The pathogenicity of Demodex folliculorum (DF) is not well established, becausc this cutaneous parasite can be found very often not only from acneic skin lesions but also on healthy human skin, surface, particularly on sebaceous gland-rich and functionaIly active areas of the skin, i.e. on face, and therefore, the mite has been generally considered as normal inhabitant of human skin. However, as is the case with candidiasis, the parasite could also be pathogenic in the state of disturbed host-para-site relationship. To find out the pathogenicity of the mite, the authors studied the incidence of finding DF from different sites of face in several groups of 60 acneic patients (various types of acne vulgaris and rosacea) and 30 normal subjects as control. And the results obtained were as follows: the mite was found in 33 cases out of the acnei patients (55%), in male patients 67% (12 out of l8) were positive and in fernales 50% (21 out of 42). In the control group of 3O (15 each sex), 17 cases (9 males and 8 females) had thc mite, the incidence rate being 57%, The incidence rate of DF in various types of acneic skin lesions were: 85% in rosacea. 80% in pustular acne 71% in cvstic acne and 32% in papular acne. The distribution of the mite in various sites of the face differed markedly in the acneic and normal groups. In the control group 17 (57 %) were positive on nose, 3 (10%) on cheek, 2 (7%) on chin, and none on the forehead. Among 60 acneic patients, however, 18 (30%) were positive on cheek, 17 (28%) on nose, 15 (25%) on chin 12 (20 %) on forehead. In addition, the acuthors observed two cases of demodicidosis in the dogs. These two dogs were siblings and lived together with other dogs of the same lineage, but the other dogs were not affected. In spite of vigorous treatment with 15 % benzyl benzoate aqueous emulsion and 10 % crotamiton ointment applied topically for two to three weeks, the dogs died within one to two months. Slight improvement only was noted in the first week of the treatment, but the dogs were gradually emaciated, leading to death. At the onset of the disease, both dogs were two to three months old. Histopathological studies of the affected skin revealed dense patchy lymphocytic infiltration predominantly in perifollicular area, follicular keratotic plugging and egg-like materials in the Iumen of hair follicle. Histopathology of the affected canine skin appeared similar to that of human demodicidosis except that the mitelike material was observed lodged in the lumen of hair follicle. The morphology of demodex folliculorum canis seemed slightly different from that of the human strain (DF hominis). It is generally smaller in size and has narrower and shorter stunted abdomen than human strain, otherwise it is almost alike. The human demo3icrdosis can be effectively treated with 15% benzyl benzoate aqueous emulsion, 1% gamma benzene hexachlrode cream and 10 % crotamiton ointment, and it seems to be most effective agent being crotamiton ointment among them. It is suggested that demodex folliculorum, which has been hitherto thought to be harmless, can be pathogenic in certain individuals and that some immunologic factors might be implicated in the process of the demodicidosis.
Abdomen ; Acne Vulgaris ; Animals ; Benzene ; Benzoates ; Candidiasis ; Cheek ; Chin ; Dogs ; Dronabinol ; Forehead ; Hair Follicle ; Humans ; Immunologic Factors ; Incidence ; Male ; Mites ; Nose ; Parasites ; Rosacea ; Siblings ; Skin ; Virulence*

Xeroderma pigmentosum is a hereditary disorder characterized by the ear1y development of pigmentary changes, atrophy, keratoses, and carcinoma, predorninantly light exposed area skin. Two cases of xeroderma pigmentosum complicated. by basal cell Ca. were presented. The one was 15 years old male who had been suffered frorn pea to walnut sized multiple tumors and ulcers on the face with scattered brownish macuIes on the sun exposed area since about 9 years old of his age. The other was 22 years old maIe who had been suffered from the same skin lesions as the former on the face, neck and dorsum of hands. In both cases skin lesions aggravated during each summer seasons and there were on history of convulsions and other neurological symptoms Histopathological findings of tumors on both cases revealed typical findings of basal cell Ca.
Adolescent ; Atrophy ; Child ; Hand ; Humans ; Juglans ; Keratosis ; Male ; Neck ; Peas ; Seasons ; Seizures ; Skin ; Solar System ; Ulcer ; Xeroderma Pigmentosum ; Young Adult

No abstract available.
Breast Neoplasms* ; Breast* ; Oncogenes*

Strongylodiasis is universal in distribution but is most abundant in countries with a tropical climate. Although infestation by Strongyloides stercoralis is usually limited to the intestines, dessemination of this helminth in debilitated host can be lead to death with various clinical disorders. characterized by profound malabsorption, diarrhea, electrolyte imbalance, gram negative or opportunistic fungal sepsis, coma and death. Cell-mediated immunity contributing significantly to the control of helminthic infections, may be suppressed by carcinoma, immunosuppressive chemotherapy and use of corticosteroids. Diagnosis of Strongyloidiasis is achieved by an examination of samples of feces, duodenal aspirates and sputum of patients for Strongyloides stercoralis. Treatment of strongyloidiasis is twofold : correction of the immunosuppressive state by withdrawal of immunosuppressive drug, if possible, and vigorous treatment with thiabendazole. Testing for strongyloidiasis is especially recommanded before treating a patients should be monitored for infection by Strongyloides stercoralis and other opportunistic infection. We are reporting a case patient with Strongyloides stercoralis hyperinfection and pulmonary tuberculosis who had been. used corticosteroid for persisting polyarthritis.
Adrenal Cortex Hormones ; Arthritis ; Coma ; Diagnosis ; Diarrhea ; Drug Therapy ; Feces ; Helminths ; Humans ; Immunity, Cellular ; Intestines ; Opportunistic Infections ; Sepsis ; Sputum ; Strongyloides stercoralis* ; Strongyloides* ; Strongyloidiasis ; Thiabendazole ; Tropical Climate ; Tuberculosis, Pulmonary

No abstract available.
Fistula*

Clinical observations were made on 349 cases of acute drug intoxication who were visited to emergency room of Yeungnam University Hospital during recent 7 years from January 1984 to December 1990. The following results were obtained. 1) Total number of cases of acute drug intoxication was 349 which was 0.39% of the total patients of the emergency room during the same period. 2) The ratio of male to female was 1.1:1. The age incidence was highest in the third decade (26.7%). The monthly incidence was highest in May. Higher frequency was observed in summer season. 3) The most common drug of the intoxication was pesticides and herbicides (71.9%), the remainders were miscellaneous drugs (11.2%), sedatives (7.7%), rodenticides (6.3%) and unknown drug (3.2%) in orders. 4) The most common cause of drug intoxication was suicide (69.1%) and the others were accident, unknown cause, intention in orders. 5) Main clinical manifestations were the impairment of consciousness, nausea, vomiting and convulsion. Physical examination revealed increased pulses, increased blood pressure, miosis of the pupil and sweating. Above symptoms and signs were more prominent in pesticide intoxication. Leukocytosis, glycosuria and abnormal LFT were common findings in acute intoxications. 6) The complications were developed in 18.3% among 349 cases and the most common complication was respiratory failure, pneumonia, cardiovascular collapse and pulmonary edema in orders. 7) Overall mortality rate was 8.3% of total cases and mortality rate was highest in herbicide intoxication (22.2%).
Blood Pressure ; Consciousness ; Emergency Service, Hospital ; Female ; Glycosuria ; Herbicides ; Humans ; Hypnotics and Sedatives ; Incidence ; Intention ; Leukocytosis ; Male ; Miosis ; Mortality ; Nausea ; Pesticides ; Physical Examination ; Pneumonia ; Pulmonary Edema ; Pupil ; Respiratory Insufficiency ; Rodenticides ; Seasons ; Seizures ; Suicide ; Sweat ; Sweating ; Vomiting

OBJECTIVE: In the case of internal carotid-posterior communicating (ICPCom) artery aneurysm it is possible to successfully clip the aneurysmal neck without any difficulty. However, if the aneurysmal neck is wide, the aneurysmal sac is giant, the aneurysmal sac is hidden by the anterior clinoid process (ACP), or its dome is located in ventral portion or low-lying ICPCom aneurysm, it is difficult to open the proximal aneurysmal neck and we encounter a barrier in controlling bleeding in case of premature rupture of the aneurysm. They need to be resected the ACP for successful aneurysmal clipping. We propose angiographic criteria for predicting necessity of resection of the ACP before clipping of the ICPCom artery aneurysm. METHODS: Between 1999 and 2003, 16 patients with ICPCom artery aneurysm were treated with the resection of the ACP prior to applying the clip on the neck of the aneurysm. We retrospectively analyzed the preoperative cerebral angiographies, and the clinical and operative findings. We measured various radiometric parameters to reveal the angiographic characteristics. RESULTS: The mean value of the radiographic measurement in case of the cerebral angiography in 16 patients is as follows: angle A (the angle between the midline of the skull and the axis of the C1 segment on A-P view) ranged from 15 to 80 degrees (mean+/-SD, 42+/-5 degrees), angle B (the angle between the axes of the C1 and C2 segments on A-P view) ranged from 70 to 150 degrees (mean+/-SD, 110+/-15 degrees), and distance C (the distance between the tip of the ACP and the most proximal portion of the aneurysmal neck on the lateral view) ranged from 2 to 9 mm (mean+/-SD, 4.5+/-1 mm). CONCLUSION: We have resected the ACP in 16 of the 40 ICPCom aneurysms. The mean values of angle A, angle B, and distance C is 42+/-5 degrees, 110+/-15 degrees, and 4.5+/-1 mm, respectively. We did not encounter any difficulty in clipping in all the cases in which there was no premature rupture of the aneurysm. Most of cases had a good outcome.
Aneurysm* ; Arteries* ; Axis, Cervical Vertebra ; Cerebral Angiography ; Hemorrhage ; Humans ; Neck ; Retrospective Studies ; Rupture ; Skull

This is a comparative study based on the data of legal autopsies performed at the National Institute of Scientific Investigation, Seoul, during the year of 2000. In South Korea, the pathologists usually do not attend the death scene, and the scene investigation is performed only by the law enforcement agency. The latter collects the information needed for clarifying the cause and manner of death. The authors tried to estimate the efficiency of the death investigation through the discrepancy between the presumed and the most possible cause of death. We presumed the cause of death on the ground of police investigation and external examination by the general physicians, The most possible cause of death means the best diagnosis after autopsy by pathologists, with the consideration of police information. Followings are the summary of the results. The coincidence rate with the most possible death are over 90% in presumed trauma, asphyxia, thermal injuries, electrocution, starvation/neglect, and over 80% in drowning and natural deaths. The rate was low in medical injuries(26.6%) and poisoning(67.2%). 7.3 to 8.2% were natural in presumed blunt trauma, traffic injury and fall down injuries. Among 48 cases of presumed ligature strangulation, 6 were other type of asphyxia or other injuries, and 2 unknown. The coincidence rate was only 30.8% in acute alcohol poisoning. 5.9% of presumed fire death was proved other type of violent injuries. In the field of medical practices, only 6.3% of accused general medical procedures were proved dead due to themselves. But the rate was increased up to 49.0% in presumed surgery/anesthetic deaths. 12.9% were violent death in presumed natural death, and 64.6% were dead due to violent causes in the cases of no presumable cause of death.
Asphyxia ; Autopsy* ; Cause of Death* ; Diagnosis ; Drowning ; Fires ; Humans ; Korea ; Law Enforcement ; Ligation ; Poisoning ; Police ; Seoul

PURPOSE: The purpose of this study was to determine the clinical and pathological risk factors for initial intravesical recurrence in patients following surgery for a transitional cell carcinoma of the upper urinary tract. MATERIALS AND METHODS: 67 patients surgically treated for a transitional cell carcinoma of the upper urinary tract, between 1994 and 2003, were reviewed. We excluded the patients with a concomitant bladder tumor or previous bladder tumor. Traditional prognostic factors, including age, gender, tumor stage, grade, location, multiplicity, structure, size, urine cytology, operation method and adjuvant chemotherapy, were analyzed with respect to disease recurrence to the bladder. RESULTS: The initial intravesical recurrence in patients following surgery for a transitional cell carcinoma of the upper urinary tract was found in 18 patients (26.9%) during a average follow-up period of 23 months (range 6 to 118). A univariate analysis of the 67 patients showed that the tumor stage and grade were significantly correlated with the incidence of a subsequent bladder tumor. On multivariate analysis, the tumor stage had a significant impact on a subsequent bladder tumor. CONCLUSIONS: The tumor stage was an important predictor of recurrence to the bladder in patients treated surgically for a transitional cell carcinoma of the upper urinary tract. For patients with a transitional cell carcinoma of the primary upper urinary tract, regular follow-up by cystoscopy and urine cytology are necessary for the detection of recurrent bladder tumors.
Carcinoma, Transitional Cell* ; Chemotherapy, Adjuvant ; Cystoscopy ; Follow-Up Studies ; Humans ; Incidence ; Multivariate Analysis ; Recurrence ; Risk Factors* ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urinary Tract*

PURPOSE: The purpose of this study is to analyze the CT features of the cystic masses in the neck and to review differential diagnosis. MATERIALS AND METHODS: We retrospectively reviewed and analyzed the CT findings of 22 histopathologically proved, cystic neck masses in regard to the location in fascial plane and relationship with adjacent organ. RESULTS: Of 22 cases, ten congenital cysts two ranulas, seven inflammatory lesions, and three solid tumors were includded. Ten congenital cystic masses were located in typical locations as branchial cleft cyst(5) in mandibular angle, thyroglossal duct cyst(3) in visceral space embeded within the strap muscles, cystic hygroma(1) and cavernous hemangioma(1) in posterior cervical space with insinuating appearance. Two cases of ranula included one simple ranula localized in sublingual space and a plunging ranula extending to adjacent submandibular space. Seven cases of inflammatory lesions were characterized by multispatial locations and good contrast-enhancement of walls and adjacent tissue. Solid masses of low density mimicking cyst were two pleomorphic adenomas of submandibular gland and one neurilemmoma. CONCLUSION: It is considered that thorough analysis of the CT findings with attention to typical location, CT appearance, and the relationship with the adjacent structures usually leads to the correct diagnosis.
Adenoma, Pleomorphic ; Branchial Region ; Diagnosis ; Diagnosis, Differential* ; Muscles ; Neck* ; Neurilemmoma ; Ranula ; Retrospective Studies ; Submandibular Gland