The human oral mucosa has noncornified lining epithelium, cornified masticatory epithelium, and complex epithelium. The epithelium of human tongue shows diverse morphological variations from one site to another, and conflicting reports exist in the literature concerning the type of lingual epithelium. Cytokeratin[CK] have been shown to characterize different type of epithelia. In the present study to clarify intermediate filament patterns of tongue mucosa and lingual gland in human fetus from second trimester of pregnancy and adult, cytokeratin expression was investigated immunohistochemically using antibodies for cytokeratins in the dorsal surface of tongue, taste bud, and lingual gland, and comparison with the expression between fetus and adult was made. The epithelium of the fetal lingual papillae consisted of 4 to 6 layered stratified cells, and that of the inferior surface of tongue consisted of 6-8 layered stratified cells in PAS-hematoxylin stain. The lingual gland was well differentiated and the alveolus was strongly positive to PAS reaction. The dorsal surface of the adult tongue was composed of lingual papillae. The papillae was covered by keratinized stratified squamous epithelium and interpapillary area by nokeratinized epithelium in hematoxylin-eosin stain. The taste bud was present in the fungiform papilla. The lingual gland appeared among the muscle layers near the inferior surtace and was composed of mucous and serous cells. By immunohistochemical stain, the epithelium of the lingual papillae exhibited various staining-intensities for cytokeratin antibodies, and showed same staining patterns bosh epithelium in tip of papilla and interpapillary area in fetus. However, the dorsal epithelium of the adult tongue showed different staining patterns between tip of the papilla and interpapillary area. In fetal lingual papilla CK7 and CK8 were expressed in superficial cells, AE8 in intermediate and superficial cells, CKl4 in basal cells. MNFI116 and AE3 showed a strong reaction in basal and suprabasal cells. The epithelium of the inferior lingual surface reacted positively with AE8 and CK14, MNF116, and AE3. CK7 and CK8, however, were not reacted. In adult lingual papilla CK10 was expressed in superficial cells of the tip of the papilla, AE8 in suprabasal cells of interpapillary epithelium, CKl4 in basal cells of papillary and interpapillary epithelium, CKl9 in superficial cells of interpapillary epithelium, MNFI116 and AE3 in suprabasal cells of papillary and interpapillary epithelium. However, CK7, CK8, CK18, and 5D3 were not expressed in the epithelium of the dorsal tongue. The cells of taste bud in fetus showed positive reactions for CK7, CK8, MNF116, and AE3, but negative reactions with CK10 and AE8. The cells of taste bud in adult were stained with CK7, CK8, CK18, and MNF116, but not stained with CK10 and AE8. In lingual gland of fetus, CK7, CK8, CKl8, 5D3, MNF116, and AE3 were expressed in alveolar cells. Only CK10 gave a negative staining in ductal cells. The mucous cells of the adult lingual gland were reacted with CK7, CK10, CK18, CK19, and MNF116, and the serous cell with CK7, CK19, and MNF116. The ductal cells of the adult lingual gland were stained with CK7, AE8, CK18, CKl9, 5D3, MNF116, and AE3. CK14 was expressed in the cells of intralubular ductule, not in the ductal cells. By electron microscopy, the epithelia of both dorsal and inferior lingual surfaces in fetus consisted of nonkeratinized stratified squamous epithelium. A cell with clear cytoplasm and some dense granules was noted among the basal cells. These results indicate that the epithelium of fetal lingual papillae is non-keratinized type and the epithelium of the papillary tip is keratinized type and interpapillary epithelium is nonkeratinized type in adult, and suggest that the superficial cell containing cytokeratins 7 and 8 in dorsal lingual epithelium of fetus has a similar role to the periderm of fatal skin.
Adult ; Antibodies ; Cytoplasm ; Epithelium* ; Female ; Fetus* ; Humans* ; Immunohistochemistry ; Intermediate Filaments ; Keratins ; Microscopy, Electron ; Mouth Mucosa ; Mucous Membrane ; Negative Staining ; Periodic Acid-Schiff Reaction ; Pregnancy ; Pregnancy Trimester, Second ; Skin ; Taste Buds ; Tongue

PURPOSE: The purpose of this study was to review our recent experiences with deep neck abscesses in children and adolescents and to provide helpful information in treatment and diagnosis by comparing them with those in other available literatures. METHODS: Medical records of 36 children and adolescents admitted for deep neck abscess at two hospitals from January 2000 to October 2010 were reviewed retrospectively. RESULTS: Male to female ratio was 1.4 : 1 and the mean age was 6.5 years. Painful neck swelling and fever were the most frequent symptoms in patients under thirteen years of age whereas trismus and headache were frequent symptoms in patients over fourteen years of age. Submandibular space was the most common site of deep neck abscess in patients under thirteen years of age, whereas peritonsillar space was the most common site in patients over fourteen years of age. The results of bacterial cultures were positive in 61.5% of drained cases. Staphylococcus aureus was the most commonly identified bacteria in 6 patients (37.5%) and 5 of them were under 2 years of age. Twenty six patients received surgical drainage while the others were treated with antibiotics only. There were no statistically significant differences in the durations of admission, fever after admission, and antibiotic treatment between surgical and medical treatment groups. CONCLUSION: The common sites of deep neck abscess, associated symptoms, and causative organisms were different between children and adolescents. As there were no differences in durations of admission, fever, or antibiotics treatments between surgical and medical treatment groups, surgical drainage may be avoided by early recognition and suspicion. However, if there is no improvement of symptoms or size of abscesses within 48-72 hours of antibiotic treatment, surgical drainage should be considered.
Abscess ; Adolescent ; Anti-Bacterial Agents ; Bacteria ; Child ; Drainage ; Female ; Fever ; Headache ; Hospitals, General ; Humans ; Male ; Medical Records ; Neck ; Staphylococcus aureus ; Trismus

Inverted papilloma of the urinary tract is a unique and uncommon tumor, characterized by an endophytic growth pattern. Recently, we experienced a case of inverted vesical papilloma in a 54-year-old women.
Female ; Humans ; Middle Aged ; Papilloma ; Papilloma, Inverted* ; Urinary Bladder* ; Urinary Tract

No abstract available.
Erythema Nodosum* ; Erythema*

Neonatal rhinitis is characterized by watery or mucous coryza and nasal mucosa edema without anatomical anomaly in neonate. The recognition and treatment of this disease is important, because neonates breathe through nose obligatory, and mismanagement of this can result in poor feeding or even death from respiratory distress. It is essential to rule out maternal syphilis infection, and anatomical anomalies such as choanal atresia, and tracheoesophgeal fistula before diagnosis is made. A newborn male infant with neonatal rhinitis is reported with a brief review of literature. He showed cyanosis 3 hours after his birth, watery and mucoid coryza, and mucosal edema examined by flexible nasoscopy.
Choanal Atresia ; Cyanosis* ; Diagnosis ; Edema ; Fistula ; Humans ; Infant ; Infant, Newborn ; Male ; Nasal Mucosa ; Nose ; Parturition* ; Rhinitis* ; Syphilis

OBJECTIVE: The aim of this study is to predict spontaneous labor onset delivery within 7 days in low risk pregnant women at 38 weeks' of gestation by ultrasonographic examination of cervical changes. MATERIAL AND METHODS: This prospective study included 110 singleton low risk pregnancies between 37(+0) and 37(+6) weeks of gestation. Fifteen cases were lost during follow-up and finally 95 pregnant women (58 nulliparous, 37 multiparous) were analysed. The study period was from Oct/2005 to May/2007. Four cervical changes (length, gland thickness, funneling and canal formation) were evaluated. Main outcome was remaining day to delivery after the examination. Remaining days to actual delivery with spontaneous labor onset were recorded and the pregnancies were divided into two groups according to remaining days (within 7 days, over 7 days) to compare predicting power of delivery within 7 days. ROC curves were drawn to find out cut-off values of cervical length and gland thickness. Sensitivity, specificity, positive predictive value and negative predictive value were extracted from four cervical changes. RESULTS: Mean cervical length of pregnant women at 38 weeks' of gestation was 25.8 (+/-10.0) mm and mean cervical gland thickness was 4.3 (+/-1.2) mm. Funnelings of uterine cervix were detected in 13 cases (13.7%), canal formations in 6 cases (6.3%). All four cervical changes were statistically valuable to predict delivery within 7 days and the cervical length showed highest sensitivity. When the cervical length was measured under 20 mm, the possibility of delivery within 7 days was 78.6% (p<0.001). The cervical gland thickness less than 4 mm could predict the delivery within 7 days with sensitivity of 57.1% (p<0.01). Sensitivities of funneling and canal formation for delivery within 7 days were 54.5%, 36.4% each. CONCLUSION: Ultrasonographic examination of the cervical changes in low risk singleton pregnancy at 38 weeks' of gestation are valuable for predicting spontaneous labor onset delivery within 7 days. Among four cervical changes, cervical length is most sensitive ultrasonographic marker.
Cervix Uteri ; Female ; Follow-Up Studies ; Humans ; Labor Onset ; Parturition* ; Pregnancy* ; Pregnant Women ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity

Hyponatremia frequently occurs in patients with chronic schizophrenia and has various causes such as compulsive drinking, neuroleptics, and physical illness. If not corrected immediately, it leads to severe problems such as seizures, change in mental status, and even death. We detected five cases of hyponatremia with neurological symptoms in patients with chronic schizophrenia. One case had a long history of primary polydipsia, whereas the other four cases had no history of polydipsia. We speculated that the cause in these latter four cases was neuroleptics or physical illness. All five cases improved with conservative treatment. Possible implications and the need for future study are discussed.
Antipsychotic Agents ; Drinking ; Humans ; Hyponatremia* ; Polydipsia ; Polydipsia, Psychogenic ; Schizophrenia* ; Seizures

Sclerosing panniculitis refers to the skin induration and hyperpigmentation of the legs that often occurs in patients who have venous insufficiency. Sclerosing panniculitis is similar to those described under the designations hypodermitis sclerodermiformis or lipodermatosclerosis. Histologically the septa of the subcutis become thickening by inflammation and fibrosis. Adipocytes coalesce to form small and large pseudocysts. Some of these are lined by refractile, amphophilic crenulated membranes. This alteration was referred to as lipomembranous change. We report a case of sclerosing panniculitis in a 40-year-old female patient presented as induration and depression of the skin and subcutaneous tissues of the lower third of the leg.
Adipocytes ; Adult ; Depression ; Female ; Fibrosis ; Humans ; Hyperpigmentation ; Inflammation ; Leg ; Membranes ; Panniculitis* ; Skin ; Subcutaneous Tissue ; Venous Insufficiency

BACKGROUND: Chronic telogen effluvium is a common problem in middle-aged women. It has been suggested that reduced iron stores are a cause of this type of baldness. OBJECTIVE: We performed this study in order to elucidate the pathogenesis of chronic telogen effluvium and to evaluate the differences in serum stored iron levels between normal females and those with chronic telogen effluvium. METHODS: Blood levels of hemoglobin, iron, ferritin, and TIBC were examined in 20 patients with chronic telogen effluvium and 20 normal females. RESULT: 1) Ferritin levels were significantly decreased in the patients group(p=0.008). 2) TIBC levels were significantly increased in the patients group(p=0.001). 3) There were no significant differences in Hb and serum iron in both groups (p<0.05). CONCLUSION: These findings suggested that the variation of serum ferritin level may play a role in the pathogenesis of chronic telogen effluvium, but further studies will be needed for evaluation of this condition.
Alopecia ; Female* ; Ferritins ; Humans ; Iron*

BACKGROUND: Because of many physical, psychological, and social stresses, adolescence is a vulnerable period to psychiatric disorders. But in Korea, there is actually not enough time for primary care physicians to screen such patients during ordinary medical interviews. Therefore this research was done to develop and validate a brief screening questionnaire for the detection of adolescent patients with psychiatric problems. METHODS: Three family physicians in charge of their own adolescent clinics developed a five-item questionnaire for screening adolescents with psychiatric problems by reviewing related literature with consultation by a psychiatrist. After performing a pretest and gathering second opinions from other psychiatrists and nurse-teachers, final questionnaire was redeveloped. Verification of its reliability by using test-retest method and internal consistency by calculating Cronbach's alpha coefficient was done. Also inspection of its validity by comparing the scores of psychiatric patient group to normal group was done. And finally the discrimination point was obtained. RESULTS: For reliability Kappa value of new questionnaires ranged from 0.33 to 0.63. One item was dropped because of its negative influence to the internal consistency and the discrimination power. With the four final items, we estimated the validity for distinguishing psychiatric patients from the normal group by calculating the sensitivity and specificity of each cutting point of scores. For the each cutting point 1, 2, and 3, sensitivity was 85%, 75%, 40%, respectively, and specificity was 27%, 62%, 84%, respectively. We considered score 1 as the best cutting point because the purpose of the questionnaire was screening rather than diagnosis. CONCLUSION: A brief four-item screening questionnaire(SAPPO. Screening method of Adolescent Psychiatric Problems in Outpatient clinic) was developed and its reliability and validity was estimated.
Adolescent* ; Diagnosis ; Discrimination (Psychology) ; Humans ; Korea ; Mass Screening* ; Outpatients ; Physicians, Family ; Physicians, Primary Care ; Primary Health Care* ; Psychiatry ; Referral and Consultation ; Reproducibility of Results ; Sensitivity and Specificity ; Surveys and Questionnaires