Two cases of vitiligo-type hypomelanosis followed by the local application of Benoquin ointment for the treatment for the treatment of melasma are reported. These two cases of hypomelanosis are unwanted and unintended side effects probably caused by the application of monobenzyl ethers of hydrcquinone (monobenzone). Monobenzone blocks the enzyme tyrosinase and thereby prevents the conversion of tyrosine to dihydroxyphenylanine, a precursor of melanin, and since this does not destroy melanocyte or facilitate the loss of melanin. The skin contact with the material will not occur, repigmentation will slow but eventuaIly complete.
Ether ; Ethers ; Hypopigmentation* ; Melanins ; Melanocytes ; Melanosis ; Monophenol Monooxygenase ; Skin ; Tyrosine ; Vitiligo*

This study was carried out to investigate the intricate mechanisms of intraalveolar fibrosis, leading to the alveolar structural remodeling, of rat lungs treated with paraquat. Sixty-three male Sprague-Dawley rats, maintained on a stock diet, weighing 200.0 gm, average, were divided into 4 experimental groups. Group 1. Control group (10 rats). Intraperitoneal injections of 2-4 ml normal saline only. Group 2(13 rats). 10, 20, 25, 30 and 40 mg per kg of body weight was administered intraperitoneally. Animals were sacificed 5 hours. 1 and 3 days after paraquat treatment. Group 3(16 rats). 20, 25, 30 and 40 mg per kg of body weight was administered to the animal, and animals died 2-5 days after paraquat administration. Group 4(24 rats). The same amount of paraquat was administered to the animal as in the group 2. Animals were sacrificed 1, 2, 6, 8 and 10 weeks after paraquat treatment. Sacrificed animal lung was examined by gross, light-microscopic, immunohistochemical, ultrastructural observation, along with cellular and chemical analyses of bronchoalveolar lavage fluid. The results were as follows: Grossly, 6 rats of chronic stage (1-10 weeks survival) developed multiple wedge-shaped scars on both lungs. These scars were situated mainly along the bronchial trees, blood vessels and subpleural regions. Light microscopically, the salient features found of the chronic stage lungs were intraalveolar fibrosis. Intraluminal buds or polypoid masses projecting into the alveolar lumen and ducts. Elsewhere, loose connective tissue masses were found to fuse together to alveolar wall, obliterating the alveolar spaces with resultant severe alveolar structural remodeling. Immunohistochemically, fibronectin was found in the center of intraalveolar buds and polypoid mass, projecting into the alveolar lumen, and in the adjacent proliferating alveolar macrophages. An attempt to measure the amount of fibronectin in the bronchoalveolar lavage fluid failed. Electron microscopically, the chronic stage lung revealed marked proliferation of both alveolar macrophages and fibroblasts in the alveolar spaces, the latter containing actin-like microfilaments and collagen fibers arranged in bundles and spirals. In areas, myofibroblasts and smooth muscle cells also present. Cellular analysis of the bronchoalveolar lavage fluid in chronic stage lungs revealed no significant findings. It can be concluded, therefore: That intraalveolar fibrosis of the paraquat-treated lungs of the rat is probably mediated by intraalveolar migrations of the interstitial cells, the main task force being the connective tissue cells, passing through the defects created in the epithelial lining surface to its basement membrane, which were inflicted upon the alveolar wall by paraquat toxicity. Fibronectin, released by activated alveolar macrophages, may be responsible for the migrations of fibroblasts and myofibroblasts into the alveolar spaces to form the intraalveolar fibrosis with subsequent alveolar structural remodeling,
Male ; Humans ; Rats ; Animals

We performed immunohistochemical stain of p-glycoprotein using JSB-1 monoclonal antibody to study multidrug resistant(MDR) gene expression in 137 gastric tumor tissues obtained from 87gastric carcinoma patients. The incidence of p-glycoprotein expression was 60 of 87 cases(69%) and it was not correlated with age, sex, depth of tumor invasion, and lymph node metastasis, but was correlated with histologic type of gastric adenocarcinoma. The distribution of p-glycoprotein positive cells in the tumor tissue was diffuse in 34 cases(73.9%) and focal in 12 cases(26.1%), and the dominant staining patterns of p-glycoprotein in the tumor cells were cytoplasmic and golgi staining in 20 cases(43.5%) and 19 cases(41.3%), respectively, and 7 cases(15.2%) showed fine granules in the cytoplasm. The incidence of p-glyco-protein expression in the tumor tissue was higher in A and AB blood type patients who have A antigen than in 0 and B blood type patients. Cytoplasmic staining pattern was dominant in O and B blood types and golgi staining in A and AB blood type patients. Among 27 patients 'who received chemotherapy, partial remission was noted in 9 of 11 p-glyco-protein negative patients(81.8%) and no remission or progression of the tumor was seen in 9 of 16 p-glycoprotein positive patient(56.3%). The p-glycoprotein expression in gastric carcinoma had no direct correlation with known several prognostic factors of the gastric tumor except for histologic type, and it is supposed that p-glycoprotein detection in gastric tumor tissue by immunohisto-chemical stain is a good method for predicting the response of chemotherapy, especially in p-gly-coprotein negative cases.
Incidence

No abstract available.
Leukemia, Hairy Cell*

Five cases of intracranial lipoma diagnosed by MR are presented. MR imaging was performed on a 0.2T permanent unit using T1 weighted, proton density-weighted, and T2 weighted spin echo sequences. In two patients, gadolinium-enhanced T1 weighted image was also obtained. The lipomas were located dorsolaterally to the splenium of the corpus callosum (n=1), inferior to the splenium (n=2), in quadrigeminal plate(n=1) and in the presumed corpus callosum area in the case of agenesis of corpus call?um (n=1). The size and shape of the lipomas were variable. No contrast enhancement was seen in post contrast study. Sagittal T1 weighted image appeared to be the most useful imaging plane for the demonstration of the relationship between the lipoma ad the adjacent normal structures. The Homogenous signal intensity paralleling the fat signal and the characteristic location of the lesion are considered to be helpful in the differential diagnosis from dermoid cyst or teratoma.
Corpus Callosum ; Dermoid Cyst ; Diagnosis, Differential ; Humans ; Lipoma* ; Magnetic Resonance Imaging* ; Protons ; Teratoma

Five cases of intracranial lipoma diagnosed by MR are presented. MR imaging was performed on a 0.2T permanent unit using T1 weighted, proton density-weighted, and T2 weighted spin echo sequences. In two patients, gadolinium-enhanced T1 weighted image was also obtained. The lipomas were located dorsolaterally to the splenium of the corpus callosum (n=1), inferior to the splenium (n=2), in quadrigeminal plate(n=1) and in the presumed corpus callosum area in the case of agenesis of corpus call?um (n=1). The size and shape of the lipomas were variable. No contrast enhancement was seen in post contrast study. Sagittal T1 weighted image appeared to be the most useful imaging plane for the demonstration of the relationship between the lipoma ad the adjacent normal structures. The Homogenous signal intensity paralleling the fat signal and the characteristic location of the lesion are considered to be helpful in the differential diagnosis from dermoid cyst or teratoma.
Corpus Callosum ; Dermoid Cyst ; Diagnosis, Differential ; Humans ; Lipoma* ; Magnetic Resonance Imaging* ; Protons ; Teratoma

No abstract available.
Neuroblastoma*

Background: The purpose of this study was to identify factors inhibiting access of people with disability to health check-ups as well as identify pertinent solutions for improvement. Methods: Twenty-three people with disability older than the age of 19 who took respective health check-ups within the last 3 years were selected as participants. For the data collection, the 1:1 intensive interview was used. The data were analyzed by the grounded theory by Corbin and Strauss. Results: The results comprised nine categories, 23 subcategories, and 179 concepts. The central phenomenon was ‘failure to obtain check-ups.’ Causal conditions were observed as a ‘lack of communication method,’ ‘physical difficulties,’ and ‘staff unfamiliar with people with disability,’ Interventional conditions comprised ‘physical accessibility,’ ‘staffs’ competency,’ and ‘assistant manpower.’ The active strategy was included ‘to investigate the professional medical institution,’ ‘to find the medical institution of convenient traffic accessibility,’ ‘to overcome communication difficulties through equipment,’ and ‘to overcome linguistic barriers through sufficient communication.’ Whereas, ‘utilization of ancillary equipment,’ ‘the education of staffs on people with disability,’ ‘universal design manual,’ and ‘customized check-ups’ were included in the passive strategy. Such processes arose in the contextual conditions of ‘lack of expectations for daily lives’ and ‘lack of government support.’ As a consequence, the subjects participated experienced the ‘disadvantages,’ ‘discrimination,’ and ‘reduced reliability of the health check-ups.’ Conclusion The subjects who participated in this study emphasized ‘staffs familiar with people with disability’ and ‘systems customized for people with disability’ are mandatory to secure complete health check-ups for people with disability.

BACKGROUND: Idiopathic left ventricular tachycardia with a QRS pattern of right bundle branch block and left axis deviation that is sensitive to verapamil is electrophysiologically distinct arrhythmia entity but descriptions in pediatric ages are infrequent. This study attempted to describe the clinical presentation and dignostic clues from the surface ECG in children with idiopathic left venteicular tachycardia. METHODS: We retrospectively reviewed the medical records, electrocardiograms, Holter recordings, echocardiographic reports of 10 children with idiopathic left ventricular tachycardia who have been managed at Sejong General Hospital and Asan Medical Center, Seoul, Korea from January 1991 to July 1996. Follow-up periods are 2 months to 5 years(mean=26 months). RESULTS: 1) Age of tachycardia onset was 8 months to 14 years(median=4.3 years). In 3 children tachycardia began from infancy. The main complaint in older children was palpitation and chest discomfort but young childen complained abdominal pain during tachycardia attack. Tachycardia was paroxysmal and sustained. Tachycardia responded to intravenous use of verapamil in 9 patients and was controlled by chronic verapamil medication in 6 patients. 2 patients were well without medication. Radiofrequency catheter ablation was done in an adolescent patient successfully. 2) In sinus rhythm, surface ECG showed normal QRS axis and normal QRS morphologies in all patients. During ventricular tachycardia, the heart rate was 183 to 270 beats/min. The taxhycardia of RBBB morphology was observed in all patients. The mean QRS duration was 109+-12ms and the QRS axis was -50* to -90*. Themean RS interval was 60+-12ms. AVdissociation was found on surface RCG in all patients and confirmed in 4 patients by transesophageal ECG. We tried rapid transesophageal atrial pacing in 3 patients and could induce and terminate the ventricular tachycardia. CONCLUSIONS: Idiopathic left ventricular tachycaedia is rare in childhood and is seen from infancy. Idiopathic left ventricular tachycardia is generally benign but occasionally causesmyocardial dysfunction. Idiopathic ventricular tachycardia with a QRS pattern of right bundle branch block amd left axis deviation that is sensitive to verapamil in children should not be confused with supraventricular tachycardia with aberrancy and most helpful diagnostic clue is AV dissociation in surface ECG.
Abdominal Pain ; Adolescent ; Arrhythmias, Cardiac ; Axis, Cervical Vertebra ; Bundle-Branch Block ; Catheter Ablation ; Child ; Chungcheongnam-do ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Rate ; Hospitals, General ; Humans ; Korea ; Medical Records ; Retrospective Studies ; Seoul ; Tachycardia ; Tachycardia, Supraventricular ; Tachycardia, Ventricular* ; Thorax ; Verapamil

Pseudoangiomatous stromal hyperplasia (PASH) of the breast occurs in premenopausal women and is characterized by anastomosing channels lined by spindle cells. It has been suggested to be of hormonal origin. This unusual condition may also be mistaken for a vascular tumor. We analyzed eight cases of PASH of the breast in Samsung Cheil Hospital from 1992 through 1998. All patients were premenopausal and had painless breast lump. Clinical diagnoses were fibroadenomas. Grossly, the masses were well circumscribed, nonhemorrhagic and measure 2.2 to 5 cm. Histologically, they consisted of complex interanastomosing channels lined by slender spindle cells, which resembled low grade angiosarcoma. Cells that line the interanastomosing channels showed no immunoreactivity for Factor VIII and electron microscopic findings consistent with fibroblast. All patients were treated with surgical excision and none of them had recurrence for 1 to 69 months (mean: 19 months) postoperatively. Pathologic diagnosis of PASH may be difficult unless the pathologists are aware of the presence of a mass lesion and appreciate the characteristic stromal changes. PASH should be included in the differential diagnosis of a circumscribed mass, especially in the premenopausal women.
Breast* ; Diagnosis ; Diagnosis, Differential ; Factor VIII ; Female ; Fibroadenoma ; Fibroblasts ; Hemangiosarcoma ; Humans ; Hyperplasia* ; Recurrence