Pretibial myxedema, which consists of localized cutaneous accumulations of acid mucopolysaccharides, oceurs in a few patients with hyperthyroidi';m after its correction by surgery or radioactive iodine therapy. We report a case of pretibial myxedema with exophthalmos in a 36 year old male. He has suffered from hyperthyroidism with bilateral pretibial myxedema for a period of 4 years. He was treated with a subtotal thyroidectomy and excision of both pletibia lesions 1 year ago. The lesions recurred on t,he left pretibial area, as a 11 X 16cm sized, non pitting, non tender, swollen, brownish plaque. The histopathologic findings showed epidermal hyperkeratosis and a considerable arnount of mucin in the mid-dermis. We treat.ed him with intralesional injection of triamcinolone acetonide with marked improvement.
Adult ; Exophthalmos ; Glycosaminoglycans ; Humans ; Hyperthyroidism ; Injections, Intralesional ; Iodine ; Male ; Mucins ; Myxedema* ; Thyroidectomy ; Triamcinolone Acetonide

BACKGROUND: Recently, partial pancreatectomy has been performed for treatment of benign pancreatic lesion with special attention to functional preservation of adjacent organs. In contrast to traditional pancreaticoduodenectomy( Whipple's procedure) and pylorus-preserving pancreaticoduodenectomy(PPPD), the duodenum-preserving pancreatic head resection(DPPHR) preserves stomach, duodenum, jejunum, extrahepatic bile duct, and this procedure is reported to preserve function of adjacent organs, to reduce morbidity and mortality rates. The indications of DPPHR are benign lesion of the head of the pancreas as well as complications of chronic pancreatitis, including distal common bile duct obstruction, duodenal obstruction, colonic stenosis, pseudocyst of the head of the pancreas, internal pancreatic fistula, portal or splenic vein stenosis. Also this procedure is indicated for the management of the pancreatic head injury. Reconstructive methods following resection of the pancreatic head are modified variously, this methods are end-to-end anastomosis of the pancreatic duct, Roux-en-Y pancreaticojejunostomy, pancreaticogastrostomy, pancreaticoduodenostomy. MATERIALS AND METHODS: The authors performed DPPHR in 4 patients; pseudocyst of the pancreatic head 1, pancreatic head injury 2, chronic pancreatitis 1. Two patients with pseudocyst of the pancreatic head and pancreatic head injury underwent end-to-end anastomosis of the pancreatic duct after resection of the head of the pancreas. This procedure involved insertion of feeding tube into the pancreatic duct and then end-to-end anastomosis of the pancreatic duct. Other two patients with pancreatic head injury and chronic pancreatitis underwent Roux-en-Y pancreaticojejunostomy after resection of the head of the pancreas. RESULTS: Two patients with end-to-end anastomosis of the pancreatic duct developed leakage of the anastomotic site of the pancreatic duct at 3rd and 8th postoperative days, respectively. So this patients were performed reoperation, Roux-en-Y pancreaticojejunostomy. But the peripancreatic abscess developed after reoperation and then performed drainage of the abscess. This patients were improved and discharged. Total hospital stay was 35days and 34days, respectively. Other two patients underwent Roux-en-Y pancreaticojejunostomy after resection of the head of the pancreas. This patients were improved without complications and discharged within 1 month. CONCLUSIONS: In our experiences, DPPHR can be appropriated in the treatment of complications of chronic pancreatitis, benign lesion of the head of the pancreas, pancreatic head injury. And we consider that the Roux-en-Y pancreaticojejunostomy is more safe reconstructive method, compare with the end-to-end anastomosis of the pancreatic duct.
Abscess ; Bile Ducts, Extrahepatic ; Colon ; Common Bile Duct ; Constriction, Pathologic ; Craniocerebral Trauma ; Drainage ; Duodenal Obstruction ; Duodenum ; Head* ; Humans ; Jejunum ; Length of Stay ; Mortality ; Pancreas ; Pancreatectomy ; Pancreatic Ducts ; Pancreatic Fistula ; Pancreaticojejunostomy ; Pancreatitis, Chronic ; Reoperation ; Splenic Vein ; Stomach

It is well established that mast cell proliferation and maturation are regulated by two principle cytokines, IL-3 and the c-kit ligand stem cell factor (SCF). Previous reports have demonstrated that bone marrow-derived IL-3-dependent mast cells exhibit the characteristic apoptosis on removal of IL-3. To know how the number of mast cells is controlled, we observed the effects of nitric oxide (NO) on the murine bone marrow-derived cultured mast cells (BMCMC). Apoptosis was measured by the analysis of flow cytometric data and electrophoretic evidence of DNA fragmentation. Our data showed that sodiurn nitroprusside (SNP)-a NO releasing substance- induced apoptosis in BMCMC. Cell cycle analysis showed that the number of the G,/G, and S phase decreased markedly, while the percentage of cell in G,/M phase was increased. Also, SNP alone induced cell death, whereas SNP in combination with SCF markedly decreased cell death of BMCMC. SNP-induced apoptosis was partially inhibited by the treatment of BMCMC with SCF. Our results suggest that NO might have sorne role in the regulation of the number of mast cells.
Apoptosis ; Bone Marrow* ; Cell Cycle ; Cell Death ; Cytokines ; DNA Fragmentation ; Interleukin-3 ; Mast Cells* ; Nitric Oxide* ; Nitroprusside ; S Phase ; Stem Cell Factor

Cutaneous horns of the penis are rare. We report a case associated with squamous cell carcinoma in a 56-year-old male. A gradually enlarging nodule had been on the glans penis for four years. He had suffered from an erythematous crusted tumor mass and horny excrescence on the glans penis which recurred and was aggravated after excision of the nodule seven months ago. Histopathologic findings of the lesions showed characteristic findings of squamous cell carcinoma and cutaneous horn. In situ DNA hybridization for human papillomavirus types 6, 11, 16, 18, 32, and 33 were all negative. The tumor mass were surgically excised and we have not found any sign of recurrence since then.
Animals ; Carcinoma, Squamous Cell* ; DNA ; Epithelial Cells* ; Horns* ; Humans ; Male ; Middle Aged ; Penis* ; Recurrence

No abstract available.
Lymphocytes* ; Macrophages* ; Nitric Oxide*

The causes of subclavian artery obstruction are arteriosclerosis, chest trauma, extrinsic compressive lesion of tumor or fibrosis, ateritis and coractation of aorta. Symptoms associated with subclavian artery obstruction can manifest dizziness, vertigo, ataxia, bilateral visual change because of vertebral-basilar artery insufficiency, or manifest fatigue, claudication, rest pain, digital necrosis because of arm ischemia. Treatment of subclavian artery occlusive lesion can be only medical treatment if patients was asymptomatic and a variety of surgical procedures-endarterectomy, carotid-subclavian bypass, subclavian- subclavian bypass, axillo-axillary bypass-can be recommended according to the state of surrounding vessel and general condition of patients. We experienced a case of subclavian artery obstruction in a 65 years-old male with severe claudication in left upper extremity and who had suffered from ischemic symptoms of left lower extremity. Patient was surgically treated by femoro-femoral bypass on occlusive lesion of the left lower extremity and carotid-subclavian transposition on left subclavian lesion. Postoperative result was excellent and claudication of left upper and lower extremities were completely relieved.
Aged ; Aorta ; Arm ; Arteries ; Arteriosclerosis ; Ataxia ; Dizziness ; Fatigue ; Fibrosis ; Humans ; Ischemia ; Lower Extremity ; Male ; Necrosis ; Subclavian Artery ; Thorax ; Upper Extremity ; Vertigo

There have been many trials to decrease the scar formation followed by wound treatment. TGF-beta plays a important role on wound healing in adult. Therefore the repression of TGF-beta expression will be helpful to decrease scar formation. Decorin is known to competitively inhibit TGF-beta expression. Decorin were subcutaneously administered in surgical wounds in rabbits to investgate the preventing effect of scar formation for clinical application. Histologic findings of wound healing progresses is similar with control and experimental group at 2week. 2.5 microgram decorin of administrated group was similar to those of control group at 4 and 8week. In wound healing process 10 microgram decorin of administrated groupsat showed that thickness of immature collagen fibers(scar) was decreased as compared with control group at 4, 8 weeks. 20 microgram decorin of administrated group showed similar histologic features to 10 microgram administrated group. The wounds of 8week experimental group(10, 20 microgram) were completely recovered to the normal surrounding skin tissue including sweat gland and hair follicle. These results suggested that decorin can be of help to the prevention of local scar formation.
Adult ; Cicatrix ; Collagen ; Decorin* ; Hair Follicle ; Humans ; Rabbits* ; Repression, Psychology ; Skin ; Sweat Glands ; Transforming Growth Factor beta* ; Wound Healing* ; Wounds and Injuries*

Analgesics ; Gastric Bypass ; Humans ; Orthognathic Surgery ; Orthopedics ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Vomiting

Diplopia ; Epistaxis ; Facial Asymmetry ; Facial Bones ; Hemorrhage ; Incidence ; Maxillary Sinus ; Nasal Bone ; Orbit ; Trismus ; Zygoma

Occult bladder injury may sometimes go unrecognized during tension-free vaginal tape (TVT) procedures. We report a case of occult intraperitoneal bladder injury that occurred during a TVT procedure. There was no sign of bladder perforation on the initial cystoscopy, which was performed just after the insertion of the trocar. Signs of general peritonitis appeared after the patient started to void the next day. A postoperative cystogram and cystoscopy showed an intraperitoneal bladder injury and a pinhead-sized ulcerative lesion in the right lateral wall of the bladder. We suspect that at the time of initial cystoscopy, the trocar passed through the submucosal area without violating the bladder mucosa. The occult bladder injury may have been caused after the initial cystoscopy by advancing the rough edge of the prolene tape during the extraction of the trocar. This report is the first description of such an occult bladder injury during a TVT procedure.
Vagina/surgery ; Urologic Surgical Procedures/adverse effects ; Urinary Incontinence, Stress/*surgery ; Urinary Bladder/*injuries/radiography ; *Postoperative Complications ; Peritonitis/diagnosis/etiology ; Humans ; Female ; Cystoscopy ; Adult