No abstract available.
Catheters*

There have been several reports of more than one type of porokeratosis occurring in the same family or the same individual. We hope to support the view of different phenotypic expressions of a common genetic aberration by describing an additional case of porokeratosis of Mibelli on the perianal area and DSAP on the face, forearms occurring in a 45-year-old man.
Actins* ; Forearm ; Hope ; Humans ; Middle Aged ; Porokeratosis*

BACKGROUND: Elafin is a serine proteinase inhibitor first discovered in keratinocytes from hyperproliferative human epidermis. In addition to the proteinase inhibiting domain, elafin contains multiple transglutaminase substrate domains which enable cross-linking to extracellular and cell envelope proteins. Several characteristics of elafin suggest potential anti-microbial activity. Elafin is absent in normal skin at protein level, but is induced in inflammatory and infectious dermatoses which threat the epidermal integrity by vesicopustule formation and neutrophilic cell infiltration. Cutaneous fungal infection is one of the well-known examples of diseases characterized by such condition. The purpose of this study was to check out the possibility that elafin may be involved in the pathomechanism of fungal infection. METHODS: The biopsy samples taken from 10 cases of superficial fungal infections, 10 cases of deep and systemic mycoses, 2 cases of slide culture specimens of Candida species, were used for the immunohistochemical tissue staining for elafin expression. Polyclonal anti-elafin was used in 1:300 dilution. As control, biopsy smaples of normal skin, ichthyosis, psoriasis were used for the staining for elafin expression. RESULTS: In the normal and ichthyotic epidermis, elafin expression was virtually negative. In superficial mycoses except candidiasis, elafin was expressed in the spinous layer of infected epidermis, and fungal structures in the stratum corneum were stained with elafin antisera. In the cases of dermatophytosis of ichthyosis patients, while fungal hyphae were stained with elafin antisera, epidermal cell did not express elafin. In candidial esophagitis, elafin was expressed in the esophgeal mucosa, but spores were not stained with elafin anti-sera. In slide culture of Candida species, spores were not stained with elafin antisera, also. In cases of systemic and deep mycoses, fungal hyphae and spores were stained with elafin antisera and epidermis adjacent to severe dermal inflammatory reaction showed elafin expression. CONCLUSION: Elafin may have certain role in systemic and cutaneous fungal infection to contribute to high resistance of the epidermis against proteolysis and fungal infections, and it is shown that elafin or elafin-like protein may also be produced and utilized by fungi themselves.
Biopsy ; Candida ; Candidiasis ; Elafin* ; Epidermis* ; Esophagitis ; Fungal Structures ; Fungi ; Humans ; Hyphae ; Ichthyosis ; Immune Sera ; Immunohistochemistry ; Keratinocytes ; Mucous Membrane ; Mycoses ; Neutrophils ; Proteolysis ; Psoriasis ; Serine Proteases ; Skin ; Skin Diseases ; Spores ; Tinea

OBJECTIVE: It is not unusual to decompress two consecutive disc levels in treating patients with multiple radiculopathy or uncertain level diagnosis. However, the controversy over whether to use corpectomy or bisegmental diskectomy for anterior cervical fusion is still largely unsettled. The aim of this study is to define the properties of these two surgical options. PATIENTS AND METHODS: We performed a retrospective review of radiological data and clinical records only in patients whom the follow up period is longer than 12 months. Functional outcome, fusion rate, complication rate, and duration of anesthesia were analyzed in both groups. RESULTS: In total of 61 cases, corpectomy was performed in 34 and the bisegmental diskectomy in 27 patients. Mean follow-up periods were over 24 months in both groups. Anesthesia time was shorter in corpectomy patients(280 minutes vs. 300 minutes in segmental diskectomy). However, the bisegmental diskectomy group was better in achieving good clinical outcome(92.6% vs. 82%). Overall fusion rate in bisegmental diskectomy was 100%. Hardware failure rate was lower in bisegmental diskectomy group(11% vs. 18%). Revision was needed in 6% of corpectomy group. CONCLUSIONS: In conclusion, although the anesthesia time is slightly longer in bisegmental fusion, we believe the method of bisegmental diskectomy is better in accomplishing higher fusion rate and lower complication rate.
Anesthesia ; Diagnosis ; Diskectomy* ; Follow-Up Studies ; Humans ; Radiculopathy ; Retrospective Studies

In an attempt to investigate the effect of intracerebral hematoma on cortical blood flow and perifocal ischemia, an experimental rat model of intracerebral hematoma was used. In a total of 44 adult male rats, cortical blood flow was studied using on H2 clearance method. The ischemic zone was investigated under light microscopy. In order to potentiate the effect of intracerebral hematoma, bilateral ligation of the common carotid artery was simultaneously performed in twelve rats. Intracerebral hematoma was induced by injecting 30nl of autologous arterial blood. Ipsilateral cortical blood flow decreased to 67.4% of baseline after the formation of intracerebral hematoma in the basal ganglia ; bilateral ligation of the common carotid artery alone decreased cortical blood flow to 59.4% of baseline ; and intracerebral hematoma formation after ligation decreased the flow to 20.5% of baseline. Neurological grades were worst in the last mentioned group, and in no group was perifocal infarction detected by light microscopy. These data suggest that the occurrence of intracerebral hematoma markedly decreases the cortical blood flow. Additionally, in a situation of compromised cerebral blood flow, the development of intracerebral hematoma can lead to a further decrease in flow, resulting in a worse neurological outcome, despite the absence of detectable histological difference.
Adult ; Animals ; Basal Ganglia ; Carotid Artery, Common ; Hematoma* ; Humans ; Infarction ; Ischemia* ; Ligation ; Male ; Microscopy ; Models, Animal ; Rats*

No abstract available.
Myelitis, Transverse* ; Retrospective Studies*

No abstract available.
Humans ; Magnetic Resonance Imaging, Cine* ; Spinal Cord Diseases*

PURPOSE: To evaluate the appropriate entry point of an intramedullary tibial cutting guide in total knee arthroplasty in Koreans by measuring the "intramedullary canal axis" of the proximal tibia in three dimensions. MATERIALS AND METHODS: Computed tomography was performed on 116 lower extremities from the hip to the ankle on 58 Korean cadavers. A three dimensional image of the tibia was reconstructed using the program, Bionix version 3.3. The location of intramedullary canal axis of proximal tibia passing through tibial plateau, canal axis center 1 (CAC 1), was measured. The beta' angle was defined as the angle between the tibial anatomical axis and a line perpendicular to the knee joint line. The correlations between the beta' angle and the CAC 1 mediolateral coordinates were analyzed. RESULTS: The CAC 1 is located on 56.3% from the medial cortex and 27.8% from the anterior cortex on the average. On average, the CAC 1 was located 1.2 mm medially and 15.9 mm anteriorly from the lateral tibial spine 1. The beta' angles and medial-lateral coordinates of the CAC 1 showed a significant positive correlation (r=0.418, p=0.000). CONCLUSION: When using an intramedullary guide for tibial cutting in total knee arthroplasty in Koreans, the entry point at the lateral and anterior positions from the surface center of the tibial plateau is appropriate. The lateralization of the entry point of intramedullary tibial cutting guide becomes necessary as the varus of the tibia becomes more severe. Because of the marked variability in the CAC 1, a preoperative evaluation of the CAC 1 needs to be carried out in order to properly locate the appropriate entry point of the intramedullary tibial cutting guide in total knee arthroplasty.
Ankle ; Arthroplasty* ; Axis, Cervical Vertebra* ; Cadaver ; Hip ; Imaging, Three-Dimensional ; Knee Joint ; Knee* ; Lower Extremity ; Spine ; Tibia*

BACKGROUND: Elafin is a serine proteinase inhibitor first discovered in keratinocytes from psoriatic epidermis. The molecular structure of elafin contains two different functional domains; one for the proteinase inhibitor, which is directed against elastase and proteinase-3, and the other for transglutaminase substrate. As this unique structural characteristic implies, elafin would be expected to have two distinct biologic functions in tissues. But, the roles and biological features of elafin have not been extensively studied in the skin. OBJECTIVES: This study was designed to demonstrate the immunohistochemical localization of elafin in inflammatory and keratinizing skin disorders, and to elucidate its biological functions. MATERIALS AND METHODS: The pre-elafin sequence was amplified by PCR using a human epidermal cDNA library and expression construct which was ligated into an expression vector. Then, the expressed proelafin sequence was purified and injected intradermally into rabbits to raise a polyclonal antibody. The skin biopsy samples of various skin diseases and normal controls were used for immunohistochemical staining to detect elafin expression. RESULTS: 1)Expression of elafin was observed in infected epidermis, and is believed to be involved in the defense mechanism of the skin. 2)In dermal and subcutaneous inflammatory diseases, epidermal elafin expression was influenced by the location of the inflammation. 3)Elafin was expressed in bullous dermatoses accompanied by acantholysis or spongiosis of epidermal cells. 4)Expression of elafin was upregulated in papulosquamous skin diseases which was characterized by epidermal hyperplasia and abnormal differentiation. 5)Elafin was expressed in keratinizing skin diseases that was accompanied by abnormal differentiation of epidermal cells. 6)Expression of elafin was demonstrated in skin tumors that showed proliferation of suprabasal cells. The intensity of expression is not related to the degree of malignancy, but to the degree of differentiation of tumor cells. CONCLUSION: Induction of elafin expression may play an important role in protecting the skin components against tissue damage. Elafin expression is related to the abnormal proliferation and differentiation of suprabasal cells. This means that elafin may be used as a marker of these conditions.
Acantholysis ; Biopsy ; Elafin* ; Epidermis ; Gene Library ; Humans ; Hyperplasia ; Immunohistochemistry ; Inflammation ; Keratinocytes ; Molecular Structure ; Pancreatic Elastase ; Polymerase Chain Reaction ; Rabbits ; Serine Proteases ; Skin Diseases ; Skin Diseases, Papulosquamous ; Skin Diseases, Vesiculobullous ; Skin*

Two cases of vertex epidural hematomas are described to illustrate their unique diagnostic and treatment problems. Due to its specific location, a correct diagnosis of the intracranial hematoma was delayed in the first case. Quantitative analysis of the hematoma volume was performed in the second case. We would like to emphasize the usefulness of the magnetic resonance imaging and quantitative analysis of vertex epidural hematoma in choosing treatment options in such patients.
Adult ; Case Report ; Hematoma, Epidural/*diagnosis/surgery ; Human ; Magnetic Resonance Imaging ; Male