Torsion of a mucocele of the vermiform appendix is an extremely rare condition and also a rare cause of an acute abdomen with a clinical presentation that is indistinguishable from acute appendicitis, and thus, the condition is diagnosed during operation. Here, the authors describe the case of a 78-year-old female, who presented with intermittent abdominal pain. The appendix had a pelvic position and the torsion was counterclockwise. In addition, the torsion was associated with mucocele of the appendix, which was considered a secondary factor of torsion. Appendectomy and drainage were performed.
Abdomen, Acute ; Abdominal Pain ; Aged ; Appendectomy ; Appendicitis ; Appendix ; Drainage ; Female ; Humans ; Mucocele ; Torsion Abnormality

Primary signet ring cell carcinoma of the prostate is extremely rare and about 18 cases have been reported in the literature. We report two cases of primary signet ring cell carcinoma of the prostate, arising in 79-year-old and 65-year-old men. Both cases were the poorly differentiated adenocarcinoma of the prostate with many signet ring cells. Signet ring cells were positive for prostatic specific antigen and prostatic acid phosphatase but negative for neutral and acid mucins. In summary, the signet ring cell carcinoma of the prostate is a rare variant of poorly differentiated adenocarcinoma of the prostate. The orgin of the prostate should be considered in cases of metastatic signet ring cell carcinoma, particularly when the signet ring cells are negative for neutral and acid mucins. Prostatic specific antigen and prostatic acid phosphatase should also be performed to confirm the primary signet ring cell carcinoma of the prostate.
Acid Phosphatase ; Adenocarcinoma ; Aged ; Carcinoma, Signet Ring Cell* ; Humans ; Male ; Mucins ; Prostate*

The diagnostic importance of finding an appendicolith in the plain x-ray of the abdomen has been well documented. However, most of the papers so far published have stressed x-ray findings of the preoperative abdomenin acute appendicitis. In the present study we have attempted to correlate incidences of appendicoliths insurgical specimen and plain x-ray of the abdomen. The materials were 37 surgical specimens of the appendix removed for acute appendicits at St. Mary's Hospital, St. Paul's Hospital, Kang Nam Hospital, Holy Family Hospital and Our Lady of Mercy Hospital of Catholic Medical College during the period of 6 months from August 1980. Each surgical specimen was subjected to soft tissue radiography to detect calcified appendicolith. Then the preoperative x-raysof abdomen were retrospectroscopically analysed for the presence of radiographically demonstrable appendicoliths.Our study revealed that in as many as 32% of 37 surgical specimens one or more calcified appendicoliths were demonstrated radiographically whereas only one of these was identified as such in the preoperative x-ray film ofthe abdomen. Such a great discrepancy between the incidences of appendicoliths in the surgical specimen andpreoperative x-ray films of the abdomen are ascribed to (1) relative smallness of appendicoliths (87% of the stones measured less than 1cm in diameter in radiographs of surgical specimen in our series), (2) overlapping of these small stones on the right iliac bone and (3) underpenetrating of the iliac bone area in x-ray films of theabdomen. For improving detctability of appendicoliths therefore it is recommended that the technique of radiography of plain abdomen should be such that a small appendicolity overlying the iliac bone can be brought outof trabecular shadows.
Abdomen ; Appendicitis ; Appendix ; Humans ; Incidence ; Radiography ; X-Ray Film

Aspergillosis is a rare disease of fungal infection produced by the genus Aspergillus in immunocompromised patients. It mainly involves the lung and may disseminate by invasion of biood vessels into the gastrointestinal tract. Brain and kidney. We report a case of the disseminated aspergillosis in malignant lymphoma affecting the lung. Brain and thyroid gland.
Aspergillosis* ; Aspergillus ; Brain ; Gastrointestinal Tract ; Immunocompromised Host ; Kidney ; Lung ; Lymphoma* ; Rare Diseases ; Thyroid Gland

Twenty-nail dystrophy is an idiopathic nail dystrophy in which all twenty nails are uniformly and simultaneously affected with excess longitudinal ridging and loss of lustre. The pathogenesis is controversial, and the treatment is unsuccessful. It is thought to have a self-limiting and reversible nature when it develops in childhood, but in adults, it is unusual and exists persistently. We re-port here two cases of adult patients with dystrophy of all twenty nails, whose ages were 58 and 55. The disease had been present for one year and may be associated with alopecia areata in the 58 year old and an idiopathic condition in the 55 year old. Negative results were obtained on mycological studies. Biopsies taken from the nail bed revealed marked hyperkeratosis consistent with nail dystrophy.
Adult ; Alopecia ; Alopecia Areata ; Biopsy ; Humans

BACKGROUND: The keratinocyte growth factor(KGF) is a recently identified mitogen for epithelial cells produced by nomal stromal fibroblasts. ln the skin, KGF has been shown to stimulate keratinocyte proliferation and differentiatian. Dendritic epidermal T cells(DETC) are skin-specific members of the epithelial y 8 T-cell family that reside normally in the murine epidermis. The DETCs recognize antigen expressed by damaged or diseased neighboring keratinoctyes and consequently secrete cytokines sueh as IFN- y, lL-2, IL-4, GM-CSF. OBJECTIVE: The purpose of this study was to observe the expression of KGF mRNA in keratinocyte and DETC as well as to investigate the cytokine-mediated intercellular communication between kerati- nocyte and DETC. METHODS: Using a RT-PCR(reverse transcription-polymerase chain reaction), we examined the expression of KGF mRNA in keratinocyte and DETC, and compared the level of KGF mRNA between resting and activated DETC with Con-A (concanavalin A).
Cytokines ; Epidermis ; Epithelial Cells ; Fibroblast Growth Factor 7* ; Fibroblasts ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Interleukin-4 ; Keratinocytes* ; RNA, Messenger* ; Skin ; T-Lymphocytes

A case of a 21-year old female with Maffucci's syndrome is presented where the patient developed multiple cutaneous spindle-cell hemangioendotheliomas. She had multiple pea to walnut sized, non-tender, normal skin colored or slight bluish nodules and bony mass-like lesions on the left upper extremity and hand. A histological examination of the lesions showed that they were composed of irregularly dilated, thin walled cavernous blood spaces containing phleboliths and collapsed vascular spaces separated by spindled fibroblastic cells. Radiologically, the bony lesions showed radiolucent densities with calcified spots within the second proximal phalanx and metacarpal bone of the left hand, which were consistent with enchondromas.
Chondroma ; Female ; Fibroblasts ; Hand ; Hemangioendothelioma* ; Humans ; Juglans ; Peas ; Skin Pigmentation ; Upper Extremity

We report a case of infantile digital fibromatosis in a 34 month-old boy, who presented with a painless subcutaneous tumor on the medial aspect of the left third toe. A histological examination showed scattered small, round eosinophilic inclusion bodies in the cytoplasm of the tumor cells, which was consistent with infantile digital fibromatosis. A'immunohistochemical study revealed that desmin, a-smooth muscle actin, and vimentin were clearly positive in the cytoplasm of the tumor cells, but the inclusions themselves showed negative staining, thus indicating a hollow-like staining pattern. Electron microscopy showed either well-defined or ill-demarcated dense bodies in the cytoplasm of the tumor cells. In some areas, small vesicles and intracellular organells were observed' in the inclusions. In the course of conservative treatment, a new lesion developed on the lateral aspect of the left third toe, seven months after the appearance of the initial lesion.
Actins ; Cytoplasm ; Desmin ; Eosinophils ; Fibroma* ; Humans ; Inclusion Bodies ; Male ; Microscopy, Electron ; Negative Staining ; Toes ; Vimentin

We report a case of porokeratosis of Mibelli coexistence with linear porokeratosis in a 28-year old male. He had multiple discrete reddish to brownish annular plaques with peripheral keratotic ridges on the left side of the neck and axilla, and such lesions extended in a linear fashion on the left side of the upper arm and posterior aspect of the lower extremity. The cutaneous lesions started on the left neck and axilla about 6 years prior to consultation. Two years after that, new lesions developed on the left side of the upper arm and lower extremity in a linear fashion. There was no family history of similar skin disorders. A histological examination showed cornoid lamellae in the horny layer. Hypogranulosis, dyskeratotic cells and perivascular mononuclear in-filtrations were also seen beneath the cornoid lamella.
Arm ; Axilla ; Humans ; Lower Extremity ; Male ; Neck ; Porokeratosis* ; Skin

Adenoid basal cell tumor of the prostate is a rare tumorous lesion that can be misdiagnosed as adenocarcinoma of the prostate. The malignant potential of adenoid basal cell tumor remains uncertain due to small number of reported cases. This 66-year-old man presented with symptoms of urinary tract obstruction. Under the impression of benign prostatic hyperplasia, a transurethral resection of the prostate (TURP) was performed. The patient was alive with no evidence of recurrence or metastasis 15 months after TURP. Microscopically, most of the lesions were composed of nodular collections of small nests of basaloid cells with peripheral palisading, and clusters of tumor cells forming cribriform pattern. Multiple areas of basal cell hyperplasia and atypical basal cell hyperpalsia were also observed. The coexistence of basal cell hyperplasia, atypical basal cell hyperpalsia, and adenoid basal cell tumor with cribriform pattern in this case supports a morphologic continuum from the benign hyperplastic lesion to malignant neoplasia.
Adenocarcinoma ; Adenoids* ; Aged ; Humans ; Hyperplasia ; Neoplasm Metastasis ; Prostate* ; Prostatic Hyperplasia ; Recurrence ; Transurethral Resection of Prostate ; Urinary Tract