Squamous cell carcinoma of the lower lip can be developec by a number of underlying etiologic factors, the most outstanding of which is solar irracdiation, and is considerably more aggresive and has a much higher incidence of metastatic spread. Its early detection and effective treatment afford a high cure rate. Cryosurgery is a simple, efficient and effective method of treatment of skin cancer and is now a widely accepted modality for the treatment of these lesions. Two patients(67-year-old male and 57-year-old female) were presented with solitary or two masses on the lower lip without regional lymphadenopathy. These two cases showed clinical and histopathologic findings of squamous cell carcinoma. They were successfully treated by cryotherapy with liquid nitrogen without any significant side effects.
Carcinoma, Squamous Cell ; Cryosurgery ; Cryotherapy ; Humans ; Incidence ; Lip* ; Lymphatic Diseases ; Male ; Middle Aged ; Nitrogen* ; Skin Neoplasms

Leukemia cutis is defined as infiltration of the skin by malignant leukocytes that have originated from the bone marrow. The cutaneous eruption of leukcmia may be divided into the specific and non-specific lesion (leukemid). These may occur separately or in combination. True leukemia infiltrations of the skin consist of nodular, diffuse, or plaque-like infiltrations with swelling, macules, papules, ecchymoses, palpable purpura, erythroderma, and ulceration. A 55-year-old man presented with multiple as mptomatic dark-brown nodules on the whole body with recurrent gingival bleeding. The patient developed seoticemia and died 6 months after the onset of the disease.
Bone Marrow ; Dermatitis, Exfoliative ; Ecchymosis ; Hemorrhage ; Humans ; Leukemia* ; Leukocytes ; Middle Aged ; Purpura ; Skin ; Ulcer

Histoid leproma usually occur in pat.ients with lepromatous leproy who have had relapsed after being undcr treatment(usually sulfones) for a long time and who have shown variable improvement. A 56 year old female patient who had been suffering from lepromatous leprosy and had been treated which clapsone relatively regularly for approximately 28 years had a history of several shiny rice grain t.o peanut sized nodules on the face and right flank. Histopathologic examination of a specimen taken from a nodular lesian revealed a well circirmscrihed nodule composed mainly of spindle-shaped cells and epithe:ioi 1 cells on the upper and mid-levmis, and granuloma composed of epithelioid cells, multinucleated wait cells and foamy histiocytes on the lower dermis. In AFB stain, numerous acid-fast bacilli were scatt red dermis and epidermis, especially stratum corneum. This study opplied a polymease chain reaction(PCR) on sections of biopsy tissues and peripheral blood of pat.ient. Positive amplification of a 530 bp fragment was deteated not only in the lesion tissues but also in the per ipher al blood.
Biopsy ; Edible Grain ; Dermis ; Epidermis ; Epithelioid Cells ; Female ; Granuloma ; Histiocytes ; Humans ; Leprosy, Lepromatous ; Middle Aged ; Mycobacterium leprae* ; Mycobacterium* ; Polymerase Chain Reaction*

BACKGROUND: Several reports have demonstrated that TGFalpha and EGF are mitogenic for keratinocytes. Whenther its expression on epithelial tumors is a marker of malignancy or signifies an important step in the development of neoplasia is poorly understood. EGF receptors are also present in normal epidermis and epithelial tumors but their physiological roles are not yet understood. OBJECTIVE: Our purpose was to examine the staining patterns of TGFalpha, EGF and EGF receptors on the npithelial tumors of the skin, and to investigate kinetics of expression of EGF receptors. METHODS: We performed immunoperoxidase staining(ABC technique) with monoclonal anti-TGFalpha antibody, polyclonal anti-EGF antibody and polyclonal anti-EGF receptor antibody on the formalinfixed, paraffin-embedded tissue specimens of benign, premalignant and malignant skin tumors. RESULTS: The density of the expression of TGFalpha and EGF was not correlated with the degree of the malignancy of the epithelial tumors and is neither constant in any kind of the tumors. However the infiltrative type of basal cell carcinoma(BCC) is stronger that its solid type on the expression of TGFalpha and EGF. All benign tumors demonstrated a diffuse pattern within tumor lobules. pression of TGFalpha and EGF. All benign tumors demonstrated a diffuse pattern within tumor lobules. Focal TGFalpha immunostaining was seen in three of 10 squamous cell carcinomas(SCC) and four of 10 BCCs. TGFalpha immunostaining was absent from the outermost one to two layers of tumor lobules of all keratoacanthomas. The specimens which increased the expression of TGFalpha and EGF tended to decrease the expression of EGF receptor. CONCLUSION: These data suggest that the density of immunohistochemical expression of TGFalpha and EGF may be not dependent on the differentiation of tumor cells, and the pattern of immunohistochemical expression of TGFalpha can differentiate SCC from benign tumors such as keratoacanthoma. FGF receptor may be occupied by both of TGFalpha and EGF. With the receptors being occupied, a down regulation of the receptors may occur which results in decreased EGF receptor expression.
Down-Regulation ; Epidermal Growth Factor* ; Epidermis ; Keratinocytes ; Keratoacanthoma ; Kinetics ; Receptor, Epidermal Growth Factor* ; Receptors, Fibroblast Growth Factor ; Skin* ; Transforming Growth Factor alpha*

No abstract available.
Rehabilitation* ; Stroke*

BACKGROUND: Endocrine pancreas tumor is a rare disease which incidence is less than 2% of all pancreatic tumors. But it comprises various types of tumor and usually secretes several hormones from one type of tumor although the patient with this tumor complains of sole symptom associated with only one hormone. The mechanism and clinical significance of multiple hormone secretion in the endocrine pancreas tumom are not yet clearly defined. METHODS: We analyzed retrospectively the clinicopathologic features of 20 cases which were operated at Seoul National University Hospital during the period between February 1989 and May 1998. RESULTS: The most common tumor was insulinoma (13 cases) and the second most common tumor was nonfunctioning tumor (6 cases). There was one case of somatostatinoma. Most of the patients with insulinoma complained of neuroglycopenic symptoms. There were 9 cases (45.0%) in which the tumors secreted more than two kinds of hormones, 7 cases in insulinoma, 2 cases in nonfunctioning tumors. Whether the tumor secreted multiple hormones was detected by the method of immunohistochemical staining. Though the tumors secreted more than two kinds of hormones, the patients with the tumors complained of symptoms which were associated with the cell type most strongly stained by immunohistochemical method. Whether or not the tumors secreted multiple hormones was not associated with the pathologic features such as tumor size, histologic patterns of the tumor, status of tumor cell differentiation and malignancy. CONCLUSION: From this results, we suggest that endocrine tumors of the pancreas secreted multiple hormones not by the mechanism of dedifferentiation from already differentiated endocrine cells but by the mechanism of neogenesis of multipotent islet stem cells. Since the relationship between the function of multiple hormone secretion in the endocrine pancreas tumors and islet stem cell would be significant, further study should be needed to find out the function of stem cells and application of stem cells to clinical use.
Cell Differentiation ; Endocrine Cells ; Humans ; Incidence ; Insulinoma ; Islets of Langerhans ; Pancreas* ; Rare Diseases ; Retrospective Studies ; Seoul ; Somatostatinoma ; Stem Cells

Juvenile xanthogranuloma is characterized by one, or oftener many, yellow, re3dish yellow, or, brown 4-to-20 mm papules or nodules on the face, scalp, trunk, and mostly, extensor surfaces. It may involve internal organ besides the skin such as eye, gastrointestinal and genitourinary tracts. anthogranuloma in adult is usually solitary and dose not involve organs other than skin, and generally dose ncit resolve without treatment. Histopathologically, characteristic Touton giant cells usually appear numerously. We report a case of juvenile xanthogranulorna which occured on scalp of 49 year-old male showing typical clinical and histopathological findings.
Adult* ; Giant Cells ; Humans ; Male ; Middle Aged ; Scalp* ; Skin ; Xanthogranuloma, Juvenile

To assess the efficacy of amiodarone on chronic atral fibrillation(AF) and to evaluate the relation between the ability to convert AF to sinus rhythm (SR) with amiodarone therapy and left atrial(LA) size and atrial fibrillatory wave forms, 22 patients with AF, aged 40 to 60 years(mean 47.5 years), were studied. Nine patients(40.9%) had mitral valvaular heart disease, 6(27.3%) hypertension, 5(18.2%) lone AF and 2 (9.1%) cadiomyopathy. Amiodarone therapy with either 600mg for 1 week, 200mg for 4 weeks in 5 consecutive patients, or 800mg for 1 week, 400mg for 4 weeks and 200mg for 6 weeks in 17 patients, converted AF to SR in 9(40.9%) patients 3 to 6 weeks after amiodarone was started on. In either group, patients who achieved conversion had smaller LA size(mean 43.7mm) than those who failed conversion(mean50.2mm)(P<0.05). Those who had LA size less than 45mm achieved conversion of AF to SR in 70%, comparing to 16.7% in patients with LA size more than 46mm(P<0.05). Among patients who achieved conversion, LA size was less than 46mm in 77.8% comparing to 23.1% in patients who failed conversion on Amiodarone. Those with coarse AF(46.2mm), althogh the difference was not significant statistically. There was no converstion in patients with LA size greater then 58mm and in patients with coarse AF who concomittantly had MVD. These findings suggest that the efficacy of amiodarone was related to LA size, and to the atrial fibrillation wave form in patients with mitral valvular heart disease.
Amiodarone* ; Atrial Fibrillation* ; Heart Diseases ; Heart Valve Diseases ; Humans ; Hypertension

Torsades de pointes is characterized by paroxysms of ventricular tachycardia at rates typically greater than 200 beats/min in which QRS morphology shows alternating polarity in an undulating pattern so that the complexes appear to be twisting about the beseline;this arrhythmia is virtually always associated with prolongation of the QT interval. Its importance lies not in its unusual structure but in the potentially fatal outcome if conventional treatment is administred. Torsades de pointes was diagnosed in 4 patients;the first with hypokalemia, the second with congenital QT prolongation syndrome, the third with amiodarone, the fourth with organophosphorous and hypokalemia. Treatment of these patients consisted of potassium supply, isoproterenol, lidocaine, phenobarbital, tenormin, phenytoin, cardioversion, atropine. Three patients improved successfully, but one patient died, as a direct result of the ensuing ventricular fibrillation and cardiac arrest on one hour after admission.
Amiodarone ; Arrhythmias, Cardiac ; Atenolol ; Atropine ; Electric Countershock ; Fatal Outcome ; Heart Arrest ; Humans ; Hypokalemia ; Isoproterenol ; Lidocaine ; Phenobarbital ; Phenytoin ; Potassium ; Tachycardia, Ventricular ; Torsades de Pointes* ; Ventricular Fibrillation

BACKGROUND: Methods to detect and quanitify Mycobacterium leprae(M. leprae)are needed for studies involving the epidemiology, pathogenesis, and chemotherapy of leprosy. Serological assays and skin tests lack the sensitivity and specificity to serve as diagnostic tool for M. leprae infection. The polymerase chain reaction(PCR) based on the selective amplification of an 530-bp frangment of the gene encoding the proline-rich antigen of M. leprae was performed with sections of fixed or frozen biopsy samples from leprosy patients. OBJECTIVE: This study was done to investigate the applicability of PCR for the detection of low numbers of M. leprae in tissues and peripheral blood. METHODS: The PCR was used to amplify a 530-base-pair M. leprae DNA with the thermoxtable Taq DNA polymerase. RESULTS: The In frozen skin tissues and peripheral blood of leprosy patients. relatively high detection rates of PCR products was achieved by using direct gel analysis as well as Southern blot hybridization. CONCLUSION: These results suggest that PCR amplification for the detection of M. leprae may be useful for the epidemiologic study of large papulations as well as coinical astudies on the individual patients.
Biopsy ; Blotting, Southern ; DNA ; Drug Therapy ; Epidemiologic Studies ; Epidemiology ; Humans ; Leprosy ; Mycobacterium leprae* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Skin ; Skin Tests ; Taq Polymerase