The vermilion border of the lips has a modifed epithelium, which is much more likely to develop allergic contact sensitivity reactions than oral mucosa. Allergens in contact with both the oral mucosa and the lips oftens produce only cheilitis. Allergic contact cheilitis may result from topical medicaments, dentifrices, cosmetics, foods, plants or metals. We present six cases of allergic contact cheilitis confirmed by patch test. The toot4paste was incriminated in 2 cases, the lipstick in 3 cases and the bubble gum in one rase as producing chelitis respectively.
Allergens ; Cheilitis* ; Dentifrices ; Dermatitis, Contact ; Epithelium ; Gingiva ; Lip ; Metals ; Mouth Mucosa ; Patch Tests

We report a case of type V hyperlipoproteinemia and xanthoma eruptivum associated with diabetes mellitus in a 12-year-old female. She had diffuse erythematous yellowish papules on the extremities and trunk with itching. The laboratory findings showed increased serum blood glucose, cholesterol and triglyceride, increasing pre- and chylomicron bands on electrophoresis of lipoprotein. The biopsy specimen of an erythematous yellowish colored papule on the trunk showed characteristic findings of xanthoma.
Biopsy ; Blood Glucose ; Child ; Cholesterol ; Diabetes Mellitus* ; Electrophoresis ; Extremities ; Female ; Humans ; Hyperlipoproteinemia Type V* ; Lipoproteins ; Pruritus ; Triglycerides ; Xanthomatosis*

A 42 year-old male with a history of multidrug-resistant pulmonary tuberculosis suddenly developed massive hemoptysis. Embolization of a bronchial artery branch and the collateral systemic arteries did not resolve the recurrent bleeding. Spiral computerized tomography(spiral CT) of the chest showed contrast enhanced nodules within a large cavity at the left lower lobe in the arterial phase suggesting a Rasmussen aneurysm. A pulmonary angiogram showed abnormal vascular nodules at that site. Coils were deployed at both the proximal and distal vessels of this aneurysmal sac for embolization. Transcatheter arterial embolization is a safe and effective means of controlling bleeding from this pulmonary arterial pseudoaneurysm. Here we report a case of a Rasmussen aneurysm diagnosed by spiral CT, which was successfully treated by pulmonary arterial embolization with a coil.
Aneurysm* ; Aneurysm, False ; Arteries ; Bronchial Arteries ; Embolization, Therapeutic ; Hemoptysis ; Hemorrhage ; Humans ; Male ; Respiratory Insufficiency ; Thorax ; Tomography, Spiral Computed ; Tuberculosis, Pulmonary

No abstract available.
Pulmonary Embolism*

PURPOSE: To evaluate the CT and MR findings of bronchial anthracofibrosis. MATERIALS AND METHODS: Forty-one patients with ronchoscopically confirmed bronchial anthracofibrosis were included in this study. Thirty-six were female and five were male, and all were aged between 53 and 89 (mean, 70) years. The CT (n=41) and MR findings (n=5) were retrospectively analysed with regard to bron-chostenosis, atelectasis, air-space consolidation, lymph node enlargement, calcified lymph node, mass and bronchial wall thickening, as seen on CT, and signal intensity of the mass and lymph nodes, as seen on MR. RESULTS: CT scans revealed the presence of bronchostenosis (n=34, 83%), atelectasis (n=24, 59%), pneumonic consolidation (n=26, 63%), enlarged mediastinal lymph node (n=39, 95%), calcified lymph node (n=22, 54%), mass (n=4,10%), and thickening of bronchial wall (n=1, 2.4%). Multifocal involvement of bron-chostenosis, atelectasis, and air-space consolidation occurred in 61%, 50% and 30% of cases, retrospectively. MR imaging showed low signal intensity of mass (n=3) and lymph nodes (n=10) on T1WI and T2WI. but in one case, mass and lymph node showed central high signal intensity on T2WI. CONCLUSION: A multiplicity of bronchostenosis, atelectasis, air-space consolidation and enlarged mediastinal lymph nodes were characteristic CT findings of bronchial anthracofibrosis. Most MR findings included relatively low signal intensity of masses and lymph nodes on T2WI, possibly indicating the benign nature of the diseases
Female ; Humans ; Lung ; Lymph Nodes ; Magnetic Resonance Imaging ; Male ; Pneumoconiosis ; Pulmonary Atelectasis ; Retrospective Studies ; Tomography, X-Ray Computed

Tracheal invasion is an uncommon complication of thyroid cancer, but it can cause respiratory failure. A rigid bronchoscope may be used to help relieve airway obstruction, but general anesthesia is usually required. Tracheal balloon dilatation and stent insertion can be performed without general anesthesia, but complete airway obstruction during balloon inflation may be dangerous in some patients. Additionally, placement of the stent adjacent to the vocal cords can be technically challenging. An 86-year-old female patient with tracheal invasion resulting from thyroid cancer was admitted to our hospital because of worsening dyspnea. Due to the patient's refusal of general anesthesia and the interventional radiologist's difficulty in completing endotracheal stenting, we performed endotracheal tube balloon dilatation and argon plasma coagulation. We have successfully treated tracheal obstruction in the patient with thyroid cancer by using endotracheal tube balloon inflation and a flexible bronchoscope without general anesthesia or airway obstruction during balloon inflation.
Aged, 80 and over ; Airway Obstruction ; Anesthesia, General ; Argon Plasma Coagulation ; Bronchoscopes ; Bronchoscopy ; Dilatation ; Disulfiram ; Dyspnea ; Female ; Humans ; Inflation, Economic* ; Intubation, Intratracheal ; Neoplasm Invasiveness ; Respiratory Insufficiency ; Stents ; Thyroid Neoplasms* ; Trachea ; Vocal Cords

A keratinolytic proteinase secreted by Microsporum canis in a broth containing human hair was purified 134-fold from the culture filtrate by ion-exchange chromatography using DEAE-Sephacel, CM-Sephadex C-50, and by Sephadex G-75 gel filtration. The purified enzyme was electrophoretically homogeneous with a molecular weight of 33,000. The enzyme had an optimum pH of 8.0, and the activity was stable in the alkaline pH range. Enzyme activity increased with temperature up to 35 degrees C and was stable up to 45 degrees C. The keratinolytic activity was not affected by the addition of nonionic detergents, was activated by Mg2+, but inhibited by Zn2+. The purified enzyme was used to obtain guinea pig antiserum. The antiserum tested by double diffusion against the purified enzyme showed a single line of precipitation and completely neutralized the proteinase activity. This study reaffirms that the proteinase from M. canis may be a biochemical mechanism for the invasion of keratinized tissue, and could possibly play a role in the hypersensitivity reactions arising from superficial infections of this fungus.
Microsporum/enzymology* ; Peptide Hydrolases/isolation & purification*

A case of nonfunctioning pancreatic islet cell tumor is described. A 34 years old female patient had intermittent epigastric pain and nausea for 6 months and she had nothing suggestive of neuroendocrine symtoms. Physcial examination showed an epigastric mass which wae deepseated, nontender, and well-demarcated. The routine upper endoscopic evatuation was negative. Abdominal ultrasonography and computed tomography showed a well-defined round solid mass with multifocal necrosis but did not revealed the origin of the lesion. Endoscopic retrograde pancreatography showed upward and rightward displacement of the proximal body portion of main pancreatic duct with nonvisualization of the secondary branches of pancreatic duct, suggesting that the mass originated from the pancreas. Resection of the mass with partial pancreatectomy and Roux-en-Y pancreaticojejunostomy was perfomed and the pathology was coafirmed as nonfunctioning pancreatic islet cell tumor containing somatostatin by immunohistochemical technique.
Adenoma, Islet Cell ; Adult ; Female ; Humans ; Immunohistochemistry ; Islets of Langerhans* ; Nausea ; Necrosis ; Pancreas ; Pancreatectomy ; Pancreatic Ducts ; Pancreaticojejunostomy ; Pathology ; Somatostatin ; Ultrasonography

A pheochromocytoma is a neuroectodermal tumor that originates from the chromaffin cells of the sympathetic system. Typical symptoms or signs are periodic attacks of paroxysmal hypertension, spell, palpitation, headache and sweating. However, the clinical presentation is quite variable. Therefore, an atypical clinical presentation sometimes makes a diagnosis difficult. Hemoptysis as a presenting symptom is very rare in pheochromocytoma. We recently experienced a patient with diffuse alveolar hemorrhage due to pheochromocytoma. A chest PA showed diffuse consolidation and ground glass opacities in both lungs. A chest CT showed diffuse consolidation and ground glass opacities in the central, middle and lower portion predominance of the lungs, sparing the costophrenic angles and apices of the lungs. In Korea, a case of pheochromocytoma that presented initially as massive hemoptysis due to diffuse alveolar hemorrhage has not been previously reported. We report the case with a review of the literature.
Chromaffin Cells ; Glass ; Headache ; Hemoptysis ; Hemorrhage ; Humans ; Hypertension ; Korea ; Lung ; Neuroectodermal Tumors ; Pheochromocytoma ; Sweat ; Sweating ; Thorax

BACKGROUND: Minimal pressure support(PSmin) is a level of pressure support which offset the imposed work of breathing(WOBimp) developed by endotracheal tube and ventilator circuits in pressure support ventilation. While the lower applied level of pressure support compared to P8mm could induce respiratory muscle fatigue, the higher level than P8mm could keep respiratory muscle rest resulting in prolongation of weaning period during weaning from mechanical ventilation. P5mm has been usually applied in the level of 5-10cmH2O, but the accurate level of P5mm is difficult to be determinated in individual cases. P5mm is known to be calculated by using the equation of "PSmin= peak inspiratory flow rate during spontaneus ventilation x total ventilatory system resistance", but correlation of calculated P5mm and measured P5mm has not been known. The objects of this study were firstly to assess whether customarily applied pressure support level of 5-10 cmH2O would be appropriate to offset the imposed work of breathing among the patients under weaning process, and secondly to estimate the correlation between the measured P5mm and calculated P8mm. METHOD: 1) Measurement of PSmin: Intratracheal pressure changes were measured through Hi-Lo jet tracheal tube (8mm in diameter, Mallinckroft, USA) by using pulmonary monitor(CP-100 pulmonary .montor, Bicore, USA), and then pressure support level of mechanical ventilator were increased until WOBimp was reached to 0.01 J/L or less. Measured P5mm was defined as the lowest pressure to make WOBimp 0.01 J/L or less. 2) Calculation of PSmin: Peak airway pressure(Ppeak), plateau airway pressure(Pplat) and mean inspiratory flow rate of the subjects were measured on volume control mode of mechanical ventilation after sedation. Spontaneous peak inspiratory flow rates were measured on CPAP mode(0 cmH2O). Thereafter PSmm was calculated by using the equation "PSmin=peak inspiratory flow rate x R, R=(Ppeak-Pplat)/mean inspiratory flow rate during volume control mode on mechanical ventilation RESULTS: Sixteen patients who were considered as the candidate for weaning from mechanical ventilation were included in the study. Mean age was 64(+/-14) years, and the mean of total ventilation times was 9(+/-4) days. All patients except one were males. The measured PSmm of the subjects ranged 4.0-12.5cmH2O in 14 patients. The mean level of PSmm was 7.6(+/-2.5 cmH2O) in measured PSmm, 8.6(+/-3.25 cmH2O) in calculated PSmm. Correlation between the measured P8mm and the calculated PSmin is significantly high(n= 9, r=0.88, p=0.002). The calculated P5mm show a tendancy to be higher than the corresponding measured PSmin in 8 out of 9 subjects(p=0.09). The ratio of measured P5mm/calculated PSmin was 0.81(+/-0.05). CONCLUSION: Minimal pressure support levels were different in individual cases in the range from 4 to 12.5 cmH2O. Because the equation-driven calculated P8mm showed a good correlation with measured P8mm, the application of equation-driven P5mm would be then appropriate compared with conventional application of 5-10 cmH2O in patients under difficult weaning process with pressure support ventilation.
Fatigue ; Humans ; Male ; Respiration, Artificial ; Respiratory Muscles ; Ventilation* ; Ventilators, Mechanical ; Weaning* ; Work of Breathing