A case of 49 year-old male with dermatomyositis associated with stomach cancer and Sjogren's syndrome is reported. The skin changes were characterized by the presence of Gottron's sign and dusky erythematous and finely scaling macular eruptions with telangiectasias on the scalp, forehead, butterfly area of the face, both elbows and knees. Dryness of eyes and mouth, nuchaI rigidity, numbness on extremities and epigastric hunger pain were also noted. The family history and past history were not contributory. After that weakness on proximal muscles, nuchal rigidity, dysphagia and walking difficulty were more aggravated. On dental and ophthalmologic examinations, shiny appearance of tongue and oral mucosa, burning and dry sensation in the mouth was noted and diminished tear and saliva production was also discovered. On laboratory findings, ESR, serum enzymes, especially CPK 3 and LDH, urinary creatine excretion were increased. LE cell was not found and RA test was also negative. Electromyographic and nerve conduction studies revealed myopathic EMG and normal nerve conduetion in both motor and sensory. There are gastric ulcer, positive vallecular sign on esophagus and thread like narrowing on almost all main and minor ducts of parotid gland. Histologic findings revealed ulcerative adenocarcinoma of stomach, a mild focal infiltration of lymphocytes and degenerative changes in left deltoid muscle and diffuse and extensive dermal edema associated with inflammatory infiltrates and hydropic degeneration and atrophy on the facial skin. He was treated with prednisolone, aspirin and intravenous methotraxate but no favorable effect was noted. Authors reviewed relevant literature.
Adenocarcinoma ; Aspirin ; Atrophy ; Burns ; Butterflies ; Creatine ; Deglutition Disorders ; Deltoid Muscle ; Dermatomyositis* ; Edema ; Elbow ; Esophagus ; Extremities ; Forehead ; Humans ; Hunger ; Hypesthesia ; Knee ; Lymphocytes ; Male ; Middle Aged ; Mouth ; Mouth Mucosa ; Muscle Rigidity ; Muscles ; Neural Conduction ; Neutrophils ; Parotid Gland ; Prednisolone ; Saliva ; Scalp ; Sensation ; Sjogren's Syndrome* ; Skin ; Stomach Neoplasms* ; Stomach Ulcer ; Stomach* ; Tears ; Telangiectasis ; Tongue ; Ulcer ; Walking

Angiotensin-converting enzyme(ACE) is a ipeptidyl carboxypeptidase that is a membrane bound mainly on the luminal surface of pulmonary endothelial capillary cells. It functions to inactivate bradykinin, and also converts angiotensin 1 to angiotensin Activity of ACE was first identified in plasma by Skeggs and co-workers in ]956 In 1974 Lieberman discovered that elevated levels of serum ACE were associated with active sarcoidosis and that this assay would be usei to assist a diagnosis of sarcoidosis. The association of sarcoidosis and enhanced ACE activity was subsequently supported by data from other investigators. Increased serum ACE levels have also been observed in patients with nongranulomatous diseases and granulomatous diseases including leprosy. The author studied the serum ACE levels in leprosy patients(fourty-three with tuberculoid type and eighty-nine with lepromatous type) and twenty normal healthy controls by the spectrophotometric method described by Lieberman. Comparative studies of ACE levels in these two types of leprosy with normal healthy controls and relationship among the duration of treatment, age, and sex were also conducted. The results were summarized as follows: Ages of the selected patients were between 3Q to 77 years in tuberculoid leprosy (average 54 1), 23 to 75 years in lepromatous leprosy(average 53. 8) and 14 to 49 years in the control group(average 28 4) The duration of treatment in tuberculoid leprosy was between 1 and 39 years and average was 2p 7 years. Of lepromatous leprosy, duration of treatment was between 2 and 50 years and the average was 25. 4 years.
Angiotensins* ; Bradykinin ; Capillaries ; Diagnosis ; Humans ; Leprosy* ; Leprosy, Lepromatous ; Leprosy, Tuberculoid ; Membranes ; Peptidyl-Dipeptidase A* ; Phenobarbital ; Plasma ; Research Personnel ; Sarcoidosis

BACKGROUND: Epidermal growth factor receptors (EGFR) have been reported to be absent in melanomas. But recently, the presence of EGFR on melanocytic cells was reported to be a marker of malignant transformation. OBJECTIVE: Our purpose was to investigate the presence of EGFF in melanocytic lesions and to determine whether EGFR presence correlates with the potential or malignant transformation of melanocytic cells. METHODS: We performed the immunohistochemical studies to reveal immunoreactivity of EGFR in 7 compound nevi, 10 intradermal nevi, and four melanomas using the Vectastain ABC immunoperoxidase stain system. RESULTS: Although the intensity of staining was slightly variable, all melanocytic cell types in the studied lesions of compound nevi, intradermal nevi, and melanoms had immunoreactive EGFR. Intense staining far EGFR of all nucleated layers of keratinocytes overlying a melanocytic lesion was also seen. But in the melanoma cells, the staining intensity was modarately deereased. CONCLUSION: Although we found no correlation of EGFR with the potential for malignancy in melanocytic lesions, the high level of expression within nevocytes and lesional keratinocytes suggests EGFR or transforming growth factor a, by acting through the EGFR, plays a role in the pathogenesis, maintenance, or evolution or these lesions.
Epidermal Growth Factor* ; Keratinocytes ; Melanoma ; Nevus ; Nevus, Intradermal ; Receptor, Epidermal Growth Factor* ; Transforming Growth Factors

BACKGROUND: It is now well known that oxygen free radicals act as mediators of cellular injury in many cardiovascular diseases. Although some evidences have been presented for an altered number of adrenergic receptors in heart disease, a detailed examination of the interaction of free radicals with cardiac adrenergic receptors has little been carried out. METHODS: This study is therefore undertaken to examine the influences of adrenergic blocking agents(propranolol, prazosin) and cyclooxygenase inhibitor(aspirin) on the cardiac damage by oxygen free radicals. Ischemic condition of the isolated rat heart was made by Langendorff preparation, and then measured superoxide dismutase(SOD), lactate dehydrogenase(LDH) released in the perfusate, and malondialdhyde(MDA) concentration in the cardiac tissue. RESULTS: We obtained the results that increased SOD activity and tendency of decreased LDH activity by the pretreatment of propranolol, prazosin, and aspirin in cardiac ischemic-reperfusion injury. Those effects were more predominant in adriamycin treated group comparing with not treated group. CONCLUSION: Adrenergic blocking agent, propranolol, prazosin, and aspirin seem to have some protective effect on the reperfusion injury of the heart.
Adrenergic Agents* ; Animals ; Aspirin ; Cardiovascular Diseases ; Doxorubicin ; Free Radicals* ; Heart ; Heart Diseases ; Lactic Acid ; Oxygen* ; Prazosin ; Propranolol ; Prostaglandin-Endoperoxide Synthases ; Rats ; Receptors, Adrenergic ; Reperfusion Injury ; Superoxides

BACKGROUND: Epidermal growth factor(EGF) usually stimulate she growth and proliferation of a variety of cell types in vitro and in vivo through binding to a peific cell surface receptor, a 170- kilodalton glycoprotein. The EGF receptor (EGFR) may be respansi ile for deranged keratinocyte proliferation and differentiation. OBJECTIVE: Our purpose was to investigate the pattern of EGFR expression in malignant epidermal tumors. METHODS: We performecl immunohistochemical studies to reveal immunoreactivity of EGFR in 7 basal cell carcinomas, 6 squamous cell carcinomas, and five nomal control skin using the Uectastain ABC immunoperoxidase stain system. RESULTS: In normal skin, EGFR showed strong staining of basal cells and lower keratinocytes of the stratum malpighii. As squaous cells matured, staining gradually beame weaker. In all cases of basal cell carcinoma studied, there was loss of membrane labelling of the tumor cells and but in half the cases there was little or no siaining of the lesional cells. In squamous cell carcinomas, variable patterns were seen. The better differentiated tumors showed an essentially no mal pattern of EGFR expression. However, less well differentiated areas showed loss of membrane staining, cytoplasmic accumulation of receptor, and a heterogeneiy of staining intensity. CONCLUSION: Dysregulation of the EGFR may be important in the levelopment, of cutaneous epithelial malignancies but that giossly abnormal forms of the receptor do not occur. The quantitative and qualitative changes in EGFR that we have demonstrated may well be of importance in the pathogenesis of these keratinocyte tumors.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cytoplasm ; Epidermal Growth Factor* ; Glycoproteins ; Keratinocytes ; Membranes ; Receptor, Epidermal Growth Factor* ; Skin

BACKGROUND: Mutations in the p53 gene are the most frecjuent genetic alterations found in human cancers to date. Bvidense suggests that wild-type p53 is a tumor suppressor protein, crucial for the negative regulative of cell cycling, and requiring loss of function mutations for tumorigenesis. OBJECTIVE: Our purposr is to investigate the expression pattern of the p53 protein in the squamous cell carcinomas(SCCs) of the human skin. METHODS: We studied p53 protein expression, using DO7 mnoclonal antibody immunohi-stochemistry, in 29 SCCs of the skin. Also, we compared the p53 expression depending upon with or without a history of UV exposure. RESULTS: p53 immunoreactivity was observed in 48% (14 of 29) of SCCs and was not seen in normal skin. In 56% (16/29) SCCs the tumors were developed on UV-light exposure area. SCCs were divided on histopatal biological criteria in to three categories, well, moderately, or poorly differentiated. Although no significant differenie in the prevalence of p53 immunoreactivity was obierved between these groups, positive, strong staining was observed more frequently in poorly differentiated than in well-differe: treated tumors. CONCLUSION: Accumulat,i,on of p53 protein, suggestive in nessary cases of p53 gene mutation and hence loss of tumors upperesor function, may play a role in the tumorigenesis of SCCs.
Amoxicillin ; Carcinogenesis ; Carcinoma, Squamous Cell* ; Genes, p53 ; Humans* ; Prevalence ; Skin*

This report deals with a 49-year-old male farmer who had a pathological fraeture. of the right femoral shaft due to metastatic carcinoma from the middle lobe of the right lung. The lesion of the femur was resected en-bloc and bone stabilization of the fractured bone was obtained by an intramedullary Kiintscher nail plus cement fixation. Two weeks later, a right middle and lower lobectomy was done. Microscopic examination of both specimens from right femur and lung revealed poorly differentiated squamous cell carcinoma. The postoperative course was satisfactory with no recurrence for period of 26 months.
Carcinoma, Squamous Cell ; Farmers ; Femur ; Humans ; Lung ; Male ; Methylmethacrylate ; Middle Aged ; Neoplasm Metastasis ; Recurrence

A case of 17 years old male with KPP of Tbost-Unna Type is reported. The akin lesions were characterized by the presence of confluent, sharply demarcated hyperk eratotic plaques on the palmar and plantar surfaces. Hypercontraction of palms and soles and hyperhidro is of scalp, face, palms and soles were also noted. Roentogenologic study revealed secondary changes of osteoporosis, flexion deformity and osteoarthritis due to soft tissue contracture and phalangeal and metatarsal bones of hands and feet showed bony resorption with tapering appearance. Histalogic findings of palmar lesion showed excessive hyperkeratosis, parakeratosis and acantosis in the epidermis and no pathology was noted in the dermis and skin appendages, He was treated with hot water compress, 5% Salicylic acid ointment and vit. A and D for 2 months and favorable effect was noted. Authors reviewed relevant literature and made discussions also.
Adolescent ; Betazole ; Congenital Abnormalities ; Contracture ; Dermis ; Epidermis ; Foot ; Hand ; Humans ; Keratoderma, Palmoplantar* ; Keratosis* ; Male ; Metatarsal Bones ; Osteoarthritis ; Osteoporosis ; Parakeratosis ; Pathology ; Salicylic Acid ; Scalp ; Skin ; Water

Angiotensin-converting enzyme (ACE), a dipeptidyl carboxypeptidase, hydrolyzes angiotensin I to the active angiotensin g and also inactivates bradykinin. Activity of ACE was first identified in plasrna by Skeggs et al in 1956. In 1975 Lieberman first reported elevation of serum ACE level in patients with active sarcoidosis and suggested clinical application of the assay to confirm a diagnosis of sarcoidosis and to serve as a guide for therapy. The author studied the serurn ACE levels in 21 syphilitic patients (11 men, 10 women) who showed positive responses in both VDRL and TPHA tests and 20 normal healthy controls (7 men, 13 women) by the spectrophotometric method described by Lieberrnan who modified Cushman and Cheungs method. Comparative studies of ACE levels in syphilitic group with normal control group and relationship among the age, sex and treatment were also conducted. The results were summarized as follows : Ages of the syphilitic patients and normal healthy control group ranged from 18 to 51 years (27 1+-8 98 years) and from 14 to 49 years (28 4+9 08 years) respectively. The mean serum ACE level in syphilitic patients was ll 33+-3 25 p/ml, which was significantly higher than that of normal healthy control group, 6 39+-2 RR p/ml, (p<0001) Of the 21 syphilitic patients, 15(71 4%) had ACE activity higher than the upper limit of normal (mean+1SD). There was no significant correlation between age and serum ACE level. -countinue-
Angiotensin I ; Angiotensins* ; Bradykinin ; Diagnosis ; Humans ; Male ; Peptidyl-Dipeptidase A* ; Sarcoidosis ; Syphilis*

BACKGROUNDS: Antiphospholipid antibodies which are frquently found in systemic lupus erythematosus and primary antiphospholipid syndrome are associated with recurrent abortions and thromboembolism. In this study the authors investigated whether antiphospholipid antibodies are found in Graves disease, a representative organ-specific autoimmune disease and what is the clinical implication of the antiphospholipid antibodies if they appear in Graves disease. METHODS: Anticardiolipin antibody and lupus anticoagulant activity were measured in 57 untreated hyperthyroid Graves patients. 42 euthyroid patients with thyroid nodules served as controls. RESULTS: Eight of the 57 patients with Graves disease had anticardiolipin antibody which was significantly more frequent than in control group. Six of the eight patients who had anticardiolipin antibody had IgM type antibody and two had IgG type antibody. All their antibody activity declined with several months of antithyroid drug therapy and finally disappeared when the patients became euthyroid. Presence of anticardiolipin antibody had no relationship with clinical events such as spontaneous abrtion and thromboembolism. CONCLUSION: Anticardiolipin antibody is frequently found in patients with Graves disease. They seem to appear as an epiphenomenon of autoimmunity and they seem not to have any clinical implications.
Abortion, Habitual ; Antibodies, Anticardiolipin* ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome ; Autoimmune Diseases ; Autoimmunity ; Drug Therapy ; Female ; Graves Disease* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Lupus Coagulation Inhibitor ; Lupus Erythematosus, Systemic ; Pregnancy ; Thromboembolism ; Thyroid Nodule