We report a case of epidermolysis bullosa acquisita in a 53 year-old woman who had. extreme skin fragility, trauma induced blisters and erosions usually localized to extensor site of the skin surface, and healing with scars and milia for several years. Histologic findings of perilesional skin showed normal epidermis, subepid malblister and spirsely infiltration of inflammatory cells. Direct immuncofluorescence showed depositiori of IgCi and C3 in a linear pattern along the epidermal basement, membrane in the per ilesional skin. In indirect immuriofluorescence, using 1.0M sodium chloride separated nor mal human skin as the sntbstrate, antitodies(IgG at a titer of 1:40) were bound to dermal site of the separation, indicating that the patient serum yields the reaction in or below the lamiria densa. Electronmicroscopic findings showed the roof of the blister was located. below the basal lamiria.
Blister ; Cicatrix ; Epidermis ; Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa* ; Female ; Humans ; Membranes ; Middle Aged ; Skin ; Sodium Chloride

No abstract available.
Amniotic Fluid* ; Female ; Humans ; Obstetric Labor, Premature* ; Pregnancy ; Pregnant Women*

BACKGROUND: Systemic arterial hypotension is relatively common following initiation of cardiopulmonary bypass (CPB). Decreased blood viscosity is induced by acute normovolemic hemodilution (ANH) and by the use of crystalloid oxygenator prime. The purpose of this paper is to study the effect of ANH on mean arterial pressure, perfusion flow index and PaO2/FiO2 upon initiation of CPB, and on homologous blood usage during CPB in coronary artery bypass grafting (CABG) surgery. METHODS: We reviewed 30 patients constituting an ANH group, and 30 patients in a control group who had undergone CABG surgery within the past 2 years. In the ANH group, 1 or 2 units of fresh autologous whole blood were sequestrated following induction of anesthesia. We compared mean arterial pressure, perfusion flow index, PaO2/FiO2, and hematocrit on the initiation of CPB, and homologous blood usage during and post CPB periods between the groups. RESULTS: Upon initiation of CPB, hematocrit in the ANH group was significantly less than in the control group, but there was no significant difference in mean arterial pressure, perfusion flow index or PaO2/FiO2 between the groups. The use of homologous blood during CPB in the ANH group was not significantly higher than in the control group. CONCLUSIONS: Acute intraoperative normovolemic hemodilution in CABG surgery was safely performed without significant hypotension and increased homologous blood usage during CPB.
Anesthesia ; Arterial Pressure ; Blood Viscosity ; Cardiopulmonary Bypass* ; Coronary Artery Bypass* ; Coronary Vessels* ; Hematocrit ; Hemodilution* ; Humans ; Hypotension ; Oxygen ; Oxygenators ; Perfusion

No abstract available.
Esophageal Neoplasms*

No abstract available.

To clarity the effect of biliary obliteration on copper metabolism of rat liver and on the hepatic morphology, 0.5% cuppuric sulfate was administered intraperitoneally for 42 days following ligation of the common bile duct (CBD) of Sprague-Dawley rats. The blood copper concentration, the hepatic copper content and the accumulation patterns of copper and copper binding protein in the liver were examined and compared with those of the simple CBD ligation group and the simple copper over loaded group. CBD ligation induced marked proliferation of bile ductular structures which, after expanding the portal tracts, invaded and divided the hepatic lobules. There was, however, no excess fibosis beyond what needed to support the new ductules. The blood copper concentration and the hepatic copper content were increased by copper overload with or without CBD ligation, particularly incases with CBD ligation. Liver cell necrosis did not occur by the overloaded copper alone in rats. The hepatic copper and copper binding protein were accumulated at periportal liver cells in the group of coppe overload after CBD ligatio, whereas they began to appear at perivenular hepatocytes in the simple copper overloaded group. In conclusion, it is suggested that CBD ligation does not induce excess fibrosis or liver cirrhosis in rat as far as during our experimental period, but affect significantly on copper metabolism by intrahepatic redistribution of the copper and the copper binding proteins.
Rats ; Animals

No abstract available.

No abstract available.
Empyema*

Adenoid cystic carcinoma of the esophagus was regarded as an esophageal counterpart of the more common adenoid cystic carcinoma of the salivary gland. However it is a rare lesion which has more malignant differentiations and thus shows more aggressive clinical behaviors than the latter. Although many authors think that this tumor arises from the submucosal esophageal gland, its histogenesis is still in dispute. A 60-year-old male patient had a tumor in the middle third of the esophagus which was incidentally found during gastrofiberscopy. The tumor was 1.5 cm sized and covered with intact mucosa. The patient underwent Ivor Lewis operation, and the postoperative complication of ARDS eventually subsided. On microscopic examination of the surgically resected specimen, the adenoid cystic carcinoma which was mainly confined to the submucosa extended to the proper muscle layer, however no regional lymph node metastasis was present. The patient is still alive and well 6 months after the surgery.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Dissent and Disputes ; Esophagus* ; Humans ; Lymph Nodes ; Male ; Middle Aged ; Mucous Membrane ; Neoplasm Metastasis ; Postoperative Complications ; Salivary Glands

No abstract available.