Alveolar echinococcosis (AE) caused by infection with E. multilocularis metacestode, represents one of the most fatal helminthic diseases. AE is principally manifested with infiltrative, proliferating hepatic mass, resembling primary hepatocellular carcinoma. Sometimes metastatic lesions are found in nearby or remote tissue. AE diagnosis largely depends on imaging studies, but atypical findings of imaging features frequently require differential diagnosis from other hepatic lesions. Serological tests may provide further evidence, while obtaining reliable AE materials is not easy. In this study, alternative antigens, specific to AE were identified by analyzing E. granulosus protoscolex proteins. An immunoblot analysis of E. granulosus protoscolex showed that a group of low-molecular-weight proteins in the range from 14 kDa to 16 kDa exhibited a sensitive and specific immune response to AE patient sera. Partial purification and proteomic analysis indicated that this protein group contained myosin, tubulin polymerization promoting protein, fatty-acid binding protein, uncharacterized DM9, heat shock protein 90 cochaperone tebp P-23, and antigen S. When the serological applicability of recombinant forms of these proteins was assessed using enzyme-linked immunosorbent assay, DM9 protein (rEgDM9) showed 90.1% sensitivity (73/81 sera tested) and 94.5% specificity (172/181 sera tested), respectively. rEgDM9 showed weak cross-reactions with patient sera from the transitional and chronic stages of cystic echinococcosis (3 to 5 stages). rEgDM9 would serve as a useful alternative antigen for serodiagnosis of both early- and advanced-stage AE cases.

Lentigo maligna, a precancerous tumor arising from abnormal melanocytes, is a chronic, slowly progressive, pigmented lesion with a range of colors from pale tan to black and an irregular shape, The commonest location of lentigo maligna is the face during the sixth and seventh decades of life. Less frequently, the lesion occurs on an extrafacial area such as the hand or lower leg. In the late stage, lentigo maligna transforms into invasive malignant melanoma. A 50-year-old male patient had a well-defined, black pigmented patch on the right sole for 30 years. The histopathologic examination revealed numerous vacuolated melanocytes clusters at the dermo-epidermal junction with invasion of the epidermis. There was no evidence of dermal invasion by atypical melanocytes.
Epidermis ; Hand ; Humans ; Hutchinson's Melanotic Freckle* ; Leg ; Lentigo* ; Male ; Melanocytes ; Melanoma ; Middle Aged ; Triacetoneamine-N-Oxyl

We report two cases of recurrent extramarnmary Pagets disease after wide local excision. Both cases involved the scrotum and the penoserotal junction, respectively. On histopathological examination, we could observed many Paget cells confined to the epidermis and the hair follicle, but not invading the underlying dermis in both cases. There was no evidence of internal malignancy. Both cases were treated with wide local reexcision.
Dermis ; Epidermis ; Hair Follicle ; Paget Disease, Extramammary* ; Scrotum

BACKGROUND: Recent evidences suggest that anesthetic action within the spinal cord is important in suppressing somatic responses to painful stimuli. Intrathecal endothelin-1 (ET-1) is known to have antinociceptive effect. The purpose of this experiment was to determine whether intrathecal ET-1 may influence the minimum alveolar concentration (MAC) of isoflurane in rats and access the role of the spinal cord as the sites of anesthetic action in blocking somatic responsiveness. METHODS: In Sprague-Dawley rats fitted with an indwelling intrathecal catheter, we determined the MAC of isoflurane using a tail-clamp technique as a painful stimulus, combined with end-tidal anesthetic sampling. In experiment 1, the control MAC was determined and changes of control MAC were observed after intrathecal ET-1 (4x10-2 nmol, 4x10-3 nmol) administration. In experiment 2, we observed the effects of L or N type Ca++ channel blocker such as verapamil (50 g) or W-conotoxin (0.5 g) on the MAC after measurement of the control MAC. In experiment 3, after measurement of the control MAC, ET-1 (10-2 nmol) was administered intrathecally and the MAC was determined again. Next, intrathecal verapamil (50 g) or W-conotoxin (0.5 g) was injected. After that, the MAC was determined again. RESULTS: In experiment 1, ET-1 decreased the MAC of isoflurane and its effect was sustained over 2 hours. In experiment 2, the MAC, determined following administration of verapamil or W-conotoxin, was not different from that of the control. In experiment 3, the MAC was decreased after ET-1 administration and then increased following injection of verapamil or W-conotoxin. CONCLUSIONS: These results suggested that ET-1, in relation to calcium, might play an important role in determining the MAC of isoflurane in the spinal cord.
Animals ; Calcium ; Catheters ; Endothelin-1* ; Isoflurane* ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord ; Verapamil

No abstract available.
Masticatory Muscles* ; Spasm* ; Tetanus*

PURPOSE: The objective of this study was to evaluate the Caspase 3 and p21 expression level and to understand the correlation between Caspase 3 expression and the clinical factors in renal cell carcinoma. MATERIALS AND METHODS: Forty-two patients with renal cell carcinoma were enrolled in this study. Immunohistochemical staining of Caspase 3 and p21 was performed in formalin-fixed and paraffin-embedded tissue sections using rabbit polyclonal antibody (Caspase 3) and mouse antibody (p21). The Caspase 3 and p21 expression levels were compared with the TNM stage, Fuhrman grade, pathological type and survival rates. RESULTS: The Caspase 3 expression level correlated only with the Fuhrman grade (p=0.017). There was no significant correlation between the Caspase 3 and p21 expression level. The prognostic values did not correlate with the Caspase 3 and p21 expression level. CONCLUSIONS: The prognostic value of the Caspase 3 expression level in renal cell carcinoma was insufficient. The relationship between Caspase 3 and p21 was not proven in renal cell carcinoma, and new factors may be implicated with Caspase 3.
Animals ; Apoptosis ; Carcinoma, Renal Cell* ; Caspase 3* ; Humans ; Mice ; Prognosis ; Survival Rate

Leiomyoma of the urethra is a rare entity. We experienced a case of leiomyoma in the female urethra recently. Twenty-eight-year-old multiparous woman admitted to the Department of Urology, Busan National University Hospital with the chief complaint of a painless mass on the anterior lip of the external urethral meatus. The mass was easily removed by electroresection. It was an ovoid mass, 3.0 x 2.0 x 2.0 cm in size, and was firm and well-encapsulated. Histologically it was confirmed as a benign leiomyoma.
Busan ; Female* ; Humans ; Leiomyoma* ; Lip ; Urethra* ; Urology

A case of right-sided infective endocarditis in a 22-year-old male with ventricular septal defect of perimembranous type, right ventricular(RV) infundibular and pulmonic valve stenosis was reported. The vegetations were found on the mural endocardium of RV infundibulum and pulmonic valve. Streptococcus viridans was identified in 5 consecutive blood cultures, Pulmonary embolism and septic infarction in the lung was associated with systemic embolization, which was manifested by left renal infarction. The RV infundibular stenosis was due to anomalous muscle bundle at the proximal portion. Therefore, we thought that the mechanism of RV infundibular vegetation was probably due to 'Venturi effect and turbulence'. Several clinical features which were found in this case were also reviewed.
Constriction, Pathologic ; Endocarditis* ; Endocardium ; Heart Septal Defects, Ventricular ; Humans ; Infarction ; Lung ; Male ; Pulmonary Embolism ; Viridans Streptococci ; Young Adult

Objective: To investigate the diagnostic performance of contrast-enhanced ultrasound (CEUS) and its role as a second-line imaging modality after gadoxetate-enhanced MRI (Gd-EOB-MRI) in the diagnosis of hepatocellular carcinoma (HCC) among at risk observations. Materials and Methods: We prospectively enrolled participants at risk of HCC with treatment-naïve solid hepatic observations (≥ 1 cm) of Liver Imaging Reporting and Data System (LR)-3/4/5/M during surveillance and performed Gd-EOB-MRI. A total of one hundred and three participants with 103 hepatic observations (mean size, 28.2 ± 24.5 mm; HCCs [n = 79], non-HCC malignancies [n = 15], benign [n = 9]; diagnosed by pathology [n = 57], or noninvasive method [n = 46]) were included in this study. The participants underwent CEUS with sulfur hexafluoride. Arterial phase hyperenhancement (APHE) and washout on Gd-EOB-MRI and CEUS were evaluated. The distinctive washout in CEUS was defined as mild washout 60 seconds after contrast injection. The diagnostic ability of Gd-EOB-MRI and of CEUS as a second-line modality for HCC were determined according to the European Association for the Study of the Liver (EASL) and the Korean Liver Cancer Association and National Cancer Center (KLCA-NCC) guidelines. The diagnostic abilities of both imaging modalities were compared using the McNemar’s test. Results: The sensitivity of CEUS (60.8%) was lower than that of Gd-EOB-MRI (72.2%, p = 0.06 by EASL; 86.1%, p < 0.01 by KLCA-NCC); however, the specificity was 100%. By performing CEUS on the inconclusive observations in Gd-EOB-MRI, HCCs without APHE (n = 10) or washout (n = 12) on Gd-EOB-MRI further presented APHE (80.0%, 8/10) or distinctive washout (66.7%, 8/12) on CEUS, and more HCCs were diagnosed than with Gd-EOB-MRI alone (sensitivity: 72.2% vs. 83.5% by EASL, p < 0.01; 86.1% vs. 91.1% by KCLA-NCC, p = 0.04). There were no false-positive cases for HCC on CEUS. Conclusion The addition of CEUS to Gd-EOB-MRI as a second-line diagnostic modality increases the frequency of HCC diagnosis without changing the specificities.

OBEJCTIVE: This study was proposed to evaluate the electrophysiologic changes in motor evoked potentials (MEPs) and silent period after paraspinal electrical stimulation near caudal area of the spinal cord in stroke patients. METHOD: Electrical stimulation was applied to T12 paraspinal area using interferential current therapy (80~100 Hz) in 18 stroke patients. The amplitude and latency of cortical motor evoked potential and duration of silent period were measured before and after the electrical stimulation. RESULTS: The amplitude of MEPs in affected side was low compared with unaffected side. The duration of silent period was variable in affected side. The duration of silent period was increased after the electrical stimulation in stroke patients (p<0.05). Changes of the amplitude and latency of MEPs were not significant. CONCLUSION: These results mean that the central inhibitory mechanism affecting the silent period is activated by a certain electrical stimulation near caudal area of the spinal cord in stroke patients.
Electric Stimulation* ; Evoked Potentials, Motor* ; Humans ; Spinal Cord ; Stroke*