PURPOSE: We studied the crystallographic component of the prostatic calculi according to the location on the transrectal prostatic ultrasonography to know the mechanism of the formation of the calculus. MATERIALS AND METHODS: From August, 1995 until May, 1997, 33 prostatic calculi from 24 patients(mean age 59 years, mean size 3.1mm) operated on for prostatism were analyzed by polarization microscopy(ZeissR), X-ray diffraction(PW-1720R, Philips) and infrared spectrophotometer(FTIR-205R, Nicolet). Location of calculi was divided two groups under guide of transrectal prostatic ultrasonography; periurethral and periadenoma type. The periurethral type showed hyperechoic density around the prostatic urethra and the periadenoma type showed hyperechoic density between adenoma and false prostatic capsule(peripheral zone). RESULTS: 22 calculi were the periurethral type and 11 were periadenoma type. Thirty stones from 20 periurethral type and 10 periadenoma type consisted two or three of the following calcium phospate, calcium oxalate and tricalcium phospate. These are mixed by the endogenous origin formed from the prostatic fluid and the exogenous origin formed at least in part from urine. Three stones (2 calcium oxalate, 1 uric acid) contained only one compound which participitate from urine. All of 11 calculi of the pericapsular type had an oxalate component. CONCLUSIONS: The calculi around the periadenoma region may be formed from not only endogenous component(calcium apatite stone) but also exogenous component(calcium oxalate) or intraductal precipitation of oxalate component which has never found in the prostatic fluid. These results may suggest the necessity of reevaluation about oxalate component within the prostatic fluid.
Adenoma ; Calcium ; Calcium Oxalate ; Calculi* ; Prostatism ; Ultrasonography* ; Urethra

No abstract available.

No abstract available.

We present a case of severe intracranial hypotension syndrome following lumbar drainage. A 60-year-old woman developed recurrent attacks of vertigo, nausea and vomiting a week prior to admission. Brain MRI revealed a homogeneously well-enhanced mass in the right frontal lobe ; this was found to be a meningioma, and was totally removed. Dural defect was covered with fat and fascia, and postoperative cerebrospinal fluid(CSF) leakage through the frontal sinus was noted. Lumbar drainage was initiated, and about 36 hours later, the patient complained of bouts of headache, nausea and vomiting. Her mental state then gradually deteriorated, and she became stuporous. Brain CT was performed immediately and revealed bifrontal subdural fluid collection and signs of severe brain edema including obliteration of ventricles and basal cisterns. The lumbar drain was then clamped and she regained consciousness 12 hours later. This case clearly demonstrates that to avoid complications such as severe intracranial hypotension syndrome in a patient who has undergone lumbar drainage, the rate and amount of CSF drainage should be closely monitored.
Brain ; Brain Edema ; Consciousness ; Drainage* ; Fascia ; Female ; Frontal Lobe ; Frontal Sinus ; Headache ; Humans ; Intracranial Hypotension* ; Magnetic Resonance Imaging ; Meningioma ; Middle Aged ; Nausea ; Stupor ; Vertigo ; Vomiting

Sebaceous trichofolliculoma, which is a variant of trichofolliculoma, is a rare disease that clinically show a centrally depressed lesion usually singly on the nose, and histologically a centrally located cavity, lined by squamous epithelium, with numerous sebaceous lobules connected to them. We describe a case of sebaceous trichofolliculoma in a 27-year-old woman who had several brown papules on the nose. We think that this is the first report of sebaceous trichofolliculloma in Korean literature.
Adult ; Epithelium ; Female ; Humans ; Nose ; Rare Diseases

Mesenchymal stem cells (MSCs) of human origin have been frequently applied to experimental animal models to evaluate their immunomodulatory functions. MSCs are known to be activated by cytokines from T cells, predominantly by interferon-gamma (IFN-gamma), in conjunction with other cytokines such as tumor necrosis factor-alpha (TNF-alpha) and interlukin-1beta. Because IFN-gamma is not cross-reactive between human and mouse species, the manner in which human MSCs administered in experimental animals are activated and stimulated to function has been questioned. In the present study, we established MSCs from human adipose tissue. They successfully suppressed the proliferation of not only human peripheral blood mononuclear cells but also mouse splenic T cells. When these human MSCs were stimulated with a culture supernatant of mouse T cells or recombinant murine TNF-alpha, they expressed cyclooxygenase-2 (COX-2), but not indoleamine 2,3-dioxygenase. The dominant role of COX-2 in suppressing mouse T cell proliferation was validated by the addition of COX-2 inhibitor in the co-culture, wherein the suppressed proliferation was almost completely recovered. In conclusion, human MSCs in a murine environment were activated, at least in part, by TNF-alpha and mainly used COX-2 as a tool for the suppression of in vitro T cell proliferation. These results should be considered when interpreting results for human MSCs in experimental animals.
Adipose Tissue ; Animals ; Cell Proliferation* ; Coculture Techniques ; Cyclooxygenase 2* ; Cytokines ; Humans* ; Immunomodulation ; Indoleamine-Pyrrole 2,3,-Dioxygenase ; Interferon-gamma ; Mesenchymal Stromal Cells* ; Mice ; Models, Animal ; T-Lymphocytes ; Tumor Necrosis Factor-alpha

Chloracne is a refractory acneiform eruption due to halogenated polyaromatic compound(eg. dioxin, dibenzofurans, polychlorinated biphenyls, etc.). 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin, a kind of dioxin isomer, contained in the Agent Orange which was used for defoliating agent during Vietnam war. It is characterized by recalcitrant comedones and cyst predominantly in the malar and postauricular area. Lesions of the penis and scrotum are also relatively frequent. The key pathological feature is the non-inflammatory keratinization of pilosebaceous unit. The meibomian glands are typically affected. Xerosis, conjunctivitis, pigmentation, follicular hyperkeratosis, actinic elastosis are occasionally associated with chloracne. We report a case of typical chloracne due to exposure to defoliating agent during Vietnam war in a 54-year-old-man who shows typical clinical and histopathological features.
Acneiform Eruptions ; Actins ; Chloracne* ; Citrus sinensis ; Conjunctivitis ; Male ; Meibomian Glands ; Penis ; Pigmentation ; Polychlorinated Biphenyls ; Scrotum ; Vietnam*

BACKGROUND: First suggested by Brent in 1979, the pocket principle is an alternative method for patients for whom a microsurgical replantation is not feasible. We report the successful results of a modified palmar pocket method in adults. METHODS: Between 2004 and 2008, we treated 10 patients by nonmicrosurgical replantation using palmar pocketing. All patients were adults who sustained a complete fingertip amputation from the tip to lunula in a digits. In all of these patients, the amputation occurred due to a crush or avulsion-type injury, and a microsurgical replantation was not feasible. We used the palmar pocketing method following a composite graft in these patients and prepared the pocket in the subcutaneous layer of the ipsilateral palm. RESULTS: Of a total of 10 cases, nine had complete survival of the replantation and one had 20% partial necrosis. All of the cases were managed to conserve the fingernails, which led to acceptable cosmetic results. CONCLUSIONS: A composite graft and palmar pocketing in adult cases of fingertip injury constitute a simple, reliable operation for digital amputation extending from the tip to the lunula. These methods had satisfactory results.
Adult ; Amputation ; Cosmetics ; Fingers ; Humans ; Nails ; Necrosis ; Replantation ; Transplants

Congenital chloridorrhea is a rare autosomal recessive disease and results from impairment of active transport of chloride in the ileum and colon. Absence of the Cl-/HCO3-, exchange pump causes polyhydramnios, distended bowel loop and absence of meconium before birth. Prenatal ultrasound examination shows a great number of circular anechoic area in the fetal abdomen, as well as polyhydramnios. Massive watery diarrhea is apparent from the first days of life. This fluid loss, with its attendant impairment of electrolyte homeostasis, is life threatening. Exact replacement of water, NaCl and KCl can prevent the growth and psychomotor retardation and the development of progressive renal damage. We experienced one case of congenital chloridorrhea and present it with brief review of literatures.
Abdomen ; Biological Transport, Active ; Colon ; Diarrhea ; Homeostasis ; Ileum ; Meconium ; Parturition ; Polyhydramnios ; Ultrasonography ; Water

PURPOSE: Report of the good results of breast reconstruction using Becker permanent tissue expander that showed a short operation time and a quick post- operation recovery time, little side effects and usually superb aesthetic results without the need for additional incisions or donor site morbidity. The authors, after carrying out breast reconstruction operations using Becker permanent tissue expander on patients with appropriate indications, attempted to analyze several factors such as complication rates and patient satisfaction measurements. METHODS: 11 cases of breast reconstruction using Becker expander implants were carried out on a total of 10 patients between March 2000 and February 2003. The patients were followed up at outpatient visit for an average of 6 months. RESULTS: The most common post-operation complication was pain resulting from saline injection into the expanders, complained by 5 patients(50%). rib fractures, skin necrosis, implant removal due to infection, and breast cancer recurrence each occurred in 1 patient (9.9%). There was no occurrence of skin contracture complications which occurs frequently in case of silicone implant insertion. Patient complacency was surveyed by patient interviews made right after the operations and during outpatient follow-up periods: 5(50%) patients out of 10 showed excellent, 3(30%) good, and 2(20%) showed fair, leaving no patients who were disappointed with operation results. On routine follow-up, 80% of patients expressed satisfaction with the cosmetic outcome of their post-mastectomy beast reconstruction. CONCLUSION: Breast reconstruction using the Becker expander is a reliable alternative to other reconstructive methods but good patient selection is essential for satisfactory results.
Breast Neoplasms ; Breast* ; Contracture ; Female ; Follow-Up Studies ; Humans ; Mammaplasty* ; Mastectomy, Modified Radical* ; Necrosis ; Outpatients ; Patient Satisfaction ; Patient Selection ; Recurrence ; Rib Fractures ; Silicones ; Skin ; Tissue Donors ; Tissue Expansion Devices*