OBJECTIVE: The purpose of this study is to evaluate the AMeX method as to the ability to preserve both antigenicity and morphologic details of the skin basement membrane zone so that precise localization of antigens can be attained in immunohistochemistry. METHODS: Tissues were fixed in acetone at -20degrees C over night, then cleared in methyl benzoate and xylene, consecutively, and embedded in ordinary paraffin at 58-60degrees C. Sections made from this paraffinembedded tissue were stained with hematoxylin and eosin for a morphologic study and immunolabelled with antibodies against major basement membrane antigens to evaluate antigenic preservation. The staining intensity and preservation of the morphology by the AMeX method were compared with conventional formalin processed tissues and frozen tissues. RESULTS: Morphological preservation of the AMeX method-processed sections was good throughout the epidermis, basement membrane, and dermis, and as good as that of routinely formalin-fixed paraffin-embedded sections. Frozen sections usually revealed revealed various degrees of damage by ice crystal formation throughout the epidermis to the dermis. The AMeX method-processed sections showed better or same antigenic preservation comparing the frozen sections when the sections were immunolabelled with specific monoclonal antibodies. But, when the sections were immunolabelled with patient's sera, the AMex method showed less antigenic preservation than the frozed sections. The anti-type IV collagen monoclonal antibody exhibited immunoreactivity only conventional formalin-fixed paraffin-embedded skin sections, but the intensity of the staining was weaker than the AMeX processed sections and the frozen sections. CONCLUSION: The AMeX method can be utilized for the demonstration of skin basement membrane antigens and is superior to the fresh-frozen method in that the histologic figures are more distinct and antigencity can be preserved for a long time.
Acetone* ; Antibodies ; Antibodies, Monoclonal ; Basement Membrane* ; Benzoates* ; Collagen ; Dermis ; Eosine Yellowish-(YS) ; Epidermis ; Formaldehyde ; Frozen Sections ; Hand ; Hematoxylin ; Ice ; Immunohistochemistry ; Paraffin ; Paraffin Embedding ; Skin* ; Xylenes*

This study was undertaken to evaluate the efficacy and safety of orally administered ketoconazole in the treatment of onychomycosis. Thirteen patients with onychomycoiis were selected for this study. For evaluation of ketoconazole efficacy twelve patients received a 200 mg tablet of ketoconazole daily and one patient received a. 10() mg tablet of ketoconazole daily. All patients were studied monthly clinically and mycologically by KOH mount and culture on Sabourauds medium. The results were as follows: 1. Seven(53.8%) of thirteen cases achieved remission, marked improvement occurred in three cases(23.1%) and moderate improvement occurred in three cases (23. 1 %). 2. The mean duration of remission or clinical improvement was 5 months for all lesions and toenail lesions(5. 4 months) took longer to heal than finger nail lesions (4 months). 3. One hundred percent of patient who previously failed to respond to griseofulvin were cured or clinically improved by ketoconazole. 4. Two patients cornplained of indigestion and one of headache. In our study, ketoconazole was highly effective in the treatment of onychomycosis.
Dyspepsia ; Fingers ; Griseofulvin ; Headache ; Humans ; Ketoconazole* ; Nails ; Onychomycosis*

PURPOSE: To assess the role of the preoperative portal vein embolization (PVE) in patients in need of major hepatectomy. MATERIALS AND METHODS: Total of 11 cases consisted of Klatskin tumor (n:6), gallbladder cancer (n=2), and hepatocellular carcinoma (n=3). After percutaneous transhepatic puncture of portal vein (right:7, left:4), the embolization of 1st order branch of right portal vein was done with Gentamicin soaked Gelfoam cubes. Radiologically, the angle between the middle hepatic vein and the inferior vena cava was measured on pre- and post-PVE CT (F/U :10 days) to evaluate the hypertrophy of the left lobe. Clinically, amount and nature of the drained bile through the PTBD tube of both lobes were analyzed in 5 patients with Klatskin tumor. The interval between PVE & operation was 10-24 days. Operative findings & the changes of postop. total bilirubin were analyzed and the complication after procedure was checked. RESULTS: There was decrease in mean angle between the middle hepatic vein and the inferior vena cava from 35.9 degree to 23.9 degree, but it was insignificant statistically (p=0.09). The embolization of right portal vein was done and there was increase in amount of drained bile from the nonembolized left lobe by 2-3 folds 8-14 days after PVE. The color and consistency between both lobes were significantly different; right lobe was darker in color and softer in consistency. Postoperative total bilirubin increased by 2-3 folds 1 to 4 days after PVE and normalized 10 to 14 days after PVE. Most of the patients had mild abdominal pain and fever after PVE and 1 patient had localized hematoma at puncture site which was subsided spontaneously. CONCLUSION: The preoperative portal vein embolization is a useful method for minimizing postoperative liver failure in patients in need of major hepatectomy.
Abdominal Pain ; Bile ; Bilirubin ; Carcinoma, Hepatocellular ; Fever ; Gallbladder Neoplasms ; Gelatin Sponge, Absorbable ; Gentamicins ; Hematoma ; Hepatectomy* ; Hepatic Veins ; Humans ; Hypertrophy ; Klatskin's Tumor ; Liver Failure ; Portal Vein* ; Punctures ; Vena Cava, Inferior

No abstract available.
Carcinoma, Hepatocellular* ; Spleen*

BACKGROUND: Apoptoss plays a major role in cellular proliferation and differentiation in tumor cells. Bcl-2, proto-oncogene, is known to inhibit apoptotic cell death of tumor cells. The high expression of bcl-2 in human melanoma cells over transforrned keratinocytes has been reported. The Loton group indicated that the growth of human melanoma cells exposed to retinoids was inhibit ed and their cellular melanin content incrensed over that of the untreated ce1Ls. The Veis group reported that bcl-2 defieient mice showed hypopigmented hair. Which suggests that bcl-2 may in volve melanogenesis. The Above mentioned findings may suggest that. bcl-2 and retinoids may play a role in melanoms biology. OBJECTIVE: We under ook this study to elucidate a possible relationship between retinoids and bcl-2 expvessions in human melanoma cell lines. METHODS: We analysed bcl-2 expressions from SK 28 cells(melanoma cell lines) after pretreat ment with retinoids using flow cytometry and imtnunoblotting. RESULTS: 1. In the results of the preliminary studies, we found that cultured human keratinocytes, fibro blasts and melanocytes n the resting state showed expressions of bcl-2. The latter showed a four fold expression of bcl-2. 2. Expression of bcl-2 was detected in SK 28, a human melanoma cell line, in the resting state. 3. After incubation with isotretinoin or etretinate treatment at 37 degrees C, for 48 hours, this treated group showed a more ir creased expression of bcl-2 than the control group. CONCLUSION: Our data may explain that the mechanism of ret.inoids indur,ing inhibition of mela noma cell growth may be partly due to upregulation of bcl-2 expression. The high base-line ex pression of bcl-2 in melanoma cells may tell us why these pigment cells can survive against oxi dative products generated during melanogenesis.
Acitretin ; Animals ; Biology ; Cell Death ; Cell Line* ; Cell Proliferation ; Etretinate ; Flow Cytometry ; Hair ; Humans* ; Isotretinoin ; Keratinocytes ; Melanins ; Melanocytes ; Melanoma* ; Mice ; Noma ; Proto-Oncogenes ; Retinoids* ; Up-Regulation

Chronic fatigue of the respiratory muscles has contributed to the decreased ventilatory capacity and reduced excercise tolerance of individuals with COPD, especially in kyphoscoliosis. Nasal mask BiPAP has been shown to be useful for the patient with nocturnal muscle fatigue and COPD. A 35-year-old man with severe kyphoscoliosis was admitted to ICU due to acute respiratory failure. He had been diagnosed of COPD and had been intubated with mechanical ventilatory support for 7 times. This time he was intubated with ventilatory support, too, in ICU and readmitted to the ICU for severe hypoxemia and hypercarbia from general ward. Thereafter he refused the intubation. Nasal mask BiPAP ventilatory support system was applied and IPAP, EPAP level being adjusted to the 12, 4 cmH2O under monitoring vital signs and arterial blood gas analysis. His condition was improved and discharged home with support of nasal mask BiPAP system after 33 day-stay in the ICU.
Adult ; Anoxia ; Blood Gas Analysis ; Fatigue ; Humans ; Intubation ; Masks* ; Muscle Fatigue ; Patients' Rooms ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Insufficiency ; Respiratory Muscles ; Vital Signs

No abstract available.
Pulmonary Artery*