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

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

No abstract available.

No abstract available.
Silver*

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

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

A case of invasive cribriform carcinoma of the breast is presented with fine need- le aspiration cytologic features. The aspiration was performed from a papable 2.0cm mass in the upper outer quadrant of the right breast in a 53 year-old woman. The aspirate showed cellular smear composed of larger three dimensional tight clusters, smaller monolayered loose clusters, and many individual cells on the clean background. In the clusters, the tumor cells were bordering central lumina, quite similar to the cribriform in histology. The tumor cells in the clusters and individual tumor cells had uniform, small and round nuclei. The chromatin was finely granular, and nuclear membrane was smooth. No discernible nucleoli were present (nuclear grade 1-2). Unless the abundance of individual cells and the cribriform growth pattern are recognized in the smear, the cytologic diagnosis of invasive cribriform carcinoma is difficult.
Female ; Humans ; Biopsy

BACKGROUND: The bcl-2 is a newly known oncogene involved in tumorigenisis by blocking apoptosis or programmed cell death. Overexpression of bcl-2 protein has been detected in a variety of human malignancies. However, recent studies of the expression of bcl-2 protein in human melanoma and melanocytic nevus have been controversial. OBJECTIVE: The purpose of this study was to examine whether there are any differences in the expression of bcl-2 protein between melanocytic nevus and rnalignant melanoma. METHODS: Immunohistochemical analysis of bcl-2 protein expression was performed on the formalin-fixed, paraffin-embedded tissue sections of 22 melanocytic nevus and 29 malignant melanomas (20 primary and 9 metastatic) using anti bcl-2 monoclonal antibody with an avidin-biotin peroxidase complex procedure. RESULTS: The results were as follows. 1. The positive rate for bcl-2 protein was observed in 95.4% (21/22) of melanocytic nevus and 95.0% (19/20) of primary malignant melanomas. Therefore, there was no significant difference between the two groups in the positive rate for bcl-2 prtoein. 2. The percentage of stained cells and the staining intensity of bcl-2 protein were significantly increased in melanocytic nevus compared to malignant melanoma (p<0.05). 3. The positive rate for bcl-2 expression of metastatic malignant melanoma [44.4% (4/9)] was significantly decreased compared to that of primary malignant melanoma [95.0%(19/20) ] (p<0. 05). But, there was no significant difference betweeen tumor thickness and histological type of malignant, melanoma in the expression of bcl-2 protein. 4. In melanocytic nevus, immunoreactivity of bcl-2 protein gradually diminished or even disappeared towards the deep dermis. CONCLUSION: the bcl-2 expression was decreased in malignant melanoma compared to melanocytic nevus. It. suggests that the loss of bcl-2 expression may play a significant role in the progression and metastasis of malignant melanoma.
Apoptosis ; Cell Death ; Dermis ; Humans ; Melanoma* ; Neoplasm Metastasis ; Nevus, Pigmented* ; Oncogenes ; Peroxidase