Clear cell tumor of borderline malignancy has been reported to account for 5 to 8% of all clear cell neoplasms, and <1% of borderline malignancies of the ovary. Borderline clear cell fibroadenoma with or without microinvasion mostly occurs in women with middle age, and the presenting symptoms associated with this tumor are non-specific. The clinico-pathologic features of borderline clear cell fibroadenoma are not well known because of its rarity. Furthermore, there is no consensus for treating the disease. Thus, we report a case of borderline clear cell fibroadenoma presenting as ovarian fibroadenoma with a review of literature.
Consensus ; Female ; Fibroadenoma ; Humans ; Middle Aged ; Naphazoline ; Ovary

BACKGROUND: Ingrown toenail is one of the most common nail complaints. It occurs chiefly on the great toes, where there is an excessive lateral nail growth into the nail fold, leading to painful irritation, inflammation, infection, and growth of excessive granulation tissue. Many treatments have been described, but these classic treatment modalities may lead to severe damage of the nail fold or to frequent relapses. OBJECTIVE: We attempted to evaluate the therapeutic effect of nail splinting which is a noninvasive therapy for ingrown toenails. METHODS: A total of 64 patients(78 lesions) with ingrown toenails were enrolled in the study. The lateral edge of the nail plate including the spicule is splinted with a lengthwise-incised flexible plastic tube. The efficacy of nail splinting for ingrown toenail was assessed by analyzing the degrees of post-treatment pain and a recurrence rate. RESULTS: 1.The average age of the patients was 37 years old. There were 38 male patients(47 lesions) and 26 female patients(31 lesions). The right big toe was affected in 27 patients and the left big toe in 23 patients. Fourteen patients had both feet affected at the same time. 2.The pain all cleared in an average 2.3 days of treatment. Other problems such as redness, swelling and granulation tissue gradually decreased as time went by. 3.There was a 7.8% recurrence rate at six months after the procedure. CONCLUSION:We recommend nail splint as an alternative to traditional treatment for ingrown toenail because it is simple and easy to perform, noninvasive, effective, well tolerated, and does not require any special equipment.
Adult ; Female ; Foot ; Granulation Tissue ; Humans ; Inflammation ; Male ; Nails* ; Naphazoline ; Plastics ; Recurrence ; Splints* ; Toes

BACKGROUND AND OBJECTIVES: An array of materials have been used for rhinoplasty, however, the fate of these materials after rhinoplasty is not all clear. This study was performed to find post-operative gross and microscopic changes of the implants and grafts (cartilage, Gore-Tex , and Alloderm), and to guide selection of implants and graft. MATERIALS AND METHODS: We took the implants and grafts out from nine patients who underwent revision rhinoplasty for cosmetic problems, and studied gross and microscopic charaterizations. RESULTS: Autologous cartilages showed minor volume reduction and remodeling in gross examination, and mild degeneration, peripheral fibrosis, and fibroblast in-growth without inflammation under microscopic examination. Gore-Tex , which was a little difficulty to remove, had good volume preservation with focal in-growth of fibroblasts and inflammatory cells. A gross examination of Alloderm showed preserved volume, but thin, soft and weak appearance. A microscopic examination of Alloderm showed well preserved collagen materials without inflammation. CONCLUSIONS: Cartilages have good biocompatibility and stabilization, but it is necessary to study absorption and remodeling. We found that Gore-Tex is a good volume filler for dorsal augmentation, whereas Alloderm is a good material for camouflage.
Absorption ; Cartilage ; Collagen ; Fibroblasts ; Fibrosis ; Humans ; Inflammation ; Naphazoline ; Polytetrafluoroethylene ; Rhinoplasty* ; Transplants*

The pathogenesis of lupus er thematosus(LE) appears to be multifactorial, including genetic, hormonal and environmental influences. Genetic factors have long been suspected to an important role in its pathogenesis. This was been shown in family studies and twin studies. We report a family in which mother developed SLE and son developed DLE. The mother, 35 year old female, had hyperpigmcnted brownish macules and atrophic scars on the face and also complained of fever, chill and arthralgia for 2 years. The clinical, laboratory and histopathological findings showed characteristic features of systemic lupus erythematosus. she had been treated with systemic prednisolone, hydrcxychloroquin sulfate and topical corticosteroid ointment for about 4 years resulting favorable improvement skin lesions. Laboratory studies during her course had demonstrated persist leukopenia, peckled pattern ANA and VDRL positive. The son, 10-year-old, had peasized, multiple erythematous papules and plaques on the face and arms for 2 months. The lirical, laboratory and histopathological findings showed characteristic features of discoid lupus erythematosus. He was treated with systernic prednisolone for 2 years, hydroxychloroquin sulfate and topical corticosteroid ointment for abcut 4 years resulting nearly all clearing of skin lesions with slighthly hyperpigmentation. Laboratory studies during his course had demonstrated only weakly ANA positive.
Adult ; Arm ; Arthralgia ; Child ; Cicatrix ; Female ; Fever ; Humans ; Hyperpigmentation ; Leukopenia ; Lupus Erythematosus, Discoid ; Lupus Erythematosus, Systemic ; Mothers* ; Naphazoline ; Prednisolone ; Skin

BACKGROUND: Sepsis is a clinical syndrome characterized by a systemic inflammatory and hemodynamic response to severe bacterial infections that involve various mediators. Endothelin (ET)-1, a potent vasocon strictor is associated with multiple organ failure, and interleukin (IL)-8, a proinflammtory cytokine, plays a major role in neurophil activation. Both have been reported to be useful parameters in the clinical assessment of sepsis. The levels of ET-1 and IL-8 in the blood were measured in patients with sepsis, and the correlation of both parameters and their relationship with the clinical data was assessed. METHODS: 19 sepsis patients and 17 controls were studied. Blood samples of the sepsis patients were drawn in day 1, 3, 7, and 14. the APACHE III scores were calculated in concurrent days. The ET-1 and IL-8 levels were measured using immunoassay methods. RESULTS: The ET-1 levels of patients with sepsis were significantly higher than in the controls. In patients with sepsis, non-survivors had higher ET-1 levels than survivors on day 1 and 7, and patients with shock also had higher ET-1 levels than normotensive patients on admission. The ET-1 levels were significantly correlated wit the creatinine levels in day 1, 7, and 14. The IL-8 levels showed a significant correlation with the ET-1 levels on day 14. CONCLUSION: ET-1 was found to be closely related with the clinical outcome, shock, and renal failure, and showed a correlation with IL-8. these mediators can be considered not only to play pathophysiologic roles but also as useful parameters in the clinical assessment of sepsis.
APACHE ; Bacterial Infections ; Creatinine ; Endothelin-1* ; Endothelins ; Hemodynamics ; Humans ; Immunoassay ; Interleukin-8* ; Interleukins ; Multiple Organ Failure ; Naphazoline ; Renal Insufficiency ; Sepsis* ; Shock ; Survivors

OBJECTIVE: Mutations in p53 are the most common genetic alterations in human malignancies. Expression of its protein product has been linked to decreased survival rate in ovarian carcinoma. P53 is well known as a pro-apoptotic tumor suppressor gene, but less is known about the importance of p21 expression in patients with epithelial ovarian malignancies. The purpose of this study was to investigate the different expression levels of p53 and p21 in various cell type of epithelial ovarian carcinomas and to determine their clinical significances. METHODS: Fifty eight patients (serous (n=18), mucinous (n=14), clear cell (n=12), endometrioid (n=14) carcinoma) with epithelial ovarian carcinoma were studied using paraffin-embedded tissue specimens. Immunohistochemical staining utilizing monoclonal antibody against p21 and p53 were performed. Amount of their proteins were quantified using western blotting. RESULTS: Mean age was 49.2 years old and advanced stage (III and IV) of cancer were 26 (44.8%). Recurrence rate and death rate were 20.7%, 22.4% respectively. With immunohistochemical staining for p21 and p53, p53 were significantly strongly stained in almost all epithelial ovarian carcinomas. However, p21 expressions were found in 10% of patients with serous carcinoma, 14% of patients with mucinous carcinoma, 38% of patients with endometrioid carcinoma, but 100% of patients with clear cell carcinoma. Among the patients whose tumors showed p21 staining, over expression were found in all clear cell typein western blot. But positive staining for p21 was below 10% in each slides of serous, mucinous and endometrioid type of ovarian carcinoma except clear cell type. This finding suggest that P21 expression was independent pathway in cell cycle regulation and apoptosis to the expression of p53 in serous, mucinous, and endometrioid type of ovarian carcinoma, but showed strongly positive correlation P21 and p53 expression in clear cell carcinoma. CONCLUSION: P21 may be used as a marker for confirmation of diagnosis of clear cell carcinoma due to its unique expressions of p21.
Adenocarcinoma, Mucinous ; Apoptosis ; Blotting, Western ; Carcinoma, Endometrioid ; Cell Cycle ; Diagnosis ; Genes, Tumor Suppressor ; Humans ; Mortality ; Mucins ; Naphazoline ; Ovarian Neoplasms ; Recurrence ; Survival Rate