PURPOSE: Although staged operations have been thought a main treatment for obstructive left colon cancer, their disadvantages make one-stage operations popular. We tried to identify technical feasibility and oncologic safety of one-stage operation with intra-operative lavage (IOL) for the treatment of obstructive left colon and rectal cancer. METHODS: From June 1996 to May 1999, of 456 colorectal cancer patients, 25 with obstructive left colon or rectal cancer underwent surgery. In 18 of those, we intended to do a one-stage operation with IOL. Male (n=14) were predominant to female (n=4). Mean age was 61.2 (29~78) years. Lesions were located on the sigmoid colon in 8, rectum in 4, descending in 3, and rectosigmoid junction in 3 cases. Operative technique: Lymphovascular division was initiated at the origin of IMA followed by mobilization of the left colon up to the splenic flexure and distal transverse colon. Thereafter antegrade irrigation of the proximal colon with warm normal saline was done by using a corrugated tube. Anastomoses were made by hand or stapler in end-to-end or side-to-end fashion. RESULTS: Mean operative time was 221 (185~360) min. No significant post-operative complications occurred except for two wound infections and one pulmonary atelectasis. There was one unexpected conversion to Hartmann's procedure due to intra-operative fecal soilage during the lavage. Within 18 months follow-up period, 4 recurrences occurred with two of them expiring. CONCLUSIONS:: One-stage operation for the treatment of obstructive left colon cancer with IOL could avoid colostomy or reoperation, and, was technically feasible, safe, and oncologically acceptable.
Colon* ; Colon, Sigmoid ; Colon, Transverse ; Colonic Neoplasms* ; Colorectal Neoplasms ; Colostomy ; Female ; Follow-Up Studies ; Hand ; Humans ; Male ; Operative Time ; Pulmonary Atelectasis ; Rectal Neoplasms ; Rectum ; Recurrence ; Reoperation ; Therapeutic Irrigation* ; Wound Infection

Acrokeratoelastoidosis of Costa is a rare palmoplantar keratoderma with autosomal dominant inheritance. It is clinically charaeterized by small, firm, yellowish, shiny, translucent papules occumng over the dorsal hands, the knuckles, and the lateral margine of the palms and soles. Histologically, the characteristic features are hyperkeratosis, aeanthosis, and most strikingly, fragmentation of coarse elastic fibers within the dermis. The lesions usually begin in early childhood and progress slowly. We herein report two familial cases of acrokeratoelastoidosis of Costa showing typical clinic1 and histopathological features.
Dermis ; Elastic Tissue ; Hand ; Keratoderma, Palmoplantar ; Wills*

Terbinafine is now widely used for the treatment of dermatophytic infections of the skin and nails. Cutaneous side effects of terbinafine are rare and mild. They includes erythema, pruritus, urticaria, desqumation, and macular exanthem. In addition, fixed drug eruption, erythema multiforme, Stevens-Johnson syndrome, and erythema annulare centrifugum-like psoriatic drug eruption were recently described in the literatures. Herein, we reported a case of acute generalized exanthematous pustulosis induced by terbinafine.
Acute Generalized Exanthematous Pustulosis* ; Drug Eruptions ; Erythema ; Erythema Multiforme ; Exanthema ; Pruritus ; Skin ; Stevens-Johnson Syndrome ; Urticaria

It is well established that mast cell proliferation and maturation are regulated by two principle cytokines, IL-3 and the c-kit ligand stem cell factor (SCF). Previous reports have demonstrated that bone marrow-derived IL-3-dependent mast cells exhibit the characteristic apoptosis on removal of IL-3. To know how the number of mast cells is controlled, we observed the effects of nitric oxide (NO) on the murine bone marrow-derived cultured mast cells (BMCMC). Apoptosis was measured by the analysis of flow cytometric data and electrophoretic evidence of DNA fragmentation. Our data showed that sodiurn nitroprusside (SNP)-a NO releasing substance- induced apoptosis in BMCMC. Cell cycle analysis showed that the number of the G,/G, and S phase decreased markedly, while the percentage of cell in G,/M phase was increased. Also, SNP alone induced cell death, whereas SNP in combination with SCF markedly decreased cell death of BMCMC. SNP-induced apoptosis was partially inhibited by the treatment of BMCMC with SCF. Our results suggest that NO might have sorne role in the regulation of the number of mast cells.
Apoptosis ; Bone Marrow* ; Cell Cycle ; Cell Death ; Cytokines ; DNA Fragmentation ; Interleukin-3 ; Mast Cells* ; Nitric Oxide* ; Nitroprusside ; S Phase ; Stem Cell Factor

Blue nevus is a benign melanocytic neoplasm and represents itself usually as a solitary blue or blue-black papule. It rarely occurs as multiple lesions grouped in a circumscribed area. How-ever, non-grouped disseminated blue nevi are exceedingly rare. We report a patient with acquired multiple blue nevi that was distributed over the entire body discretely and showed an increase in the number of the nevi without any causal factors.
Humans ; Nevus ; Nevus, Blue*

OBJECTIVE: The present study was undertaken to examine the effects of magnesium ion in the culture medium on the development of mouse fertilized oocytes either before or after pronuclear formation, and to investigate whether the effect of magnesium ion is related with the redistributional change of mitochondria. METHODS: Fertilized oocytes obtained from the oviducts of mice at 15 hr after hCG injection before pronuclear formation (pre-PN) or 21 hr after hCG injection after pronuclear formation (post-PN) were used. The embryos were cultured for 3 days with basic T6 medium-magnesium free and various concentrations of magnesium ion, 0.0, 0.5, 1.0, 2.0, 4.0 or 8.0 mM, respectively. After culture, the developmental stages of embryos and the number of nuclei were evaluated. To observe the effects of magnesium ion on the mitochondrial distribution, fertilized oocytes were collected at 21 hr after hCG injection and cultured for 6 hr with various concentration of magnesium ion. As a control, fertilized oocytes with pronuclei at 27 hr after hCG injection were used. RESULTS: The concentration of magnesium ion to accelerate the in vitro development of mouse fertilized oocytes appeared to be at 2.0 mM for the pre-PN and the post-PN stage embryos. In the mitochondrial redistribution patterns, the embryos cultured in 2.0 mM concentration of magnesium ion showed the highest percentage (22.6%) of distinct perinuclear clustering pattern comparing to other experimental group. CONCLUSION: The effect of magnesium ion may be related to the cytoplasmic redistribution of mitochondria. This relationship seems to connect the developmental competence of preimplantation mouse embryos in vitro. These results can suggest that higher concentration of magnesium ion (2.0 mM) than those of conventional culture medium (0.2~1.2 mM) is more suitable for in vitro culture of preimplantation mouse embryos.
Animals ; Cytoplasm ; Embryonic Structures* ; Magnesium* ; Mental Competency ; Mice* ; Mitochondria ; Oocytes ; Oviducts

Tegafur is a fluoropyrimidine structurally similar to 5-fluorouracil, used in the treatment of advanced gastrointestinal neoplasms. Mucocutaneous side reactions induced by this agent are rare and include photosensitivity of lichenoid and eczematous types, acral erythema, hyperpigmentation and palmoplantar keratoderma. However, to our knowledge, there has been no report of concurrent development of eruptions of two types in a patient. We describe a female patient with breast cancer, presented with combined features of acral erythema and hyperpigmentation due to oral tegafur.
Breast Neoplasms ; Erythema* ; Female ; Fluorouracil ; Gastrointestinal Neoplasms ; Humans ; Hyperpigmentation* ; Keratoderma, Palmoplantar ; Tegafur*

The purpose of this study was to analyse the various patterns of calcification demonstrated in the anteriorand lateral neck roentgenograms of 213 unselected patients with thyroid enlargement. The patterns of thyroidcalcifications were correlated with clinical, surgical and histological findings. The results were as follows: 1.Of 213 cases of thyroid enlargement, 180 cases were benign and 168 cases were female. 2. The calcification ratewas high in the chronic thyroid enlargement. 3. The incidence of calcification was 30.2% in the malignancy and17.2% in the benign disease. There was no clacification in the Hashimoto's disease. 4. The nodular calcificationwas demonstrated in the both benign and malignant disease but curvilinear calcifiation was predominantly seen inbenign disease.
Female ; Hashimoto Disease ; Humans ; Incidence ; Neck ; Thyroid Gland

Very little information is available regarding psychiatry in North Korea, which is based on the legacy of Soviet psychiatry. This paper reviews the characteristics of psychiatry in former socialist countries and discusses its implications for North Korean psychiatry. Under socialism, psychiatric disorders were attributed primarily to neurophysiologic or neurobiological origins. Psychosocial or psychodynamic etiology was denied or distorted in line with the political ideology of the Communist Party. Psychiatry was primarily concerned with psychotic disorders, and this diagnostic category was sometimes applied based on political considerations. Neurotic disorders were ignored by psychiatry or were regarded as the remnants of capitalism. Several neurotic disorders characterized by high levels of somatization were considered to be neurological or physical in nature. The majority of "mental patients" were institutionalized for a long periods in large-scale psychiatric hospitals. Treatment of psychiatric disorders depended largely on a few outdated biological therapies. In former socialist countries, psychodynamic psychotherapy was not common, and psychiatric patients were likely to experience social stigma. According to North Korean doctors living in South Korea, North Korean psychiatry is heavily influenced by the aforementioned traditions of psychiatry. During the post-socialist transition, the suicide rate in many of these countries dramatically increased. Given such mental health crises in post-socialist transitional societies, the field of psychiatry may face major challenges in a future unified Korea.
Biological Therapy ; Capitalism ; Democratic People's Republic of Korea ; Hospitals, Psychiatric ; Humans ; Korea ; Mental Health ; Neurotic Disorders ; Psychotherapy, Psychodynamic ; Psychotic Disorders ; Social Stigma ; Socialism ; Suicide

Linear IgA bullous dermatosis (LABD) is an autoimmune subepidermal blistering disease characterized on direct immunofluorescence of perilesional skin by the linear deposition of IgA at the basement membrane zone. The pathogenesis of LABD is not known, but rar ely some cases of LABD have been reported in association with drug exposure. We report a case of drug-induced LABD showing linear deposits of IgA and IgG at the basement membrane zone on direct immunofluorescence of perilesional skin as well as typical clinical and histologic characteristics, although the causative agent could not be specified.
Basement Membrane ; Blister ; Fluorescent Antibody Technique, Direct ; Immunoglobulin A ; Immunoglobulin G ; Linear IgA Bullous Dermatosis* ; Skin