The effect of intravesical formalin instillation as a therapeutic modality for intractable bladder hemorrhage in well known. And despite clear evidence of therapeutic efficacy of intravesical cytotoxic drugs and / or BCG immunotherapy, there have been substantial recurrences during follow up after transurethral resection for superficial bladder tumor. If formalin injected at the bed of superficial bladder tumor is able to coagulate and necrotize the tumor, it will be greatly helpful to the patients with recurrent bladder tumor developed during follow up. Since this technique is applicable on outpatient basis, an economical as well as a psychological burden of the patients can be reduced considerably. The purpose of this study is to evaluate the effect of submucosal formalin injection on rat bladder wall. 36 healthy adult male Sprague-Dawley rats (weighing 350 gm in average) were divided into 3 groups: In Group I (control group), 0.01ml of normal saline was injected submucosally at the left posterolateral wall of the bladder opened under intraperitoneal Nembutal anesthesia; In Group II and III, 0.01 ml of 10% and 4% formalin, respectively, were administered at the same site as in the Group I, two rats in each group were sacrificed at day 1, 2, and 3, and week 1, 2, and 4 after injection, respectively. Gross and microscopic examination of the cystectomized specimen were done in each group. In the Group II, bladder stones were formed at week 1, and in both the Group I and III, stones were seen at week 2 post injection. There was no significant difference in histologic findings of the bladder between the group II and III. Mucosal ulcer and/or prominent mucosal disruption was observed at 24 hours after injection in both Group II and III. Epithelial regeneration began at day 2, and was marked at day 3, and epithelial lining was almost normalized one week after injection. Subepithelial edema, telangiectasia and inflammatory reaction were prominent at 24 hours post formalin injection. Subepithelial edema persisted in moderate degree for 1 week. Telangiectasia and inflammatory reaction were noted for 4 weeks. Mild degree of these findings also appeared in the control group. Fibroblastic proliferation appeared at day 2 and persisted in moderate degree for 4 weeks. There has been no mortality or bladder perforation. These results suggest that clinical application of this technique is feasible for the selected cases of recurrent, solitary superficial bladder tumor. However, optimal dosage of formalin in relation to the size of the lesion remains to be investigated.
Adult ; Anesthesia ; Animals ; Edema ; Fibroblasts ; Follow-Up Studies ; Formaldehyde* ; Hemorrhage ; Humans ; Immunotherapy ; Male ; Mortality ; Mycobacterium bovis ; Outpatients ; Pentobarbital ; Rats* ; Rats, Sprague-Dawley ; Recurrence ; Regeneration ; Telangiectasis ; Ulcer ; Urinary Bladder Calculi ; Urinary Bladder Neoplasms ; Urinary Bladder*

No abstract available.
Klippel-Trenaunay-Weber Syndrome*

BACKGROUND: There are some variables including chamber size in irritant patch test responses. Several non-invasive bidengineering methods for quantifying and obtaining information have been developed in recent decades. OBJECTIVE: Our study was done to compare the effect of chamber size and the volume effect on the irritation potential of 1% SLS solution. METHODS: Patches with 1% sodium lauryl sulfate(SLS) solution were applied to the volar forearm of 14 healthy volunteers for 24 h. Finn chambers with 8mm(20ul), 12mm(60pl), 18mm(80ul, 200ul) inner diameters were used. Visual score and transepidermal water loss (TEWL) were measured at 30 min after removal of the patches, and every 24 h up to 4 days. RESULTS: The results are summarized as follows. 1. Visual scores were 0.18+0.32(8mm), 0.75+0.33(12mm) and 0.64+0.41(18mm) at 24 h after removal of 1% SLS and were 0.11+0.29, 0.50+0.34 and 0.25+0.26 on 4 days after removal. They were inereased 30 min and 24 h after removal and decreased towards normal 4 days after removal. By chamber size, the skin response with the large Finn chamber(12mm) increased more significantly than with the small Finn chamber(8mm). However, there were no significant differences in skin response between large and extralarge Finn chambers(18mm). 2. TEWL values were 11.86+4.09, 23.05+6.1l and 22.24+7.54g/m/h at 30 min after removal and were 9.37+2.30, 1..49+3.08 and 14.56+5.00g/m/h on 4 days after removal. They were increased 30 min after removal and decreased towards normal 4 days after removal. By chamber size, their results were the same as visual scores. 3. By visual score and TEWL, the skin response with 200pl of 1% SLS increased more significantly than 80pl in the extralarge Finn chamber. CONCLUSION: The small Finn chamber may be too small to elicit sufficient cutaneous irritation for evaluation. The large Finn chamber having larger test areas may be suitable to yield positive reactions to certain irritants. Also, the quantity of test solution per mm skin may be of importance for the skin response.
Forearm ; Healthy Volunteers ; Irritants ; Patch Tests ; Skin ; Sodium

BACKGROUND: The chemiluminescent assay(CLA) is a new in vitro non-radioactive modification of the radioallergosorbent test(RAST). The CLA permits quick, siultaneous detection of total and specific IgE in human serum up to 35 different allergens, as well as their semiquantitative concentrations into classes from 0(negative) to 4(very high). The CLA has shown sensitivity, specificity, and a good correlation with the RAST and also with skin pick testing. OBJECTIVE: The purpose of this study was to find the causatix llergens and to evaluate the clinical significance of CLA comparing the results of tbe CLA wi! h hose of the prick test in patients with chronic urticaria. METHODS: We performed the CLA with 35 allergens(MAST immunosunosystems, Inc., California, America) and the prick test with 51 allergens(Bencard Ltd., Bricantord, England) in 70 patients with chronic urticaria. The CLA detects the allergen-IgE reactic say the use of an enzyme-labeled anti-IgE and a coupled photoreagent mixture. lhe amount of the luminescent energy is measured by exposing a polarcid film and then semiquantitation is a sessed by using a densitometer. RESULTS: Except for those over the age of 60, all age-groups ealed a similar positive reaction to the CLA and prick test, but the positive reaction rate o the prick test(91.4%) was higher than that of the CLA(38.6%). The positive reaction rate oringle allergen and compound allergens was 10.0% and 28.6% in the CLA, but 10.0% and 81.4% in the prick test, respectively. In the CLA, the rate of positive reaction was 17(24.3%) in Dermatophagoides(D.) farinae, 15(21.4% ) in D. pteronyssinus, 5(7.1% ) in house dust, an 13(4.3%) in shrimp in that order. In the prick test, the rate of positive reaction was 39(55.7%) in house dust, 35(50.0%) in D. farinae, 29(41.4%) in D. pteronyssinus, and 21(30.0%) in haydrst(30.0%) in that order. The results of the CLA to 3 comrnon allergens showed a concordance rare of 67.6%, sensitivity of 34.3%, and specificity of 97.3% compared with those of the prick case. The levels of total IgE and eosinophils were elevated in 59(n=70, 843%) and in 5(n=56, 84.3%), respectively. CONCLUSION: The results of this study suggest that the CLA may be used as an alternative method for the diagnosis of chronic urticaria because it is and coiomic, safe, simple procedure with very high specificity and trelative low sensitivity, and is sirnilt. neously capable of testing to multiple allergens.
Allergens ; California ; Diagnosis ; Dust ; Eosinophils ; Humans ; Immunoglobulin E ; Luminescent Measurements* ; Sensitivity and Specificity ; Skin ; Urticaria*

Solitary circumscribed neuroma is a benign nerve sheath tumor of unknown etiology. Clinically, it appears as a long-standing, solitary, asymptomatic, skin-colored papule or papulonodule. It has been found predominantly on the face in both sexes, mostly in middle age. A 53-year-old female patient visited our department because of a nodule on the side of the distal interphalangeal joint of the left second finger. A biopsy specimen showed a well-circumscribed, partially encapsulated tumor composed of interlacing fascicles of spindle cells. Neither pleomorphism nor mitosis was found. Immunohistochemical stainings for vimentin, neuron specific enolase (NSE) and epithelial membrane antigen (EMA) were positive, but negative for S-100 protein and smooth muscle actin (SMA). We herein report an uncommon case of solitary circumscribed neuroma.
Actins ; Biopsy ; Female ; Fingers ; Humans ; Joints ; Middle Aged ; Mitosis ; Mucin-1 ; Muscle, Smooth ; Neuroma* ; Phosphopyruvate Hydratase ; S100 Proteins ; Vimentin

Ki-1 antigen was found by a monoclonal antibody, made against a Hidgkin' disease-derived cell line (L428) that reacted with Reed-Sternberg cells in Hodgkins disease and a few lymphocytes around lymphoid follicle. In 1985, Stein et al identified a large cell anaplastic lymphoma showing a distinctive pleomorphic appearance, sinus growth pattern, and reactivity to Ki-l. We report a case of Ki-1 positive large cell anaplastic lymphoma, which was presenting as a elevated plaque on the skin of popliteal fossa in a 69-year-old female.
Aged ; Antigens, CD30 ; Cell Line ; Female ; Hodgkin Disease ; Humans ; Lymphocytes ; Lymphoma* ; Reed-Sternberg Cells ; Skin

No abstract available.
Malingering*

BACKGROUND: Atopic dermatitis(AD) exibit multiple immune akno malities including elevated serum IgE levels and impaired cell mediated immunity, but basic immunology defect is largely unknown. OBJECTIVE: The purpose of this study was to evaluate the immnologic changes after treatment with Cyclosporin A(CsA) in AD patients. MEHTODS: Eight patients of severe AD were treated with CsA(4mg/kg body weight per day) for 5 weeks, and evaluated clinical and immunological parameters before aid after treatment. RESULTS: Peripheral blood eosinophil counts were significantly decreased after treatment(P<0.05), and serum IgE level was decressed but not significantly. In immediate hypersensitivity reaction by pinprick test, antigen score was.significantly decreased, and in the evaiuation of cell mediated immunity to recall antigens, total induration score was significantly increased(p<0.05). The number of helper T cell and helper/suppressor 7 cell ratio in peripheral blood, and the niimber of helper T and suppressor T cell in skin lesion were both significantly decreased after treatment(P<0.05). Clinical state after treatrnent was good in all of patients. CONCLUSION: The results indicate that CsA act on peripheral blood osinophil and immediate and delayed hypersensitivity reaction as well as helper T-cells in peripheral blood and skin lesion, and it may by useful in the treatrnent of severe AD.
Allergy and Immunology ; Body Weight ; Cyclosporine* ; Dermatitis, Atopic* ; Eosinophils ; Humans ; Hypersensitivity, Delayed ; Hypersensitivity, Immediate ; Immunity, Cellular ; Immunoglobulin E ; Skin ; T-Lymphocytes, Helper-Inducer

Laureth 9 is a nonionic surfactant and it is used as a sclerosing agen; in the treatment of esophageal and gastric varices and a local anesthetics. We report a 20-year-old male patient presenting with features of alergic contact dermatitis due to laureth 9 used in the oxoralen, ointment.
Anesthetics, Local ; Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Esophageal and Gastric Varices ; Humans ; Male ; Young Adult

OBJECTIVE: Hysterectomy is one of the most common gynecological operations. The objective of this study is to compare the efficacy of suturing methods of vaginal cuff between laparoscopic and vaginal approach. METHODS: One hundred and sixty one cases of laparoscopic hysterectomy were devided into two groups. In group A(n=67), vaginal cuff was sutured by laparoscopic suture technique and in group B(n=94), vaginal cuff was repaired by vaginal approach. RESULTS: There were no significant differences in uterine weight, hospital stay, pre-and postoperative hemoglobin level and complications including febrile morbidity in two groups. Operation time was significantly shorter in group B(p=0.05). CONCLUSION: Transvaginal repair of vaginal cuff showed shorter duration of operation time than laparoscopic suture technique in total laparoscopichy sterectomy.
Hysterectomy* ; Laparoscopy ; Length of Stay ; Suture Techniques