Skin atrophy is one of the most common side effects of topical steroid use and results from decreased skin proalphaI collagen mRNA production due to specific alterations in collagen gene transcription or from reduced collagen mRNA stability. This report describes a case of a 8 year-old-girl who visited our hospital with a complaint of ambiguous genitalia. She was observed to have atrophic labia majora and atrophic striae resembling scrotal rugae. However, her serum levels of FSH, LH, 17-KS, 17-OHCS, 5-DHT, DHT and DHEA-S were all in normal range and her karyotype was 46,XX. Abdominal and pelvic ultrasonogram showed a normal uterus and ovaries. Careful history taking revealed frequent use of steroid ointment due to vulvar pruritus for 2 years and she was finally diagnosed to have atrophy of external genitalia induced by long-term use of topical steroid.
Atrophy* ; Collagen ; Disorders of Sex Development ; Female ; Genitalia* ; Karyotype ; Ovary ; Pruritus ; Reference Values ; RNA Stability ; RNA, Messenger ; Skin ; Ultrasonography ; Uterus

No abstract available.

Incarceration of the gravid uterus is a rare but serious complication of pregnancy. Reported is the case of a gravid 2, para 0, abortus 1 with known uterine subserosal myoma(5.3 x5.5cm sized) 26-year-old woman presented with acute dysuria and urinary retention. The patient was 14 weeks and 3 days pregnant and presented several week history of urinary frequency and sensation of incomplete bladder emptying. Examination revealed a retroflexed uterus with cervical opening pointing toward the anterior abdominal wall. An ultrasound revealed a thin, elongated maternal bladder and a uterus incarcerated between the sacral promontary and the pubis. The incarceration was successfully reduced by tenaculum traction of the cervical posterior lip without surgical intervention and had a normal infant of appropriate weight at term.
Abdominal Wall ; Adult ; Dysuria ; Female ; Humans ; Infant ; Leiomyoma ; Lip ; Myoma* ; Pregnancy ; Sensation ; Traction ; Ultrasonography ; Urinary Bladder ; Urinary Retention ; Uterine Retroversion ; Uterus*

Acute otitis media (AOM) is one of the most common childhood infectious diseases. Despite antibiotic treatment for AOM, AOM and its complication still continue to develop. Acute mastoiditis is a serious complication of AOM and epidural abscess constitutes the commonest of all intracranial complication of AOM. Neurological complication of acute mastoiditis are rare but can be life threatening. Their presentation may be masked by the use of antibiotics. We report the rare case of acute otitis media progressing to acute mastoiditis, epidural abscess formation and lateral sinus thrombophlebitis caused by Streptococcus pneumoniae in a child. She was admitted with acute otitis media with fever. Despite proper antibiotics, acute mastodititis and epidural abscess were developed, and after surgical drainage and antibiotics therapy she was recovered without sequalae.
Anti-Bacterial Agents ; Child ; Communicable Diseases ; Drainage ; Epidural Abscess* ; Fever ; Humans ; Lateral Sinus Thrombosis ; Masks ; Mastoid* ; Mastoiditis* ; Otitis Media ; Streptococcus pneumoniae*

Objectives: . Resident macrophages are well known to be present in the cochlea, but the exact patterns thereof in spiral ligaments have not been discussed in previous studies. We sought to document the distribution of macrophages in intact cochleae using three-dimensional imaging. Methods: . Cochleae were obtained from C-X3-C motif chemokine receptor 1+/GFP mice, and organ clearing was performed. Three-dimensional images of cleared intact cochleae were reconstructed using two-photon microscopy. The locations of individual macrophages were investigated using 100-μm stacked images to reduce bias. Cochlear inflammation was then induced by lipopolysaccharide (LPS) inoculation into the middle ear through the tympanic membrane. Four days after inoculation, three-dimensional images were obtained. Results: . Macrophages were scarce in areas adjacent to the stria vascularis, particularly the area just beneath it even though many have suspected macrophages to be abundant in this area. This finding remained consistent upon LPS-induced cochlear inflammation, despite a significant increase in the number of macrophages, compared to non-treated cochlea. Conclusion . Resident macrophages in spiral ligaments are scarce in areas adjacent to the stria vascularis.

Objectives: . Resident macrophages are well known to be present in the cochlea, but the exact patterns thereof in spiral ligaments have not been discussed in previous studies. We sought to document the distribution of macrophages in intact cochleae using three-dimensional imaging. Methods: . Cochleae were obtained from C-X3-C motif chemokine receptor 1+/GFP mice, and organ clearing was performed. Three-dimensional images of cleared intact cochleae were reconstructed using two-photon microscopy. The locations of individual macrophages were investigated using 100-μm stacked images to reduce bias. Cochlear inflammation was then induced by lipopolysaccharide (LPS) inoculation into the middle ear through the tympanic membrane. Four days after inoculation, three-dimensional images were obtained. Results: . Macrophages were scarce in areas adjacent to the stria vascularis, particularly the area just beneath it even though many have suspected macrophages to be abundant in this area. This finding remained consistent upon LPS-induced cochlear inflammation, despite a significant increase in the number of macrophages, compared to non-treated cochlea. Conclusion . Resident macrophages in spiral ligaments are scarce in areas adjacent to the stria vascularis.

BACKGROUND: Angioleiomyoma of the skin is a rare smooth muscle tumor and may develop anywhere in the body. Comprehensive clinicopathological analysis of angioleiomyomas developed in Korean has not been reported in domestic dermatological journals. OBJECTIVE: The purpose of this study was to evaluate the clinical and pathological characteristics of angioleiomyoma and the relationship between the tumor and the nerve with immunohistochemical stains. METHODS: Fifty nine cases of angioleiomyoma were reappraised from the files of the pathology of Seoul National University, Green Cross Reference Laboratory Center and Korea Veterans Hospital. Brief clinical histories of all cases were examined and microscopic findings in 35 cases were classified according to subtypes. Paraffin blocks were recut and stained in 16 cases for desmin, smooth muscle actin and S-100 protein. RESULTS AND CONCLUSION: 1. Male to female ratio was 1:1.27. 2. The age of the patients was mostly over 20 years and the mean age was 51 years in men and 40 years in women. 3. Tumors occurred most frequently in the lower extremity(38 cases), and followed by upper extremity(18 cases), head(2 cases), and trunk(1 case). Women had predominance of the legs in location site and men showed equal distribution in the lower and upper extremities.
Actins ; Angiomyoma* ; Coloring Agents ; Desmin ; Female ; Hospitals, Veterans ; Humans ; Korea ; Leg ; Male ; Muscle, Smooth ; Paraffin ; Pathology ; S100 Proteins ; Seoul ; Skin ; Smooth Muscle Tumor ; Upper Extremity

PURPOSE: We assessed the clinical significance of a suprapubic cystostomy for the treatment of patients with voiding difficulties, and analyzed the related courses and complications. PATIENTS AND METHODS: A review of 55 patients managed with suprapubic cystostomy was undertaken. The changes in the serum Cr, urinary pH and white blood cell values, after a suprapubic cystostomy, were analyzed. The stone-free rate after insertion of a suprapubic catheter was estimated by the Kaplan-Meier method. RESULTS: The original diseases included: spinal cord injury in 20 (36.3%), inoperable benign prostatic hyperplasia in 12 (21.8%), cerebrovascular accident in 10 (18.2%), diabetic cystopathy in 4 (7.3%), recurrent urethral stricture in 3 (5.5%), spinal stenosis in 2 (3.6%), prostatic cancer in 2 (3.6%) and 1 (1.18%) each of Parkinson's disease and multiple sclerosis. The indications for the need for a cystostomy were: poor hand function in 35 (64%), patient request in 8, worsening of the original disease in 6, vesicoureteral reflux in 3, severe urethral damage in 2 and a recurrent urinary tract infection in 1. The most common complication was the formation of bladder calculi, which occurred in 9 (16%). There were no serious complications associated with the procedure. The mean serum creatinine levels changed from 1.01+/-0.09mg/ml to 0.90 +/-0.09mg/ml, but with no statistical significance. The stone-free rates at 1 and 5 years after the procedure were 91.9 and 61.6%, respectively. The urinary pH of the stone-forming group was significantly higher than that of the stone-free group (p<0.05). CONCLUSIONS: Although continuous cystostomy drainage is not considered an ideal management for bladder emptying, the long-term uses of suprapubic catheters are well tolerated by patients, despite the frequent catheter-related complications. Therefore, a suprapubic cystostomy, as a management, may be indicated in some patients with severe urethral damage and limited activity of the upper extremities.
Catheters ; Creatinine ; Cystostomy* ; Drainage ; Hand ; Humans ; Hydrogen-Ion Concentration ; Leukocytes ; Multiple Sclerosis ; Parkinson Disease ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Spinal Cord Injuries ; Spinal Stenosis ; Stroke ; Upper Extremity ; Urethral Stricture ; Urinary Bladder ; Urinary Bladder Calculi ; Urinary Tract Infections ; Vesico-Ureteral Reflux

PURPOSE: In cases of overactive bladders, especially hyperreflexic neurogenic bladders, that arise in patients with spine disorder above sacral micturition center, current primary treatment modalities include the administration of anticholinergics and the intermittent catheterization. Because anticholinergics have many side effects including dry mouth, the demand for new agents has been rising. This study was designed to investigate the effects of ylang-ylang (YY) essential oil, which is currently used in aromatherapy, on the relaxation of urinary bladder muscle in vitro. MATERIALS AND METHODS: Isometric tension changes of isolated rat bladder muscle strips were recorded in an organ bath using a pressure transducer. Effects of YY oil were assessed on resting tension, electrical field stimulation(EFS)-, bethanechol-, ATP- and KCl-induced contraction. In order to determine the mechanism of YY oil, effects of YY oil on above all stimulations were assessed in the presence of methylene blue, L-NAME(N-nitro-L-arginine methyl ester) and N-ethylmaleimide. RESULTS: The contractility of strips pre-treated with YY oil was significantly decreased on all stimulation-induced contractions. There was no statistically significant difference between treated group only with YY oil and pre-treated group with YY oil and methylene blue. Similar findings were obtained when L-NAME(another NOS inhibitor) was used. When N-ethylmaleimide(c-AMP inhibitor) was employed, there was a statistically significant decrease in the rate of contraction induced by EFS, bethanechol, KCl and ATP applications. CONCLUSION: From the obtained data, the results of this study indicate that YY essential oil has relaxing effect on the bladder, and such mechanism is thought to be brought about by a pathway mediated by c-AMP.
Adenosine Triphosphate ; Animals ; Aromatherapy ; Baths ; Bethanechol ; Cananga* ; Catheterization ; Catheters ; Cholinergic Antagonists ; Ethylmaleimide ; Humans ; Methylene Blue ; Mouth ; Muscles* ; Rats* ; Relaxation* ; Spine ; Transducers, Pressure ; Urinary Bladder* ; Urination

Acute interstitial pneumonia is a fulminant disease of unknown etiology that usually occurs in a previously healthy person and produces the histologic findings of the organizing phase of diffuse alveolar damage. We experienced an autopsy case of acute interstitial pneumonia of unknown etiology. The patient was a 48 year old man who had been healthy and had not been exposed to organic dusts or other toxic materials. The chief complaints represented were dyspnea and a dry cough for several weeks before hospitalization, and the chest radiographs showed bilateral interstitial infiltrates. Patchy consolidation of air space was also identified and ground-glass attenuation similar to those described in ARDS was detected on high-resolution computed tomography. Steroid pulse therapy, mechanical ventilation, and antibiotics for superimposed bacterial infection were performed, but the symptoms did not improve and the patient died of generalized respiratory insufficiency and severe hypoxemia 2 1/2 months after hospitalization. At autopsy the macroscopic and microscopic findings were confined mainly to the lungs. On the whole, both lungs were firm in consistency and the external surface showed a cobblestone appearance. The cut surface showed almost complete replacement of the normal lung parenchyma with gray to yellow fibrous tissue with a little residual functional area remaining. The pathology of both open lung biopsy and autopsy tissue showed marked hyperplasia of type II pneumocytes, hyaline membrane formation, thickening of the alveolar wall due to extensive fibroblast proliferation, and relatively abundant young collagen deposition in the interstitium. An immunohistochemical stain for cytokeratin revealed epithelial hyperplasia and showed that the alveolar spaces were markedly shrunken by fibrous tissue.
Anoxia ; Anti-Bacterial Agents ; Autopsy* ; Bacterial Infections ; Biopsy ; Collagen ; Cough ; Dust ; Dyspnea ; Fibroblasts ; Hospitalization ; Humans ; Hyalin ; Hyperplasia ; Keratins ; Lung ; Lung Diseases, Interstitial* ; Membranes ; Middle Aged ; Pathology ; Pneumocytes ; Pulmonary Fibrosis ; Radiography, Thoracic ; Respiration, Artificial ; Respiratory Insufficiency