Because most of the benign skin appendage tumors arise from pluripotential cells that form during adult life and possess the potentiality of differentiating in more than one direction, combinations of several tumor types can occur. We report a case of combined with eccrine poroma, clear cell hidradenoma, and syringocystadenoma papilliferum as a single tumor in a 41-year-old male who had suffered from a tumor on posterior neck for 5 years. The tumor was a relatively oval shaped pedunculated, and rubbery hard mass, measuring 3.5*3.0* 1.3cm in size. The outer surface was variegated and covered with hair. The diagnosis was confirmed by histopathological findings and surgical excision was done.
Acrospiroma* ; Adult ; Diagnosis ; Hair ; Humans ; Male ; Neck ; Poroma* ; Skin

Electron microscopic examination of specimens from lesions of eight patients with hyperpigmented and six patients with hypopigmented tinea versicolor and from unaffected skin in each patient was performed. The results are summarized as follows; 1. In hyperpigmented lesions, melanosomes are larger and more singly dispersed than in unaffected skin. 2. In hypopigmented lesions, melanosomes are smaller and less singly diepersed than in unaffected skin. 3. Number of total melanosomes in hyperpigmented and hypopigmented lesions was not different from in unaffected skin.
Humans ; Melanosomes* ; Skin ; Tinea Versicolor* ; Tinea*

Clear cell sarcoma of tendon and aponeurosis is a rare malignant tumor. It occurs chiefly in young adults, predominates in women and is most common in the regions of the foot and ankle. We report a case of clear cell sarcoma of tendon and aponeurosis in s 22-year-old man. he pstient had had a asymptomatic, normal skin colored, relativerly hard, dome shsped nodule on the anterior chest for 6 months. Histopsthologic findings revealed uniform pattern composed of compact nests of round or fusiform cells which had clear cytoplasm and were surrounded by delicate framework of fibrocollagenous tissue, and the individual tumor cell had a fairly regular appearance of possessing round to avoid vesicular nucleus with prominent basophilic nucleolus. One year after surgical excision and post operative radiotherapy, there was no recurrence.
Ankle ; Basophils ; Cytoplasm ; Female ; Foot ; Humans ; Radiotherapy ; Recurrence ; Sarcoma, Clear Cell* ; Skin ; Tendons ; Thorax* ; Young Adult

Percutaneous biliary drainage is an effective new nonsurgical method for combined external/internal catheterdecompression of obstructed extrahepatic bile ducts. Molnar and Stockum, and more recently others, have reportedsucdess utilizing this approach to establish biliary drainage in patients with obstructive jaundice. Percutaneousbiliary drainage was performed in 9 patients with obstructive jaundice. Internal drainage was accomplished in 4patients (44.4%), and external drainage in 5 patients (55.6%). Major complications occurred in 2 patients; bileleakage, one; sepsis, one. Minor complications occurred in 7 patients; mild or high fever, 5 cases; transienthemobilia, 2 cases. The catheter management problems encoutered including pain, catheter dislodgement ormigration, lumen occulusion, and external bile leakage.
Bile ; Bile Ducts, Extrahepatic ; Catheters ; Drainage ; Fever ; Humans ; Jaundice, Obstructive ; Methods ; Sepsis

BACKGROUND: Hydroxyethyl starches (HES) solutions are the most commonly used colloids for treating hypovolemia and expanding plasma, but they compromise platelet function and reduce the level of coagulation factors. As opposed to other HES solutions, 6% HES (130/0.4) solution may influence hemostasis minimally due to its low mean molecular weight and degree of substitution. This study was designed to establish the safety of HES (130/0.4) infusion in the presence of massive blood loss. METHODS: Twelve healthy adult patients scheduled for spine surgery were enrolled in this study. Before the induction of general anesthesia, all patients underwent acute normovolemic hemodilution (ANH), which was independent of surgical stress and other confounding factors. While approximately 30% of the estimated blood volume was procured, the blood deficit was replaced with the same volume of 6% HES (130/0.4) solution. Hematocrit, platelet count, factor VIII activity and plasma fibrinogen concentration were determined and thrombelastography was performed to evaluate the hemodilution effect and hemostatic impairment before and after ANH. Statistical testing was conducted to analyze the effect of HES on hemostasis. RESULTS: Hematocrit, platelet count, factor VIII activity and plasma fibrinogen concentrations decreased significantly (P < 0.05 respectively) after the ANH. On comparing pre-ANH and post-ANH thrombelastographic findings, the R time was shortened (P = 0.045), the alpha angle increased (P = 0.01) and MA decreased (P = 0.003) significantly. CONCLUSIONS: Summarizing, little effect was observed on the hemostatic system when 20 ml/kg of 6% HES (130/0.4) solution was infused. HES (130/0.4) solution as used to maintain normovolemia during ANH may be free from bleeding risk.
Adult ; Anesthesia, General ; Blood Coagulation Factors ; Blood Platelets ; Blood Volume ; Colloids ; Factor VIII ; Fibrinogen ; Hematocrit ; Hemodilution ; Hemorrhage ; Hemostasis* ; Humans ; Hypovolemia ; Molecular Weight ; Plasma ; Platelet Count ; Spine ; Starch ; Thrombelastography

No abstract available.
Emergencies* ; Emergency Service, Hospital*

The renin-angiotensin system plays an important role in renal growth and development. Exposure of the fetus or neonate to angiotensin converting enzyme (ACE) inhibitors increases mortality, growth retardation, and results in renal anomalies. This study was designed to investigate the effects of ACE inhibition in the neonatal rat on the expression of genes known to modulate renal cellular proliferation, cell interactions, and extracellular matrix. Newborn rat pups were treated with enalapril (30mg/ kg/day) or vehicle for 14 days, and kidneys were removed for determination of mRNA for transforming growth factor-beta 1 (TGF- B1) and prepro epidermal growth factor (EGF). Enalapril treatment resulted in 40Yo mortality by day 14 as well as reduced body and kidney weight (P<0.05 vs vehicle group). Also enalapril decreased renal TGF-Bl and EGF mRNA expression (P<0.05). These results indicate that ACE inhibition in the developing kidney reduces the renal expression of critical growth factors, which may account for renal growth impairment.
Angiotensins* ; Animals ; Cell Communication ; Cell Proliferation ; Enalapril ; Epidermal Growth Factor ; Extracellular Matrix ; Fetus ; Growth and Development ; Humans ; Infant, Newborn ; Intercellular Signaling Peptides and Proteins ; Kidney* ; Mortality ; Peptidyl-Dipeptidase A* ; Rats* ; Renin-Angiotensin System ; RNA, Messenger ; Transforming Growth Factor beta1

High-resolution (HR) ultrasound, which has been progressing continuously in technology, has improved in aspect of spatial and contrast resolution. The HR ultrasonography is a noninvasive, readily applicable imaging technique, which could get static and dynamic image in real-time for various neuromuscular disorders, especially in entrapment neuropathy. It is also a reliable tool to detect dynamic muscle movements such as fasciculation as well as muscle atrophy in chronic myopathies or neuropathies. Although reliability of the HR ultrasonography has not been investigated in large series of patients, different neuromuscular disorders tend to show specific changes on the ultrasound, which can be helpful in differential diagnosis. The HR ultrasonography is an ideal tool for the clinical and research investigation of neuromuscular system complementary to electrodiagnostic studies. This review briefly describes applicability for various neuromuscular disorders with previous study results and the technical aspects of ultrasound and its physical principles.
Diagnosis, Differential ; Fasciculation ; Humans ; Muscles ; Muscular Atrophy ; Muscular Diseases ; Nerve Compression Syndromes