Laryngeal leukoplakia is seen in a number of pathologic settings such as keratosis without atypia(KWOA), keratosis with atypia(KWA), squamous cell carcinoma in situ(CIS) and invasive squamous cell carcinoma, and it continues to be a confusing and controversial topic for both otolaryngologist and pathologist. This is largely due to the use of ambiguous and inconsistent terminology, the lack of unanimous agreement on the definition of these terms, failure of the clinician to obtain a representative biopsy, and the subjectivity of the pathologist interpreting the biopsy. To evaluate the applicability of the expression pattern of p53 and PCNA in borderline cases of histopathologic classification, we performed a histopathologic analysis of leukoplakia to includ clinical follow-up, correlation of disease progression and degree of atypia, and expression of p53 and PCNA according to the degree of atypia. Histologically, laryngeal leukoplakia included seven cases of KWOA, fourteen cases of KWA (mild-2, moderate-8, severe-4), three cases of CIS, and one case of invasive squamous cell carcinoma. Keratosis with atypia, a moderate degree or more, showed a strong tendency to progress to invasive carcinoma(p<0.05). The degree of p53 and PCNA expression correlated with the degree of atypia(p<0.05). p53-positive cases at the initial biopsy clearly tended to recur and develop into invasive carcinoma(p<0.01).
Biopsy

No abstract available.
Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Humans ; Kidney Transplantation*

No abstract available.
Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Humans ; Kidney Transplantation*

No abstract available.
Endothelial Cells* ; Hantaan virus* ; Humans* ; Umbilical Veins*

Berardinelli lipodystrophy syndrome is a rare autosomal recessive disorder, characterized by loss of body fat, muscular hypertrophy, acanthosis nigricans, hepatomegaly, hyperlipidemia, insulin resistant diabetes, and elevated metabolic rate. The mechanism(s) responsible for these abnormalities is not known. We report a forteen-month old girl with Berardinelli Lipodystriphy Syndrome, who had signs above mentioned, with a brief review and its related literatures.
Acanthosis Nigricans ; Adipose Tissue ; Female ; Hepatomegaly ; Humans ; Hyperlipidemias ; Hypertrophy ; Insulin ; Lipodystrophy*

PURPOSE: Early detection of arteriovenous fistula (AVF) dysfunction in hemodialysis patients and prompt corrective procedures reduces the AVF thrombosis rates and lengthens access survival. We tried to develop a new simple and cheap bedside measurement technique based on the Bernoulli's theory. METHOD: From a total of 20 case of vascular accesses for hemodialysis, of at least 3 months of construction, we twicely measured the AVF flow rate (QD) with Doppler ultrasonography and vascular conduit pressure. Four kinds of pressure were measured: tubing set free from dialysis machine and positioned on the patient's bed (PrF), two kinds of artificial stenosis made with tourniquet (PrS1, PrS2), pump flow rate at 100ml/min (Pr100), and pump off (Pr0). We calculated the flow rate of vascular conduit (QF) with PrF and mean arterial pressure on Bernouli's equation, and QF was compared with QD. RESULT: AVF was 26.0+/-28.6 (3~108) months after operation, with five cases (including 2 PTFE grafts) using brachial artery. PrF was closely correlated with Pr100 (R2=0.914), and inversely correlated with QD (R2=-0.026). QF was poorly correlated with QD (R2=0.003). There was no statistical difference in the double pressure measurement (P>0.05), but there was differenence in QD (P<0.05). When artificial stenosis was made, the pressures increased, and the calculated flow rates decreased in every patients. Thrombosis or stenosis was detected in all patients with decrement of QF, but not in all with decrement of QD. CONCLUSION: Pressure measurement and calculated flow rate in dialysis vascular conduit represent alterations of AVF flow rate. However its value in long-term follow up awaits further study with accurate constant number.
Arterial Pressure ; Arteriovenous Fistula ; Brachial Artery ; Constriction, Pathologic ; Dialysis ; Humans ; Polytetrafluoroethylene ; Renal Dialysis ; Thrombosis ; Tourniquets ; Ultrasonography, Doppler

PURPOSE: Hematuria is a frequently encountered clinical problem in kidney graft recipients. The causes are variable, may be benign or malignant, but imperative to affect long- term graft function and survival. We have evaluated renal recipients who had hematuria using a newly defined algorithm. METHODS: We evaluated 1060 renal transplant recipients from March 1, 1992 to February 28, 2000. In 93 recipients, hematuria was transitory and spontaneously resolved within 3 months. We tried to identify the cause of persistent hematuria in 126 recipients. Patients were evaluated with plain x-ray, sonography, cystoscopic examination and/or graft biopsy. RESULTS: The mean duration of hematuria onset after transplantation was 17.81+/-14.6 months (4-70 months). The causes of gross hematuria were urolithiasis (n= 15), benign bladder mucosal bleeding (n=3), bladder cancer (n=2) and kidney cancer from an original kidney (n=1). Graft kidney biopsies were performed in 96 patients and the results were as follows: chronic rejection in 18, IgA nephropathy in 16, cyclosporine toxicity in 8, acute rejection in 5, focal segmental glomerulosclerosis in 3, the other glomerulonephritis in 2, and tubular atrophy and interstitial fibrosis in 19 patients. Combined pathologic findings were detected in 15 patients. In 8 patients, no pathological diagnoses were made. We were unable to evaluate 9 patients due to patient's refusal. CONCLUSION: The causes of hematuria after kidney transplantation are variable from benign to malignant disease. If the cause of hematuria is uncertain on ultrasonographic examination, cystoscopic examination and/or graft biopsy should be performed for making a definite diagnosis.
Atrophy ; Biopsy ; Cyclosporine ; Diagnosis ; Disulfiram ; Fibrosis ; Glomerulonephritis ; Glomerulonephritis, IGA ; Glomerulosclerosis, Focal Segmental ; Hematuria* ; Hemorrhage ; Humans ; Kidney ; Kidney Neoplasms ; Kidney Transplantation ; Transplantation ; Transplants ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urolithiasis

Peripheral neuroepithelioma (PNE) of soft tissue is a malignant neuroectodermal tumor arising from peripheral(nonautonomic) nerve. It may occur in both children and adults, and are highly aggressive neoplasms that rapidly give rise to metastatic disease and death. We exprienced a case of peripheral neuroepithelioma of soft tissue in the upper arm in a 18-year-old female. Cytologic features revealed small round cells with scanty cytoplasm occurring both singly and in clusters. The clusters frequently tended to form Homer-Wright rosettes. The cells had a round to oval nucleus with fine chromatin and inconspicuous nucleoli in a hemorrhagic background.
Adolescent ; Adult ; Arm ; Biopsy, Fine-Needle* ; Child ; Chromatin ; Cytoplasm ; Female ; Humans ; Neuroectodermal Tumors ; Neuroectodermal Tumors, Primitive, Peripheral*

Previous studies have demonstrated that enalapril and verapamil seem to attenuate the cyclosporine nephrotoxicity. However, the mechanisms have not been completely understood, especially on molecular events. The aim of this study was to examine the effect of individual or combined treatment on osteopontin, TGF-beta, endothelin-1 and procollagen alpha 1(I) mRNA expressions. Enalapril (50 mg/L in drinking water) and verapamil (0.5 mg/kg/day, subcutaneously), alone or in combination, were administered to rats with chronic cyclosporine nephrotoxicity (cyclosporine, 25 mg/kg/day, subcutaneously) (n = 5 each). Five rats treated with olive oil vehicle were used as control. After 4 weeks, biochemical parameters were measured, and renal cortical mRNA levels were evaluated by Northern blot analysis. Cyclosporine reduced renal creatinine clearance significantly and induced renal cortical osteopontin, TGF-beta, endothelin-1 and procollagen alpha 1(I) gene expressions around 13.5 +/- 1.3, 2.4 +/- 0.2, 1.5 +/- 0.1, 1.9 +/- 0.1 folds, respectively. Individual treatment with enalapril or verapamil significantly suppressed the osteopontin and TGF-beta mRNA expression, but not endothelin-1 and procollagen alpha 1(I). Combined treatment also inhibited the osteopontin and TGF-beta mRNA expression but there was no difference between combined and individual treatment. In conclusion, enalapril or verapamil significantly blunted the cyclosporine-induced osteopontin and TGF-beta gene expressions. However, combined treatment did not show any additive effect.
Angiotensin-Converting Enzyme Inhibitors/therapeutic use* ; Animal ; Calcium Channel Blockers/therapeutic use* ; Cyclosporine/adverse effects ; Drug Therapy, Combination ; Enalapril/therapeutic use* ; Enalapril/administration & dosage ; Endothelin-1/metabolism ; Endothelin-1/genetics ; Gene Expression Regulation/drug effects ; Immunosuppressive Agents/adverse effects ; Kidney Cortex/metabolism ; Male ; Nephritis/drug therapy* ; Nephritis/chemically induced ; Procollagen/metabolism ; Procollagen/genetics ; RNA, Messenger/analysis ; Rats ; Rats, Wistar ; Sialoglycoproteins/metabolism ; Sialoglycoproteins/genetics ; Transforming Growth Factor beta/metabolism ; Transforming Growth Factor beta/genetics ; Verapamil/therapeutic use* ; Verapamil/administration & dosage

STUDY DESIGN: A retrospective study. PURPOSE: To comparatively investigated the rate of the adjacent segment degeneration and the clinical outcomes in patients with spondylolytic spondylolisthesis, spinal stenosis or degenerative spondylolisthesis. OVERVIEW OF LITERATURE: There have been few studies reported on the adjacent segment degeneration following posterior lumbar interbody fusion(PLIF). Many risk factors for the adjacent segment degeneration following PLIF have been proposed. The range of decompression has been presented as one of the risk factors, yet controversial. METHODS: This study enrolled sixty-three patients who had been treated with single-level PLIF and who were followed up for more than two years. The patients were divided into 3 groups based on the preoperative diagnosis. We analyzed the difference between the preoperative and postoperative intervertebral disc heights of the superior adjacent segments. The incidence rates of instability and the clinical outcomes were comparatively analyzed between each group. RESULTS: The average age of the patients was 55.8 years in the spondylolytic spondylolisthesis group, 65.9 years in the degenerative spondylolisthesis group and 60.4 years in the spinal stenosis group. The average follow-up period was 44 months, 43 months and 42 months, respectively. At the last follow-up, compared to the preoperative period, the intervertebral disc height decreased in all three groups. A statistically significant decrease (p < 0.01) was observed only in the spondylolytic spondylolisthesis group and no significant difference was observed between each group (p = 0.41). The incidence rate of instability and the clinical outcome were not significantly different between each group. CONCLUSIONS: Spondylolytic spondylolisthesis with total laminectomy and single-level PLIF showed no significant difference in the superior adjacent segment degeneration and instability, and the clinical outcome as compared to that of partial laminectomy with single-level PLIF for treating degenerative spondylolisthesis or spinal stenosis.
Decompression ; Follow-Up Studies ; Humans ; Incidence ; Intervertebral Disc ; Laminectomy ; Preoperative Period ; Retrospective Studies ; Risk Factors ; Spinal Stenosis ; Spondylolisthesis