No abstract available.
Free Tissue Flaps* ; Rectus Abdominis*

BACKGROUND: Vitiligo is riot quite a rare diseasep; it has about 1% prevalence. The cause of vitiligo is not clear, however, in recent studies an autoimmune origin is freqluei itily mentioned. OBJECT: We tried to an lyze some clinical features of vitiligo and relate them with the presence of autoantibodies. MEHTODS: A total of 381 vitiligo patients was included for the analysis of clinical features. A laboratory study included rhumatoid factor, antinuclear antibocoly, antithyroglobulin antibody and antimicrosome antibody. Some 62 patients were examined for opl thmologic changes. RESULTS: One hundred and one(26.5%) of 381 patients exam ned showed at least one of the autoantibodies tested. Twenty nine pateints showed 2 different aitintibodies. The age at aonset of vitiligo in the autoantibody positive group was 6.6 years later than that of the autoantibody negative group. Autoimmune and/or endocrine diseases were more frequinty found among aut.oantibody positive patients. These diseas s included hyperthyroidism, diabetes me litus and alopecia areata. One patient revealed retinal hypoigmentation and showed no autoantibcidics. CONCLUSION: About 9% of vitiligo patients who were autoantiocyte positive had clinical evidence of diseases associated with the autoantibody. However, it is prudent. to xpect that more patients with t.he autoantibody may develop later systemic autoimmune diseases or endocrinopathies. A long term follow-up of these patients seem:, to be very important.
Alopecia Areata ; Antibodies, Antinuclear ; Autoantibodies* ; Autoimmune Diseases ; Endocrine System Diseases ; Follow-Up Studies ; Humans ; Hyperthyroidism ; Prevalence ; Retinaldehyde ; Riots ; Vitiligo

Histiocytic necrotizing lymphadenitis that causes unusual lymphadenopathy is a newly recognized disease of unknown etiology and may be mistaken for other conditions such as malignant lymphoma and tuberculosis, in which specific treatment will be required. Local lymph node enlargement especially in neck is the only characteristic feature, sometimes accompanied by pain, tenderness, fever and chill like a cold, nausea, vomiting. Laboratory investigations are usually noncontributory with an occasional case showing leukopenia or an elevated erythrocyte sedimentation rate. For further understanding of this disease and helping make diagnosis, clinical features were reviewed in 15 patients (29 lymph node enlargement), who were diagnosed as histiocytic necrotizing lymphadenitis on clinical evaluation (9 patients) or excisional biopsy (6 patients). The results are as follows; Disease was more common in female(1:2) and young patient. It involved left sided neck nodes frequently (67%) and the most common site was suboccipit-al triangle (62%). 47% of patient showed multiple enlargement of lymph nodes and the size of nodes were varied from 8 to 23 mm (mean: 12.4 mm). Most nodes were movable and showed oval in shape. Fever (47%), pain (33%), tenderness (53%), recent history of upper respiratory infection (33%), leukopenia (47%) and increased erythrocyte sedimentation rate (67%) were showed in many cases. Ultrasonogrphic and CT scan showed well defined oval to round lymph nodes enlargement with inhomogenous enhancement. All affected nodes are resolved spontaneously within 3-10 weeks (mean 5.1 weeks) without specific treatment. After reviewing all of above results, it is concluded that histiocytic necrotizing lymphadenitis is self-limiting disease without characteristic clinical features, but some factors like fever, pain, tendrness, leukopenia and increased erythrocyte sedimentation rate with cervical lymphadenopathy in young female patient are thought to be very helpful in diagnosis and in these circumstances, lymph node biopsy must be delayed for 2-3 months.
Biopsy ; Blood Sedimentation ; Diagnosis ; Female ; Fever ; Histiocytic Necrotizing Lymphadenitis* ; Humans ; Leukopenia ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Nausea ; Neck ; Tomography, X-Ray Computed ; Tuberculosis ; Vomiting

PURPOSE: Metalloproteinases (MMPs) and tissue inhibitors of metalloproteinase (TIMPs) have been linked to the angiogenic process in general. In order to understand the potential roles of MMPs and TIMPs in corneal neovascularization process, we examined the expression and activities of MMP-2, MMP-9, TIMP-1 and TIMP-2 during the course of suture-induced corneal neovascularization in rat model. METHODS: Corneal neovascularization of rat cornea was induced by suturing. The expression of MMP-2, MMP-9, TIMP-1 and TIMP-2 in sutured corneas was examined by immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR). The activities of MMP-2 and MMP-9 were measured before and after suture by gelatin zymography. RESULTS: MMP-2 proenzyme, and TIMP-1, -2 were expressed in normal corneas, predominantly in corneal epithelium. After injury, expression of MMP-2, MMP-9, TIMP-1 and TIMP-2 increased, notably in healing corneal epithelium, infiltrating inflammatory cells, stromal fibroblasts, and ingrowing vascular endothelial cells. The intensity of immunostaining and enzymatic activities of MMP-2 and MMP-9 paralleled the magnitude of inflammatory cell infiltration, which peaked around day 7 after suture. Immunoreactivity of MMP/TIMP decreased significantly two weeks after suturing. At day 35 after suture, staining of MMP-2, TIMP-1, -2 remained visible only in corneal epithelium and vascular endothelial cells. CONCLUSIONS: MMPs as well as TIMPs were upregulated during suture-induced corneal neo-vascularization, suggesting that both may take part in extracellular matrix remodeling in the corneal wound healing, inflammatory, and neovascularization processes.
Animals ; Cornea ; Corneal Neovascularization* ; Endothelial Cells ; Epithelium, Corneal ; Extracellular Matrix ; Fibroblasts ; Gelatin ; Immunohistochemistry ; Matrix Metalloproteinase 2* ; Matrix Metalloproteinases ; Metalloproteases ; Models, Animal ; Rats ; Stromal Cells ; Sutures ; Tissue Inhibitor of Metalloproteinase-1* ; Tissue Inhibitor of Metalloproteinase-2 ; Wound Healing

No abstract available.
Sinus of Valsalva*

No abstract available.
Epilepsy* ; Vigabatrin*

Chronic granulomatous disease (CGD) is an inherited immunodeficient disease characterized by recurrent infections and granuloma formation. Granulomatous obstruction of esophagus is one of the rare complications of CGD. The use of steroids and antimicrobials for esophageal obstruction by granuloma in CGD patients has been controversial due to the possibility of concomitant inapparent infection. We report a case of esophageal obstruction in an 8-year-old CGD patient showing the poor response to antibiotics therapy. However, dramatic improvement of symptoms and radiologic findings of esophageal obstruction were achieved after steroid therapy. One month after discontinuation of steroid, esophageal obstruction recurred and the patient was re-treated with steroid. After that time, he experienced one more recurrence of esophageal obstruction. This symptom subsided after antibiotics therapy without steroid and he has been followed up to the present without further relapse.
Anti-Bacterial Agents ; Child ; Esophageal Stenosis ; Esophagus ; Granuloma ; Granulomatous Disease, Chronic* ; Humans ; Recurrence ; Steroids

BACKGROUND: Although surgical angioplasty for isolated coronary ostial stenosis is assumend as an alternative approach to CABG, the clinical features of isolated coronary ostial stenosis, postoperative complications and follow-up angiographic results would have not been well studied. METHODS: We retrospectively studied 24 patients (female : male = 20 : 4, mean age 50.0 +/- 12.3 yr) who underwent surgical angioplasty for isolated coronary ostial stenosis using patch ( 22 fresh autologous pericardium, 2 saphenous vein) during the period of March 1990 through February 1998. Repeat coronary angiography (16 patients) and echocardiography (24 patients) were performed. Aortic regurgitation was evaluated semiquantitatively (Grade I - Grade IV). RESULTS: There were 3 deaths after surgical angioplasty. One death was due to acute coronary dissection perioperatively, the second due to low cardiac output syndrome 2 weeks post-surgery, and the third due to traumatic panperitonitis 10 months post-procedure. Angina recurred in 4 patients and the remaning 18 patients were symptom-free. Repeat angiography (19.3 +/- 20.7 Mo) showed widely patent ostium with excellent run-off except 2 patients (1 distal patch stenosis, 1 ostial restenosis in Takayasu's arteritis). The third symptomatic patient was proven to have coronary spasm by ergonovine test. AR increased in the fourth patient (Grade II -> III) with patent ostium. CONCLUSION: Surgical angioplasty may be feasible and alternative operative method to CABG for isolated coronary ostial stenosis. It should however be noted that postop AR can develop and/or increase. Further investigation is needed to evaluate the clinical significance of the AR.
Angiography ; Angioplasty* ; Aortic Valve Insufficiency ; Cardiac Output, Low ; Constriction, Pathologic* ; Coronary Angiography ; Coronary Artery Disease ; Echocardiography ; Ergonovine ; Follow-Up Studies ; Humans ; Male ; Pericardium ; Postoperative Complications ; Retrospective Studies ; Spasm

Seventeen volunteers with cutaneous dermatophytosis were enrolled in a clinical trial to evaluate the effectiveness of oral ketoconazole. The group included six patients with tinea cruris(6 malcs), four with tinea corporis, including one with tinea faciai, (3 males, 1 female), three with tinea versicolor(3 males) and four with tinea capitis(3 males, 1 female). The oral ketoconazole was taken within 10 minutes after a meal. The patients under the age of 10 received 100mg of ketoconazole per day, whereas those aged over 11 received 200mg of ketoconazole until the skin lesions are cured. Seventeen patients had complete clinical and mycologic cure, one responded clinically. It required one to four weeks to become culturally negative for tinea cruris, four to seven weeks for tinea corporis, three to eight weeks for tinea capitis. For tinea versicolor it required three to five weeks to become negative by scotch tape method. Adverse reactions to ketoconazole were absent and no patients required discontinuation of the drug. The results indicate that ketoconazole is a safe and effective drug for the treatment of dermatophytosis.
Humans ; Ketoconazole* ; Male ; Meals ; Skin ; Tinea Capitis ; Tinea Versicolor ; Tinea* ; Volunteers

No abstract available.
Drainage* ; Prognosis*