PURPOSE: To report a rare case of upper eyelid schwannoma presenting as a chalazion. CASE SUMMARY: A 54-year-old male presented to our clinic with a slowly growing, painless recurred mass located in the middle area of the right upper eyelid margin. Surgical incision had been performed on a similar mass two year previous, although no histological analysis had been performed. On examination, a 4 × 3-mm-sized, firm, nonpigmented mass was palpable in the right upper eyelid, and no signs of neurofibromatosis were present elsewhere. The lesion was initially thought to be an eyelid mass, so we performed an excisional biopsy under local anesthesia. The lesion was easily isolated from the surrounding tissue and was excised completely. Histopathologically, the excised mass showed a compact arrangement of spindle cells forming palisades with Verocay bodies (Antoni A patterns). Immunohistochemistry revealed diffuse and strong S-100 protein positivity. These findings resulted in the diagnosis of eyelid schwannoma. CONCLUSIONS: Because of its rarity and solitary feature, eyelid schwannoma can be confused with chalazion. Thus, ophthalmologists should consider schwannoma in the differential diagnosis of a slowly growing, painless recurred mass or a lesion with malignant transformation after incomplete excision.
Anesthesia, Local ; Biopsy ; Chalazion ; Diagnosis ; Diagnosis, Differential ; Eyelids* ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Neurilemmoma* ; Neurofibromatoses ; S100 Proteins

No abstract available.
Hypoglycemia*

PURPOSE: To evaluate the predictability of amount of hemothorax in the patients with blunt chest trauma, supine chest AP radiographs of 66 patients were reviewed and statistically analyzed. MATERIALS AND METHODS: In 66 patients, rib fractures were present in 53 patients, hemothorax in 46 patients, pneumothorax in 25 patients, and pulmonary contusions in 18 patients. Width and length of hemothorax were measured on supine chest AP radiograph, and were correlated with known drained amount of hemothorax. The presence and number of rib fracture, pulmonary contusion, subcutaneous emphysema, fracture of scapula and clavicle, and total opacification of hemithorax were also correlated with the drained amount of hemothorax. RESULTS: In multiple logistic regression analysis, width of hemothorax had the highest correlation with drained amount of hemothorax(regression coefficient 0.718, p value 0.00005). The presence and number of rib fracture, scapular fracture, subcutaneous emphysema were also correlated with drained amount of hemothorax. But length of hemothorax, pulmonary contusion, clavicular fracture, total opacification of hemithorax were not correlated with drained amount of hemothorax. CONCLUSION: Measured width of hemothorax in supine chest AP radiograph is the most reliable predictor for estimation of the amount of hemothorax, and may also be used as an indication for the application of closed thoracostomy in the treatment of hemothorax.
Clavicle ; Contusions ; Hemothorax* ; Humans ; Logistic Models ; Pneumothorax ; Rib Fractures ; Scapula ; Subcutaneous Emphysema ; Thoracostomy ; Thorax*

No abstract available.
Glycoproteins* ; Histamine* ; Rhinitis*

Granzyme B is one of the serine proteases expressed in natural killer (NK) cells and activated cytotoxic T-lymphocytes. To evaluate the usefulness of granzyme B immunoreactivity in the diagnosis of T/NK-cell lymphoma, we studied 69 cases of lymphomas occurring in the upper aerodigestive tract by paraffin-section immunohistochemistry using a commercially available monoclonal antibody to granzyme B (GrB-7). All 19 cases of T/NK-cell lymphomas defined by the expression of CD56 (NHK-1) and one or both T-cell markers (polyclonal CD3 and CD45RO) expressed granular cytoplasmic granzyme B immunoreactivity. Two out of 9 cases of T-cell lymphomas showing no CD56 expression demonstrated strong granzyme B immunoreactivity. No tumor cells among 39 cases of B-cell diffuse large cell lymphomas and 2 cases of null cell diffuse large cell lymphomas were immunoreactive for granzyme B, however a few scattered granzyme B-positive reactive small lymphoid cells were consistently observed. Based on its sensitivity in this study as well as its reactivity in routinely processed tissue sections, even without heat-induced epitope retrieval technique, monoclonal antibody to granzyme B (GrB-7) can be applied as a useful marker in the diagnosis of T/NK-cell lymphomas in conjunction with CD56.
Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Human ; Immunohistochemistry ; Killer Cells/pathology* ; Lymphoma/pathology* ; Lymphoma/enzymology* ; Lymphoma, T-Cell/pathology ; Lymphoma, T-Cell/enzymology* ; Male ; Middle Age ; Serine Endopeptidases/metabolism*

PURPOSE: This study is to describe authors'experience on mammographic findings of breast cancer and to know if there is difference between 35 years of age or younger and older groups. MATERIALS AND METHODS: Mammograms of 72 patients with breast cancer detected from January, 1991 to December, 1993 were retrospectively analysed. Mammographic findings were classified into mass only, mass with microcalcifications, microcalcifications only and others. Marginal characteristics of mass were classified into spiculated, poorly marginated and well marginated. Shape of microcalcifications were classified into casting, granular and mixed types. These findings were compared between 35 years of age or younger and older groups. RESULTS: Mammogram showed mass only in 33 patients(46%), mass with microcalcifications in 26 patients (36%), microcalcifications only in seven(10%) and other findings in six(8%). Other findings were architectural distortion, asymmetric high density and incidental breart carcinoma from paraffinoma in one patient respectively, and dense breast in three patients. The margins of the breast mass were spiculated in ten(17%) poorly marginated in 30(51%), well-marginated in 19(32%). Shape of microcalcifications were casting type in 13(40%), granular in 14(42%) and mixed in six(18%) cases. 3 patients had dense breast with which mammography did not demonstrate the lesion. 3 patients without mammographically demonstrable lesions due to dense breasts were under 35 years in age. and there was statistically significant difference between the two groups(p-value<0.05). Microcalcifications only was more common findings in 35 years of age or younger. CONCLUSION: The most important mammographic findings of breast cancer were mass and microcalcifications. Architectural distortion and asymmetric high density were additional findings. In 35 years of age or younger, microcalcifications only was an important finding because mass lesions are frequently masked by dense breast. Thus other imaging modalities, such as ultrasonography, were required.
Breast Neoplasms* ; Breast* ; Humans ; Mammography ; Masks ; Retrospective Studies ; Ultrasonography

To date, no cases of nasal septal perforation during or after chemotherapy in patients with acute leukemia have been reported. In this study, we report three acute leukemia patients that had septal perforation and saddle nose deformity after chemotherapy and the results of our attempts to determine the causes of this phenomenon. We investigated retrospectively the types of chemotherapeutic agents involved and the duration of chemotherapy until the development of the nasal septal perforation. In addition, we also studied whether there were any remaining malignant cells by biopsy from the septal perforation margin. We found that Ara-C was the only drug that was used in all 3 patients. Nasal septal perforation and saddle nose developed approximately 4~7 weeks after the chemotherapy. A biopsy revealed inflammatory cells but no malignant cell infiltration. In cases of saddle nose associated with septal perforation after the chemotherapy for acute leukemia, one may consider the possibility of side effects of Ara-C. Furthermore, more active diagnosis and treatment are required when patients with acute leukemia complain of epistaxis or nasal obstruction during or after chemotherapy.
Biopsy ; Congenital Abnormalities ; Cytarabine ; Diagnosis ; Drug Therapy* ; Epistaxis ; Humans ; Leukemia* ; Nasal Obstruction ; Nasal Septal Perforation ; Nose* ; Retrospective Studies

Urethral carcinomas represent a rare and challenging subset of genitourinary malignancies. Treatments are variable from a radical operation to only radiotherapy, depending upon the size, extent and location of the lesion. Despite of the various treatments, the prognosis for urethral carcinoma is poor. We report a case of a 41-year-old woman with squamous cell carcinoma which occurred concomitantly in the urethra and vulva.
Adult ; Carcinoma, Squamous Cell* ; Female* ; Humans ; Prognosis ; Radiotherapy ; Urethra* ; Urethral Neoplasms ; Vulva*

BACKGROUND: The aim of this study is to evaluate the effect of electromyographically triggered electrical stimulation (ETES) on shoulder subluxation in stroke patients. METHOD: Twenty-three patients, who had hemiplegic shoulder subluxation within 3 months after stroke attack, were included. They were assigned randomly to either a control group (11 subjects) or a study group (12 subjects), and divided clinically to mild and severe subgroups by the degree in subluxation. Patients in both groups were received physical therapy and used an arm-sling. Subjects in the study group were taken ETES using biofeedback training on posterior deltoid and the supraspinatus muscle of hemiplegic subluxation side, daily 30 minutes a session, five days a week for 6 weeks. Electromyographic signals, which are derived from patient's voluntary muscle contraction, that exceeded a preset threshold trigger an immediate stimulation to force movement completion. The effect of ETES was assessed by the degree of subluxation using radiologic measurements at pre-treatment and 6 weeks post-treatment. RESULTS: In the control group, the degree of subluxation was increased after 6 weeks (p>0.05). In the study group, the subluxation was significantly reduced (p<0.05). The significant difference after treatment 6 weeks in mild and severe subgroups implied similar improvement between subgroups. CONCLUSION: The ETES may be the one of effective treatment methods for reducing the severity of hemiplegic shoulder subluxation in stroke patients.
Biofeedback, Psychology ; Electric Stimulation* ; Hemiplegia ; Humans ; Muscle, Skeletal ; Shoulder* ; Stroke*

BACKGROUND AND OBJECTIVES: Lysozyme, a major serous component of airway epithelial secretions, plays an important role in airway defense. However, little is understood about the regulation of its expression and the associated signaling pathway. The object of this study is to investigate the regulation of lysozyme expression, the downstream signaling pathway of lysozyme expression, and the related protein kinases under inflammatory conditions using the IL-1beta, which acts as a significant cytokine in many airway inflammations. MATERIALS AND METHODS: After the IL-1beta treatment of normal human nasal epithelial cells (NHNE), lysozyme mRNA expression was determined by RT-PCR. Expressed levels of ERK/p38 kinase were determined by Western blot analysis. RESULTS: IL-1beta treated NHNEcells had over-expressed lysozyme compared to the control group. Activated ERK/p38 kinase level showed marked increment by treating NHNE with IL-1beta. Lysozyme expression and ERK/p38 kinase levels decreased when inhibitors of ERK/p38 MAP kinases were added to the IL-1beta treated cells. Finally, expression of lysozyme and activated level of ERK/p38 MAP kinases decreased in a dominant-negative cell line even when treated with IL-1beta. CONCLUSION: From these results, we concluded that IL-1beta induces over-expression of lysozyme via ERK/p38 MAP kinase signaling pathways in airway epithelial cells.
Blotting, Western ; Cell Line ; Epithelial Cells* ; Humans* ; Inflammation ; MAP Kinase Signaling System ; Muramidase* ; p38 Mitogen-Activated Protein Kinases ; Phosphotransferases ; Protein Kinases* ; RNA, Messenger