BLISTER-SPREAD INDUCED BY FINGER-PRESSURE, A DIAGNOSTIC SIGN
|
|
- Marian Carter
- 5 years ago
- Views:
Transcription
1 BLSTER-SPREAD NDUCED BY FNGER-PRESSURE, A DAGNOSTC SGN N PEMPHGUS* A dignostic nd pthognomonic feture of pemphigus vulgris (cutus) is the reduction or loss of cohesion between the epiderml cells. This phenomenon, clled cntholysis, is ccompnied by intercellulr edem nd dmge to the intercellulr bridges. n contrst, the microscopic picture of bullous pemphigoid or pemphigus vulgris chronicus (1, 2) is chrcterized by clefts or bulle between the bsl epiderml lyer nd the corium. Both the reduced cohesion between bsl nd prickle cells nd the loss of foothold of the bsl cells in the connective tissue constitute the pthologicl bsis of the Nikoisky phenomenon. This clinicl test is vluble sign to llow differentition of pemphigus from other bullous skin diseses. t is not, however, specific for the pemphigus group of diseses, nd, in pemphigus vulgris, the sign my be present only in certin stges or res, or be lcking completely, even in infiltrted nd erythemtous res where intrepiderml blisters re observed microscopiclly. f histopthologic dignosis is to be mde, fresh bull should be excised nd the tissue fixed in tolo. n older bulle, epithelil regenertion my hve tken plce covering the floor of the bull, thus disturbing the dignosis (2). The phenomenon described below offers higher dignostic vlue to the histopthologist, s well s, s it seems, n lmost pthognomonic feture t disposl for the clinicin in his efforts to distinguish pemphigus from other severe bullous dermtoses. MATERAL The bullous skin diseses observed were the following: Pemphigus vulgris (cutus) (6); pemphigus foliceus (3); pemphigus vegetns (2); bullous pemphigoid (pemphigus vulgris chronicus) (6); benign mucous membrne pemphigoid (2); fmilil benign chronic pemphigus (Hiley nd GUSTAV ASBOE-HANSEN, M.D. * From the Deprtment of Dermtology nd Venereology, University Hospitl (Rigshospitlet), Copenhgen, Denmrk. Received for publiction My 12, Hiley) (2); dermtitis herpetiformis (11); epidermolysis bullos hereditri (3); urticri bullos (1); urticri pigmentos bullos (2); bullous erythem multiforme (8); bullous drug eruption (2); bullous contct dermtitis (6); bullous epidermophytid (3); bullous lichen plnus (2); impetigo (4); pemphigus neontorum (3); erysipels (1); herpes simplex (8); Kposi's vricelliform eruption (2); herpes zoster (5); vricelle (2); bullous kertogenous nd pigmentry dermtitis (2); trumtic bull (7); embolic hemorrhgic bull (1); hemorrhgic bull in uremi (1); rtificil congeltion (C02) (4); mustrd gs corrosion (1); burn (6). TECJNCS AND RESULTS 1. Clinicl Dignosis A bull is pressed by finger pulp from bove verticlly down. By slight to moderte pressure, pemphigus bull cn be brought to spred in one or more directions depending on the min direction of the pressure (Figs. 1, 2). Thus, it is possible to expnd the blister severl centimeters, the only limit being the mount of fluid. The phenomenon my be produced in res where no Nikoisky sign cn be produced, nd where, to the nked eye, the surfce revels no disese. The phenomenon reflects reduced cohesion between the epiderml cells or between the bsl epiderml cells nd the derml connective tissue. The sign hs been found positive in pemphigus vulgris (eutus), pemphigus foliceus, pemphigus vegetns nd bullous pemphigoid (pemphigus vulgris chronicus). n one cse of embolic gngrene in foot nd one of bullous drug eruption, spred of bulle could be produced by exertion of strong pressure. n dermtitis herpetiformis, benign mucous membrne pemphigoid, epidermolysis bullos, erythem multiforme, nd ll other mentioned bullous diseses the blebs could not be moved before bursting. Two cses of fmilil benign chronic pemphigus (Hiley nd Hiley) did not present bulle of size nd chrcter tht could be used for these studies.
2 6 THE JOURNAL OP NYTGSTVE DZRM&TOLOGT 'Pt S. Pm. 1. Right hnd of ptient with bullous peniipbigid (pemphigus nigeri ehronieue). 1 nd 2 indicte spontneous nd untouched bulle. J! 2 9 'PC. w Pm. t Seine res s Pig. 1. The "blister.spred" ph.nonwmon is shown to the right, where blister 1 is being trnsported. Bllster2hs been spred; the dotted line indicting the expns1m. Note the wrin- Medsurfce of the spred blister in comprison to the tense bulls 2 of Fig. 1.
3 BLSTER SPREADNG N PEMPHGTJS 7 2. Histoplhologic Dignosis described bove, nd to remove the specimen nsted of choosing fresh bull for totl for biopsy from the new, dvnced border. excision, it is preferble to move spontneous t cn now be seen which lyer is the site of bull, young or old, into the surroundings s most pronounced brekdown of the resistnce F FG. 3. Microphotogrph of the new, dvnced edge of n rtificlly spred pemphigus vulgris blister produced by finger pressure. Note the shrp intrepiderml edge to tbe right, nd the single lyer of bsl epiderml cells covering the bottom. >< indictes cntholytic cells. Mgn. X600. Stining: Hemtoxylin-eosin. A. S 4 Si.'. 'p t. S. 0 c,. pp p ' 'A 4.%_.'pp t' Fin. 4. Microphotogrph of n rtificilly spred pcmphigus vulgris (cutus) blister. Note the extensive lysis of epiderml cells. X cntholytic cell cluster. Mgn. X350. Stining: Hemtoxylincosin.
4 8 THE JOURNAL OF NVESTGATVE DERMATOLOGY ginst spred, i.e. is the site of the most dvnced physicl nd/or chemicl dmge to intercellulr bridges or to the derml-epiderrnl junction. n pemphigus vulgris (cutus) the displcement of the fluid tkes plce in the suprbsl re, usully leving single lyer of epiderml cells ttched to the corium. The new-formed ngle _. C 'i r" 4l 'it 'i_s p 4 FG. 5. Microphotogrph of n rtificilly spred bullous pemphigoid (chronic pemphigus vulgris) blister. Note the lysis in the derml-epiderml junction. To the left the dvnced edge is rounded. No cntholytic cells. Mgn. X350. Stining: Hemtoxylin-eosin. SW-' 0 2. '% '._c.. t':. :.i:'.4. 1, FG. 6. Microphotogrph of n rtificilly produced derml-epidcrml lysis in bullous pemphigoid. The most dvnced border is to the left. No cntholytic cells. Mgn. X160. Stining: llcmtoxylineosin.
5 BLSTER SPREADNG N PEMPHGUS 9 into the surrounding epidermis is shrp, nd the bull extends into cleft-like edge zone. There is detchment (cntholysis) of single cells or clusters of cells of the epidermis nd the hir follicles (Fig. 3). The intercellulr lysis nd fluid invsion long verticl or horizontl clefts (Fig. 4) re constnt findings, s in spontneous bullc, nd the totl picture is replic of pemphigus vulgris blister, except for the bsence of nucler chnges in the cntholytic cells. Like in pemphigus vulgris, blisters of pemphigus vegetns my be moved intrepidcrmlly in the suprbsl re. n pemphigus follceus blisters rc esily moved. The trnsport tkes plce in the upper Mlpighin lyer or in the re immeditely below the strtum corneum. n bullous pemphi gold (pemphigus eulgris chronicus) the bull my be trnsported by slight pressure between the epidermis nd the corium (Fig. 5). n some cses, intrcpiderml displcement hs occsionlly been noted; but in such cses the dvnced border is rounded like in the pressure bull (2), nd true cntholysis hs not been observed. t is possible to rtificilly detch the epidermis from the connective tissue in wide res, depending on the mount of blister fluid (Fig. 6). DscussoN n this reltively smll mteril, it ppers tht the blister spred, lthough not bsolutely specific, is chrcteristic phenomenon belonging to the pemphigus group of diseses. n the present study the term dermtitis herpetiformis hs been scribed to cses comptible with the description of Brocq's "dermtite polymorphe doulourcuse." Cses without herpetiform grouping, polymorphism, itching or pins, exhibiting low blood lbumin levels, nd lrge subepiderml blisters hve been designted bullous pemphigoid nd considered synonymous with pemphigus vulgris chronicus. Like cute pemphigus vulgris, this disese is chrcterized by positive Nikolsky nd "blister spred" signs; nd by these phenomen oriented to the pemphigus group. The microscopic studies of the morphologic bckground of the blister spred suggest tht either cntholysis or derml-epidcrml lysis occur in skin where the sign cn be produced. The phenomenon is of dignostic vlue to the histopthologist, reproducing the microscopic picture of spontneous fresh blister. Compred to spontneous bulle, the rtificilly expnded blister does not crry the risk of misinterprettion of the site of bull, becuse there cn be no secondry epithelil regenertion. SUMMARY A spreding of blisters cn be rtificilly induced by slight to moderte externl finger pressure in pemphigus vulgris (cutus), pemphigus foliceus, pemphigus vegetns nd bullous pcmphigoid (pcmphigus vulgris chronicus). The sign is chrcteristic, lthough possibly not bsolutely specific, of the pemphigus group of diseses. t reflects reduction or loss of intercellulr bridges between cpiderml cells or dermlcpidcrml lysis. n the new re of the expnded blister, the microscopic picture of spontneous fresh blister is reproduced. The blister spred sign is of dignostic vlue to the clinicin s well s to the histopthologist. REFERENCES 1. LEvER, W.: Pemphigus. Arch. dcrmt. syph., 64: 727, LEVER, W.: Femphigus. Medicine, 32: 1, 1953.
Original Research. Oral mucocutaneous lesions - Histopathological and immunofluorescence study Rameshkumar A et al
Received: 18 th Septemer 2014 Accepted: 20 th Decemer 2014 Conflicts of Interest: None Source of Support: Nil Originl Reserch Orl Mucocutneous Lesions A Comprtive Clinicopthologicl nd Immunofluorescence
More informationGeneral Microscopic Changes
Generl Microscopic Chnges 2 This chpter covers collection of microscopic chnges tht lck dignostic specificity ut occur in different specific diseses, s will ecome pprent in susequent chpters. Almost ll
More informationComparison of three simple methods for the
J. clin. Pth. (1967), 2, 5 Comprison of three simple methods for the ssessment of 'free' thyroid hormone T. M. D. GIMLETTE1 From the Rdio-Isotope Lbortory, St. Thoms's Hospitl, London SYNOPSIS A dilysis
More informationCheck your understanding 3
1 Wht is the difference etween pssive trnsport nd ctive trnsport? Pssive trnsport is the movement of prticles not requiring energy. Movement of prticles in ctive trnsport uses energy. 2 A gs tp in the
More informationTHE BONE MARROW AS A DIAGNOSTIC AID IN ACUTE DISSEMINATED LUPUS ERYTHEMATOSUS*
THE BONE MARROW AS A DIAGNOSTIC AID IN ACUTE DISSEMINATED LUPUS ERYTHEMATOSUS REPORT ON THE HARGRAVES' "L. E." CELL JOHN R. HASERICK, M.D., AND R. DOROTHY SUNDBERG, PH.D. In 1946 Hrgrves observed phgocytic
More information27 June Bmnly L. WALTER ET AL.: RESPONSE OF CERVICAL CANCERS TO IRRADIATION
27 June 1964 Bmnly MEDICAL JOURNAL L. WALTER ET AL.: RESPONSE OF CERVICAL CANCERS TO IRRADIATION x 1,638.) FIG. 2.-Foci of sme tumour s in Fig. 1 contining vible tumour cells with scnty cytoplsm, reltively
More informationSupplementary Online Content
Supplementry Online Content Zulmn DM, Pl Chee C, Ezeji-Okoye SC, et l. Effect of n intensive outptient progrm to ugment primry cre for high-need Veterns Affirs ptients: rndomized clinicl tril. JAMA Intern
More informationHEMOGLOBIN STANDARDS*
HEMOGLOBIN STANDARDS* RUSSELL L. HADEN Clevelnd Clinic, Clevelnd, Ohio Estimtions of hemoglobin often re unstisfctory to the lbortory worker nd the reports my be confusing to the clinicin. Unfortuntely,
More informationThe Dynamics of Varicella-Zoster Virus Epithelial Keratitis in Herpes Zoster Ophthalmicus
Chpter 2 The Dynmics of Vricell-Zoster Virus Epithelil Kertitis in Herpes Zoster Ophthlmicus The morphology of n individul VZV lesion reflects sequence of events triggered y the virus impct on cornel epithelil
More informationRecall Bias in Childhood Atopic Diseases Among Adults in The Odense Adolescence Cohort Study
Syddnsk Universitet Recll Bis in Childhood Atopic Diseses Among Adults in The Odense Adolescence Cohort Study Mørtz, Chrlotte G; Andersen, Klus Ejner; Bindslev-Jensen, Crsten Published in: Act Dermto-Venereologic
More informationChapter 02 Crime-Scene Investigation and Evidence Collection
Nme: Clss: Dte: Chpter 02 Crime-Scene Investigtion nd Evidence Collection 1. The terms grid, liner, qudrnt, zone, nd spirl re typiclly used to descrie dtum points... Flse Flse 2. An evidence log nd chin
More informationOriginal Contribution
Direct Immunofluorescence Test of Skin Biopsy Samples Results of 204 Cases Kabir AN, 1 Das RK, 2 Kamal M 3 Direct immunofluorescence (DIF) test of skin and renal biopsy specimens is being done on regular
More informationHistopathology and quantitative bone changes
Archives of Disese in Childhood, 198, 55, 945-949 Neontl rickets Histopthology nd quntittive bone chnges S J OPPENHEMER AND G J A SNODGRASS Deprtment of Morbid Antomy, London Hospitl Medicl College, nd
More informationdistraction cleaning Peaks cages specifications
Peks cges specifictions We thnk for choosing Qulgenix Peks lumbr cges. 0Pwith α 8 00D8S Mteril 9 0D9S 9 be po Peks 0 - -8 0 0D0S resection with introduce remer 0DM remer 007RM Acute or chronic 0DM remer
More informationEffect of environmental stress on biochemical and physiological features in cultured fish
Effect of environmentl stress on biochemicl nd physiologicl fetures in cultured fish Toshiki Nkno, Toshiysu Ymguchi, nd Yoshihiro Ochii Grd. Sch. Agric. Sci., Tohoku Univ., Sendi, Jpn Fmous Smuri Mr. Msmune
More informationBENIGN ulceration along the greater curvature of the pars media of the
BENIGN ULCERS OF THE GREATER CURVATURE OF THE STOMACH Report of Two Cses CHARLES H. BROWN, M.D. Deprtment of Gstroenterology nd ANTHONY D. INTRIERE, M.D.* BENIGN ulcertion long the greter curvture of the
More informationCLINICAL REPORT. Acta Derm Venereol 2015; 95: Line KIBSGAARD 1, Bjørn BAY 2, Mette DELEURAN 1 and Christian VESTERGAARD 1 1
Act Derm Venereol 2015; 95: 307 311 CLINICAL REPORT A Retrospective Consecutive Cse-series Study on the Effect of Systemic Tretment, Length of Admission Time, nd Co-morbidities in 98 Bullous Pemphigoid
More informationHistometry of thyroids containing few and multiple
J Clin Pthol 1986;39:483-488 Histometry of thyroids contining few nd multiple nodules M AL-MOUSSA, J SWANSON BECK From the Deprtment ofpthology, The University ofdundee, Ninewells Hospitl nd Medicl School,
More informationCase 18 A 63-year-old woman from Pathumthani. Chief complaint: Abnormal skin color on extremities for 20 years.
Cse 18 A 63-yer-old womn from Pthumthni. Chief complint: Abnorml skin color extremities for 20 yers. F les Phs. res Sk top sm fee Hi leg Present illness: The ptient first noticed drkening of her skin the
More informationComparative effectiveness of the tumour diagnostics,
Gut, 1987, 28, 323-329 Comprtive effectiveness of the tumour dignostics, C 19-9, C 125 nd crcinoembryonic ntigen in ptients with diseses of the digestive system K SKMOTO, Y HG, R YOSHIMR, H GMI, Y YOKOYM,
More informationLATE RESULTS OF TRANSFER OF THE TIBIAL TUBERCLE FOR RECURRENT DISLOCATION OF THE PATELLA1
LATE RESULTS OF TRANSFER OF THE TIBIAL TUBERCLE FOR RECURRENT DISLOCATION OF THE PATELLA1 W. G. J. HAMPSON nd P. HILL, BRISTOL, ENGLAND The uthors wished to determine the lte results of the Huser opertion,
More informationTHE EXPERIMENTAL USE OF LIPOCAIC IN THE TREATMENT OF PSORIASIS A PRELIMINARY REPORT1,2
THE EXPERIMENTAL USE OF LIPOCAIC IN THE TREATMENT OF PSORIASIS A PRELIMINARY REPORT1,2 C. DUNCAN STEWART, M.D., D. E. CLARK, M.S., M.D., L. R. DRAGSTEDT, PH.D., M.D. AND S. WILLIAM BECKER, M.S., M.D. (Received
More informationA process whereby two sex cells (gametes), egg and sperm, fuse together to form an entirely new. organism. the number of chromosomes.
UNIT15: REPR()DUCTION IN PTANTS Lerning Objectives: g Define sexul reprocluction nd sexul reproduction g ldentify, drw nd stte the sepls, petls, srmens nd crpels ofn insect-pollinted, dicotyledonous fiower
More informationDural Repair DURAL REPAIR. Solutions
Durl Repir DURAL REPAIR Solutions Science Technology Innotion Proen Performnce Six Pltform Technologies At Collgen Mtrix we re pssionte bout dncing the science of tissue repir nd We he deeloped six proprietry
More informationPreliminary and Short Report
TEE JOURNAL OF INVESTIGATIVE DREMATOLOOT Copyright 1967 by The Willims & Wilkins Co. Vol. 48 No. 3 Printed in U.S.A. Preliminry nd Short Report PARTICLES IN THE CISTERNAE OF THE ENDOPLASMIC RETICULUM OF
More informationThe effects of diversion of intestinal contents on the progress of Crohn's disease of the large bowel
Gut, 1971, 12, 11-15 The effects of diversion of intestinl contents on the progress of Crohn's disese of the lrge owel J. H. BURMAN, H. THOMPSON, W. T. COOKE, AND J. ALEXANDER WILLIAMS From the Nutritionl
More informationStudy of early diagnosis of various vesiculobullous lesions of the skin using histopathology
Original article: Study of early of various vesiculobullous lesions of the skin using histopathology Dr Sachin Parhe* Department of Pathology, DVVPF s Medical College & Hospital, Ahmednagar -414111. Corresponding
More informationDifferentiation of malignant from normal and reactive mesothelial cells by the argyrophil technique for
Thorx 1988;43:366-370 Differentition of mlignnt from norml nd rective mesothelil cells by the rgyrophil technique for nucleolr orgniser region ssocited proteins JON G AYRES, JOHN G CROCKER, NCHOLAS Q SKLBECK
More informationScientific research on the biological value of olive oil
Scientific reserch on the biologicl vlue olive oil Cov F.G. Ally M. (ed.). L' économie de l' olivier Pr : CIHEAM Options Méditerrnéennes : Série Etudes; n. 1988-V 1988 pges 149-152 Article vilble on le
More informationPNEUMOVAX 23 is recommended by the CDC for all your appropriate adult patients at increased risk for pneumococcal disease 1,2 :
PNEUMOVAX 23 is recommended y the CDC for ll your pproprite dult ptients t incresed risk for pneumococcl disese 1,2 : Adults ged
More informationSARCOIDOSIS, AND CARCINOMA' By FLORENCE B. SEIBERT, MABEL V. SEIBERT, A. JANE ATNO, AND
VARIATION IN PROTEIN AND POLYSACCHARIDE CONTENT OF SERA IN THE CHRONIC DISEASES, TUBERCULOSIS, SARCOIDOSIS, AND CARCINOMA' By FLORENCE B SEIBERT, MABEL V SEIBERT, A JANE ATNO, AND HAROLD W CAMPBELL (From
More informationGENITAL INFECTION IN ASSOCIATION WITH TRIC VIRUS
Brit. J. vener. Dis. (1964), 40, 25. GENITAL INFECTION IN ASSOCIATION WITH TRIC VIRUS INFECTION OF THE EYE II. CYTOLOGY.* PRELIMINARY REPORT BY M. KHALAF AL-HUSSAINI AND BARRIE R. JONES The Institute of
More informationC reactive protein: an aid to assessment and
C rective protein: n id to ssessment nd monitoring of cute pncretitis J Clin Pthol 1984;37:27-211 AD MAYR,* MJ McMAHON,* MARGART BOWN,t H COOPRt From the *University Deprtment ofsurgery, Generl Infrmry,
More informationb) SKILLS The student should be able to
1. GOAL The aim of teaching the undergraduate student in Dermatology, S.T.D. and Leprology is to impart such knowledge and skills that may enable him to diagnose and treat common ailments and to refer
More informationof the intercostal muscles and a suggested nomenclature for the
15 J. Phy8iol. (1964), 172, pp. 15-161 With 2 pltes nd 4 text-figures Printed in Gret Britin THE FIBRE CALIBRE SPECTRA OF SENSORY AND MOTOR FIBRES IN THE INTERCOSTAL NERVES OF THE CAT By T. A. SEARS* From
More informationIdentical twins with borderline lepromatous leprosy mimicking extensive alopecia areata: A rare presentation
Lepr Rev (2018) 89, 301 305 CASE REPORT Identicl twins with orderline lepromtous leprosy mimicking extensive lopeci ret: A rre presenttion RUBINA JASSI*, KRISHNA DEB BURMAN**, BHAVYA SWARNKAR** & RADHIKA
More informationAnalysis of Regulatory of Interrelated Activity of Hepatocyte and Hepatitis B Viruses
Interntionl Journl of Biomedicl Mterils Reserch 8 6(): -7 http://www.sciencepublishinggroup.com/j/ijbmr doi:.648/j.ijbmr.86. ISSN: 33-756 (Print) ISSN: 33-7579 (Online) Anlysis of Regultory of Interrelted
More informationPrognostic significance of pretreatment serum levels of albumin, LDH and total bilirubin in patients with nonmetastatic
Crcinogenesis, 2015, Vol. 36, No. 2, 243 248 doi:10.1093/crcin/bgu247 Advnce Access publiction December 18, 2014 Originl Mnuscript originl mnuscript Prognostic significnce of pretretment serum levels of
More informationInfrared Image Edge Detection based on Morphology- Canny Fusion Algorithm
, pp.42-46 http://dx.doi.org/10.14257/stl.2016.137.08 Infrred Imge Edge Detection bsed on Morphology- Cnny Fusion Algorithm Tng Qingju 1, Bu Chiwu 2, Liu Yunlin 1, Zng Jinsuo 1, Li Dyong 1 1 School of
More informationTHE NEW ARMENIAN MEDICAL JOURNAL
THE NEW ARMENIAN MEDICAL JOURNAL Vol.9 (2015), Nо 1 p. 83-89 THE USE OF LUMINESCENCE MICROSCOPY FOR DIAGNOSIS OF SUDDEN CARDIAC DEATH DUE TO ISCHEMIC HEART DISEASE IN THE FORENSIC PRACTICE Khchtryn P.S.
More informationSTUDY. Confocal Laser Scanning Microscopy vs 3-Dimensional Histologic Imaging in Basal Cell Carcinoma
STUDY Confocl Lser Scnning Microscopy vs 3-Dimensionl Histologic Imging in Bsl Cell Crcinom Srh Ziefle; Deorh Schüle; Helmut Breuninger, MD; Wilfried Schippert, MD; Mtthis Moehrle, MD Ojective: To compre
More informationACTAS Dermo-Sifiliográficas
ISSN: 0001-7310 Pulicción Oficil de l Acdemi Espñol de Dermtologí y Venereologí Documento descrgdo de http://www.ctsdermo.org el 04/04/2017. Copi pr uso personl, se prohíe l trnsmisión de este documento
More informationOriginal Article Prognostic and clinicopathologic significance of AEG-1/MTDH and E-cadherin expression in human gallbladder carcinoma
Int J Clin Exp Pthol 2018;11(12):6025-6031 www.ijcep.com /ISSN:1936-2625/IJCEP0086349 Originl Article Prognostic nd clinicopthologic significnce of AEG-1/MTDH nd E-cdherin expression in humn gllbldder
More informationCUTIS. Dermoscopy was developed as an adjunctive. Do Not Copy
A Pilot Tril of Dermoscopy s Rpid Assessment Tool in Peditric Dermtoses Nnette B. Silverberg, MD Dermoscopy is noninvsive technique to ssess skin rchitecture. A pilot study ws conducted using polrized
More informationLung cancer is the leading cause of cancer death worldwide, EGFR Mutation and Brain Metastasis in Pulmonary Adenocarcinomas
Originl Article EGFR Muttion nd Brin Metstsis in Pulmonry Adenocrcinoms Dong-Yeop Shin, MD,* Im Il N, MD,* Cheol Hyeon Kim, MD, PhD, Sunhoo Prk, MD, PhD, HeeJong Bek, MD, PhD, nd Sung Hyun Yng, MD, PhD*
More informationSummary. Effect evaluation of the Rehabilitation of Drug-Addicted Offenders Act (SOV)
Summry Effect evlution of the Rehbilittion of Drug-Addicted Offenders Act (SOV) The Rehbilittion of Drug-Addicted Offenders Act (SOV) ws lunched on April first 2001. This lw permitted the compulsory plcement
More informationClassification: 1. Infective: 2. Traumatic: 3. Idiopathic: Recurrent Aphthous Stomatitis (RAS) 4. Associated with systemic disease:
Classification: 1. Infective: 2. Traumatic: 3. Idiopathic: Recurrent Aphthous Stomatitis (RAS) 4. Associated with systemic disease: Hematological GIT Behcet s HIV 5. Associated with dermatological diseases:
More informationPathological Evidence of the Cause of Spontaneous Regression in a Case of Resected Hepatocellular Carcinoma
CSE REPORT Pthologicl Evidence of the Cuse of Spontneous Regression in Cse of Resected Heptocellulr Crcinom Shunichi Mtsuok 1, kinori Tmur 1, Mitsuhiko Moriym 1, Hirotoshi Fujikw 2, Kenji Mimtsu 3, Tktsugu
More informationABNORMAL CYTOLOGY OF EPITHELIAL CELLS IN PEMPHIGTJS VTJLGARIS: A DIAGNOSTIC AID*
ABNORMAL CYTOLOGY OF EPTHELAL CELL N PEMPHGTJ VTJLGAR: A DAGNOTC AD* HARVEY BLANK, M.D. AND CARROLL F. BURGOON, M.D. There has been a pressing need for a reliable diagnostic test for pemphigus vulgaris.
More informationThe potential future of targeted radionuclide therapy: implications for occupational exposure? P. Covens
The potentil future of trgeted rdionuclide therpy: implictions for occuptionl exposure? Introduction: Trgeted Rdionuclide Therpy (TRT) Systemic tretment Molecule lbelled with rdionuclide delivers toxic
More informationWORKSHOP FOR SYRIA. A SHORT TERM PROJECT A Collaborative Map proposal Al Moadamyeh, Syria
Al Modmyeh is city locted south-west Dmscus, in Syri. It is fcing post-conflict sitution, fter yers of siege nd displcement of its inhbitnts. Now, the popultion is coming bck, s lso new incomers. Therefore,
More informationthyroidectomy for primary thyrotoxicosis
J clin Pth, 1975, 28, 94-98 The predictive vlue of histometry of thyroid tissue in nticipting hypothyroidism fter subtotl thyroidectomy for primry thyrotoxicosis R J YOUNG, J SWNSON BECK', ND W MICHIE
More informationArthroscopic Anatomy of Shoulder
Arthroscopic Antomy of Shoulder Murt Bozkurt, Mehmet Emin Simsek, nd Hlil İrhim Açr 2 2.1 Introduction In the lst 30 yers, shoulder rthroscopy hs ecome of greter importnce in the dignosis nd tretment of
More informationLESIONS OF THE ORAL CAVITY ORAL CAVITY. Oral Cavity Subsites 4/10/2013 LIPS TEETH GINGIVA ORAL MUCOUS MEMBRANES PALATE TONGUE ORAL LYMPHOID TISSUES
LESIONS OF THE ORAL CAVITY David I. Kutler, MD, FACS Associate Professor Division of Head and Neck Surgery Department of Otolaryngology HNS Weill Cornell Medical Center ORAL CAVITY LIPS TEETH GINGIVA ORAL
More informationSuccessful Diagnosis of a Thymoma by Endobronchial Ultrasound-guided Transbronchial Needle Aspiration: A Report of Two Cases
CASE REPORT Successful Dignosis of Thymom y Endoronchil Ultrsound-guided Trnsronchil Needle Aspirtion: A Report of Two Cses Ysushi Yoshid 1, Msto Singyoji 1, Hironori Ashinum 1, Meiji Itkur 1, Toshihiko
More informationCitation for published version (APA): Krajenbrink, T. G. A. (1994). The silhouette of the mandibular condyle on radiographs. s.n.
University of Groningen The silhouette of the mndibulr condyle on rdiogrphs. Krjenbrink, Thierry Guy Alexis IMPORTANT NOTE: You re dvised to consult the publisher's version (publisher's PDF) if you wish
More informationHospital. 50%1. of the body surface, that is, such patients in. area of full-thickness skin-loss are percentages of the
J. clin. Pth. (1957), 1, 1. From the THE CLINICAL CONTROL OF RED CELL LOSS IN BURNS BY Medicl ELIZABETH TOPLEY AN D D. MAcG. JACKSON Reserch Council industril Injuries nd Burns Reserch Unit, Birminghm
More informationAmbiguity in the Dural Tail Sign on MRI
SNI: Unique Cse Oservtions OPEN ACCESS For entire Editoril Bord visit : http://www.surgiclneurologyint.com Editor: Ather Enm, M.D., Ag Khn University, Krchi, Sindh, Pkistn Cse Report Amiguity in the Durl
More informationSummary of Package Insert 1
Summry of Pckge Insert 1 For Sttes with Non-Published Policies Indictions Non-infected prtil nd full-thickness skin ulcers due to VSU 2 of greter thn 1 month durtion nd which hve not dequtely responded
More informationET 100 EXTERIOR FRONT DOOR BLACK OUT TAPE INSTALLATION
100 EXTERIOR FRONT DOOR BLCK OUT TPE INSTLLTION The procedure descried elow is for the LH side. Use the sme procedure for oth the RH nd LH sides, unless otherwise specified. 1. INSTLL NO. 2 BLCK OUT TPE
More informationAdnexal Tumors of Skin: An Experience at a Tertiary Care Center at Delhi
[Downloded free from http://www.mhsr.org] Originl Article Adnexl Tumors of Skin: An Experience t Tertiry Cre Center t Delhi Pujni M, Mdn GB 1, Jirjpuri ZS 2, Jetley S 2, Hssn MJ 2, Khn S 2 Deprtment of
More informationEstimating the impact of the 2009 influenza A(H1N1) pandemic on mortality in the elderly in Navarre, Spain
Rpid communictions Estimting the impct of the influenz pndemic on mortlity in the elderly in Nvrre, Spin J Cstill (jcstilc@nvrr.es) 1, J Etxeberri 1, E Ardnz 1, Y Floristán 1, R López Escudero 1, M Guevr
More informationDESCRIPTIONS FOR MED 3 ROTATIONS Dermatology A3S
Regardless of your future field of practice, you will be exposed to a considerable amount of dermatology and this rotation provides you the chance to see a range of skin diseases. You will have the opportunity
More informationEvaluation of New Urinary Tract Infection Screening Devices
APPLIED MICROBIOLOGY, Aug. 1973, p. 196-201 Copyright 0 1973 Americn Society for Microbiology Vol. 26, No. 2 Printed in U.S.A. Evlution of New Urinry Trct Infection Screening Devices WILLIAM A. CRAIG,
More informationOriginal Article. T Akter 1, N Islam 2, MA Hoque 3, S Khanam 4, HA khan 5, BK Saha 6. Abstract:
Fridpur Med. Coll. J. 214;9(2):61-67 Originl Article Nebuliztion by Isotonic Mgnesium Sulphte Solution with Provide Erly nd Better Response s Compred to Conventionl Approch ( Plus Norml Sline) in Acute
More informationNail Disorders in Children
Review Article Received: Novemer 13, 2017 Accepted: Decemer 5, 2017 Pulished online: Jnury 23, 2018 Nil Disorders in Children Michel Strce Auror Alessndrini Binc Mri Pirccini Dermtology, Deprtment of Experimentl,
More informationValidation of Self-testing as a Method to Estimate the Prevalence of Nickel Allergy
Vlidtion of Self-testing s Method to Estimte the Prevlence of Nickel Allergy Josefson, Ann; Svensson, Ake; Frm, Gunill; Engfeldt, Mlin; Meding, Birgitt Published in: Act Dermto-Venereologic DOI: 10.2340/00015555-1125
More informationSEIZURES AND EPILEPSY
SEIZURES AND EPILEPSY CONTENT CREATED BY Lern more t www.helth.hrvrd.edu TALK WITH YOUR DOCTOR Tble of Contents WHAT IS A SEIZURE? 4 WHAT IS EPILEPSY? 6 TESTING 7 TREATMENT OPTIONS 9 ANTI-SEIZURE MEDICATION
More informationXII. HIV/AIDS. Knowledge about HIV Transmission and Misconceptions about HIV
XII. HIV/AIDS Knowledge bout HIV Trnsmission nd Misconceptions bout HIV One of the most importnt prerequisites for reducing the rte of HIV infection is ccurte knowledge of how HIV is trnsmitted nd strtegies
More informationchapter 3. Squamous intraepithelial lesions: cytology histology correlation
chpter 3. Squmous intrepithelil lesions: cytology histology correltion CHAPTER 1 This chpter discusses the nturl history of cervicl precncer, HPV nd oncogenesis, cytology nomenclture, nd the cytologicl
More informationAnus,Rectum and Colon
JOURNAL OF THE Anus,Rectum nd Colon http://journl-rc.jp CASE REPORT Anl Cnl Dupliction Associted with Prescrl Cyst in n Adult Tkyuki Toyong 1), Hiromitsu Mtsud 1), Ryuichi Miu 1), Yohei Toming 1), Keiji
More informationColonoscopic decompression of childhood sigmoid and cecal volvulus
CASE REPORT Colonoscopic decompression of childhood sigmoid nd cecl volvulus Irj Shhrmin 1, Ali Bzi 1,2, Dnil Edti 3, Krim Rostmi 3, Mojt Delrmns 1,2 1 Peditric Digestive nd Heptic Reserch Center, Zol
More informationLipase and Pancreatic Amylase Activities in Tissues and in Patients with Hyperamylasemia
CLINICAL CHEMISTRY Originl Article Lipse nd Pncretic Amylse Activities in Tissues nd in Ptients with Hypermylsemi FRED APPLE, PH.D, PETER BENSON, M.D., LYNNE PREESE, MT, M.B.A., STEVEN EASTEP, M.D., LAURA
More informationClinical manifestations in patients with alpha-fetoprotein producing gastric cancer
Curr Oncol, Vol. 21, pp. e394-399; doi: http://dx.doi.org/10.3747/co.21.1768 CLINICAL MANIFESTATIONS IN AFP PRODUCING GASTRIC CANCER ORIGINAL ARTICLE Clinicl mnifesttions in ptients with lph-fetoprotein
More informationBiochemical Laboratory Tests in Viral Hepatitis
Bull. Org. mond. Snte' 1965 32 59-72 Bull. Wid Hith Org. 19532597 Biochemicl Lbortory Tests in Virl Heptitis nd other Heptic Diseses Evlution nd Follow-Up * FERNANDO DE RITIS,1 GlUSEPPE GIUSTI,2 FELICE
More information(Received for publication February 17, 1944) Since, as has been demonstrated by Enders (3),
CHEMICAL, CLINICAL, AND IMMUNOLOGICAL STUDIES ON THE PRODUCTS OF HUMAN PLASMA FRACTIONATION. XII. THE USE OF CONCENTRATED NORMAL HUMAN SERUM GAMMA GLOBULIN (HUMAN IMMUNE SERUM GLOBULIN) IN THE PREVENTION
More informationEffect of fungicide timing and wheat varietal resistance on Mycosphaerella graminicola and its sterol 14 α-demethylation-inhibitorresistant
Effect of fungicide timing nd whet vrietl resistnce on Mycospherell grminicol nd its sterol 14 α-demethyltion-inhiitorresistnt genotypes Didierlurent L., Roisin-Fichter C., Snssené J., Selim S. Pltform
More informationBODY OF REPORT. SEAT0 Medic Study No. 4. Serologic Response to Tha.i Hemorrha.gic Fever Virus Infection. Project No.
BODY OF REPORT SEAT Medic Study No. 4 Project No. 3A 2561 A 811 Tsk 1: Serologic Response to Th.i Hemorrh.gic Fever Virus Infection Mi1it.q Medicl Reserch Prgr.m S. E. Asi. Mi1it.r~ Medic.1 Rese.rch Prgr.m
More informationJuvenile spondylodiscitis : the value of magnetic resonance imaging A report of two cases
Act Orthop. Belg., 2004, 70, 627-631 CASE REPORT Juvenile spondylodiscitis : the vlue of mgnetic resonnce imging A report of two cses Herbert PLASSCHAERT, Kristof DE GEETER, Guy FABRY From the Deprtment
More informationSUPPLEMENTARY INFORMATION
TM TM tip link horizontl top connectors 1 leucine-rich (21 %) otoncorin-like 1809 ntigenic peptides B D signl peptide hydrophoic segment proline/threonine-rich (79 %) Supplementry Figure 1. () The outer
More informationConcomitant Intraocular Retinoblastoma and Choroidal Hemangioma in a 1-Year-Old Boy
Cse Report doi: 10.5146/tjpth.2017.01411 Concomitnt Introculr Retinoblstom nd Choroidl Hemngiom in 1-Yer-Old oy Ycoub A. Yousef 1, Mys Al-Hussini 2, Freed H. rkt 2, Al Sleh 3, Mon Mohmmd 1, Rsh Deebjh
More informationChemico-physical changes occur in red cells during
THE RATE OF POST-TRANSFUSION LOSS OF NON-VIABLE STORED HUMAN ERYTHROCYTES AND THE RE-UTILI- ZATION OF HEMOGLOBIN-DERIVED RADIO- ACTIVE IRON1 BY JOHN G.GIBSON, 2ND, WENDELL C. PEACOCK, ROBLEY D. EVANS,
More informationORIGINAL ARTICLE ABSTRACT INTRODUCTION
ORIGINAL ARTICLE LOSS OF EPCAM STAINING CORRELATES WITH POOR OUTCOME IN CRC, Wng et l. Reduction in membrnous immunohistochemicl stining for the intrcellulr domin of epithelil cell dhesion molecule correltes
More informationby an estimation of maximal breathing capacity, vital were made on all subjects but one (G. W.), and showed
CEREBRAL CRCULATON AND METABOLSM N PULMONARY EMPHYSEMA AND FBROSS WTH OBSERVATONS ON THE EFFECTS OF MLD EXERCSE1 By P SCHENBERG, BLACKBURN, M SASLAW, M RCH, AND G BAUM (From the Deprtment of Physiology,
More informationA Rare Manifestation of Solitary Primary Bone Lymphoma of the Finger: a Case Report
pissn 2384-1095 eissn 2384-1109 imri 2018;22:240-244 A Rre Mnifesttion of Solitry Primry Bone Lymphom of the Finger: Cse Report Jeong A Yeom 2, You Seon Song 1 *, In Sook Lee 1, Kyung Un Choi 3, Jeung
More informationHit and False-Positive Rates for the Middle Latency Response in Patients with Central Nervous System Involvement
J Am Acd Audiol 1 : 124-132 (1999) Hit nd Flse-Positive Rtes for the Middle Ltency Response in Ptients with Centrl Nervous System Involvement Frnk Musiek* Lori Chrettet Tim Kelly* Wei Wei Lee* Erik Musiek~
More informationOutline. AMH as a diagnostic marker for cryptorchidism 2/4/2018. Use of. in diagnosing ovarian tumors and cryptorchidism. Anti-Müllerian hormone (AMH)
2/4/28 Universiteit Utrecht Outline Use of nti-müllerin hormone () in dignosing ovrin tumors nd cryptorchidism nti-müllerin hormone () Wht, origin, Mrker for equine cryptorchidism Mrker for equine grnulos
More informationphosphatase isoenzyme activity: estimation of
J Clin Pthol 1988;41:202-206 Quntittive method for determining serum lkline phosphtse isoenzyme ctivity: estimtion of intestinl component M J PEAKE, M PEJAKOVIC, G H WHITE From the Deprtment ofbiochemistry
More informationFirst-line and Maintenance Treatment with ALIMTA therapy for advanced nonsquamous non-small cell lung cancer (NSCLC)
YOUR LIFE. First-line nd Mintennce Tretment with ALIMTA therpy for dvnced nonsqumous non-smll cell lung cncer (NSCLC) ALIMTA is pproved by the FDA in combintion with cispltin (nother chemotherpy drug)
More informationPaper-based skin patch for the diagnostic screening of cystic fibrosis
Electronic Supplementry Mteril (ESI) for ChemComm. This journl is The Royl Society of Chemistry 2015 Supplementry informtion Pper-bsed skin ptch for the dignostic screening of cystic fibrosis Xun Mu,*
More informationA case of pulmonary adenocarcinoma showing rapid progression of peritoneal dissemination after immune checkpoint inhibitor therapy
Shinozki et l. BMC Cncer (2018) 18:620 https://doi.org/10.1186/s12885-018-4549-5 CASE REPORT A cse of pulmonry denocrcinom showing rpid progression of peritonel dissemintion fter immune checkpoint inhiitor
More informationA radiographic. Leroy Roberts, Jr., M.D.4. Gregory Gibbons, M.D.t
RdioGrphics Index terms: Adult esophgel cndidisis: Gstrointestinl rdiology umultive Index terms: ndldlsls Esophgitis Esophgus, rdiogrphy A rdiogrphic spectrum Leroy Roberts, Jr., M.D.4 Rebecc Gibbons,
More informationCorrelation between CT features and liver function and p53 expression in hepatitis, cirrhosis and hepatocellular carcinoma
ONCOLOGY LETTERS Correltion between CT fetures nd liver function nd p53 expression in heptitis, cirrhosis nd heptocellulr crcinom YAHUI HU, JING WU, SHA LI nd XIAOXIAO ZHAO Deprtment of Nucler Medicine,
More informationChilblains (pernio, perniosis) are cold-induced, painful or itching
Nifedipine vs Plcebo for Tretment of Chronic Chilblins: A Rndomized Controlled Tril Ibo H. Souwer, MD 1 Jcobus H. J. Bor, BSc (Mth) 2 Pul Smits, MD, PhD 3 Antoine L. M. Lgro-Jnssen, MD, PhD 1 1 Deprtment
More informationDERMATOLOGICAL EMERGENCIES. DR. Ian Hoyle MBBS DIP IMC RCS (Ed), DA (UK),FRACGP,FACRRM,DIP DERM(Wales) TASMANIAN SKIN AND BODY CENTRE
DERMATOLOGICAL EMERGENCIES DR. Ian Hoyle MBBS DIP IMC RCS (Ed), DA (UK),FRACGP,FACRRM,DIP DERM(Wales) TASMANIAN SKIN AND BODY CENTRE Dermatological Emergencies INFECTIONS ERYTHRODERMA DRUG ERUPTIONS STEVENS-JOHNSON
More informationالسكري للداء مرافقة فقاعات diabeticorum= Bullosis
1 / 6 Bullosis diabeticorum Bullous disease of diabetes (bullosis diabeticorum) is a distinct, spontaneous, noninflammatory, blistering condition of acral skin unique to patients with diabetes mellitus.
More informationCourse of Skin Symptoms and Quality of Life in Children Referred for Patch Testing A Long-term Follow-up Study
Act Derm Venereol 2015; 95: 206 210 CLINICAL REPORT Course of Skin Symptoms nd Qulity of Life in Children Referred for Ptch Testing A Long-term Follow-up Study Anne B. SIMONSEN 1, Mette SOMMERLUND 1, Mette
More informationHyperplastic dental follicle or peri-follicle fibrosis, is. Hyperplastic Dental Follicle Review of Literature and Report of Two Cases in One Family
Puliction Hyperplstic Dentl Follicle Review of Literture nd Report of Two Cses in One Fmily Chun Xio SUN 1, Crig RIRIE 1, Jeffrey M HENKIN 1 Hyperplstic dentl follicle is n extremely rre lesion. The prctitioner
More information2 nd Properties of the Exponential Functions
Dte:/26/25 2 nd Clss Objective: Appl the concept to eplore the properties of functions of the form = bˣ. Appl the concept to grph eponentil functions tht hve bse e Agend: Bell ringer (e: 3,32 pge 44) vocbulr
More information