Vitamin A and its metabolite, retinoic acid, have been recommended for the treatment of psoriasis, ichthyosis, acne vulgaris and Darier's disease which resulted from abaormal regulatory function of keratinocytes. In recent years retinoic acid analogs (retinoids) have been synthesized and shown to be more potent and less toxic than retinoic acid. Since these drugs are therapeutically effective for skin diseases, only with longterm adminiatration of large doses, their toxicities must be seriously considered. The liver is the main site for both storage and excretion of vitamin A and ita derivatives, which may produce injury to the liver and other organs as a result of excess of lysosomal enzyme control. Fatty vacuoles, infiltration of inflammatory cells, focal necrosis, increase in lysosomal enzymes, distension of the RER, decrease in the ribosomes, swelling of the mitochondria, and proliferation of the SER within the hepatocytes have been observed in livers of vitamin A- as well as retinoic acid-treated rats. Its excess may also cause mucous metaplasia of secretory cells of the pancreas. (countinued...)
Acne Vulgaris ; Amphotericin B* ; Animals ; Darier Disease ; Hepatocytes ; Ichthyosis ; Keratinocytes ; Liver ; Metaplasia ; Mitochondria ; Necrosis ; Pancreas ; Psoriasis ; Rats ; Ribosomes ; Skin Diseases ; Tretinoin ; Vacuoles ; Vitamin A ; Vitamins

No abstract available.
Silver*

BACKGROUND: Topical 1% butenafine hydrochloride cream, a new benzylamine derivative, has been reported to have antimycotic effect. OBJECTIVE: An open trial as conducted to assess the efficacy and safety of 1% butenafine hydrochloride cream used once daily in the treatment of tinea pecis. METHODS: Of 45 patients with clinically and mycologically proertinea pedis from the department of dermatology at Kosin medical college hospital, 42 patient, who could be monitored to the end of this study were evaluated. They applied 1% butenafine hydrochloride cream once daily until clinical improvement became evident or for 4 weeks and the effects were evaluated clinically and mycologically. RESULTS: 1. From the mycological studies at the initial visit, causative organisms were isolated from 36 patients out of the 42 subjects and Trichophyton rubrum was most comnmon organism. 2. The negative conversion rate of the mycological study( negative microscopy and negative culture) was 90.5%(38/42) after 4 weeks of treatment. 3. The effective treatment vate at 4 weeks was 90.5%(38/42) 4. A adverse effects of using 1% butenafine hydrochloride cream was noted in 1 patient, who had a moderate degree of puritus, out of the 42 subjects. The presritus disappeared soon after the cessation of application of the cream. CONCLUSION: 1% butenafine lydrochloride cream is effective andafe in the treatment of tinea pedis.
Dermatology ; Humans ; Microscopy ; Tinea Pedis* ; Tinea* ; Trichophyton

Trichoepithelioma, a tumor of the hair follicle, is usually seen as multiple lesions, but occasionally appears as a single tumor. Multiple trichoepithelioma is a dominant hereditary skin conditions whereas solitary trichoepithelioma is not hereditary and is growing tumor, usually seen in adults. A case of 56 year old housewife with solitary trichoepithelioma was reported. The skin lesion appeased as a firm, skin colored papule and the size was 0.5cm in diameter on right side of nose. Shaving biopsy was done and showed a high degree of differentiation toward hair structure and horn cyst that the keratinization is abrupt and complete. The methood of treatment is a surgical excision and electrodesiccation but remain a scar due to surgical trauma. And so, we used a 5-fluorouracil ointment instead of surgical excision and electrodesiccation, The skin lesion on nose was cured completely as a result of 5-FU ointment application without any scar formation cosmetically.
Adult ; Animals ; Biopsy ; Cicatrix ; Fluorouracil* ; Hair ; Hair Follicle ; Horns ; Humans ; Middle Aged ; Nose ; Skin

No abstract available.

A prospective study was conducted on 510 respiratory specimens for the presence of M. tuberculosis detected by direct acid-fast bacilli (AFB) smear examination, culture in the Manual Mycobacteria Growth Indicator Tube (BBL MGIT, Becton-Dickinson) and culture on Lowenstein-Jensen (LJ) medium. From positive BBL MGIT tubes, Ziehl-Neelsen and Gram stains were performed and subcultures were put up on LJ medium. A total of 101 (19.8%) specimens were positive by the BBL MGIT, 60 (11.8%) by primary LJ medium culture, 31 (6.1%) by direct smear examination and 29 (5.7%) by all three methods. Using primary LJ culture as the gold standard, the sensitivity and specifi city of the BBL MGIT were 90% and 89.6% respectively but the sensitivity of AFB smear microscopy was only 48.3%. About half (51.1%) of the BBL MGIT false positives were due to contamination by non-AFB bacteria. The remaining false positives comprised specimens that were AFB microscopy positive but LJ culture negative. Of the AFB isolates obtained on LJ primary and sub-cultures, almost all (93.3%) were identifi ed as Mycobacterium tuberculosis complex. The mean time-to-detection was signifi cantly shorter (p<0.0001) for the BBL MGIT than for LJ culture. For the former, positive results were available within 14 days for both AFB smear-positive and AFB smear-negative specimens. On the average, positive results were obtained 1.8 days earlier for direct AFB smear-positive samples than for AFB smear-negative samples. On the other hand, positive growth on LJ medium appeared after at least 33 days of incubation. These fi ndings suggest that the BBL MGIT system will be a suitable alternative to LJ culture for the routine diagnosis of pulmonary tuberculosis, but a combination of liquid and solid cultures is still required for the highest diagnostic accuracy.

Cutaneous cholesterol embolism is a disease with severe arterosclercsis of the abdominal aorta in which emboli of cholesterol crystals from atheromatous plaques occlude airterioles. We report a case of cutaneous cholesterol embolism in a 61-year-old man who had livedo reticularis on both his feet for 10 days. Histopathologic findings showed needle-shaped cholesterol clefts viithin the lumina of arterioles. The patient died of myocardial infarction 3 months later.
Acrospiroma ; Aorta, Abdominal ; Arterioles ; Cholesterol* ; Embolism, Cholesterol* ; Foot ; Humans ; Livedo Reticularis ; Middle Aged ; Myocardial Infarction ; Plaque, Atherosclerotic

Reye syndrome is a rapidly progressive encephalopathy with hepatic dysfunction, which often begins several days after apparent recovery from a viral illness, especially varicella or influenza A or B. Salicylate use was identified as a major precipitating factor for the development of Reye syndrome. With the recommendation to avoid use of salicylates in children, Reye syndrome has virtually disappeared in recent years. We report a case of Reye syndrome in a 5-month-old infant who had been treated with intravenous immunoglobulin and aspirin under the diagnosis of Kawasaki disease, and showed symptoms of sudden onset of irritability, rigidity, decreased activity, vomiting, poor appetite, lethargy, liver dysfunction without jaundice, coagulopathy, and hyperammonemia.
Appetite ; Aspirin ; Chickenpox ; Child ; Humans ; Hyperammonemia ; Immunoglobulins ; Infant ; Influenza, Human ; Jaundice ; Lethargy ; Liver Diseases ; Mucocutaneous Lymph Node Syndrome ; Precipitating Factors ; Reye Syndrome ; Salicylates ; Vomiting

The pseudolymphoma syndrome that may mimic malignant lymphoma clinically and histopathologically has been described as a hypersensitivity reaction to anticonvulsant drugs. It consists of the triad of a fever, generalized rash and lyrnphadenopathy. In some cases, varying degrees of malaise, hepatosplenornegaly, abnormal liver function tests, arthralgias, eosinophilia and blood dyscriasias may also be present. We report a case of pseudolymphoma syndrome due to carbamazepine in a 47-year-old man. He had a diffuse edematous and erythematous patches, papules and vesicles associated with high fever, hepatosplenomegaly and lymphadenopathy. The histopathologic finding slowed a dense atypical mononuclear cell infiltrate of the upper dermis associated with Pautriers microabscess like structures and severe dermal edema. Laboratory findings revealed leukocytosis and an abnormal liver function test. Three weeks after the withdrawal of carbamazepine and treatment with oral prednisolone, his skin lesion and general condition markedly improved.
Anticonvulsants ; Arthralgia ; Carbamazepine* ; Dermis ; Edema ; Eosinophilia ; Exanthema ; Fever ; Humans ; Hypersensitivity ; Leukocytosis ; Liver Function Tests ; Lymphatic Diseases ; Lymphoma ; Middle Aged ; Prednisolone ; Pseudolymphoma* ; Skin

OBJECTIVE: A multi-center, open-labeled, prospective, observational study was conducted to evaluate the efficacy of fluoxetine on energy level over 8 weeks in a group of Korean patients with major depressive disorder. METHODS: Of 635 (Ed- to avoid having to say "Six hundred..") patients with major depressive disorder in 24 centers who were recruited to 8 weeks treatment with fluoxetine, 136 were terminated at initial session, leaving 499 patients to be included in the final analysis. They were predominantly female (59.5%), with a mean age of 45.7+/-15.9 years. At three visits to the clinic (weeks 0, 4 and 8), a record was made of Retardation Factor score of Hamilton Rating Scale for Depression (HD-RF), Lack of Energy score of Symptom Check List-90R (SCL-E), Energy score (QOL-E) and Fatigue score (QOL-F) of Quality of Life, and Visual Analogue Scale for Energy Level (VAS-E). RESULTS: The average dose of fluoxetine was 18.5+/-6.8mg/day for the first 4 weeks and 25.3+/-10.6 mg/day for the second 4 weeks. Of the patients, 85.4% in the first 4-week period and 86.8% in the second 4-week period took more than 85% of the prescribed medication. At least one of the concomitant anxiolytic drugs with fluoxetine was prescribed to 79.8% of the patients (alprazolam 47.9%, lorazepam 21.4%). The energy symptoms were significantly improved by fluoxetine over time, according to the analysis controlling the improvement effect of global depressive symptoms using repeated measures ANCOVA with the change of total HAM-D score as a covariate. Even comparing with the patients who took concomitant anti-anxiety medication, those who did not take concomitant anti-anxiety medication showed greater improvement of energy symptoms irrespective of the severity of baseline anxiety symptoms. CONCLUSION: These findings demonstrate that fluoxetine is effective in restoring the energy of patients with major depressive disorder. They also suggest that physicians should be careful in prescribing sedating antidepressants or concomitant anti-anxiety medication with fluoxetine for patients with major depressive disorder.
Antidepressive Agents ; Anxiety ; Depression ; Depressive Disorder, Major* ; Fatigue ; Female ; Fluoxetine* ; Humans ; Lorazepam ; Observational Study* ; Prospective Studies ; Quality of Life