The prostate-specific antigen (PSA) has been considered a useful tumor marker in monitoring responses, disease progression and recurrence after therapy in patients with prostatic cancer. However. The effect of digital rectal examination on serum PSA determination has remained controversial. The author. therefore. investigated the influence of examination on seurm PSA values. Blood samples were taken before (T0) and 5 minutes (T1), 1 hour (T2), 24 hours (Ts) and I week (T4) after digital rectal examination and the concentration of serum PSA was measured using a Tandeme radioimmunometric assay in 49 persons including 7 patients with prostatic cancer. 27 patients with BPH and 15 controls free of prostatic disorder, The following results were obtained. 1. In normal control group. the mean (+/-SD) PSA values before and 5 minutes, 1 hour. 24 hours and l week after digital rectal examination were 1.51+/-1.12, 2.12+/-1.57. 2.53+/-1.62, 2.39+/-1.41 and 1.97+/-1.20 (ng/ml) respectively. Although serum PSA values measured at 5 minutes. 1 hour, 24 hours and 1 week after digital rectal examination were significantly elevated (p<0.05), most of post-examination PSA values remained within the normal range. 2. In benign prostatic hyperplasia. statistically significant differences between PSA values before and 1 hour and 24 hours after digital rectal examination were observed (p<0.05), while in prostatic cancer group. there were no significant differences between paired pre-examination and post-examination mean PSA values. 3. There were statistically significant differences between PSA values before and 5 minutes, 1 hour, 24 hours and 1 week after rectal examination in normal-value group (<4.0 ng/ml) and between PSA values before and 1 hour after rectal examination in high-value group (>4.0 ng /ml). These results suggest that the evaluation of the concentration or PSA level for prostatic cancer suspected should be done before or immediately after prostatic manipulation.
Digital Rectal Examination* ; Disease Progression ; Humans ; Prostate* ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Recurrence ; Reference Values

BACKGROUND: Morphologic characteristics of the human embryonic and fetal periderm according to body region are not very clearly defined. OBJECTIVE: We have tried to Clarify the sequential development of periderm regionally. METHOD: Skin samples were obtained from 12 human embryos and fetuses ranging from 4 to 23 estimated gestational ages(EGA) and divided regionally into scalp, face, back. abdomen, thigh and sale. Specimens were observed by scainning with an electron microscope. RESULTS: Human embryonic end fetal periderm show distinct morphologic changes as follows along its own sequence of development flattened surface, elevated surface, fiormation of incomplete bleb. single bleb stage, multiple-complex bleb stage, formation of regressinjg bieb. Then towards the end of the second trimester, most of thieperidermal cells are completely regressed. Regional variation in peridermal development is not evide!nt during the embryonic period, but earlier development is apparent in the sole, face and scalp especially in the sole compared to other areas during the late first snd second trimester after EGA 9 weeks. CONCLUSION: The periderm, which can be seen only in embryonic and fetal epidermis, shows distinct sequential developmental changeis with regional variation.
Abdomen ; Blister ; Body Regions ; Commerce ; Embryonic Structures ; Epidermis ; Female ; Fetus ; Humans* ; Pregnancy ; Pregnancy Trimester, Second ; Scalp ; Skin ; Thigh

No abstract available.
Humans ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder*

Cheilitis glandularis simplex, the clinical term first defined by Puente and Acevedo in 1935, is characterized by the development of hyperplastic mucous glands in the lips, associated with dilated ductal canals; it is manifested clinically by a usually painless swelling of the lips and a variably constant, bothersome, sticky mucoid discharge. Recently we have experienced a case of cheilitis glandularis simplex in a 13-year-old boy and an excellent cosmetic result was obtained after surgical excision and repair.
Adolescent ; Cheilitis* ; Humans ; Lip ; Male

No abstract available.
Laparoscopy* ; Ureter*

Wegener's granulomatosis is a systemic necrotizing vasculitis of unknown cause. The disease is characterized by the involvement of the upper airway, the lung, and the kidney. Skin lesions are frequent and the most common lesion is purpura distributed on the limbs and trunk. A 34-year-old female showed recurrent purpuric macules on the both lower extremities and buttocks. The patient. showed nasal septal perforation with saddle nose deformity and C-ANCA positivity. Histopathologic findings of purpuric lesion revealed the features of necrotizing vasculitis. The histologic specimen from the nasal cavity showed chronic inflammation with granuloma formation and kidney showed focal necrotizing glomerulonephritis. Therefore, we treated the patient with prednisolone and cyclophosphamide having diagnosed Wegener's granulomatosis.
Adult ; Antibodies, Antineutrophil Cytoplasmic ; Buttocks ; Congenital Abnormalities ; Cyclophosphamide ; Extremities ; Female ; Glomerulonephritis ; Granuloma ; Humans ; Inflammation ; Kidney ; Lower Extremity ; Lung ; Nasal Cavity ; Nasal Septal Perforation ; Nose ; Prednisolone ; Purpura ; Skin ; Vasculitis ; Wegener Granulomatosis

BACKGROUND: Tufted angioma is an uncommon slowly progressive vascular tumor found typically in infants and young children with characteristic histologic findings, so called "cannonball" appearance. OBJECTIVE: The purpose of this study was aimed to investigate the clinical and histopathological characteristics of tufted angioma and the response to intralesional steroid. METHODS: Clinical information of 10 patients with tufted angioma diagnosed in Severance hospital and Pundang CHA hospital from 1983 to 1999 was obtained from the medical records and clinical follow-ups. We re-evaluated 10 biopsy specimens obtained from them with routine H&E staining. RESULTS: Five male and five female patients were included. In 9 patients the lesion appeared before 2 months of age. Four had a lesion at birth. The thigh was the most common site. The clinical symptoms were diverse, but characteristically tenderness was present in most cases. In all the patients the lesions had a tendency to spread progressively. Microscopically, numerous, distinct, variably sized, tightly packed capillary and endothelial cellular lobules were scattered in the dermis. There were characteristic semilunar spaces adjacent to the capillary tufts. Six patients received intralesional triamcinolone. This treatment was found to be effective in 5 patients who experienced remarkable improvement. The improved cases had similar histologic findings which were composed of cellular mass more than lumen formation. We classified our specimens into two categories, one with more cellular mass and the other with more lumen formation in relative proportion. The former was different from the latter in that it had more solid appearance and more definite margin. And we realized that it was useful to divide into these two categories since its response to treatment could be different. CONCLUSIONS: Tufted angioma is a relatively uncommon disease with characteristic histopathologic findings. It seems not to regress spontaneously. So early treatment is required to pre-vent further spreading up to the extent. We treated 6 patients with intralesional injection of triamcinolone and 5 patients experienced marked improvement which had more cellular mass more than lumen formation histopathologically.
Biopsy ; Capillaries ; Child ; Dermis ; Female ; Follow-Up Studies ; Hemangioma ; Humans ; Infant ; Injections, Intralesional ; Male ; Medical Records ; Parturition ; Thigh ; Triamcinolone

The onset of systemic scleroderma in the first. decade of lif occurs in less than 1.5% of instances. Systemic sclerodrma in childhood have been characterized by less severe visceral involvement and a benign course We report a boy, aged 7 years, with a history of Raynaid; phenomenon and dysphagia. He had a mask-like face, flexion contracture of hands and knee joints, digital pitting scars, ichthyosiform skin change on leg and hyperpigrnented induration on all extremities and trunk. Antinuclear antibodies were positive in nucleolar type and Scl-70 antiocy was also present. On radiologie study, the pattern of reflux esophagitis and resorption of the listal ends of all phalanges were nated. Histopathological findings were compatible with sclerodma. He was treated with Penicillamine-D and oral corticosteroic with good improvernent.
Antibodies, Antinuclear ; Cicatrix ; Contracture ; Deglutition Disorders ; Esophagitis, Peptic ; Extremities ; Hand ; Humans ; Knee Joint ; Leg ; Male ; Scleroderma, Systemic* ; Skin

No abstract available.
Urodynamics*

Carcinoma of the breast can produce cutaneous metastases which sbow highly diversified clinical pictures. The cutaneous metastases produce four definite clinical types: inflammatory carcinoma, telangiectatic carcinoma, nodular carcinoma, and carcinoma, en cuirasse. We present a case of 78-year-old nulliparous woman who had several painful dark purplish colored zosteriform papulovesicular eruptions, suggestive of herpes zoster, on the right breast, right axilla, scapular area, and upper arm for three month. Two month later, well dermacated linearly arranged erysipeloid eruptions appeared around the previous skin lesions and the right chest wall. Histopathological findings showed metastatic ductal carcinoma with massive vascular permeation but the primary focus was undetermined.
Female ; Humans ; Neoplasm Metastasis