Multicentric pigmented Bowen's diseas. (MPBD) is a bowenoid atypia in the genitalia of young adults which was first described by Lloyd in 1970. Clinically the lesions appear to be benign warts, but histologically they show bowenoid atypia., Although the pathogenesis and cours of MPBD is as yet unknown, many authors have suggested viral etiology. We recentiy encountered two cases of MPBD, one a 25 year-old male and the other a 38 year-old female, confirmed clinicallr and histopathologically. Case 1 showed spontaneous regression without any treatment, but case 2 showed recurrence of the lesions inspite of three times of surgical excision. The recurrent MPBD which has proven to be resistant to surgical therapy is unusual according to the previous reported cases.
Adult ; Bowen's Disease* ; Female ; Genitalia ; Humans ; Male ; Recurrence ; Warts ; Young Adult

Pulmonary carcinosarcoma(Sarcomatoid carcinoma of the lung) is a rare pulmonary malignancy, which is defined as having an admixtture of both carcinomatous and sarcomatous components. Pulmonary carcinosarcoma occurs most frequentlly in males between 50 and 80 years of age. It predominantly affects the upper lobe and/or the principal bronchi, and is associated with a history of smoking. Here, we report a case of pulmonary carcinosarcoma with a left lobe atelectasis due to an endobronchial mass in a 56-year-old male. After a left pneumonectomy, the pathologic stage was IIb (T3N0M0). Four months later, an abdominal mass was observed and exploratory laparotomy revealed metastases of the pulmonary carcinosarcoma to the pelvic cavity.
Bronchi ; Carcinosarcoma* ; Humans ; Laparotomy ; Male ; Middle Aged ; Neoplasm Metastasis ; Pneumonectomy* ; Pulmonary Atelectasis ; Smoke ; Smoking

Computerized tomography(CT) has proven to be far superior to other diagnostic studies in the detection of intracranial lesions after head injuries. The procedure is especially appropriate for early and accurate diagnosis because it can be done quickly with no discomfort and minimal risk. CT was utilized as a screening diagnostic procedures in 100 consecutive patients of head injuries who were alert and neurologically no deficits in a 8 months period. 11 abnormal CT Scans found at 10 patients:six epidural hematomas, two intracerebral hematomas, one sudural hygroma and one temporal contusion. The cases presented are discussed in light of pertinent literature.
Contusions ; Craniocerebral Trauma* ; Diagnosis ; Head* ; Hematoma ; Humans ; Lymphangioma, Cystic ; Mass Screening ; Tomography, X-Ray Computed

No abstract available in English.
Acromioclavicular Joint ; Dislocations ; Methods

Muscles from three patients were obtained during continuous ischemic periods and were investigated ultrastructural changes to know the reversible tourniquet time. Tourniquet was applied for periods lasting between 60 minutes and 90 minutes in the human and muscle biopsies were taken from 10 minutes to 90 minutes ischemic period and at the same periods after release of the tourniquet. All specimens were investigated with electron microscopy and the results were as follows: In 10 minutes tourniquet period, loss of cristae in few mitochondria were observed. In 30 minutes tourniquet period, partial swelling, loss of cristae and myelin figure in many mitochondrias and vacuolar dilatation in T-tubule and sarcoplasmic reticulumn were observed. In 60 minutes tourniquet period, above change were observed in nearly all mitochondrias and total number of mitochondrias were decreased. In 90 minutes tourniquet period, above changes were more distinct. 20 minutes after release of 90 minutes tourniquet period, small sized new mitochondria were appeared and abundant electron dense granule in their matrix and sarcoplasmic reticulumn were visible. 60 minutes after release of 90 minutes tourniquet period, the majority of damaged mitochondrias were replaced by small sized new mitochondrias and electron dense granule were abundant in sarcoplasmic reticulumn. In human, the changes on the ultrastructure were reversible for at least a succeeding 90 minutes ischemic periods.
Biopsy ; Dilatation ; Humans ; Microscopy, Electron ; Mitochondria ; Muscle, Skeletal ; Muscles ; Myelin Sheath ; Tourniquets

PURPOSE: The purpose of study was to identify violence episodes by patients and/or their guardians and responses from emergency room nurses. METHOD: A convenient sample of 172 emergency nurses was selected from general hospitals with more than 200 beds. A survey design was used and data were collected from October 2 to October 11, 2006. using self-report questionnaires which were developed by the authors. Descriptive statistics, with the SPSS PC program were used to analyze the data. RESULTS: The majority of nurses (97.1%) had experienced violence by patients or their guardians in the previous month. Violence offenders who were drunk comprised 68.6% of total offenders. Causes of violence were delays in examination and treatment (59.9%). The major coping behavior in dealing with violence episodes was ignoring (40.1%). Responses to violence experienced by emergency nurses were rated as 2.39. Response to violence according to general characteristics of the nurses showed no statistically significant differences. CONCLUSION: Considering the high prevalence of violence experienced by emergency nurses, hospitals must develop and manage preventive education programs and policy.
Adaptation, Psychological ; Criminals ; Education ; Emergencies* ; Emergency Service, Hospital* ; Hospitals, General ; Humans ; Prevalence ; Surveys and Questionnaires ; Violence*

Purpose: To evaluate the correlation between the fibrillar pattern of the Achilles tendon on ultrasonography (US) and functional outcomes in patients who underwent open tendon repair after Achilles tendon rupture. Materials and Methods: Data of 44 patients who had been subjected to US at least 6 months after repair, during the period between July 2012 and July 2019 were reviewed. Those with bilateral tendon rupture, re-rupture, open injury, and chronic or insertional rupture, were excluded from the review. We divided them into two groups, the homogenous group (HoP) and the heterogenous group (HeP) based on the fibrillar pattern on US. We also divided the HoP into linear and wavy subgroups, and the HeP into no hypoechoic lesion and hypoechoic lesion subgroups. The rupture type of the Achilles tendon, radiographic factors including US and magnetic resonance images, patient-related, surgical factors, and clinical results at the last visit after repair were assessed retrospectively. Results: The tendon thickness was 11.4±1.7 mm in the HoP, and 14.5±3.0 mm in the HeP (p<0.001). A shredded pattern was observed in 17 cases (65.4%) in the HoP, and in 17 cases (94.4%) in the HeP (p=0.031). The mean value of the number of sutures used was 8.9±3.05 in the HoP and 11.39±1.75 in the HeP (p=0.001). The mean value of the difference in calf circumference was 0.9±0.67 cm in the HoP and 1.36±0.71 cm in the HeP (p=0.037). There were no statistically significant differences in the fibrillar patterns and patient-related factors. Conclusion The fibrillar pattern observed after repair was correlated with the functional outcome and showed a significant relationship with the rupture pattern and the number of sutures used. Therefore, we suggest a careful individualized postoperative rehabilitation protocol to maximize functional outcomes by referring to the fibrillar pattern in US, especially in shredded ruptures.

Rupture of an internal carotid artery pseudoaneurysm is a rare but lethal complication in patients with nasopharyngeal cancer. Here, we report a case of severe nasal bleeding from a left petrous internal carotid artery aneurysm after chemoradiotherapy in a patient with nasopharyngeal cancer. A 76-year-old man who was being treated with concurrent chemoradiotherapy and who had achieved a complete response for 14 months developed massive epistaxis . A postnasal space computed tomography scan showed an enhanced nodular lesion at the left petrous internal carotid artery, and angiography revealed a pseudoaneurysm measuring 11.5x9.1 mm in the left internal carotid artery. Bleeding was well controlled with endovascular occlusion using a coil. The patient showed no recurrence of bleeding during follow-up.
Aged ; Aneurysm ; Aneurysm, False ; Angiography ; Carotid Arteries ; Carotid Artery, Internal ; Chemoradiotherapy ; Epistaxis ; Follow-Up Studies ; Hemorrhage ; Humans ; Nasopharyngeal Neoplasms ; Recurrence

We report a familial case of visceral larva migrans of Toxocara canis after eating raw chicken liver. A 9-year-old female ate raw chicken liver with her father and older brother and was admitted to the hospital with periumbilical pain, a mild fever, and headache. The total peripheral eosinophil count was 9,884/mm3 and the total lgE concentration was 2,317 IU/dL. Chest and abdominal computed tomography (CT) scans demonstrated multiple, poorly-defined, small, nodular lesions scattered in the liver and lung parenchyma. Toxocara ELISA and Western blot tests were positive in the patient, and her father and brother. A liver biopsy revealed extensive eosinophilic infiltrations in the portal and lobular areas. She took albendazole for 5 days and was discharged in good condition. These results suggest that clinicians should consider foodborne toxocariasis in patients with multiple, small nodules in the liver and lung parenchyma with eosinophilia and a history of raw meat ingestion.
Albendazole ; Biopsy ; Blotting, Western ; Chickens ; Child ; Eating ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia ; Eosinophils ; Fathers ; Female ; Fever ; Headache ; Humans ; Larva Migrans, Visceral ; Liver ; Lung ; Meat ; Siblings ; Thorax ; Toxocara ; Toxocara canis ; Toxocariasis

Basal cell carcinoma(BCC) and squamous cell carcinoma (SCC) are very prevalent neoplasms of the human skin. Ultraviolet radiation in sunlight is a well-established mutagen of the p53 gene and is one of basal cell carcinoma and squamous cell carcinoma. The newly-formed vascular network is important for neoplasms to grow beyond a size of about 1 mm2. Recent reports have suggested the hypothesis that a mutant p53 protein is closely related with capillary density. Immumohistochemistry for p53 protein and CD34 was performed in 20 cases of BCCs and 14 SCCs to evaluated the relationship between p53 protein and capillary density. The results were as follows:1. The microvessels stained by CD34 were mainly located in the interface of tumor cells and stroma. 2. There was no difference in the microvessel density according to the histologic types and age of the patients, but a higher microvessel density was noted in male patients. 3. The aggressive BCCs and the less-differentiated SCCs showed higher p53 immunostaining. 4. The mean microvessel density of cases showing strong positive immunostaining of the p53 gene(54.73+/-17.75) was higher than that of others(39.75+/-18.30). These results suggested that p53 protein expression and microvessel density are not related to the histologic types and age of the patients, but that differentiation and biologic behavior such as the infiltrating property of tumors and the microvessel density are closely related to p53 protein expression.
Capillaries ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell* ; Genes, p53 ; Humans ; Male ; Microvessels* ; Skin* ; Sunlight