Hospice Care ; Hospices ; Humans ; Palliative Care ; Renal Dialysis

BACKGROUND AND OBJECTIVES: Post-tonsillectomy pain is unavoidable and related to the dysphagia, dehydration and loss of time in returning to normal activities. This study was performed to investigate whether fibrin glue (Tissucol(R) Duo Quick, Baxter AG, Wien, Austria) applied to tonsillar bed after the completion of tonsillectomy reduced pain. SUBJECTS AND METHOD: Twenty-five adults scheduled for an elective tonsillectomy were included in this prospective double-blind study. After removal of both tonsils electrocauterization was done on both tonsillar bed for adequate hemostasis. And then, one side of tonsillar bed randomly selected by operating surgeon was coated with the fibrin glue and the other side was left without coating. Pain scores were measured at the first (postoperative day, POD1), third (POD3) and tenth (POD10) day of the operation by using visual analogue scale (VAS). RESULTS: The VAS scores of the side treated with fibrin glue and the non-coated side were 3.67+/-1.16/3.14+/-0.96/1.52+/-0.81 (POD1/POD3/POD10) and 5.33+/-1.28/4.19+/-1.21/1.71+/- 0.96 (POD1/POD3/POD10), respectively. The VAS score difference between both sides were 1.67+/-0.58/1.05+/-0.59/0.19+/-0.40 (POD1/PO3/POD10). CONCLUSION: This study shows that the application of fibrin glue on tonsillectomy site was effective for postoperative pain control. Moreover, the efficacy was prominent at early postoperative days known as period of severe pain.
Adult ; Deglutition Disorders ; Dehydration ; Double-Blind Method ; Fibrin ; Fibrin Tissue Adhesive ; Hemostasis ; Humans ; Pain, Postoperative ; Palatine Tonsil ; Prospective Studies ; Tonsillectomy

Isolated sudden hearing loss with vertigo is usually peripheral origin. We report two cases with anterior inferior cerebellar artery infarction (AICA) manifesting sudden hearing loss with vertigo as an isolated symptom. Patient 1 was a 64-year-old man presented with right sided sudden hearing loss and vertigo accompanying horizontal beating nystagmus to the left. He had no other neurologic symptoms. MRI showed right AICA infarction involving lateral pons and middle cerebellar peduncle. Patient 2 was a hypertensive 56-year-old man. Left sided sudden hearing loss with vertigo was as an initial manifestation. Two days later, left sided facial palsy developed and MRI showed acute infarction in left lateral pons, middle cerebellar peduncle, and cerebellum. AICA infarction can be presented the hearing loss and vertigo as an isolated symptom and mimic the syndrome of peripheral origin.
Arteries ; Cerebellum ; Cerebral Infarction ; Facial Paralysis ; Hearing Loss ; Hearing Loss, Sudden ; Humans ; Hydrazines ; Infarction ; Middle Aged ; Neurologic Manifestations ; Pons ; Vertigo

We report a case of warty dyskeratoma in a 59-year-old man. For 10 years, he had had an asymptomatic solitary 0.5x0.5 cm sized, erythematous, hard papule with a yellowish, central keratotic plug on the vertex. Histological findings showed a large cup-shaped, keratin-filled invagination of acanthotic epidermis, and a suprabasal cleft formation with corps ronds, grains and numerous villi at the lower portion of the invagination, the characteristic features of warty dyskeratoma.
Edible Grain ; Epidermis ; Humans ; Middle Aged ; Scalp*

Cutaneous leiomyosarcoma is a rare soft-tissue tumor of smooth muscle derivation that accounts for 2%-3% of all soft tissue sarcomas. Cutaneous leiomyosarcomas can be subdivided into dermal and subcutaneous leiomyosarcomas. Because of the different prognosis, it is important to distinguish between dermal and subcutaneous forms. Immunohistochemical stains, such as vimentin, smooth muscle actin (SMA), desmin, CD68, CD34, and S-100, may aid in the recognition of smooth muscle derivation and in the differentiation from other malignant spindle cell tumors. We report a case of cutaneous leiomyosarcoma on the extensor surface of the left thigh in a 61-year-old man.
Actins ; Coloring Agents ; Desmin ; Humans ; Leiomyosarcoma* ; Middle Aged ; Muscle, Smooth ; Prognosis ; Sarcoma ; Thigh ; Vimentin

BACKGROUND: Catenins are the associated protein with E-cadherin in the formation of adhesion complexes in normal and tumor cells related with epithelial differentiation and development of organ formation as well as in the tumor spread. The present study was aimed to find the distribution of alpha- and gamma-catenins in fetal skin development. OBJECTIVE: The purpose of this study was to observe the distribution of above two adhesion related proteins in the fetal skin during development, and to find its relationship by expression and their distribution pattern. METHODS: Skin was obtained from the scalp, chest, and sole of 21 human fetuses, ranging from 13 to 37 weeks of gestational age. Immunohistochemical staining was performed by the avidin biotin peroxidase complex method on paraffin embedded tissue using the anti-human monoclonal antibody against the human alpha- and gamma-catenins. RESULTS: alpha- and gamma-catenins were expressed strongly in basal cells of the epidermis and germ cells of skin adnexa, such as hair and eccrine glands at 13th week, followed by decreased basal cell expression. Increase in the suprabasal epithelium and differentiated adnexal epithelium, such as outer root sheath cells and eccrine ducts and glands at 18th week, and adult pattern in 23th week of gestation. Both showed similar distribution pattern in skin though gamma-catenin appeared two or three weeks later. alpha- and gamma-catenins are expressed not only in the epithelium of the skin, but also in the mesenchymal cells such as endothelial cells and fibroblasts. Though both catenins are more strongly expressed in the membrane portion, cytoplasmic expression is also noted. CONCLUSION: Both alpha- and gamma-catenin showed basically the same expression distribution pattern in the fetal skin developmental stage, suggesting that both adhesion molecules are highly related to each other in function and development of epidermis and adnexae of the skin in fetal stage.
Adult ; Avidin ; Biotin ; Cadherins ; Catenins ; Cytoplasm ; Eccrine Glands ; Endothelial Cells ; Epidermis ; Epithelium ; Fetus ; Fibroblasts ; gamma Catenin* ; Germ Cells ; Gestational Age ; Hair ; Humans ; Membranes ; Paraffin ; Peroxidase ; Pregnancy ; Scalp ; Skin* ; Thorax

PURPOSE: Nowadays laparoscopic appendectomy is widely practiced in developed countries. The purpose of this study was to evaluate laparoscopic appendectomy in comparison with open appendectomy. METHODS: On hundred cases each of laparoscopic appendectomy and open appendectomy, performed between February 2001 and June 2002, were reviewed for age, sex, operative time, hospital days, time for first meal, number of used parenteral analgesia, number of OPD visits, etc. RESULTS: Operative time was longer in the laparoscopic appendectomy group (P>0.05) and the number of used parenteral analgesia was slightly higher in the laparoscopic group (P>0.05). However, recovery time for diet was slightly shorter in the laparoscopic group (P>0.05). None of these trends were statistically significant. The times of OPD visit after discharge was less in the laparoscopic group (P<0.05). The hospital days of pathological simple appendicitis were shorter in the laparoscopic appendectomy group (P<0.05). In the laparoscopic group, intraabdominal abscess was developed in 2 cases, wound infection in 4, and intestinal obstruction in 2. The conversion rate to open appendectomy was 7% (7/100) in the laparoscopic group. CONCLUSION: Laparoscopic appendectomy can shorten overall OPD follow up days and in case of simple appendicitis, laparoscopic appendectomy can also shorten hospital days.
Abscess ; Analgesia ; Appendectomy* ; Appendicitis ; Developed Countries ; Diet ; Follow-Up Studies ; Intestinal Obstruction ; Meals ; Operative Time ; Wound Infection

Trichoblastoma is a benign cutaneous neoplasm that consists of follicular germinative cells. We report a case of trichoblastoma in a 58-year-old man. The tumor was presented as a solitary symmetrical shaped pedunculated 5.0x4.0x2.0cm sized multilobular tumor on right lower leg for 2 years. Histopathologic examination showed well circumscribed dermal tumor composed of multilobular tumor islands of palisaded basaloid epithelial cells. The tumoral lobules were concentrically surrounded by hyalinized collagen bundles with fibroblasts. The overall architecture was reminiscent of hair bulbs. Cytokeratin 14 stain showed positive reaction, but cytokeratin 10 stain showed negative reaction. The tumor was completely excised with clear margin. No sign of recurrence has been noted until 9 months later.
Collagen ; Epithelial Cells ; Fibroblasts ; Hair ; Humans ; Hyalin ; Islands ; Keratin-14 ; Keratins ; Leg ; Middle Aged ; Recurrence

BACKGROUND: Glutathione S-transferases(GST) are a family of multi-functional enzymes involved in cellular detoxification and excretion of a variety of exogenous and endogenous toxic or carcinogenic compounds. The GST family has been divided into three classes, alpha, mu, and pi, based on substrate specificity and sequence homology. GST-pi is an acidic type and predominant in skin, small intestine, breast, lung and prostate. The overexpression of GST-pi associated with skin tumor and tumor-like lesion suggests that GST-pi is a major detoxifying enzyme in skin tumors. OBJECTIVE: The purpose of this study was to observe the expression and the distribution pattern of GST-pi in the human fetal skin. METHODS: Skin was obtained from the scalp, chest, and sole of 49 human fetuses, ranging from 8th to 40th weeks of gestational age. Immunohistochemical staining was performed using avidin biotin peroxidase complex method on paraffin embedded tissue using antirabbit polyclonal antibody against the human GST-pi. RESULTS: GST-pi was expressed in intermediated layer of epidermis at 8th week, and gradually increased in strength of expression stronger in suprabasal layer. In hair unit, GST-pi was expressed in sebaceous gland, bulge, hair matrix cell and outer root sheath cell from 15th week. In eccrine gland, also GST-pi was expressed in central differentiated cells of intradermal eccrine duct from 18th week, and in terminal duct and acini from 26th week of fetal age. CONCLUSION: GST-pi was expressed from the 8th week of gestation suggesting that GST-pi plays an important role in detoxification for the protection of the skin in fetal stage from the various toxic agent.
Avidin ; Biotin ; Breast ; Eccrine Glands ; Epidermis ; Fetus ; Gestational Age ; Glutathione Transferase* ; Glutathione* ; Hair ; Humans ; Intestine, Small ; Lung ; Paraffin ; Peroxidase ; Pregnancy ; Prostate ; Scalp ; Sebaceous Glands ; Sequence Homology ; Skin* ; Substrate Specificity ; Thorax

OBJECTIVE: The content of meconium in amniotic fluid(AF) is important for assessing the risk of several perinatal problems. This estimate is usually performed subjectively by visual inspection. The purpose of this study is to evaluate the clinical usefulness of meconium-crit method as an objective method for quantitative measurement of meconium content in AF. METHODS: Seventy of AF samples were obtained with amniocentesis from the pregnants of 30 weeks and over. Twenty-four of meconium-stained AF(MSAF)samples among them were separated through the subjective and gross assessment of clinicians. MSAF samples, except for the two samples contaminated by blood, were again divided into two categories: AF with fresh-meconium (11 samples) and AF with old-meconium(11 samples). Absorption spectra and meconium-crit of the samples were measured. RESULTS: Correlation coefficients between meconium-crit and absorption spectra at 425nm were 0.741 for 11 AF with fresh meconium, 0.255 for AF with old meconium and 0.354 for all MSAF samples. Those at 550nm were 0.934 for 11 AF with fresh meconium, 0.669 for 11 AF with old meconium and 0.639 for all MSAF samples. Those at 700nm were 0.916 for 11 AF with fresh meconium, 0.680 for 11 AF with old meconium and 0.706 for all MSAF samples. Analyses of correlation coefficients show very good or excellent relationship between absorption spectra and meconium-crit for AF with fresh meconium while little or moderate relationship for AF with old meconium. CONCLUSIONS: Therefore meconium-crit can be used as the objective and quantitative method that can measure meconium content in AF although variable results are shown in AF with old meconium.
Absorption ; Amniocentesis ; Amniotic Fluid* ; Female ; Meconium*