Gastrointestinal cytomegalovirus(CMV) infection in adults is observed as a part of a generalized or localized infection in patients who are immunocompromized. We report a case of CMV infection of the small intestine. The patient is a 34 year-old woman who has complained of palpable purpura in the lower extremities and buttocks, and arthralgia of large joints. The skin biopsy showed fibrinoid necrosis and neutrophils with leukocytoclasis, which findings are compatible with hypersensitivity angiitis. The patient received steroid and cyclophosphamide. During the follow-up period, generalized edema and bloody stool were detected. Resected specimen of small bowel has multiple aphthous ulcer. Microscopically, cytomegalic cells are observed along the endothelial cells and mesenchymal cells. In situ hybridization using DNA probes against CMV revealed positive staining in the cytomegalic inclusions in vascular endothelial and mesenchymal cells.
Adult ; Male ; Female ; Humans ; Biopsy

Immunohistochemical staining on paraffin sections for S-100 protein improved diagnostic accuracy for melanocytic tumor. But specificity of S-100 protein in the diagnosis of melanocytic tumor is very low, because S-100 protein was also expressed in neurogenic tumor and salivary gland tumor. To investigate a specific tumor marker for the malignant melanoma, immunohistochemical staining for HMB-45 and S-100 protein was performed on the paraffin sections of 25 cases of malignant melanoma and 46 cases of nevi. Positive reaction for HMB-45 and S-100 protein was diffusely identified in the cytoplasm of tumor cells. Positive ratio for HMB-45 was 100% in malignant melanoma, 92% in junctional component of compound nevus and 0% in intradermal nevus. Positive ratio for S-100 protein was 92% in malignant melanoma, 100% in compound nevus and 100% in intradermal nevus. The sensitivity and specificity for HMB-45 in malignant melanoma were 100%, but those for S-100 protein were 92% in sensitivity and 86.7% in specificity. These results indicate that HMB-45 has a high sensitivity and specificity for malignant melanoma cells and it can be quite useful for the histopathological diagnosis of malignant melanoma.
Sensitivity and Specificity ; Tumor Markers, Biological

No abstract available.
Aneurysm* ; Heart Septal Defects, Ventricular*

To evaluate the differentiation status of smooth muscle in gastric stromal tumors which were negative for S-100 protein, immunohistochemistry using desmin, actin, myosin and vimentin was performed in 14 cases of gastric smooth muscle tumors. Ultrastructural Examination was also performed. For comparison a case of leiomyoma of the esophagus, a case of the sigmoid colon, 10 cases of the uterus were also examined. The results obtained were as follows. All gastric smooth muscle tumors showed vimentin-positivity. Six of 14 gastric smooth muscle tumors, (5 of 8 leiomyoma and 1 of 4 leiomyosarcoma) showed positivity for desmin, actin, and myosin(42.9%). All esophageal, colonic, and uterine leiomyomas showed diffuse positive reaction for desmin, actin, and myosin. Vimentin positivity was also noted in leiomyoma of the colon and uterus. Ultrastructurally, a few cells in the gastric stromal tumors had scattered microfilaments with dense bodies, subplasmalemmal dense plaques, and micropinocytic vesicles. However, most of the tumor cells did not have any of the ultrastructural features of smooth muscle differentiation. Leiomyomas of the esophagus and uterus showed many cytoplasmic microfilaments with dense bodies. These results suggest that most of the benign and malignant tumor cells of gastric stromal tumors have features of the undifferentiated cells, immunohistochemically as well as ultrastructurally, although a few cells have. It is speculated that most gastric stromal tumors may have lost their smooth muscle differentiation.

The authors evaluated ultlrasonographic findings of surgically or pathologically proven anterior abdominalwall lesion in 17 cases. The results were follows; 1. Ultrasonography is an accurate, convenient and noninvasive method to detect and determine the extent of anterior abdominal wall lesion. 2. Peritoneal fascia interface is animportant landmark in differenciation between intraperitoneal and abdominal wall lesion. 3. Sonographic differenciation of abscess and hematoma from tumor was impossible.
Abdominal Wall ; Abscess ; Fascia ; Hematoma ; Methods ; Ultrasonography

OBJECTIVES: We performed anterior spinal fusion and instrumentation in treatment of spinal tuberculosis. The clinical results of this operation and metal-related complications were evaluated to determine the rationale of anterior instrumentation in active tuberculous lesion. METHODS: From July 1989 to February 1993, we treated twenty-one patients with spinal tuberculosis by radical resection of the tuberculous lesion and bone grafting, followed by anterior instrumentation using Zielke rod system. The changes in spinal deformity were measured from lateral spinal radiographs obtained preoperatively and postoperatively at 3 months, 6 months, 1 year, 2 years and final follow-up. The recurrence of infection and possible complications were also observed clinically and radiologically. RESULTS: The mean kyphotic angle was decreased preoperatively from 21 degrees to 16 degrees at final follow-up in patients with thoracolumbar tuberculous lesions. The mean deformity angle was corrected 7 degrees in thoracolumbar tuberculosis and 12 degrees in lumbar tuberculosis compared with the preoperative deformity angle. There was not any persistence or recurrence of infection possibly related to the instrumentation. All patients were allowed early ambulation with the aid of a light brace. CONCLUSION: The clinical and radiological results suggested that the anterior instrumentation seemed to be one of the rational approaches for providing immediate stability in treating severe spinal tuberculosis without any significant risk of persistence or recurrence of infection.
Bone Transplantation ; Braces ; Congenital Abnormalities ; Early Ambulation ; Follow-Up Studies ; Humans ; Recurrence ; Spinal Fusion ; Tuberculosis ; Tuberculosis, Spinal*

No abstract available.
Carcinoma, Squamous Cell*

Bonding orthodontic adhesive resins to glazed porcelain surface is not attainable. The aim of this investigation was to examine, in vitro, the effect of three methods of porcelain surface pretreatment on the shear bond strength of orthodontic adhesives, and to compare the shear strength of orthodontic bracket bonding to porcelain surface by the best results that to human enamel. Porcelain disks (Ceramco((TM)) and Vita((TM))) baked in the laboratory were roughened by sandpapers, #320, #600, #800, #1000 and #1200, and were pretreated with silane and dried at the various temperatures, room temperature, 50degreesC, 70degreesC and 90degreesC, and were etched by 3% hydrofluoric acid solution for 1, 3, 5, 7, and 9 minutes, orthodontic adhesives (System 1 +((TM)) and Unite((TM))) were applied on them, and shear bond strengths were measured by Instron. The best results of pretreatment of each method were determined by the shear bond strengths. Again, porcelain disks were pretreated by the determined best results and human enamel were etched by 37% hydrofluoric acid solution, orthodontic brackets were bonded on them by the orthodontic adhesives, and the shear bond strengths were measured and compared between them. 1. Roughening porcelain surfaces with coarse sandpaper (#300) showed higher shear bond strength than that with finer sandpapers, but it (22.44 Kgf/cm2) was distinguishably low compared to that from etched human enamel (144.11 Kgf/cm2). 2. There were disparities in shear bond strengths upon the orthodontic resins, which was presumably related to the contents of fillers in orthodontic adhesive resins. Also there were disparities in shear bond strength upon the porcelains which had different composition. 3. Silane enhanced the shear bond strength of orthodontic resins to porcelain surfaces (25.20 Kgf/cm2 at 50degreesC), which was markedly low compared to that from etched human enamel. 4. Etched porcelain surface with 3% hydrofluoric acid solution for 1 to 9 minutes showed no difference in shear bonding strength of orthodontic adhesive resins. Shear bond strength from etched porcelain (97.43-120.72 Kgf/cm2) were as high as clinically available, but low compared to that from etched human enamel. 5. Roughening with #300 sandpaper and etching by 3% hydrofluoric acid followed silane application on porcelain surface showed lower shear bond strength than etched human enamel, but were as high as clinically useful. 6. The results suggest that etching porcelain surface by 3% hydrofluoric acid solution might provide comparatively high shear bond strength as much as clinically favorable.
Dental Cements ; Dental Enamel ; Dental Porcelain* ; Humans ; Hydrofluoric Acid ; Orthodontic Brackets ; Shear Strength

From January 1992 to May 1993, we performed a new method of spinal instrumentation, namely the combined instumentation with the soft and rigid stabilizer, to minimize the adverse effects induced by rigid multi-segment fixation and fusion in twenty patients with complex degenerative lumbar disorders. By using this combined method, we were able to preserve one or two more motion segments from the fusion. And we also expect that the rate of deterioration at the adjacent motion segments to the fusion level will decrease. Though the follow-up period is short, the clinical results were satisfactory in 80% of the patients. We think that this combined instrumentation can be a choice of treatment for complex multi-segment lumbar disorders.
Follow-Up Studies ; Humans ; Methods

Purpose: To determine the incidence of atypical ductal hyperplasia (ADH) in needle biopsy and the upgrade rate to carcinoma, and to evaluate difference in findings between the upgrade and non-upgrade groups. Materials and Methods: Among 9660 needle biopsies performed over 48 months, we reviewed the radiologic and histopathologic findings of ADH and compared the differences in imaging findings (mammography and breast US) and biopsy methods between the upgrade and non-upgrade groups. Results: The incidence of ADH was 1.7% (169/9660). Of 112 resected cases and 30 cases followed-up for over 2 years, 35 were upgraded to carcinoma (24.6%, 35/142). The upgrade rates were significantly different according to biopsy methods: US-guided core needle biopsy (US-CNB) (40.7%, 22/54) vs. stereotactic-vacuum-assisted biopsy (S-VAB) (16.0%, 12/75) vs. US-guided VAB (US-VAB) (7.7%, 1/13) (p = 0.002). Multivariable analysis showed that only US-CNB (odds ratio = 5.19, 95% confidence interval: 2.16–13.95, p < 0.001) was an independent predictor for pathologic upgrade. There was no upgrade when a sonographic mass was biopsied by US-VAB (n = 7) Conclusion The incidence of ADH was relatively low (1.7%) and the upgrade rate was 24.6%. Surgical excision should be considered because of the considerable upgrade rate, except in the case of US-VAB.