We report a case of a 53-year-old woman with squamous cell carcinoma with lymph node metastasis who has had a recurrent painful bleeding papule on the right toe nail bed with resultant nail plate shedding over the past two years. X-ray and computer tomography examinations showed nearly total destruction of the distal phalanx of the right fifth toe and right inguinal lymph node enlargemet it. A nail bed biopsy specimen disclosed invading tumor masses composed of atypical squamous cells and multiple horn pearls. While squamous cell carcinoma of the nail bed is not usually aggresive and local removal is usually adequate, the possibility that metastasis or invasion of the adjacent phalanx or joint can occur should be kept in mind.
Animals ; Biopsy ; Carcinoma, Squamous Cell* ; Female ; Hemorrhage ; Horns ; Humans ; Joints ; Lymph Nodes* ; Middle Aged ; Neoplasm Metastasis* ; Toes

The authors have studied 37 Korean embryos of Carnegie stage 11~23 and 18 fetuses to demonstrate the development of the shoulder joint. The external feature of the upperlimb bud is observed by stereoscope and camera, and the internal structures are studied by microscopic observation. The results obtained were as follows: In stage 12 upperlimb buds were appeared. In stage 17 mesenchymal condensations for humerus and scapula, and glenoid labrum were observed. In stage 19 one-layered interzone between the humerus and scapula was visible. In stage 22 three-layered interzone between the humerus and glenoid labrum was formed. In stage 23 three-layered interzone between the humerus and glenoid fossa of scapula was visible. In the 9th and 10th weeks distinct joint cavity was formed between humerus and glenoid labrum, and tendon of long head of Biceps brachii was attached to supraglenoid tuberosity and glenoid labrum. In the 11th week the joint cavity was formed between the midportion of humerus and glenoid fossa, and tendon of long head of Biceps brachii was more dense. In the 16th week the glenoid labrum was visible as fibrous cartilage, and joint cavity was more widened. In the 20th to 32nd week the shoulder joint was matured with the distinct joint cavity and glenoid labrum time after time.
Cartilage ; Embryonic Structures* ; Fetus* ; Head ; Humans* ; Humerus ; Joints ; Scapula ; Shoulder Joint* ; Shoulder* ; Tendons

The localizations of efferent and afferent neurons were observed following injection of neural tracers, cholera toxin B subunit (CTB) and wheat germ agglutinin-horseradish peroxidase (WGA-HRP) into the rat thymus with ages. Thirty Sprague-Dawley rats were examined at 3 weeks, 5~6 and 20 months of age. After survival times of 48~96 hours following injection of neural tracers, the rats were perfused and their brain, spinal cord, sympathetic ganglia, dorsal root ganglia and vagal ganglia were frozen sectioned (40 mm). These sections were stained by CTB immunohistochemical and HRP histochemical staining methods, and observed with polarized dark and light microscope. The results were as follows: 1. WGA-HRP and CTB labeled parasympathetic neurons were bilaterally seen in the nucleus ambiguus and medullary reticular formation of medulla with all ages. 2. WGA-HRP labeled sympathetic neurons were bilaterally labeled in superior cervical ganglia, middle cervical ganglia, stellate ganglia and T4-8 sympathetic chain ganglia. The number of labeled sympathetic neurons was increased in the thymus at 20 months of age. According to the aging, sympathetic neuronal processes were more developed, and the nerve fibers were coarse and more branched. 3. WGA-HRP labeled sensory neurons were bilaterally observed within the vagal and C1-6 dorsal root ganglia. The number of labeled sensory neurons was decreased in the thymus at 20 months of age.
Aging ; Animals ; Brain ; Cholera Toxin ; Ganglia ; Ganglia, Spinal ; Ganglia, Sympathetic ; Nerve Fibers ; Neurons ; Neurons, Afferent* ; Peroxidase ; Rats* ; Rats, Sprague-Dawley ; Reticular Formation ; Sensory Receptor Cells ; Spinal Cord ; Stellate Ganglion ; Superior Cervical Ganglion ; Thymus Gland* ; Triticum ; Wheat Germ Agglutinin-Horseradish Peroxidase Conjugate

Pseudohypoparathyroidism (PHP) is a rare clinical type of hypoparathyroidism. The patients with PHP show classic clinical and biochemical features of hypoparathyroidism, but elevated serum level of parathyroid hormone (PTH) and characteristic physical appearances termed 'Albright's hereditary osteodystrophy' (AHO). PHP is classified into types Ia, Ib, Ic and II according to the presence of AHO phenotype and the mechanism of PTH resistance. We experienced a case of PHP in a 12 year-old girl with carpopedal spasm, syncope and partial AHO. She showed very low serum calcium level (1.4 mmol/L), high phosphorus level (3.62 mmol/L) and high immunoreactive PTH level (186.6 ng/L). In the Ellsworth-Howard test, urinary cyclic adenosine monophosphate and phosphorus levels after an exogenous PTH injection remained unchanged. Therefore, we were able to classify the patient as either PHP type Ia or Ic. After the patient had been treated with daily calcium carbonate (1 g), cholecalciferol (250 IU) and calcitriol (0.5 microgram), her neurological signs and symptoms as well as her biochemical abnormalities of hypocalcemia and hyperphosphatemia were improved.
Adenosine Monophosphate ; Calcitriol ; Calcium ; Calcium Carbonate ; Child ; Cholecalciferol ; Female ; Humans ; Hyperphosphatemia ; Hypocalcemia ; Hypoparathyroidism ; Parathyroid Hormone ; Phenotype ; Phosphorus ; Pseudohypoparathyroidism* ; Spasm ; Syncope

Pseudohypoparathyroidism (PHP) is a rare clinical type of hypoparathyroidism. The patients with PHP show classic clinical and biochemical features of hypoparathyroidism, but elevated serum level of parathyroid hormone (PTH) and characteristic physical appearances termed 'Albright's hereditary osteodystrophy' (AHO). PHP is classified into types Ia, Ib, Ic and II according to the presence of AHO phenotype and the mechanism of PTH resistance. We experienced a case of PHP in a 12 year-old girl with carpopedal spasm, syncope and partial AHO. She showed very low serum calcium level (1.4 mmol/L), high phosphorus level (3.62 mmol/L) and high immunoreactive PTH level (186.6 ng/L). In the Ellsworth-Howard test, urinary cyclic adenosine monophosphate and phosphorus levels after an exogenous PTH injection remained unchanged. Therefore, we were able to classify the patient as either PHP type Ia or Ic. After the patient had been treated with daily calcium carbonate (1 g), cholecalciferol (250 IU) and calcitriol (0.5 microgram), her neurological signs and symptoms as well as her biochemical abnormalities of hypocalcemia and hyperphosphatemia were improved.
Adenosine Monophosphate ; Calcitriol ; Calcium ; Calcium Carbonate ; Child ; Cholecalciferol ; Female ; Humans ; Hyperphosphatemia ; Hypocalcemia ; Hypoparathyroidism ; Parathyroid Hormone ; Phenotype ; Phosphorus ; Pseudohypoparathyroidism* ; Spasm ; Syncope

PURPOSE: Combination therapy of alpha-blockers and 5alpha-reductase inhibitors (5-ARIs) is widely used for the treatment of benign prostatic hyperplasia (BPH). We aimed to study the effect on prostate volume and symptoms of shifting to monotherapy in patients who previously received a combination therapy. MATERIALS AND METHODS: A prospective study was conducted of 60 patients who were diagnosed with BPH. Patients were aged 45 years or older and had a prostate volume of 30 cc or more, International Prostate Symptom Score (IPSS) of 12 or above, maximal flow rate (Qmax) of 15 ml/s or less, and prostate-specific antigen (PSA) level of less than 10 ng/ml. The patients initially received a combination therapy of doxazosin 4 mg/day and finasteride 5 mg/day for 3 months and were then randomly assigned to receive monotherapy for 3 months. The factors were then compared. RESULTS: A total of 30 patients were assigned to doxazosin (group 1) and 30 to finasteride (group 2) after the combination therapy. The percentage changes in prostate volume, IPSS, and Qmax during the period from post-combination therapy to post-monotherapy were not significantly different between the two groups (p=0.052, 0.908, 0.081), whereas PSA significantly decreased in group 2 (p<0.001). IPSS was not significantly different at post-combination therapy and at post-monotherapy in both groups (p=0.858, 0.071). The prostate volume significantly increased from 40.97 cc at post-combination therapy to 44.29 cc at post-monotherapy in group 1 (p=0.001) and insignificantly increased from 38.32 cc to 38.61 cc in group 2 (p=0.696). CONCLUSIONS: Although the duration of drug administration was short in this study, 5-ARI monotherapy could maintain the alleviated symptoms and reduce the risk of acute urinary retention and surgery due to prostate regrowth in BPH patients whose symptoms improved with combination therapy.
Adrenergic alpha-Antagonists ; Aged ; Doxazosin ; Finasteride ; Humans ; Prospective Studies ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Urinary Retention

Light and electron microscopic obserbations of developing heart wall of zebrafish, which has been recently used for developmental studies of many organs, were performed. Heart tissue was obtained from adult and 24, 48 and 72 hour embryos of zebrafish. Heart wall of adult zebrafish was composed of 3 typical layers, endocardium, myocardium and epicardium, as ones of other vertebrates. Heart wall of 24 hour embryo was composed of primitive myocytes. Myofibrils in myocytes at this period was found as assembly of myofilaments, 500~1,000 nm sized and 5~10 layered. Heart of 48 hour embryo has ventricle and atrium. Ventricular wall of was composed of endocardium, myocardium and incomplete epicardium. Atrial wall at 48 hour embryo was composed of endocardium and myocardium. Development of myocytes in ventricle was earlier than those of atrium, and myofibrils with Z disc were found first at 48 hour embryo. Heart wall of 72 hour embryo was morphologically similar to that of 48 hour embryo, but development of myocytes was more progressed. Specific atrial granules of 100~200 nm size appeared very rarely at 24 hour embryo and its numbers increased gradually at 48 and 72 hour embryos in myocytes of atrium as well as the ventricle. Specific atrial granules were consider as ones containing atrial natriuretic peptide (ANP).
Adult ; Embryonic Structures ; Endocardium ; Heart* ; Humans ; Muscle Cells ; Myocardium ; Myofibrils ; Pericardium ; Vertebrates ; Zebrafish*

The ultrastructural changes of atrial myocytes were examined by transmission electron microscopy and ultrastructural morphometry by dehydrated and rehydrated rat. Sprague-Dawley rats weighting 210 to 240 gm were fed with dried diet and without water for 3, 7 and 9 days, and then with standard diet and tap water for 9 days. On day 7 of dehydration, morphological changes in atrial myocytes were mainly the alterations of mitochondria and myofibrils, and the appearance of vacuoles with myelin structures and vesicular typed granules. On day 9 of dehydration, cells containing the myelin structures were increased than those on day 7 of dehydration. On day 3 to 5 rehydration, many atrial myocytes were damaged. On day 9 rehydration, most atrial myocytes were similar to control groups. The numbers of atrial specific granules were increased in all dehydrated groups and decreased in 1 day and 3 day rehydrated groups then that of normal atria. The numbers of atrial specific granules were similar level to normal animals in 5 day and 9 day rehydrated groups.
Animals ; Dehydration ; Diet ; Fluid Therapy ; Microscopy, Electron, Transmission ; Mitochondria ; Muscle Cells* ; Myelin Sheath ; Myofibrils ; Rats* ; Rats, Sprague-Dawley ; Vacuoles ; Water

Atrial natriuretic peptide (ANP), a 28 amino acid basic polypeptide, is known to induce histamine release from human and rat mast cells in vitro and cause a wheel formation in rat skin. However, cellular events associated with histamine release are not clearly understood. In this study, we have examined the calcium flux and cGMP formation associated with histamine release in the ANP-treated mast cells. ANP, in vitro, induced mast cell degranulation and histamine release in a dose-dependent manner. ANP also induced an enhanced calcium uptake into cells and increased the cellular level of cGMP in mast cells. A high level of calcium in the media caused an inhibition of ANP-dependent histamine release but enhanced the level of intracellular cGMP of mast cells. ANP inducing a dose-dependent increase in vascular permeability of rat skin was confirmed by the extravasation of the circulating Evans blue. The results indicate ANP induced the histamine release and an increase in vascular permeability through mast cell degranulation in cGMP-independent and calcium uptake-dependent manner.
Animal ; Atrial Natriuretic Factor/*pharmacology ; Biological Transport ; Calcium/*metabolism ; Capillary Permeability ; Cell Degranulation ; Cyclic GMP/*metabolism ; Dose-Response Relationship, Drug ; *Histamine Release ; Mast Cells/*drug effects ; Peritoneal Cavity/cytology ; Rats

PURPOSE: Some gastric cancer patients in whom the cancer has infiltrated up to the muscularis propria (mp) have a good postoperative course similar to that of early gastric cancer (EGC) patients (this does not match the general classification of gastric cancer). Therefore, we performed a retrospective analysis of 125 patients with mp gastric cancer based on the degree of mp invasion. MATERIALS AND METHODS: The clinicopathologic features of 125 cases of mp gastric cancer were subdivided according to depth of invasion, and were retrospectively reviewed and compared with the surgical features of 222 patients with gastric cancer invading the submucosa (sm). For each tumor, using the section that showed the greatest extent of invasion, we evaluated the degree of tumor invasion into the mp layer at a magnification of x100. The patients were classified into 2 groups: mp1, the tumor was limited to the first of the 3 mp layers, and mp2, the tumor had expanded beyond the first layer. RESULTS: Patients with mp1 (n=50) had a significantly lower incidence of lymph node metastasis, and a smaller tumor size than patients with mp2 (n=75)(P=0.01 and P=0.029, respectively). The 5-year survival rate of mp1 patients was significantly better than that of mp2 patients (95.3% vs. 77.6%, P=0.0282), but was similar to that (91.2%) of the 222 sm patients. The 5-year survival rate of mp patients without lymph node metastasis (n=55) was significantly better than that of those with lymph node metastasis (n=70)(93.3% vs. 78.2%, P=0.0192). Patients with mp1 had a significantly higher incidence of lymph node metastasis (42.5% vs 23%, P=0.006) than patients with sm. CONCLUSION: There were clear differences in clinical features between the mp1 and the mp2 patients. Subdivision of mp gastric cancer according to the depth of invasion may enable a more precise prognosis and a more pertinent treatment plan for mp patients. In particular, as the clinicopathological findings and surgical outcomes for mp1 patients were akin to those of the sm patients, mp1 patients may require treatment analogous to that administered to patients with sm gastric cancer.
Classification ; Humans ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate