Tricho-rhion-phalangeal syndrome is characterized by the triad of slow growing, brittle hair and early loss of hair, distinctive faces which include a long philtrum and pear-shape nose, and peripheral cone shape epiphysis with brachyphalangia. Tricho-rhion-phalangeal syndrome is probably not so much uncommon. The tricho-rhion-phalangeal syndrome, however, is not well recognized to orthopaedic surgeons due to the minor finger deformities. We report a case of tricho-rhion-phalangeal syndrome with brief review of literature.
Congenital Abnormalities ; Epiphyses ; Fingers ; Hair ; Lip ; Nose ; Surgeons

The lack of sufficient oral mucosa available for intra-oral reconstruction has been dealt with by the use of skin or oral mucosa grafts harvested from donor sites but grafts requires more than one surgical procedures and could cause donor site morbidity. Many investigators have attempted to increase available soft tissue by tissue engineered skin or oral mucosa replacements for clinical applications. But, reconstructed mucosa by several methods have low physical properties such as rolling and contraction. The aims of this study were to develope an in vitro experimental model that maintains an epithelial-mesenchymal interaction by organotypic raft culture, and to characterize biologic properties of three-dimensionally cultured oral mucosa embedded with Polydioxanone mesh by histological and immunohistochemical analysis. The results were as follows; 1. Oral mucosa reconstructed by three-dimensional organotypic culture revealed similar morphologic characteristics to equvalent normal oral mucosa in the point that they show stratification and differentiation. 2. The expression of cytokeratin 10/13 and involucrin in the cultured tissue showed the same pattern with normal oral mucosa suggesting that organotypic co-culture condition is able to induce cellular differentiation. 3. After insertion of polydioxanone mesh, increased tensile strength were observed. These results suggest that three-dimensional organotypic co-culture of the oral mucosa cell lines with the dermal equvalent consisting type I collagen and fibroblasts reproduce the morphologic and immunohistochemical characteristics similar to those in vivo condition. And increased physical properties by use of polydioxanone mesh will helpful for clinical applications.
Cell Line ; Coculture Techniques ; Collagen Type I ; Fibroblasts ; Humans ; Keratins ; Models, Theoretical ; Mouth Mucosa* ; Mucous Membrane ; Polydioxanone* ; Research Personnel ; Skin ; Tensile Strength ; Tissue Donors ; Transplants

Bacterial, fungal, and viral infections of the skin with extended skin involvement can occur during the early phase of human immunodeficiency virus infection. A significant reduction in circulating CD4+ lymphocytes in the late stage of the disease may cause tumors of the skin such as Kaposi's sarcoma. A 40-year male patient, a former sailor who had multiple sexual contact with native African women, presented with multiple tender follicular pustules and fibrotic brown patches on both his legs. these had been present for 6 months. The skin lesions were healed leaving brown pigmentation. Laboratory examinations revealed the presence of leukopenia, thromocytopenia and a reversed T4/T8 ratio. The ELISA and Western blot analysis to human immunodeficiency virus were positive. A skin biopsy from a brown patch showed early stages of scar tissue and perivascular hemosiderin deposition. We herein report a case of acquired immunodeficiency syndrome patient with atypical dark brown scarring atrophic patches on the lower legs following purulent bacterial folliculitis. This may have been an early manifestation of Kaposi's sarcoma from a preceding skin lesion.
Acquired Immunodeficiency Syndrome ; Biopsy ; Blotting, Western ; Cicatrix* ; Enzyme-Linked Immunosorbent Assay ; Female ; Folliculitis* ; Hemosiderin ; HIV ; Humans ; Leg ; Leukopenia ; Lymphocytes ; Male ; Military Personnel ; Pigmentation ; Sarcoma, Kaposi ; Skin

We have constructed several panels of MAbs which specifically recognize B-subunit of HCG (BHCG). Splenocytes from Balb/c mice immunized with B-subunit of HCG were fused with SP2/o-Ag14 myeloma cells by PEG method. Fifteen different hybridorna clones (individually named as mG10.127, mG10.61, mG9.5, mG9.18, rnG9.20, mG6.3, mG6.36, mG6.8, mG7.31, mG7.79, mG9.11, mG9.51.6, mG9.51.12, mH4.17, and mH4.4) were obtained by indirect ELISA screening and three to five successive cloning procedures. The distinct features of these MAbs were determined by specificity, western blot, isotyping, and isoelectrofocusing. All of the MAbs except mG9.20 and mG6.8 specifically bind to BHCG without cross- reaction with B-subunit of LH (BLH). In western blot analysis, all of the MAbs bind to non-denatured form of BHCG suggesting that the MAbs recognize conformation-dependent epitope of BHCG. This new panels of MAbs to BHCG should be useful for developing diagnostic reagent such as pregnancy, choriocarcinoma, Down's syndrome as well as for the fine quantitation of serum or urinary HCG.
Animals ; Antibodies, Monoclonal* ; Blotting, Western ; Choriocarcinoma ; Chorionic Gonadotropin* ; Clone Cells ; Cloning, Organism ; Down Syndrome ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans* ; Mass Screening ; Mice ; Pregnancy ; Sensitivity and Specificity

No abstract available.
Mastoid* ; Otitis Media with Effusion* ; Otitis Media* ; Otitis*

PURPOSE: To evaluate the ultrasonographic features of nonlactiferous breast abscess. MATERIALS AND METHODS: We retrospectively reviewed ultrasonograms of 21 cases with surgically and clinically proved nonlactiferous breast abscess. The cases included 17 cases of acute or chronic inflammation and 4 cases of tuberculosis. RESULTS: Location of the lesion was subareolar in 15 cases and peripheral in 6. Mean anteroposterior/transverse diameter ratio was 0.49. Internal echogenicitiy of the lesion was variable, with heterogeneous mixed-echoic echotexture in 18 cases and homogeneous hypoechoic in 3. Margin of the lesion was irregular in 18 cases(85.7%) and posterior sonic enhancement was observed in 17 cases(81%). There were also noted obliteration of adjacent superficial fascia, localized skin thickening, and sinus tract or ductal ectasia in 19(90.5%), 9 (42.9%), and 9(42.9%) cases respectively. CONCLUSION: Major ultrasonographic findings of nonlactiferous breast abscess was subareolar located, variable shaped mass with posterior enhancement. Additional findings were fistular formation, loss of superficial fascia, and axillary lymphadenopathy.
Abscess* ; Breast* ; Dilatation, Pathologic ; Inflammation ; Lymphatic Diseases ; Retrospective Studies ; Skin ; Subcutaneous Tissue ; Tuberculosis ; Ultrasonography

PURPOSE: To evaluate the ultrasonographic features of nonlactiferous breast abscess. MATERIALS AND METHODS: We retrospectively reviewed ultrasonograms of 21 cases with surgically and clinically proved nonlactiferous breast abscess. The cases included 17 cases of acute or chronic inflammation and 4 cases of tuberculosis. RESULTS: Location of the lesion was subareolar in 15 cases and peripheral in 6. Mean anteroposterior/transverse diameter ratio was 0.49. Internal echogenicitiy of the lesion was variable, with heterogeneous mixed-echoic echotexture in 18 cases and homogeneous hypoechoic in 3. Margin of the lesion was irregular in 18 cases(85.7%) and posterior sonic enhancement was observed in 17 cases(81%). There were also noted obliteration of adjacent superficial fascia, localized skin thickening, and sinus tract or ductal ectasia in 19(90.5%), 9 (42.9%), and 9(42.9%) cases respectively. CONCLUSION: Major ultrasonographic findings of nonlactiferous breast abscess was subareolar located, variable shaped mass with posterior enhancement. Additional findings were fistular formation, loss of superficial fascia, and axillary lymphadenopathy.
Abscess* ; Breast* ; Dilatation, Pathologic ; Inflammation ; Lymphatic Diseases ; Retrospective Studies ; Skin ; Subcutaneous Tissue ; Tuberculosis ; Ultrasonography

Objective: The vulnerable and frail elderly individuals are at a compounded risk of worsening, rather than recovering, from external stress such as sepsis. Ambulation is majorly considered as a phenotype and determining factor of frailty. This study was undertaken to determine whether inability of ambulation is predictive for the prognosis of elderly patients afflicted with sepsis. Methods: Data were collected retrospectively from the medical records of an emergency medical center, from 1 November 2016 to 28 February 2017. Patients older than 65 years, who underwent blood culture or with a diagnosis of sepsis or septic shock and with Sequential Organ Failure Assessment (SOFA) score above 2 points, were included in the study. The predictive ability of the clinical factors was analyzed by comparing with the primary outcome of in-hospital mortality. Results: A total of 105 patients were included in the study; 58 (55.2%) male and 47 (44.8%) female patients, with median age 78 years (range, 65-96 years). Of these, 89 (84.8%) patients were independently ambulatory before presentation. The median SOFA score was 3 (2-12), and 20 (19%) patients had expired in the hospital. Logistic regression revealed that inability of ambulation is not predictive of mortality (odds ratio, 0.872; 95% confidence Interval, 0.176-4.309; P=0.866). However, correlation analysis with the SOFA score revealed an association with inability of ambulation (r=0.277, P=0.004), and multiple regression analysis also showed that ambulation affects the SOFA score (t=2.435, P=0.017; t=-2.521, P=0.013). Conclusion Inability of ambulation does not predict in-hospital mortality, but affects the SOFA score of elderly patients afflicted with sepsis or in septic shock.

Objective: The vulnerable and frail elderly individuals are at a compounded risk of worsening, rather than recovering, from external stress such as sepsis. Ambulation is majorly considered as a phenotype and determining factor of frailty. This study was undertaken to determine whether inability of ambulation is predictive for the prognosis of elderly patients afflicted with sepsis. Methods: Data were collected retrospectively from the medical records of an emergency medical center, from 1 November 2016 to 28 February 2017. Patients older than 65 years, who underwent blood culture or with a diagnosis of sepsis or septic shock and with Sequential Organ Failure Assessment (SOFA) score above 2 points, were included in the study. The predictive ability of the clinical factors was analyzed by comparing with the primary outcome of in-hospital mortality. Results: A total of 105 patients were included in the study; 58 (55.2%) male and 47 (44.8%) female patients, with median age 78 years (range, 65-96 years). Of these, 89 (84.8%) patients were independently ambulatory before presentation. The median SOFA score was 3 (2-12), and 20 (19%) patients had expired in the hospital. Logistic regression revealed that inability of ambulation is not predictive of mortality (odds ratio, 0.872; 95% confidence Interval, 0.176-4.309; P=0.866). However, correlation analysis with the SOFA score revealed an association with inability of ambulation (r=0.277, P=0.004), and multiple regression analysis also showed that ambulation affects the SOFA score (t=2.435, P=0.017; t=-2.521, P=0.013). Conclusion Inability of ambulation does not predict in-hospital mortality, but affects the SOFA score of elderly patients afflicted with sepsis or in septic shock.

PURPOSE: Aspiration pneumonia is an important complication of drug intoxication with decreased mental status. The purpose of the study is to investigate the risk factors of aspiration pneumonia in the patients of benzodiazepine overdose with or without co-ingestion of other drugs. METHODS: A retrospective chart review of patients who visited the emergency department between January 2012 and December 2014 was conducted. Demographic data, time from ingestion to visit, initial vital signs, symptoms, mental status, medical history, laboratory results, chest radiological findings and co-ingested medications were recorded. Multiple logistic analyses were performed to verify the association between variables and the development of aspiration pneumonia. RESULTS: A total of 249 patients presented to the emergency department with benzodiazepine overdose. Aspiration pneumonia had developed in 24 patients (9.6%). Univariate analysis revealed time from ingestion to visit was longer, Glasgow coma scale score was lower, hypoxia was presented, leukocytosis was shown, types of ingested drugs was high, less activated charcoal was applied and tricyclic antidepressants was taken in patients that developed aspiration pneumonia. Time from ingestion to visit (odds ratio (OR) 1.121, 95% confidence interval (CI), 1.057-1.189, p=0.000), GCS score (OR 0.724. 95% CI, 0.624-0.839, p=0.000), oxygen saturation (OR 0.895, 95% CI, 0.835-0.959, p=0.002), and co-ingestion of TCA (OR 4.595, 95% CI, 1.169-18.063, p=0.029) were identified as risk factors of morbidity of aspiration pneumonia upon multiple logistic regression analysis. CONCLUSION: Time from ingestion to visit, low GCS score, low oxygen saturation and co-ingestion of TCA were risk factors of the development of aspiration pneumonia in benzodiazepine overdose patients.
Anoxia ; Antidepressive Agents, Tricyclic ; Benzodiazepines* ; Charcoal ; Drug Overdose ; Eating ; Emergency Service, Hospital ; Glasgow Coma Scale ; Humans ; Leukocytosis ; Logistic Models ; Oxygen ; Pneumonia ; Pneumonia, Aspiration* ; Retrospective Studies ; Risk Factors* ; Thorax ; Vital Signs