The occurrence of a fistula between the duodenum and the colon is very rare, although these two structures commonly lie in intimate relationship to each other. It is not uncommon for tumor of the right colon and proximal transverse colon to involve the duodenum by continuity, but fistulous connection between the duodenum and colon are infrequent In most of the reported malignant cases, the fistulas follow carcinomas of the transverse colon or the hepatic flexure of the colon. We report a rare case of malignant duodenocolic fistula which was first suspected by endoscopic examination and confirmed by operation.
Colon ; Colon, Transverse ; Duodenum ; Endoscopy* ; Fistula*

We are report on three cases of typical clinical characterstics and treatment response in neuroleptic maligant syndrome(NMS), and reviewed the literatures of NMS. NMS was first recognized as a life-threatening complication of dopamine receptor antagonists, and defined as a catatonic-like states associated with fever, obtundation, muscle rigidity, and unstable vital sign in patients taking neuroleptic agents. Concepts of NMS have changed because medications other than classic neuroleptic drugs have been implicated as triggering agents and syndromes identical to NMS have been observed in other conditions. The important neurochemical features are probably functional dopamine deficiency and ensuing hyperactivity of excitatory amino and neurotransmission in the basal ganglia and hypothalamus. Recognition of NMS and early discontinuation of neuroleptics are the most important step in its management. Supportive care includes management of hyperthermia and fluid replacement. Contraversial therapeutic measures include the application of dopamine receptor agonists, excitatory amino acid antagosists, or dantrolene. Psychiatric patients with a history on NMS and psychotic relapse necessitating antipsycotics do not commonly redevelop NMS.
Antipsychotic Agents ; Basal Ganglia ; Dantrolene ; Dopamine ; Dopamine Agonists ; Dopamine Antagonists ; Excitatory Amino Acids ; Fever ; Humans ; Hypothalamus ; Muscle Rigidity ; Neuroleptic Malignant Syndrome* ; Recurrence ; Synaptic Transmission ; Vital Signs

No abstract available.
Embryonic Structures* ; Head* ; Humans* ; Neck*

BACKGROUND: We investigated the effectiveness of fibular strut allograft augmentation of proximal humerus fractures to prevent varus deformity in patients over the age of 65 years with insufficient medial support. METHODS: We analyzed the clinical and radiological outcomes of locking plate fixation with adjunct fibular strut allograft augmentation in 21 patients with proximal humeral fractures. The inclusion criteria were age (65-year-old or older); presence of severe medial comminution; inadequate medial support; and those who could participate in at least a one year follow-up. The average age was 76.4 years. We analyzed each patient's Constant score, our indicator of clinical outcome. As radiological parameters, we analyzed time-to-bone union; restoration of the medial hinge; difference between the immediately postoperative and the last follow-up humeral neck-shaft angles;; and anatomical reduction status, which was assessed using the Paavolainen method. RESULTS: A successful bone union was achieved in all patients at an average of 11.4 weeks. We found that the average Constant score was 74.2, showing a satisfactory outcome. The average difference in the humeral neck-shaft angles between the immediately postoperative time-point and at the final follow-up was 3.09°. According to the Paavolainen method, the anatomical reduction was rated excellent. The medial hinge was restored in 14 of 21 patients. Although we did not find evidence for osteonecrosis, we found that a single patient had a postoperative complication of screw cut-out. CONCLUSIONS: Fibular strut allografting as an adjunct treatment of proximal humeral fractures may reduce varus deformity in patients with severe medial comminution.
Allografts ; Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Humerus* ; Methods ; Osteonecrosis ; Postoperative Complications ; Shoulder Fractures ; Transplantation, Homologous

PURPOSES: We experienced a case of infected cephalhematoma drained spontaneously. So we wanted to review the most appropriate method for investigating cephalhematomas for possible infection and to clarify the indications for the diagnostic aspiration. METHODS: MEDLINE searches were conducted for the period from 1972 to 1997, and all reports were obtained. 15 articles reporting 18 infected cephalhematomas were identified in the literature. We analyzed the medical records in patients according to age: sex ; associated infections especially sepsis or osteomyelitis, risk factors such as scalp electrode or vacuum use, local signs such as increase in size, fluctuation, local redness: organisrns: and radiographic findings. RESULTS: Escherichia coli was isolated from over 50% of the cephalhematomas that were aspirated. Most patients presented with sepsis, meningitis, and/or osteomyelitis. Plain radiographs, bone scans, and enhanced CT scans were limited in their ability to determine if a cephalhematoma was infected unless associated osteomyelitis existed. Local signs of scalp infection, such as increase in size, fluctuation, local redness were obvious in almost all cases. CONCLUSIONS: Aspiration is the diagnostic procedure of choice for cephalhematomas suspected of being infected. The indications for aspiration were increase in size, development of erythema, development of fluctuation, relapse of systemic infection, or a delay in the resolution of clinical symptoms of infection.
Diagnosis ; Electrodes ; Erythema ; Escherichia coli ; Humans ; Infant, Newborn ; Medical Records ; Meningitis ; Osteomyelitis ; Recurrence ; Risk Factors ; Scalp ; Sepsis ; Tomography, X-Ray Computed ; Vacuum

BACKGROUND: In recent studies, tacrolimus ointment has been shown to be effective for the treatment of atopic dermatitis with an excellent safety profile. OBJECTIVE: This study was done to assess the efficacy and side-effects of tacrolimus ointment for the facial atopic dermatitis(AD) in Korean. PATIENTS AND METHODS: Open-label, non-comparative study with 2 months' follow-up was done to assess the efficacy and safety of tacrolimus ointment (Protopic0ointment 0.1%, Fujisawa, Japan) in moderate to severe facial AD. Patients were instructed to apply it two times daily for 8 weeks. Facial lesions were evaluated at baseline, 4 and 8 weeks of treatment with in-tensity score by investigator. RESULTS: In comparing of intensity scores and each clinical score at baseline with those of 4 and 8 weeks of treatment, a significant decrease was noticed at all follow-up periods. Burning sense(54.5%) and pruritus(18.2%) were detected. CONCLUSION: Tacrolimus ointment is effective in treatment of severe facial AD and has tolerable mild adverse effects at the site of application in Korean.
Burns ; Dermatitis, Atopic* ; Follow-Up Studies ; Humans ; Research Personnel ; Tacrolimus*

Clear cell sarcoma of tendons and aponeuroses is the term coined by Enzinger in 1965 to describe a rare but unique type of soft tisse neoplasm whose cells characteristically have the capacity to produce melanin. The authors experienced a case of 64-year old female who presented with a 6x5x4 cm sized mass deeply seated in the left popliteal fossa. The mass was firm and multinodular, and on cut section revealed patches of brown black pigmentation. Histologically the tumor was composed of round to fusiform cells with clear or pale eosinophilic cytoplasm that contained small amounts of glycogen, separated into compact nests or short fascicles by delicate septa of fibrous tissue. The brown black pigment seen in tumor cells and stroma was proven to be melanin by special stain, and ultrastructural examination showed melanosomes in varying stages of development dispersed freely in the cytoplasm or in the lysosomes. These findings strongly support the view that clear cell sarcoma is a tumor of neural crest origin rather than of tenosynovial mesenchyme origin, and is a soft tissue variant of malignant melanoma.
Female ; Humans

The status of DNA synthesis and the effect of UV radiation on the DNA synthesis were studied in mouse skin by microautoradiography. Mice exposed to 100mJ/cm of UVB were injected intradermally with tritiated thymidine, 5 minutes, 2, 6 and 24 hours after irradiation and biopsies were processed for light microscopic autoradiography, A total of 25 ICR female albino haired mice were used as subjects. We compared heavily labeled cells(>10 grains/nucleus) and sparsely labeled cells (3-10 grains/nucleus) in UVL irradiated skin with nonirradiated control skin. 1. Within 5 minutes after UVL exposure an apparent depression in the number of heavily labeled cells occurred. This reduction was statistically significant and remained so for at least six hours post,irradiation. By 24 hours after UVL exposure, the reduction was recovered to nearly control level. 2. By five minutes after UVL exposure, sparsely labeled cells were observed in basal cell layer and differentiated cell layer. The nurriber of sparsely labeled cells appeared highest at five minutes after UVL exposure and then tended to fall to nearly control level at 24 hours. This aberrant type of TdR H incorporation is thought to represent unscheduled DNA synthesis to repair pyrimidine dimers formed in UVL injured DNA molecules,
Animals ; Autoradiography* ; Biopsy ; Depression ; DNA* ; Female ; Hair ; Humans ; Mice* ; Pyrimidine Dimers ; Skin* ; Thymidine ; Ultraviolet Rays

Recent advances in cell culture and tissue engineering permit the successful treatment of deep articular defects with autologous chondrocyte transplantation. While chondrocyte culturing from articular cartilage is commonplace, in vitro growth of chondrocytes from temporomandibular joint fibrocartilage has not been defined. Likewise, the concept of autologous chondrocyte transplantation has not been applied to the temporomandibular joint. Since fibrocartilage differs structurally and functionally from articular cartilage, an effective culturing method for this tissue is essential as well. The ultimate goal of this project is to enable the use of autologous temporomandibular joint chondrocyte transplantation for the regeneration of damaged or missing components of the joint. The aim of this pilot study is to develop an effective cell culturing technique for chondrocytes harvested from the temporomandibular joint disc of dogs. Cartilage of the temporomandibular joint disc of drug-free mongrel dogs was dissected, dissociated, and centrifuged for chondrocyte collection. Blood specimen was collected from the same animal to produce the autologous serum. Chondrocytes were then dispersed in 24-well plates and incubated in one of four media, DMEM (Dulbecco's modified Eagle's medium), Ham's F-12, DMEM/F-12, or Iscove's MDM(modified Dulbecco's medium). Each medium was also mixed with either 10% fetal bovine serum or 10% autologous serum. Temporomandibular joint disc chondrocytic proliferation was tested in all the culture media with sera on the fifth day. The initial plating count was held constant throughout at 1 x 10(4) cells/well and eight samples were evaluated in each culture. The results demonstrated that fetal bovine serum worked much better than autologous serum in all evaluated media and that DMEM/F-12 mixed with 10% fetal bovine serum was the most optimal culture condition for expansion of temporomandibular joint disc chondrocytes.
Animals ; Cartilage ; Cartilage, Articular ; Cell Culture Techniques ; Chondrocytes ; Culture Media ; Dogs ; Fibrocartilage ; Joints ; Pilot Projects ; Regeneration ; Temporomandibular Joint Disc* ; Temporomandibular Joint* ; Tissue Engineering

: In order to know the species and frequency of human parasitic infection diagnosed by biopsy, 149 cases (0.18%) of parasitic infection were reviwed, which were selected from 80,947 biopsied materials submitted for routine histopathological examination during a period of 10 years from 1980 to 1989 at Department of Pathology, Chonnam National University Hospital. They consisted of 112 cases of cysticercosis, 17 paragonimiasis, 7 clonorchiasis, 4 amebiasis, 1 sparganosis, 1 enterbiasis, 1 aniskiasis, and 1 fascioliasis respectively. Based on morphological preservation of cysticercus, they could be divided into mild (20.2%), morderate (40.4%), and severe (39.4%) degeneration. Except 2 cases biopsied at the lungs, 15 cases of ectopic paragonimiasis were located at abdominal cavity (8 cases) and central nervous system (7 cases). One case of intrahepatic fascioliasis was observed. This is the 13th human fascioliasis reported in Korea. From the above results, the frequency of parasitic infections found in biopsied specimens was on the decrease as the cysticercosis and ectopic paragonimiasis.
parasitology-helminth-cestoda-nematoda-trematoda ; biopsy ; histopathology ; tissue parasite ; cysticercose ; ectopic ; Enterobius vermicularis ; Taenia solium ; Paragonimus westermani ; Clonorchis sinensis ; Entamoeba histolytica ; Anisakis ; Fasciola sp. ; paragonimiasis ; fascioliasis