BACKGROUND: The immunohistochemical detection of endothelial differentiation in skin tumors has been hindered by the relative paucity of reliable markers that are applicable to rou- tinely-processed specimens, which are both specific and sensitive as well. OBJECTIVE: This study was designed to evaluate the utility of CD31 and CD34, newly introduced vascular markers, in the immunohistochemical differentiation of vascular neoplasms from other mesenchymal tumors and to compare their sensitivity and specificity with factor VII-related antigen (FVIIIRA). METHODS: Paraffin-embedded specimens of 26 cases of benign and malignant vascular tumors and 25 cases of non-vascular mesenchymal neoplasms of the skin and subcutis were investigated for CD31, CD34, and FVIIIRA expression using immunohistochemical methods. RESULTS: CD31-immunoreactivity was observed in all of the 26 vascular lesions. CD34 and FVlllRA were labelled in 23 cases and 16 cases of vascular tumors, respectively. All of the 25 non-vascular mesenchymal tumors were negative for CD31 and FVIIIRA. In contrast, positive reactivity for CD34 was seen in 14 cases, among which dermatofibrosarcoma protuberans(2/2), neurofibroma(8/8), neuriilemmoma(2/2), and leiomyoma(2/3) were included. CONCLUSION: Our results indicate that CD31 is a more sensitive and specific vascular marker than CD34 and FVIIIRA. A small panel composed of these three antibodies will constitute a comprehensive and reliable method for identifying tumors of vascular origin.
Antibodies ; Dermatofibrosarcoma ; Methods ; Sensitivity and Specificity ; Skin* ; Vascular Neoplasms ; von Willebrand Factor*

BACKGROUND: Isolated lung perfusion (ILP) was developed as a new treatment approach to non-resectable primary or metastatic lung cancer, because of its ability to reduce systemic toxicity while delivering high-dose chemotherapeutic agents to the target organs. This research was planned to evaluate the direct toxic effect of high-dose cisplatin to the lung tissue during isolated lung perfusion. MATERIAL AND METHOD: Fifteen mongrel dogs were divided in the perfusate for 40 minutes. The second group was composed of 5 mongrel dogs which underwent ILP with cisplatin 2.5 mg/Kg added to the perfusate for 30 minutes and 10 minutes with washing solution without cisplatin. The third group underwent the same procedure as the second group except cisplatin 5.0 mg/Kg in the perfusate. Activities of serum angiotensin converting enzyme (ACE), tumor necrosis factor-alpha (TNF-alpha), and concentration of serum lactate dehydrogenase (LDH) and blood urea nitrogen/creatinine (BUN/Cr) were analyzed in each groups at the time of pre-perfusion, 1 hour, 1 day, 1 week, and 2 weeks after ILP. RESULT: Serum ACE activities before and 1 hour, 1 day, 1 week, and 2 weeks after ILP in control group were 45.1+/-6.3, 44.6+/-9.3, 46.7+/-9.5, 50.8+/-9.1, 46.1+/-4.3 U/L. Those in cisplatin 2.5 and 5.0 mg/Kg groups were 49.4+/-12.6, 39.0+/-8.6, 42.3+/-15.9, 50.0+/-2.6, 53.8+/-8.3 and 55.5+/-12.3, 47.0+/-6.3, 45.1+/-6.9, 74.8+/-19.5, 60.2+/-12.0 U/L, respectively. Serum TNF-alpha activities in each group before and after ILP were 5.0+/-1.5 / 7.7+/-2.2 / 6.6+/-2.5 / 4.3+/-1.3 / 5.2+/-1.1 (control), 8.7+/-1.6 / 9.9+/-2.2 / 7.9+/-1.5 / 6.3+/-2.2 / 7.4+/-2.4 (cisplatin 2.5 mg/Kg), and 6.9+/-0.7 / 8.9+/-3.4 / 7.9+/-4.0 / 3.3+/-0.9 / 5.8+/-1.3 pg/ml (cisplatin 5.0 mg/Kg). Mean LDH levels of each group were 225.7 / 271.3 / 328.9 / 350.8 / 255.7(control), 235.7 / 265.7 / 336.0 / 379.5 / 299.2 (cisplatin 2.5 mg/Kg), and 259.6 / 285.2 / 340.6 / 433.4 / 292.4 IU/L (cisplatin 5.0 mg/Kg). So there was no significant difference in serum ACE, TNF-alpha, and LDH activity changes after ILP between the 3 groups. And, there was no significant changes in BUN/Cr in each groups, which was independent of ILP and perfused concentration of cisplatin. In addition, all dogs survived the ILP and there was no significant evidence of pulmonary vascular injury after 2 weeks of ILP with cisplatin. CONCLUSION: There was no harmful effect of cisplatin to the lund tissue of the mongrel dog up to 5.0 mg/Kg in perfusate. Therefore, it is perceived to be safe and effective to deliver high-dose cisplatin to the lung without pulmonary toxicity and renal damage with ILP.
Animals ; Cisplatin* ; Dogs* ; L-Lactate Dehydrogenase ; Lung Neoplasms ; Lung* ; Peptidyl-Dipeptidase A ; Perfusion* ; Tumor Necrosis Factor-alpha ; Urea ; Vascular System Injuries

The alterations in the localization of keratinocyte membrane glycoconjugates in allergic contact dermatitis were investigated in guinea pig skin treated with topical application of 2.4-dinitro-chlorobenzene. We employed the avidin-biotin complex(ABC) method for the detection of localization of 10 commercially available lectins labelled with biotin: Con-A, SBA, WGA, DBA, UEA-1, RCA-1, PNA, HP, MPA, and ECA. Staining with WGA showed a remarkably decreased intensity in basal and spinous layers of the allergic skin in comparison to those of the control skin, suggesting loss of terminal sialic acids in cell membrane glycoconjugates. The other lectins showed no remarkable difference in the staining patterns between the normal and the allergic ski. The results suggest that epidermal cell membrane glycoconjugates undergoes selective perturbations in acute allergic contact dermatitis, and that the keratinocytes might be an active part of the cutaneous immune system.

Fabry's disease is a rare hereditary metabolic disease caused by alpha-galactosidase deficiency, resulting in abnormal accumulation of galactosyl galactosyl galactosyl ceramide (ceramide trihexoside) in various organs. Articles in English reported approximately one hundred cases but only two cases in Korea. Recently the authors experienced a case of Fabry's disease of a male patient and studied the electronmicroscopy on skin biopsied tissue and enzyme assay of alpha -galactosidase activity in his peripheral blood leukocytes. The male patient was a 21-year-old soldier who suffered from anhidrosis with heat intolerance and generalized telangietatic papules (Angiokeratoma corporis diffusum) since childhood. Other clinical findings were ocular change, paroxysmal pain of lower extremities and proteinuria with oval fat bodies on urinalysis. The ultrastructural study of skin demonstrated abnormal lysosomal deposits of finger-prints or "zebra" body configuration in the endothelial cells, pericytes, perineural cells and intercalated ductal epithelium of sweat glands. Enzyme activity of alpha-galactosidase was markedly decreased in the peripheral blood leukocytes comparing to the normal control, which was conclusive to make a diagnosis of Fabry's disease.
Child ; Male ; Female ; Humans

Fabry's disease is a rare hereditary metabolic disease caused by alpha-galactosidase deficiency, resulting in abnormal accumulation of galactosyl galactosyl galactosyl ceramide (ceramide trihexoside) in various organs. Articles in English reported approximately one hundred cases but only two cases in Korea. Recently the authors experienced a case of Fabry's disease of a male patient and studied the electronmicroscopy on skin biopsied tissue and enzyme assay of alpha -galactosidase activity in his peripheral blood leukocytes. The male patient was a 21-year-old soldier who suffered from anhidrosis with heat intolerance and generalized telangietatic papules (Angiokeratoma corporis diffusum) since childhood. Other clinical findings were ocular change, paroxysmal pain of lower extremities and proteinuria with oval fat bodies on urinalysis. The ultrastructural study of skin demonstrated abnormal lysosomal deposits of finger-prints or "zebra" body configuration in the endothelial cells, pericytes, perineural cells and intercalated ductal epithelium of sweat glands. Enzyme activity of alpha-galactosidase was markedly decreased in the peripheral blood leukocytes comparing to the normal control, which was conclusive to make a diagnosis of Fabry's disease.
Child ; Male ; Female ; Humans

We examined the p53 protein overexpression and evaluated its correlation with pathobiological variables, including: (1) patient age, sex, tumor size, histological type and grade, invasion depth, vascular invasion, perineural invasion and lymph node status; (2) the Ki-67 labeling index in 100 gastric carcinomas; and (3) the DNA ploidy pattern, S phase fraction (SPF), and the proliferation index (PI) in 84 cases using flow cytometry. The positive rate of p53 staining was 48% and the p53 immunoreactivity was independent of variable clinicopathologic factors. No correlation was made between the Ki-67 labeling index with p53 immunostaining and DNA ploidy parameters. Aneuploidy rate was slightly higher in the p53 positive group (55.6%) than the p53 negative group (44.4%)(p=0.097). The mean values of SPF and PI were significantly higher in the p53 protein positive group. Aneuploidy was more often observed in the intestinal type (p=0.038), advanced gastric carcinoma (p=0.015) and lymph node positive group(p=0.039). The above results suggest that although the p53 protein overexpression has no significant correlation with pathological factors and the Ki-67 labeling index, it may play an important role in tumor cell proliferation. Since p53 protein overexpression was slightly higher in the aneuploidy group showing significant correlation with poor prognostic parameters, it is thought that re-evaluation of the p53 mutation by molecular biological study is needed.
Aneuploidy ; Cell Proliferation ; DNA* ; Flow Cytometry ; Humans ; Lymph Nodes ; Ploidies* ; S Phase

Rhinoscleroma, or scleroma, is a chronic, slowly progressing granulomatous disease involving the upper respiratory tract, especially the nasal vestibules, choanae, pharynx, and larynx. Almost certainly the causative agent is Klebsiella rhinoscleromatis. The disease occurs frequently in Eastern Europe, the Middle East, and parts of Latin America, but it is hard to find such case in Korea. We prisent a case of rhinoscleroma involving the nasal vestibule in a 18-year-old male who was admitted due to nasal obstruction for 5 years and epistaxis for 2 months. The resected specimen was an irregular polypoid mass with relatively firm consistency and measured 3 cm in the largest diameter. Microscopically, the lesion was characterized by extensive fibrosis and inflammatory cell infiltration. The infiltrates consisted of predominantly lumphocytes, plasma cells, foamy or granular histiocytes which were singly scattered or grouped in clusters. In the cytoplasm of the histiocytes, round slightly basophilic bodies were noted. Warthin-Starry satin showed short positive rods within the cytoplasm of the cell (Mikulicz cell). Electron microscopically, the cytoplasm of Mikulicz cells contained large, round or irregular shaped clear vacuoles in which numerous Klebsiella bacilli attached to the boundaries of the vaculoes were noted. With higher magnifications, the bacilli were seen as roung or rod-shaped organisms.
Male ; Humans

Alendronate sodium (Fosamax(R)) is an aminophosphonate used in treatment of postmenopausal osteoporosis by inhibition of osteoclastic activity. Esophageal ulcers related to alendronate use have been reported at the rate of 2~6%. However, there have been no reports of esophagitis or esophageal ulcer by alendronate in Korea. We present a case of esophageal ulcer caused by alendronate. The patient presented with retrosternal pain and severe odynophagia for a few days. Esophagogastroduodenoscopy revealed multiple deep ulcers at the esophagus. Her symptoms resolved completely after stopping alendronate. A follow-up esophagogastroduodenoscopy 6 weeks later revealed complete healing of the ulcers.
Alendronate* ; Endoscopy, Digestive System ; Esophagitis ; Esophagus ; Female ; Follow-Up Studies ; Humans ; Korea ; Osteoclasts ; Osteoporosis, Postmenopausal ; Ulcer*

BACKGROUND: Mannitol is widely used in neurosurgical patients and may induce an increase in serum potassium concentration according to doses and administration rates with unknown mechanism. The treatment of hyperkalemia is aimed at eliminating the causes and includes calcium, sodium bicarbonate, glucose with insulin, loop diuretics and hyperventilation. This study was undertaken to observe the effects of hyperventilation on the serum potassium concentration following infusion of mannitol (2.0 gm/kg). METHODS: We studied 30 patients who were operated brain aneurysm clipping surgery and were divided into 3 groups (n=10). In control group, mild hypocapnia was maintained (PaCO2, 32 2 mmHg) before and after mannitol infusion. In group I, moderate hypocapnia was maintained (PaCO2, 27 2 mmHg) before and after mannitol infusion. In group II, mild hypocapnia (PaCO2, 32 2 mmHg) was maintained before 30 minutes of mannitol infusion and moderate hypocapnia (PaCO2, 27 2 mHg) after mannitol infusion. We started infusion of 20% mannitol with a dosage of 2.0 gm/kg, 15~20 min after cranium was opened. RESULTS: The changes of serum potassium were as follows (Mean SD mEq/l) (just before and 15min, 30min, 60min after mannitol infusion): 3.79 0.48, 4.66 0.60, 4.44 0.48, 4.13 0.40 (Control group), 3.62 0.18, 3.63 0.42, 4.14 0.51, 3.95 0.33 (Group I), 3.76 0.20, 3.91 0.15, 4.11 0.30, 4.04 0.23 (Group II). After 15 minutes of mannitol infusion, the serum potassium levels of group I and II were lower than that of control group (p<0.05) and there was no significant difference between group I and II. CONCLUSIONS: These results suggest that hyperventilation may blunt the increase in serum potassium concentration following rapid infusion of high dose mannitol.
Calcium ; Glucose ; Humans ; Hyperkalemia ; Hyperventilation* ; Hypocapnia ; Insulin ; Intracranial Aneurysm ; Mannitol* ; Potassium* ; Skull ; Sodium Bicarbonate ; Sodium Potassium Chloride Symporter Inhibitors

BACKGROUND: In general, the outcomes of arthroscopic repair for superior labrum anterior to posterior lesions (SLAP) are favorable, however, persistent pain and limitation of motion are not rare complications. One of the possible cause is a “knot-ache”. This study evaluated the results of reoperation of symptomatic recurrent SLAP lesions and asked whether the knot is associated with postoperative complications. METHODS: Between 2005 and 2015, a total of 11 patients who had undergone arthroscopic SLAP repair were reoperated for recurrent symptomatic SLAP lesion. By retrospective chart review, operative findings, the visual analogue scale for pain (pVAS), the range of motion (ROM), and functional scores were analyzed. RESULTS: The mean age of the study participants was 38.3 years, and the mean follow-up period was 42.5 months. In the primary operation, there were nine cases of repairs with conventional knot-tying anchors and three cases with knotless anchors. Impingement of the knots during abduction and external rotation of the shoulder was observed in the all cases with knot-tying anchors. The mean pVAS, ROM, and functional scores significantly improved with reoperation. At the final follow-up, the mean satisfaction VAS was 8.3. CONCLUSIONS: The knots of suture anchor maybe a possible etiology of the pain, which we termed a “knot-ache”. Considering that reoperation is performed due to pain after primary repair, the use of knotless suture anchor may have benefits of eliminating one of possible cause, “knot-ache”. Therefore, authors suggest the use of knotless anchors during reoperation for recurrent or recalcitrant pain after primary SLAP repair.