We report a rare case of intrathoracic lymphangiomatosis associated with chylothorax in a 3-year-old boy. The patient had been healthy until he had chickenpox followed by continued dyspnea. The biopsy specimen showed proliferating lymphatic channels & spindle cells in the lung tissue. The boy died of respiratory failure despite conservative treatment and surgical treatment with pleurodesis. An autopsy was performed. Pleura and pericardium showed severe adhesion to the right lung parenchyma. The cut surface of lung showed thickened interlobular septum with honeycomb-appearance. Histologically, extensive intercommunicating and anastomosing endothelial-lined lymphatic channels were noted along the visceral and parietal pleura, pericardium, around the great vessels, and in the anterior mediastinum over the thymus. These lymphatic channels infiltrated into the pulmonary parenchyme along the bronchovascular bundles. There were scattered areas of spindle cell proliferation with extravasation of RBCs mimicking Kaposi's sarcoma. Histologic diagnosis and differential diagnosis on biopsy materials can be difficult to establish but awareness of the intrathoracic lymphangiomatosis and its various clinical presentation may be helpful for diagnosis.
Autopsy* ; Biopsy ; Cell Proliferation ; Chickenpox ; Child, Preschool ; Chylothorax ; Diagnosis ; Diagnosis, Differential ; Dyspnea ; Humans ; Lung ; Male ; Mediastinum ; Pericardium ; Pleura ; Pleurodesis ; Respiratory Insufficiency ; Sarcoma, Kaposi ; Thymus Gland

The posterior cruciate ligament in the stoutest ligamentous structure in the knee joint. Kennedy and Hawkins have confirmed its strenght to be about 2 times that of the anterior cruciate ligament or tibial collateral ligament. This would appear to offer the support that this ligament has a vital role to play in knee stabilization. But, in the past, non-surgical management was frequently elected either because of the belief that most kness with posterior cruciate insufficiency are asymptomatic or because it is difficult to access surgically. Recently, Hughston and Trickey reported good results after surgical repair of the rupture of the posterior cruciate ligament. And current trend is to repair it surgically. So, we analyzed the 36 cases of acute posterior cruciate ligament injuries, who were admitted and treated surgically in Severance Hospital between Jan. 1981 to Dec. 1985, and obtained the following results. 1. Single rupture of the posterior cruciate ligament largely results in good outcome. 2. When the rupture site is in the substane, we can obtain relatively good results with the augmentation using the medial head of the gastrocnemius. 3. When combined with medial or lateral compartment injuries, the chance of later instability and reconstruction is high.
Anterior Cruciate Ligament ; Clinical Study ; Head ; Knee ; Knee Joint ; Ligaments ; Medial Collateral Ligament, Knee ; Posterior Cruciate Ligament ; Rupture

No abstract available in English.
Blood Pressure ; Immobilization ; Orthopedics

BACKGROUND: Gamma linoleic acid (GLA, Epogam) is considered a safe and effective modality in the treatment of atopic dermatitis (AD) in which impaired function of the enzyme, delta-6-desaturase, has been reported to result in reduced levels of GLA, desaturated fatty acids. OBJECTIVE: We performed this study to observe the changes of skin surface conditions measured objectively by bioengineering methods in relation to clinical improvement after treatment with GLA (Epogam®) in children with AD. METHODS: Thirty-four children with AD were treated with GLA (Epogam®) and evaluated with clinical parameters.The changes of skin surface conditions were monitored by non-invasive experimental instruments. RESULTS: There was a significant decrease of transepidermal water loss (TEWL) and gradual improvements in clinical severity after 12 weeks of GLA (Epogam®) treatment. The change of skin surface pH was statistically significant on the antecubital fossa and abdomen except the popliteal fossa. The other parameters including skin surface hydration and skin surface lipid did not show consistent changes. CONCLUSION: Clinical improvement of AD with GLA (Epogam) seemed to be achieved by the reduction of TEWL.
Abdomen ; Bioengineering ; Child ; Dermatitis, Atopic* ; Fatty Acids ; Humans ; Hydrogen-Ion Concentration ; Linoleic Acid* ; Linoleoyl-CoA Desaturase ; Skin* ; Water

No abstract available.
Chickenpox*

Author list should be corrected.

Our study was performed to evaluate the efficacy of anthralin-UVB therapy for psoriasis by simplifying the conventional Ingram regimen, 34 patients(21 admitted, and 13 OPD patients) were included in our study and the resulti can be summarized as follows. 1. There were no cases of treatment failure. 16 patients(76. 2%) out of the 2l admitted patients and 7 patients(53.8%) out of the 13 OPD patients showed clearing. 2. In the case of the admitted patients, the mean numbers of therapy(days) of the improved patients reaching grade 4 were 12. 0(18. 1 days) in the trunk lesions and 15. 5 (22. 0 days) in the extremity lesions' and those of the cleared patients reaching grade 4 were 11. 2(16. 0 days) in the trunk lesions, and 13. 4(lg. 5 days) in the extremity lesions, but the difference was not significant statistically(pp o.ps). The difference between the therapeutic effects of the admitted and the OPD patients was significant statistically(p<0. 05). 3. There were some notable side effects such as staining, pruritus, and erythema, but there were no cases of therapy termination.
Erythema ; Extremities ; Humans ; Pruritus ; Psoriasis* ; Treatment Failure

No abstract available.
Humans

Richter's syndrome is generally accepted taht lymphoma or leukemia of low grade malignancy, during their course, may alter both their morphologic and clinical appearance and evolve into highly malignant neoplasia. The pathogenesis is not clear, however, dedifferentiation by the emergence of a new clone of cells of higher maligancy similar to the blastic transformation in chronic myelocytic leukemia is suggested as possible mechanism. A case of Richter's syndrome is described. This 45 year old female had been diagnosed as chronic lymphocytic leukemia by absolute peripheral lymphocytosis 5 months before, developed sudden severe abdominal pain and was received segmental resection of ileum under the clinical impression of intestinal perforation with peritonitis. Histologically, the ulcer margin was diffusely infiltrated by polymorphic cells composed of large atypical cells having vesicular nuclei, multinucleated giant cells and Reed-Sternberg like cells admixed with mature lymphocytes. These atypical and multinucleated cells of the paraffin section showed strong monoclonal immunoreactivity for IgG and lambda light chain by PAP method and was interpreted as malignant lymphoma, diffuse, large cell, immunoblastic, polymorphous.
Female ; Humans

BACKGROUND: The wound healing process is impaired or delayed in aged patients. The development of a new wound healing model is needed. Nerve growth factor (NGF) plays a special role in wound healing because NGF is expressed only in proliferating tissues such as wounds. OBJECTIVE: The aim of our study was to develop a wound healing model using a 3-dimensional culture system, raft culture, by comparing the level of NGF expression according to the wound stage after an artificial wound was made to the raft samples. We tried to specifically localize the site of NGF expression both in mRNA and protein level. METHODS: Raft culture using normal human keratinocytes was done and a 2 mm slit wound was made in the center of the raft samples. Raft samples of no wound, 4 d, 7 d, and 9 d after wounding were prepared. In situ RT-PCR and immunohistochemistry were performed to detect and localize NGF expression after making wounds and the addition of substance P (SP). RESULTS: We failed to localize NGF mRNA expression in raft samples by in situ RT-PCR. Immunohistochemistry showed NGF staining throughout the epidermis although a little more dense staining was found in the basal layer. NGF(+) cells tended to increase until 7 d after wounding, but there were no significant differences according to the wounding days. There was `a tendency that the SP(+) group showed more NGF(+) cells than the SP(-) group, but there were no statistical differences. CONCLUSION: We think that our in vitro raft wound model using NGF expression could be used, at least in part, as an objective indicator for wound healing. In our raft model lacking nerve, NGF may not be suitable for representing wound healing process because this model can not reflect the interaction between the skin and the nervous system. Expression of growth factors or cytokines other than NGF need to be applied to our raft culture system.
Cytokines ; Epidermis ; Humans ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; Keratinocytes ; Nerve Growth Factor ; Nervous System ; RNA, Messenger ; Skin ; Substance P ; Wound Healing* ; Wounds and Injuries*