No abstract available.
Aortic Rupture*

Percutaneous vertebroplasty is a relatively recent procedure in the treatment of osteoporotic vertebral compression fractures. Bone cement embolism is a severe and potentially life-threatening complication of percutaneous vertebroplasty with cement. The risk for cement pulmonary embolism ranges between 3.5 and 23% for osteoporotic fractures. Bone cement leakage may be usually more frequent with vertebroplasty than with kyphoplasty. We experienced a 69-year-old female patient of an asymptomatic pulmonary embolus (length 8 cm) after kyphoplasty for an osteoporotic vertebral compression fracture
Aged ; Embolism ; Female ; Fractures, Compression ; Humans ; Kyphoplasty ; Osteoporotic Fractures ; Pulmonary Embolism ; Vertebroplasty

BACKGROUND: The bcl-2 is a newly known oncogene involved in tumorigenisis by blocking apoptosis or programmed cell death. Overexpression of bcl-2 protein has been detected in a variety of human malignancies. However, recent studies of the expression of bcl-2 protein in human melanoma and melanocytic nevus have been controversial. OBJECTIVE: The purpose of this study was to examine whether there are any differences in the expression of bcl-2 protein between melanocytic nevus and rnalignant melanoma. METHODS: Immunohistochemical analysis of bcl-2 protein expression was performed on the formalin-fixed, paraffin-embedded tissue sections of 22 melanocytic nevus and 29 malignant melanomas (20 primary and 9 metastatic) using anti bcl-2 monoclonal antibody with an avidin-biotin peroxidase complex procedure. RESULTS: The results were as follows. 1. The positive rate for bcl-2 protein was observed in 95.4% (21/22) of melanocytic nevus and 95.0% (19/20) of primary malignant melanomas. Therefore, there was no significant difference between the two groups in the positive rate for bcl-2 prtoein. 2. The percentage of stained cells and the staining intensity of bcl-2 protein were significantly increased in melanocytic nevus compared to malignant melanoma (p<0.05). 3. The positive rate for bcl-2 expression of metastatic malignant melanoma [44.4% (4/9)] was significantly decreased compared to that of primary malignant melanoma [95.0%(19/20) ] (p<0. 05). But, there was no significant difference betweeen tumor thickness and histological type of malignant, melanoma in the expression of bcl-2 protein. 4. In melanocytic nevus, immunoreactivity of bcl-2 protein gradually diminished or even disappeared towards the deep dermis. CONCLUSION: the bcl-2 expression was decreased in malignant melanoma compared to melanocytic nevus. It. suggests that the loss of bcl-2 expression may play a significant role in the progression and metastasis of malignant melanoma.
Apoptosis ; Cell Death ; Dermis ; Humans ; Melanoma* ; Neoplasm Metastasis ; Nevus, Pigmented* ; Oncogenes ; Peroxidase

The pseudolymphoma syndrome that may mimic malignant lymphoma clinically and histopathologically has been described as a hypersensitivity reaction to anticonvulsant drugs. It consists of the triad of a fever, generalized rash and lyrnphadenopathy. In some cases, varying degrees of malaise, hepatosplenornegaly, abnormal liver function tests, arthralgias, eosinophilia and blood dyscriasias may also be present. We report a case of pseudolymphoma syndrome due to carbamazepine in a 47-year-old man. He had a diffuse edematous and erythematous patches, papules and vesicles associated with high fever, hepatosplenomegaly and lymphadenopathy. The histopathologic finding slowed a dense atypical mononuclear cell infiltrate of the upper dermis associated with Pautriers microabscess like structures and severe dermal edema. Laboratory findings revealed leukocytosis and an abnormal liver function test. Three weeks after the withdrawal of carbamazepine and treatment with oral prednisolone, his skin lesion and general condition markedly improved.
Anticonvulsants ; Arthralgia ; Carbamazepine* ; Dermis ; Edema ; Eosinophilia ; Exanthema ; Fever ; Humans ; Hypersensitivity ; Leukocytosis ; Liver Function Tests ; Lymphatic Diseases ; Lymphoma ; Middle Aged ; Prednisolone ; Pseudolymphoma* ; Skin

Infections of the face, especially of the medial third or "the danger triangle", are the most frequent primary foci associated with thrombosis of cavernous sinus. Microorganisms entering the facial vein and pterygoid plexus from these sites are easily carried to the sinus through the ophthalmic vein. When the septic thrombosis involves various structures in the sinus, multiple clinical manifestations develop and if appropriate anti-infective therapy is not instituted timely, grave consequences with high mortality is possible. Recently, we experienced such a case. A five-year-old boy had high fever, proptosis, periorbital edema, chemosis and limitation of eye movements. Three days before admission, he had suffered from erythematous swelling spreading over the periorbital area, where simple steroid ointment containing no antibiotics had been applied after a furuncle on the nose had been squeezed. On admission, brain MRI revealed meningeal enhancement, high-signal densities in enlarged right cavernous sinus and narrowing of internal carotid artery. Analysis of cerebrospinal fluid showed bacterial meningitis and the cultures of blood and eye discharge proved to be Staphylococcus aureus. On massive antibiotic therapy, he recovered swiftly without any adverse sequelae. The authors report this case with a warning against wide-spread misuse of steroids and inadequate treatment of the mostly neglected, but once-dreaded minor infections on the face.
Anti-Bacterial Agents ; Brain ; Carotid Artery, Internal ; Cavernous Sinus Thrombosis* ; Cavernous Sinus* ; Cerebrospinal Fluid ; Edema ; Exophthalmos ; Eye Movements ; Fever ; Furunculosis* ; Humans ; Magnetic Resonance Imaging ; Male ; Meningitis, Bacterial ; Mortality ; Nose ; Staphylococcus aureus ; Steroids ; Thrombosis ; Veins

Cutaneous cholesterol embolism is a disease with severe arterosclercsis of the abdominal aorta in which emboli of cholesterol crystals from atheromatous plaques occlude airterioles. We report a case of cutaneous cholesterol embolism in a 61-year-old man who had livedo reticularis on both his feet for 10 days. Histopathologic findings showed needle-shaped cholesterol clefts viithin the lumina of arterioles. The patient died of myocardial infarction 3 months later.
Acrospiroma ; Aorta, Abdominal ; Arterioles ; Cholesterol* ; Embolism, Cholesterol* ; Foot ; Humans ; Livedo Reticularis ; Middle Aged ; Myocardial Infarction ; Plaque, Atherosclerotic

Penile melanosis is a beniign macular hyperpigmentation of the penile shaft and/or glans. Clinically the lesions are irregular in outline and show variegated pigmentation. The main differential diagnostic problem is with acral levtiginous melanoma. A 28-year-old man was seen with slowly growing, asymptomatic, multifocal, and variegated hyperpigmented maculs on the glans penis of 28-year-duration. The post and family history were non-contributory. Hostogologic examination showed acanthosis and basal layer hyperpigrnentation but atypical melanocytes were not seen. Fontana-Masson stain showed increased melanin pigmentation with dendritic elongation of melanocytes in the basal layer of the epidermis. Little is known about the natural history and melnona risk of penile melanosis and we believe that a long-term follow-up is warranted. This patient showed no change during the follow-up period of 2 years and we will continue to monitor him long-term.
Adult ; Epidermis ; Follow-Up Studies ; Humans ; Hyperpigmentation ; Male ; Melanins ; Melanocytes ; Melanoma ; Melanosis* ; Natural History ; Penis ; Pigmentation ; Vitiligo

Woringer-Kolopp(W-K) disease is a rare, localized, histologically malignant, but clinically indolent lymphoproliferative disorder. It usually shows only a single slowly enlarging skin lesion mainly on the extremities. Some authors have regarded W-K disease as a variant of mycosis fungoides. However, recent studies suggest that W-K disease may represent a spectrum of T cell lymphoproliferative disoreers that may not be related to mycosis fungoides. We report a case of Woringer-Kolopp disease in a 60-year-old male who presented with a solitary slowly growing tumor on his left palm for 3 years. Histopathologic examination showed marked acanthosis and pagetoid infiltration confined to the epidermis. He was treated with 4,000 red electron beam irradiation to the area with complete resolution of the lesion. Three years later, a similar lesion appeared on his left foot dorsum. He was treated as previously with a good response and there has been no new lesion during the last 1 year follow up period.
Epidermis ; Extremities ; Follow-Up Studies ; Foot ; Humans ; Lymphoproliferative Disorders ; Male ; Middle Aged ; Mycosis Fungoides ; Pagetoid Reticulosis* ; Skin

Proliferations of the endometrial glands form a continuum from focal glandular crowding through simple hyperplasia, complex hyperplasia and atypical hyperplasia to frank adenocarcinoma. But objective criteria to distinguish these proliferative endometrial lesions are not clear-cut and terminology is confusing. The p53 protein is a nuclear phosphoprotein that can regulate cell proliferation and suppress tumor growth. Mutation in the p53 gene have been reported in a variety of human tumors, and in selected malignancies overexpression of p53 has been associated with poor prognosis. In this study we examined a series of endometrial proliferative lesion, including hyperplasia, adenocarcinoma, and adenomyosis to determine whether or not p53 is overexpressed in these lesions. In the result, p53 immunoreactivity was observed in 3 of 17 (17.6%) simple hyperplasia, one of 6 (16.6%) complex hyperplasia, none of 3 (O%) atypical hyperplasia, 6 of 13 (46.1%) adenocarcinoma and none of 10 (O%) adenomyosis. In conclusion, p53 mutation seems to play a role in oncogenesis of endometrial adenocarcinoma in early phase but there was no significant relationship between p53 overexpression and histologic grade of adenocarcinoma.
Adenocarcinoma* ; Adenomyosis ; Carcinogenesis ; Cell Proliferation ; Crowding ; Endometrial Hyperplasia* ; Female ; Genes, p53 ; Humans ; Hyperplasia ; Prognosis

No abstract available.