No abstract available.
Neurofibroma*

Familial amyloid polyneuropathy is commonly the result of deposition of variant transthyretin in nerves and other organs. Apart from the Val30Met variant commonly seen in endemic areas of familial amyloid polyneuropathy, many transthyretin mutations have been described in various populations worldwide. We report a Malaysian patient of ethnic Chinese descent with familial amyloid polyneuropathy and a transthyretin mutation, Ala117Ser. This mutation has not been previously reported in Chinese patients. He presented in middle-age with carpal tunnel syndrome followed progressive sensorimotor polyneuropathy. There was evidence of autonomic dysfunction clinically and cardiomyopathy on 2Dechocardiography. Familial amyloid polyneuropathy is uncommon in Asian patients outside Japan, but the diagnosis should be considered in a progressive late onset sensorimotor axonal polyneuropathy.

We report two human cases of tick bite. A 63-year-old male had a pruritic pea-sized brownish nodule on the left popliteal area. Another 41-year-old male had an asymptomatic bean-sized black nodule in the pubic area. The ticks were identified as Ixodes nipponensis, which are the 18th and the 19th cases in Korea.
Adult ; Animals ; Bites and Stings/*parasitology/pathology ; Human ; *Ixodes/anatomy & histology ; Male ; Middle Aged ; Skin/*parasitology/pathology ; Tick Infestations/*parasitology/pathology

No abstract available.
Friction* ; Hyperpigmentation* ; Skin Diseases*

Lichen myxedematosus (synonym, papular mucinosis) is a disorder characterized by lichenoid papules, nodules and plaques due to dermal mucin deposition, and a variable degree of fibrosis without thyroid dysfunction. Discrete lichen myxedematosus is a subtype of the localized lichen myxedematosus. Clinically, firm, smooth, waxy or flesh-colored papules measuring 2 to 5 mm in diameter, numbering just a few to hundreds, and involving limbs and trunk. The lesions progress slowly without systemic symptoms and rarely resolve spontaneously. Histologically, the upper and mid dermis shows edema and diffuse or focal mucinous deposit under normal epidermis. Fibroblast proliferation is variable, but there is neither collagen deposition nor sclerosis. On experiencing a case of discrete grouped papules on the arm and thigh of a sixty three year-old women, we present it as discrete lichen myxedematosus.
Arm ; Collagen ; Dermis ; Edema ; Epidermis ; Extremities ; Female ; Fibroblasts ; Fibrosis ; Humans ; Lichens* ; Mucins ; Scleromyxedema* ; Sclerosis ; Thigh ; Thyroid Gland

No abstract available.
Epidermis* ; Psoriasis

A herniated lumbar intervertebral disc has been the most common cause of low back pain and sciatica since Mixter and Barr reported it in 1934. Our methods of treatment were the conservative treatment and the excision of the herniated disc for a limited number of carefully selected cases. The results of disc surgery relate to a number of factors, unquestionably the most important being patient selectivity. We emplopyed Finneson's lumbar disc surgery predictive score card to determine the relationship between patient selection and the outcome of lumbar disc surgery in operative cases. This report is to give a clinical review of 46 cases of the herniated disc upon which surgical removal were performed at Eul-Ji General Hospital from March 1981 to July 1982. The results were obtained as follows: 1. The most common age group were 21 to 40 year old. 2. In 46 surgically treated cases, 34 cases were male (74%) and 12 cases were female (26%). 3. The bulging of disc was found in 25 cases and the ruptured disc was found in 14 cases. The most common site of the lesion was L4-5 intervertebral disc with 30 cases (65%) and the next L5-Sl intervertebral disc with 10 cases (22%). 4. The outcomes of lumbar disc surgery were evaluated at follow-up as good in 77 per cent, fair in 11 per cent, marginal in 7 per cent and poor in 5 per cent of the patients. 5. The predictive scores of each result category were averaged and were as follows; Good: 77.1, Fair: 67.3, Marginal: 58.0, Poor: 40.0 6. The average predictive scores of each result category fell within the anticipated parameters of the score card. 7. The score card may be utilized as reliable system for presurgical patient selection.
Female ; Follow-Up Studies ; Hospitals, General ; Humans ; Intervertebral Disc ; Intervertebral Disc Displacement ; Low Back Pain ; Male ; Patient Selection ; Sciatica

OBJECTIVES: We evaluate the efficacy of transcellualr K-lowering effect at 1 hour following mono-therapy compared to that of dual-therapy , and aimed to find the sage and rapid method for acute therapy of hyperkalemia before dialysis in 10 ESRD patients with maintenance hemodialysis. METHOD: For ten patients of end stage renal failure with body weight between 55 and 65 Kg and a predialysis plasma potassium greater than 5.5 mEq/L, we studied in three separated phases separated from one another by at least 1 week. After 1 hour following mono-therapy (2mEq/Kg of NaHCO3 in interavenous infusion, 10 units of regular insulin with 50ml of 50% glucose in i.v. push, or 15mg of salbutamol in nebulizer) or dual therapy(NaHCO3 + Insulin with glucose, NaHCO3 + salbutamol, or salbutamol + insulin with glucose) for hyperkalemia, we compared the efficacy and safety of each transcellular K shifting methods. RESULTS: Bicarbonate infusion induced a signigicant raise in plasma bicarbonate and pH from baseline values in both mono-therapy and dual-therapy without any significant difference each other. Among mono-therapeutic regimens, bicarbonate alone failed to lower plasme K from baseline levels (-0.1+/-0.15 mEq/L, P=NS) whereas two other regimens effectively lowered plasma K (-0.62+/-0.06 mEq/L in insulin with glucose, -0.57+/-0.04 mEq/L in salbutamol, P vs. basal <0.05 in both). The K-lowering effects in the three combined regimeds of dual therapy were more prominent as compared to that of three regimens of monotherapy (-0.96+/-0.08 mEq/L in NaHCO3 + salbutamol, -1.20+/-0.6 mEq/L in NaHCO3 + insulin with glucose, and -1.20+/-0.10 mEq/L in salbutamol + insulin with glucose, respectively)(P<0.05). Two patients in monotherapy with salbutamol alone were resistant to the hypokalemic effect, however in dual therapy with simultaneous administration of salbutamol and bicarbonate resolved it. Also, hypoglycemia (<60mg/dL of fasting glucose) was noted in 4 patients in mon-therapy of insuli with glucose alone, 2 in dual-therapy of insulin with glucose + NaHCO3, but none in insulin with glucose + salbutamol. CONCLUSION: Dudal-therapeutic regimens lowered plasma potassium more effectively than mono-therapeutic regimens, and among them, the combination of insulin with glucose plus salbutamol could be recommended as an efficacious and safe modality in the acute therapy of hyperkalimia in ESRD patients.
Albuterol ; Body Weight ; Dialysis ; Fasting ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Hyperkalemia* ; Hypoglycemia ; Insulin ; Kidney Failure, Chronic ; Plasma ; Potassium ; Renal Dialysis* ; Renal Insufficiency

PURPOSE: To evaluate the extrahepatic spread of peripheral cholangiocarcinoma with CT. MATERIALS AND METHODS: We retrospectively reviewed CT findings of extrahepatic spread in thirty-six patients with peripheral cholangiocarcinoma confirmed adenocarcinoma at surgery(n=5) or percutaneous biopsy(n--31) without primary leion in other organs, and analysed the frequency and distribution of enlarged lymph nodes, direct invasion of adjacent solid organs, and thrombosis of major vessels. RESULTS: Among the 36 cases, enlarged metastatic lymph node was noted in twenty-four(66.7%), direct invasion into adjacent organs in six(16.7%), portal and inferior vena caval thrombosis in five(13.9%). Enlarged lymph nodes were seen in hepatic nodes(n=16, 44.4%), portocaval nodes(n=15, 41.7%), interaortocaval nodes (n=10, 27.8) and celiac nodes in two(5.6%). Direct invasion was detected in the greater omentum(n=6), gallbladder(n:3) and stomach(n=2). Portal vein thrombosis(n:5) and thrombosis of inferior vena cava(n=2) were noted. CONCLUSION: Lymph node metastasis was seen in 67% in patients with peripheral cholangiocarcinoma. Direct invasion to adjacent organs and thrombosis in portal vein or inferior vena cava were occasionally associated.
Adenocarcinoma ; Cholangiocarcinoma* ; Humans ; Lymph Nodes ; Neoplasm Metastasis* ; Portal Vein ; Retrospective Studies ; Thrombosis ; Vena Cava, Inferior

BACKGROUND/AIMS: Hepatocytes on the hepatic lobule mipate from portal zone to centrilobular mea as the DNA synthesis within it. And also, the xenobiotic reactions reveal characteristic differences associated with zone specific metabolism in the liver acinus. In this study, the zonal distribution of ethylnitrosourea (ENU)-induced hepatic precancerous lesion was stereologically investigated. METHODS: Nine B6C3F1 mices were given I.p. injection of ENU (60 ug/pn body weight) when the pups were 15 days old prior to sacrifices at 8 weeks of life. All the 150 consecutive sections, 3 p m in thickness, were stained with hematoxylin and eosin and identified the basophilic precancerous lesions with 80-165 p m diameter in equatorial plane by the Zeiss microprojector. And then the distances from the center of selected foci to terminal hepatic vein or portal vein branches were estimated under the microscopic fields. As a control group, the same estimations were performed from the random points by the appointments of random digit table. RESULTS: Mean distance between ENU-induced 52 hepatocellular foci and the nearest terminal hepytic vein was 181.15+112.39 p m (Mean+ SD), but that of randomly selected 104 points was 291.73+157.98pm (Mean+5D) (Students t-test, p<0.0005). Substantially, 52.7% of ENU-induced 52 hepatocellular foci were within 300 p m from the terminal hepatic vein, but randomly selected 104 points were only 50.9% (Shapiro Wilk W test, w=0.819857, p=0.048038). Mean distance from ENU-induced 52 foci to portal vein was 398.85+149.98pm (Mean+SD), but that from the randomly selected 104 points was 315.87+145.79 pm (Mean+SD)(Students t-test, p<0.0005). CONCLUSION: Stereologically, ENU-induced mice liver cell foci distribute non-randomly to Zone III, centrilobular zone of mouse hepatic acini where promote invasion toward terminal hepatic veins.
Animals ; Appointments and Schedules ; Basophils ; Cholestasis ; DNA ; Eosine Yellowish-(YS) ; Ethylnitrosourea ; Fluconazole ; Hematoxylin ; Hepatic Veins ; Hepatocytes ; Liver ; Metabolism ; Mice* ; Portal Vein ; Veins