Basaloid follicular hamartoma(BFH) is a rare, benign adnexal tumor with a wide clinical appearance spectrum. A characteristic finding is multifocal islands in the papillary dermis and branching cords of basaloid epithelial cells in continuity at various sites with the basal layer of the epidermis and the hair follicles. We present a case of basaloid follicular hamartoma combined with basal cell epithelioma that developed on the tip of the nose in a 75-year-old man. To our knowledge, this is the first case report of basaloid follicular hamartoma combined with basal cell epithelioma in the Korean literature.
Aged ; Carcinoma, Basal Cell* ; Dermis ; Epidermis ; Epithelial Cells ; Hair Follicle ; Hamartoma* ; Humans ; Islands ; Nose

Extracellular ATP has been known to modulate various cellular responses including mitogenesis, secretion and morphogenic activity in neuronal cells. In the ATP-induced morphogenic activity, focal adhesion kinase(s) such as Fak have been suggested to play a critical role. Binding of ATP to its specific cell surface receptor in PC12 cells induces phospholipase D (PLD) activity. However, the role of PLD on ATP-induced Fak activation in PC12 cells remains unclear. In this study, we investigated the role of PLD on the ATP-induced Fak activation and paxillin phosphorylation using two established cell lines: wild type PLD2- and lipase-inactive mutant PLD2-inducible PC12 cells. Stimulation of cells with ATP caused PLD2 activation via classical protein kinase C activation. ATP also induced Fak activation, and paxillin phosphorylation, and were dramatically reduced by wild type PLD2 overexpression but not by lipase-inactive mutant PLD2 overexpression. When the PC12 cells were pretreated with propranolol, a specific inhibitor for phosphatidic acid phosphohydrolase resulting in the accumulation of PA, ATP-induced Fak activation and paxillin phosphorylation were also reduced. We found that inhibition of tyrosine phosphatases by pervanadate completely blocked PLD2-dependent Fak and paxillin dephosphorylation. Taken together, we suggest that PLD2 activity might play a negative role in ATP-induced Fak and paxillin phosphorylation possibly through tyrosine phosphatases.
Adenosine Triphosphate/*metabolism ; Animal ; Culture Media, Serum-Free ; Cytoskeletal Proteins/metabolism ; Enzyme Activation/drug effects ; Enzyme Inhibitors/pharmacology ; Focal Adhesions/metabolism ; PC12 Cells ; Phospholipase D/*metabolism ; Phosphoproteins/metabolism ; Phosphorylation ; Propranolol/pharmacology ; Protein Kinase C/antagonists & inhibitors ; Protein-Tyrosine Kinase/*metabolism ; Rats ; Support, Non-U.S. Gov't ; Vasodilator Agents/pharmacology

BACKGROUND: Two results have been conflict regarding the pH of gastric contents in obese and lean surgical patients. Obese patients have been considered to have lower pH of gastric contents than lean surgical patients since the study by Vaughan, whereas Harter reported no significant difference in the pH's of obese and lean surgical patients. The author wanted to investigate whether gastric content pH differs or not between obese and lean surgical patients aged from 20 to 60 years. METHODS: Forty patients scheduled for elective abdominal hysterectomy under general endotracheal anesthesia were studied. Group I (n = 20) was composed of lean patients whose body mass indices (BMIs) were between 20 and 25, whereas Group II (n = 20) was composed of obese patients whose BMIs were above 30. Every patient was fasted between 8 and 14 hours preoperatively. Within 10 minutes of endotracheal intubation, gastric contents were withdrawn with a 20 cc syringe connected to a 16F nasogastric tube placed in the stomach. pH and the incidences of pH <2.5, and pH <1.8 were compared. RESULTS: No significant difference in pH (P = 0.199) or in the incidences of pH less than 2.5 (P = 0.23) or 1.8 (P = 0.52) were observed between obese and lean patients. CONCLUSIONS: Obese and lean patients have similar fasting gastric pH's, as long as the obesity is not too severe (BMI under 40).
Anesthesia ; Fasting ; Humans ; Hydrogen-Ion Concentration* ; Hysterectomy ; Incidence ; Intubation, Intratracheal ; Obesity ; Stomach ; Syringes

BACKGROUND: Onlay vein patch coronary angioplasty has been known to be an option for coronary artery stenosis in the selective iesions MATERIAL AND METHOD: During the period between July 1997 and August 1999, coronary angioplasty using autologous saphenous vein was done on 16 sites in 14 cases for the stenotic lesion at the bifurcation area and significantly stenosis distal to anastomosis. RESULT: Early patency of the angioplasty site was 85.7% at postoperative day 7. There was no statistically difference in graft patency, operative parameters, and complications compared to conventional anatomosis(p>0.05). CONCLUSIONS: Despite the small number of cases, the patency rate of the coronary patch angioplasty was comparable to the conventional CABG. Coronary artery only patch angioplasty could be performed in highly selected coronary arteries.
Angioplasty* ; Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Stenosis ; Coronary Vessels ; Inlays* ; Saphenous Vein* ; Transplants ; Veins

BACKGROUND: Early patency of the coronary artery bypass grafting is determined mainly by surgical technique and status of coronary artery. We analyzed the early result, focusing on the relationship between postoperative angiographic findings and the patency rate. MATERIAL AND METHOD: During the period of July 1997- August 1999, 86 cases of CABG were performed and the postoperative coronary artery angiography was done in 76 cases on postoperative day 7 to assess the graft patency. RESULT: Overall graft patency was 90.2% on the angiographic finding. Factors influencing the early graft occlusion were the surgeon's experience, small coronary artery size less than 1.5mm in diameter, coronary arteries related to pre-operative myocardial infarction, and local atheroma at the anastomosis site(p<0.001). Operative mortailty was 2.3%. Early recurrence of the symptom was 19.8% during the follow up period. CONCLUSIONS: We examined the postoperative coronary angiography and found that the surgeon's experience, small coronary artery size less than 1.5mm in diameter, bypass surgery on the coronary arteries related to pre-operative myocardial infarction, and local atheroma at the anastomosis site were the factors for the graft occlusion.
Angiography* ; Coronary Angiography ; Coronary Artery Bypass* ; Coronary Vessels* ; Follow-Up Studies ; Myocardial Infarction ; Plaque, Atherosclerotic ; Recurrence ; Transplants

Traumatic amputation of a penis is an unusual injury. Amputation of the penis occurs most commonly as an act of self-emasculation, but has also been reported as resulting from assaults or accidental dismemberments. We report a case of successful clinical replantation of an amputated penis resulting from assaults by using a microvascular surgery.
Amputation ; Amputation, Traumatic ; Male ; Penis ; Replantation*

Cavernous hemangioma is a congenital, benign vascular tumor occurring in the deep dermis and subcutaneous tissue. Scrotal involvement is rare. A case of cavernous hemangioma of scrotum in a 2-year-old child is reported here with review of the literature.
Child* ; Child, Preschool ; Dermis ; Hemangioma ; Hemangioma, Cavernous* ; Humans ; Scrotum* ; Subcutaneous Tissue

We experienced a case of transient right-sided heart failure after angioplasty of membranous obstruction of the inferior vena cava confirmed by sonography and an inferior vena cavogram. Angioplasty involved the use of a self-expandable metallic stent, but after successful recanalization of the obstruction , the patient became dyspneic. Chest radiography revealed mild cardiomegaly with pulmonary congestion, but this was resolved spontaneously. For the prevention of serious heart failure, we recommend preprocedural evaluation of cardiac function.
Angioplasty* ; Cardiomegaly ; Estrogens, Conjugated (USP) ; Heart Failure* ; Humans ; Radiography ; Stents ; Thorax ; Vena Cava, Inferior*

A 42 year-old male with a history of multidrug-resistant pulmonary tuberculosis suddenly developed massive hemoptysis. Embolization of a bronchial artery branch and the collateral systemic arteries did not resolve the recurrent bleeding. Spiral computerized tomography(spiral CT) of the chest showed contrast enhanced nodules within a large cavity at the left lower lobe in the arterial phase suggesting a Rasmussen aneurysm. A pulmonary angiogram showed abnormal vascular nodules at that site. Coils were deployed at both the proximal and distal vessels of this aneurysmal sac for embolization. Transcatheter arterial embolization is a safe and effective means of controlling bleeding from this pulmonary arterial pseudoaneurysm. Here we report a case of a Rasmussen aneurysm diagnosed by spiral CT, which was successfully treated by pulmonary arterial embolization with a coil.
Aneurysm* ; Aneurysm, False ; Arteries ; Bronchial Arteries ; Embolization, Therapeutic ; Hemoptysis ; Hemorrhage ; Humans ; Male ; Respiratory Insufficiency ; Thorax ; Tomography, Spiral Computed ; Tuberculosis, Pulmonary

The prognoses for the gastric cancer patients treated with total gastrectomies are known to be unsatisfactory due to the low survival rates, the high frequency of postoperative mortality or morbidity, and long-term complications such as nutritional deficiency. The authors evaluated the 5-year survival rates and analyzed the prognostic factors in 557 patients with gastric cancer who underwent total gastrectomies during the period between Jan. 1987 and Dec. 1993. The overall 5-year survival rate was 49.7%, and the survival rates according to the stage were stage Ia, 92.0%; Ib, 85.5%; II 64.1%; IIIa 55.0%; IIIb 26.5%; and stage IV, 6.3%. Postoperative mortality rate was 1.1%. By using univariate analysis to evaluate the prognostic factors, factors such as age, depth of invasion, extent of lymph node metastasis (according to the Japanese rule), number of involved nodes, lymph node ratio, distant metastasis (peritoneal and/or hepatic), size of the tumor, gross type, histological type, the surgical curability and the TNM stage were found to be related with the survival of the patients. In a multivariate analysis using 11 variables, the TNM stage was the single most significant prognostic factor. Besides the TNM, depth of invasion (ratio of risk (R.R)=1.50), extent of lymph node metastasis (R.R=1.83), number of involved nodes (R.R=1.64), lymph node ratio (R.R=1.91), and peritoneal metastasis (R.R=3.11) were found to be independent prognostic factors influencing survival. It was thought that the radicality of surgery could be reflected in the number of removed nodes per specimen. In this study, the average number of removed nodes was 42.3 per case. Hence, it may be said that adequate lymphadenectomy was performed for almost all the grossly curable cancers. The 5-year survival rate in stage IV patients with tertiary node (N3) metastasis and no peritoneal or hepatic metastasis was 16.8%; in patients with peritoneal or hepatic metastasis, the survival rate was 0%. There was a significant survival difference between these two groups (p<0.05). This result suggests that the tertiary node metastasis is a potentially curable factor, and that it should be classified differently in the current TNM system. In conclusion, the overall survival rates in the patients treated with total gastrectomies were favorable compared with the results in other reports. Depth of invasion, extent of lymph node metastasis, number of involved nodes, lymph node ratio were important prognostic factors for survival after a total gastrectomy. The current TNM staging system appears to be a reasonable one, except that the probable curability of tertiary node metastasis may need to be taken into consideration.
Asian Continental Ancestry Group ; Gastrectomy* ; Humans ; Lymph Node Excision ; Lymph Nodes ; Malnutrition ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Stomach Neoplasms* ; Survival Rate