Apocrine sweat gland carcinoma is a very unusual malignant skin adnexal tumor and mostly occurs in areas where apocrine elands are abundant namely. axilla. upper arm. scalp. eyelid. vulva and external auditory meatus. The scrotal location is not yet reported. We report a case of apocrine sweat gland carcinoma of scrotum in a man aged 85, which was managed by local excision. The histologic finding is that of poorly differentiated adenocarcinoma. Evidence of decapitation secretion typical or apocrine glands. is present in some areas.
Adenocarcinoma ; Apocrine Glands ; Arm ; Axilla ; Decapitation ; Eyelids ; Scalp ; Scrotum* ; Skin ; Sweat Glands* ; Sweat* ; Vulva

BACKGROUND: Aprotinin, which is a nonspecific serine protease inhibitor, has an antiinflammatory and thrombogenic effect. However, it has an antithrombogenic effect during the cardiopulmonary bypass. This study was performed to evaluated the effects of aprotinin on the activated clotting time(ACT) and the total amount of the heparin used during the cardiopulmonary bypass. MATERIAL AND METHOD: From December 1998 to November 1999, 82 consecutive patients electively underwent open heart surgery at Gachon medical school. The patients were older than 18 years. Eighty two patients were classified into a control group(group C, n=36) and a aprotinin-treated group(group A, n=46). Body weight, height, body surface area(BSA), pump time(PT), aortic cross clamping time(ACCT), and body temperature(BT) were determined. Total amount of heparin and protamine during the CPB were also measured. ACT was determined before heparin administration, at 20, 40 and 60 minutes after heparin administration, and after protamine administration. RESULT: No significant differences were noted in either group in body weight, height, BSA, BT, and the total amoun of heparin and protamine. Group A demonstrated a significant(p<0.05) increase in age, PT, ACCT, and ACT at 20, 40, and 60 minutes after heparin administration. CONCLUSION: In summary, the use of aprotinin prime resulted in an increase in ACT. The total amount of heparin in aproinin-treated patient was similar to that of the control group in spite of having the prolonged pump time. Therefore aprotinin may reduce the requirement of heparin.
Aprotinin* ; Body Height ; Body Weight ; Cardiopulmonary Bypass ; Constriction ; Heart* ; Heparin* ; Humans ; Schools, Medical ; Serine Proteases ; Thoracic Surgery*

The authors evaluated the clinical significance of the bilirubin values as screening test means for predicting the occurrence of neonatal jaundice earlier after birth, by using the transcutaneous bilirubinometry which is known to measure the bilirubin values in a noninvasive, accurate and simple way. The results obtained were as follows: 1. In comparison between the test group(showing the symptom of a jaundice within 72 hours after birth) and the control group, there were found no statistically significant differences in terms of sex, delivery type, birth weight, gestational age and mother's age, while being found statistically significant differences in terms of transcutaneous bilirubin at birth(TcBbirth), transcutaneous bilirubin at 24 hours after birth(TcB24hr), increase in transcutaneous bilirubin per hour during the first 24 hours after birth(TcBin/hr) and transcutaneous bilirubin at 72 hours after birth(TcB72hr)(p<0,05). 2. The correlation test using the Pearson's coefficient produced statistically significant correlationship between each transcutaneous bilirubin index (TcBbirth, TcB24hr, TcBin/hr and TcB72hr) and serum bilirubin concentration at 72 hours after birth(B72hr)(p<0.05), while the result of the correlation test using the Spearman's roh showed statistically significant correlationship only between TcB24hr or TcB72hr and B72hr(p<0.05). As it was, the correlationship between TcB72hr and B72hr was highest in both Pearsons coefficient and Spearman's roh tests, followed by that between TcB24hr and B72hr. 3. In view of the ROC graph, the most effective means of predicting the occurrence of the neonatal jaundice was TcB72hr followed by TcB24hr, TcBbirth and TcBin/hr in their order. In particular, TcB24hr was conceived to be useful as screening test for determining an early discharge from the nursery within 48 hours. On the other hand, since the negative predictive value of TcBbirth, and TcB24hr is higher, the possibility that those infants showing a lower value of these indices may well be free later from a serious neonatal jaundice even if they should be discharged earlier from the nursery. In conclusion, those four indices predicting the neonatal jaundice in a simple, quick and noninvasive manner using the transcutaneous bilirubinometry were considered to be effective screening test means whereby any serious neonatal jaundice developed earlier after delivery can be successfully predicted.
Bilirubin ; Birth Weight ; Gestational Age ; Hand ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Jaundice, Neonatal* ; Mass Screening* ; Nurseries ; Parturition

No abstract available.
Cerebral Hemorrhage* ; Mucormycosis*

Cerebral gigantism(Sotos syndrome) is a growth disorder that consists of large size at birth, rapid early growth rate with accompanying advanced bone age, acromegalic features, and developmental delay. Clumsiness in the absence of other abnormal neurologic findings is common. The cause is unknown. We report here a case of 238/12-year-old Sotos syndrome with final adult height above 97 percentile, abnormal brain MRI findings(large ventricles, prominent trigone, prominent occipital horn & thining of corpus callosum), clumsiness, and some behavioral problems.
Adult ; Animals ; Brain ; Growth Disorders ; Horns ; Humans ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Parturition ; Sotos Syndrome

Determining the current status of therapeutic results of acute lymphoblastic leukemia (ALL), and identifying the important clinical predictors of survival and relapse are essential for establishing therapeutic strategies. Sixty-two children with ALL who were admitted to Chonnam University Hospital from January 1983 to June 1991 were studied. With a mean follow-up period of 53.7 months, the overall 5-year survival rate (5YSR) was 46.1%. The overall rate of 5-year event-free survival (EFS) was 25.4% and significantly differed between risk groups: 48.7% for standard, 16.3% for high, and 12.5% for very high (p<.05). Overall 4-year survival after initial relapse was 34.2% and there was no significant difference in survival between those who relapsed during maintenance therapy and those who relapsed after completing maintenance. The Cox proportional hazards model identified central nervous system (CNS) irradiation (P<0.001) as having the most important influence upon EFS, followed by serum alanine aminotransferase level, platelet level, and age. On the other hand, CNS leukemia at diagnosis, followed by mediastinal mass, and hemoglobin level were found to be the most important prognostic predictors for relapse. On the basis that present results differ from those of developed countries, we suggest the necessity of a nation-wide cohort study to delineate the characteristics of Korean ALL in children, to make our own protocols, and ultimately to improve the therapeutic outcome.
Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Child ; Child, Preschool ; Combined Modality Therapy ; Female ; Humans ; Infant ; Korea ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality/physiopathology/*therapy ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Recurrence ; Survival Rate ; Treatment Outcome

Dental porcelain is one of the materials of choice for restoration where esthetics is of concern, but has a considerable potentials of wear. The wear of enamel is variable when opposed by different porcelain systems and surface conditions, and the exposed dentine and opaque porcelain due to clinical failure is expected to have high potentials of wear. The purpose of this study was to investigate the wear effects of self-glazed, polished incisal porcelain, polished dentine and opaque porcelain against human enamel in the laboratory by use of a pin-on-disk type wear tester. 4 types of dental porcelain(Vita-omega, Ceramco-II, Vintage powder, Vita-alpha of In-Ceram system) and type IV gold alloy as cotrol group were used for test specimens. Intact buccal cusps of maxillary premolar were used for enamel specimens, and the cusp converged to a point and was devoid of visible abrasion, caries, decalcification. The upper part was the cusp of a maxillary premolar and the lower part was a porcelain specimen. The enamel wear was determined by weighing the cusp before and after each test. Surface profilometer was used to quantitate wear of the porcelain specimens. Vicker's hardness tester was used to evaluate the surface hardness of test specimens. The SEM was used to evaluate the wear surfaces. The results were as follows : 1.Self-glazed porcelain produced more enamel wear than polished porcelain, especially the enamel wear of Vita-alpha self-glazed porcelain was 3.2 times more than that of other groups. 2.Opaque porcelain produced least porcelain wear, Vita-alpha self-glazed porcelain produce greatest porcelain wear, but there was no statistically significant difference between the groups(p>0.05). 3.The enamel wear of dentine porcelain was 3.8 times more than that of polished inisal porcelain(p<0.05), and the enamel wear of opaque porcelain was 1.9 times more than that of polished inisal porcelain, but there was no statistically significant difference between the groups(p>0.05). 4.Overglazed porcelain produced less enamel wear than self-glazed porcelain, and more enamel wear than polished porcelain, but there was no statistically significant difference between the groups(p>0.05). 5.The hardness number of Vita-omega dentine and Ceramco-II opaque porcelain was larger, but that of Vintage dentine and Vita-alpha self-glazed porcelain was similar to other groups. 6.Examination of SEM photographs revealed that overglazed porcelain had smoother surface than self-glazed porcelain, and self-glazed porcelain had smoother surface than polished porcelain. Much polishing scratches and larger porosities were observed on the opaque porcelain specimen, and much polishing scratchess and small porosities were observed on the dentine porcelain specimen.
Alloys ; Bicuspid ; Dental Enamel* ; Dental Porcelain* ; Dentin ; Esthetics ; Hardness ; Hardness Tests ; Humans* ; Porosity

Leiomyomas, which are the commonest pelvic tumors in women, are originated from myometrial cells. Although the exact initial pathophysiologic event of the leiomyoma is not known, recent evidences suggested that the effects of sex steroid hormones in the process of tumor growth are mediated by local production of growth factors including epidermal growth factor(EGF), insulin-like growth factor-I(IGF-I) and insulin-like growth factor-II(IGF-II). Recently, it was suggested that transforming growth factor-beta(TGF-beta) may play a role for growing of leiomyomas. It was known that TGF-beta increase the formation of extracellular matrix. And we examined TGF-beta1 expression and tried to know the effect of TGF-beta1 on the extracellular matrix, collagen I and III mRNA levels in cultured leiomyoma and myometrial cells. We found that immunoreactive TGF-beta1 was expressed in myometriums and in leiomyomas. There was no difference at the intensity of immunostaining between two tissues. In northern blotting, there was no difference of TGF-beta1 expression at the transcriptional level in both tissues. TGF-beta1 increased the mRNA levels of collagen I in cultured myometrial and leiomyoma cells at the concentration of 1 ng/ml(p<0.05), 10 ng/ml(p<0.001). And TGF-beta1 increased the mRNA levels of collagen III in cultured myometrial and leiomyoma cells at the concentration of 1 ng/ml (p<0.05), 10 ng/ml(p<0.05). Therefore, expressed TGF-beta1 may stimulate the incorporation of collagen I and III into the extracellular matrix in myometriums and leiomyomas.
Animals ; Blotting, Northern ; Collagen* ; Extracellular Matrix ; Female ; Gonadal Steroid Hormones ; Humans ; Intercellular Signaling Peptides and Proteins ; Leiomyoma* ; Mice ; Myometrium* ; RNA* ; RNA, Messenger ; Transforming Growth Factor beta ; Transforming Growth Factor beta1*

BACKGROUND: The Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system and the Sequential Organ Failure Assessment (SOFA) scoring system are widely used for critically ill patients. We evaluated whether APACHE II score and SOFA score predict the outcome for trauma patients in the intensive care unit (ICU). METHODS: We retrospectively analyzed trauma patients admitted to the ICU in a single trauma center between January 2014 and December 2015. The APACHE II score was figured out based on the data acquired from the first 24 hours of admission; the SOFA score was evaluated based on the first 3 days in the ICU. A total of 241 patients were available for analysis. Injury Severity score, APACHE II score, and SOFA score were evaluated. RESULTS: The overall survival rate was 83.4%. The non-survival group had a significantly high APACHE II score (24.1 ± 8.1 vs. 12.3 ± 7.2, P < 0.001) and SOFA score (7.7 ± 1.7 vs. 4.3 ± 1.9, P < 0.001) at admission. SOFA score had the highest areas under the curve (0.904). During the first 3 days, SOFA score remained high in the non-survival group. In the non-survival group, cardiovascular system, neurological system, renal system, and coagulation system scores were significantly higher. CONCLUSIONS: In ICU trauma patients, both SOFA and APACHE II scores were good predictors of outcome, with the SOFA score being the most effective. In trauma ICU patients, the trauma scoring system should be complemented, recognizing that multi-organ failure is an important factor for mortality.
APACHE* ; Cardiovascular System ; Complement System Proteins ; Critical Care* ; Critical Illness ; Humans ; Injury Severity Score ; Intensive Care Units* ; Mortality ; Multiple Trauma ; Retrospective Studies ; Survival Rate ; Trauma Centers

No abstract available.
Hematuria*