There has not been any report on massive air-containing liver abscess in diabetic patients, although emphysematous cholecystitis or pyelonephritis is a well-known complication in them. Authors report two cases of emphysematous liver abscess in diabetic patient, which showed typical findings of massive air-containing hepatic abscess on ultrasonography and computed tomography, but very poor progrosis in spite of immediate and successful percutanoeus drainage procedure.
Drainage ; Emphysematous Cholecystitis ; Humans ; Liver Abscess* ; Liver* ; Pyelonephritis ; Ultrasonography

BACKGROUND: Despite concern about information of neuropeptide, the has been no baseline study of neuropeptide in Koreans. OBJECTIVE: The purpose of the study was to investigate the skin sinsitivity of substance P and VIP in normal healthy persoas. METHODS: We prepared 1000pM, 100pM, 10pM solution of substan P 1-11, substnace P 1-7, substnace P 7-11, and VIP. We injected intradermally 50ul of the br ve solutions on 12 sites of both forearms in addition plaebo. We measured the size of the area of flare and wheal along time. We repeated the same test after antihistamine intake. RESULTS: Flare and wheal respinses were dose dependent. Injection of substance P 1-7 did not evoke wheal responses and injection of substance P 7-11 did not wake flare responses. Flare responses of substance P 1-11, ubstance P 7-11, VIP were inhibiteb antihistamine and wheal responses of VIP were inhibitedly antihistamine. CONCLUSION: N-terminal of subtance P is responsible for flarers onses and C-terminal of substnace P is responsible for wieal responses. Flare responses of sisance P were mediated by histamine but wheal responses osubstance P were direct effect on postcapillary venule. Flare and wheal responses of VIF were mediated by histamine.
Forearm ; Histamine ; Humans ; Neuropeptides ; Skin ; Substance P* ; Venules

A 29 year old woman with unresectable leiomyosarcoma of the inferior vena cave extending into the right atrium of the heart was presented. The upper and middle inferior vena cava involved and there were both intrinsic and extrinsic tumor growth components. The diagnosis was made by a combination of radiological studies including ultrasound, CT, inferior vena cavography and arteriography and the diagnosis was confirmed by ultrasound guided rumor biopsy. The clinical and radiological presenting features were reviewed.
Angiography ; Biopsy ; Diagnosis ; Female ; Heart ; Heart Atria ; Humans ; Leiomyosarcoma* ; Ultrasonography ; Vena Cava, Inferior*

A 29 year old woman with unresectable leiomyosarcoma of the inferior vena cave extending into the right atrium of the heart was presented. The upper and middle inferior vena cava involved and there were both intrinsic and extrinsic tumor growth components. The diagnosis was made by a combination of radiological studies including ultrasound, CT, inferior vena cavography and arteriography and the diagnosis was confirmed by ultrasound guided rumor biopsy. The clinical and radiological presenting features were reviewed.
Angiography ; Biopsy ; Diagnosis ; Female ; Heart ; Heart Atria ; Humans ; Leiomyosarcoma* ; Ultrasonography ; Vena Cava, Inferior*

In normal hurnan dermis, factor XIIIa positive dermal dendrocyte are located in the papillary areas closely associated with blood vessels and the upper reticular dem These cells represent a specific type of bone marrow derived dermal cells, distinct from Langerhans cells having some features in common with rnonocyte/macrophage lineage and with potential antier presenting activity. Although the significance of these cells has not yet been fully established, it been suggested that they play a major role in skin immune iesponses, in collagen synsthesis regultic and in wound repair. We report a case of acaqired fibrokeratoma which is studiec conventional histopathology and immunohistochemistry. Histopathologic findings of this case showed ovascular proliferation and the increased presence of fibroblast like cells as a common fe;ture of these benign tumors. Immunohistochemical staining with anti factor XIIIa antibody deiaoi strates increased numbera of positive dendritic cells in the upper dermis. There finding supports the fat that some fibroblagt like cells in the upper dermis of acquireid fibrokeratoma may be factor XIIIa positive dermal dendritic cells.
Blood Vessels ; Bone Marrow ; Collagen ; Dendritic Cells ; Dermis ; Factor XIIIa* ; Fibroblasts ; Immunohistochemistry ; Langerhans Cells ; Skin ; Wounds and Injuries

BACKGROUND: A definition of granuloma is a focal chronic inflammatory response to tissue injury evolved by a poorly soluble substwice characterized by the accumulation and proliferation of the mono-nuclear histiocytic cells. The accuracy with which rnononuclear cells may be identified in skir. is much improved by the use of both heteroantisera and monoclonal antibodies directed against selected cellular antigens, OBJECTIVE: Our purpose was to examine the staining patterns of anti-lysozyme, anti-a-1-antitrypsin, anti-S-100 protein antibodies, and MAC-387 monoclonal anibody in granulomatous skin diseases. METHOD: We performed imminoperoxidase staining(the labelled str prvidin-biotin peroxidase complex method on the formalin-fixed, paraffin-embedded tissue specimens of granulomatous skin diseases. RESULTS: S-100 protein positive dendritic cells were demonstrated in the granulomatous infiltrates as scattered pattern and MAC-387 positive cells were predominantly found in the center of granulomas, The staining pattern and percentage of positively stained cells of a--antitrypsin were similar to those of lysozyme. A1Pha-1-antitrypsin and lysozyme positive cells w re present in the center as well as lymphohistiocytic infiltrates of granulomas. CONCLUSION: These data sugget that histiocytes are composed of heter igeneous groups of cells such as the mononuclear-phagocyte system and dendritic cell system.
Antibodies ; Antibodies, Monoclonal ; Dendritic Cells ; Granuloma ; Histiocytes ; Muramidase ; Peroxidase ; S100 Proteins ; Skin Diseases ; Skin*

BACKGROUND AND PURPOSE: The present study was carried out to investigate transient arteriolar vasospasm following reperfusion in the gerbil as an ischemic model and relationship between vasospasm and the changes of morphologic, physiologic and regional blood flow. METHODS: The transient arteriolar vasospasm was observed under the microscope. All gerbils were perfusion fixed and ischemic neuronal damage was checked in the CA1 subfield of the dorsal hippocampus. Metabolic parameters were serially measured during the occlusion and after recirculation, and cerebral blood flow was measured with a laser Doppler flowmetry. RESULTS: 1. Among the 18 gerbils with BCAO(bilateral carotid artery occlusion) for 2 minutes, 8 gerbils showed vasospasm after reopening, namely post-ischemic vasospasm, and 10 gerbils did not show vasospasm. 2. In all animals, metabolic parameters showed decreased PaCO2 and high pH just after the occlusion but increased PaCO2 and lowered pH following the recirculation. BCAO caused marked increase in systemic blood pressure but it returned to preischemic levels following the recirculation. 3. In all animals, BCAO caused marked decrease of cerebral blood flow compared to preischemic levels immediately following the occlusion but it returned to preischemic levels following the recirculation. And it took some longer the onset and duration of the transient increase in blood volume after reopening in the animals with vasospasm than those without vasospasm. 4. There was no morphological neuronal damage in the hippocampal CA1 subfield, at 1, 3, 7 days following 2-minute ischemic insult. CONCLUSION: The present study confirmed that BCAO in gerbils resulted in forebrain ischemia caused transient cortical vasospasm in the gerbil. But there was no close relationship between vasospasm and the changes of morphologic, physiologic and regional blood flow.
Animals ; Blood Pressure ; Blood Volume ; Brain Ischemia* ; Brain* ; Carotid Arteries* ; Cerebral Cortex* ; Gerbillinae* ; Hippocampus ; Hydrogen-Ion Concentration ; Ischemia ; Laser-Doppler Flowmetry ; Microcirculation* ; Neurons ; Perfusion ; Prosencephalon ; Regional Blood Flow ; Reperfusion

Nevus lipomatosus cutaneous superficialis is a very rare skin disease which usually is present from birth. This uncommon condition is due to collections of ectopic. fat cells within the upper and mid dermis. There are two clinical varieties. The first is a lesion of zonal distribution, present from birth or childhood, usualIy on the buttocks or the lower back. The second form, a dome or sessile, papule, begins. in adult life and is less restricted in distribution. Cerebriform plaques tend to form from the coalescence of soft, yellowish papules. The authors observed two cases of typical nevus lipomatosus cutaneous superficialis. The first case is a 25-year-old female who has had asymptomatic, soft, skin colored, and huge confluent nodules on the right infragluteal fold and upper thigh for 15 years; and the second case is a 15-year-old male who has had multiple, skin colored and soft papules or nodules in zosteriform distribution affecting the right side of the lower back and coccygeal area and right buttock for 4 years. The authors made the diagnosis of nevus lipomatosus cutaneous superficialis from the characteristic clinical and histopathological findings.
Adipocytes ; Adolescent ; Adult ; Buttocks ; Dermis ; Diagnosis ; Female ; Fluconazole ; Humans ; Male ; Nevus* ; Parturition ; Skin ; Skin Diseases ; Thigh

For more than 80% of body weight is transmitted through the anterior and middle column, the interbody gap produced by operative reduction of spondylolisthesis is potential risk factor for redisplacement, implant failure, pseudoarthrosis and kyphosis. In biomechanical aspect, augmentation of the anterior column support by interbody fusion is desirable to prevent above problems in surgical treatment of spondylolisthesis. Recently, circumferential fusion is recommended in high-grade spondylolisthesis (grade III, IV, or V ), but there is some controversy about additional interbody fusion in posterior instrumentation for low-grade spondylolisthesis (grade I or II ). So, the purpose of this retrospective study was to compare the segmental sagittal angle in 35 patients of low-grade spondylolisthesis who was performed posterior instrumentation with or without posterial lumbar interbody fusion (PLIF) and to find out the risk factors of the loss of segmental sagittal angle in cases of posterior instrumentation without posterial lumbar interbody fusion (PLIF).
Body Weight ; Humans ; Kyphosis ; Pseudarthrosis ; Retrospective Studies ; Risk Factors ; Spondylolisthesis*

BACKGROUND: The purpose of this study was to evaluate the historical anesthetic trends for last 35 years at Chonnam National University Hospital (CNUH). METHODS: The anesthetic records of total 101,637 anesthetic cases performed at CNUH from January 1961 to December 1996 were reviewed and analyzed according to age, sex, department, operation site, physical status, preoperative findings, anesthetic methods and agents, duration of operation, etc. RESULTS: Annual anesthetic cases was increased remarkably year by year; annual surgical patients increased 19 times for 35 years. The ratio of male to female was 1.18:1. The percent of geriatric anesthesia was increased year by year. In preoperative physical status from ASA definitions, 83.6 % of total patients was assigned class I and II. The average departmental distributions in descending order were surgery, orthopedic surgery, obstetrics and gynecology, neurosurgery, urology, ENT, thoracic surgery, ophthalmology, plastic surgery, oral and maxillofacial surgery, and others. The distributions of operation site in descending order were lower abdomen, neck, upper abdomen, lower extremities, head, chest, spine, upper extremities, and breast. Inhalational anesthesia was the most frequent used methods. Ether was abandoned from 1983, and major volatile anesthetics was halothane from 1981 to 1991. The use of enflurane has steadily increased and isoflurane has also been used with increasing frequency since 1992. CONCLUSIONS: Anesthetic cases are markedly increased year by year, and major volatile anesthetics and neuromuscular blocker were changed from halothane to enflurane and from pancuronium to vecuronium, respectively.
Abdomen ; Anesthesia ; Anesthetics ; Breast ; Enflurane ; Ether ; Female ; Gynecology ; Halothane ; Head ; Humans ; Isoflurane ; Jeollanam-do* ; Lower Extremity ; Male ; Neck ; Neuromuscular Blockade ; Neurosurgery ; Obstetrics ; Ophthalmology ; Orthopedics ; Pancuronium ; Retrospective Studies* ; Spine ; Surgery, Oral ; Surgery, Plastic ; Thoracic Surgery ; Thorax ; Upper Extremity ; Urology ; Vecuronium Bromide