No abstract available.
Toes*

The combination of dacryocystography and computed tomography have been called as computed tomographic dacryocystography. The authors carried out computed tomographic dacryocystography using water soluble contrast media, Rayvist(R), in two patients with a mass around the lacrimal fossa. This radiologic technique demonstrated that the lacrimal system was not invaded by the tumor and was helpful in planning the surgical approach. The results of excisional biopsy of the mass revealed an epidermoid cyst in both cases.
Biopsy ; Contrast Media ; Epidermal Cyst ; Humans

Cysts of accessory lacrimal gland are rare. They are generally retension cysts that result from obstruction of the excretory duct and are found between the palpebral conjunctiva and the levator aponeurosis. We experienced three cases of subconjunctival cyst in the upper fornix. Histopathological examination showed the cysts lined by two layers and occasionally one layer of epithelium. These cysts seem to be originated from Krause's gland, considering their anatomical location and histopathological findings.
Conjunctiva* ; Epithelium ; Lacrimal Apparatus

Angiomyolipoma(AML) of the liver is a rare benign tumor; about 60 cases, almost solitary, have been reported. We present here a extremely rare case of multiple AML in the liver diagnosed by fine needle aspiration cytology (FNAC). Two large masses were found in a 51 year-old woman complaining of abdominal discomfort by computed tomography and several smaller masses are scattered in the liver. FNAC was performed, showing bundles of spindle shaped smooth muscle cells intermingled with mature fat cells. FNAC may be a valuable method for definitive diagnosis of hepatic AML. The diagnosis was further confirmed by histologic examination with immunohistochemical studies.
Adipocytes ; Angiomyolipoma* ; Biopsy, Fine-Needle* ; Diagnosis* ; Female ; Humans ; Immunohistochemistry ; Liver* ; Middle Aged ; Myocytes, Smooth Muscle

An one-day-old female patient was admitted due to marked abdominal distension, cyanosis, right upper quadrant mass, and respiratory failure since birth. We applied ventilator and supportive care immediatly. However, 4 days later, she was dead due to respiratory failure and hemorragic complication. The radiographic finding showed a huge intra-abdominal mass anterior to the intestine. Autopsy findings showed a huge single cystic tumor in the right lobe of the liver. The cysts were filled with sanguinous fluid. There wasn't any signs of necrosis or calcification. Microscopically, the tumor was well demarcated from the adjacent hepatic parenchyma. It consists of connective tissue with dilated lymphatics, vessels, and bile ducts.
Autopsy ; Bile Ducts ; Connective Tissue ; Cyanosis ; Female ; Hamartoma* ; Humans ; Intestines ; Liver ; Necrosis ; Parturition ; Respiratory Insufficiency ; Ventilators, Mechanical

Leber's hereditary optic neuropathy (LHON) is an important cause of bilateral optic neuropathy in youth and occasionally associated with other neurological abnormalities (Leber's plus). The authors recently found out one family of LHON and another patient of Leber's plus with mitochondrial DNA (mtDNA) 11778 mutation. The presence of a point mutation of mtDNA was investigated by restriction length fragment polymorphism. Among 14 patients who had mtDNA 11778 mutation in the family, only two men had bilateral optic neuropathy. The other was a man of optic neuropathy with myelopathy. The age at onset of visual loss ranged from 14 to 25 (average 19.7). The time delay between involvement of the two eyes was I to 3 months Central visual field defect was observed in each of all affected eyes and worse in the earlier affected. The brain MRI and CSF studies revealed no abnormality. This study showed that the clinical manifestations and genealogical features of LHON in our patients are similar to those of previously reported cases in other countries.
Adolescent ; Brain ; DNA, Mitochondrial* ; Humans ; Magnetic Resonance Imaging ; Male ; Optic Atrophy, Hereditary, Leber ; Optic Nerve Diseases ; Point Mutation ; Spinal Cord Diseases ; Visual Fields

Grover disease (GD), also referred to as transient or persistent acantholytic dermatosis, is an acquired pruritic papular or papulovesicular eruption characterized histopathologically by focal acantholysis and dyskeratosis. Because GD resembles several generalized papular diseases, the diagnosis of GD is a clinical challenge, particularly when dermatologists meet patients without papular eruptions. We experienced two elderly men showing eczematoid plaques with severe pruritus on their backs. Histopathological examinations revealed a focal acantholysis, spongiosis, and dyskeratosis, a pattern consistent with GD. We report two cases of GD with clinical features of nonspecific eczematous dermatosis.
Acantholysis ; Aged ; Diagnosis ; Humans ; Male ; Pruritus ; Skin Diseases*

Grover disease (GD), also referred to as transient or persistent acantholytic dermatosis, is an acquired pruritic papular or papulovesicular eruption characterized histopathologically by focal acantholysis and dyskeratosis. Because GD resembles several generalized papular diseases, the diagnosis of GD is a clinical challenge, particularly when dermatologists meet patients without papular eruptions. We experienced two elderly men showing eczematoid plaques with severe pruritus on their backs. Histopathological examinations revealed a focal acantholysis, spongiosis, and dyskeratosis, a pattern consistent with GD. We report two cases of GD with clinical features of nonspecific eczematous dermatosis.
Acantholysis ; Aged ; Diagnosis ; Humans ; Male ; Pruritus ; Skin Diseases*

Melanosis ilei is an extremely rare condition in which black pigment, consisted of aluminum, magnesium, or silicon, accumulate in the terminal ileal mucosa. Medical treatment with charcoal enhances the neutralization of the toxic material and elimination of many drugs. In addition, it has been used as a traditional remedy in some oriental countries to relieve chronic diarrhea, abdominal pain, or acute enterocolitis, which is made up carbon, oxygen, aluminum, magnesium, silicon, calcium, and palladium. Two patients taking the charcoal for a long time underwent a colonoscopy to evaluate chronic diarrhea or abdominal pain. The colonoscopy revealed a normal colonic mucosa and multiple geographic black-pigmented mucosal changes at the terminal ileum. Therefore, it was assumed that melanosis ilei can develop in patients with long-standing charcoal ingestion. To the best of our knowledge, this is the first case of melanosis ilei associated with the ingestion of charcoal.
Abdominal Pain ; Aluminum ; Calcium ; Carbon ; Charcoal ; Colon ; Colonoscopy ; Diarrhea ; Eating ; Enterocolitis ; Humans ; Ileum ; Magnesium ; Melanosis ; Mucous Membrane ; Oxygen ; Palladium

BACKGROUND: Introduction of a pneumoperitoneum using CO2 is accompanied by significant alterations in respiratory function and pulmonary gas exchange during laparoscopic cholecystectomy. Previous studies have shown differing results concerning pulmonary gas exchange: a significant decrease of PaO2 was induced with isoflurane. In contrast, no significant changes were observed with propofol. The purpose of the present study was to compare the effects of propofol vs isoflurane on pulmonary gas exchange during general anesthesia for laparoscopic cholecystectomy. METHODS: Forty patients were divided randomly between isoflurane and propofol groups. After induction of anesthesia, ventilation was controlled and intra-abdominal pressure was maintained automatically at 12 mmHg by a CO2 insufflator. After the measuring of baseline values of blood pressure, heart rate, PaO2, PaCO2 and PetCO2 before CO2 insufflation, measurements were also made immediately, 30min after CO2 insufflation and 5 min after CO2 exsufflation. RESULTS: In the isoflurane group, PaCO2, PetCO2, PaO2, and P(a-et)CO2 changed significantly 30 min after CO2 insufflation and 5 min after CO2 exsufflation (P < 0.05). In the propofol group, PaCO2 and PetCO2 increased significantly 30 min after CO2 insufflation and 5 min after CO2 exsufflation (P < 0.05), but PaO2 and P(a-et)CO2 remained constant. When the two groups were compared, there were significant differences in PaO2, PaCO2, PetCO2 and P(a-et)CO2 at 30min after CO2 insufflation and 5 min after CO2 exsufflation (P < 0.05). CONCLUSIONS: These results indicate that during laparoscopic cholecystectomy the PaO2 was significantly lower and PaCO2 and P(a-et)CO2 were significantly higher in the isoflurane group compared with the propofol group.
Anesthesia* ; Anesthesia, General ; Blood Pressure ; Cholecystectomy, Laparoscopic* ; Heart Rate ; Humans ; Insufflation ; Isoflurane* ; Pneumoperitoneum ; Propofol* ; Pulmonary Gas Exchange ; Ventilation