Large cell neuroendocrine carcinoma (LCNEC) of the lung is a newly recognized entity of pulmonary neuroendocrine carcinoma. Histologically, it is very difficult to differentiate LCNEC from other pulmonary carcinomas and the prognosis is significantly poor. The cutaneous metastasis of LCNEC of the lung shares some features with Merkel cell carcinoma of the skin in light microscopy and yet it is negatively stained with cytokeratin 20. We report a case of cutaneous metastasis of LCNEC of the lung, previously misdiagnosed as squamous cell carcinoma. Our patient showed a poor response to the chemotherapy and also revealed a brain metastasis on follow-up brain CT scan.
Brain ; Carcinoma, Merkel Cell* ; Carcinoma, Neuroendocrine* ; Carcinoma, Squamous Cell ; Drug Therapy ; Follow-Up Studies ; Humans ; Keratin-20 ; Lung* ; Microscopy ; Neoplasm Metastasis ; Prognosis ; Skin ; Tomography, X-Ray Computed

We report two cases of cutaneous oveilap syndrome in a 30-year-old woman and a 63-year-old woman. Histologically two cases showed characteristic findings of morphea and LE simultaneously in the same lesion. In case 1, direct immunofluoieence findings showed granular deposits of IgM, IgG, IgA along the dermoepidermal junction and antinuclear antibody test showed 1:80 positive finding. 1n case 2, direct immunofluoreaene findings were negative, but histopathologic findings showed distinct hydropic degeneration of the cell layer and thickening of basement membrane zone with the characteristic findings of morch. For the treatment, oral prednisolone(10mg/day), intralesicna triamcinolone injection and hydroxychloroquine(200rng/day), intralesional triamcinolone injection were performed respectively, but both two cases were not much improved.
Adult ; Antibodies, Antinuclear ; Basement Membrane ; Female ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Middle Aged ; Scleroderma, Localized ; Triamcinolone

During 1964 to 1967, a survey of 30,534 persons for filariasis was made on all over the country with the following results: Among 24,816 draftees from all over the country in the army recruitment camp 155(0.63 %) were found infected with Brugia malayi. Cheju Do showed the highest microfilaria rate(3.5 %), North Kyongsang Do(1.4 %) the next and South Cholla Do(1.2 %) the third. Blood films from 2,308 inhabitants were examined and 407(17.6 %) showed microfilaria in Cheju Do. 30(3.1 %) out of 974 inhabitants in North Kyongsang Do were found to be infected. The microfilaria rates were 2.0 per cent for 400 inhabitants of Chindo island in South Cholla Do. However, no positive case of microfilaria was found in the inhabitants of Kokumdo among 1,820 persons examined in South Cholla Do and of Namhae island(among 165 persons examined) in South Kyongsang Do. The mean microfilarial density per 20 cu. mm of blood was 52.6 in the inhabitants of Cheju Do, 12.2 in North Kyongsang Do and 27.3 in Chindo island(South Cholla Do). Any distinct relationship between the incidence of positive cases of microfilariae and age or sex of the cases was not observed in Cheju Do. However, in Norh Kyongsang Do and South Cholla Do the microfilaria rate of the male group is higher than the one of the female group of the inhabitants. From the above survey results it turned out that filariasis was found throughout Southern Korea except Kyonggi Do and South Kyongsang Do. A total 30,534 persons examined, 601(2.0 %) were found to be infected by Brugia malayi. Therefore, it seems that there are some endemic foci of malayian filariasis in three main areas such as North Kyongsang Do, South Cholla Do and Cheju Do.
parsitology-helminth-nematoda-Brugia malayi ; filariasis ; epidemiology ; Army

No abstract available.

The trematode Paramphistomum cervi empolyed in this experiment was obtained from the reticulum of cattle slaughtered at the local abbatoir. The worms were selected and washed several times in normal sterilized saline solution. Each about ten of intact worms were incubated in 50 cc volume of special incubation flasks with incubation mixture consisting of 50 cc of Krebs-Ringer phosohate buffer (pH 7.4) to which were added universally labeled C(14)-glucose and non-radioactive carrier glucose concentration of 200 mg per cent. The worms were allowed to incubate for 3 hours in the incubator at 38 C. After incubation period, respiratory CO(2) samples from central wall of incubation flask were analysed for total CO(2) production rate and their specific activity of respiratory CO(2). Glycogen samples isolated from worms were analysed for the tissue concentration and their radioactivities in order to determine the turnover rate of glycogen pool. The glucose uptake rate was determined by analysing the difference of the glucose concentration in a medium before and after incubation period. Radioactivities of these series of experiments were counted by an endwindow Geiger-Muller counter as an infinitely thin samples. The quantitative analysis of C(14)-glucose utilized by Paramphistomum cervi was summerized as the following. The glucose uptake rate by Paramphistomum was a mean value of 2.32+/-0.27 micro-mole/hr/g of wet wt. and total CO(2) production rate by the worms averaged 10.85+/-0.41 micro-mole/hr/g of wet wt. The relative specific activities of respiratory CO(2) averaged 49.72+/-13.20 per cent. Thus, a mean of 49.72 per cent of total CO(2) production rate was originated from the glucose in the medium, therefore the rate of CO(2) production derived from medium glucose was mean of 5.24+/-2.16 micro-mole/hr/g of wet wt. Thus, the average value of 37.46+/-5.28 per cent of glucose utilized by the worms from the medium glucose was oxidized to respiratory CO(2). The tissue concentration of Paraphismum was a mean of 41.56+/-5.82 micro-mole/hr/g of wet wt or 4.16+/-0.72 per cent/g , and the turnover rate of glycogen pool yielded with a mean of 0.12+/-0.014 percent/hr or 0.06+/-0.04 mg/hr/g of wet wt. Therefore, a mean value of 16.75+/-4.84 per cent of glucose was incorporated to the glycogen. These data account for that at least 54.21 per cent of the utilized glucose by the worms participated in furnishing the oxidation into respiratory CO(2) and the synthetic process into glycogen. According to the above data of the experiment, it is suggested in the metabolic process of glucose by the Paramphistomum that the synthetic process into the glycogen is less active than the oxidative process into the resppiratory CO(2).
parasitology-helminth-trematoda ; Paramphistomum cervi ; autoradiography ; biochemistry ; glucose ; metabolism ; CO(2) ; glycogen

Ticlopidine is a powerful inhibitor of platelet aggregation which is induced by adenosine diphosphate. Ticlopidine has been shown to be effective in reducing combined stroke, myocardial infarction, reocclusion of coronary stent. The principal side effects of ticlopidine are severe neutropenia, rash and gastrointestinal upset. Recently, we experienced two cases of severe neutropenia associated with ticlopidine. One was administered ticlopidine to prevent subacute thrombosis after intracoronary stent implantation in unstable angina pectoris. Thirty days of therapy, her absolute neutrophil count (ANC) had dropped to 14/mm3 . The other patient was presented with recurrent episodes of cerebral infarction, for which he had undergone right carotid angiogram. The carotid angiogram demonstrated tight stenosis of right internal carotid artery. Carotid artery stenting was performed at right internal carotid artery without any complications. Twenty seven days of ticlopidine therapy, his ANC had dropped to 111/mm3. The ticlopidine was stopped, and they were given granulocyte-colony stim-ulating factor 250 microgram/day subcutaneous injection until their ANC was up to 1000/mm3. They were discharged with normal neutrophil count and no other complications.
Adenosine Diphosphate ; Angina, Unstable ; Carotid Arteries ; Carotid Artery, Internal ; Cerebral Infarction ; Constriction, Pathologic ; Exanthema ; Granulocyte Colony-Stimulating Factor ; Humans ; Injections, Subcutaneous ; Myocardial Infarction ; Neutropenia* ; Neutrophils ; Platelet Aggregation ; Stents ; Stroke ; Thrombosis ; Ticlopidine*

Systemic lupus erythematosus is a multisystemic autoimmune disease in which the kidneys are frequently involved. Clinical diagnosis of SLE is based on the criteria of American Rheumatism Association (ARA). A few cases who were classified as SLE by the ARA criteria but were antinuclear antibody (ANA)-negative have been reported. It was reported that critical factor in ANA positivity is the choice of substrate. It is generally accepted that the cultured cell of human origin, especially HEP-2 cell, is better than tissue section or animal cells. Thus, the ANA test is negative only in approximately 2M of SLE patients when human tissue culture cells are used as substrate. We report a 25-year-old man admitted to our hospital because of generalized edema. He was found to have active lupus nephritis(WHO class IV), photosensitivity and pancytopenia. The result of FANA test which used HEP-2 cell as substrate was repeatedly negative, but anti-ds DNA and anti-Ro antibody were positive.
Adult ; Animals ; Antibodies, Antinuclear ; Autoimmune Diseases ; Cells, Cultured ; Diagnosis ; DNA ; Edema ; Humans ; Kidney ; Lupus Erythematosus, Systemic ; Lupus Nephritis* ; Pancytopenia ; Rheumatic Diseases

BACKGROUND: Defective adhesion and migration of melanocyte may be involved in pathogenesis of vitiligo. Tenascin, a glycoprotein of the extracellular matrix, has a role in cell adhesion and migration. It has been reported that abundant expression of tenascin in vitiligo lesion may inhibit melanocyte adhesion and migration. OBJECTIVE: To investigate the tenascin expression in vitiligo skin lesions and to compare with clinical findings. METHODS: We studied 9 patients with vitiligo. The expressions of tenascin were studied by immunahistochemieal techniques.
Cell Adhesion ; Extracellular Matrix ; Glycoproteins ; Humans ; Melanocytes ; Skin ; Tenascin* ; Vitiligo*

A night blood survey was carried out among inhabitants aged over 1 year from the fifteen villages throughout Cheju-Do (Quelpart Island). Blood films from 2,139 persons were examined and 183(8.6 percent) showed microfilariae, the incidences varying according to geographical sources are from 0.8 to 19.5 per cent. All the microfilariae found in this survey were of the nocturnal periodic Brugia malayi. The microfilarial density was 1.9 per cent of blood. The age and sex distributions of microfilaria rate in Cheju-Do were not distinctly different. On the other hand, the intradermal test using Dirofilaria antigen (FPT antigen) and clinical survey of filariasis were also undertaken in same areas of microfilaria survey. Out of 2,449 inhabitants examined 1,434(58.6 percent) persons showed positive reaction of skin test, 503(20.5 percent) persons have clinical manifestations and 112 (4.6 percent) persons showed elephantiasis . It is assumed that Aedes togoi may be the most probable vector of B. malayi in the areas of Cheju-Do.
parasitology ; helminth ; nematoda ; Brugia malayi ; epidemiolgy ; filariasis ; intradermal test ; blood

PURPOSE: Although percutaneous aspiration and sclerotherapy is a simple, noninvasive and cost-effective therapy for symptomatic renal cysts, the recurrence rate is high. Recently, a laparoscopy has been attempted on symptomatic renal cysts. To assess the clinical efficacy and safety of the laparoscopic cyst marsupialization, the clinical characteristics and operative parameters were evaluated, and compared with the results of sclerotherapy. MATERIALS AND METHODS: Between November 1993 and February 2003, 71 patients with symptomatic simple renal cysts were treated with either laparoscopic marsupialization or sclerotherapy. Respectively, 26 of 31 laparoscopy patients and 27 of 40 sclerotherapy patients were followed-up over a 2 months period and included in this study. The laparoscopic marsupialization was accomplished with either transperitoneal (15 patients) or retroperitoneal approaches (11). The sclerotherapy was composed of percutaneous aspiration followed by an injection of 99% ethanol. RESULTS: The clinical characteristics, including cyst size, location and laterality, were no different in either group. The mean follow-up durations were 19.7 and 18.1 months in laparoscopy and sclerotherapy groups, respectively. Comparing the laparoscopy with the sclerotherapy group, the operation time (106.2 vs. 15.3 min.), hospital stay (7.8 vs. 4.6 days) and complication rate (23.1 vs. 3.7%) were significantly decreased in the sclerotherapy group. However, the success rate (96.2 vs. 77.8%) was significantly increased in the laparoscopy group. With either the transperitoneal or retroperitoneal approaches in the laparoscopy group, there was no statistical difference in the operative time, hospital stay and complication and success rates. CONCLUSIONS: For a symptomatic renal cyst, laparoscopic marsupialization is an effective therapy, with a high success rate on the long-term follow-up. The clinical results, according to the approach method, were not different for the transperitoneal and retroperitoneal approaches.
Ethanol ; Follow-Up Studies* ; Humans ; Laparoscopy ; Length of Stay ; Operative Time ; Recurrence ; Sclerotherapy*