Ae opposed to most other drug eruptions, drug-induced pemphigus may not develop for at least several months following the initiation of therapy with the offending agent. Unlike sporadically occuring pemphigus, the clinical and hietopathologic patterns of drug-induced pemphigus are most often those of pemphigus foliaceus. We report a case of diphenylhydantoin-induced pemphigus occuring in 30-year-old male with epilepsy. A few coinsized erythematous scaly patches developed on his fae, chest, snd left wrist, and two flaccid bullae on erythemstous base developed on his abdomen after three years snd nine months of therapy with diphenylhydantcin. Histopathologicslly, a biopsy specimin taken from a bullous lesion revealed that bulla is formed just beneath the granular layer and aeaitholytic cells are seen within the bulla. Direct and indirect irnmunofluorescence studies showed regitive findings. Administration of diphenylhydantoin was discontinued and he was treated with systemi and topical corticoeteroid. After 4 weeks, the skin lesions were healed with postinflammatory hysroigmentation and no new lesions were developed thereafter.
Abdomen ; Adult ; Biopsy ; Blister ; Drug Eruptions ; Epilepsy ; Humans ; Male ; Pemphigus* ; Phenytoin* ; Skin ; Thorax ; Wrist

No abstract available.
Crohn Disease*

BACKGROUND: It has been suggested that the regulation of hair growth might involve complex interaction between dermal papilla cells and hair matrix cells. Dermal papilla cells secrete diffusible factors that would act an hair matrix cells. During anagen the papilla appears to have prominent capillary loop, whereas in telogen it is nonvascularized. Vascular endothelial growth factor(VEGF) was recently reported to be produced by dermal papilla cells in rats. OBJECTIVES: We performed this study in order to evaluate the effect of VEGF on human hair growth in vitro and on the proliferation of dermal papilla cells and to define the splice forms of VEGF. METHODS: To detect the isoforms of VEGF, RT-PCR was performed on RNA isolated from dermal papilla cells and RT-PCR products were hybridized with VEGF-specific oligonucleotide probe located in exon 4. Isolated human hair follicles were cultured with various concentrations of VEGF165 and VEGF121. Hair follicle growth was measured by an Olympus inverted microscope with an eyepiece measuring graticule. RESULTS: The following results were obtained from this study. 1. Southern hybridization and size calculation of RT-PCR products revealed that mRNA species corresponding to 121, 165, 189, and 206 amino-acid forms of VEGF were praduced by cultured human dermal papilla cells. 2. 10 ng/ml of rhVEGF165, 0.1 ng/ml of rhVEGF165 and 10 ng/ml of rhVEGF121 stimulated follicle elongation in vitro(p < 0.05). 3. rhVEGF165 and rhVEGF121 had no effect on the numbers and thymidine incorporation of dermal papilla cells. CONCLUSION: These results suggest that VEGF is produced by dermal papilla cells and is able to promote hair growth in vitro. Increased hair growth by VEGF might occur other than by proliferation of dermal papilia cells.
Animals ; Capillaries ; Endothelial Growth Factors* ; Exons ; Hair Follicle ; Hair* ; Humans ; Protein Isoforms ; Rats ; RNA ; RNA, Messenger ; Thymidine ; Vascular Endothelial Growth Factor A

Crohns disease is a granulomatous isease of the gastrointetin 1 tract, especially terminal ileum, but may involve the lip, mouth, anus, skin, liver and bone. The skin is a common site of extraintestinal involvement in Crohns disease, with the perianil, perineal, and peristomal areas most frequently affected. Vulvar involvement, however, is an uncommon extraintestinal manifestantion of Crohns disease. We report a case of a 16-year-old girl with Crohns disease of the vulva and perianal region. A histopathologic study of the descending colon and vulvar skin showed noncaseating granulomatous reactions composed of lymphocytes, epithelioidell and giant cells. We were able to make the diagnosis of Crohns disease of the vulvar and the patient was treated with prednisolone and metronidazole.
Adolescent ; Anal Canal ; Colon, Descending ; Crohn Disease* ; Diagnosis ; Female ; Giant Cells ; Humans ; Ileum ; Lip ; Liver ; Lymphocytes ; Metronidazole ; Mouth ; Prednisolone ; Skin ; Vulva*

Succinylcholine-induced prolonged neuromuscular blockade may occur in patients with either a low level of plasma cholinesterase activity or genotypically abnormal form of that enzyme. We experienced a case of succinylcholine-induced prolonged apnea due to a low level of plasma cholinesterase activity. A 31-year-old woman, full term primigravida, underwent cesarean section for breech presentation under general anesthesia. Familial and past medical history were nonspecific and preoperative physical and laboratory findings were within normal range. After operation, delayed apnea was detected and lasted for about one hour. We performed controlled and assisted ventilation for two and half hours. Plasma cholinesterase activity measured 30.00 IU/L (colorimetric method, normal value: 1130~1960 IU/L) at the first postoperative day. She was discharged on 7th postoperative day without any sequelae. From follow-up study after six months, it measured 1.02 U/ml (EIA, normal value: 7~9 U/ml).
Adult ; Anesthesia, General ; Apnea* ; Breech Presentation ; Cesarean Section* ; Cholinesterases* ; Female ; Follow-Up Studies ; Humans ; Neuromuscular Blockade ; Plasma* ; Pregnancy ; Reference Values ; Ventilation

BACKGROUND: Androgenic alopecia, commonly known in men as male pattern baldness is the gradual balding of the scalp in response to androgens in genetically predisposed individuals. Androgens can gradually transform large scalp hair follicles to smaller vellus ones, causing balding. The mechanisms involved are unclear, although androgens are believed to act on the epithelial hair follicle via the mesenchymal derived dermal papilla. During pregnancy, hair growth is increased, as estrogen appears to prolong the anagen phase, and postpartum hair loss may be related to a rapid decrease in estrogen. OBJECTIVE: The aim of the present study was to evaluate the difference of the expressions of androgen receptors(AR) and estrogen receptors(ER) by monoclonal antibodies in biopsy specimens between bald area and non-bald area. METHODS: Immunohistochemical analysis of AR and ER receptor were preformed on the paraffine-embedded tissue sections of bald area and non-bald area in 6 cases of androgenic alopecia using anti-AR and anti-ER monoclonal antibodies with avidin-biotin peroxidase complex procedure. RESULTS: The results were that androgen receptors were higher level in bald area and estrogen receptors showed no difference between bald and non-bald area. CONCLUSION: This study supports that locally increased androgen activities may be related with hair loss in androgenic alopecia and estrogens have less relationship in the pathogenesis of androgenic alopecia.
Alopecia* ; Androgens ; Antibodies, Monoclonal ; Biopsy ; Estrogens* ; Hair ; Hair Follicle ; Humans ; Male ; Peroxidase ; Postpartum Period ; Pregnancy ; Receptors, Androgen* ; Receptors, Estrogen* ; Scalp

BACKGROUND: This study purposed to survey the fit rate of respirators by person and by product through conducting a qualitative fit test of high-efficiency respirators; moreover, this study also tests for differences in the fit rates determined by the qualitative fit tests with an increase in the number of the types of respirators tested. METHODS: The subjects of this study were 30 healthcare personnel who had passed a sensitivity test. The fit test of high-efficiency respirators was conducted using FT10 (3M Co., USA), an experimental tool used for performing the qualitative fit test of high-efficiency respirators, and three types of high-efficiency respirators - 1860, PFR95, and N7000 - were tested. RESULTS: The qualitative fit test was performed for the three types of high-efficiency respirators and the fit rate of the respirators that the subjects had been using previously was 43.3%; however, the probability that one or more of the three types of high-efficiency respirators would fit the subjects increased to 83.3%, and this increase was statistically significant (P<0.05). The difference in the fit rates of the three types of high-efficiency respirator types was not statistically significant; however, the differences in the satisfaction of and preference for the different respirator products were all statistically significant (P<0.05). CONCLUSION: Healthcare personnel are using ill-fitting respirators and a qualitative fit test should be performed to improve the fit of their respirator. In the qualitative fit test performed for the high-efficiency respirators, the fit rate increased with the increase in the variety of respirator types. Thus, a large variety of respirators should be made available to increase the fit rate of high-efficiency respirators for healthcare personnel.
Delivery of Health Care ; Humans ; Respiratory Protective Devices ; Ventilators, Mechanical

No abstract available.
Humans ; Infant, Newborn* ; Respiration, Artificial*

BACKGROUND: Psoriasis is a chronic relapsing disease characterized by epidermal hyperproliferation and epiderrnal and dermal inflammatory cell infiltration. The etiology of this disease is still unclear. Recently, there has been growing interest in the probable role of a T cell mediated immune response in the pathogetiesis of psoriasis. The infiltrating cells in psoriatic lesions have been iden- tified by monoclonal ant~ibodies and T cells were found to be the major infiltrating type. OBJECTIVE: This stud was done to investigate the difference of cellular infiltration and adhesion molecule exg!ressions between early and late skin lesions of psoriasis using immunohistochernical studies. Methpds : Patients with psoriatic lesions were divided into two groups. The early gr oup were defined as having skin lisions that had lasted for about 4 weeks, and late group were defined as having skin lesions that had lasted for more than 8 weeks. Then biopsy specirnens were stained using monoclonal antibidies for CD4, CD8, CD1, LFA-1, and ICAM l. RESULTS: 1. CD4 positive cells,vere tly increased in both the early and late groups compared with CD8 positive cells. Z. CD8 positive cells were significantly increased in the late g~roup compared with the early group. 3. CDl-posit,ive dendri!ic cells were more nurnerous in the late group than the early group. 4. There were no significant differences between the early and late group with regard to numbers of LFA-1 positive (ells. 5. ICAM-1 were more strongly expressed on epidermal keratinocytes in the late than the early group. CONCLUSION: CD4-positive cells are important in early and late psoriatic lesions and CD8 positive cells playi more important role in late than early lesions. ICAM-1 and LI'A-1 play a role in cell adhesion of infiltrating cells and lymphocytic rnigration to the epidermis.
Biopsy ; Cell Adhesion ; Epidermis ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes ; Lymphocyte Function-Associated Antigen-1 ; Psoriasis ; Skin ; T-Lymphocytes

BACKGROUND: Psoriasis is a chronic relapsing disease characterized by epidermal hyperproliferation and epiderrnal and dermal inflammatory cell infiltration. The etiology of this disease is still unclear. Recently, there has been growing interest in the probable role of a T cell mediated immune response in the pathogetiesis of psoriasis. The infiltrating cells in psoriatic lesions have been iden- tified by monoclonal ant~ibodies and T cells were found to be the major infiltrating type. OBJECTIVE: This stud was done to investigate the difference of cellular infiltration and adhesion molecule exg!ressions between early and late skin lesions of psoriasis using immunohistochernical studies. Methpds : Patients with psoriatic lesions were divided into two groups. The early gr oup were defined as having skin lisions that had lasted for about 4 weeks, and late group were defined as having skin lesions that had lasted for more than 8 weeks. Then biopsy specirnens were stained using monoclonal antibidies for CD4, CD8, CD1, LFA-1, and ICAM l. RESULTS: 1. CD4 positive cells,vere tly increased in both the early and late groups compared with CD8 positive cells. Z. CD8 positive cells were significantly increased in the late g~roup compared with the early group. 3. CDl-posit,ive dendri!ic cells were more nurnerous in the late group than the early group. 4. There were no significant differences between the early and late group with regard to numbers of LFA-1 positive (ells. 5. ICAM-1 were more strongly expressed on epidermal keratinocytes in the late than the early group. CONCLUSION: CD4-positive cells are important in early and late psoriatic lesions and CD8 positive cells playi more important role in late than early lesions. ICAM-1 and LI'A-1 play a role in cell adhesion of infiltrating cells and lymphocytic rnigration to the epidermis.
Biopsy ; Cell Adhesion ; Epidermis ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes ; Lymphocyte Function-Associated Antigen-1 ; Psoriasis ; Skin ; T-Lymphocytes