A 38-year-old man presented with a black pigmented patch overlying his upper lip, a part of the gingiva and the hard palate. An intradermal tumor mass was palpated at the central portion of the pigmented patch of the upper lip. Diphenylcyclopropenone (DPCP) is a potent contact sensitizer that could stimulate non-specific immunity. We report a case of desmoplastic malignant melanoma (DMM) in which an atypical lentiginous pigmentation disappeared with topical DPCP immunotherapy and the dermal tumor mass was removed by a surgical wedge-shaped excision. Though an atypical lentiginous pigmentation of DMM sometimes undergoes extensive spontaneous regression, in our case it could be attributed to the therapeutic effect of topical DPCP immunotherapy rather than a spontaneous regression.
Adult ; Gingiva ; Humans ; Immunity, Innate ; Immunotherapy ; Lip ; Melanoma* ; Palate, Hard ; Pigmentation*

The purpose of this study was to evaluate the clinical and microbiological effects of metronidazole 25% dental gel that was applied to periodontal pockets who have moderate to advanced chronic adult periodontitis were selected for this study. The quadrants that had 2 or 3 teeth with 5-8mm probing pocket depth were selected and divided into test side and control side according to the split-mouth design. The metronidazole 25% dental gel applied on test side and 0.12% chlorhexidine solution applicated on positive control side, normal saline irrigation into periodontal pocket was applicated to negative control side respectively. Above procedures followed scaling and root planing at baseline(0week). The subgingival sterile saline irrigation and chlorhexidine irrigation were done for about 30seconds respectively. The metronidazole 25% dental gel was applied to periodontal pocket at 0,1 week in the test side. The clinical and microbiological analysis carried out at baseline(0week) and 4,8 weeks. The results of this study were as follows; 1. The sulcular bleeding index, probing pocket depth were significantly reduced in the test group. The relative proportions of spirochetes and motile rods were significantly reduced to negative control group and the proportion of cocci was correspondingly increased in the test group. 2. The sulcular bleeding index, probing pocket depth were significantly reduced in metronidazole group. and, there was a significant differences between 2 groups. Also, the relative proportions of spirochetes and motile rods were reduced in both group. And, there was a significant differences between 2 groups. In conclusion, application of metronidazole 25% dental gel as an adjunct to mechanical debridement of root surfaces may improved the clinical and microbiological status of periodontal disease sites.
Adult* ; Chlorhexidine ; Chronic Periodontitis* ; Debridement ; Hemorrhage ; Humans ; Metronidazole* ; Periodontal Diseases ; Periodontal Pocket ; Root Planing* ; Spirochaetales ; Tooth

Trichilemmal horn(trichilemmal keratosis) is a rare keratinizing tumor that resembles a cutaneous horn. Histologically, it is characterized by an abrupt maturation of keratinocytes into lamellar keratin without the formation of a granular layer. We describe a case of a trichilemmal horn on the right cheek of a 78-year-old woman.
Aged ; Animals ; Cheek ; Female ; Horns* ; Humans ; Keratinocytes

The aim of our study is to achieve complete periodontal tissue regeneration by the application of BMP and resorbable membrane. Three beagle dogs aged over one and half years and weighed 14 to 16 kg were used in this study. Mandibular 1st, 2nd premolars were extracted bilaterally. Horizontal furcation defects were induced around 3rd, 4th premolars bilaterally. BMP-4 were applied in the right side with resorbable membranes and only resorbable membranes were applied in the left side respectively. Each animal was sacrificed at 2, 4, and 8weeks, after regenerative surgery. Specimens were prepared with Hematoxylin-Eosin stain and Goldner's modified Masson Trichrome stain for light microscopic evaluation. The results were as follows: 1. At 2 weeks after regenerative surgery, downgrowth of junctional epithelium was observed both in the membrane-applied site and BMP-4-and-membrane-applied site. 2. At 4 weeks after regenerative surgery, resorbable membranes were completely resolved, therefore would not prevent downgrowth of junctional epithelium. New bone formation, new cementum formation and Sharpey's fiber were observed in BMP-4-and-membrane-applied site. 3. At 8 weeks after regenerative surgery, downgrowth of junctional epithelium was observed in the membrane-applied site. But, new cementum formation was observed in the same site. The extensive regeneration of new bone, new cementum and remarkable formation of Shapey's fiber were showed in BMP-4-and-membrane-applied site. 4. Resorbable membranes were resolved via the cell-mediated processes. 5. Periodontal tissue regeneration were better achieved in the BMP-4-and-membrane-applied site than in the membrane-applied site. Within the above results, BMP-4 may have the strong capability to form the new bone and resorbable membrane may be able to prevent the bony ankylosis. However, resolution rate of resorbable membrane may not be enough to protect rapid epithelial downgrowth for ideal periodontal regeneration. In conclusion, I suggest BMP-4 may have the strong possibility to be utilized in the clinical periodontal treatments.
Animals ; Ankylosis ; Bicuspid ; Dental Cementum ; Dogs ; Epithelial Attachment ; Furcation Defects ; Membranes* ; Osteogenesis ; Regeneration*

Cervical incompetence is characterized by painless dilation and effacement of the cervix in the second trimester of pregnancy leading to premature rupture of membranes and preterm delivery. Various surgical and nonsurgical approaches have been advocated as treatment for incompetent cervix. The most widely used surgical methods are the Shirodkar and McDonald methods of cervical cerclage. Shirodkar method is more difficult to perform than the McDonald method, but it makes it possible for the cervix to return to more anatomically safe position. We experienced two cases of mild amniotic membrane bulging associated with incompetent cervix; one during 28(+4) weeks of pregnancy and the other during 25(+6) weeks of pregnancy. We were able to perform the emergency cervical cerclage with Shirodkar method by using the allis clamp on the edge of the incision site to traction the dilated and effaced cervix effectively, and were able to maintain the two cases of pregnancy. Both delivered healthy babies at term. So we report this case with a brief review of literature.
Amnion ; Cerclage, Cervical* ; Cervix Uteri ; Emergencies* ; Female ; Humans ; Membranes ; Pregnancy ; Pregnancy Trimester, Second ; Rupture ; Traction ; Uterine Cervical Incompetence

Cervical incompetence is characterized by painless dilation and effacement of the cervix in the second trimester of pregnancy leading to premature rupture of membranes and preterm delivery. Various surgical and nonsurgical approaches have been advocated as treatment for incompetent cervix. The most widely used surgical methods are the Shirodkar and McDonald methods of cervical cerclage. Shirodkar method is more difficult to perform than the McDonald method, but it makes it possible for the cervix to return to more anatomically safe position. We experienced two cases of mild amniotic membrane bulging associated with incompetent cervix; one during 28(+4) weeks of pregnancy and the other during 25(+6) weeks of pregnancy. We were able to perform the emergency cervical cerclage with Shirodkar method by using the allis clamp on the edge of the incision site to traction the dilated and effaced cervix effectively, and were able to maintain the two cases of pregnancy. Both delivered healthy babies at term. So we report this case with a brief review of literature.
Amnion ; Cerclage, Cervical* ; Cervix Uteri ; Emergencies* ; Female ; Humans ; Membranes ; Pregnancy ; Pregnancy Trimester, Second ; Rupture ; Traction ; Uterine Cervical Incompetence

Female pelvic tuberculosis is almost invariably secondary to disease elsewhere, usually in the lungs. It is difficult to diagnose pelvic tuberculosis, because it is often a disease with absent or few non-specific symptoms. Pelvic tuberculosis should be considered in the differential diagnosis of all ovarian mass and pelvic malignancy. We report a case of retroperitoneal tuberculous lymphadenopathy that may be mistaken for pelvic malignancy, because of the nonspecific clinical features and radiologic findings. The diagnosis was made post-operatively by histopathology.
Diagnosis ; Diagnosis, Differential ; Female ; Humans ; Lung ; Lymphatic Diseases* ; Retroperitoneal Space ; Tuberculosis

No abstract available.
Classification* ; Humans ; Spinal Cord* ; Urodynamics*

Hirsutoid papillomas of vulvae present as smooth or filiform papules located on the inner surfaces of the labia minora. This disease is usually considered as anatomical variants of the vestibular mucosa. Differentiation from condyloma acuminata is important to avoid unnecessary treatment. Herein we report a case of hirsutoid papillomas of vulvae in a 21-year-old female who complained of pruritic papules on the vulva of one year's duration. Papules were located on the inner surfaces of the left labia minora and vestible of the vulva. Clinically, they were quite similar to condyloma acuminata. Histologically, however, the epithelium was devoid of features of human papillomavirus(HPV) infections such as koilocytosis, double nucleation, and dyskeratosis.
Epithelium ; Female ; Humans ; Mucous Membrane ; Papilloma* ; Vulva* ; Young Adult

BACKGROUND: Calcium channel blockers and volatile anesthetics have depressant effects on cardiac function. Both of them appear to exert, qualitatively and quantitatively, different effects on myocardial contractility, coronary flow, and myocardial oxygen balance. The aim of this study was to examine the direct cardiac effects of the enflurane in the presence of diltiazem. METHODS: Isolated Sprague-Dawley rat hearts (N=45) were perfused at constant pressure with oxygenated Modified-Krebs solution (pH 7.4, 37oC). Isovolumetric left ventricular pressure (LVP) and dP/dt were measured via a latex balloon and transducer. Also, coronary flow and oxygen tensions at the coronary inflow and outflow were measured. After stabilization period, all hearts were subjected to the application with diltiazem (100 ng/ml). Thereafter, they were subdivided into three groups; group 1, 2, 3. Groups subjected to the combination of diltiazem (100 ng/ml) with enflurane 1.1, 2.2, or 3.3 vol%, respectively. RESULTS: After the application of diltiazem, myocardial contractility and heart rate were significantly decreased, and coronary flow were significantly increased. The combination of diltiazem with enflurane depressed myocardial contractility, heart rate, myocardial O2 consumption, and percentage of O2 extraction more than diltiazem alone, and their effects were dependent on the concentration of enflurane. However, there was no difference in the change of coronary flow and oxygen delivery between diltiazem and the combination of diltiazem with enflurane. CONCLUSIONS: These in vitro findings demonstrate that the combination of diltiazem with enflurane shows greater direct negative inotropic and negative chronotropic effect, and is associated with less attenuation of coronary autoregulation, but with a larger reduction in O2 utilization. The present results suggest that high enflurane anesthesia in the diltiazem-pretreated patients could result in profound cardiac depression.
Anesthesia ; Anesthetics ; Animals ; Calcium Channel Blockers ; Depression ; Diltiazem ; Enflurane* ; Heart Rate ; Heart* ; Homeostasis ; Humans ; Latex ; Myocardial Contraction ; Oxygen ; Rats* ; Rats, Sprague-Dawley ; Transducers ; Ventricular Function, Left* ; Ventricular Pressure