Scleredema is a rare scleradematosis of unknown cause involving the face, neck, upper portion of the trunk, and proximal upper extremities. The clinical features of the disease are nonpitting indurated edema or stiffness of the neck, which may be sudden or insidious in onset. Diabetes mellitus and its complications have been frequently described to be associated with this disease. We present a case of scleredema developed on the nape, upper portion of the back and shoulder in 60-year-old man who had been suffered from diabetes mellitus for the past ten years.
Diabetes Mellitus ; Edema ; Humans ; Middle Aged ; Neck ; Scleredema Adultorum* ; Shoulder ; Upper Extremity

The purpose of this study was to aid in the prediction of tumor cell tolerance to radiotherapy and/or chomotherapy . For this study, cell surviving curves were obtained for mouse lymphoma YAC-1 cell line using semiautomated MTT assay. 2, 4, 6, 8, 10Gy were irradiated at a dose rate of 210cGy/min using 60Co Irradiator ALDORADO 8. After irra diation, YAC-1 cell lines(3X10(4) cells/ml) were exposed to bleomycin or cisplatin for 1 hour. The viable cells were determined for each radiation dose and/or each concentration of drug at the 4th day. And they w ere compared to control values. The obtained results were as follows: 1. The surviving curve with gentle slope was obtained after irradiation of 2, 4, 6, 8, 10Gy on YAC-1 cell line. 2. The cytotoxicity of bleomycin or cisplatin was increased significantly at all concentration of 0.2microgram/ml, microgram/ml an d 20microgram/ml on YAC-1 cell line (P<0.01). 3. There were no significant differences of surviving fractions among 4Gy, 6Gy, and 8Gy after irradiation of each radia tion dose with 2microgram/ml of bleomycin compared with irradiation only on YAC-1 cell line(P<0.05). 5. There were significant differences of surviving fractions between the groups of irradiation only and the groups of i rradiation with 2microgram/ml of bleomycin or cisplatin at all doses of 2, 4, 6, 8 and 10Gy on YAC-1 cell line(P<0.05).
Animals ; Bleomycin ; Cell Line* ; Cisplatin ; Lymphoma ; Mice ; Radiation Tolerance* ; Radiotherapy

PURPOSE: To compare the pullout strength and insertion torque of proximally tapered screw (PT) with fully tapered screw (FT) and to investigate the correlation between the pullout strength and bone mineral density, morphology of pedicle, and insertion torque of the screw in osteoporotic lumbar spine. MATERIALS AND METHODS: Fifteen osteoporotic lumbar vertebrae from four white human cadavers were used. Bone mineral density, pullout strength and insertion torque were measured by dual energy x-ray absorptiometry, MTS and torque screw driver individually. RESULTS: The FT screw provided greater pullout force and insertion torque than the PT screw in 12 of 15 vertebrae tested (p<0.01). Pullout strength was correlated with insertion torque in PT (r=0.666, P=0.0006) and FT (r=0.464, P=0.19) screws. CONCLUSIONS: Results of this study indicate that the FT screws provide higher pullout strength and insertion torque than PT screws in osteoporotic lumbar spine and suggest that the development of tapered minor diameter may lead to an improved pedicle screw with high pullout strength and insertion torque. Nevertheless, further study is needed to investigate the effect of tapering the minor diameter on the mechanical bending strength of the screw.
Absorptiometry, Photon ; Bone Density ; Cadaver ; Humans ; Lumbar Vertebrae ; Spine* ; Torque

We experienced a case of 16-year-old female with verruciform xanthoma transformed from lesions of epidermal nevus syndrome. The biopsy specimen of yellowish brown to red verrucous papule on the right buttock showed 1) uniform and verrucous acanthosis without cytological atypia, 2) parakeratosis and hyperkeratosis,3) variable foci of superficial necrosis with crusting and microabscess in the granular layer, 4) rete ridge elongation and papillomatosis, 5) characteristic foam cells located within the papillary dermis, but not below the rete ridges. Our case was diagnosed verruciform xanthoma by histopathologic finding which occured as a secondary development in lesions of epidermal nevus syndrome.
Adolescent ; Biopsy ; Buttocks ; Dermis ; Female ; Foam Cells ; Humans ; Necrosis ; Nevus ; Papilloma ; Parakeratosis ; Xanthomatosis*

The calcifying epithelial odontogenic tumor is a rare benign odontogenic neoplasm which was first described by Pindborg in 1955 and accounts for less than 1% of all odontogenic tumors. The tumor occurs primarily in the molar-premolar region of the mandible, and 52% of cases are associated with an unerupted tooth. The clinical feature is most commonly a slow-growing painless swelling. The tumor may show considerable radiographic variation and usually characteristic histopathologic features. In this study, we report a case of the calcifying epithelial odontogenic tumor on the left mandibular body and ramus area in a 28-year-old male with a brief review of the concerned literatures.
Adult ; Humans ; Male ; Mandible ; Odontogenic Tumors ; Tooth, Unerupted

PURPOSE: To investigate the caspase-3 expression in the acinar and ductal cells of rat submandibular glands after the irradiation of various doses. MATERIALS AND METHODS: The male Sprague-Dawley rats weighing approximately 250 gm were used for this study. The experimental group was irradiated with a single absorbed dose of 2, 5, 10, and 15 Gy on the head and neck region. The rats were sacrificed on the 1st, 3rd, 7th, 14th, 21st, and 28th day after irradiation. The specimens including the submandibular gland were sectioned and observed using histopathological and immunohistochemical methods. RESULTS: The local destruction of the acinar and ductal cells and the karyopyknotic nuclei of the acinar cells were observed in the 2 Gy and 5 Gy irradiation groups later than in the 10 Gy and 15 Gy irradiation groups. And the expression of caspase-3 was prominent only in the ductal cells in the 2 Gy and 5 Gy irradiation groups. CONCLUSION: This experiment suggests that radiation-induced apoptosis in the ductal cells of rat submandibular glands was induced by a low dose radiation associated with the activation of caspase-3 and radiation-induced necrosis was induced by a high dose radiation.
Acinar Cells ; Animals ; Apoptosis ; Caspase 3* ; Head ; Humans ; Male ; Neck ; Necrosis ; Rats* ; Rats, Sprague-Dawley ; Submandibular Gland*

PURPOSE: This study was designed to compare the clinical and radiologic outcome of the patients who underwent percutaneous vertebroplasty among the groups based on follow-up period and BMD. MATERIALS AND METHODS: A total of 99 patients (171 vertebral bodies) underwent percutaneous vertebroplasty from January 2001 to September 2003. The patients were divided into 3 groups by follow-up periods, and also divided into 2 groups by BMD. We investigated the difference of radiologic and clinical effects among the groups. Radiologic findings was assessed as vertebral height restoration rate and rate of reduction loss by measurement of the height of vertebral body. The clinical outcomes were graded into 5. The statistical analysis was done using Chi-squire test and Independent-samples T test. RESULTS: Among the groups divided by follow-up period, there was no statistically significant difference of clinical and radiologic results except the rate of reduction loss between group I and group III (p>0.05). Between the groups divided by BMD, there was no statistically significant difference of clinical and radiologic results. CONCLUSION: Percutaneous vertebroplasty with bone cement for the osteoporotic compression fracture is an efficient procedure and considered as technique producing pleasurable clinical and radiologic results regardless of follow up-period and BMD.
Follow-Up Studies ; Fractures, Compression* ; Humans ; Osteoporosis ; Vertebroplasty*

The laparoscopic pancreaticoduodenectomy (LPD), introduced by Gagner and Pomp in 1994, is typically done in high-volume centers due to its technical demands. Our methods aim to provide effective traction, enabling efficient surgery despite limited staffing. A retrospective analysis of 29 patients undergoing LPD by a single surgeon between September 2021 and December 2022 showed promising outcomes: median intraoperative bleeding of 425 mL, operation time of 505 minutes, and postoperative hospital stay of 10 days. With only one case requiring open conversion, our external retraction techniques demonstrate efficacy in overcoming challenges associated with manpower constraints, highlighting potential utility for surgeons in similar settings. We share LPD external retraction techniques and outcomes.

PURPOSE: This study was performed to evaluate whether N-terminal pro-brain-type natriuretic peptide (NT-proBNP) could predict 28-day mortality in patients with severe sepsis and septic shock. METHODS: We performed a retrospective analysis of prospectively collected data from patients with severe sepsis and septic shock. Patients' demographic data, comorbidities, blood test results (including NT-proBNP concentration), and Acute Physiology and Chronic Health Evaluation (APACHE) II scores were compared between 28-day survivors and nonsurvivors. NT-proBNP levels were categorized into quartiles by their concentration (< or =600, 601 to 2,000, 2,001 to 6,000, and >6,000 pg/ml). Multivariate Cox proportional hazard regression analysis was performed to identify the predictors of mortality during a 28-day follow-up period. RESULTS: Out of 349 patients, 117(33.5%) died. NT-proBNP concentrations were significantly higher in nonsurvivors compared to survivors (median 4,630 [IQR, 1,876-10,582] vs. 1,552 [IQR, 440-4,064] pg/ml, respectively, p<0.01). The mortality rate increased with increasing NT-proBNP concentrations; patients with NT-proBNP < or =600, 601 to 2,000, 2,001 to 6,000, and >6,000 pg/ml were 12.9%, 26.1%, 39.8%, and 51.1%, respectively. By Cox proportional hazards analysis, compared to patients with the lowest NT-proBNP levels (< or =600 pg/ml), patients in groups with higher NT-proBNP levels were more associated with 28-day mortality; 601 to 2,000 pg/ml (hazard ratio [HR], 1.15; 95% CI, 0.50-2.63); 2,001 to 6,000 pg/ml (HR, 2.10; 95% CI, 1.05-4.81); >600 pg/ml (HR, 2.30; 95% CI, 1.15-6.14). CONCLUSION: NT-proBNP is an independent prognostic factor for 28-day mortality in patients with severe sepsis and septic shock.
APACHE ; Comorbidity ; Follow-Up Studies ; Hematologic Tests ; Humans ; Natriuretic Peptide, Brain ; Peptide Fragments ; Prognosis ; Prospective Studies ; Retrospective Studies ; Sepsis ; Shock, Septic ; Survivors

Ochratoxin A is a natural contaminant of mouldy food and feed, which is produced by Penicillium and Aspergillus, and is suspected of being one of the etiological agents responsible for Balkan endemic nephropathy and the associated urinary tract tumors. For evaluation of the mutagenicity of ochratoxin A, we performed in vitro chromosome aberration tests using Chinese hamster lung fibroblast cells (CHL cells) and monkey kidney cells (VERO cells), in vivo micronueleus tests using ddY mouse bone marrow cells and somatic mutation and recombination tests (SMART) using Drosophila melanogaster. The results of chromosome aberration tests in CHL cells showed no incidence of increased structural and numerical aberrations regardless of metabolic activation, while in VERO cells treated with 2.0, 1.0, 0.5, 0.3 ug/ml of ochratoxin A showed significant increase of structural aberrations without metabolic activation. Aspartame and-phenylalanine, structural analogs of ochratoxin A, didn't affect the chromosome aberrations induced by ochratoxin A. The in vivo induction of micronucleated polychromatic erythrocytes were measured in bone marrows of ddY mice treated with 10.0, 5.0, 2.5mg/kg/10ml of ochratoxin A through intraperitoneal route once. At 24 and 48 hours after treatment, ochratoxin A didn't induce micronuclei in bone marrows of ddY mice. And at the concentration of 40, 20, 10 ug/ml of ochratoxin A, which was administered by feeding to larvae of Drosophila melanogaster, showed no incidence of increased multiple wing hairs and flares. Summarizing all results, we concluded that ochratoxin A is a kidney cell specific direct genotoxicant.
Animals ; Asian Continental Ancestry Group* ; Aspartame ; Aspergillus ; Balkan Nephropathy ; Biotransformation ; Bone Marrow ; Bone Marrow Cells ; Chromosome Aberrations ; Cricetinae ; Cricetulus* ; Drosophila melanogaster* ; Drosophila* ; Erythrocytes ; Fibroblasts ; Hair ; Haplorhini ; Humans ; Incidence ; Kidney ; Larva ; Lung* ; Mice* ; Penicillium ; Recombination, Genetic ; Urinary Tract ; Vero Cells*