No abstract available.
Biomarkers* ; Carcinoma, Hepatocellular* ; Hepatitis B* ; Hepatitis* ; Humans ; Korea* ; Prevalence*

Spindle cell lipoma was first described in 1975 by Enzinger and Harvey as a variant of lipomas. Histopathological findings show the lipomatous tissue to be replaced by a mixture of uniform spindle cells and mature fat cells closely associated with a mucoid matrix and a varying number of collagen fibers. Immunohistochemical staining is reported to give assistance in the differential diagnosis af spindle cell lipoma from other fibrous or neural tumors. Also, it can be used to investigate the origin of the spindle cells. We report a case of spindle cell lipoma in a 41-year-old female. She had a solitary, normal skin colored, bean sized, subcutaneous mass on the forearm. Most of the spindle cells were strongly positive for vimentin, CD34 and NSE, but negative for actin, factor VIII, S-100 protein and neuro- filaments. The tumor was excised. No recurrence was recognized in a 10 month follow up period.
Actins ; Adipocytes ; Adult ; Collagen ; Diagnosis, Differential ; Factor VIII ; Female ; Follow-Up Studies ; Forearm ; Humans ; Lipoma* ; Recurrence ; S100 Proteins ; Skin ; Vimentin

The nasal ala is a challenging area for surgical reconstruction, with thick sebaceous skin, the lack of an ample tissue reservoir, and an adjacent free margin. Numerous flaps have been reported for the repair of alae defects. A 71-year-old woman with simultaneous basal cell carcinomas involving both nasal alae was treated by Mohs micrographic surgery. The surgical defects measured 1.5x1.5 cm on the center of the right nasal ala and 1.0x1.0 cm on the left nasal ala, including the alar crease and rim. The right nasal ala was used as a nasolabial transposition flap and the left nasal ala was reconstructed by an island pedicle flap. The final shape and texture were satisfactory. The flaps survived and nasal symmetry was preserved. Combined nasolabial transposition and island pedicle flaps thus offer a superior esthetic and functional result owing to minimized tension. This may be a valuable reconstructive option in the repair of bilateral nasal alae defects.
Aged ; Carcinoma, Basal Cell ; Female ; Humans ; Mohs Surgery ; Skin ; Succinates

We have experienced a case of deflation failure of Inoue balloon in the left atrium during mitral balloon valvuloplasty in a 44 year old male patient with tight mitral stenosis, who died just after emergency open heart surgery for removal of undeflated Inoue balloon and mitral valve replacement because of associated acute hemorrhagic myocardial infarction.
Adult ; Balloon Valvuloplasty ; Emergencies ; Heart Atria ; Humans ; Male ; Mitral Valve ; Mitral Valve Stenosis ; Myocardial Infarction ; Thoracic Surgery

Two cases of exercise-induced atrial fibrillation were diagnosed in 68 years old female and 47 years old male. They complained palpitation during exercise, and emotional upset for the last 5 years. There was no evidence of organic heart disease except mild hypertension in female patient. The atrial fibrillation was induced repeatedly by treadmill exercise test and intravenous infusion of isoproterenol. The beta blocker(atenolol 50mg po dialy) prevented the induction of atrial fibrillation during treadmill exercise. We report two cases of exercise-induced atrial fibrillation which is very rare and might be related to catecholamine.
Aged ; Atrial Fibrillation* ; Exercise Test ; Female ; Heart Diseases ; Humans ; Hypertension ; Infusions, Intravenous ; Isoproterenol ; Male ; Middle Aged

No abstract available.
Animals ; Antibiotics, Antifungal/*therapeutic use ; Humans ; Immunosuppression/*methods ; Protein Structure, Tertiary ; T-Lymphocytes/*immunology ; *Transduction, Genetic

BACKGROUND: Psoriasis is characterized by chronic recurrent erythematous skin plaques that exhibit epidermal hyperplasia, inflammatory cell accumulation and abnormalities of the papillary dermal vasculature. Psoriatic skin lesions show enlargement and increased tortuosity of cutaneous microvessels without formation of new vessel sprouts, that is, inflammatory angiogenesis. Placental growth factor (PlGF) and Tie-2 were reported to be up-regulated during inflammatory angiogenesis. Tazarotene is the first receptor-selective retinoid and its effects include normalizing keratinocyte differentiation, reducing keratinocyte proliferation and reducing inflammation. OBJECTIVE: Our study evaluated the clinical efficacy of topical tazarotene treatment and clarified histological changes and possible action mechanisms of this agent in respect of inflammatory angiogenesis. METHODS: We selected patients with symmetric psoriatic lesions and applied 0.1% tazarotene gel (Tazorac(R)) versus calcitriol 3 microgram/g gel (Silkis(R)) twice a day for 12 weeks with a right-left comparison. We grouped the patients with treatment modalities. Clinical efficacy, which was measured by the overall lesional assessment (OLA) scores, was assessed at each visit in 2 week' intervals until treatment closed. Skin biopsies were performed before the treatment started and again at 4 weeks and 12 weeks after treatment. Immunohistochemistry of PlGF, Tie-2 and factor-VIII was performed to elucidate the anti-angiogenetic effect of tazarotene. RESULTS: At the completion of 12 weeks of treatment, the OLA score of tazarotene-treated lesions was more reduced than that of calcitriol-treated lesions combined with phototherapy, it was more effective. Several histologic features such as epidermal hyperplasia, inflammatory cell infiltration and vessel dilation/tortousity were improved with decreased PlGF and Tie-2 expressions. CONCLUSION: These results indicate that tazarotene is an effective topical agent for psoriasis by blocking inflammatory angiogenesis.
Biopsy ; Calcitriol ; Humans ; Hyperplasia ; Immunohistochemistry ; Inflammation ; Keratinocytes ; Microvessels ; Phototherapy ; Psoriasis* ; Skin

BACKGROUND: Vascular lesions can be diagnosed by biopsy, simple x-ray, ultrasound, CT, MRI, venography and MR angiography. These diagnostic tools can identify the detailed structure and abnormalities in the peri-lesional area of vascular lesions. Color Doppler ultrasound (CDU) can demonstrate the hemodynamic features, distribution of veins and arteries, shunts and structures of vascular lesions. Authors have tried to categorize vascular lesions with CDU and also applied this to the selection of treatment methods. MATERIALS AND METHODS: Forty-seven vascular lesions were evaluated by means of CDU. All patients underwent a complete clinical evaluation as well as peak systolic velocity (PSV), peak diastolic velocity (PDV), resistive index (RI) of feeding arteries. In particular, we evaluated the hemodynamic features and structures of vascular lesions. We categorized the vascular lesions and then treated them with systemic steroid, compression, SPTL1 Dye laser, steroid intralesional injection and sclerotherapy. We evaluated the clinical improvement and objective effects of treatments by CDU. RESULTS: There were 37 hemangiomas and 10 vascular malformations. Vascular lesions were classified by the hemodynamic features and structures: category Ia (infantile hemangioma, regressed infantile hemangioma), Ib (RICH), Ic (deep hemangioma, mixed hemangioma), II (arteriovenous malformation), III (venous malformation, verrucous hemangioma). The clinical improvement after treatment was associated with the decrease of PSV and RI values. The clinical improvement above 50% resolution of the lesion showed 70.9% in category Ia, 50% in Ib, 66.6% in Ic, 83.3% in II and 50% in III. CONCLUSIONS: The analysis of hemodynamic feature and structures by CDU can be helpful in the study of vascular lesions. These processes suggest CDU be a useful modality in differential diagnosis of vascular lesions and a more advantageous tool in the decision of treatment policy than the conventional modalities. And it is also useful for the evaluation of treatment effects.
Angiography ; Arteries ; Biopsy ; Diagnosis, Differential ; Hemangioma ; Hemodynamics ; Humans ; Injections, Intralesional ; Lasers, Dye ; Magnetic Resonance Imaging ; Phlebography ; Sclerotherapy ; Ultrasonography* ; Vascular Malformations ; Veins

BACKGROUND: These days, narrowband-UVB (NB-UVB) phototherapy is used worldwide for treating psoriasis. Some evidence allegedly suggests that, in contrast to broadband UVB therapy, near- erythemogenic doses are not required as starting doses for NB-UVB phototherapy to decrease the risk of burning. However, a recent study has proved that the near-erythemogenic dose to start NB-UVB phothotherapy was preferable to the far-erythemogenic dose method. OBJECTIVE: We compared the therapeutic effects between 70% MED (MED70%) and 50% MED (MED50%) methods in NB-UVB phototherapy of psoriasis. In addition, to elucidate the action mechanism of NB-UVB in psoriasis treatment, we also investigated the immunosuppresive effects of Langerhans cells, macrophages and chemokine/chemokine receptors. METHOD: We compared the near-erythemogenic NB-UVB protocol (initial 70% MED+delta10% increase at each visit, twice per week) with the far-erythemogenic protocol (initial 50% MED+delta10% increase at each visit, twice per week). We performed skin biopsies after 4 times of 1 MED, once of 4 MED and once of 1 MED, along with corresponding controls from the lesional and non-lesional sites. Immunohistochemistry was also performed with anti-CD1a, anti-CD11b, anti-MCP-1 and anti-CCR2 antibodies. RESULTS: The results of immunohistochemcial experiments were as follows; 1. NB-UVB irradiation decreased the number of CD1a+ Langerhans cells in the epidermis, but increased CD11b+ macrophages in the dermis. CD11b+ macrophages were increased more in the dermis in single high-dose irradiation than repeated small dose irradiations of equivalent total doses. 2. MCP-1 was expressed only in the entire epidermis of the psoriatic lesion, and was especially high in proliferating keratinocytes of basal and suprabasal layers. It was also expressed in the papillary dermis to a lesser extent. CCR2, a receptor for MCP-1, was also found to be expressed in a similar pattern to MCP-1. Single high-dose irradiation reduced MCP-1 and CCR2 to a moderate degree, especially in the basal layer, more than the repeated low-dose irradiation of an equivalent total dose. CONCLUSION: The near erythemogenic NB-UVB protocol (MED70%) showed an earlier resolution of the psoriatic lesions and a lower recurrent rate than the far-erythemogenic NB-UVB protocol. Higher NB-UVB reduced the number of CD1a+ Langerhans cells in the epidermis, and increased CD11b+ monocytes/macrophages in the dermis. A higher dose of NB-UVB downregulated CCR-2 and MCP-1 expression. The expression patterns of epidermal and dermal APCs and chemokines in this study indicate that NB-UVB in psoriasis treatment has immunosuppressive properties. For better NB-UVB protocols in psoriasis treatment, higher starting doses and incremental doses may be desirable.
Antibodies ; Biopsy ; Burns ; Chemokines* ; Dendritic Cells* ; Dermis ; Epidermis ; Immunohistochemistry ; Keratinocytes ; Langerhans Cells ; Macrophages ; Phototherapy* ; Psoriasis* ; Skin

A 47-year-old woman with stage IV chronic kidney disease developed a fistula between common carotid artery (CCA) and internal jugular vein (IJV) during central catheterization of the right IJV. The patient was treated with a self-expandable graft stent, which achieved successful closure of the carotid-jugular fistula. As demonstrated in our case, self-expandable graft stents could be a feasible treatment option for CCA-IJV fistulas without additional interventional procedures such as balloon angioplasty.
Angioplasty, Balloon ; Carotid Artery, Common* ; Catheterization, Central Venous ; Female ; Fistula* ; Humans ; Jugular Veins* ; Middle Aged ; Renal Insufficiency, Chronic ; Stents* ; Transplants*