Photodynamic therapy(PDT) is a treatment modality by highly reactive oxygen intermediates generated through the interaction of light with a photosensiziter. It has been shown to be an effective treatment for various cutaneous and noncutaneous malignancies. It is efficient for the curative and palliative treatment of epithelial skin tumor in situ or early invasive lesions. In effect, it is a useful alternative treatment for the lesions located on anatomically difficult areas or the large-sized lesions. We treated a case of Bowen's disease arising on the plantar area and 3rd and 4th toewebs of left forefoot in a 61-year-old man with PDT using the hematoporphyrin derivative, porfirmer sodium(Photofrin, Russia) as a photosensitizer and gold vapor laser as a visible light source. The outcome showed partial clinical improvement after about 2 months' follow-up.
Bowen's Disease* ; Follow-Up Studies ; Hematoporphyrin Derivative ; Humans ; Lasers, Gas ; Light ; Middle Aged ; Oxygen ; Palliative Care ; Photochemotherapy* ; Skin

There are several methods for the reconstruction of partial urethral defect, including split-thickness skin graft, full-thickness skin graft, and preputial flap and free flap. Despite partial success using these methods, most results are unsatisfactory due to frequent complications such as postoperative infection, fistula formation, hair growth and stricture. There have been several pioneering experiments in this field using autogenous vein graft and the results have been controversial. However, the fact that the endothelial lining is replaced by natural urethral epithlium is generally accepted as a positive effect of this method. This experiment was designed to identify the possibility of using vein graft for the reconstruction of partial urethral defect. Two different types of vein graft method were performed in a total of 20 New Zealand White rabbits with partial urethral defect. Firth, for the patch-graft group, a 1 x 1 cm rectangular vein graft was sutured at a defective area of the same size. Second, for the tubed-graft group, a vein graft segment 1 cm long was replaced at a segmental urethral defect of the same length. Histologic study was performed at three and eight weeks postoperatively in each group. The process of transitional ell epithelial replacement within the grafted vein was uniformly observed in both experimental groups at three weeks postoperatively. At eight weeks postoperatively, the epithelial replacement was almost complete and histologically undistinguishable. In the retrograde urethrogram performed after 8 weeks, the urinary flow in the patch-graft group was normal and showed no stricture, and two of five rabbits in the tubed-graft group showed partial stricture at the graft site. In conclusion, natural urethral epithelium was restored in grafted venous segments irrespective of the type of graft. Partial stricture was observed in 40% of the tubed-graft group while complete reconstruction was possible in the patch-graft group.
Constriction, Pathologic ; Epithelium ; Fistula ; Free Tissue Flaps ; Hair ; Rabbits ; Skin ; Transplants* ; Veins*

Nerve conduction studies help delineate the extent and distribution of the neural lesion. The nerve conduction was studied on upper (median, ulnar and radial nerves) and lower (personal, posterior tibial and sural nerves) extremities in 83 healthy subjects 23 to 66 years of age, and normal values were established (Table 1). The mean motor terminal latency (TL): median, 3.6 (±0.6) milliseconds; ulnar, 2.9 (±0.5) milliseconds; radial nerve, 2.3 (±0.4) milliseconds. Mean motor nerve conduction velocity (MNCV) along distal and proximal segments: median, 61.2 (±9.1) (W-E) and 57.8 (±13.2) (E-Ax) meters per second; ulnar, 63.7 (±9.1) (W-E) and 50.6 (±10.0) meters per second. Mean sensory nerve conduction velocity (SNCV): median, 34.7 (±6.7) (F-W), 63.7 (±7.1) (W-E) and 62.8 (±12.3) (E-Ax) meters per second; ulnar, 38.0 (±6.7) (F-W), 63.4 (±7.5) (W-E) and 57.0 (±10.1) (E-Ax) meters per second; radial, 45.3 (±6.8) (F-W) and 64.2 (±11.0) (W-E) meters per second; sural nerve, 43.4 (±6.1) meters per second. The amplitudes of action potential and H-reflex were also standardized. Mean H latency was 28.4 (±3.2) milliseconds. And, the fundamental principles, several factors altering the rate of nerve conduction and clinical application of nerve stimulation techniques were reviewed.
Action Potentials ; Adult* ; Extremities ; H-Reflex ; Healthy Volunteers ; Humans ; Neural Conduction* ; Radial Nerve ; Reference Values ; Sural Nerve

No abstract available.

No abstract available.

OBJECTIVE: To investigate the characteristics of the motor cortex map for abductor pollicis brevis muscle (APB) using transcranial magnetic stimulation (TMS) in normal subjects. METHOD: Ten adults without neurological disorder were studied. A piece of cloth which marked at 1 cm interval was fixed on the head of the subject. The motor cortex mapping for APB was done with butterfly magnetic stimulator, and then with round magnetic stimulator. RESULTS: The average optimal scalp position for left APB was located on lateral 6.2 cm, anterior 0.1 cm from Cz and that for right APB was located on lateral 6.0 cm, anterior 0.1 cm from Cz when stimulated with butterfly magnetic stimulator. The differences between hemispheres were less than 1 cm in the location of optimal scalp position and less than 10% in excitatory threshold (ET) irrespective of magnetic stimulator. The ipsilateral motor evoked potential (MEP) was not evoked in all subjects. The ET when stimulated with butterfly magnetic stimulator was higher to that when stimulated with round magnetic stimulator. CONCLUSION: We conclude that TMS using butterfly and round magnetic stimulator is useful for the motor cortex mapping.
Adult ; Butterflies ; Evoked Potentials, Motor ; Head ; Humans ; Motor Cortex* ; Nervous System Diseases ; Scalp ; Transcranial Magnetic Stimulation*

BACKGROUND AND OBJECTIVE: The induction of allergic sensitization is the key process of guinea pig asthma model, but few studies has been done on allergen sensitization per se. We performed to investigate the effect of initial sensitization route on asthmatic reactions in response to subsequent repeated allergen challenges. Subjects and METHODS: Thirteen guinea pigs were sensitized with ovalbumin by intraperitoneal injection(group A) and 14 by exposure to aerosolized ovalbumin(group B) on two occasions separated by 1 week. Animals were challenged by inhalation of stepwise increasing concentration of 0.1, 0.5, 1, and 2% ovalbumin every 2 weeks 5 times. We used Penh (enhanced pause) as an index of airway constriction. Allergen inhalation discontinued when an increase of Penh more than 200%, and provocative concentration of ovalbumin causing a 200% increase in Penh was defined as PC200 Bronchoalveolar lavage and histopathological examination of lung tissue was done 24 after last challenge. RESULTS: On first challenge, 11 (85%) of group A had asthmatic reactions, but only 5 (36%) of group B did. Geographic mean of PC200 was significantly lower in group A than that of group B(0.26% vs. 1.26 %, p<0.01). On repeated allergen challenge, PC200 of group A was relatively unchanged, but that of group B was much variable. Sensitized guinea pig had increased eosinophil infiltration in BAL and there are no differences between group A and B in lang pathology. CONCLUSION: Ovalbumin sensitization by intraperitoneal injection of guinea pig is better than inhalation method in first allergen challenge and unvaried asthmatic reactions on repeated challenges.
Animals ; Asthma* ; Bronchoalveolar Lavage ; Constriction ; Eosinophils ; Guinea Pigs* ; Guinea* ; Inhalation* ; Injections, Intraperitoneal* ; Lung ; Ovalbumin* ; Pathology

BACKGROUND: Coronary artery calcification is frequently seen in hemodialysis patients. The development and progression of coronary artery calcification is similar to osteogenesis, and a naturally occurring serum inhibitor of calcification may be involved. The aim of this study was to evaluate the relationship between coronary artery calcification, bone remodeling related factor, serum osteoprotegerin (OPG), calcification inhibitor and the serum fetuin-A levels in hemodialysis patients. METHODS: A total of 51 hemodialysis patient were assessed for their coronary artery calcium (CAC) scores with using multirow spiral computed tomography and measuring the serum OPG level, the serum fetuin-A level, the biochemical markers of inflammation, the lipid profile and the mineral metabolism. RESULTS: The mean serum OPG level was 3,561+/-1,160 pg/mL and the mean serum fetuin-A level was 28.5+/-4.1 mg/dL. The CAC scores were significantly correlated with the duration of dialysis (p=0.0225), hs-CRP (p=0.0392), serum phosphate (p=0.0341), Ca x P (p=0.0434), the serum OPG level (p=0.0026) and LDL-cholesterol (p=0.0438), after adjusting for age, gender, BMI, smoking history and the presence of diabetes. Multiple regression analysis showed that the CAC scores were significantly associated with the serum OPG level (p<0.0001) and the serum phosphate level (p=0.0003). The subgroup of the patients with a CAC score greater than 400 (the severe CAC group) had significantly higher OPG levels and lower fetuin-A levels than the groups of the patients with lower CAC scores. CONCLUSIONS: Our data suggest that the CAC scores in the patients undergoing hemodialysis were related with higher serum OPG and higher serum phosphate levels. The serum fetuin-A level was significantly lower in the patients with severe coronary artery calcification.
alpha-2-HS-Glycoprotein* ; Biomarkers ; Bone Remodeling ; Calcium ; Coronary Disease ; Coronary Vessels* ; Dialysis ; Humans ; Inflammation ; Kidney Failure, Chronic* ; Metabolism ; Osteogenesis ; Osteoprotegerin* ; Renal Dialysis ; Smoke ; Smoking ; Tomography, Spiral Computed

The perinephric cyst in which cystic structures are in close relation to the kidney and renal pelvis is rare in occurrence. The causes may be obscure but most perinephric cysts around the kidney are a result of trauma, either accidental or an operative complication and doubtful origin, in which there is an encysted collection of urine or serous fluid lying beside and sometimes compressingthe kidney, and sometimes communicating with the pelvis. Clinical presentation is characterized by palpable flank mass and history of trauma. The diagnosis is made by excretory urography, ultrasonogram and CT scan. The treatment is aspiration or encleation of the cyst, or rarely nephrectomy. We report a case of perinephric cyst with hypertension developed in a 58-year-old woman presented with a child-fist sized palpable mass on right upper abdomen.
Abdomen ; Deception ; Diagnosis ; Female ; Humans ; Hypertension ; Kidney ; Kidney Pelvis ; Middle Aged ; Nephrectomy ; Pelvis ; Tomography, X-Ray Computed ; Ultrasonography ; Urography

Recent literature has emphasized the clinical and socio-epidemiological significance of asthma in the elderly. However, why the disease burden remains high in this group is unclear. Elderly subjects usually have multiple chronic illnesses, and the role played by comorbidities in the context of asthma has been underappreciated. This review aims to summarize the literature associations between comorbidities and asthma in elderly patients. In addition, we discuss patient management issues.
Aged* ; Asthma* ; Chronic Disease ; Comorbidity ; Humans