Secondary localized amyloidosis of the skin is occasionaly associated with keratoma, epithelioma, seborrheic keratosis, chronic dermatitis, etc. It was generally known that amyloidosis, especially lichen amyloidosis, is frequently seen in atopic disorders. But the exact mechanism and relationship of atopic disorders to the development of the amyloidosis is obscure still nowadays. This 72 years old male patient was suffered from itching sensation on the whole body which is suggested to be atopic dermatitis since about 35 years ago and pruritic lichenoicl papulonodular eruptions developed on the extensor surface of the lower extremity first since about 10 years ago and then occured gradually on the thigh and extensor surface of the arm and forearm in both side. The charateristic lesions seems to be lichen amyloidosis. But we suggest thc case is secondary localized amyloidosis of the skin probably due to atopic dermatitis in according to past history, physical examination and eosinophilia without other definitive diseases, The therapeutic results were not promissing, however itching and lichenoid papules were much disappeared during the treatment with steroid cream for occlusivc dressing therapy and oral use of steroid.
Aged ; Amyloidosis* ; Arm ; Bandages ; Carcinoma ; Dermatitis ; Dermatitis, Atopic* ; Dronabinol ; Eosinophilia ; Forearm ; Humans ; Keratosis ; Keratosis, Seborrheic ; Lichens ; Lower Extremity ; Male ; Physical Examination ; Pruritus ; Sensation ; Skin ; Thigh

Pulmonary vascular hypertension is characterized by migration and proliferation of smooth muscle cells accompanying abnormal synthesis and accumulation of extracellular proteins in vascular wall. The aim of this study is to define the role of endogneous TGF-betas and PDGF in the process of remodeling vessels through determining the temporal and spatial distribution of these growth factors in hypertensive pulmonary vessels in monocrotaline-induced pulmonary hypertension in rat. Sprague-Dawley rats were sacrificed 12 hours, 1, 2, 4, 7, 10, 14, 21, 28, and 56 days after treatment. The morphometric analysis of medial thickening and immunohistochemical study using antibodies to TGF-beta1, TGF-beta2, TGF-beta3, and PDGF were performed. Immunoreactivities for TGF-beta1 and TGF-beta3 were increased from the 14th day in the medial smooth muscle cells and PDGF showed increased expression from the 21st day in the medial smooth muscle cells. No difference in TGF-beta2 immunoreactivity was found between control and experimental groups. The expression of TGF-beta1, TGF-beta3 and PDGF increased in medial layers with the progressive thickening of pulmonary arteries which was considered to have close relation to medial hypertrophy of pulmonary arterioles. In the case of PDGF, however, the morphologic change occurred before increase in immunoreactivity was observed in the medial layer of pulmonary arterioles. Moreover, the function of isoforms of TGF-beta has yet to be completely elucidated; the different affinity to receptors and the degree of expression of these receptors that are supposed to affect the function of growth factors. Thus, further studies are needed.
Animals ; Antibodies ; Arterioles ; Hypertension ; Hypertension, Pulmonary* ; Hypertrophy ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; Monocrotaline ; Myocytes, Smooth Muscle ; Protein Isoforms ; Pulmonary Artery ; Rats* ; Rats, Sprague-Dawley ; Transforming Growth Factor beta* ; Transforming Growth Factor beta1 ; Transforming Growth Factor beta2 ; Transforming Growth Factor beta3

Diurnally fluctuating hereditary progessive dystonia is a rare movement disorder characterized by marked diurnal fluctuation of symptoms and dramatic response to levodopa. We report two advanced female patients of two families who presented with progressive dystonia and gait disturbance. Both patients have a family history and showed excellent response to levodopa.
Dystonia* ; Female ; Gait ; Humans ; Levodopa ; Movement Disorders

The hemostatic effect of endoscopic microwave coagulation method for upper gastrointestinal bleeding was evaluated clinically. Hemostasis over 72 hours was achieved in 18 of 20 cases (90%) with upper gastrointestinal bleeding by the endoscopic microwave coagulation method. It is noteworthy that this method was effective in all 4 cases of pulsatile bleeding from exposed vessels. We conclude that this method is useful for emergency endoscopic hemostasis on upper gastrointestinal bleeding, especially bleeding from exposed vessels.
Emergencies ; Hemorrhage* ; Hemostasis ; Hemostasis, Endoscopic ; Microwaves*

In planning treatment of tibial condylar fracture, the patient's age and physical condition, associated ligament injury and accurate fracture diagnosis, such as presence and degree of separatiori of split fragment, type of fracture and the severity of comminution must be considered. For accurate diagnosis, many kinds of methods including simple X-ray, arthroscopy, arthrography and tomography can be used. In spite of these procedures, sometimes we cannot know the accurate fracture morphology. The computed tomography(CT) has many advantages over other diagnostic methods. The application of CT in the evaluation of patients with spinal and pelvic fractures has been established, but rarely has its usefulness been noted in tibial condylar fracture. We thought that in assessing tibial condylar fracture, CT is more useful and accurate than conventional radiography. From March 1985 to August 1986, we took 17 patients(18 cases) of tibial condylar CT and were convinced with that it is a good diagnostic method. The results are as follows: l. In 5 cases, we could find a new fracture on CT film, which was impossible to be detected on simple X-ray. 2. In 7 cases, the fracture classification by plain X-rays was changed after CT check-up. 3. We could make the decision of treatment methods easily through more realistic classification and better recognition of split and comminution. 4. Proper approach could be done by understanding the accurate fracture size and localization.
Arthrography ; Arthroscopy ; Classification ; Diagnosis ; Humans ; Ligaments ; Methods ; Radiography

We performed the same day dipyridamole stress/rest myocardial SPECT in 14 healthy young men, reconstructed the polar maps according to Cedars-Sinal method and quantitated the radioactivity of myocardial wall. We divided the whole myocardium to 9 sectors. The latero-anterior wall contains the highest count. The infero-septal wall contains the lowest count. There isn't any significant differences of radioactivity in each segment between stress and rest polar map. The hemodynamic parameters after dipyridamole injection in the subjects were significantly changed except systolic blood pressure : the heart rate was increased and diastolic blood pressure was decreased. Adverse effects were reported in 85.7%. We suggest that these data can be used to dectect perfusion defect in the coromary artery disease.
Arteries ; Blood Pressure ; Dipyridamole* ; Heart Rate ; Hemodynamics ; Humans ; Male ; Methods ; Myocardium ; Perfusion ; Radioactivity ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Humans ; Thyroid Diseases* ; Thyroid Gland*

One of the major complications in cervical anterior interbody fusion is slipping or dislodgement of grafted bone. Authors descibe a simple wiring technique for prevention slipping or dislodgement of grafted bone. Results are briefly discussed.
Transplants*

Chronic invasive fungal sinusitis is a relatively rare disease that can span from months to years in its clinical course and is described to be more common in immunocompetent patients. Most cases of chronic invasive fungal sinusitis are due to the Aspergillus species and have been treated with a combination of surgery and antifungal agents. However, the incidence is increasing with frequent use of antibiotics, cytotoxic drugs, and systemic corticosteroids. We report a case of chronic invasive fungal sinusitis with orbital complication in the patient who underwent endoscopic sinus surgery for chronic rhinosinusitis. Although chronic invasive fungal sinusitis is relatively rare, it is important for otolaryngologists to be aware of its diagnosis and treatment.
Adrenal Cortex Hormones ; Antibiotics, Antineoplastic ; Antifungal Agents ; Aspergillosis ; Aspergillus ; Diagnosis ; Endoscopy ; Fungi ; Humans ; Incidence ; Orbit ; Postoperative Complications ; Rare Diseases ; Sinusitis*

Behcet's disease is a chronic inflammatory symptom complex consisting of recurrent aphthous sttomatitis, nonspectific ulcerative lesions of the genital area, and uveitis. Skin, cardiovascular, arthritic, central nerve system and gastrointestinal involvement have been reported in association with the major triad. Intestinal involvement in Behcets disease most commonly affects the ileocecal region as ulceration. Intestinal ulcers give rise to abdominal pain, perforation, melena, and tumor in order of frequency. A 36-year-old female patient was addmitted to this hospital because of right upper quadrent abdominal pain and mass. There was a history of recurrent aphthous stomatitis and vaginal ulcers. Barium enema showed that the terminal ileum was irregularly indented with multiple nodular filling defects and the proximal ascending colon around ileocecal valve had several round shaped filling defects. Colonoscopy showed that the terminal ileum was irregularly marginated geographic ulcer, surrounded with hyperemic edematous mucosa, extended to ileoeecal valve. And the proximal ascending colon around ileocecal valve revealed several discreted whitish patched ulcers with apparently normal intervening mucosa. She was operated with right hemicolectomy and end to end ileotransverse colostomy under the impression of inttinal-Behcets disease. About 1 year after operation, right upper quardrent abdominal pain was reappeared. Colonoscopy was performed and revealed a recurred ulcer at anastomotic site. We report a case of Behcet's disease with multiple ileocecal ulcers, recurred after operation.
Abdominal Pain ; Adult ; Barium ; Colon, Ascending ; Colonoscopy ; Colostomy ; Enema ; Female ; Humans ; Ileocecal Valve ; Ileum ; Melena ; Mucous Membrane ; Skin ; Stomatitis, Aphthous ; Ulcer* ; Uveitis