PURPOSE: To investigate the levels of radiation exposure of an operator which may be influenced by the wearing an apron, type of procedure, duration of fluoroscopy and operator's skill during various interventional procedures MATERIALS AND METHODS: Radiation doses were measured both inside and outside the apron(0.5mm lead equivalent) of the operator by a film badge monitoring method and the duration of fluoroscopy was measured in 96 procedures prospectively. The procedures were 30 transcatheter arterial embolizations (TAE), 25 percutaneous transhepatic biliary drainages (PTBD), 16 stone removals (SR), 15 percutaneous needle aspirations (PCNA) and 10 percutaneous nephrostomies(PCN). To assess the difference of exposure by the operator's skill, the procedures of TAE and PTBD were done separately by groups of staffs and residents. RESULTS: Average protective effect of the apron was 72.8%. Average radiation exposure(unit:micro Sv/procedure) was 23.3 in PTBD by residents, 10.0 in PTBD by staffs, 10.0 in SR, 8.7 in TAE by residents, 7.3 in TAE by staffs, 9.0 in PCN and 6.0 in PCNA. Average radiation exposure of residents were 1.9 times greater than those of staffs. CONCLUSION: Radiation exposure was not proportionally related to the duration of fiuoroscopy, but influenced by wearing an apron, various types o[procedure and operator's skills.
Aspirations (Psychology) ; Film Dosimetry ; Fluoroscopy ; Needles ; Pregnenolone Carbonitrile ; Proliferating Cell Nuclear Antigen ; Prospective Studies

We experienced a case of arteriovenous hemangioma showing Dariers sign on the forehead of a 43-year-old man. He presented with a single, 1 * 1.5cm sized, violaceous, asymptomatic nodule with a history of an intermittent wheal at the lesional site. This skin lesion showed Dariers sign clinically and proliferation of mast cells histopathologically with the punch biopsy specirnen suggesting urticaria pig- mentosa. Howerer, we could diagnose it as a arteriovenous hemangioma on complete excision, as the specimen showed arteriovenous proliferation with increased mast cells in a perivascular pattern. This case showed confusing clinical signs and showed the importance of complete excision for the diagnosis of a small skin tumor especially when a vascular proliferating tumor is suspected.
Adult ; Biopsy ; Diagnosis ; Forehead ; Hemangioma* ; Humans ; Mast Cells ; Skin ; Urticaria

Studies on milk transfer of drugs in non-human primates (NHPs) are among the crucial components in the assessment of peri- and postnatal toxicity because of the similarity between NHPs and humans. To evaluate the milk transfer of valproic acid (VPA) in NHPs, the toxicokinetics of VPA, an antiepileptic drug, were studied in pregnant cynomolgus monkeys. VPA was administered once daily to pregnant cynomolgus monkeys at doses of 0, 30, 90, and 270 mg/kg by oral gavage from Day 100 of gestation (GD 100) to Day 31 of lactation (LD 31). Concentrations of VPA and its metabolite, 4-ene-VPA, in the maternal plasma on GD 100, GD 140, and LD 30, and concentrations of VPA and 4-ene-VPA in the offspring plasma and milk on LDs 30 and 31, respectively, were quantified using liquid chromatography tandem mass spectrometry (LC/MS/MS). After administration of a single oral dose of VPA to pregnant monkeys on GD 100, the concentrations of VPA and 4-ene-VPA were generally quantifiable in the plasma of all treatment groups up to 24 hr after administration, which showed that VPA was absorbed and that the monkeys were systemically exposed to VPA and 4-ene-VPA. After administration of multiple doses of VPA to the monkeys, VPA was detected in the pup's plasma and in milk taken on LD 30 and LD 31, respectively, which showed that VPA was transferred via milk, and the pup was exposed to VPA. Further, the concentration of VPA in the milk increased with an increase in the dose. Extremely low concentrations of 4-ene VPA were detected in the milk and in the pup plasma. In conclusion, pregnant monkeys were exposed to VPA and 4-ene-VPA after oral administration of VPA at doses of 30, 90, and 270 mg/kg/day from GD 100 to LD 31. VPA was transferred via milk, and the VPA exposure to the pup increased with an increase in the dose of VPA. The metabolite, 4-ene VPA, was present in extremely low concentrations (< 0.5 microg/ml) in the milk and in the pup plasma. In this study, we established methods to confirm milk transfer in NHPs, such as mating and diagnosis of pregnancy by examining gestational sac with ultrasonography, collection of milk and pup plasma and determination of toxicokinetics, using cynomolgus monkeys.
Administration, Oral ; Chromatography, Liquid ; Fatty Acids, Monounsaturated ; Female ; Gestational Sac ; Haplorhini ; Humans ; Lactation ; Macaca fascicularis ; Milk ; Plasma ; Pregnancy ; Primates ; Tandem Mass Spectrometry ; Valproic Acid

This study was conducted to investigate the potential embryo-fetal toxicity and toxicokinetics of the antimalarial agent artesunate (ARTS) in Sprague-Dawley rats. Pregnant rats were administered ARTS daily from gestational day 6~15 via oral gavage, at test doses of 0, 2, 4, or 8 mg/kg (22 females per group). The fetuses were examined for external, visceral, and skeletal abnormalities on gestational day 20. With regard to the dams, there were no deaths, treatment-related clinical signs, changes in body weight, or food intake in any of the treatment groups. There were no treatment-related gross findings at necropsy in any treatment group. In the 8 mg/kg group, there was a decrease in gravid uterine weight and in the weight of female fetuses. There was also an increase in fetal deaths (primarily late resorptions) and an increase in post-implantation losses (37%) at 8 mg/kg. An increase in the incidence of visceral and skeletal variations at 4 and 8 mg/kg was observed. These defects included minor changes in the appearance of the kidney and thymus, as well as absent ribs or thoracic vertebrae. Toxicokinetics were assessed in a parallel study, using 4 mated females per group. Using liquid chromatography-mass spectrometry (LC-MS) analysis, the concentration of ARTS and its metabolite dihydroartemisinin (DHA) were quantified in plasma from rats on gestational days 5, 6, 10, and 15. Amniotic fluid was assayed for ARTS and DHA on gestational day 15. There was evidence of rapid conversion of ARTS to the metabolite DHA in maternal plasma, since ARTS could not be consistently detected in plasma at the three doses tested. ARTS and DHA were not detected in amniotic fluid at gestational day 15, indicating limited placental transfer of the two agents. The embryo-fetal no-observable-adverse-effect level (NOAEL) of the test item was considered to be 8 mg/kg/day for dams, and 2 mg/kg/day for embryo-fetal development.
Amniotic Fluid ; Animals ; Artemisinins ; Body Weight ; Eating ; Female ; Fetal Death ; Fetus ; Humans ; Incidence ; Kidney ; Plasma ; Rats ; Rats, Sprague-Dawley ; Ribs ; Spectrum Analysis ; Thoracic Vertebrae ; Thymus Gland

Bronchogenic cyst is a congenital anomaly of the embryolgic foregut. A bronchogenic cyst is thought to arise from developing lung bud structure in the 7th week of gestation. Subcutaneous bronchogenic cyst is developed from isolated lung parenchyme during cell migration. Sometimes the fistula is formed between cyst and epidermis. Histologically, fistula tract is lined with sebaceous gland, which is the evidence of embryologic anomaly of cyst. The most common extrapulmonary location of bronchogenic cyst is mediastinum. Subcutaneous location is uncommon. Subcutaneous bronchogenic cyst is commonly located in suprasternal notch followed by the presternal area, neck and scapula. Subcutaneous bronchogenic cyst is predominantly found in male and the ratio is four to one. Clinically the cutaneous presentation vary from nodular swelling, sinus tract ostium to papillomatous lesion. The differential diagnosis of bronchogenic cyst include branchial cleft cyst, thyroglossal duct cyst, cutaneous ciliated cyst and mature cystic teratoma. The diagnosis of subcutanoeus cyst is entirely dependent on the histologic feature. Bronchogenic cyst is lined with ciliated pseudostratified columar epithelium of respiratory origin. Underlying wall is surrounded by the smooth muscle, cartilage and seromucinous gland. This report is on a subcutaneous bronchogenic cyst in a 5-years-old male without fistula tract. The cyst is 5 x 4 x 3 cm in size and histolgically shows the typical feature of bronchogenic cyst.
Branchioma ; Bronchogenic Cyst* ; Cartilage ; Cell Movement ; Diagnosis ; Diagnosis, Differential ; Epidermis ; Epithelium ; Fistula ; Humans ; Lung ; Male ; Mediastinum ; Muscle, Smooth ; Neck ; Pregnancy ; Scapula ; Sebaceous Glands ; Teratoma ; Thyroglossal Cyst

Trichoadenoma is a rare cutaneous tumor that was first described by Nikolowski in 1958. It usually occurs as a single tumor on the face and its size varies from 3 to 50mm in diameter. It may arise any time during adult life. This tumor is less mature than trichofolliculoma and more differentiated than trichoepithelioma, and it is considered as a benign tumor with differentiation toward the infundibular portion of the pilosebaceous canal. In this report, we describe a 61-year-old women who developed trichoadenoma on the left shoulder of 3 years duration. The lesion was asymptomatic and had grown slowly. Histopathological findings showed numurous horn cysts with central keratinous material and solid tumor islands reaching to the deep dermis. Immunohistochemical studies showed negative findings for eccrine differentiation.
Adult ; Animals ; Dermis ; Female ; Horns ; Humans ; Islands ; Middle Aged ; Shoulder

OBJECTIVE: Shunt-dependent chronic hydrocephalus (SDCH) is known to be a major complication associated with aneurysmal subarachnoid hemorrhage (aSAH). Old age is known to be one of numerous factors related to the development of SDCH. This study investigated whether postoperative cisternal drainage affects the incidence of SDCH and clinical outcome in elderly patients with aSAH. METHODS: Fifty-nine patients participated in this study. All patients underwent aneurysmal clipping with cisternal cerebrospinal fluid (CSF) drainage. Clinical variables relevant to the study included age, sex, location of ruptured aneurysm, CT finding and clinical state on admission, clinical outcome, and CSF drainage. We first divided patients into two groups according to age (<70 years of age and > or =70 years of age) and compared the two groups. Secondly, we analyzed variables to find factors associated with SDCH in both groups (<70 years of age and > or =70 years of age). RESULTS: Of 59 patients, SDCH was observed in 20 patients (33.9 %), who underwent shunt placement for treatment of hydrocephalus. Forty seven percent of cases of acute hydrocephalus developed SDCH. In the elderly group (> or =70 years of age), the duration and amount of CSF drainage did not affect the development of chronic hydrocephalus. CONCLUSION: In elderly patients, although the incidence of SDCH was significantly higher, clinical outcome was acceptable. The duration and the amount of cisternal drainage did not seem to be related to subsequent development of chronic hydrocephalus within elderly patients aged 70 or older.
Aged ; Aneurysm ; Aneurysm, Ruptured ; Dependency (Psychology) ; Drainage ; Humans ; Hydrocephalus ; Incidence ; Subarachnoid Hemorrhage

Poroid hidradenoma is a benign tumor with eccrine differentiation. It is a recently described variant of a group of neoplasms known as poromas. This neoplasm shows architectural characteristics of hidradenoma (tumor cells confined within the dermis in both solid and cystic components) and cytologic characteristics of poroid neoplasm (poroid and cuticular cells). We herein report a case of poroid hidradenoma in a 51-year-old woman who presented with a solitary, bluish, tender nodule on the lateral aspect of her right thigh.
Acrospiroma* ; Dermis ; Female ; Humans ; Middle Aged ; Poroma ; Thigh

Aplasia cutis congenita(ACC) is a rare congenital anomaly characterized by a well-demarcated skin defect. In the majority of cases it is limited to the scalp especially on the vertex although other areas of the body may also be involved. We report a case of aplasia cutis congenita, in a month-old female infant born with a round shaped hairless transparent menbrane on the left temporal area of the scalp. No associated other congenital anomalies were in this case.
Ectodermal Dysplasia* ; Female ; Humans ; Infant ; Scalp ; Skin

The isomorphic response of Koebner is a well-known phenomenon commonly associated with psoriasis, but it has been also described in conjuction with a host of other disorders. However it has seldom been associated with necrobiosis lipoidica diabeticorum, a rare skin manifestation of diabetes mellicuts. In this report, we describe a 59-year-old woman who developed necrobiosis lipoidica diabeticorum on the left shin where a mosquito had bitten her 2 months ago. Four months ago, she was diagnosed as necrobiosis lipoidica diabeticorum on the right forearm and shin by biopsy and the lesions were improved with corticosteroids intralesional injection. The lesions were asymptomatic and had grown slowly. Histopathological findings showed a large palisading granulomas composed of histiocytes, epithelioid cells and areas of necrobiosis of collagen with multinucleated giant cells. Van Gieson stain showed decreased and fragmented elastic fibers and there were no deposits of mucin in the necrobiotic areas. The lesions were improved with triamcinolone acetonide intralesional injection and there was no recurrence during 4 months.
Adrenal Cortex Hormones ; Biopsy ; Collagen ; Culicidae ; Elastic Tissue ; Epithelioid Cells ; Female ; Forearm ; Giant Cells ; Granuloma ; Histiocytes ; Humans ; Injections, Intralesional ; Middle Aged ; Mucins ; Necrobiosis Lipoidica* ; Necrobiotic Disorders* ; Psoriasis ; Recurrence ; Skin Manifestations ; Triamcinolone Acetonide