Elephantiasis nostras, the result of recurrent skin infection or chronic lymphedema is characterized by marked skin fibrosis and massive enlargement of a body part. We present a case of elephantiasis nostras due to chronic recurrent erysipelas which affected the lower extremities in a 62-year-old man. The patient had had persisting non-pitting edema, and tender multiple verrucous brownish plaques and nodules on both lower legs for 1 year. On histological examination, there was hyperkeratosis and papilomatosis in the epidermis, fibroplasia, dilated thick walled venules and collagen fibers oriented vertical to the skin surface, and hyperplasia of eccrine ducts in the dermis.
Collagen ; Dermis ; Edema ; Elephantiasis* ; Epidermis ; Erysipelas ; Fibrosis ; Humans ; Hyperplasia ; Leg ; Lower Extremity ; Lymphedema ; Middle Aged ; Skin ; Venules

Myeloid body formation is an ultrastructural feature of gentamicin induced nephrotoxicity in human being and experimental animals. The origin of the myeloid body is not satisfactorily understood and morphological verification of the developing process of this structure is not fully accomplished. We injected 100 mg/kg/12 hour of gentamicin in 20 Spraque-Dawley rats and examined the ultrastructural feature of the proximal convoluted tubular cells of the kidney every 30 minutes in the first 4 hours, and in 5 hours, 6 hours, 12 hours, 24 hours and 48 hours after injection of gentamicin, with a TEM and a SEM. Myeloid bodies were noted as concentric layers of membranous structures of degenerated endoplasmic reticulum and mitochondria in the lysosome. The number and size of the myeloid body containing lysosomes were increased with time. We can deduce from this observation that injured cell organelles by diffusible gentamicin within the cells are autophagocytosed by lysosomes which were also injured by the drug from pinocytotic vesicles, and incompletely digested organellar remnants are retained in the lysosomes as myeloid bodies. So we think that the myeloid body formation is a result of an exaggerated and a pathologic autophagocytic process due to cell injury induced by gentamicin.
Animals ; Endoplasmic Reticulum ; Gentamicins* ; Humans ; Kidney ; Lysosomes ; Mitochondria ; Organelles ; Rats*

PURPOSE: TGF-beta is a key regulator of epithelial-mesenchymal transition. Among the TGF-beta responses, cell migration is closely associated with the expression of matrix metalloproteinases (MMPs). Therefore, we determined which MMPs are regulated by TGF-beta and examined the TGF-beta signaling involved in this event, focusing on Src family tyrosine kinases (SFKs) METHODS: First we examined the expression of MMPs in rat lens explant culture treated with TGF-beta and LECs attached to the anterior capsules of patients with nuclear (N), anterior polar (AP) cataracts using RT-PCR and immunofluorescence staining. It was examined whether the expression of MMPs is regulated by SFKs. RESULTS: The study using RT-PCR and immunofluorescence staining showed the expression of MMP-2 and -14 in explants and the expression of MMP-14 LECs of AP cataracts. The expression of MMP-2 and -14 was blocked by PP2 in explants. Furthermore, the activated form of SFKs was observed in LECs of AP cataracts by immunofluorescence staining. CONCLUSIONS: We suggest a novel role of SFKs signaling in the expression of MMP-14 induced by TGF-beta.
Animals ; Capsules ; Cataract ; Cell Movement ; Epithelial Cells* ; Epithelial-Mesenchymal Transition ; Fluorescent Antibody Technique ; Humans ; Matrix Metalloproteinases ; Rats ; src-Family Kinases ; Transforming Growth Factor beta*

Reconstruction of extensive soft tissue defects of the lower extremity, especially when complicated by open fracture and bone loss, is usually a difficult problem for the plastic surgeon. Many methods have been devised to treat these conditions Musculocutaneous flaps add a valuable surgical alternative that bring vascularized cover to the defects, and the free microvascular transfer of these flaps gives the surgeon an added dimension of versatility. The latissimus dorsi is an extremly reliable musculocutaneous flap with a long, large-caliber vascular pedicle, so that dissection of the muscle can be performed with relative ease. The size of the latissimus dorsi muscle lends itself to coverage of large defects. While these characteristics appear to make the free latissimus dorsi musculocutaneous transfer ideal in many circumstances, it has some disadvantages. At the recipient site, the flap is ofter too bulky, and donor-site closure requires skin grafts if the flap is wider than 10cm. These skin grafts on the posterior thorax seriously detract from the final appearance of the donor site. The authors have experienced 12 cases of reconstruction of extensive lower extremity soft tissue defect in which the latissimus dorsi muscle alone was transferred and covered with a split-thickness skin graft. This method improves the recipient-site contour by decreasing the bulk of the flap and it also improves the donor-site appearance. We described technical considerations in each case and the advantages of free latissimus dorsi muscle flap and skin graft for the reconstruction of extensive soft tissue defect in the lower extremity.
Fractures, Open ; Humans ; Lower Extremity ; Myocutaneous Flap ; Skin ; Superficial Back Muscles* ; Thorax ; Tissue Donors ; Transplants

Wear of articular cartilage usually occurs at flexion zones (30°–60°) of the femorotibial articulation, which is demonstrable on the 45°posteroanterior (PA) weight-bearing view. The authors measured and evaluated the cartilage space on the non weight-bearing AP view, AP extension weight-bearing view and 45°PA flexion weight-bearing view, comparing operative findings in cases of 18 osteoarthritis, 7 rheumatoid arthritis and 2 spontaneous osteonecrosis of the lateral femoral condyle, who underwent total or hemiarthro plasty (1 case) of the knee. The results were as follows. l. Operative findings of 11 out of 18 osteoarthritis (61.1%) showed cartilage defect of middle 3/4–4/5 of the medial tibial condyle (sparing finger tip sized anterior & posterior edge) and corresponding femoral condyle. The cartilage space on the AP non weight-bearing, AP extension weight-bearing and 45°PA flexion weight-bearing view were normal to 20% decrease (4.1–5.0mm remained), 60–80% decrease (1.1–2.0mm remained) and 80–100% decrease (0–1.0mm remained), respectively, showing one grade increased cartilage space narrowing on the 45°PA flexion weight-bearing view comparing to AP extension weight-bearing view. 2. Uniform cartilage defect of medial compartment was found in 7(38.9%) osteoarthritic knees. The cartilage space on the non weight-bearing AP view were normal. Both AP & PA weightbearing views showed 60–80% decrease (1.1–2.0mm remained) in 3 knees & 80–100% decrease (0–1.0 mm remained) in 4 knees without any difference between the two views. 3. Uniform cartilage space narrowing of both medal & lateral compartment was noted in 7 rheumatoid knees. The cartilage space on the AP non weight-bearing view were 20–40% decrease (3.1–4.0mm remained) in all knees. The AP extension & 45°PA flexion view showed 40–60% decrease (2.1–3.0mm remained) in 2 knees, 60–80% (1.1–2.0mm remained) in 5 knees respectively without any difference between two groups. 4. The anterior horn of menisci was always intact. The presence of menisci didn't affect the radiological cartilage space. 5. The 45°PA flexion weight-bearing view functioned as a tunnel view showing bone defect and less than 20% decrease of cartilage space in cases of the spontaneous osteonecrosis of the lateral femoral condyle. From our results it was concluded that the radiologic cartilage space could be more accurately demonstrated with 45°PA flexion weight-bearing view in addition to the conventional AP extension weight-bearing view.
Animals ; Arthritis, Rheumatoid ; Cartilage ; Cartilage, Articular ; Clothing ; Fingers ; Horns ; Knee ; Numismatics ; Osteoarthritis ; Osteonecrosis ; Weight-Bearing

Lipomas of the heart are benign neoplasms and have rarely been described. Due to the fact that they normally cause no symptoms, diagnosis is often purely accidental. Because of the rarity of these tumors, it seems worthwhile to present an example studied at autopsy. It was associated with the sudden death of a 15-year-old boy. The tumor arose from the wall of the left ventricle and occupied the pericardial cavity, measuring 13x7x6 cm in size. The tumor was whitish-yellow, translucent, and soft. Microscopically, the tumor was composed of mature adipose tissue which extended between muscle fibers. This current case, the giant cardiac lipoma is believed to produce disturbances of the conduction system and distrubances of cardiac filling.

No abstract available.
Uterus*

No abstract available.
Aneurysm* ; Carotid Artery, Internal*

We describe an ovarian mucinous cystadenocarcinoma with a sarcoma-like mural nodule. In the literature, rare cases of ovarian mucinous tumors have been described which contain foci of undifferentiated carcinoma, sarcoma, and sarcoma-like nodules. The distinction between these lesions is important because of poorer prognosis of true sarcoma and anaplastic carcinoma than sarcoma-like mural nodules. This case shows different results of immunohistochemical stain for anaplastic carcinoma.

BACKGROUND AND OBJECTIVES: Many studies report changes in the expressions of nasal secretory proteins which play important roles in the evaluation of sinonasal mucosal status. The biomarkers in nasal secretions provide valuable information on pathophysiological status of the rhinosinusitis. We have monitored the level and ratio of nasal secretion markers, especially secretory IgA (sIgA) and lactoferrin as markers of sinonasal submucosal glands to evaluate mucosal status for chronic sinonasal diseases and allergic rhinitis. SUBJECTS AND METHOD: Samples were obtained with the filter paper absorption method from 20 normal healthy controls (Group I), 20 patients with chronic rhinosinusitis (Group II), 20 patients with allergic rhinitis (Group III), 20 normalized persons of chronic rhinosinusitis patients treated with antibiotics, previously (Group IV). We estimated concentrations of sIgA and lactoferrin determined by enzyme-linked immunosorbent assay method. RESULTS: The concentration of sIgA and lactoferrin in nasal secretion showed a significant difference between the control group and other groups (p<0.05). The sIgA/lactoferrin ratio was more highly significant in the normal group and normalized in chronic rhinosinusitis patients treated with antibiotics (Group IV) than other groups (p<0.05). CONCLUSION: In this study, sIgA and lactoferrin are useful secretion markers and the levels of sIgA, lactoferrin and sIgA/lactoferrin ratios in nasal secretions seem to be very useful parameters for monitoring and assessing the conditions of the sinonasal mucosal diseases.
Absorption ; Anti-Bacterial Agents ; Biomarkers ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin A, Secretory ; Lactoferrin ; Rhinitis