We experienced a case of venous hemangioma occuring on the inner aspect of right forearm of 40-year-old woman. The skin lesion was slight tender, pea sized, dark brown surfaced, subcutaneous mass. The entire dermis was filled with numerous coiled thick walled vessels surrounded by fibrous stroma on the histopathologic examination. The wall, lined by a single layer of endothelial cells, lacked elastic fibers on the specimen of Verhoeff-Van Gieson and Massons trichrotne stains.
Adult ; Coloring Agents ; Dermis ; Elastic Tissue ; Endothelial Cells ; Female ; Forearm ; Hemangioma* ; Humans ; Peas ; Skin

We present herein a case of painless piezogenic pedal papules occurring on the both heels of 25-year-old female patient, Histopathologic findings showed normal adipose tissue surrounded by loose fibrous tissue in the nid-dermis and thickening of venous wall. Hyalinized thick collagen bundles were distributed below the herniated adipose tissue in the nodular pattern. Her parents, one brother and sister had the sarne clinical features.
Adipose Tissue ; Adult ; Collagen ; Female ; Heel ; Humans ; Hyalin ; Parents ; Siblings

Leiomyoma Cutis is an unusual benign tumor of smooth muscle derivecl either from the arrector pili muscle, from the media of blood vesseles, or from smooth muscles of scrotum, labia or nipple. Two casea of leiomyoma cutis confirmed by H&E stain and Massons stain is presented, one with lesion on the left thigh and the ather with lesion of the left ankle. The first case was a 49 year-old female with solitary pinhead sized subcutaneous firm mass with intermittent pain and tenderess for 10 months, The second case waa a 36 year-old female with painful solitary peanut sized firm nodule which had pinkish center of 1 year duration.
Adult ; Ankle ; Blood Vessels ; Female ; Humans ; Leiomyoma* ; Middle Aged ; Muscle, Smooth ; Nipples ; Scrotum ; Thigh

The clinical and biological study for Sarcoptes scabiei from 66 scabies patients was performed form Nov. 1974 to April 1975. The diagnosis of these scabies patients were confirmed by method proposed by Muller et al. The results were as follows; 1) Male to female ratio is 5. 6: 1 in total patients and predominant age group is in 16~20 in both sexes(Table 1). 2) 50% of cases had family history of similar troubles and the duration of subjective symptom complaind at their first visit was 1~2 weeks in 20 cases, 3~4 weeks in 25, 2 months in 10, and over 3 months and unknown were 12. 3) Suspected sources of infestation were, 22 cases from one of their family members, 15 at hotel, 7 at boarding house, 2 at camping, 1 at military camp, 19 were unknown. 4) Distribution of burrows was hand(79.4%), wrist(12.4%), foot(3.1%), penis(2.6%) scrotum(2.1%) and axillary area(0.5%). Number of burrows was 1~2 in 61.4%, 3~4 in 19.3%, 5~6 in 5.3%, 7~8 in 1.8%, 9~10 in 5.3% and 10 in 7. 6%. 5) 44 patients (66.7%) were confirmed by finding of female mite and among them 50% had 1 female mite, 36.7% had 2, 6.8% had 3, 2.3% had 4 and 4.5% had 6. 6) 69 among total 79 female mites detected were found at burrow, 6 from papule and 4 from vesicle. Total 7 male mites were found from patients and 4 from papules and 2 from veside and 1 from pustule(Table 5) 7) From total 194 burrows examined 69 female mites (36.1%) were found and non of male mite were found. 8) Mean size of female mite(length*breadth) was 359.3u*266.5u, male mite 21.1u*160.9u, larva 131.8ux94.2u, egg with developing larva 167.3*93.6u, egg with developed larva 159.7u * 92.3u and scybala 18.7u x 12.3u. Sizes of egg with developing larva and egg with developed larva had no significant difference, statistically.
Camping ; Diagnosis ; Female ; Humans ; Larva ; Male ; Military Personnel ; Mites* ; Ovum ; Sarcoptes scabiei ; Scabies*

Recently, it has been postulated that diabetic autonomic neuropathy is caused by reduction in availability of nerve growth factor (NGF) in enteric nervous system. This experiments were performed to determine the changes of the distribution of enteric neuropeptide by diabetes and these changes could be prevented by administration of NGF. Sprague Dawley rats (200~250gm) were made diabetic by a single intraperitoneal injection of streptozotocin 65 mg/kg in saline. Recombinant human NGF (Sigma, Co., Ltd.) were administered at a dose of 500ng/kg subcutaneously every day for consecutive 4 weeks after streptozotocin administration. After 4 weeks, rats were anesthetized with ether and perfused with 4% paraformaldehyde. ileum was dissected and prepared by whole mount preparation method. Prepared segments were immunostained for substance p, calcitonin gene-related peptide, vasoactive intestinal peptide, and galanin by PAP technique. For the observation of the interstitial cells of Cajal, segments were immersed in Champy-Maillet solution for 2 days Results obtained were as follows: 1. In myenteric plexus of diabetic rats, substance P-like and VIP-like immunoreactivity were not changed compared with that of the control group. CGRP-like and galanin-like immunoreactivity were decreased in diabetic group and immunoreactive cells for CGRP and galanin were also decreased 18.1% (P<0.01) and 43.7% (P<0.01) respectively. 2. In NGF administerd diabetic group, immunoreactivity of substance p, VIP, galanin in myenteric plexus were slightly increased and immunoreactive cells for substancre p, VIP, galanin were almost the same as that of the control group. However, immunoreactive cells for CGRP of myenteric plexus were not changed by NGF. 3. In submucous plexus of diabetic rats, immunoreactivity of all four neuropeptides(substance p, CGRP, VIP, galanin) were decreased compared with that of the control group. Immunoreactive cells for substance p, CGRP, VIP, and galanin were also decreased in 38.8%, 77.6%, 33.0%, and 35.7%, respectively (P<0.01). 4. In NGF administered diabetic group, immunoreactivities of substance p, VIP and galanin in submucous plexus were increased and the immunoreactive cells were increased significantly compared to diabetic group. However, immunoreactive cells for CGRP of submucous plexus were not changed by NGF. 5. Interstitial cells of Cajal of diabetic group were decreased 7.4% ovoidal cells (A type) and 28.3% round cells (B type) In NGF administered group, the morphology and the number of ICC were not different to the control group. With the above results, it could be assumed that NGF prevent the damage of neurotransmitter and ICC in enteric nervous system.
Animals ; Calcitonin Gene-Related Peptide ; Diabetic Neuropathies ; Enteric Nervous System ; Ether ; Galanin ; Humans ; Ileum ; Injections, Intraperitoneal ; Interstitial Cells of Cajal ; Myenteric Plexus ; Nerve Growth Factor* ; Neuropeptides ; Neurotransmitter Agents ; Peristalsis* ; Rats* ; Rats, Sprague-Dawley ; Streptozocin ; Submucous Plexus ; Substance P ; Vasoactive Intestinal Peptide

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.
Central Nervous System ; Epilepsy ; Sarcoidosis

PURPOSE: Diagnosis of a hemodynamically significant patent ductus arteriosus (PDA) that should be treated is difficult to determine by clinical and echocardiographic examination. The purpose of this study is to clarify the usefulness of diastolic flow velocity (DFV) of the left pulmonary artery (LPA) determined by echocardiography in the assessment of significant PDA in preterm infants. METHODS: Clinical and echocardiographic findings, including DFV in LPA, of PDA were evaluated at 24 hours, 48-72 hours of age and after indomethacin treatment in thirty-nine infants ranging from 25 to 34 gestational weeks of age. DFVs of the study group (N=13) with significant PDA were compared with those of healthy control group (N=26) without significant PDA. RESULTS: DFVs in healthy preterm infants were high in the first few days and were significantly decreased after spontaneous ductal closure. DFVs in preterm infants with significant PDA who underwent indomethacin treatment were significantly higher than that of healthy control infants. After indomethacin treatment, DFVs in this study group remained high with continuing significant PDA and markedly decreased with disappearance of significant PDA. Until ductus arteriosus closed, DFVs showed a significant correlation with the magnitudes of ductal shunt. A cutoff value for DFV of 30 cm/sec showed a sensitivity of 77% and a specificity of 92% as a predictor of significnat PDA in preterm infants. CONCLUSION: Measurement of DFV in LPA by echocardiography is a useful method for assessing the significnat PDA which may require treatment in preterm infants.
Diagnosis* ; Ductus Arteriosus ; Ductus Arteriosus, Patent* ; Echocardiography ; Humans ; Indomethacin ; Infant ; Infant, Newborn ; Infant, Premature* ; Pulmonary Artery* ; Sensitivity and Specificity

The objective of aneurysm surgery is to exclude the aneurysm from the circulation while preserving blood flow distal to the lesion. In certain situations, the aneurysm neck cannot be clipped safely or the parent vessel reconstructed, primarily in large or giant size with incorporation of parent vessels or perforating arteries, calcification at the aneurysm base, and fusiform or dissecting aneurysms. In such cases, occlusion of the parent vessel is a treatment of option. In many patients, however, sacrifice of the parent artery has an associated risk of ischemic stroke. Therefore, sacrifice of the parent vessel can be supplimented with distal revascularization to provide the necessary distal blood flow while allowing the aneurysm to be trapped. The indications, options, and surgical approaches are described with review of literatures. Finally the authors' experiences of revascularization in 7 patients with unclippable aneurysms are reported.
Aneurysm ; Aneurysm, Dissecting ; Arteries ; Humans ; Intracranial Aneurysm* ; Neck ; Parents ; Stroke

Initially, when periaqueductal gray (PAG) is electrically stimulated, analgesia is induced, and this phenomenon is called stimulation-produced analgesia. Nucleus raphe magnus (NRM) as well as PAG are known to be the potent analgesic centers. NRM could modulate the nociceptive response of spinal cord neurons through spinally projecting fibers. However, as well as the above analgesic effects have been confined to the somatic pain, it was variable according to species, and the analgesic effect by NRM stimulation on the visceral pain was not yet clarified. In this study the analgesic effect by NRM stimulation on the visceral pain was examined through recording the activities of the dorsal horn neurons with renal input and renal pain, as a type of visceral pain. The renal pain was induced by ureteral occlusion or renal arterial occlusion, which in turn activated the renal mechanoreceptor or chemoreceptor. These cells had concomitant somatic input. In order to compare the effects of NRM stimulation on the renal pain with somatic pain, the somatic stimulation such as squeezing was conducted on the peripheral receptive field. The main results are summarized as follows: 1) After an electrical stimulation of NRM, spontaneous activities of dorsal horn neurons with renal input were reduced to 73.3 +/- 9.7% of the control value. 2) After an electrical stimulation of NRM, activities of dorsal horn neurons with renal input evoked by a brush, a type of non-noxious stimuli, did not change significantly. But the activities by a squeeze, a type of noxious stimuli, the activities were reduced to 63.2 +/- 7.2% of the control value. 3) After an electrical stimulation of NRM, activities of dorsal horn neurons with renal input evoked by occlusion of ureter or renal artery were reduced to 46.7 +/- 8.8% and 49.0 +/- 8.0% of the control value respectively. 4) The inhibitory effect of NRM on the dorsal horn neurons with renal input did not show any difference between renal A delta fiber and C fiber group. 5) By the electrical stimulation of NRM, the activities evoked by ureteral occlusion showed more reduction in the high threshold cell group than in the wide dynamic range cell group. These results suggest that activation of NRM can alleviate the renal pain as well as the somatic pain by modulating the dorsal horn neurons activities.
Afferent Pathways/cytology/physiology ; Animal ; Cats ; Electric Stimulation ; Female ; Kidney/innervation/*physiopathology ; Male ; Nervous System/cytology ; Nervous System Physiology ; Neurons/physiology ; *Pain Threshold ; Raphe Nuclei/*physiology ; Spinal Cord/cytology/physiology ; Support, Non-U.S. Gov't