BACKGROUND: Desmosomes are adhesive intercellular junctions that form an important component of the junction complexes of epithelial cells. They provide intercellular links between the intermediate filament cytoskeletons of adjacent cells and are thus involved in maintaining the structural integrity of tissues. OBJECTIVE: Calcium and retinoids are major regulators of epidermal differentiation and their role on keratin proteins are well known. However, their effects on desmosome moleucles are unknown. To address this question we initiated a study of the effects of these epidermal differentiation regulators on desmosomal components, i.e., desmoplakin, desmoglein, and pemphigus antigens. METHODS: We used monoclonal antibodies against desmoplakin(DP) and desmoglein(DG), and sera from patients with pemphigus vulgaris(PV), pemphigus foliaceus(PF) and paraneoplastic pemphigus (PNP) to study the effects of calcium and retinoic acids, which are major regulators of epidermal differentation, on desmosomal protein formation in human cultured deratinocytes. We performed immunofluorescence, immunoblotting and immunoprecipitation study using human keratinocytes cultured in high calcium media with or without retinoic acid and in low calcium media with or without retinoic acid. RESULTS: 1. In low calcium (0.15mM) media, PV antigen and DG were produced in a small amount and it appeared that these desmosomal proteins were located in cytosol. Whereas in high calcium (1.8mM) media, production of these desmosomal proteins was increased not they were assembled at the desmosomal structures located in cell-cell contact margins. 2. PF antigen, which was identical to the DG, were not produced or expressed in cultured keratinocytes even when cultured in high calcium media. 3. PNP antigen and DP were produced in cultured keratinocytes grown in both high low calcium media but their production was increased in high calcium media and only in high calcium media they were assembled at the desmosomal structures. 4. Retinoic acids induced loosening of cell-cell contacts of cultured keratinocytes and decreased the production of desmosomal proteins. CONCLUSION: Our results suggests calcium is a major regulator of the production and assembly of desmosomal proteins including pemphigus antigens, but PF sera and monoclonal antibodies against DG show different antigen binding characteristics. It appears that retinoic acids inhibit production of desmosomal proteins.
Adhesives ; Antibodies, Monoclonal ; Calcium* ; Cytoskeleton ; Cytosol ; Desmogleins ; Desmoplakins ; Desmosomes* ; Epithelial Cells ; Fluorescent Antibody Technique ; Humans ; Immunoblotting ; Immunoprecipitation ; Intercellular Junctions ; Intermediate Filaments ; Keratinocytes ; Pemphigus ; Retinoids ; Tretinoin*

Vascular injury is a serious but rare complication of hip procedures. Most of vascular complications reported in articles occured in vessels around hip joint and femoral artery. To date, report of popliteal artery occlusion during or after total hip arthroplasty was absent. The authors have experienced one case of popliteal artery occlusion after total hip arthroplasty. It was suspected that the cause of occlusion of this particular case was a excessive maneuvering of limb during operation and then, artheromatous plaque fracture or thrombosis made occulusion in popliteal artery. Angiographic embolectomy using a catheter was performed and circulation of limb was recovered. To reduce the risk of vascular complications after total hip arthroplasty procedure, we recommend a thorough evaluation of lower extremity circulation in risky patient. And if a vascular insult is suspected either during or soon after the procedure, then a vascular consultation with arteriography including popliteal artery should be obtained urgently. Delay in treatment could result in a deleterious outcome.
Angiography ; Arthroplasty, Replacement, Hip* ; Catheters ; Embolectomy ; Extremities ; Femoral Artery ; Hip ; Hip Joint ; Humans ; Lower Extremity ; Popliteal Artery* ; Thrombosis ; Vascular System Injuries

No abstract available.
Meniere Disease*

We report a case of a 41-year-old female with acrogeria. She was in good health except for the prominent atrophy over the hands and feet. On microscopic examination of a biopsy specimen from the atropl6c skin, elastic fibers were clumped and fragmented. Electronmicroscopy revealed amorphous and granulous pseudoelastin, which is presumed to be consistent with acrogeria. Our patient had acro-osteolysis and an extra chromosome in addition to the normal 23 pairs of chromosomes in one of 20 cells examined, which have been very rarely reported in the literature. Further studies are needed to find out whether this chromosomal aberration might contribute to the pathogenesis.
Acro-Osteolysis ; Adult ; Atrophy ; Biopsy ; Chromosome Aberrations ; Elastic Tissue ; Female ; Foot ; Hand ; Humans ; Skin

The case of a 56-year-old woman with a keratoacarithoma(KA) of the labial mucosa is herein reported, The tumor was excised and the pathological features were characteristic of a KA, This case is reported because the oral mucosa is such an unexpected location for solitary KA and the labial mucosa of this patient received chronic actinic damage, which suggested an etiological relationship. Follow-up examination of the patient after four months showed no recurrence.
Actins ; Female ; Follow-Up Studies ; Humans ; Keratoacanthoma* ; Middle Aged ; Mouth Mucosa ; Mucous Membrane* ; Recurrence ; Solar System*

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.
Embryonic Structures* ; Head* ; Humans* ; Neck*

Coronavirus disease 2019 (COVID-19) reduces airline passengers, which leads to a sharp decline in airline sales. They are concerned about the dismissal or unpaid leave of the flight pilot and crew, and the management of the passengers is also under great stress. Stress management methods for COVID-19 can be divided into general stress management such as ‘Let’s change me’, ‘Let’s find the source of life’, and ‘Let’s ask for help’, and mental health management in a disaster situation.

Aneurysm of the internal carotid artery is a rare disease and is known to be associated with congenital arterial anomalies such as neurofibromatosis type I (NF-I). NF-I is an autosomal dominant neurocutaneous disorder characterized by a variety of manifestations that involve the central and peripheral nervous systems, skin, vascular system, and skeleton. In particular, the involvement of vascular abnormalities in NF-I is well known. Any vessel may be affected by this condition, although the renal artery is most frequently involved. The vascular abnormality can be occlusive or an aneurysmal degenerative change. Therefore, symptomatic presentations might assume an indolent pathophysiologic course such as hypertension, or manifest as a catastrophic event such as arterial rupture that could result in sudden death. We report a rare autopsy case of an aneurysmal rupture of the internal carotid artery in a woman with suspected NF-I, who collapsed in her home.
Aneurysm ; Autopsy ; Carotid Artery, Internal ; Death, Sudden ; Female ; Glycosaminoglycans ; Humans ; Hypertension ; Neurocutaneous Syndromes ; Neurofibromatoses ; Neurofibromatosis 1 ; Peripheral Nervous System ; Rare Diseases ; Renal Artery ; Rupture ; Skeleton ; Skin

OBJECTIVE: In recent years, the neurosurgeon's role in managing cerebrovascular diseases (CVD) has becomes rapidly challenged and overlapped with other specialists. Furthermore, the patterns of CVD and patient recruitment have also changed. We conducted a retrospective study regarding the practical trends of CVD with reference to the management paradigms at our institute. METHOD: We reviewed all the available data, including the annual reports, the daily department records, the medical records and the radiographic films of the CVD patients who had been admitted to our Neurosurgery Department during the five years between Jan. 2004 and Dec. 2008. RESULTS: The total numbers of CVD operations showed a slight initial increase, but then they remained steady for the latter 3 years. The number of cases of non-angiomatous hemorrhage has been relatively steady, regardless of surgery. The total numbers of treated aneurysms increased, but the main body of this increment was attributed to the initiation of endovascular treatment and increased identification of unruptured vascular lesions. Vascular malformations were sustained with a small number of cases due to referring them to other institutes for radiosurgery, except for the cases that required urgent hemorrhagic evacuation. CONCLUSION: Hemorrhagic CVDs tended to decrease either due to increasing identification before rupture or shifting such patients into a large volume hospital. The increasing awareness of ischemic CVD, the early detection of unruptured aneurysms, and the separation of medical responsibilities from neurologists have all pushed neurosurgeons to make treatment plans in a more cooperative fashion, instead of a competitive way. Neurosurgeons should be furnished with several revolutionary surgical options to widen their scope of managing patients with CVD.
Academies and Institutes ; Aneurysm ; Hemorrhage ; Humans ; Infarction ; Intracranial Aneurysm ; Medical Records ; Neurosurgery ; Patient Selection ; Radiosurgery ; Retrospective Studies ; Rupture ; Specialization ; Subarachnoid Hemorrhage ; Vascular Malformations ; X-Ray Film