We reviewed surgical specimens from 11 patients with diffuse neurofibroma to define the specific clinicopathologic characteristics. Ten cases were cutaneous neurofibromas and one case was an uncommon gastrointestinal neurofibroma involving the rectum. The most frequent sites of involvement were the head and neck, especially the eyelids and the periorbital areas. They usually presented as a plaque-like elevation of the skin. They primarily occured in children and young adults and positive family histories of von Recklinghausen's neurofibromatosis were obtained in 45.4%. Pathologically, the involved skin & rectum were diffusely thickened by an infiltrative growing mass, showing proliferation of short fusiform cells in the uniform matrix of fine fibrillary collagen. The characteristic prominence of Wagner-Meissner bodies (45.4%) suggests they could be associated with pathogenesis of diffuse neurofibroma. On the basis of these findings, we could confirm diffuse neurofibroma to be a distinct form of neurofibroma.
Child ; Adult ; Male ; Female ; Humans

Radilogy plays an important role in evaluating patients with suspected adrenal gland pathology. Morphologicdelineation of adrenal gland is especially valuable in patients with clinical and/or biochemical evidence of adisturbance in adrenal function. Many diagnostic radiologic methods are avilable for demonstrating adrenallesions. CT overcomes many of the disadvantages of these other radiologic techniques. The high degree of spatialand density resolution allows precise demonstration of the normal adrenal glands as well as detection of bothsmall and large tumors in almost all patients. So CT of adrenal gland is an excellet nonivasive screening methodand definitive imaging technique. The authers have investigated the capability of CT to image the nomral size,location and shape of both glands. Knowledge of the range of normal is useful for optimal interpretation of CTscans in patients with suspected aderenal pathology. We reviewed CT scan of 150 cases without evidence of adrenaldisease. The following results were obtained: 1. There were 90 male and 60 female patients. 2. Their ages rangedfrom 20 to 60 years. 3. On CT, both gland were shown in 135 (90.0%), the right in 143(95.3%), the left in142(94.6%). 4. In the shape of adrenal glands, most of right adrenal gland was linear or comet shaped; 68(47.6%),most of left adrenal gland was inverted-Y shaped: 103(72.6%). 5. In the length of adrenal glands, theright was2.5+-0.77cm, the left was 2.9+-0.75cm. 6. In the width of adrenal glands, the right was 3.2+-0.74cm, the left was2.7+-0.57cm. 7. In the thickness of adrenal glands, the right was 0.5+-0.14cm, the left was 0.6+-0.16cm.
Adrenal Glands ; Female ; Humans ; Male ; Mass Screening ; Pathology ; Pheniramine ; Tomography, X-Ray Computed

No abstract available.
Thymus Hyperplasia*

The types of K+ channel which determine the pattern of spontaneous action potential (SAP) were investigated using whole-cell variation of patch clamp techniques under current- and voltage-clamp recording conditions in rat clonal pituitary GH3 cells. Heterogeneous pattern of SAP activities was changed into more regular mode with elongation of activity duration and afterhyperpolarization by treatment of TEA (10 mM). Under this condition, exposure of the class III antiarrhythmic agent E-4031 (5 micrometer) to GH3 cells hardly affected SAP activities. On the other hand, the main GH3 stimulator thyrotropin-releasing hormone (TRH) still produced its dual effects (transient hyperpolarization and later increase in SAP frequency) in the presence of TEA. However, addition of BaCl2 (2 mM) in the presence of TEA completely blocked SAP repolarization process and produced membrane depolarization in all tested cells. This effect was observed even in TEA-untreated cells and was not mimicked by higher concentration of TEA (30 mM). Also this barium-induced membrane depolarization effect was still observed after L-type Ca2+ channel was blocked by nicardipine (10 micrometer). These results suggest that barium-sensitive current is important in SAP repolarization process and barium itself may have some depolarizing effect in GH3 cells.
Action Potentials* ; Animals ; Barium ; Cell Line* ; Hand ; Membranes ; Nicardipine ; Patch-Clamp Techniques ; Rats* ; Tea ; Thyrotropin-Releasing Hormone

This study highlights a new case of an infant death caused by mechanical asphyxia, who was found dead after being wrapped and pressed by a daycare center teacher with the body and beddings. Moreover, we present a comparative review of four similar previously reported cases and the implications for forensic pathologists in the management of such cases from the perspectives of judicial verdicts of the cases. The previous report commented that the four cases could be considered as overlaying as a type of accidental asphyxia. However, a contextual comprehensive review including the whole scenarios of the cases and negative postmortem findings concluded that all the cases were explicitly different from overlaying cases. Furthermore, we followed up the judicial processes and verdicts in all five cases, including the present case and the four previously reported cases. In the four cases, the defendants were incarcerated for violation of ‘Act on Special Cases Concerning the Punishment of Child Abuse Crimes.’ The ruling trend revealed that the prison sentence durations had been prolonged from 4 to 19 years. Therefore, for a pediatric death suspecting mechanical asphyxia involving a daycare center, contextual comprehensive approach is essential to determine the cause of death and to provide appropriate medicolegal interpretation.

PURPOSE: We explored the relationship between the use of each medical intervention and the length of time between do-not-resuscitate (DNR) consent and death in Korea. MATERIALS AND METHODS: A total of 295 terminal cancer patients participated in this retrospective study. Invasive interventions (e.g., cardiopulmonary resuscitation, intubation, and hemodialysis), less invasive interventions (e.g., transfusion, antibiotic use, inotropic use, and laboratory tests), and the time interval between the DNR order and death were evaluated. The subjects were divided into three groups based on the amount of time between DNR consent and death (G1, time interval ≤ 1 day; G2, time interval > 1 day to ≤ 3 days; and G3, time interval > 3 days). RESULTS: In general, there were fewer transfusions and laboratory tests near death. Invasive interventions tended to be implemented only in the G1 group. There was also less inotrope use and fewer laboratory tests in the G3 group than G1 and G2. Moreover, the G3 group received fewer less invasive interventions than those in G1 (odds ratio [OR], 0.16; 95% confidence interval [CI], 0.03 to 0.84; 3 days before death, and OR, 0.16; 95% CI, 0.04 to 0.59; the day before death). The frequency of less invasive interventions both 1 and 3 days before death was significantly lower for the G3 group than the G1 (p ≤ 0.001) and G2 group compared to G1 (p=0.001). CONCLUSION: Earlier attainment of DNR permission was associated with reduced use of medical intervention. Thus, physicians should discuss death with terminal cancer patients at the earliest practical time to prevent unnecessary and uncomfortable procedures and reduce health care costs.
Cardiopulmonary Resuscitation ; Health Care Costs ; Humans ; Intubation ; Korea* ; Resuscitation Orders ; Retrospective Studies ; Terminal Care

PURPOSE: Leptin is encoded by the ob gene and is involved in the control of food intake and energy expenditure. Recent studies have implicated leptin expression to be an indicator of tumor features and prognosis. The purpose of this study was to investigate the association of tissue expression of leptin with the clinicopathological characteristics and clinical outcomes in colorectal cancer patients. METHODS: Patients who had undergone a curative surgical resection for a colorectal adenocarcinoma from 2000 to 2004 were included in the study. Immunohistochemical analyses of leptin expression were performed, and clinicopathological parameters were evaluated. RESULTS: Clinical data and tumor tissues of 146 patients were evaluated. The mean age was 68.6 +/- 11.3 years, and 61.0% were men. Immunohistochemically, the rates of negative, weak, moderate, and strong leptin expression were 2.7% (4 of 146), 5.5% (8 of 146), 43.2% (63 of 146), and 48.6% (71 of 146), respectively. We compared the negative, weak, and moderate expression group (group A) with the strong expression group (group B). Leptin expression was inversely associated with nodal stage (P = 0.007) between the two groups. Leptin expression was not significantly associated with differentiation (P = 0.37), T stage (P = 0.16), and American Joint Committee on Cancer stage (P = 0.49), and no significant differences in the disease-free and the overall survivals (P = 0.78 and P = 0.61) were observed. CONCLUSION: Results demonstrated an inverse association of nodal stage with high leptin expression. Higher leptin expression level might predict better oncologic outcome. However, further studies are warranted to identify the exact role of leptin expression in colorectal cancer.
Adenocarcinoma ; Colorectal Neoplasms* ; Eating ; Energy Metabolism ; Humans ; Immunohistochemistry ; Joints ; Leptin* ; Male ; Prognosis ; Survival Rate ; Tissue Array Analysis

Background: The use of cosmeceuticals, cosmetics that are medically proven to improve certain skin qualities, has been generalized to the public. While they were invented to selectively enhance targeted biophysical skin qualities, product selection is highly dependent on subjective perceptions rather than objective assessments. Objective: To evaluate whether subjective perceptions can accurately characterize one’s skin condition, especially in the Korean population, which shows a high interest in cosmetics and skin conditions. Methods: Biophysical parameter measurements were obtained from the 2018 International Skin Characteristics Data Bank Project conducted by the Foundation of the Korea Cosmetic Industry Institute. Participants were 220 healthy South Korean adults. Each participant was asked to evaluate their own skin type in terms of sensitivity, hydration, oiliness, roughness, and thickness. The same subjects were objectively examined using bioengineering devices for the related biophysical parameters. Significance was evaluated using the chi-squared test. Results: Oiliness showed a significant correlation between subjective and objective skin assessments. Although sensitivity, hydration, roughness, and thickness showed positive relationships, none were statistically significant. Interestingly, self-perceived skin texture was highly dependent on pore-induced bumpiness rather than intricate skin surface topology. Also, uneven skin texture tended to be perceived as thick skin. Conclusion Subjectively assessed skin types may limit the precise characterization of the skin’s properties. Therefore, biophysical measurements should be used to assess skin types, particularly with regard to sensitivity, hydration, roughness, and thickness. This Korean population showed no superiority at perceiving skin types compared to subjects of previous studies.

Many studies have reported reduced beta-adrenergic receptor responsiveness in major depression, but there were few studies to see the effect of antidepressant treatment on beta-adrenergic receptor function in depressed patients. This study examined beta-adrenergic receptor responsiveness in patients with major depression before and after antidepressant treatment. After careful psychiatric interviews by two experienced psychiatrists, twenty depressed patients (Hamilton Depression Rating Scale scores>18) were randomly assigned to 8 weeks of double-blind treatment with either milnacipran or sertraline. Twenty normal control subjects who had no previous history of major medical and psychiatric illness were matched with the patients considering age, sex and body mass index. The Hamilton Depression Rating Scale (HAM-D), Montgomery-Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Rating Scale (HAM-A) were performed to assess clinical change of depression in the patients before and after treatment. We measured the lymphocyte cyclic AMP ratio (ratio of isoproterenol-stimulated cAMP/ basal cAMP), beta-adrenergic receptor density (Bmax) and receptor affinity (Kd) in all subjects. Depressed patients showed much lower HAM-D scores (25.7+/-4.8 vs. 14.3+/-9.1, p=0.002), MADRS scores (34.3+/-5.7 vs. 21.5+/-13.1, p=0.005) and HAM-A scores (31.4+/-7.9 vs. 22.1+/-13.5, p=0.040) after 8 weeks of antidepressant treatment than those before treatment. There were statistically significant differences in the means of Bmax and Kd between control subjects and patients before treatment. Contrary to our expectation, there was no statistically significant difference in the means of cAMP ratio between the two groups. Lymphocyte Bmax (4.90+/-3.08 vs. 8.13+/-3.08, p=0.027) and Kd (63.61+/-6.52 vs. 70.89+/-9.40, p=0.029) in the patients increased after antidepressant treatment. This result suggests that antidepressant treatment increases beta-adrenergic receptor responsiveness in depressed patients.
Anxiety ; Body Mass Index ; Cyclic AMP ; Depression* ; Humans ; Lymphocytes ; Psychiatry ; Sertraline

Eccrine poroma is a benign, rare cutaneous neoplasm that clinically represents as solitary, reddish and pink papule or nodule chiefly on the soles or sides of the feet. But it can occur anywhere wherever sweat glands are found. Eccrine poroma generally arises in the middle-aged and elderly people and do not usually exceed 20 mm in diameter. To the best our knowledge, no congenital cases of eccrine poroma have been reported in the Korean literature. We, herein, report a rare case of eccrine poroma arising on the left temple in a 45-year-old man since birth.
Aged ; Foot ; Humans ; Middle Aged ; Parturition ; Poroma ; Sweat Glands