Basal cell carcinoma(BCC) is the most common human malignancy. It involves the face and neck most frequently. However, BCC can very rarely occur on external glenitalia such as scrotum and vulva. We report two cases of serotal and vulvar BCCs in a 67 year old imale and a 43 year old female. He suffered from well defineril erythematous to violet colored plaque with central erosion on the left scrotum for 5 years. She had a brown black colored plaque on the left vulva for 8 years. They did not show any metastatic foci from g!rimary cutaneous lesions, and underwent surgical excision and curettage respectively.
Adult ; Aged ; Carcinoma, Basal Cell* ; Curettage ; Female* ; Genitalia* ; Humans ; Male* ; Neck ; Scrotum ; Viola ; Vulva

Letterer-Siwe disease is one of Langerhans cell histiocytosis, with Hand-Schuller-Christian disease and eosinophilic granuloma, characterized by proliferation of Langevha is cell. The clinical course of Letterer-Siwe disease is acute fulmunant of casionally fatal, involving skin and many other internal organs, such as the lymph node, liver, spleen, ung and bone. We present 3 cases of Letterer-Siwe disease with characteristic cutaneous findings and revealed Langerhans granules by imrriunohistochemical stain and electronmicrc scopic examination. All patients died in spite of combined chernotherapy.
Eosinophilic Granuloma ; Histiocytosis, Langerhans-Cell ; Humans ; Liver ; Lymph Nodes ; Skin ; Spleen

OBJECTIVE: We investigated the norepinephrine transporter (NET) expression in normal and pre-eclamptic placentas and analyzed the invasion activity of trophoblastic cells based on norepinephrine (NE)-NET regulation. METHODS: NET and NE expression levels were examined by western blot and enzyme-linked immunosorbent assay, respectively. Trophoblast invasion activity, depending on NE-NET regulation, was determined by NET-small interfering RNA (siRNA) and NET transfection into the human extravillous trophoblast cells with or without NE treatment and invasion rates were analyzed by zymography and an invasion assay. RESULTS: NET mRNA was expressed at a low level in pre-eclamptic placentas compared with normal placentas and NE concentration in maternal plasma increased significantly in pre-eclamptic women compared to normal pregnant women (p<0.05). NET gene upregulation and NE treatment stimulated trophoblast cell invasion up to 2.5-fold (p<0.05) by stimulating matrix metalloproteinase-9 activity via the phosphoinositol-3-kinase/AKT signaling pathway, whereas NET-siRNA with NE treatment reduced invasion rates. CONCLUSION: NET expression is reduced by inadequate regulation of NE levels during placental development. This suggests that a complementary balance between NET and NE regulates trophoblast cell invasion activities during placental development.
Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Matrix Metalloproteinase 9 ; Norepinephrine ; Norepinephrine Plasma Membrane Transport Proteins ; Placenta ; Placentation ; Plasma ; Pre-Eclampsia ; Pregnant Women ; RNA ; RNA, Messenger ; RNA, Small Interfering ; Transfection ; Trophoblasts ; Up-Regulation

Xanthogranulomatous cystitis is a rare benign inflammatory disease that develops from a urachal remnant or occurs in association with pelvic surgery. Because it manifests as an infiltrative tumor-like lesion arising from the mid-line along the bladder dome and anterior abdominal wall, it is not easy to differentiate from The authors encountered one case of xanthogranulomatous cystitis, diagnosed by means of surgery and pathologic examination, and we report the related ultrasonographic and CT findings.
Abdominal Wall ; Cystitis* ; Urinary Bladder

A myeloid sarcoma (MS) is an extramedullary tumor consisting of primitive granulocytic precursor cells. Although most such tumors have been reported in patients with acute myelogenous leukemia, MS is rarely recognized as an isolated tumor without any evidence of leukemia. However, in such cases, the initial diagnosis of MS can be difficult, so initial misdiagnosis rates of up to 75% have been reported. This report describes an unusual case of MS in a 3-year 5-month-old girl presenting as bilateral renal enlargements, and brain masses, with multiple bone involvements, but no hematological abnormalities.
Bone Neoplasms/pathology/*radiography ; Brain Neoplasms/pathology/*radiography ; Child, Preschool ; Female ; Human ; Kidney Neoplasms/pathology/*radiography ; Sarcoma, Granulocytic/pathology/*radiography ; Tomography, X-Ray Computed

BACKGROUND: Infection is a frequent complication in patients with chronic liver disease, mainly during the advanced stages. This study was performed to investigate the risk factors for infections in hospitalized patients with decompensated liver cirrhosis. METHODS: We analyzed 108 decompensated hospitalized cirrhotic patients (34 cases with infection and 117 cases without infection) without clinical evidence of infection at the time of admission and during initial 72 hours after admission. RESULTS: Univariate and multivariate analysis revealed that patients who developed an infection were more likely to have a lower serum albumin levels. Gram-negative bacterial strains were detected most frequently, in 13 of the 18 strains isolated. There was no significant difference in etiology of disease, Child-Pugh classification, cirrhotic complications including upper G-I bleeding, hepatocelluar caricnoma, invasive procedure, diabetus mellitus, admission to ICU, duration of admission, survival rate and various parameters related to liver and renal function between patients with infection and without infection. CONCLUSION: The present study indicates that decompensated cirrhotic patient with low serum albumin levels have a higher risk of developing a hospital acquired infection, especially by gram negative bacteria.
Classification ; Cross Infection ; Gram-Negative Bacteria ; Gram-Negative Bacterial Infections ; Hemorrhage ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Multivariate Analysis ; Risk Factors* ; Serum Albumin ; Survival Rate

Extramedullary plasmacytoma of the gallbladder is extremely rare. A review of the literature in English revealed only one case, involving a patient with initial extramedullary plasmacytoma of the maxillary sinus. In this report, we describe the case of a 63-year-old man with surgically confirmed extramedullary plasmacytoma confined to the gallbladder. At ultrasonography and computed tomography, diffuse and uniform thickening of the gallbladder wall without evidence of surrounding tissue infiltration was depicted.
Gallbladder* ; Humans ; Maxillary Sinus ; Middle Aged ; Plasmacytoma* ; Ultrasonography

PURPOSE: To correlate the mammographic and ultrasonographic findings with the pathologic results in women undergoing hormone replacement therapy (HRT), and to determine the characteristic clinical, mammographic or histologic findings of breast cancer in these patients. MATERIALS AND METHODS: Twenty-five breast lesions in 25 patients aged 44-65 (mean, 55.5) years undergoing HRT were surgically removed due to abnormal mammographic findings or the presence of palpable masses. Mammograms in all patients and ultrasonograms in 23 were retrospectively analyzed in terms of the shape and margin of the mass, and microcalcifications, and the imaging findings were correlated with the pathologic results. As a control group, 45 cancer patients not undergoing HRT were selected. Using the student t test, detection methods, tumor size, mammographic findings, and the proportion of intraductal cancers were compared between the two groups. RESULTS: Surgical excision revealed ten benign lesions (four fibroadenomas and six cases of fibrocystic change) and 15 cancers (three intraductal and twelve invasive ductal cancers). Abnormal findings at mammography were a mass in 16 cases, clustered microcalcifications in seven, and a mass with microcalcifications in two. Mammography showed that all four circumscribed masses were benign. Five of seven ill-defined masses (71%) and all six spiculated masses were malignant. Three of seven cases (43%) with microcalcification, and both with a mass and microcalcification, were malignant. In two cases in which ultrasonography revealed cystic lesions, histologic examination showed that fibrocystic change had occurred. Compared to non-HRT-related cancers, HRT-related cancers were more often detected by mammography (60% vs 16%; p <0.001), smaller (17 mm vs 24 mm, p <0.01), showed microcalcification only (20% vs 13%; p <0.05), and were intraductal (20% vs 7%; p <0.01). CONCLUSION: In patients with HRT, mammographic findings of an ill-defined or spiculated mass, or one with microcalcifications, were associated with breast cancer. Compared to non-HRT-related cancers, breast cancers in patients undergoing HRT tend to manifest more frequently as a mammographic abnormality, and to be intraductal.
Breast Neoplasms ; Breast* ; Female ; Fibroadenoma ; Hormone Replacement Therapy* ; Humans ; Mammography ; Retrospective Studies ; Ultrasonography

Henoch-Sch?nlein purpura (HSP) is an immunologically medicated systemic vasculitis of small blood vessels affecting the skin, gastrointestinal tract, joints, and kidneys predominantly. Neurological complications in HSP include headache, focal cerebral deficit, coma, convulsion, subarachnoid hemorrhage, and chorea. However, intracerebral hemorrhage complicating HSP is rare. We describe a case of HSP with an intracerebral hemorrhage in a 67-year-old female who was diagnosed with HSP and complained of left homonymous hemianopsia and numbness in the right hand during treatment. Brain imaging showed an intracerebral hemorrhage in the occipital lobe. Her symptoms improved after conservative care. Ultimately, the patient died because of vasculitis and a worsening infection. We report the case of an elderly female with an intracerebral hemorrhage in HSP and review the literature.
Aged ; Blood Vessels ; Cerebral Hemorrhage ; Chorea ; Coma ; Female ; Gastrointestinal Tract ; Hand ; Headache ; Hemianopsia ; Humans ; Hypesthesia ; Joints ; Kidney ; Neuroimaging ; Occipital Lobe ; Purpura ; Purpura, Schoenlein-Henoch ; Seizures ; Skin ; Subarachnoid Hemorrhage ; Systemic Vasculitis ; Vasculitis

PURPOSE: This study was designed to investigate the feasibility and advantages of minimally invasive plate osteosynthesis of periarticular tibial fractures. MATERIALS AND METHODS: Twenty-one patients with periarticular tibial fractures were treated, including 7 proximal and 14 distal fractures. According to the AO classification, 11 cases were A type. After fracture reduction with the traction or distractor, the pre-contoured narrow LC-DCP was inserted at the distant site to the fracture-site, and the screws were percutaneously fixed. RESULTS: Time to union averaged 15.0 weeks (range 10-24 weeks). There were 2 cases of delayed union (above 6 months), and 2 cases of malunion, one with >5 degrees of varus alignment and one with >10 degrees of external rotation. Two patients with failure had second operations, one to correct angulation and for bone graft due to comminution, and the other for early plate removal due to repeated superficial infection. CONCLUSION: The authors feel confident that this minimally invasive technique for plate osteosynthesis of tibial fractures will prove to be a feasible and worthwhile method of stabilization, which avoids the severe complications associated with conventional open plating.
Classification ; Humans ; Tibia ; Tibial Fractures* ; Traction ; Transplants