The papillary eccrine adenoma is a rare benign sweat gland neoplasm charscterized by potentislly locally aggressive clinical course. We report herein a case of papillsry eccrine adenoma in a 28-year-old female who presented single intradermal tumor on the right postauricular ares. Histopathological findings showed dilated ducts containing eosinophilic or keratinous materials and intraluminal papillary rowths.
Adenoma* ; Adult ; Eosinophils ; Female ; Humans ; Sweat Gland Neoplasms

Somatosensory evoked potentials(SSEP's) are commonly employed to monitor cerebral and spinal cord function in patients with various lesions in the nervous system. In this study, we evaluated SSEP's as a means of measuring not only neurophysiological function but also the alteration of blood folw in the territory of cerebral ischemia. We examined SSEP's and regional cerebral blood flow(rCBF) in the bilateral suprasy1vian gyri following unilateral middle cerebral artery(MCA) occlusion in 15 cats(Group II). The duration of arterial occlusion was 30 minutes followed by 1 hour of recirculation. Five additional cats served as sham-operated groups(Group I). The animals in Group II were divided into 2 subgroups according to the change of the observed rCBF in the ipsilateral hemisphere. Immediately after MCA occlusion, rCBF decreased from around 50 to 14mg/100g/min. Decreased rCBF was remained below 20ml/100g/min throughout the ischemic period in 6 cats(Group IIb), and in the remaining 9 cats, the decreased rCBF was increasing during ischemia although the blood flow was subnormal(Group IIa). The recovery of rCBF during recirculation was faster in Group IIa than in Group IIb. In Group IIa and IIb, there was a significant slowing of the interpeak latency between dorsal column nuclei(Fz) and the major negative deflection(MN) (P<0.05) in the ipsilateral hemisphere and a precipitous decrease in the amplitude of the ipsilateral P1-MN complex immediately after occlusion(P<0.05). In Group IIb the suppressed SSEP's did not show any recovery during ischemia, and recovered late during recirculation. In Group IIa the suppressed SSEP's tended to recover during recirculation. In Group IIa the suppressed SSEP's tended to recover during ischemia and recovered early during recirculation. SSEP's were not completely abolished throughout the experiment in any experimental grup. The relationship between the changes in rCBF and amplitude of SSEP's in the ipsilateral hemisphere was significant(r=0.943, P<0.05) during occlusion of the middle cerebral artery in Group IIa. However there was not any other relationship in the other groups or among other wave components. These results indicate that the suppression of SSEP's and their failure to recover during focal cerebral ischemia correlate with the lack of collateral circulation. Furthermore, SSEP's can be useful means to evaluate the reversibility of cerebral ischemia, which may be decided by existence of collateral circulation. And it appers that the time threshold for abolition of SSEP's is more than 30 minutes in focal cerebral ischemia in the cat.
Animals ; Brain Ischemia* ; Cats ; Cerebral Infarction* ; Collateral Circulation ; Evoked Potentials, Somatosensory* ; Humans ; Ischemia ; Middle Cerebral Artery ; Nervous System ; Spinal Cord

Dieulafoy ulcer is an unusual cause of massive, recurrent and frequently fatal gastrointestinal hemorrhage that results from erosion of abnormally large submucosal artery. Although the lesion has been found throughout the gastrointestinal tract, it most commonly occurs in the proximal stomach. Diagnosis depends on the observation of protruding and eroded artery with pulsatile bleeding or adherent thrombus by endoscopy. Even during active bleeding, the endoseopic examination can be negative if intraluminal blood or clots obscure the source of bleeding. If the bleeding has stopped, the small mucosal lesion can be easily overlooked. Unlike peptic ulceration, there is no excavation of the mucosa. A 76-year-old man presented with massive hematemesis and melena. The patient had no previous history of peptic ulcer disease. He did not drink alcohol and use aspirin or NSAIDs. Physical examination revealed a pale, severely diaphoretic male with hypotension and melenic stools. He was found to have hemoglobin 4.0 g/dL and hematocrit 12.7%. We performed emergency endoscopy which showed a pulsatile and bleeding exposed artery without evidence of surrounding ulcerative lesion on the posterior wall of upper body of stomach. Endoscopic ligation using O ring of Stiegman-Goff endoscopic ligator kit was done successfully and the bleeding stopped immediately after ligation. Ten days after treatment, endoscopy showed artificial ulcerative lesion on previous ligated site and no evidence of bleeding. Another endoscopy four days later revealed healing ulcerative lesion. After improvement, the patient was discharged and rebleeding has not occurred to date.
Aged ; Anti-Inflammatory Agents, Non-Steroidal ; Arteries ; Aspirin ; Cytochrome P-450 CYP1A1 ; Diagnosis ; Emergencies ; Endoscopy ; Gastrointestinal Hemorrhage ; Gastrointestinal Tract ; Hematemesis ; Hematocrit ; Hemorrhage ; Humans ; Hypotension ; Ligation* ; Male ; Melena ; Mucous Membrane ; Peptic Ulcer ; Physical Examination ; Stomach ; Thrombosis ; Ulcer*

Heterotopia (of Ectopia) is defined as the occurrence of normal tissue in an abnormal location. Heterotopic gastric mucosa has been found throughout the length of the gastrointestinal tract from oral cavity to the rectum. Curiously, it is extremely rare in the gailbladder, but when it occurs, it tends to cause symptoms of acute cholecystitis in patients under 20 years of age, and chronic cholecystitis and gallstones in older patients. The heterotopic mucosa results in an intramural mass, a polyp or multiloculated gallbladder. A firm diagnosis of gastric heterotopia is based on the presence of fundic or pyrolic mucosa replete with parietal and chief cells. A clear distinction from intestinal rnetaplasia should be made, but at times may be difficult. Potential complications include mucosal ulceration, obstruction, and hemorrhage. Treatment is cholecystectomy. We report a case of gastric heterotopia in the gallbladder of a 35-year-old-man. Ultrasonography showed fatty change of liver with a 1.5 cm-sized polypoid lesion in the gallbladder. Endoscopic retrograde cholangiography showed a small filling defect, revealed by pooling of the dye in the center, in the body of gallbladder. Laparoscopic cholecystectomy was performed. A sessile polypoid leision with central umbilication was seen in the upper body of gallbladder, without gallstones. The microscopic finding of polypoid lesion consisted of gastric pyloric glands with parietal and chief cells. The surrounding mucosa revealed ordinary gallbladder epithelium without any metaplastic change. We report a case of this condition in which there was a separate loculus lined by gastric epithelium.
Cholangiography ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholecystitis, Acute ; Diagnosis ; Epithelium ; Gallbladder* ; Gallstones ; Gastric Mucosa ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Liver ; Mouth ; Mucous Membrane ; Polyps ; Rabeprazole ; Rectum ; Ulcer ; Ultrasonography

No abstract available.
Neoplasm Metastasis* ; Vena Cava, Inferior*

BACKGROUND/AIMS: The p53 mutations have been described as the most common genetic alteration during development and progression of malignancy in a wide range of human cancers. Mutant p53 proteins have a prolonged half-life accounting for increased levels of p53 protein frequently detected in tumors. This can induce the production of anti-p53 in the senzn of patients with HCC. We determined the relationship of serum anti-p53 with p53 expression in the liver tissue of chronic liver disease and the correlation of serum anti-p53 with serum alpha- fetoprotein(AFP) in patients with HCC. METHODS: In sera of same patients, we analysed the anti- p53 using ELISA system As controls we tested 50 healthy individuals and 20 patients with chronic hepatitis. Immaiohistochemical study for the presence of mutant p53 was performed on liver tissue from 50 patients with cirrhosis and 30 patients with HCC using monoclonal antibody clone DO-7 and LSAB kit by ABC method. RESULTS: Anti-p53 was positive in 9(30%) of 30 patients with HCC. Among nine patients with positive anti-p53, only two patients had detectable p53 expression in their tumor tissues. Anti-p53 was positive in 5(10%) of 50 patients with liver cirrhosis. The AFP was elevated in 21(70%) of 30 patients with HCC. Among the 9 AFP- negative HCC patients, 4(44.4%) were found to be positive for anti-p53. P53 expression was detectable in 9(30%) of 30 HCCs and 1(3.3%) of RO surrounding non-tumorous cirrhotic tissues. CONCLUSION: Mese findings suggest that anti-p53 was not correlated with the status of p53 expression in liver tissue and serological testing for anti-p53 antibody may be complementary to serum AFP for diagnosing of HCC with normal serum AFP.
Carcinoma, Hepatocellular ; Chronic Disease* ; Clone Cells ; Enzyme-Linked Immunosorbent Assay ; Fibrosis ; Half-Life ; Hepatitis, Chronic ; Humans ; Liver Cirrhosis ; Liver Diseases ; Liver* ; Serologic Tests

Endoscopic incision therapy was applied to two patients with postoperative anast-omotic stenosis. Radial diathermy incision was performed by needle knife papillot-ome using cutting current. Tne anastomotic stenosis was characteristic of short fibrotic segment and frequent restenosis after dilatation. An sufficient caliber and smooth, supple wall at the site of the stenosis was produced by incisional therapy by needle knife papillotome using cutting current. Clinical symptoms and endoscopic findings were improved after endoscopic incision. It is concluded that endoscopic incisional therapy seems to be safe and effective method for the treatment of anastomotic stenosis after gastrointestinal operation.
Constriction, Pathologic* ; Diathermy ; Dilatation ; Humans ; Needles*

Endoscopic incision therapy was applied to two patients with postoperative anast-omotic stenosis. Radial diathermy incision was performed by needle knife papillot-ome using cutting current. Tne anastomotic stenosis was characteristic of short fibrotic segment and frequent restenosis after dilatation. An sufficient caliber and smooth, supple wall at the site of the stenosis was produced by incisional therapy by needle knife papillotome using cutting current. Clinical symptoms and endoscopic findings were improved after endoscopic incision. It is concluded that endoscopic incisional therapy seems to be safe and effective method for the treatment of anastomotic stenosis after gastrointestinal operation.
Constriction, Pathologic* ; Diathermy ; Dilatation ; Humans ; Needles*

Among the primary carcinoma of the extrahepatic bile duct, papillary carcinoma is the least common form and usually located in the distal common bile duct. The cholangiographic findings of the papillary carcinoma is similar to translucency produced by stone. We report a case of multiple papillary adenocarcinoma of the extrahepatic bile duct of which the cholangiographic findings mimicking stones.
Adenocarcinoma, Papillary* ; Bile Ducts, Extrahepatic* ; Calculi ; Carcinoma, Papillary ; Cholangiopancreatography, Endoscopic Retrograde* ; Common Bile Duct

There is growing evidence that oxygen-derived free radicals(OFR's) play a role in the pathogenesis of pancreatic diseases, especially of acute pancreatitis. Many types of experimental ex vivo and in vitro pancreatitis can be inhibited by superoxide dismutase and catalse. (continue...)
Hyperamylasemia* ; Oxygen* ; Pancreatic Diseases ; Pancreatitis ; Superoxide Dismutase