Trichoepithelioma, a tumor of the hair follicle, is usually seen as multiple lesions, but occasionally appears as a single tumor. Multiple trichoepithelioma is a dominant hereditary skin conditions whereas solitary trichoepithelioma is not hereditary and is growing tumor, usually seen in adults. A case of 56 year old housewife with solitary trichoepithelioma was reported. The skin lesion appeased as a firm, skin colored papule and the size was 0.5cm in diameter on right side of nose. Shaving biopsy was done and showed a high degree of differentiation toward hair structure and horn cyst that the keratinization is abrupt and complete. The methood of treatment is a surgical excision and electrodesiccation but remain a scar due to surgical trauma. And so, we used a 5-fluorouracil ointment instead of surgical excision and electrodesiccation, The skin lesion on nose was cured completely as a result of 5-FU ointment application without any scar formation cosmetically.
Adult ; Animals ; Biopsy ; Cicatrix ; Fluorouracil* ; Hair ; Hair Follicle ; Horns ; Humans ; Middle Aged ; Nose ; Skin

No abstract available.
Tracheoesophageal Fistula*

Considering the recent advancements in endovascular management of aortoiliac aneurysms, the use of an iliac branch device (IBD) to preserve pelvic blood flow and reduce complications caused by embolization of the internal iliac artery (IIA) is recommended by various guidelines. Although the outcomes reported following IBD placement are mainly positive and durable, IBD-specific complications such as a type Ic endoleak and associated reintervention may occur. Moreover, only one IBD device and one type of balloon-expandable bridging stent graft for IIA are currently available on the domestic market. Here we present two cases of type Ic endoleak following IBD placement. In both cases, IIA diameter was slightly larger than the basic instructions for use. Notably, the initial procedures were considered successful; however, type Ic endoleaks were detected on 1-month follow-up imaging. This finding emphasizes the need for a precise preoperative evaluation, intraoperative manipulation, and postoperative follow-up.

Gold therapy of rheumatoid arthritis is effective, but adverse reactions are also common. There are some cutaneous, hematologic, renal, and pulmonary side effects which have been associated with immunologic abnormalities. Also, hypersensitivity pneumonitis induced by gold therapy was rarely reported in literature. But, the mechanism for the induction of the pulmonary disease is not blown. We report a case of seropositive rheumatoid arthritis presented as gold induced hypersensitivity pneumonitis which was confirmed by the peripheral blood lymphocyte stimulation test with gold.
Alveolitis, Extrinsic Allergic* ; Arthritis, Rheumatoid ; Hypersensitivity* ; Lung Diseases ; Lymphocyte Activation* ; Lymphocytes*

Chronic eosinophilic pneumonia is a very rare disorder of unknown etiology characterized by striking systemic and pulmonary manifestations such as fever, weight loss, dyspnea, blood eosinophilia, and fluffy peripheral opacities on chest radiograph. A number of these patients developed asthma before or with the onset of illness. The roentgenographic lesion rapidly resoluted with corticosteroid and recurrence was occasionally occured in the same location. Histopathologic features of chronic eosinophilic pneumonia include dense aggregates of eosinophils, histiocytes, and multinucleated giant cells within alveolar spaces, interstitium, and bronchioles associated with scattered lymphocytes and plasma cells. We report a case of chronic eosinophilic pneumonia diagnosed by clinical, radiographic, and histologic findings with review of the literature.
Asthma ; Bronchioles ; Dyspnea ; Eosinophilia ; Eosinophils* ; Fever ; Giant Cells ; Histiocytes ; Humans ; Lymphocytes ; Plasma Cells ; Pneumonia ; Pulmonary Eosinophilia* ; Radiography, Thoracic ; Recurrence ; Strikes, Employee ; Weight Loss

PURPOSE: It remains controversial whether to use a tube graft or a bifurcated graft during open abdominal aortic aneurysm (AAA) repair, due to the potential for progression or development of a common iliac artery (CIA) aneurysm. This study evaluated the fate of CIA after tubular AAA repair. METHODS: On a retrospective basis, we reviewed 61 patients who underwent open AAA repair with a tube graft, between March 2000 and December 2009. Fifty-seven patients were included in this study; we excluded 4 cases in which the patients died in-hospital. Of those enrolled, 24 patients underwent follow-up computed tomography at least 1-year after surgery. CIAs were categorized into 3 groups: normal (< or =12 mm), ectasia (range, 13 to 18 mm), and aneurysm (range, 19 to 25 mm). The incidence of CIA aneurysm rupture was investigated, and the expansion rate of CIA was calculated. RESULTS: Mean patient age was 64 years and 73% of patients were male. Preoperatively, 8 patients had 2 normal CIAs, 14 patients had one CIA aneurysm at least, 27 patients had one CIA ectasia, and 8 patients were unknown. There was a mean follow-up of 51 months; no deaths were caused by rupture of CIA aneurysm, and no patient underwent invasive treatment for a CIA aneurysm. The mean follow-up for 24 patients with 48 CIAs was 45 months. The mean expansion rate of CIA was 0.5 mm/y. CONCLUSION: AAA repair using a tube graft was a safe and durable procedure. However, a bifurcated graft should be considered when patients are young and there is the expectation of a long life expectancy is anticipated allowing for a CIA expansion rate of 0.5 mm/y.
Aneurysm ; Aortic Aneurysm, Abdominal ; Dilatation, Pathologic ; Follow-Up Studies ; Humans ; Iliac Artery ; Incidence ; Life Expectancy ; Male ; Retrospective Studies ; Rupture ; Transplants

No abstract available.
Humans

BACKGROUND: The mechanism of increased peritoneal permeability during peritonitis has not been clearly determined. We studied the changes in vascular endothelial growth factor (VEGF) levels in dialysate effluents during CAPD peritonitis, and VEGF expression in cultured peritoneal mesothelial cells (MCs) stimulated with IL-1 alpha, TNF alpha, and IFN gamma. METHODS: In 30 CAPD patients with peritonitis, dialysate effluents were serially collected at the time of diagnosis of peritonitis and when the peritonitis was recovered. Primarily cultured MCs were incubated with IL-1alpha or TNFalpha alone or in combination with INF gamma. VEGF level in dialysate effluent and MCs conditioned medium was measured by sandwich ELISA. VEGF mRNA expression was analyzed by Northern blotting. The activation of NFkappaB in response to IL-1alpha or TNFalpha was measured by electrophoretic mobility shift assay (EMSA). RESULTS: VEGF levels in dialysate effluent at the time of diagnosis of peritonitis were significantly higher (456+/-45 pg/mL) than those when the peritonitis was recovered (245+/-21 pg/mL)(p<0.00001). Both IL-1 alpha and TNFalpha stimulated VEGF production in MCs, and the stimulation was significant from 24 hours to 72 hours. INFgamma, in combination with IL-1 alpha or TNF alpha, significantly amplified IL-1 alpha - or TNF alpha - induced VEGF production. Pre-incubation of MCs with NF kappa B inhibitor, pyrrolidine dithiocarbamate, totally blocked IL-1 alpha - or TNF alpha-induced VEGF production. Northern blot analysis revealed that IL-1 alpha and TNF alpha stimulated VEGF mRNA expression in a dose dependent manner. The stimulation was peak at 4 hours. IL-1alpha and TNF alpha stimulated NFkappa B binding activity in MCs as early as at 15 minutes, with a peak activity at 1 hour, and p65 subunit was supershifted. CONCLUSION: Our results suggest that increased expression of VEGF in peritoneal mesothelial cells stimulated with proinflammatory cytokines, IL-1alpha, TNFalpha, and IFN gamma, plays a role in the increased peritoneal permeability during CAPD peritonitis.
Blotting, Northern ; Culture Media, Conditioned ; Cytokines ; Diagnosis ; Electrophoretic Mobility Shift Assay ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-1alpha ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Permeability ; RNA, Messenger ; Tumor Necrosis Factor-alpha ; Vascular Endothelial Growth Factor A*

OBJECTIVES: We examined the impact of 12-session group cognitive behavioral trerapy(GCBT) on quality of life in patients with panic disorder, and also investigated correlation with the change of some clinical characteristics. METHODS: Patients(N=108) who met DSM-IV criteria for panic disorder with or without agoraphobia were treated by 12-session GCBT. We assessed the quality of life using SF-36 and some clinical characteristics including symptom profiles. We measured anxiety and depression levels using the Spielberger State-Trait Anxiety Inventory(STAI) and the Beck Depression Inventory(BDI), and also measured some cognitive behavioral indexes typically found in panic patients using the Anxiety Sensitivity Index(ASI), the Agoraphobic Cognition Questionnaire(ACQ), the Panic Belief Questionnaire(PBQ), and the Body Sensation Questionnaire(BSQ). RESULTS: GCBT-treated patients showed significant improvement in quality of life in all subscales of SF-36(general health, t=-5.23; , physical functioning, t=-5.89; , role physical, t=-3.67; , body pain, t=-6.36; , vitality t=-8.29; , social functioning, t=-6.56; , role emotion, t=-3.62; , mental health, t=-6.81). Multiple regression analysis showed that the change of anxiety sensitivity was the best predictor of the improvement of SF-36(mental health, R2=.19, p<0.001;, vitality, R2=.14, p<0.001; , social functioning, R2=.15, p<0.001). Otherwise the change of panic belief(general health, R2=.11, p< 0.01; , body pain, R2=15, p<0.001), BDI(role emotion, R2=.08, p<0.05) could explain the improvement of one of subscales of SF-36. CONCLUSION: Our results suggested that 12-session GCBT could significantly improve quality of life in patients with panic disorder. Especially, the reduction of anxiety sensitivity, panic belief and depression with the correction of cognitive distortion and sensitivity might play an important role in improving quality of life in panic patients.
Agoraphobia ; Anxiety ; Cognition ; Cognitive Therapy* ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Mental Health ; Panic Disorder* ; Panic* ; Quality of Life* ; Sensation