Herpes simplex esophagitis has been recognized with increased frequency as an opportunistic infection in immunosuppressed or debilitated patients. However, it is also documented as self-limited esophagitis in apparently healthy patients. We report two cases of herpetic esophagitis diagnosed by biopsies. One case was noted in an immunocompetent patient having gastric peptic ulcer who had clinical improvement with symptomatic treatment. And the other was noted in an immunosuppressed patient having chemotherapy for gastric carcinoma who had resolution of symptoms with acyclovir therapy. Histologically, esophageal mucosa exhibited erosion and inflammatory cellular exudate with intranuclear eosinophilic inclusions in the epithelial cells. These were confirmed by the PCR and immunohistochemical stain for herpes simplex virus using a biopsy material.
Acyclovir ; Biopsy ; Drug Therapy ; Eosinophils ; Epithelial Cells ; Esophagitis* ; Exudates and Transudates ; Herpes Simplex* ; Humans ; Mucous Membrane ; Opportunistic Infections ; Peptic Ulcer ; Polymerase Chain Reaction ; Simplexvirus

No abstract available.
Mediastinum* ; Neuroblastoma*

Nucleolar organizer regions are DNA loops encoding rihbosomal RNA production and detectable by the argyrophilia of their associated proteins(AgNORs). AgNOR numbers correlate with cellular proliferating activity. Many studies have shown a significnt difference in AgNOR counts between benign and malignant tumors. AgNOR counts were also helpful in differential diagnosis. For the evaluation of its diagnostic utility in gastric lesions, a silver staining technique was carried out in paraffin sections of 5 control cases, 5 benign peptic ulcers, 7 hyperplastic polyps, 10 tubular adenomas, 16 early gastric adenocarcinomas and 15 advanced gastric adenocarcinomas. The results were as follows. The mean numbers of AgNORs in early and advanced gastric adenocarcinomas(1.94 and 2.16) were significantly higher than those of normal foveolar epithelium(1.43) and epithelia of benign gastric ulcers(1.54), hyperplastic polyps(1.64) and tubular adenomas(1.79). In malignancy, there was increased variability in size and shape of AgNORs. There was little differences in mean AgNOR numbers between early and advanced gastric adenocarcinomas. Differentiation of the tumor made no difference in AgNOR numbers. From the above results, the AgNORs count, if its morphologic change are taken into consideration, is helpful in differentiation between malignant and non-malignant lesions.
Diagnosis, Differential ; Adenocarcinoma

One case of congenital cutis aplasia is presented. The defect involved includes full-thickness skin defect of scalp and cranium. The patient was treated with debridement of dirty necrosed crust which covered exposed dura mater and with double opposing rotation flap including pericranium for bone regeneration. The donor site was covered with skin graft from right thigh. During operation, the superficial temporal artery was found to be short and weak. And after operation, the margin of flap were congested and finally necrotized. The necrotic wound was treated with conservative management. The vascular impairment is thought to be main course of congenital cutis aplasia. So we conclude that the treatment of choice is conservative management or careful flap surgery for coverage of defect area.
Bone Regeneration ; Debridement ; Dura Mater ; Estrogens, Conjugated (USP) ; Humans ; Scalp ; Skin ; Skull ; Temporal Arteries ; Thigh ; Tissue Donors ; Transplants ; Wounds and Injuries

The purpose of this study was to observe the additive effect of halothane anesthesia and propranolol, and also the effect of atropine and isoproterenol on the heart rate and the blood pressure after propranolol during halothane anesthesia in human-volunteers. The results were as follows: 1) In conscious patients, 10 minutes after intravenous administration of 1.0mg propranolol the heart rate was slower but there was no significant change in the blood pressure. 2) Twenty-thirty minutes after halothane anesthesia, the heart rate was slower by 6 to 8 beats per minute: systolic and diastolic blood pressure was lower by 20.4 torr and 10.5 torr, respectively. 3) 10 minutes after intravenous administration of 1.0mg propranolol during halothane anesthesia, the heart rate was decreased by 7.8, 7.0 per minute: systolic and diastolic blood pressure decreased by 6.7, 5.7 torr and 3.0, 3.9 torr in the atropine and isoproterenol group, respectively. 4) One minute after intravenous administration of atropine 0.5mg after propranolol 1.0mg during halothane anesthesia, the heart rate increased by 12.1 per minute and persisted so far 10 minutes, but the blood pressure did not increase. 5) One minute after intravenous administration of isoproterenol 0.025mg after propranolol 1.0mg during halothane anesthesia, the heart rate had markedly increased by 35, but normalized 10 minutes later. The systolic blood pressure was increased by 13.4 torr but normalized 10 minutes later. 6) The above results indicate: Atropine increases the heart rate which has been slowed with propranolol during halothane anesthesia: isoproterenol increases the heart rate and blood pressure but the duration of action was short. Therefore, authors considered that atropine is useful for the maintenance of heart rate, and continuous administration of isoproterenol for maintenance of blood pressure and heart rate after propranolol during halothane anesthesia.
Administration, Intravenous ; Anesthesia* ; Atropine* ; Blood Pressure* ; Halothane* ; Heart Rate* ; Heart* ; Humans ; Isoproterenol* ; Propranolol*

Localized enterocolic lymphocytic phlebitis is characterized by selective phlebitis involving the small to medium-sized veins and venules, infiltration exclusively by lymphocytes, and no other systemic vasculitis or inflammatory bowel disease. This vasculitis can be a rare cause of intestinal ischemia. We experienced a case of enterocolic lymphocytic phlebitis in a 72-year-old woman, who presented with abdominal pain and distension. The resected colon and terminal ileum showed striking lymphocytic phlebitis affecting the veins and venules of the bowel and mesentery which resulted in ischemic injury of the bowel. This vasculopathy was the only demonstrable cause of ischemia. Arteritis and arteriolitis was not found. There is no clinical or laboratory evidence or a history of extraintestinal vasculitis. The etiology of this clinicopathological entity has not been elucidated. Herein, we report the clinicopathological findings in this patient who presented with ischemic intestinal necrosis caused by localized intestinal lymphocytic phlebitis associated with thrombosis.
Female ; Humans

No abstract available.
Child* ; Humans ; Hypercalciuria*

Choroidal neovascularization(CNV) secondary to age-related macular degeneration(AMD) occurs in the majority of patients with exudative maculopathy. Using an Indocyanine-green (ICG) angiography system, the authors obtained 24 ICG angiograms with CNV in AMD, and compared them with fluorescein angiograms. CNV was classic in 3 eyes(12.5%) and occult in 21 eyes(87.5%) on fluorescein angiography. The location of the CNV was extrafoveal in 12 eyes(50%), juxtafoveal in 6 eyes(25%) and subfoveal in 6 eyes(25%). Occult CNV was diagnosed in 21 eyes. Of these eyes, 8(38%) had solitary or multifocal hot spot by ICG angiography. Plaques were seen in 13(62%) of these eyes. Occult CNV with pigment epithelial detachment was diagnosed in 7 eyes. In 5 eyes, we were able to detect a well-defined CNV underlying a subretinal hemorrhage. Sixty-seven percentage of eyes with occult CNV could be reclassified as having well-delinated CNV by virtue of the additional findings provided by ICG angiography. But thirty-three percentage of eyes with occult CNV remained ill defined on the ICG angiography. ICG angiography is especially useful in delineating occult neovascularization, neovascularization with overlying subretinal hemorrhage or serosanguineous fluid, and neovasularization associated with pigment epithelial detachments. The results of this study suggest that ICG angiography is a safe test and an important test in evaluation, classification, and laser treatment of patients with occult CNV secondary to AMD.
Angiography* ; Choroid* ; Choroidal Neovascularization* ; Classification ; Diagnosis* ; Fluorescein Angiography* ; Fluorescein* ; Hemorrhage ; Humans ; Indocyanine Green* ; Macular Degeneration* ; Virtues

Anal duct carcinoma is a rare tumor, and accounts for less than 5 percent of all anal cancers, which typically present a long-standing perianal fistulas. Some authors suggest that the fistulous tracts are congenital duplications of the lower end of the hind gut lined by rectal mucosa which is prone to malignant change to mucinous adenocarcinoma. It is usually a well differentiated mucinous (colloid) adenocarcinoma. The prognosis after wide excision of the rectum is relatively good. Since 1985, we have had three cases of anal duct carcinoma with well differentiated mucinous adenocarcinoma involving the posterior wall of the anus. Two patients had a long history of perianal fistula with mucinous discharge. There was no spread to the regional lymph node except one patient who had regional lymph node metastasis, and post-operative chemotherapy and radiation therapy were then given. All patients have no evidence of any recurrent problem at 16 months to 3 years following the surgical treatment. Because of their rarity and the failure of recognition at an early stage, we are presenting three cases to emphasize the characteristic features of this insidious, slow-growing carcinoma.
Adenocarcinoma

A retrospective study of the effect of vitrectomy, scleral bucling and intraocular tamponade (SF6 gas or silicone oil) was carried out in 39 patients with retinal detachment complicated by proliferative vitreoretinopathy. Complete anatomic retinal reattachment posterior to the encircling scleral buckle was obtained in 53% (21/40) of these eyes. Useful vision was restored in 52% of the 21 anatomically successful cases. Anatomic success was not correlated with severity of proliferative vitreoretinopathy and lens status. The most frequent postoperative complication was cataract in phakic eyes and recurrent retinal detachment in aphakic eyes.
Cataract ; Humans ; Postoperative Complications ; Retinal Detachment ; Retinaldehyde ; Retrospective Studies ; Scleral Buckling ; Silicone Oils ; Vitrectomy ; Vitreoretinopathy, Proliferative*