BACKGROUND: Transepidermal water loss(TEWL) measurement is widely used in monitoring the degree of skin irritation. There have been many reports of site variation of TEWL between different body sites. However, there have been no reports concerning site variation on the different parts of the hand, which is important for the evaluation of hand eczema. OBJECTIVE: This study was done to better understand site variation of TEWL on the hands. METHODS: TEWL measurement has been performed on the mid-forearm and seven different sites of the hands in 20 normal human volunteers using an evaporimeter. RESULTS: A marked site variation has been observed and high values observed on most parts of the hands compared to forearms. CONCLUSION: Site selection should be seriously considered in any kind of study concerning TEWL measurement of hands.
Eczema ; Forearm ; Hand* ; Healthy Volunteers* ; Humans* ; Skin* ; Water*

Epilepsy surgery can be a safe, effective treatment for individuals with intractable partial epilepsy. There is increasing evidence that brain abnormalities in focal epilepsy are not restricted to a single area. The longstanding debate around the relationship between structural lesions and the epileptic zone remains unresolved. Patients with DNT (dysembryoplastic neuroepithelial tumor), which is an essentially benign tumor, can be cured by epilepsy surgery-oriented approach. Cortical dysplasia is frequently associated with DNT and seems to contribute to epileptogenic activity of DNT. Surgical treatment should be aimed at removal of the associated cortical dysplasia as well as DNT itself for ideal treatment of the disease. Simple lesionectomy of cavernous angioma would relieve seizures significantly, but not always. The concept of epilepsy surgery needs to be recruited in the treatment of cavernous angioma with seizures because diffusion of hemosiderin into the surrounding brain tissue and formation of cortical scars can make epileptogenic areas. Cortical dysplasia is a highly epileptogenic lesion constituting an important cause of medically intractable epilepsy and surgery is a treatment of choice in a selected group of patients. Identification and complete resection of the lesion and ictal onset zone are necessary to achieve a good surgical results. Intractable epilepsy accompanied by benign brain lesions can be treated surgically using the entire armamentarium of presurgical investigations. Deliberate resective procedures aimed at complete removal of dysplastic tissue and epiletogenically active areas on and around the lesion ensure excellent seizure control without permanent neurologic deficit.
Brain* ; Cicatrix ; Diffusion ; Epilepsies, Partial ; Epilepsy* ; Hemangioma, Cavernous ; Hemosiderin ; Humans ; Malformations of Cortical Development ; Neurologic Manifestations ; Seizures

Adenomyoepithelioma is a rare benign tumor which occurs mainly in the skin, salivary gland and very rarely in the breast. Histologically this tumor demonstrates biphasic differentiation of luminal epithelial cells and myoepithelial cells. We report a case of adenomyoepithelioma occuring in the outer lower quadrant of the right breast of a 56-year-old female, confirmed histologically with an aid of immunohistochemistry. This is the first documented report in Korean literature.
Adenomyoepithelioma* ; Breast* ; Epithelial Cells ; Female ; Humans ; Immunohistochemistry ; Middle Aged ; Phenobarbital ; Salivary Glands ; Skin

Malignant rhabdoid tumor is a distinct renal tumor in pediatric age group and extremely rare in adults. It was originally described as a rhabdomyosarcomatoid variant of Wilms' tumor. But subsequent studies failed to confirm myogenous differentiation, so the rhabdoid tumor is now considered to be a distinct and unique disease type of highly malignant renal tumor, histogenetically unrelated to Wilms' tumor. However the histogenesis have not been clearly defined until now. We report a case of malignant rhabdoid tumor of the kidney in a 34-year-old man who represented with a left abdominal mass. Grossly, a large mass occupying most of the left kidney except for a part of upper pole was invading beyond renal capsule and the perirenal soft tissue. It measured 18x14 cm in dimension and was soft, lobulated and yellowish gray with large areas of hemorrhage and necroses. Microscopically, the tumor mass was composed of sheets of round or polygonal neoplastic cells growing in a solid pattern. These tumor cells were medium to large in size with ample cytoplasm containing recognizable eosinophilic inclusion and had an eccentrically located, large nucleus with one or a few prominent nucleoli. Mitotic figures were frequently observed. Ultrastructurally, the tumor cells contained whorled filamentous inclusions corresponding to vimentin, epithelial membrane antigen and cytokeratin in immunostaining.
Adult ; Male ; Female ; Humans

During tumor progression, a subset of cells acquires metastatic properties, presumably through a series of genetic alterations. As the result, cells detach from the primary tumor, penetrate the basement membrane and invade the adjacent structures including lymph and blood vessels. Loss of adhesive functions and gain of new adhesive functions are thought to play a crucial role in this metastatic cascade. Since tumor metastasis is the principle cause of death for cancer patients including colon cancer, there is a consensus that a search for tools that allow effective assessment of the metastatic potential of tumors is a prime goal for cancer research. An immunohistochemical study of cell adhesion molecules, CD44H and its variant CD44v6, was done to evaluate their relationship with known prognostic factors related to the progression and metastasis of colorectal carcinoma in 94 cases of colorectal carcinoma tissues. The results were as follows. The CD44H expression was detected in 90 (95.7%) and CD44v6 in 53 (56.4%) out of 94 cases of colorectal carcinoma, and the CD44H was overexpressed in tumor tissue more than in normal mucosa in 62% of the cases. The expression rates of both protein were not significantly correlated with age and sex of the patients, invasion depth, lymph node metastasis, tumor differentiation, and tumor site. The coexpression of CD44H and CD44v6 in tumor was significant (p<0.05). The above results suggest that overexpression of CD44H and loss of function to control the alternative splicing of CD44 mRNA resulting in CD44v6 expression and alteration of adhesive function are closely associated with tumorigenesis of the colorectum.
Adhesives ; Alternative Splicing ; Basement Membrane ; Blood Vessels ; Carcinogenesis ; Cause of Death ; Cell Adhesion Molecules* ; Cell Adhesion* ; Colonic Neoplasms ; Colorectal Neoplasms* ; Consensus ; Humans ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Prognosis ; RNA, Messenger

Benign symmetric lipomatosis is characterised by diffuse symmetric deposits of adipose tissue, predominantly on the neck, shoulder, back and upper extremities. We report a case of benign symmetric lipomatosis in a 61-year-old-man, which was first noted one year previously. It began growing rapidly about 3 months ago and was associated with alcoholic liver disease. Histopathological findings showed that the reticular dermis had been replaced by normal uncapsulated mature fat cells that were slightly increased in number in the fibrous connective tissue. He was treated with theophylline 300mg/day for two months.
Adipocytes ; Adipose Tissue ; Connective Tissue ; Dermis ; Lipomatosis* ; Liver Diseases, Alcoholic ; Neck ; Shoulder ; Theophylline ; Upper Extremity

There is increasing evidence that thrombin is directly involved in the pathogenesis of cerebral edema after intracerebral hemorrhage. Some authors emphasize that early removal of hematoma using plasminogen activator can be an effective intervention that interrupts the cascade of events leading to increasing edema formation and white matter injury. Recently, there are many reports of the edema intensification following plasminogen activator-induced lysis of the intracerebral clot. The author reports a case who showed protracted perihematomal edema after hematoma evacuation and fibrinolysis therapy with urokinase. Considering that the benefit obtained from fibrinolysis therapy may be offset by an accentuation of its toxic edematous effect, further investigation into the use of urokinase for hematoma evacuation should be undertaken.
Brain Edema ; Cerebral Hemorrhage ; Edema* ; Fibrinolysis* ; Hematoma ; Plasminogen ; Plasminogen Activators ; Thrombin ; Urokinase-Type Plasminogen Activator*

Isolated ACTH deficiency is a uncommon disorder causing secondary adrenocortical insufficiency. Less than 200 cases have been reported in the world. The major clinical manifestations are hypoglycemia, weight loss, hypotension, anemia, weakness, nausea, inability to excrete water load, and hyponatremia. A 56-year-old male was admitted because of weakness, fatigue, nausea and vomiting. He was pallor and not associated with hyperpigmentation. The basal plasma ACTH and cortisol levels were 8.30 pg/ml and 0.6 ug/dl. The serum cortisol did not response to rapid ACTH stimulation test. On combined pituitary stimulation test, the cortisol did not response to insulin-induced hypoglycemia. Other anterior pituitary hormones showed normal responses except elevated prolactin level. Six months after glucocorticoid replacement therapy, the elevated basal prolactin level returned to normal. Brain MRI did not show any anatomic abnormalities of the sellar and suprasella area. We report a case of isolated ACTH deficiency accompanied by hyperprolactineia, which respond to glucocorticoid replacement therapy.
Adrenal Insufficiency ; Adrenocorticotropic Hormone* ; Anemia ; Brain ; Fatigue ; Humans ; Hydrocortisone ; Hyperpigmentation ; Hyperprolactinemia* ; Hypoglycemia ; Hyponatremia ; Hypotension ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nausea ; Pallor ; Pituitary Hormones, Anterior ; Plasma ; Prolactin ; Vomiting ; Water ; Weight Loss

In this retrospective study, 49 patients who were treated by surgical resection of colorectal cancer, confuted to proper muscle and confirmed histologically from 1979 to 1996 were included. To examine the significance of growth pattern in terms of polypoid growth(PG)(n=26; m,sm 5, pm 21) and non-polypoid growth(NPG)(n=23; m,sm 3, pm 20), we analyzed several clinocopathologic variables by x2 test and unpaired t-test, 5-year survival rate by Kaplan-Meier method and Log-Rank statistics according to growth type comparatively: 1) In the PG tumor, muscle elevation(P<0.0117) and association with adenoma(P<0.0001) were more frequent than in the NPG. 2) The NPG type showed smaller size(P<0.0172) and higher rate of lymph node metastasis(P=0.025) and higher tendency of lymphatic invasion(P=0.07) and poor differentiation(P=0.0693) and deeper invasion(P=0.0972) and worse 5-year survival(P=0.0607). 3) Otherwise there was no difference in inflammation, fibrosis, and angioinvasion. 4) The mean thickness of Outer Longitudinal Muscle(OLM) was thicker in rectum than colon(rectum 1.62 mm, colon 0.74 mm, p<0.0059) and pm cancer was more in rectum than in colon(rectum 10.3%, colon 4.0% , p=0.0057). In the view of results, NPG in early colorectal cancer may suggest the possibility of de novo cancer. NPG type was smaller in the size but more aggressive in lymph node metastasis, lymphatic invasion, invasion depth, tumor differentiation, 5-year survival rate. So it needs more thorough follow up. The higher incidence of pm cancer in rectum than in colon, is probably due to thicker OLM of rectum than that of colon.
Colon ; Colorectal Neoplasms* ; Fibrosis ; Follow-Up Studies ; Humans ; Incidence ; Inflammation ; Lymph Nodes ; Lymphatic Metastasis ; Rectum ; Retrospective Studies ; Survival Rate

The vasoactive effecs of ketamine on aortic and pulmonary arteries have not heen clearly characterized. Nevertheless, it has been recommended to avoid ketamine in systemic and pulmonary hypertension because of its tendency to increase systemic and pulmonary vascular resistance. This study was designed to investigate and compare the direct effects of ketamine on isolated rat aortic and pulmonary arteries, with or without intact endothelium. The optimal resting tension (Lmax) of each ring was searched hased on contractile responses to 3.7X10(6)M norepinephrine. Once the Lmax was Obtained, the peak developed tension was recorded as the control. Thereafter, in the second part of the experiments, prior to ketamine exposure, the endothelium was denuded which was confirmed pharmacologically using norepinephrine(3.7X10-6M) and acetylcholine(10(-6)M). In groups with intact endothelium, .3X10(3)M ketamine relaxed aortic and pulmonary artery ring by -10.3+/-5.6%, -17.8+/-4.4%, respectively. In groups without intact endothelium, 3X10(3)M ketamine relaxed aortic and pulmonary artery ring by -9.9+/-3.6%, -14.2+/-3.8%, respectively. It was statistically significant. In groups with or without intact endothelium, 0.1X10(3) M ketamine relaxed aortic and pulmonary artery ring. Hut it was statistically insignificant. We conclude that ketamine is a powerful aortic and pulmonary artery dilator in vitro and that is endothelium independent.
Animals ; Aorta* ; Endothelium ; Hypertension, Pulmonary ; Ketamine* ; Norepinephrine ; Pulmonary Artery* ; Rats* ; Vascular Resistance