We presented here a case of an 80-year-old male patient who was, confirmed in the typical tumor stage of Mycosis fungoide by skin biopay. Relatively well-defined, brown-colored, round patches were found about 3 years ago on the chest, abdomen and inguinal area. He had received some treatment at several private clinics uder the impression of seborrheic dermatitis, paoriaais and eczematoid dermatitis. However, the skin manifestations were not improved t.ut rarther increased in eize, similarly to tinea corporis. Two months ago, firm nodules and tumors developecl a new on the lesinn sites, assoviated with intense pruritus and ulcerative tendency. We tried radiation therapy, but due to old age the patient chose to discontinurue.
Abdomen ; Aged, 80 and over ; Dermatitis ; Dermatitis, Seborrheic ; Humans ; Male ; Mycosis Fungoides* ; Pruritus ; Skin ; Skin Manifestations ; Thorax ; Tinea ; Ulcer

During development of central nervous system, cell proliferation, cell migration, cell differentiation and cell death are required. It has been reported that a number of cells are dying during development in the mammalian retinae examined so far, but the pattern of cell death has not been clarified yet. In addition. little has been studied on cell proliferation after birth. This study was conducted to identify histogenesis, cell death and cell proliferation in the retinae of the developing rats by light and electron microscopic methods as well as by immunohistochemical method using anti-proliferating cell nuclear antigen [PCNA] antiserum. The results were as follows : 1. In the developing rat, from postnatal 0 through 7 days, retina consisted of ganglion cell layer, inner plexiform layer and neuroblast layer. Neuroblast layer could be subdivided into three sublaminae : sublamina a, sublamina b and sublamina p, from postnatal 3 through 7 days. 2. From postnatal 10 days, retina consisted of ganglion cell layer, inner plexiform layer, inner nuclear layer, outer plexiform layer and outer nuclear layer. 3. Cells undergoing degeneration were observed from postnatal 0 to 13 days, and patterns of cell death were apoptosis, cytoplasmic degeneration and autophagic degeneration. 4. PCNA-immunoreactivity was seen in the cells located in sublaminae b and p of the neuroblast layer at postnatal 0 and 1 days. From postnatal 3 days PCNA immunoreactivity decreased. At 7-day-old rat, PCNA-Immunoreactive cells scattered in the distal part of sublamina p of the neuroblast layer.No immunoreactivity was observed from postnatal 10 days. These results demonstrate that retinal cell proliferation ends at postnatal 7 days, and histogenesis of retina is completed at postnatal 10 days, and superfluous cells during retinal development are eliminated by apoptosis, cytoplasmic degeneration and autophagic degeneration.
Animals ; Apoptosis ; Cell Death* ; Cell Differentiation ; Cell Movement ; Cell Proliferation* ; Central Nervous System ; Cytoplasm ; Ganglion Cysts ; Parturition* ; Proliferating Cell Nuclear Antigen ; Rats* ; Retina* ; Retinaldehyde

In the treatment of an infected ununited fractures of a long bone, it often is difficult to achieve union and eradicate the infection. Over the past two decades, the electrical behaviour of bone has been studied with increasing interest and several reports reveal that electricity can stimulate osteogenesis. We have experienced 11 cases of infected non-union who were treated by immobilization plus direct current stimulation from January, 1980 to July, 1982. In all cases satisfactorv union occurred within averaging 8.1 months. The results obtained are as follows: 1. The direct current stimulation has revealed to be effective with antibiotics and some kinds of immobilization in treatment of infected non union. 2. If bone graft is combined with electrical stimulation, time from beginning of electrical treatment to union is shortened, as compared with cases of electrical stimulation alone. 3. The electrical stimulation is preferable to other surgeries in treatment of infected non-union due to its effectiveness and simplicity. 4. It is considered treatment of chronic osteomyelitis with silver anode is not due to electrically generated silver ion but its electricity per se. 5. To prevent refracture and assure complete healing, continued immobilization such as cast brace, walking cast, or conventional brace is necessary after electrical stimulation for the time being.
Anti-Bacterial Agents ; Braces ; Electric Stimulation ; Electricity ; Electrodes ; Fractures, Ununited ; Immobilization ; Osteogenesis ; Osteomyelitis ; Silver ; Transplants ; Walking

Extraskeletal Ewing's sarcoma is a rare primary malignant soft tissue tumor that has the same pathological characteristics of skeletal Ewing's sarcoma. It is known that the differential diagnosis of Ewing's sarcoma from undifferentiated rhabdomyosarcoma, neuroblastoma, reticulum cell sarcoma, and malignant lymphoma by the histologic studies only are not easy because their histologic findings are nearly similar each other. Therefore, immunohistochemical method, electron microscopic examination, cytogenetic study, or molecular gene study are used together to confirm the diagnosis. It chiefly involves the lower extremity, soft tissues of the paravertebral region, and adjacent chest wall. We recently experienced a case of extraskeletal Ewing's sarcoma of duodenum in a 21-year old female. The patient underwent Whipple's operation and postoperative combined chemotherapy were done.
Cytogenetics ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Duodenum* ; Female ; Humans ; Lower Extremity ; Lymphoma ; Lymphoma, Non-Hodgkin ; Neuroblastoma ; Rhabdomyosarcoma ; Sarcoma* ; Sarcoma, Ewing ; Thoracic Wall ; Young Adult

PURPOSE:Tumor cells can be shed into a venous blood stream by manipulation of tumor during surgery, resulting metastasis to distant organs from the primary tumor. In order to elucidate the effect of early lymphovascular dissection prior to tumor mobilization, we studied the difference in carcinoembryonic antigen (CEA) values of tumor draining veins before and after tumor mobilization. METHODS:Blood samples were taken from the tumor draining veins of sixteen patients during operations. The lymphovascular dissection was performed before the tumor mobilization, and the main draining vein from the tumor was isolated and the proximal end was ligated and blood samples were taken, then the tumor mobilization was made. Just before the removal of the tumor, we took the second sets of blood samples from the same sites. RESULTS:There were no significant differences in CEA values between peripheral blood (1.8+/-1.2 ng/mL) and tumor draining veins before the tumor mobilization. The mean CEA value of draining veins after the tumor mobilization (14.3+/-11.9 ng/mL) was significantly higher than that of draining veins before the mobilization (2.2+/-2.1 ng/mL)(P<0.001). CONCLUSIONS:Theses results suggest that early lymphovascular dissection procedures before tumor mobilization can reduce the opportunity of tumor cell dissemination into draining vein.
Carcinoembryonic Antigen* ; Colorectal Neoplasms* ; Humans ; Neoplasm Metastasis ; Rivers ; Veins

In spite of general agreement that pain relief after upper abdominal surgery is important for the reduction of postoperative morbidity, the most widely used method remains intramuscular injection of narcotics or non-opioid analgesics with their well known disadvantages of respiratory depression, nausea, vomiting and epidural anesthesia and intercostal nerve block are invasive, so do not achieve much popularity. This double-blind prospective study, 30 patients with subcostal incision performed for cholecystectomy, reeeived 20 ml of either physiologic saline or 0.5% bupivacaine by wound infiltration at the time of closure of the incision. After operation, pain score and analgesic requirements were compared at emergence and postoperative 24 hour in each group. The results were as following: 1) Mean age of control and bupivacaine group were 45.3+/-14.9 and 53.6+/-10.3 yr respectively and mean duration of anesthesia 175+/-63 and 145+/-54 minutes respectively. 2) At emergence, mean pain score was 7.7+/-1.7 in control and 2.7+/-2.6 in bupivacaine group (p < 0.01), and at postoperative 24 hour, mean value of pain score was 6.8+/-2.1 in control and 2.31.9 in bupivacaine group(p<0.01). 3) At emergence, there were 11 patients(73%) of none to mild pain, 3(20%) of moderate pain and 1(7%) of severe pain in bupivacaine group, while 0(0%), 6(40%) and 9(60%) respectively in control group. But at postoperative 24 hour, the number of patients with none to mild, moderate and severe pain were 13(87%), 2(13%) and 0(0%) in bupivacaine group and 4(27%), 3(20%) and 8(53%) in control group respectively. 4) In experimental group, patients less than 14% needed additive analgesic, and there were no side reactions in the bupivacaine group. With above results, we suggest that pouring of 0.5% bupivacaine into incisional wound, especially in cholecystectomy patients, would be a method for postoperative pain relief.
Analgesics ; Anesthesia ; Anesthesia, Epidural ; Bupivacaine* ; Cholecystectomy* ; Humans ; Injections, Intramuscular ; Intercostal Nerves ; Narcotics ; Nausea ; Pain, Postoperative* ; Prospective Studies ; Respiratory Insufficiency ; Vomiting ; Wounds and Injuries

The tottering (tg/tg) is neurologic mutant mouse exhibiting three neurological disorders: ataxia, petit mal-like absence seizures and myoclonic intermittent movement disorder. The tottering mouse carries an autosomal recessive single gene mutation on chromosome 8. The leaner (tgla) and Nagoya rolling (tgrol) are another two alleles of the tottering (tg). The combination of two mutant (tottering and leaner) produces compound heterozygous, tottering/leaner (tg/tgla) mouse. The genetic etilogy of the tottering and leaner was identified to be a mutation in voltage-dependent calcium channel a1A subunit. It made us link these animal model to human neurologic disease such as autosomal dominant cerebellar ataxia (SCA6), familial hemiplegic migraine and episodic ataxia type-2. The different onset and severity of neurological symptom of these three mutants (tg/tg, tg/tgla, tgla/tgla) offer good scale to analysis of pathophysiolgy of the neurologic disorder. Altered synapase between parallel fiber varicosity and dendritic spines of Purkinje cell was observed in adult tottering and leaner mice. Through the electron microscopic observation and anticalbindin-28 kd immunohistochemistry, we anaylzed not only the relationship between neurologic symptoms and synaptic plasticity around the ataxic onset of tottering, leaner and tottering leaner double mutation but also Purkinje cell morphology affected by voltage-sensitive calcium channel a1A subunit mutation in totterring mouse. Purkinje cell dendritic spines from proximal dendrites and axonal swellings of Purkine cell were observed frequently in wild type mice. The first apperance point of altered synapse based on semi-quantitative analysis was postnatal 15 days in leaner, postnatal 18 days in totering/leaner double mutation, and 30 days in tottering. These data suggest that altered synapse is associated with ataxia in tottering and leaner mice. Further study is needed to determine whether altered synapse is primary cause of ataxia.
Adult ; Alleles ; Animals ; Ataxia ; Axons ; Calcium Channels ; Cerebellar Ataxia ; Cerebellum* ; Chromosomes, Human, Pair 8 ; Dendrites ; Dendritic Spines* ; Epilepsy, Absence ; Humans ; Immunohistochemistry ; Mice* ; Mice, Neurologic Mutants ; Migraine with Aura ; Models, Animal ; Movement Disorders ; Nervous System Diseases ; Neurologic Manifestations ; Plastics* ; Synapses*

There is a direct relationship between the plasma concentration of the drugs and the magnitude of neuromuscular blockade in non-depolarizing neuromuscular blocking agents. But the classical pharmacokinetic data of succinylcholine have not been obtained because of the lack of an appropriate assay to detect plasma concentration hydrolyzed rapidly by pseudocholinesterase. The purposes of this study was to determine neuromuscular response from the release of minute interval of toumiquet occlusion after intravenous bolus adminstration of succinylcholine at one arm following blood flow occlusion at contralateral arm with pneumatic toumiquet. The twitch height of neuromuscular responses after adminisration of succinylcholine was completely depressed in the group(control) without occlusion, but 5.40+/-3.63% on 1 minute, 30.11+/-9.72% on 2 minutes, 85.00+/-4.19% on 4 minutes and 97.75+/-0.59% on 5 minutes after blood flow occlusion respectively. The onset time of maximum depression in each group was not significant different. At 5 minutes after succinylcholine given systemically, the twitch height was 8.35%, while it was 97.75% from tourniquet release on 5 minutes after blood flow occlusion. It is concluded that succinylcholine should be also related to plasma concentration in magnitude of neuromuscular block, and receptor binding(dissociation constant) more than plasma concentration in offset of neuromuscular blockade.
Arm ; Depression ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Plasma ; Pseudocholinesterase ; Succinylcholine* ; Tourniquets

Wandering spleen is a rare condition characterized by migration of the spleen from its normal position due to laxity or absence of the supporting splenic ligaments. Ultrasonography shows the absence of the spleen in left upper quadrant (LUQ) and the presentation in the lower abdomen of a homognous mass whose sonographic appearance is consistent with that of a spleen. Contrast-enhanced CT reveals the absence of the spleen in LUQ, a soft tissue mass resembling spleen in the lower abdomen, and the splenic pedicle of whirled appearance. We present a case of wandering spleen, which could be diagnosed with US and CT by the ectopic location of spleen and the whirling pattern of splenic pedicle.
Abdomen ; Ligaments ; Spleen ; Tomography, X-Ray Computed ; Ultrasonography ; Wandering Spleen*

Individuals with psychoses show excess mortality, which is a major public health concern. This study examined all-cause and suicide mortality rates in Korean patients diagnosed with schizophrenia, mood disorder, or mental and behavioral disorder due to psychoactive substance use and to compare this with that of the general population. Data were from the National Health Insurance cohort, 2002 to 2013. A total of 107,190 cases aged 15 years or over were included. Mortality rates per 100,000 person years (PY) were obtained. Poisson regression modelling was conducted to quantify the effect of baseline characteristics on all-cause and suicide mortality risks. Standardized mortality ratios (SMRs) were also calculated. All-cause mortality was the highest among mental and behavioral disorder patients (1,051.0 per 100,000 PY), followed by schizophrenia (949.1 per 100,000 PY) and mood disorder patients (559.5 per 100,000 PY). Highest suicide mortality was found in schizophrenia (177.2 per 100,000 PY), mental and behavioral disorder (143.7 per 100,000 PY), and mood disorder patients (59.7 per 100,000 PY). The rate ratios (RRs) for all-cause and suicide mortality were reduced for younger populations and women. Psychoses patients had higher all-cause (schizophrenia, SMR 2.4; 95% confidence interval [CI] 2.2–2.5; mood disorder, SMR 1.4; 95% CI 1.3–1.5; mental and behavioral disorder, SMR 2.6; 95% CI 2.5–2.8) and suicide (schizophrenia, SMR 8.4; 95% CI 7.2–9.6; mood disorder, SMR 2.8; 95% CI 2.1–3.5; mental and behavioral disorder, SMR 6.8; 95% CI 5.7–7.9) mortality rates than the general population. These findings infer that efforts should be made to reduce excess mortality in psychoses.
Cohort Studies* ; Female ; Humans ; Korea* ; Mood Disorders ; Mortality* ; National Health Programs* ; Psychotic Disorders* ; Public Health ; Schizophrenia* ; Suicide