We have experienced three cases of extrarnsmmary Pagets disease. The first case was a 77-year-old female who showed 8x10cm sized, erythematous plaque on the suprspubic area of one year's duration. The second case was a 60-year-old male who showed erythematous, oozing, crusted, well circumscribed patches on the right scrotum and the pubic area of 8 years' duration. Third case was a 79-year-old male who showed erythernstous to gray, eczemstoid plaques with marginal elevation on the right side of the scrotum, penile root and pubic area of 3 years duration. On histologic exarnination, the third case showed swest gland adenocarcinoma in the dermis.
Adenocarcinoma ; Aged ; Dermis ; Female ; Humans ; Male ; Middle Aged ; Paget Disease, Extramammary* ; Scrotum

Immunoadjuvant activities of the extract (KM-110) from Korean mistletoe ( Viscum album coloratum) on the induction of humoral and cellular responses against Keyhole limpet hemocyanim (KLH) as an antigen and allogenic tumor cells were examined. When mice were immunized subcataneously (s.c.) with KLH admixed with KM-110, more than 1000-times higher antibody titers to KLH than those immunized with KLH alone was observed. KM-110 induced high level of KLH- specific IgG1, IgG2a and IgG2b antibodies. In an in vitro analysis of lymphocytes proliferation to KLH on week 4, the splenocytes of mice treated with KLH and KM- 110 exhibited significantly higher proliferating activity than those treated with KLH alone. In addition, the culture supernatnats obtained from the splenocytes of mice treated with both KLH and KM-110 showed high level of IL-2 and IL-4. In the test of cellular immune responses, KM-110 enhanced the DTH reaction to KLH in mice. Furthemore, cytotoxic T-lymphocyte (CTL) activity using an allogenic CTL induction model where C57BL/6 (H-2b) mice were injected with allogenic P815 (H-2d) mastocytoma cells admixed with or without KM-110, mice treated with P815 cells and KM-110 showed higher cytatoxic activity against allogenic tumor cells than those treated without KM-110. This results suggest that KM-110 may possess adjuvant activities to potentially enhance humoral as well as cellular immune responses against antigens.
Animals ; Antibodies ; B-Lymphocytes ; Immunity, Cellular* ; Immunoglobulin G ; Interleukin-2 ; Interleukin-4 ; Lymphocytes ; Mastocytoma ; Mice ; Mistletoe* ; T-Lymphocytes ; T-Lymphocytes, Cytotoxic ; Viscum album* ; Viscum*

Immunological effect of the extract (KM-110) from Korean mistletoe (Viscum album coloratum) was examined. Lymphocytes obtained from KM-110-administrated mice showed increased responsiveness to mitogens, concanavalin-A (Con.A) and lipopolysaccharide (LPS). In order to study cytokine induct ability of the KM-110, macrophages from the Balb/c mice were cultivated in the medium containing the extract. the macrophages were shown to induce secretion of tumor necrosis factor-alpha (TNF-alpha), interleukin 1 and 6 (IL-1, IL-6) and interferon-gamma (INF-gamma). We then tested antitumor activity of the macrophages activated by the KM-110. Peritoneal macrophages harvested from the KM110-treated Balb/c mice exhibited cytotoxicity against the syngeneic 3LL carcinoma cells. ...continue...
Animals ; Interferon-gamma ; Interleukin-1 ; Lymphocytes ; Macrophages ; Macrophages, Peritoneal ; Mice ; Mistletoe* ; Mitogens ; Tumor Necrosis Factor-alpha ; Viscum album* ; Viscum*

PURPOSE: Tuberculosis of the thyroid gland is very rare and some cases were reported in Korea since 1968. We experienced a case of tuberculous thyroiditis and found a old case in our medical center. This report is about the two case and the review of all cases reported about tuberculosis of the thyroid gland in Korea. METHODS: We present the case of a 55-year-old woman with thyroid tuberculosis who has been treated with antituberculous medication because of tuberculous meningitis during 6 months. We performed thyroid isthmectomy and she is now taking the antituberculous drugs. We found a case of 40- year-old woman who underwent extended thyroid lobectomy, Lt. in 1985 at our medical center. We reviewed the 18 literatures with 29 cases of tuberculosis of the thyroid gland reported in Korea and analyzed total 31 cases (reported 29 cases and our 2 cases). RESULTS: 28 patients were women and only 2 patients were over 60 years old. 26 patients had complained the neck mass. Duration of symptoms were below 6 months in 18 cases. There were associated symptoms like as weight loss, easy fatigue or generalized weakness, dysphagia, palpitation, fever, chills and/or anorexia. Only 9 patients had underlying tuberculosis - 2 meningitis, 2 pneumonia, 3 lymphadenopathy and 2 pneumonia combined with meningitis. But 3 patients were newly diagnosed as old or active pulmonary tuberculosis at the time of diagnosis of thyroid tuberculosis. Thyroid function was normal in 9 cases and abnormal in 5 cases. 3 cases were diagnosed nonoperatively and 15 patients of surgically treated 28 cases were underwent lobectomy. AFB stain was positive in only 13 cases and 2 cases were positive of culture with negative AFB stain. All of cases were diagnosed by pathology as granulomatous tuberculosis with caseous necrosis. CONCLUSION: Either surgical resection plus antituberculous medications or only medications are effective and recurrences were not reported after any initial treatments. So preoperative evaluation is very important and will guide the patient and the surgeon to the most effective management.
Anorexia ; Chills ; Deglutition Disorders ; Diagnosis ; Fatigue ; Female ; Fever ; Humans ; Korea ; Lymphatic Diseases ; Meningitis ; Middle Aged ; Neck ; Necrosis ; Pathology ; Pneumonia ; Recurrence ; Thyroid Gland* ; Thyroiditis ; Tuberculosis* ; Tuberculosis, Meningeal ; Tuberculosis, Pulmonary ; Weight Loss

Trochlear nerve palsy associated with spontaneous subarachnoid hemorrhage (SAH) is known to be a rare malady. We report here on a patient who suffered with left trochlear nerve palsy following rupture of a right posterior communicating artery aneurysm. A 56-year-woman visited our emergency department with stuporous mental change. Her Hunt-and-Hess grade was 3 and the Fisher grade was 4. Cerebral angiography revealed a ruptured aneurysm of the right posterior communicating artery. The aneurysm was clipped via a right pterional approach on the day of admission. The patient complained of diplopia when she gazed to the left side, and the ophthalmologist found limited left inferolateral side gazing due to left superior oblique muscle palsy on day 3. Elevated intracranial pressure, intraventricular hemorrhage or a dense clot in the basal cisterns might have caused this trochlear nerve palsy.
Aneurysm ; Aneurysm, Ruptured ; Arteries ; Cerebral Angiography ; Diplopia ; Emergencies ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Intracranial Hypertension ; Muscles ; Paralysis ; Rupture ; Stupor ; Subarachnoid Hemorrhage ; Trochlear Nerve ; Trochlear Nerve Diseases

Cysts of the salivary gland are non-neoplastic, localized lesions of the duct system. They form about 6 % of lesions of the salivary glands. Mucoceles represent more than 70% of the salivary cysts and usually arise from minor salivary glands; however, major salivary glands, especially the sublingual glands, may also be involved. Characteristically, mucoceles consist of a soft fluctuant bluish or translucent swelling which contain mucus, varying in size. They are most commonly found on the lower lip, but may also occur on the buccal mucosa, floor of the mouth, palate, upper lip, and tongue. They are found in all age groups but are most frequent in children and young adults. There are two types of mucoceles-one in which mucus has extravasated into the tissues (extravasation cyst) and one which is lined with epithelium (retention cyst). Recently, we experienced an unusual case of huge extravasation mucocele arising from the submandibular gland. The mucocele and submandibular gland were completely excised surgically, which were confirmed by computed tomographic scanning and histopathologic examination.
Child ; Epithelium ; Humans ; Lip ; Mouth ; Mouth Mucosa ; Mucocele* ; Mucus ; Palate ; Salivary Glands ; Salivary Glands, Minor ; Sublingual Gland ; Submandibular Gland* ; Tongue ; Young Adult

OBJECTIVE: Ultrasonography has benefit in detecting soft tissue abnormalities within the joints, which cannot be assessed by conventional X-ray. In this study, we investigated the relationship between soft tissue and/or bony abnormalities on ultrasonography and biochemical markers of synovium and cartilage in knee osteoarthritis (OA) patients METHODS: Fifty-one knee OA patients who fulfilled the ACR criteria were enrolled in this study. Knee ultrasonography was performed in affected knee joints with a 12 MHz linear probe to assess the presence of effusion, synovial proliferation, capsular distension, length of osteophytes, and thickness of cartilage. At the same time, the serum levels of hyaluronic acid (HA) and cartilage oligomeric protein (COMP) were measured by ELISA and serum osteocalcin levels were determined by RIA. RESULTS: The patients with longer medial osteophytes showed higher levels of serum HA and COMP than those with shorter ones. Serum HA levels were significantly higher in patients with larger amount of effusion and/or synovial proliferation, suggesting inflammatory changes within the joint, than those without. In addition, the severity of capsular distention was also correlated well with serum HA and COMP levels. However, the length of lateral osteophytes and thickness of femoral cartilage were not correlated with serum HA or COMP levels. Serum osteocalcin levels did not show any association with above ultrasonographic parameters, either. CONCLUSIONS: Using knee ultrasonography, we demonstrated that serum HA and COMP levels were elevated in more severe OA patients than less severe patients. This result suggests that detailed pathologic changes in the soft tissue and/or bone of OA joints on ultrasonography are being directly reflected to biochemical markers measured in the peripheral blood.
Biomarkers* ; Cartilage* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hyaluronic Acid ; Joints ; Knee Joint ; Knee* ; Osteoarthritis, Knee* ; Osteocalcin ; Osteophyte ; Synovial Membrane* ; Ultrasonography*

We report a rare case of tuberculosis as a cause of secondary basilar impression. A 35-year-old man was admitted to our hospital complaining of severe neck pain and motor weakness on both sides (upper and lower limbs). CT and MRI demonstrated C1/C2 subluxation, basilar impression, and an abscess occupying the prevertebral space. We performed a single-stage operation, comprising anterior removal of the abscess, posterior fixation, and fusion. The patient was discharged five weeks after surgery without any neurologic deficits or complications. Only few reports have been published worldwide describing cases of tuberculosis as a cause of secondary basilar impression. Tuberculosis of the craniovertebral (CV) junction should be considered, especially in young patients with mid- to long-term histories of neck pain without clear origins, to allow for early intervention.
Abscess ; Adult ; Early Intervention (Education) ; Humans ; Neck Pain ; Neurologic Manifestations ; Platybasia ; Tuberculosis

BACKGROUND: We hypothesized that the decreased nitric oxide after cardiopulmonary bypass and reperfusion would play an important role in temporary pulmonary hypertension. METHODS: We used the pulmonary arteries of three pigs weighing 40-50 kg after cardiopulmonary bypass and reperfusion in experimental group. We also used the pulmonary arteries of five pigs before cardiopulmonary bypass under sham operation in control group. All cumulative concentration-effect curves were performed on vessel rings beginning at their optimum resting zone. EC50 and maximal response (Emax) were calculated by using nonlineal logistic regression analysis with the software PRISM (Graphpad, Mountain View, CA). RESULTS: CPB inhibited endothelium-dependent relaxation to acetylcholine in pulmonary arterial rings, but did not affect SNP induced relaxation in ones. CONCLUSIONS: The Ability of pulmonary arterial relaxation after CPB and reperfusion in pigs was decreased without attenuated pulmonary arterial sensitivity to NO.
Acetylcholine ; Cardiopulmonary Bypass* ; Hypertension, Pulmonary ; Logistic Models ; Nitric Oxide* ; Pulmonary Artery ; Relaxation ; Reperfusion* ; Swine*

PURPOSE: The increased prevalence and incidence of end-stage renal disease in the elderly is a worldwide phenomenon. We investigated the survival rate, technical success, cause of death and the predictors of death in patients starting peritoneal dialysis over 65 years of age. METHODS: We analyzed 67 patients; 37 were in the elderly group (>65 years of age) and 30 in the control group (45-64 years of age) that started peritoneal dialysis between January 1995 and June 2006. Clinical characteristics and laboratory findings at the beginning of dialysis and 6 months later were retrospectively analyzed. In addition, the survival rate and independent predictors of survival were analyzed. RESULTS: The prevalence of complication was not different in the two groups. However, leakage of dialysate was more common in the elderly group. The duration of patient survival, serum albumin levels and BMI were lower in the elderly group. The multivariate analysis showed that age, presence of diabetes, initial albumin level, and residual renal function was associated with patient survival, gender, age, initial albumin level, and the prevalence of peritonitis affected the technical success rate. CONCLUSION: Among elderly patients, leakage was more prevalent compared to the younger patients and the most common cause of death was cardiovascular disease. The presence of diabetes, a low serum albumin and BMI, and residual renal function were associated with the duration of survival
Aged ; Cardiovascular Diseases ; Cause of Death ; Dialysis ; Humans ; Incidence ; Kidney Failure, Chronic ; Multivariate Analysis ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Prevalence ; Retrospective Studies ; Serum Albumin ; Survival Analysis* ; Survival Rate