Laser photocoagulation was applied in vitro to organ culture exoplants of porcine retinal pigment epithelium(RPE) attached to Bruch's membrane, choroid, and sclera using the Del Priore method for de-monstrating the proliferation of RPE cells and characterizing the response with respect to power level of treatment. Six-millimetor-round buttons of eyewall were treated with 20-30 spots from the argon bluegreen laser using a 500 micrometer spot size, 0.1s duration, and variable powers(100mW, 300mW, and 500mW). Group 1 is untreated control group and group 2(100mW) and group 4(500mW) showed less active proliferation of RPE than group 3(300mW). In group 3, all RPE cells, Bruch's membrane, and a part of choroid were disrupted and lifted off three hours after laser photocoagulation and then RPE cells began to proliferate actively at third day. The treated area became completely covered with several layers of RPE cells. The proliferation of RPE cells turned out to be larger when the power was moderate(300mW) as compared to the case when the power was too high(500mW) or too low(100mW).
Argon ; Bruch Membrane ; Choroid ; Light Coagulation* ; Organ Culture Techniques* ; Retinal Pigment Epithelium* ; Retinaldehyde* ; Sclera

Angiocentric lymphoma is a lymphoma like lesion which has been known as a lethal midline granuloma, lymphomatoid granulomatosis and polymorphic reticulosis. It involves predominantly lungs, and other extranodal sites such as upper respiratory tract, skin, kidneys, peripheral nervous system and CNS. The authors experienced a case of angiocentric lymphoma which was misdiagnosed as orbital cellulitis because there were persistent epiphora, erythematous swelling in dacryocyst area and diffuse edema in upper and lower eyelids which occurred after functional endoscopic sinus surgery. This case was diagnosised as angiocentric lymphoma through multiple tissue biopsies. This disease is rare, especially in orbit and eyelid. It leads to the destruction and inflammation of tissue. To avoid misdiagnosis to orbital cellulitis, accurate biopsy is needed with the interchange of clinical informations with pathologist. We report this case with the review of literatures.
Biopsy ; Diagnosis ; Diagnostic Errors ; Edema ; Eyelids ; Granuloma, Lethal Midline ; Inflammation ; Kidney ; Lacrimal Apparatus Diseases ; Lung ; Lymphoma* ; Lymphomatoid Granulomatosis ; Orbit ; Orbital Cellulitis ; Peripheral Nervous System ; Respiratory System ; Skin

No abstract available.
Biopsy, Fine-Needle* ; Coinfection* ; Liver Abscess, Amebic*

Scrub typhus (tsutusgamushi disease) is an acute febrile illness caused by Orientia tsutsugamushi, which is endemic in the Asia-Pacific area. Scrub typhus in pregnant woman is uncommon and some reports have suggested that this disease may be associated with increased fetal loss. An effective and safe treatment regime for scrub typhus on pregnancy has not been established and the clinical outcome on the pregnant woman and fetus is unclear. We report a case of scrub typhus during pregnancy treated with azithromycin, which showed no recurrence and no fetal and neonatal complications.
Azithromycin ; Female ; Fetus ; Humans ; Orientia tsutsugamushi ; Pregnancy ; Pregnant Women ; Recurrence ; Scrub Typhus

Lichenoid drug eruption is a lichenoid skin eruption caused by certain drugs and compounds, and can be similar to lichen planus. A 51-year-old man who had taken antihypertensive drugs (enalapril, dilazep dihydrochloride) and cholesterol lowering drug (atorvastatin) for 4 years had received allopurinol for asymptomatic hyperuricemia for 4 months. He developed pruritic erythematous papules and plaques with silvery scales on the face, trunk and extremities after taking allopurinol for 3 months. He had no fever, no eosinophilia and no systemic abnormalities. Histopathologic findings showed hyperkeratosis, parakeratosis, hypergranulosis, band-like lymphohistiocytic infiltration and perivascular lymphohistiocytic infiltration in the dermis, which were compatible with lichenoid drug eruption. The skin rashes disappeared after he stopped taking allopurinol and was treated with steroids.
Allopurinol ; Antihypertensive Agents ; Cholesterol ; Dermis ; Dilazep ; Drug Eruptions ; Enalapril ; Eosinophilia ; Exanthema ; Extremities ; Fever ; Humans ; Hyperuricemia ; Lichen Planus ; Middle Aged ; Parakeratosis ; Skin ; Steroids ; Weights and Measures

Acrosyringeal nevus is a rare condition, which includes proliferation of acrosyringeal keratinocytes, and the proliferation extends from the undersurface of the epidermis down into the dermis as thin anastomosing cords. It is, however, controversial whether acrosyringeal nevus is the same lesion as eccrine syringofibroadenoma, because of several clinicopathological differences. We report a case of benign tumor, consisting of eccrine structures, which occurred in a 60-year-old man. The histopathological features of the excisional biopsy were consistent with acrosyringeal nevus.
Biopsy ; Dermis ; Epidermis ; Humans ; Keratinocytes ; Middle Aged ; Nevus*

The purpose of this study was to compare and evaluate the shaping abilities of various hybrid instrumentation method using constant tapered file systems with ProTaper(R) S1 and the difference between experts and inexperienced clinicians in use of NiTi file. Three hybrid methods used in this study were composed of ProTaper(R) S1 and K-Flexofile(R) (group S), ProTaper(R) S1 and HeroShaper(R) (group H), and ProTaper(R) S1 and ProFile(R) (group P), respectively. The ProTaper(R)-alone method (group C) was introduced as a control group. After canal preparation, the lapse of time was recorded. The images of pre- and post-operative canal were scanned and superimposed. Amounts of instrumented canal widths and centering ratio were measured at apical 1, 2 and 3 mm levels and statistical analysis was performed. In this study, both of the group C and S took more time to prepare canals than other groups. Inexperienced operators required more time for the entire preparation with the groups C and H than the experienced (p < 0.05). And the centering ratio of group P were preferable to ProTaper(R)-alone method or the hybrid technique using stainless steel files. As such, within experienced operators, group H also showed better results in addition to the group P. Under these condition, the hybrid methods of each the ProFile(R) system and HeroShaper(R) with ProTaper(R) are recommendable comparative to ProTaper(R)-alone method. According to the results, the hybrid instrumentation method is a more appropriate method of canal preparation than single file system for narrow or curved canals.
Stainless Steel

BACKGROUNDS/AIMS: Complete elimination of intrahepatic duct (IHD) stones is difficult and IHD stone disease is frequently associated with various complications, recurrence and sometimes cholangiocarcinoma. Therefore, we analyzed the long-term surgical results and evaluated the management currently considered appropriate. METHODS: Overall 110 patients who had been diagnosed with benign IHD stone disease and who underwent surgical treatment were enrolled in this study. The patients were categorized into three groups according to the type of surgery performed; liver resection (LR) group, intrahepatic duct exploration (IHDE) group and hepaticoenterostomy (HE) group. We compared and analyzed the results of these three groups. RESULTS: The number of cases in the LR group, IHDE group and HE group were 77, 25 and 8 respectively. The LR group required a longer operation time (p=0.000), more frequent transfusion (p=0.028) and had higher morbidity (p=0.049). However, the LR group had a higher clearance rate (90.9%) (p=0.000) than the other groups. In addition, there were a total of 22 cases of IHD stone recurrence during the follow-up, but there was no statistically significant difference among the three groups. The location of IHD stones was related to a risk factor for incomplete stone removal, but not for recurrence. CONCLUSION: The fundamental principle for the treatment of IHD stone disease should be liver resection. However, it can lead to a longer operative time and higher rate of complications than the other procedures. There is also no difference in the IHD stone recurrence rate among the procedures. Therefore, these alternative and minor procedures could also be taken into account for patients with poor preoperative condition.
Cholangiocarcinoma ; Follow-Up Studies ; Humans ; Liver ; Operative Time ; Recurrence ; Risk Factors

Dermatomyositis is a rare disease of unknown origin that combines an inflammatory myopathy with characteristic cutaneous findings. Scalp disease has rarely been considered as a manifestation of dermatomyositis and is often misdiagnosed as being scalp paosiasis or seborrheic dermatitis. We report a case of 27-year-old woman who presented with brownish alopecic patches on the scalp, and chronic proximal muscle weakness.
Adult ; Cicatrix* ; Dermatitis, Seborrheic ; Dermatomyositis* ; Female ; Humans ; Muscle Weakness ; Myositis ; Rare Diseases ; Scalp

PURPOSE: Although procalcitonin (PCT) level is useful for the diagnosis of neonatal sepsis, PCT reliability is inconsistent because of the varied conditions encountered in neonatal intensive care units. This study aimed to investigate PCT levels and factors influencing increased PCT levelin newborns without bacterial infection during the first week of life. METHODS: In newborns hospitalized between March 2013 and October 2015, PCT levels were measured on the first, third, and seventh days after birth. Newborns with proven bacterial (blood culture positive for bacteria) or suspicious infection (presence of C-reactive protein expression or leukocytosis/leukopenia) were excluded. Various neonatal conditions were analyzed to identify the factors influencing increased PCT level. RESULTS: Among 292 newborns with a gestational age of 35.2±3.0 weeks and a birth weight of 2,428±643 g, preterm newborns (n=212) had higher PCT levels than term newborns (n=80). Of the newborns, 7.9% had increased PCT level (23 of 292) on the firstday; 28.3% (81 of 286), on the third day; and 3.3% (7 of 121), on the seventh day after birth. The increased PCT level was significantly associated with prenatal disuse of antibiotics (P=0.004) and surfactant administration (P<0.001) on the first day after birth, postnatal use of antibiotics (P=0.001) and ventilator application (P=0.001) on the third day after birth, and very low birth weight (P=0.042) on the seventh day after birth. CONCLUSION: In newborns without bacterial infection, increased PCT level was significantly associated with lower gestational age and respiratory difficulty during the first week of life. Further studies are needed for clinical applications.
Anti-Bacterial Agents ; Bacterial Infections ; Birth Weight ; C-Reactive Protein ; Diagnosis ; Dyspnea ; Gestational Age ; Humans ; Infant, Newborn* ; Infant, Very Low Birth Weight ; Intensive Care Units, Neonatal ; Parturition ; Premature Birth ; Sepsis ; Ventilators, Mechanical