A case of diffuse malignant mesothelioma of peritoneum which was difficult to distinguish from metastatic anaplastic carcinoma or malignant melanoma was presented. The patient was a 50 year-old woman and complained of an abdominal pain and ascites for 20 days. Histologically, the tumor cells showed highly anaplastic appearance with sheet-like arrangement without any papillary or tubular structure. They stained Positive for cytokeratin and vimentin and negative for CEA, S-100 protein and melanoma associated antigen. A few cells within the tumor showed Positive reactivity to desmin. Ultrastructurally, the tumor cells had characteristic findings of mesothelioma such as long, exuberant, wavy microvilli with 10 to 12 of length/diameter ratio. The patient died 3 months after the diagnosis in spite of intraperitoneal chemotherapy.
Female ; Humans ; Neoplasm Metastasis

Microvascular tissue transfers have facilitated primary closure of various complex defects after radical ablation of head and neck cancers. From Oct 1991 to Feb 1992, we used forearm free flap in two patients and delto-pectoral flap in one patient who had preoperative irradiation for pharyngoesophageal reconstruction. The stricture and fistula formation were most troublesome complication in forearm free flap, so we designed as lazy S shape in distal flap margin to prevent circular contraction and longitudinal margin was deepithelialized (5 mm) and sutured double layer to withstand fistular formation and this can be considered useful in place of a free jejuna transfer.
Constriction, Pathologic ; Fistula ; Forearm ; Free Tissue Flaps ; Head ; Humans ; Neck

A solitary, asymptomatic lesion, clinically resembling a transpare it cyst, has been present for 4 months in the vaginal mucosa of a 43-year-old healthy woman. An xcisional biopsy revealed the lesion to be a focal accumulatition of hyaluronic acid replacing the collagen fibers and fibroblastic proliferation in the dermis consistant with cutaneous focal mucinosis. During the follow-up period for 3 months, no recurrence was observed.
Adult ; Biopsy ; Collagen ; Dermis ; Female ; Fibroblasts ; Follow-Up Studies ; Humans ; Hyaluronic Acid ; Mucinoses* ; Mucous Membrane* ; Recurrence

A solitary, asymptomatic lesion, clinically resembling a transpare it cyst, has been present for 4 months in the vaginal mucosa of a 43-year-old healthy woman. An xcisional biopsy revealed the lesion to be a focal accumulatition of hyaluronic acid replacing the collagen fibers and fibroblastic proliferation in the dermis consistant with cutaneous focal mucinosis. During the follow-up period for 3 months, no recurrence was observed.
Adult ; Biopsy ; Collagen ; Dermis ; Female ; Fibroblasts ; Follow-Up Studies ; Humans ; Hyaluronic Acid ; Mucinoses* ; Mucous Membrane* ; Recurrence

PURPOSE: To compare the corneal endothelial cell changes in both eyes of Korean patients with clinically unilateral exfoliation syndrome using specular microscopy. METHODS: A total of 144 eyes of 72 patients diagnosed with clinically unilateral exfoliation syndrome at Yeungnam University Hospital between March 2000 and February 2011 were retrospectively reviewed. Comparisons of corneal morphometric analysis were made including endothelial cell density, coefficient of variation, hexagonality, and central corneal thickness between the exfoliative and fellow non-exfoliative eyes in 72 patients with naive unilateral exfoliation syndrome. If patients received intraocular surgery during the follow-up periods, the number of intraocular surgeries and changes of the above-mentioned morphometric analysis were evaluated. RESULTS: The paired exfoliative and fellow non-exfoliative eyes did not differ in endothelial cell density (2587.0 +/- 391.0 vs. 2626.8 +/- 354.6 cells/mm2, p = 0.321), in the coefficient of variation of cell size (35.9 +/- 5.1 vs. 37.1 +/- 4.7%), hexagonality (59.5 +/- 7.3 vs. 57.8 +/- 6.3%), and central corneal thickness (530.5 +/- 37.6 vs. 532.0 +/- 35.2 microm). However, the exfoliative eyes had significantly higher values for the number of intraocular surgeries (0.97 +/- 0.78 vs. 0.28 +/- 0.48, p < 0.001) and decrement of corneal endothelial cells (410.9 +/- 538.7 vs. 19.0 +/- 284.5 cells/mm2, p = 0.007). CONCLUSIONS: There were no significant morphologic differences in corneal endothelium between exfoliative eyes and fellow eyes in the present study. However, the authors suggest that specular microscopic examination be performed before intraocular surgery in eyes with exfoliation syndrome when considering the higher frequency of intraocular surgeries and the resultant corneal endothelial damages observed in the present study.
Cell Size ; Cornea ; Endothelial Cells ; Endothelium ; Endothelium, Corneal ; Exfoliation Syndrome ; Eye ; Follow-Up Studies ; Humans ; Retrospective Studies

BACKGROUND AND PURPOSE: Cilostazol, a phosphodiesterase III inhibitor, is known to be a useful antiplatelet agent that inhibits the progression of atherosclerosis in ischemic stroke. This study investigated the effects of combining cilostazol with aspirin on the expressions of P-selectin and PAC-1 on activated platelets in acute ischemic stroke. METHODS: We analyzed 70 patients with acute ischemic stroke (<72 hrs of an ischemic event). The daily intake was 100 mg of aspirin in 37 patients and 100 mg of aspirin plus 200 mg of cilostazol in 33 patients. The expressions of P-selectin and PAC-1 on activated platelets were measured on the day of admission and 5 days later. We also evaluated the clinical progression using the National Institutes of Health Stroke Scale (NIHSS) at the same times. RESULTS: After 5 days the extent of PAC-1 expression on activated platelets was significantly lower for combined aspirin and cilostazol treatment (61.0+/-19.3%, p=0.008; mean+/-standard deviation) than the baseline level (70.9+/-12.9%), but did not differ between aspirin alone (66.0 +/-19.0%) and baseline (70.1+/-15.7%). The expression of P-selectin did not differ between combined aspirin and cilostazol treatment and baseline. The clinical progression did not differ between the two groups, as indicated by the absence of significant changes on the NIHSS in the acute period. CONCLUSIONS:This study found that the combined regimen of aspirin and cilostazol exerts the beneficial effect of reducing PAC-1 activity on activated platelets in acute ischemic stroke. However, the clinical outcome of this regimen was no better than that of the aspirin-only regimen. Therefore, further detailed studies of the possible clinical benefits of cilostazol in acute ischemic stroke are needed.
Aspirin ; Atherosclerosis ; Blood Platelets ; Cyclic Nucleotide Phosphodiesterases, Type 3 ; Humans ; National Institutes of Health (U.S.) ; P-Selectin ; Stroke ; Tetrazoles

Lyme disease is a multi-systemic, tick-borne infectious disease caused by a spirochete, Borrelia burgdorferi. Various urologic symptoms are associated with Lyme disease, which can be primary or late manifestations of the disease. Although voiding dysfunction is a rarely reported symptom in patients with Lyme disease, it is one of the most disabling complications of Lyme disease. Korea is not an endemic area of Lyme disease, thus, fewer cases have been reported. Herein, we report a case of a 32-year-old man with rapidly progressive bilateral ptosis, dysphagia, spastic paraparesis, and voiding difficulty in whom Lyme disease was diagnosed through serologic tests for antibodies and Western blot testing. A urodynamic study demonstrated detrusor areflexia and bulbocavernosus reflex tests showed delayed latency, indicating demyelination at S2-S4 levels. He received a 4-week course of intravenous ceftriaxone (2 g/day). The patient has recovered from the bilateral ptosis and spastic paraparesis but still suffers from neurogenic bladder.
Antibodies ; Blotting, Western ; Borrelia burgdorferi ; Ceftriaxone ; Communicable Diseases ; Deglutition Disorders ; Demyelinating Diseases ; Humans ; Korea ; Lyme Disease ; Paraparesis, Spastic ; Reflex ; Serologic Tests ; Spirochaetales ; Urinary Bladder, Neurogenic ; Urodynamics

Transient synovitis of the hip is non-specific inflammation and self limited condition, which is most common cause of painful limping in children under 10 years of age. Ultrasonography presents some merits, simple, rapid, non-invasive, low cost, repetitive to assess soft structures in and around the hip joint compared to other diagnostic methods. We prospectively studied 32 cases of unilateral transient synovitis at OPD from Jan. 1988 to Oct. 1989 using 5-7.5 MH, probe ultrasonography. 2-times serial check up in symptomatic and asymptomatic stage about capsule thickness and bone-capsule distance in 3 different positions of the both hips were performed for comparision. The following results were obtained; 1. Boys were 25 cases (78%) and 26 cases (83%) were between 3 and 7 years old of age. 2. Bone-capsule distance in ultrasonography revealed abnormal increase in 72%. 3. External rotation position showed wider bone-capsule distance than other position. 4. Capsule thickness was 3.3mm in diseased and 3.0mm in sound, 0.3mm decrease after treatment. 5. Bone-capsule distance was 4.5mm in symptomatic stage, 2.7mm in asymptomatic stage, 1.8mm decrease after treatment in averge.
Child ; Hip Joint ; Hip ; Humans ; Inflammation ; Prospective Studies ; Synovitis ; Ultrasonography

A 31-year-old woman, who was pregnant with twins, underwent chorionic villus sampling because of increased nuchal translucency in one of the fetuses. Cytogenetic analysis showed a normal karyotype in the fetus with increased nuchal translucency. However, the other fetus, with normal nuchal translucency, had a derivative X chromosome (der(X)). For further analysis, fluorescence in situ hybridization (FISH) and additional molecular studies including fragile X analysis were performed. FISH analysis confirmed that the Y chromosome was the origin of extra segment of the der(X). The X-chromosome breakpoint was determined to be at Xq27 by FMR1 CGG repeat analysis, and the Y-chromosome breakpoint was determined to be at Yq11.23 by the Y chromosome microdeletion study. To predict the fetal outcome, the X-inactivation pattern was examined, and it revealed non-random X inactivation of the der(X). To the best of our knowledge, the identification of an unbalanced Xq;Yq translocation at prenatal diagnosis has never been reported. This study was performed to identify precise breakpoints and the X-inactivation pattern as well as to provide the parents with appropriate genetic counseling.
Adult ; Chorionic Villi Sampling ; Cytogenetic Analysis ; Female ; Fetus* ; Fluorescence ; Genetic Counseling ; Humans ; In Situ Hybridization ; Karyotype ; Nuchal Translucency Measurement ; Parents ; Pregnancy ; Prenatal Diagnosis ; Twins ; X Chromosome ; X Chromosome Inactivation ; Y Chromosome

No abstract available.