solated ACTH deficiency is a very uncommon cause of hypoadrenocorticism, with less than 200 cases reported in the literatures. The clinical presentation can be similar to that of primary adrenal insufficiency, but there is a greater tendency for hypoglycemia and absence of hyperpigmentation. The diagnosis is established by demonstrating hypocortisolism with undetectable serum levels of ACTH, normal adrenal responsiveness to prolonged ACTH infusion, and an absent ACTH response to insulin-induced hypoglycemia. Other endocrine function is normal.We experienced a case of isolated ACTH deficiency in 34 years old female who was admitted due to fever and drowsy mentality.So we present this case with a review of literatures.
Addison Disease ; Adrenocorticotropic Hormone ; Diagnosis ; Female ; Fever ; Humans ; Hyperpigmentation ; Hypoglycemia

Hypergammaglobulinemic purpura of Waldenstrom is a distinct syndrome consisting of recurrent episodes of purpura, elevated serum r-globulins, elevated erythrocyteed rnentation rate, and mild anemia. This disease has been divided into the prirnary type without an uncerlying disease, and the secondary type with a known underlying disease. We diagnosed a hypergammaglobulinemic purpura of Waldenstram in a 53-year-old woman who presented sudden onset of showers of purpuric macules and petechiae of 24 hours duration involving her lower extremities with a 10-rnonth history. She showed characteristic laboratory findings consistent with those of hypergammiglobulnemic purpura of Waldenstrorri and also showed positive results of antinuclear antibody and rheumatoid factor. We tried to find out if there we any associated underlying disases such as systemic lupus erythematosus or Sjogren synirorne through various tests but faile it find any. We concluded she showed a primary type of hypergarnmhglobulinemic purpura of Waldcnstrorn.
Anemia ; Antibodies, Antinuclear ; Erythrocytes ; Female ; Humans ; Lower Extremity ; Lupus Erythematosus, Systemic ; Middle Aged ; Purpura ; Purpura, Hyperglobulinemic* ; Rheumatoid Factor

Perifollicular fibromas are very undsual adnexal tumor of the skin. Clinically, they are small firm akin colored or pinkish papules and usually located on the face and neck. We report a case of perifollicular fibroma which occurred in a 30-year-old woman, who had asymptomatic multiple small skin colored papules on the right side of her face for about 20 years. On physical examination, the papules were ferm and non-tender. The biopsy specimen demonstrated concentric proliferation of fibrous tissue surrounding hair follicles ad the collagen fibers within concentric fibrous sheaths surrounding hair follicles stained green with Masson's trichrome stain, which were quite typical for perifollicular fibroma. Because we could not find any epithelial proliferation in the serial sections, fibrofolliculoma could be ruled out. The skin lesions were removed by electrodesiccation and followed up for 5 months without recurrence.
Adult ; Biopsy ; Collagen ; Female ; Fibroma* ; Hair Follicle ; Humans ; Neck ; Physical Examination ; Recurrence ; Skin

A 53-year-old man developed some erythematous follicular macules accompanied with tingling sensation on both shoulders. Histologic finding showed a dense lymphocytic infiltrate around the infundibular portion of the follicle, where separation of the dermoepidermal junction was seen. The insect, obtained from the skin lesion, was identified as a larva of an Ap- hid
Aphids ; Cryptococcosis* ; Humans ; Insect Bites and Stings ; Insects ; Larva ; Middle Aged ; Sensation ; Shoulder ; Skin

PURPOSE: The main factor limiting endovascular treatment of intracranial aneurysms is the shape of the a-neurysmal sac, especially the width of the neck. We describe an early experience and technical aspects of treating wide-necked cerebral aneurysm using a Guglielmi detachable coil (GDC) and simultaneous application of a temporary balloon. MATERIALS AND METHODS: Four cases of unruptured wide-necked cerebral aneurysm were treated with GDC, with simultaneous application of a temporary balloon. Patients were aged between 29 and 49 years. On admission, clinical presentation was subarachnoid hemorrhage (SAH) in all cases. Hunt and Hess grade was II in two cases, III in one case, and traumatic SAH in one case. In all patients angiography revealed an asymptomatic a-neurysm after rupture of another aneurysm or traumatic SAH. The aneurysms were occluded with GDC-10, and a Cirrus balloon occlusion system was used simultaneously. All procedures were performed under endo-tracheal general anesthesia and systemic heparinization. RESULTS: All cases were treated successfully, without parent artery compromise. The occlusion rate at the end of the procedure was total in three cases and subtotal in one. In one case a heparin-related hematoma occurred during post-procedural treatment and the patient eventually expired. One patient underwent follow-up angiography after 6 months, and the coil was not changed. CONCLUSION: An aneurysm may not be completely occluded, but with regard to coil compaction and parent artery preservation, the technique is an attractive alternative.
Anesthesia, General ; Aneurysm ; Angiography ; Arteries ; Balloon Occlusion ; Follow-Up Studies ; Hematoma ; Heparin ; Humans ; Intracranial Aneurysm* ; Neck ; Parents ; Rupture ; Subarachnoid Hemorrhage

No abstract available.

BACKGROUND: Evaluation of the cell proliferation activity of neoplasm is useful in making a diagnosis and prognosis. Immunohistochemical staining using MIB1 monoclonal antibodies has recently been demonstrated to assess tumor cell proliferation activity easily, because it can be performed on paraffin-embedded specimens and is available in a retrospective study. OBJECTIVE: The purpose of this study to investigate (a) the use of Ki-67 antibodies in distinguising between benign melanocytic nevus and malignant melanoma, and (b) the correlation between the Ki-67 labelling index(positive number per 100cells) and histological parameters such as the Breslow index, Clarks level, mitotic rate(mitoses per 100cells) in malignant melanoma. METHOD: A total of 37 formalin-fixed, paraffin-embedded melanocytic skin lesions(benign melanocytic nevus 21; malignant melanoma 16) were stained with MIB1 using the one hour method. The values of the Ki-67 labelling index were measured in all the lesions. For each case of malignant melanoma, the Breslow index, Clarks level and mitotic rate were quantitatively evaluated. RESULT: The Ki-67 labelling index averaged 2.6 +1.4 in benign melanocytic nevus and 22.4+ 6.2 in malignant melanoma. In malignant melanoma, the values of the Ki-67 labelling index were significantly correlated with Breslow index(r=0.764), Clark's level(r=0.885) and mitotic rate(r=0.754). CONCLUSION: Our findings suggest that Ki-67 may be a useful tool in distinguising between benign melanocytic nevus and malignant melanoma. According as Ki-67 labelling index correlates with well-established prognostic parameters(Breslow index, Clark's level, mitotic rate), it may therefore carry additional prognostic value for patients with malignant melanoma.
Antibodies ; Antibodies, Monoclonal ; Cell Proliferation ; Diagnosis ; Humans ; Ki-67 Antigen* ; Melanoma ; Nevus, Pigmented ; Prognosis ; Retrospective Studies ; Skin*

No abstract available.
Pancreaticoduodenectomy*

No abstract available.
Doxorubicin* ; Drug Therapy, Combination* ; Etoposide* ; Fluorouracil* ; Mitomycin* ; Retrospective Studies* ; Stomach Neoplasms*

The species composition, population density, and seasonal prevalence of vector mosquitoes in an inland area of Kyungpook province were studied, based on light trap and human bait trap collections, and the recent patterns of infestation for infective larvae of Brugia malayi in these vector hosts were investigated from May to November in 1985. Nine species in four genera of mosquitoes were collected by light trap, human bait trap, and/or by nets. Anopheles sinensis Wiedemann was the most abundant species collected by light traps during this year. Culex tritaeniorhychus Giles was the second abundant species, and Aedes vexans nipponii(Theobald) ranked third in total abundance. The earlist time when A. sinensis were found was the middle of May. At that time the temperature ranged from 14.3 C to 22.8 C and the humidity 53-90 per cent. The month of highest average nightly catch was July, when the temperature was betweeen 21.5 C and 30.6 C and the humidity 72-91 per cent. The peak time of biting activity of mosquitoes was different in each month, i.e. between 22:00-23:00 in July, and 20:00-21:00 hours in September, when the temperature was between 24.3 C and 26.5 C and the humidity 73-88 per cent in the field. While infective larvae of B. malayi were reported to have been found in one species of mosquito in 1975, no larvae were found in any species collected in this survey.
parasitology-helminth-nematoda ; arthropoda ; Brugia malayi ; Anopheles sinensis ; epidemiology