Bleomycin is an antitumoral antibiotic derived from Streptomyces verticillus in 1965. The drug has been used with a varying success in the treatment of squamous cell carcinomas and malignant lymphomas. The cutaneous toxicities of bleomycin include hyperpigmentation, sclerosis, gangrene, nail changes and erythema. Linear streaks appear to be a characteristic eruption induced by bleomycin. We report three cases of flagellate pigmentation from intravenous bleomycin. Three patients were suffering from uterine cervical carcinomas and were treated with chemotherapy with a VBP (vincristine, bleomycin, cisplatire) regimen. During or after their courses of chemotherapy, dark brownish skin lesions developed on the body surface of these patients. A Light microscopic study of each specimen showed increased pigmentation of the basal layer and an electron microscopic study showed a slightly increased number of melanosomes in keratinocytes.
Bleomycin* ; Carcinoma, Squamous Cell ; Drug Therapy ; Erythema ; Gangrene ; Humans ; Hyperpigmentation ; Keratinocytes ; Lymphoma ; Melanosomes ; Pigmentation* ; Sclerosis ; Skin ; Streptomyces

Purpose: This study aimed to analyze the immunologic profile of children with postinfectious bronchiolitis obliterans (PIBO) in order to approach pathophysiology affected by host factors. Methods: A total of 10 children with PIBO were prospectively enrolled. We obtained information on demographics from their caregiver and electric medical records. Peripheral blood samples were collected before cyclic systemic methylprednisolone therapy and complete blood count, immunoglobulin level and lymphocyte subset were analyzed. Results: The white blood cell count and immunoglobulin level were within the normal range in children with PIBO. The CD4+/CD8+ ratio was not significantly different from those of the healthy control group. A decreased proportion of both central memory T cells (median [interquartile range]; 13.5% [8.3%–16.3%] vs. 18.5% [15.9%–24.1%], P = 0.01) and effector memory T cells (10.3% [5.0%–18.4%] vs. 20.9% [16.6%–26.3%], P = 0.03) in CD4+T cells was observed in the PIBO group compared with those in the control group. In CD8+T cells, the proportion of effector memory T cells (7.8% [4.2%–13.8%] vs. 24.3% [15.3%–27.9%], P = 0.02) and CD45RA+effector memory T cells (16.2% [11.0%–36.6%] vs. 24.2% [17.1%–39.7%], P = 0.04) was decreased in the patient group compared with the control group. Conclusion It is suggested that T lymphocyte subset abnormalities may be associated with a decrease in the ability to differentiate the T cells immediately upon reinfection and induce an effective response to infection. These results may partially explain the pathophysiological individual vulnerabilities to PIBO after lower respiratory tract infections in children.

No abstract available.
Adenoids* ; Carcinoma, Adenoid Cystic*

No abstract available.
Adenoids* ; Carcinoma, Adenoid Cystic*

The three mammalian isoforms of transforming growth factor-beta (TGF-beta1, beta2, beta3) are potent regulators of cell growth, differentiation, and extracellular matrix deposition. To study their role in skin differentiation, we investigated the expression of TGF-beta isoforms on cell growth and differentiation induction of the human keratinocyte cell line, HaCaT by elevating the Ca2+ concentration. An ELISA and RT-PCR assay revealed secreted TGF-beta 1 protein and TGF-beta1 mRNA were increased during calci-um-induced differentiation. In contrast, major differences were seen for TGF-beta 2 and TGF-beta 3 mRNA which were decreased during differentiation, but TGF-beta 2 and TGF-3beta protein were not evident on an ELISA. These results suggest different functions for each TGF-beta isoforms in epidermal differentiation, such that TGF-beta 1 is associ-ated with the more differentiated state, and TGF-beta 2 and TGF-beta 3 may be associ-ated the more proliferated state.
Cell Differentiation/physiology ; Cell Line ; Gene Expression Regulation, Developmental/*physiology ; Humans ; Keratinocytes/*cytology/*physiology ; Protein Isoforms/metabolism ; Transforming Growth Factor beta/*metabolism

Crohn's disease is characterized by its chronic course and transmural inflammation of gastrointestinal tract. The accompanying fibrous reaction and adhesion to adjacent viscera appears to limit the complication of free perforation. The true incidence of free bowel perforation is difficult to assess, however, the anticipated occurrence rate is 1-2% during the course of illness. Moreover, portal venous gas is also an uncommon event in the natural history of Crohn's disease. Portal venous gas occurs when intraluminal gas from the gastrointestinal tract or gas-forming bacteria enters the portal venous circulation. The finding of portal venous gas associated with Crohn's disease does not always mandate surgical intervention. We experienced a case of Crohn's disease presenting with free perforation and portal venous gas. The literatures on the cases with perforation and portal venous gas associated with Crohn's disease were reviewed.
Adult ; Colonoscopy ; Crohn Disease/complications/drug therapy/*pathology ; Diagnosis, Differential ; Embolism, Air/*diagnosis/etiology ; Humans ; Intestinal Perforation/*diagnosis/etiology ; Male ; *Portal Vein ; Tomography, X-Ray Computed

Gastroesophageal reflux disease (GERD) is caused by abnormal reflux of gastric contents into the esophagus. GERD can be divided into two groups, erosive esophagitis and non-erosive reflux disease (NERD). The aim of this study was to compare the clinical characteristics of patients with erosive esophagitis to those with NERD. All participating patients underwent an upper endoscopy during a voluntary health check-up. The NERD group consisted of 500 subjects with classic GERD symptoms in the absence of esophageal mucosal injury during upper endoscopy. The erosive esophagitis group consisted of 292 subjects with superficial esophageal erosions with or without typical symptoms of GERD. Among GERD patients, male gender, high body mass index, high obesity degree, high waist-to-hip ratio, high triglycerides, alcohol intake, smoking and the presence of a hiatal hernia were positively related to the development of erosive esophagitis compared to NERD. In multivariated analysis, male gender, waist-to-hip ratio and the presence of a hiatal hernia were the significant risk factors of erosive esophagitis. We suggest that erosive esophagitis was more closely related to abdominal obesity.
Adult ; Alcohol Drinking ; Body Mass Index ; Esophagitis, Peptic/complications/*diagnosis ; Female ; Gastroesophageal Reflux/complications/*diagnosis ; Gastroscopy ; Hernia, Hiatal/complications ; Humans ; Male ; Middle Aged ; Obesity/complications ; Republic of Korea ; Risk Factors ; Sex Factors ; Smoking/adverse effects ; Triglycerides/blood ; Waist-Hip Ratio

OBJECTIVE: To evaluate the effectiveness of transumbilical single-port access laparoscopic surgery of ectopic pregnancy. METHODS: Retrospective analysis was performed on six patients who underwent transumbilical single-port access laparoscopic management of ectopic pregnancies. RESULTS: The median age of 6 cases was 33.5 years (range, 32 to 36), and the median body mass index was 20.6 kg/m2 (range, 16.5 to 28.7). The median largest diameter of G-sac was 4.8 cm (range, 3.0 to 5.4). Intracorporeal rupture and hemoperitoneum were accompanied in all cases. The median time needed for the surgery was 77.5 minutes (range, 59 to 95). The median estimated blood loss was 40 mL (range, 20 to 50). The median postoperative hospital day was 2 days (range, 1 to 3). There were no complications on postoperative course and follow-up. CONCLUSION: Transumbilical single-port access laparoscopic surgery for ectopic pregnancy was feasible and safe. This approach might be reasonable alternative to conventional laparoscopic surgery using 3 or 4 port in the management of ectopic pregnancy.
Body Mass Index ; Female ; Follow-Up Studies ; Hemoperitoneum ; Humans ; Laparoscopy ; Pregnancy ; Pregnancy, Ectopic ; Retrospective Studies ; Rupture

PURPOSE: Circular stapled hemorrhoidopexy (CSH) is widely used to treat patients with grades III–IV hemorrhoids because of less pain and short hospital stay. However, this procedure is associated with some complications, such as urge to defecate, anal stenosis, staple line dehiscence, abscess and sepsis. To avoid these complications, surgeons perform a partial stapled hemorrhoidopexy (PSH). The aim of this study is to present our early experience with the PSH. METHODS: We retrospectively reviewed the medical records of 58 patients with hemorrhoids who were treated with a PSH at Busan Hang-Un Hospital from January 2016 to June 2016. A specially designed tri-window anoscope was used, and a purse string suture was made at the mucosae of the protruding hemorrhoids through the window of the anoscope. The hemorrhoidopexy was done by using a circular stapler. RESULTS: Of the 58 patients included in this study, 34 were male and 24 were female patients (mean age, 50.4 years). The mean operation time was 12.4 minutes, and the mean postoperative hospital stay was 3.8 days. Three patients experienced bleeding (5.1%) 5 urinary retention (8.6%) and 5 skin tags (8.6%). Urge to defecate, tenesmus, abscess, rectovaginal fistula, anal stricture, incontinence, and recurrence did not occur. CONCLUSION: PSH is a minimally invasive, feasible, and safe technique for treating patients with grades III–IV hemorrhoids. A PSH, instead of a CSH, can be used to treat certain patients with hemorrhoids.
Abscess ; Busan ; Constriction, Pathologic ; Female ; Hemorrhage ; Hemorrhoids* ; Humans ; Length of Stay ; Male ; Medical Records ; Mucous Membrane ; Rectovaginal Fistula ; Recurrence ; Retrospective Studies ; Sepsis ; Skin ; Surgeons ; Sutures ; Urinary Retention

We used five adult dog mandibles embedded in resin block and six different cross-sectional planes for each mandible were choosen. According to the angle of mandibular occlusal plane to vertical plane(mandibular angle) and gantry angle of CT machine, we classfied 4 experimental groups and 1 control group. The control group images were taken at the mandivylar angle 0 degrees (group 1) ;30 degrees and 0 degrees (group 2);15 degrees and 15 degrees (group 3);30 degrees and 30 degrees(group 4), respectively. Using the reformatted cross-sectional images, the distance from the mandibular canal to the alveolar crest and the distance from the mandibular canal to the buccal cortex and to the lingual cortex was measured and compared. The obtained results were as follows ; 1. The distance from the mandibular canal to the alveolar crest of group 1 and 2 was larger than control group, but the distance of group 3 and 4 was smaller. The distance from the mandibular canal to the buccal cortex and to the lingual cortex of all experimental groups was smaller than control group. 2. The distance from the mandibular canal to the alveolar crest showed the largest difference from control group in all experimental groups, especially in group 2 and 4(P<0.05). 3. In the distance from the mandibular canal to the alveolar crest, the number of deviation value under 1mm was 20 in group 3 and was 11 in group 2 and 4, respectively. 4. The deviation value of the distance from the mandibular canal to the buccal cortex and to the lingual cortex was under 1mm in most cases.
Adult ; Animals ; Dental Occlusion ; Dogs ; Humans ; Mandible*