No abstract available.
Moyamoya Disease*

A 63-year-old male patient with extensive carcinoma in situ of the urinary bladder was found to have unsuspected transitional cell carcinoma of the prostate. Mapping of the totally embedded radical cystectomy specimen demonstrated diffuse, multifocal, epithelial abnormalities, ranging from mucosal atypia to the nonpapillary carcinoma in situ with extension to the urethra, prostatic ducts and glands, seminal vesicles and ureter, probably reflecting individual urothelial susceptibility in reaction to carcinogenic stimulus. The importance of prostatic assessment in the evaluation of the patient with carcinoma in situ of the urinary bladder is emphasized.
Male ; Humans

We studied distribution of fibronectin in paraquat-induced adult fibrotic lung by indirect immunofluorescence and indirect immunoperoxidase methods, using affinity-purified antifibronectin IgG peroxidase conjugates and antifibronectin IgG FITC conjugates. In contrast to the relative paucity of staining in normal lung, there was a marked increase in interstitial staining for fibronectin in this fibrotic lung. This marked alterations in the apparent amounts and distribution of fibronectin in fibrotic human lung suggest its involvement in the cellular events accompanying human lung fibrosis.
Adult ; Male ; Female ; Humans

No abstract available.
Cerebral Ventriculitis* ; Enterobacter aerogenes* ; Enterobacter* ; Pefloxacin*

Extravasation necrosis due to intravenously administered fluids and drugs is an increasing problem in hospital practice. The incidence of extravasation is variable but skin necrosis is a potentially devastating complication of intravenous therapy. Local injection of hyaluronidase has been recommended for several types of infusion extravasations. The previous studies found hyaluronidase to be effective in the prevention of necrosis following intradermal nafcillin, 12% dextrose, sodium bicarbonate, aminophylline or vince alkaloids.The objectives of the study are to determine the dosage of hyaluronidase which is effective in reducing extravasation necrosis caused by 10% calcium-gluconate and to establish how soon after this extravasation it must be given to retain its effectiveness.Study I evaluated control versus only normal saline group and normal saline with hyaluronidase groups (dose:75,150,300,450 units; all in volume 2 ml, treatment delay:immediate, 15-minutes delay, half hour delay, one hour delay, three hour delay). Size and rate of eschar were compared between groups. Study II was undertaken to examine the evolution of calcium-gluconate induced soft tissue injury in the rabbit. The histologic findings of extravasation sites were compared between groups. A statistically significant protective effect was found in the treated group versus the nontreated group within 15 minutes to 30 minutes. The most effective protection was achieved by the immediate injection of 300 units dosage of hyaluronidase.In conclusion, in the 10% calcium gluconate-induced extravasation, the given data suggest that one can expect the most protective effect with a 300 units dosage of hyaluronidase and within half-hour delay in the treatment group.
Aminophylline ; Calcium* ; Glucose ; Hyaluronoglucosaminidase* ; Incidence ; Nafcillin ; Necrosis* ; Skin ; Sodium Bicarbonate ; Soft Tissue Injuries

No abstract available.
Colonoscopy* ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

A 68-year-old man was refered for evaluation and treatment of advanced esophageal cancer. He complained of substernal dysphagia for solid and liquid foods. He did not remember episodes about ingesting something that correlated with symptoms. The single-contrast esophagogram revealed subtotal obstruction of the cervical esophagus with barium outlining the polypoid-filling defect irregularly. After 18 hours later, the patient underwent endoscopic examination and at the direct esophagoscopic finding, the food materials mainly consisted of packed rice was filled in the cervical esophagus. After saline irrigation, a fish bone, which was about 50X9 mm, and looked like a knife was lodged just distal to the impacted food materials. The fish bone was removed successfully from the esophagus. The patient experienced dramatic relief of symptoms shortly after procedure.
Aged ; Barium ; Deglutition Disorders ; Esophageal Neoplasms ; Esophagus ; Humans

No abstract available.
Hidrocystoma* ; Syringoma*

BACKGROUND: The high level of susceptibility of patients with liver cirrhosis (LC) to septicemic infection is thought to be due to decreased reticuloendothelial function and irnpairment of several components of cell mediated and humoral immunity. It is well known that LC may cause many characteristic skin changes including jaundice, spider angioma, palmar erythema, xanthelasrna and nail changes such as clubbing and white nails. OBJECTIVE AND METHODS: During a 7 month period frorn April to October 1995, 100 patients who had been diagnosed as having LC were evaluated for the duration of their LC, the associated diseases they had apart from LC and various skin manifestations. Also, we performed the tuberculin test in 20 patients with LC and evaluated the correlation of the tuberculin test with severity of LC divided into 3 groups according to the Childs classification. RESULTS: The results are summarized as follows ; 1. The most frequent duration of LC was under 5 years (74%). 2. The most common associated disease of patients with LC was upper GI bleeding including esophageal varix (24 cases). Also, diabetes mellitus (13 cases) and hepatic coma (11 cases) were observed. 3. Jaundice (82 cases) was the most frequent skin rnanifestation of patients with LC. In addition, vascular changes (81 cases) and various nail changes (69 cases) were observed. Onychomychosis was the most common nail change of patients with LC. 4. 60% of the patients who were given the tuberculin test showed anergy, and the frequency of anergy increased in proport on to the severity of LC. However, it was not significant statistically (p> 0.05 ). CONCLUSIONS: Some of the skin manifestations help in the diagnosis of LC. Also, increased frequency of tuberculin test anergy in proportion to the severity of LC is thought to be related to decreased cell mediated immunity, although statistically it is not significant.
Child ; Classification ; Diabetes Mellitus ; Diagnosis ; Erythema ; Esophageal and Gastric Varices ; Hemangioma ; Hemorrhage ; Hepatic Encephalopathy ; Humans ; Immunity, Cellular ; Immunity, Humoral ; Jaundice ; Liver Cirrhosis* ; Liver* ; Skin Manifestations* ; Skin* ; Spiders ; Tuberculin Test

BACKGROUND: Generally, there are few problems in the diagnosis of Paget's disease(PD) using the H&E stain. However, the differentiation of PD from the clonal type of Bowens disease and superficial spreading melanoma in situ that shows pagetoid spreading of tumor cells, may present diagnostic difficulties. In addition, the specia1 stains used for demonstrating the presenee of Pagets cells, such as PAS and mucicarmim, are non-specific and not always sensitive. So, inenunohistochemical stains with monoclonal antibodies against various antigens may be helpful for differentiating PD from ather morphologically similar skin lesions. OBJECTIVE: The purpose of this study was to investigate the diagnostic accuracy of immunohisto- chemical staining for diagnostic use in PD. METHODS: Immunohistochemical stains used in the biotin streptavidin amplificxl technique with monoclonal antibodies to several low rnolecular weight cytokeratin(CK)s, EMA and CEA, were performed on formalin-fixed, paraffin-embedded tissue. Twelve cases of PD(10 cases of extranmmmary PD and 2 cases of mammary PD), five cases of superficial spreading melanoma in situ and five cases of Bowens disease were investigated. RESULTS: The results were as follows. 1. Positive reactions with variable intensity using CK7, CKS, CK19 were seen in all cases(100%) of PD and the. staining intensity tor CK7 or CK19 was stronger than that of CKS. 2. Of the 12 cases of PD, both CK18 and CAM5.2 staining showed positivity in 11 cases(92%). 3. EMA and CEA staining showed positivity in 10(83%) and 9(75%) of 12 cases, respectively. 4. Some Pagets cells were negative for CK8, CK18 and EMA, although other positive cells were observed in the same sections. 5. All antigens were consistently negative in all cases of Bowens disease and superficial spreading melanoma in situ. CONCLUSION: The results show that moaoclonal antibodies to low molecular weight CKs are more sensitive than EMA or CEA in the demonstration of Pagets cells. Moreover, among the low molecular weight CK series, CK7 and CK19 are most useful for their high sensitivity and intensity.
Antibodies ; Antibodies, Monoclonal ; Biotin ; Bowen's Disease ; Coloring Agents ; Diagnosis ; Melanoma ; Molecular Weight ; Skin ; Streptavidin