Eosinophilic cystitis is a baffling rarity impossible to distinguish grossly from bladder tumor. It is characterized by vesical irritability, hematuria and eosinophilia. The etiology is unknown. Authors have found only 7 cases in the literature and present one case which was mimicking papillary carcinoma. Patient 35 years-old married man, was admitted to Seoul National University Hospital on March 13. 1967. with a one-week history of hematuria, urgency, frequency and dysuria. Physical examination was negative. Hemograms showed normal except eosinophilia of 10% to 16%. Urinalysis showed one plus proteinuria, many red cells and 5 to 6 white cells per high power field. An excretory urogram displayed essentially normal. At cystoscopy marked bullous edema on entire bladder wall and large polypoid lesion in anterior wall were noted. Punch biopsy was done and it revealed mild degree transitional cell carcinoma of the bladder. He underwent bilateral cutaneoureteroetomy and cystectomy. The surgical specimen, however, showed no malignant lesion but diffuse eosinophilic cystitis.
Adult ; Biopsy ; Carcinoma, Papillary ; Carcinoma, Transitional Cell ; Cystectomy ; Cystitis* ; Cystoscopy ; Dysuria ; Edema ; Eosinophilia ; Eosinophils* ; Hematuria ; Humans ; Physical Examination ; Proteinuria ; Seoul ; Urinalysis ; Urinary Bladder ; Urinary Bladder Neoplasms

No abstract available.
Humans ; Pericardial Effusion* ; Rheumatic Fever*

A 5 year-old girl was admitted to the hospital on April 18, 1967 to be investigated for genital anomalies such as greatly enlarged clitoris, sexual hair in axillae and on pubic region, acne on the face, and excessive somatic growth which were first noticed by her parents at the age of two(Figures 1 and 2). She measured 118 cm in height (normal, 96 cm), and 20kg in weight (normal, 11kg) and was very muscular (Fig. 2 and table 1). The enlarged clitoris measured 3 cm long and showed a groove on its ventral surface communicating with a small opening from the urogenital sinus. The urogenital sinus was persitted and the labia minora are small, but the labia majora are large and resemble an open scrotum. the two labio-scrotal folds were separated and contained no exteriorized gonads. Pubic and axillary hair were scanty but acne on the face was moderately developed (Fig. 3). Nuclear sexing was female type. Her blood pressure and strum electrolytes were normal. Her bone age was around 9 years of a girl. Cystogram and vaginogram were found to be normal (Figure 4,5 and 6). Three consecutive urinary 17-ketosteroid outputs per day were 9.0, 14.0 and 11.4 mg prior to treatment. On cortisone suppression test, the amount of it dropped from 14.0 to 3.7 mg, but it was not significantly suppressed on the third to seventh days of the test to a value below two-third of the pretest level (Fig. 7). Constructive operation of feminine external genitalia including vaginoplasty and clitoridectomy was performed following a vaginogram being taken under general anesthesia on April 28. 1967 (Fig. 8). Both adrenal glands were explored on May 16, 1967 by Young's bilateral approach under general anesthesia and they were found to be hyperplastic almost three times bigger than the normal size but no tumor man was seen. After having decided that both adrenals were in a condition of marked hyperplasia, outer halves of both adrenals were excised. The removed specimens measured 4.0X1.5X 0.5 cm in the right side and 3.5X2.0X0.4 cm in the left. Histological examination showed simple cortical hyperplasia of both adrenals, but the severity was more marked in left than in right (Fig. 9-A, B). Acne subsided and hirsutism decreased one month after the initiation of cortisone therapy in addition to the subtotal adrenal resection. Although it is too early to evaluate the ultimate value of long-term suppressive therapy, clinical results at this time are encouraging.
Acne Vulgaris ; Adrenal Glands ; Adrenogenital Syndrome* ; Anesthesia, General ; Axilla ; Blood Pressure ; Child, Preschool ; Circumcision, Female ; Clitoris ; Cortisone ; Electrolytes ; Female ; Genitalia ; Gonads ; Hair ; Hirsutism ; Humans ; Hyperplasia ; Male ; Parents ; Scrotum

No abstract available.
Hernia*

Protein Kinase C (PKC) relays information in the form of a various extracellar signals across the membrane and is known to play an important role in the production of B lymphocytes and T lymphocytes, in the antigen-presentation of Langerhans cell, and in inflammatory reactions. The presentation of allergens to T lymphocytes is likely an important aspect in the pathophysiological mechanism of allergic rhinitis. Although several theories have been formulated in allergic rhinitis, signal transduction of this disease remains unknown. In this study, we focused on the role of the enzyme PKC in the allergic mucosa of the nose. Specifically, we investigated the role and the distribution of PKC isozymes in the mucous membrane of the nose. We obtained nasal mucous membrane specimens from 10 patients with house dust mite allergy and 10 patients with normal nasal mucous membrane. We performed an immunohistochemical study, an RT-PCR, and a densitometric measurement. PKCalpha, PKCbeta, and PKCzeta proteins were detected in the subepithelial layer of the allergic mucosa. However there were no detectable reactions in the nonallergic mucosa. In the RT-PCR for PKCalpha, PKCbeta and PKCzeta, there was no difference between the allergic and nonallergic nasal mucous membrane in terms of m-RNA expression. It is possible that the signal transduction pathway of PKC and over-expression of PKC protein at the post-transcription level contribute to the development of allergic inflammation in allergic nasal mucosa.
Allergens ; B-Lymphocytes ; Humans ; Hypersensitivity ; Inflammation ; Isoenzymes ; Membranes ; Mucous Membrane ; Nasal Mucosa* ; Nose ; Protein Kinase C* ; Protein Kinases* ; Pyroglyphidae ; Rhinitis ; Signal Transduction ; T-Lymphocytes

PURPOSE: To evaluate the low attenuation of mosaic pattern in pulmonary embolism, as observed on HRCT, and to correlate the findings with the pathologic features of resected lung. MATERIALS AND METHODS: Using permanent embolic materials, pulmonary embolism was induced in eight Yorkshire pigs. Pre-and post-embolic pulmonary angiography was performed and after 6 weeks, the incidence and pattern of parenchymal change in low attenuation (mosaic pattern), as seen on HRCT, was evaluated. The animals were then sacrified and contact radiography of the lung was performed. Thirty-eight segments of pathology were taken from the area in which the presence of embolism had been suggested. Pathologic and HRCT findings were then correlated. RESULTS: On HRCT, low attenuation was seen in 23 of 36 segments (64%) and showed variable patterns : crescent peripheral hyperlucency (61%, n=14), heterogeneous mottled hyperlucency (17%, n=4), lobular hyperlucency (13%, n=3), and homogeneous segmental hyperlucency (9%, n=2). Parenchymal low attenuation was seen on HRCT in 10 of 11 segments (91%) in which large segmental arterial occlusion occurred, and in 3 of 16 segments (19%) in which there was small segmental arterial occlusion. Abnormal pathologic findings were pulmonary congestion, dilatation of pulmonary arteries, interlobular septal thickening, and thrombus formation. Among the 38 pathologic segmental specimens, 29 were from the area in which HRCT findings were positive, and in which pulmonary embolism subsequently occurred. In only four of nine segments (44%) in the area in which HRCT fingings were negative was pulmonary embolism subsequently. CONCLUSION: HRCT findings of pulmonary embolism at six weeks after embolization showed variable patterns of low attenuation, diminished diameter of pulmonary arteries, and normal diameter of bronchi. In cases with large segmental arterial occlusion, the finding of low attenuation was more common ; this may be due to reduced blood flow to the embolic area, in combination with bronchiolar spasm. For the early diagnosis of pulmonary embolism, these findings may be useful.
Angiography ; Animals ; Bronchi ; Dilatation ; Early Diagnosis ; Embolism ; Estrogens, Conjugated (USP) ; Incidence ; Lung ; Pathology ; Pulmonary Artery ; Pulmonary Embolism* ; Radiography ; Spasm ; Swine ; Thrombosis

Ludwig's Angina is the term given to the symptoms resulting from infection of the submandibular space and is characterized especially by extreme edema of the floor of the mouth. Airway obstruction and respiratory difficulty is common due to edema of the mouth, tongue, and the glottis, from mediastinitis due to spread, or from septicemia or pneumonia. Thus it is necessary for the anesthetist to attend to specific management of airway maintenance. A 49 year old male had an operation for incision and drainage under balanced anesthesia. After the operation, posthypoxic myoclonus due to anoxia for three minutes appeared while in the recovery room. The patient, controlled by oxygen supply and diazepam and antiepileptics, has recovered from the seizures, but has not recovered from intention myoclonus and speech disturbance, which are slowly improving. This report describes this case of posthypoxic myoclonus following anesthesia and reviews the literatures.
Airway Obstruction ; Anesthesia* ; Anoxia ; Anticonvulsants ; Balanced Anesthesia ; Diazepam ; Drainage ; Edema ; Glottis ; Humans ; Hypoxia, Brain* ; Ludwig's Angina ; Male ; Mediastinitis ; Middle Aged ; Mouth ; Myoclonus ; Oxygen ; Pneumonia ; Recovery Room ; Seizures ; Sepsis ; Tongue

BACKGROUND AND OBJECTIVES: Abundance of Japanese cedars (JC) in Cheju Island has caused some of the island's residents to suffer from severe allergic symptom in the spring time. This study was carried out to verify the presence of JC allergic rhinitis (AR) in the island. Materials and Method: We performed a history survey, skin testing and nasal provocation test to JC and other common allergens for 170 residents who have symptom of AR. We also performed the same tests in 18 Japanese who had history of AR to JC and have lived in Korea more than 3 years. And as a control, skin tests were performed for 581 patients who live in Seoul. RESULTS: Positive reactions to JC were seen in 22.4% of the resident group. The prevalence rate was remarkable in the state capital of Cheju. These reactions were associated with conjunctivitis, dermatitis, asthma and food allergy. All the 18 Japanese patients were sensitive to JC. However, the allergic symptoms disappeared within 1 year after the move to Korea. And there were no patients sensitive to JC in the control subjects. Conclusions: We confirmed the presence of AR of JC in Cheju island. The distribution is comparatively coincided with JC and/or air pollution and this result indicate that environmental factors can be involved in the manifestation of the disease.
Air Pollution ; Allergens ; Asian Continental Ancestry Group* ; Asthma ; Conjunctivitis ; Cryptomeria* ; Dermatitis ; Food Hypersensitivity ; Humans ; Jeju-do* ; Korea ; Nasal Provocation Tests ; Prevalence ; Rhinitis* ; Seoul ; Skin Tests

BACKGROUND AND OBJECTIVES: Retinoids have recently become an interest to clinicians because of their ability to inhibit migration and proliferation of the premalignant squamous cells, while enhancing growth and proliferation of normal cells. Aural cholesteatoma is defined as the state of hyperproliferative keratinocytes in the middle ear cavity. An in vitro investigation was undertaken to determine whether all-trans retinoic acid (t-RA) exhibits an inhibitory effect on cholesteatoma cell proliferation. METHODS: Cholesteatoma tissue was obtained during a middle ear operation, and the explant was cultured on six well-plates in a culture medium of Medium M-154 (Cascade Biologics Inc., USA) for one week. T-RA was then treated with 10M, 10M, 10M, 10M concentrations, respectively. The cholesteatoma explant cultures were observed daily, and topographic maps were constructed weekly to quantify the proliferation area. The explant culture area was estimated by Multiscan. RESULTS: In the absence of t-RA, the cholesteatoma explant culture area reached 401.5mm in four weeks. But with the administration of t-RA, the cultured area decreased proportionally to t-RA concentrations which reduced to 224.0 mm, 94.4 mm respectively in four weeks with 10M, 10M concentration of t-RA (p<0.05). CONCLUSIONS: This investigation showed that t-RA has a significant inhibitory effect on cholesteatoma proliferation. These results suggest that retionoids may have a role in controlling cholesteatoma disease.
Biological Products ; Cell Proliferation ; Cholesteatoma ; Cholesteatoma, Middle Ear* ; Ear, Middle ; Keratinocytes* ; Retinoids ; Tretinoin*

No abstract available.
Lung*