BACKGROUND: Fas is a member of the tumor necrosis factor (TNF)/nerve growth factor (NGF) receptor family. Triggering of the Fas receptor pathway by its ligand results in apoptosis. Soluble Fas consists of the extracellular region of Fas receptor and it binds to Fas ligand to inhibit the Fas and Fas ligand induced apoptosis. Recently some evidence indicates that the Fas/Fas ligand system represents an important pathway responsible for the induction of apoptosis in bone marrow CD34+ cells of patients with aplastic anemia. METHODS: We measured serum soluble Fas levels in 27 patients with aplastic anemia at diagnosis using ELISA to define the status of soluble Fas in this disorder. RESULTS: Levels of serum soluble Fas in patients with aplastic anemia were lower com-pared with that of normal healthy controls. No difference was noted in the serum soluble Fas levels according to severity of disease. No correlation was found between serum soluble Fas levels and hematologic parameters at diagnosis such as neutrophil count, lymphocyte count, platelet count and corrected reticulocyte count. CONCLUSION: These results indicate that serum soluble Fas levels are decreased in patients with aplastic anemia. Further studies recruiting more patients and measuring Fas receptor on peripheral blood lymphocyte subsets and bone marrow CD34+ cells concomitantly may be helpful to determine pathophysiology of bone marrow failure.
Anemia, Aplastic* ; Antigens, CD95 ; Apoptosis ; Bone Marrow ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Fas Ligand Protein ; Humans ; Lymphocyte Count ; Lymphocyte Subsets ; Neutrophils ; Platelet Count ; Reticulocyte Count ; Tumor Necrosis Factor-alpha

PURPOSE: To determine whether initial corrected anion gap (C(o)AG), base excess caused by unmeasured anions (BEua), and strong ion gap (SIG) can predict the morbidity of critically ill patients admitted to emergency department (ED). METHODS: 138 patients who visited the critical section of the ED and were admitted to intensive care unit (ICU) were enrolled. We calculated the C(o)AG, BEua, and SIG from the initial blood samples of the patients and initial logistic organ dysfunction score (LODS) also. Then we measured the LODS at the last day of ICU stay again. Comparing with the initial LODS, we divided the patients into two groups based on the changes of the values: favorable group and poor group. RESULTS: There was a significant difference in the mean AGcorr (p=0.007), BEua (p=0.008), SIG (p=0.037) between favorable and poor group. The area under the receiver operating characteristic (AUROC) curves for morbidity prediction were relatively small: 0.66 (95% CI, 0.56-0.77) for C(o)AG, 0.65 (95% CI, 0.54-0.76) for BEua, and 0.59 (95% CI, 0.49-0.70) for SIG. CONCLUSION: We found the initial unmeasured anions at the ED of the patients who eventually showed improved LODS during ICU period are significantly different to those of the other patients. But they failed to show enough capability of discriminating the morbidities between two groups.
Acid-Base Equilibrium ; Anions* ; Critical Illness* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Intensive Care Units ; Organ Dysfunction Scores ; Organization and Administration ; ROC Curve

Spitz nevi, benign melanocytic tumors, have some histologic resemblance to malignant melanoma. They usually appear as asymptomatic, solitary, reddish to pinkish, hairless, dome-shaped, round to oval, smooth-surfaced papules or nodules, measuring less than 1.0 cm in diameter. Histologically, these lesions display striking nests of large spindle cells and epithelioid cells, usually extending from the epidermis to the reticular dermis. Here in, we report a case of Spitz nevus on the helix of the right ear of a 23-year-old man which was treated with Er:YAG laser.
Dermis ; Ear* ; Epidermis ; Epithelioid Cells ; Humans ; Melanoma ; Nevus ; Nevus, Epithelioid and Spindle Cell* ; Strikes, Employee ; Young Adult

Tubular apocrine adenoma is a well-circumscribed, intradermal benign tumor, with tubular structures showing apocrine differentiation. Histologically, the characteristic features are various-sized dilated tubules with intraluminary papillary projection and apocrine decapitation secretion. It usually presents as a solitary lesion and is sometimes associated with nevus sebaceous and/or syringocystadenoma papilliferum. We have in report a case of tubular apocrine adenoma with epidermal cysts which developed in the right inguinal area of a 37-year-old man.
Adenoma* ; Adult ; Decapitation ; Epidermal Cyst ; Humans ; Nevus

Ameloblastic fibro-odontoma(AFO) is a rare mixed odontogenic tumor. It is composed of connective tissue characteristic of an ameloblastic fibroma and calcified tissue as a complex or compound odontoma. AFO usually presents itself as an asymptomatic swelling of jaw or failure of tooth eruption. The lesion usually occurs in individual less than 30 years old. The differential diagnosis of this tumor includes odontoma, ameloblastoma, and ameloblastic fibroma. This report describes an ameloblastic fibro-odontoma occurring in maxilla of sixteen-year-old female. The lesion was treated by surgical enucleation and curettage without extraction of the involved canine(#23). This patient has shown no sign of recurrence during postoperative 34 months. So we report our case with review of literatures.
Adult ; Ameloblastoma ; Ameloblasts* ; Connective Tissue ; Curettage ; Diagnosis, Differential ; Female ; Fibroma ; Humans ; Jaw ; Maxilla* ; Odontogenic Tumors ; Odontoma ; Recurrence ; Tooth Eruption

Mucoceles are common benign cystic lesions of the oral cavity that develop following extravasation or retention of mucous material from the major or minor salivary glands. Mucoceles are usually located in the lower lip (60 to 70% of cases), and the floor of the mouth is only involved in 6 to 15% of cases. Submandibular gland mucocele is extremely rare but should be considered in the differential diagnosis of swelling at the submandibular triangle in young children. We present the rare case of a 16-month-old child who was diagnosed with bilateral submandibular gland mucocele, presenting as serial swellings in both submandibular regions. We removed the cystic mass with the submandibular and sublingual glands to prevent recurrence.
Child ; Diagnosis, Differential ; Floors and Floorcoverings ; Humans ; Infant ; Lip ; Mouth ; Mucocele ; Recurrence ; Retention (Psychology) ; Salivary Glands, Minor ; Sublingual Gland ; Submandibular Gland

Mucoceles are common benign cystic lesions of the oral cavity that develop following extravasation or retention of mucous material from the major or minor salivary glands. Mucoceles are usually located in the lower lip (60 to 70% of cases), and the floor of the mouth is only involved in 6 to 15% of cases. Submandibular gland mucocele is extremely rare but should be considered in the differential diagnosis of swelling at the submandibular triangle in young children. We present the rare case of a 16-month-old child who was diagnosed with bilateral submandibular gland mucocele, presenting as serial swellings in both submandibular regions. We removed the cystic mass with the submandibular and sublingual glands to prevent recurrence.
Child ; Diagnosis, Differential ; Floors and Floorcoverings ; Humans ; Infant ; Lip ; Mouth ; Mucocele ; Recurrence ; Retention (Psychology) ; Salivary Glands, Minor ; Sublingual Gland ; Submandibular Gland

A feeding gastrostomy tube is used to provide chronic nutritional support for patients who have a swallowing disability. Serious complications associated with feeding gastrostomy are rare. However, dislocation of the gastrostomy tube into the duodenum can lead to serious complications. There have been 7 reports in which the gastrostomy tube used for enteral feeding was associated with acute pancreatitis. But there have been no reports of pancreatitis associated with feeding gastrostomy in Korea. Further, all the reported cases were associated with both pancreatitis and cholangitis secondary to the compression of the major papilla by the percutaneous endoscopic gastrostomy tube. To the best our knowledge, this is the first report of acute pancreatitis, without cholangitis, that was induced by the compression of migrating surgical gastrostomy tube. Herein, we report on a case of a 68-year-old Korean male diagnosed with acute pancreatitis, and this was induced by the migration of a surgical gastrostomy tube.
Aged ; Cholangitis ; Deglutition ; Dislocations ; Duodenum ; Enteral Nutrition ; Gastrostomy ; Humans ; Korea ; Male ; Nutritional Support ; Pancreatitis

Fifteen percent of patients with Cushing's syndrome could be accompanied with nonpituitary tumors that secrets ACTH-the ectopic ACTH syndrome. Among them, bronchial carcinoid is one of the rare causes of the ectopic ACTH syndrome. We experienced a 60-year-old woman who showed conditions of weight gain, generalized edema, hypokalemia, diabetes mellitus, and right middle lung mass. Histologically, the tumor was diagnosed with bronchial carcinoid and was confirmed as an ectopic ACTH syndrome through immunohistochemical staining of ACTH. After resection of the lung mass, blood sugar, electrolytes, generalized weakness, and blood pressure improved.
ACTH Syndrome, Ectopic* ; Adrenocorticotropic Hormone ; Blood Glucose ; Blood Pressure ; Carcinoid Tumor* ; Cushing Syndrome ; Diabetes Mellitus ; Edema ; Electrolytes ; Female ; Humans ; Hypokalemia ; Lung ; Middle Aged ; Weight Gain

Situs inversus totalis (SIT) is very rare autosomal recessive condition, and patients with SIT have complete mirror image reversal of the thoracic and abdominal viscera. There have been no case reports of esophageal bezoar in a patient with situs inversus totalis. Bezoars are retained concretions of indigestible foreign material, including food material, vegetable material and hair, and they are usually founded in the stomach, small intestine and rectum. Esophageal bezoars are very rare, but they are known to occur in patients with anatomical defects or esophageal motility disorders. The treatment of esophageal bezoar is usually based on endoscopic fragmentation and extraction, dissolution with papain, cellulose, pancreatic enzyme and/or Coca cola. We report here on a case of an endoscopically treated primary esophageal bezoar in a patient with situs inversus totalis, and the patient experienced no complications from the treatment.
Bezoars ; Cellulose ; Coca ; Cola ; Esophageal Motility Disorders ; Hair ; Humans ; Intestine, Small ; Papain ; Rectum ; Situs Inversus ; Stomach ; Vegetables ; Viscera