BACKGROUND: Preservation of antigen determinants while retaining morphological detail is prerequisite for high quality immunohistochemistry. Conventional formalin fixation and paraffin embedding procedures are useful in preserving tissue architecture and cytologic detail. However, they destroy the antigenicity of many proteins is tissue samples. On the other hand, fresh frozen section preserve the antigenicity of most proteins, but vield poor morphological preservation. OBJECTIVE: The purpose of this study is to evaluate the AMeX method as to the ability to preserve both antigenicity and morphologic details of the skin basement membrane zone so that precise localization of antigens can be attained in immunohistochemistry. METHODS: Tissues were fixed in acetone at -20degrees C over night, then cleared in methyl benzoate and xylene, consecutively, and embedded in ordinary paraffin at 58-60degrees C. Sections made from this paraffinembedded tissue were stained with hematoxylin and eosin for a morphologic study and immunolabelled with antibodies against major basement membrane antigens to evaluate antigenic preservation. The staining intensity and preservation of the morphology by the AMeX method were compared with conventional formalin processed tissues and frozen tissues. RESULTS: Morphological preservation of the AMeX method-processed sections was good throughout the epidermis, basement membrane, and dermis, and as good as that of routinely formalin-fixed paraffin-embedded sections. Frozen sections usually revealed revealed various degrees of damage by ice crystal formation throughout the epidermis to the dermis. The AMeX method-processed sections showed better or same antigenic preservation comparing the frozen sections when the sections were immunolabelled with specific monoclonal antibodies. But, when the sections were immunolabelled with patient's sera, the AMex method showed less antigenic preservation than the frozed sections. The anti-type IV collagen monoclonal antibody exhibited immunoreactivity only conventional formalin-fixed paraffin-embedded skin sections, but the intensity of the staining was weaker than the AMeX processed sections and the frozen sections. CONCLUSION: The AMeX method can be utilized for the demonstration of skin basement membrane antigens and is superior to the fresh-frozen method in that the histologic figures are more distinct and antigencity can be preserved for a long time.
Acetone* ; Antibodies ; Antibodies, Monoclonal ; Basement Membrane* ; Benzoates* ; Collagen ; Dermis ; Eosine Yellowish-(YS) ; Epidermis ; Formaldehyde ; Frozen Sections ; Hand ; Hematoxylin ; Ice ; Immunohistochemistry ; Paraffin ; Paraffin Embedding ; Skin* ; Xylenes*

The gout is a hereditary condition of disturbed uric acid metabolism. There are medical and surgical management in tophaceous gout for prevention of recurrence of acute attack and creation of a negative uric acid balance. The surgical management is removal of tophaceous material in the soft tissue and osseous structure. Aditionally, the resection of bone and joint, arthrodesis and bone graft improve the functional capacity of the gouty patients. A 53 years old man was managed by removal of tophaceous materials in both prepatellar area, left olecranon area and both feet and arthrodesis of left first metatarsophalangeal joint with autogenous iliac bone graft and supportive medication with probenecid and indomethacine, and was followed up from March, 1986 to April, 1987. There was no significant difference in duration between the union of nonpathologic fracture and the union of arthrodesis area in this gouty patient. We found the progressive recovery of normal trabeculation in previous destructive bone lesions with drug therapy, but there was no specific change in the soft tissue lesions.
Arthrodesis ; Drug Therapy ; Foot ; Gout ; Humans ; Indomethacin ; Joints ; Metabolism ; Metatarsophalangeal Joint ; Olecranon Process ; Probenecid ; Recurrence ; Transplants ; Uric Acid

Fracuture-dislocation of the cuboid is an extremely rere injury compared with fracture-dislocation of other tarsal bones. We report a case of the fracture-dislocation of the cuboid treated by open reduction and internal fixation.
Tarsal Bones

BACKGROUND: Radiofrequecy(RF) catheter ablation is the choice of treatment of refractory supraventricular tachycardia. Althogh catheter ablation is invasive, it is well-known that this procedure is safe. However RF catheter ablation may provoke some adverse conditions. The purpose of this study was to assess functional and morphologic changes shortly after radiofrequency catheter ablation in patients with supraventricular tachycardia by means of two-dimensional echocardiography. METHOD: Echocardiogram underwent 1 day before and within 3 days after RF catheter ablation. Cardiac chamber size, wall thickness, and valve motion in the M-mode were Measured. Left ventricular volume, area, dimension, pericardial effusion and segmental wall motion were measured by means of two-dimensional echocardiography and valve incompetence were also measured with color Doppler echocardiography. RESULTS: New echocardiographic abnormalities were observed in 4(5.4%) among 73 patients. One mild aortic regurgitation,one increase in severity of tricuspid imcompetence, one increase in severity of mitral regurgitation and one mild pericardial effusion were found. CONCLUSION: We concluded that echocardiographic changes after radiofrequency ablation are rate and of minor significance.
Catheter Ablation ; Echocardiography ; Echocardiography, Doppler, Color ; Humans ; Methods ; Mitral Valve Insufficiency ; Pericardial Effusion ; Tachycardia, Supraventricular

Kimura's disease is an uncommon, chronic inflammatory disease of unknown etiology. It is an important category of reactive lymphadenopathy in the oriental population. The most common sites are the subcutis of the head and neck, and parotid gland. It's clinical course is benign nature. The treatment modalities for this disease are steroid therapy, radiation therapy and surgical excision. We experienced a case of soft tissue mass in the left arm. It was slightly tender and relatively movable. We excised the mass, which was turned out to be Kimura's disease on microscopic examination.
Arm ; Head ; Lymphatic Diseases ; Neck ; Parotid Gland

No abstract available.
Humans ; Interferon-alpha* ; Prednisolone*

This retrospective analysis describes the clinical characteristics, treatment, and long-term outcome of 30 patients with axis fracture admitted to our institution between January 1991 and December 1995. The incidence of axis fracture was 27.2% in the 110 cervical spine fractures. Among these, odontoid process fracture was the most common type, 19 cases(63%) followed by 8 hangmans fractures(27%), 3 miscellaneous fractures(10%). Hangman's fractures, odontoid type III fractures and miscellaneous fractures were treated with external immobilization devices. Remaining 11 odontoid type II fractures, and six patients with dens dislocation of 6 mm or greater were initially treated by early surgical stabilization. Individuals with dens dislocated less than 6 mm were treated by external immobilization only. Among the nonoperative group of acute axis fractures, there was no fusion failure. In the early operated group, all patients were stable clinically or radiologically. But three patients with posterior wiring and bone graft complained of their neck motion limitation.
Axis, Cervical Vertebra* ; Dislocations ; Humans ; Immobilization ; Incidence ; Neck ; Odontoid Process ; Retrospective Studies ; Spine ; Transplants

PURPOSE: We investigated incidence of feeding intolerance and time when normal enteral feeding can be established in full term neonates with hypoxic-ischemic encephalopathy (HIE). METHODS: We reviewed medical records of 61 full term infants with HIE who were admitted to St. Paul's Hospital from Jan. 1996 to Dec. 2001. The incidence of feeding intolerance, day of first feeding, and day of full enteral feeding were studied in respective to Sarnat stages. RESULTS: Among the full term with HIE, 32 were classified into stage I, 20 into stage II, and 9 into stage III. The incidence of feeding intolerance was 6%, 30%, and 89% for stages I, II and III, respectively. There was only one case of necrotizing enterocolitis among infants of stage III HIE. Feeding first began on 0.13+/-0.01 postnatal day (PND) in normal infants compared to 0.15+/-0.03 PND in infants of stage I, 3.24+/-1.82 PND in stage II and 5.58+/-2.50 PND in stage III. The incidence of feeding intolerance, day of first feeding, and day of normal enteral feeding achieved in infants with stage I were not different from those of normal infants but significantly higher and delayed in infants with more severe degrees of encephalopathy. CONCLUSION: The first feeding should vary according to severity of encephalopathy so as to lower the incidence of feeding intolerance and the risk of necrotizing enterocolitis. We suggest that infants of stageIencephalopathy be first fed as same as normal infants, but precaution is in order when deciding an appropriate time to start feeding in infants of stage II, III encephalopathy.
Enteral Nutrition ; Enterocolitis, Necrotizing ; Humans ; Hypoxia-Ischemia, Brain* ; Incidence* ; Infant ; Infant, Newborn* ; Medical Records

PURPOSE: We investigated incidence of feeding intolerance and time when normal enteral feeding can be established in full term neonates with hypoxic-ischemic encephalopathy (HIE). METHODS: We reviewed medical records of 61 full term infants with HIE who were admitted to St. Paul's Hospital from Jan. 1996 to Dec. 2001. The incidence of feeding intolerance, day of first feeding, and day of full enteral feeding were studied in respective to Sarnat stages. RESULTS: Among the full term with HIE, 32 were classified into stage I, 20 into stage II, and 9 into stage III. The incidence of feeding intolerance was 6%, 30%, and 89% for stages I, II and III, respectively. There was only one case of necrotizing enterocolitis among infants of stage III HIE. Feeding first began on 0.13+/-0.01 postnatal day (PND) in normal infants compared to 0.15+/-0.03 PND in infants of stage I, 3.24+/-1.82 PND in stage II and 5.58+/-2.50 PND in stage III. The incidence of feeding intolerance, day of first feeding, and day of normal enteral feeding achieved in infants with stage I were not different from those of normal infants but significantly higher and delayed in infants with more severe degrees of encephalopathy. CONCLUSION: The first feeding should vary according to severity of encephalopathy so as to lower the incidence of feeding intolerance and the risk of necrotizing enterocolitis. We suggest that infants of stageIencephalopathy be first fed as same as normal infants, but precaution is in order when deciding an appropriate time to start feeding in infants of stage II, III encephalopathy.
Enteral Nutrition ; Enterocolitis, Necrotizing ; Humans ; Hypoxia-Ischemia, Brain* ; Incidence* ; Infant ; Infant, Newborn* ; Medical Records

No abstract available.
Hypothyroidism* ; Myasthenia Gravis*