No abstract available.
Urinary Bladder Neoplasms* ; Urinary Bladder* ; Vascular Endothelial Growth Factor A*

Chylothorax is the most common cause of pleural effusion in the neonatal period and is defined as an effusion of lymph in the pleural cavity. We report a case of chylothorax in a 13-day-old male who was admitted due to respiratory difficulty. Chest AP showed pleural effusion of the left lung and milky yellow fluid was aspirated via thoracentesis upon which laboratory and lipoprotein electrophoresis of pleural fluid revealed findings compatible with that of chylothorax. Due to reaccumulation of chyle after daily thoracentesis, chest tube was inserted at the 4th hospital day, and MCT containing diet was given. He was discharged on the 21st hospital day in good health, and revealed no recurrence for 3 months during outpatient follow up visits.
Chest Tubes ; Chyle ; Chylothorax* ; Diet* ; Electrophoresis ; Follow-Up Studies ; Humans ; Infant, Newborn ; Lipoproteins ; Lung ; Male ; Outpatients ; Pleural Cavity ; Pleural Effusion ; Recurrence ; Thoracostomy* ; Thorax ; Triglycerides*

PURPOSE: Abnormalities in calcium(Ca), vitamin D and bone mineral density (BMD) associated with antiepileptic drug(AED) are reported, but the results are inconsistent. In case of intractable epilepsy, poor growth and altered bone mineral metabolism may be prominent, possibly related to previous long-term use of multiple AED and poor activity. The aim of this study was to assess growth status, concentrations of calcium regulating hormones and BMD in children with intractable epilepsy. METHODS: Sixty-six intractable epilepsy patients aged 0.8 to 14.7 years(mean+/-D:4.6+/-.6 years) were included in the study. Height and weight were measured and then height SDS and weight SDS were calculated. Serum Ca, i-Ca, P, Mg, Zinc, osteocalcin, intact-PTH, 25-OHD, 1,25(OH)2D were measured. BMD of the lumbar spine was measured by dual energy X-ray absorption. RESULTS: Most of the patients showed normal height SDS and weight SDS. Percentage of severe short stature(height SDS <-2) was 1.5% and tall stature(height SDS >2) was 4.5%. Percentage of severe thin(weight SDS <-2) was 1.5% and obesity(weight SDS >2) was 6%. Duration of AED was not related to height SDS or weight SDS. Etiology of epilepsy and physical activity were not related to height SDS and weight SDS. Most of them had normal Ca, iCa, P, Mg, Zinc, intact-PTH, osteocalcin, 25-OHD and 1,25(OH)2D concentrations. BMD was not related to the levels of Ca, i-Ca, P, Mg, intact-PTH, osteocalcin, 25-OHD, 1,25(OH)2D. BMD was not related to the duration of AED. BMD positively correlated with age(r=0.75, P>0.01) and body weight(r=0.72, P<0.01). CONCLUSION: Most of the children with intractable epilepsy, who regularly visits epilepsy clinic, showed normal growth and normal bone mineral metabolism, but careful monitoring about growth and bone mineral metabolism is needed.
Absorption ; Bone Density* ; Calcium* ; Child* ; Epilepsy* ; Humans ; Metabolism ; Motor Activity ; Osteocalcin ; Spine ; Vitamin D ; Zinc

The reconstruction of soft tissue defects with open fracture around the knee joint is limited by its unique location. Free tissue transfer is hindered by the selection of the recipient vessel and problems of microsurgery. The arc of rotation, defect size, and location must be taken into consideration in the use of regional muscle transfer such as gastrocnemius. According to Mathes et al, the flap survival can be enhanced by selective division of the dominant segmental pedicles, only a part of which can normally be transposed safely on its minor segmental pedicle. Neovascularization, vascular proliferation, and dilatation have also been produced by the delay procedure using silicone sheets. The authors have used the delay procedures with wrapping of the gracilis or sartorius muscle which enabled distally-based transposition of these muscles. The method showed satisfactory outcome in resurfacing the wound around the knee joint. The indictions for this procedure were defects of moderate size and those difficult to reach with conventional muscle flaps. The flap could reach the upper one-third of the lower leg. Other merits are relative simplicity and reliability without significant extension of hospital stay. The drawbacks are the two operative procedures necessary and the risk of infection due to silicone sheets.
Dilatation ; Fractures, Open ; Knee Joint* ; Knee* ; Leg ; Length of Stay ; Microsurgery ; Muscles ; Silicones ; Surgical Procedures, Operative ; Wounds and Injuries*

We present a case of onychogryphosis of both great toe nails associated with onychomycosis of all toe nails occurring in a 90-year-old female patient. She also had senile dementia. Affected nail plates were thickened, increased in length, and curved like the horn of a ram. The nail plates were removed surgically form the nail bed. Direct microscopic examination revealed many hyphae with potassium hydroxide. Trichophyton rnbrum was isolated from the culture in Sabouraud glucose agar media. On histopathologic examination, we found many hyphae in the nail plate. We suggest an onychomycosis as one of the causes of onychogryphosis.
Agar ; Aged, 80 and over ; Alzheimer Disease ; Animals ; Female ; Glucose ; Horns ; Humans ; Hyphae ; Onychomycosis* ; Potassium ; Toes ; Trichophyton

Eccrine spiradenoma is a txnign, painful tumor of the skin, which probably originates in the coil of the eccrine sweat glands and presents a characteristic clinical and pa.hological picture. However recently, the weakness and inconsistency of the enzymes histochemican, actions and electron microscopic findings, and the presence of numerous undifferentiated and indetirn, inate cells suggest a rather low degree of differentiation. We present herein four cases of eccrine spiradenoma which show livrse histopat.hologic characteristics including typical rosette-like structure, ductal structure, vacuar structure and mixed type, respectively. This report may support the premise that eccrine spiridinoma is defived not only from the eccrine duct but also from pluripotential stem cells.
Skin ; Stem Cells ; Sweat Glands

PURPOSE: The aim of this study was to estimate the prevalence of anatomic anal stenosis in patients with chronic anal fissure (CAF) and ascertain the results of lateral internal sphincterotomy (LIS) using a new calibrator. METHODS: Ninety-eight adults with CAF and a control group of 40 normal adults underwent anal calibration under spinal anesthesia. The calibrator was a conical design and the diameter was scaled in increments of 1 mm. The calibration was standardized and the reliability of it was assessed by two independent examiners for the same group (n=45). Confounding effects of age, sex, body weight, and height on the anal caliber were studied. The internal sphincter was divided to the level of the dentate line during LIS. RESULTS: The anal caliber was 34.6 +/- 1.4 mm (mean +/- SD) in the control group and 28.7 +/- 3.0 mm (mean +/- SD) in patients with CAF. Excellent correlation was obtained between the two examiners (r=0.958). The confounding effects of age, sex, body weight, and height were not significant. Therefore, anal stenosis was defined as when the measurement was 31 mm or below (mean-2SD of control value). Stenosis was present in 82 of 98 patients (84%) with CAF. Patients with stenosis had an anal caliber of 27.9 +/- 2.5 mm, with a range of 21 to 31 mm. Following LIS, 91 of 98 patients (93%) with CAF attained the normal range, two patients still had stenosis, and five patients had an anal caliber exceeding the normal value. CONCLUSIONS: Anatomic anal stenosis was found in 84% of the patients with CAF. Ninety three percent of these patients attained a normal anal caliber, 2 percent of the patients still had stenosis and 5 percent of the patients had an anal caliber exceeding the normal value after LIS.
Adult ; Anesthesia, Spinal ; Body Weight ; Calibration ; Constriction, Pathologic* ; Fissure in Ano* ; Humans ; Prevalence* ; Reference Values

No abstract available.
DNA* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction*

Localized primary cutaneous amyloidosis consists of three types: nodular, macular, and lichenoid amyloidosis. Lichen amyloidosis is characterized by the appearance of paroxysmally itchy lichenoid papules on the shins. Although the origin of the amyloid is controversial and can not provide any definite answer, some of amyloid substances can be derived from epidermal cells and others from degenerative collagen fibers. We suggested the origin of amyloid in our cases as epidermal keratinocyte and collagen degenerations. Because degeneration of basal keratinocyte is observed on electron microscopy and degeneration of collagen is in H&E and Masson's trichrome stain although amyloid materials are negatively stained against pankeratin antibody and collagen antibody. The skin lesion was improved after triamcinolone intralesional injections which reduce collagen synthesis. We report two cases of lichen amyloidosis which stained negatively for antikeratin antibodies and improved with triamcinolone intralesional injection.
Amyloid ; Amyloidosis* ; Antibodies* ; Collagen ; Injections, Intralesional ; Keratinocytes ; Lichens* ; Microscopy, Electron ; Skin ; Triamcinolone

BACKGROUND: E-cadherin is the prime mediator of cell-cell adhesion in epithelial cells and the beta-catenin is the associated protein with E-cadherin in the formation of adhesion complexes in normal and tumor cells related with tumor spread. The present study aimed to find the distribution of E-cadherin and beta-catenin in fetal skin during development. OBJECTIVE: The purpose of this study was to observe the distribution of above two adhesion related proteins in the fetal skin during development, to find its relationship by expression and their distribution patterns. METHODS: Skin was obtained from the scalp, chest, and sole of 21 human fetuses, ranging from 13 to 37 weeks of gestational age. Immunohistochemical staining was performed by avidin biotin peroxidase complex method on paraffin embedded tissue using anti-human monoclonal antibody against the human E-cadherin and beta-catenin. RESULTS: E-cadherin and beta-catenin were expressed in cell membrane of intermediate cell layer of epidermis at 13th week followed by increased basal cell expression at 15th week and adult pattern in 24th week of gestation. Both showed similar distribution pattern in skin. Difference was that E-cadherin was expressed only in cell membrane, but beta-catenin was expressed in both cell membrane and cytoplasm, stronger in cell membrane. beta-catenin also expressed in mesenchymal tissue. In the skin adnexae, E-cadherin and beta-catenin were also expressed very similar distribution pattern both in hair follicular development and eccrine duct epithelium. CONCLUSION: Both E-caherin and beta-catenin showed the same expression in the fetal stage and distribution pattern suggesting that both adhesion molecules are highly related each other in function and development of epidermis and adnexae of the skin in fetal stage, though their expression are not noted in all epithelial cells.
Adult ; Avidin ; beta Catenin ; Biotin ; Cadherins* ; Cell Membrane ; Cytoplasm ; Epidermis ; Epithelial Cells ; Epithelium ; Fetus ; Gestational Age ; Hair ; Humans ; Paraffin ; Peroxidase ; Pregnancy ; Scalp ; Skin* ; Thorax