No abstract available.
Equidae*

No abstract available.
Humans ; Pregnancy, Twin* ; Twins*

The pilomatricoma (Calcifying Epithelioma of Malherbe) is rare benign tumor of adnexal keratinocytes. It is occuring usually as a single, asymptomatic, 0. 5 cm to 3. 0 cm sized, deep seated, firm nodule, covered by normal or pink skin. Multiple pilomatricoma is relatively rare, as 3. 5% of reported cases of pilomatricoma. A 21-year-old male patient had 7 subcutaneous nodules on the neck, both upper extremities and trunk for 9 years. We excised one of them, under the impression of calcinosis cutis, cysticercosis cutis or benign skin tumor. But histopathologic findings of the lesion showed the typical pattern of pilomatricoma with shadow cells, calcification and foreign body giant cells. Five of remainders were excised and they showed same histopathological findings of pilomatricoma. The authors presented herein one case of multiple pilomatricoma with the review of literature.
Calcinosis ; Carcinoma ; Cysticercosis ; Giant Cells, Foreign-Body ; Humans ; Keratinocytes ; Male ; Neck ; Pilomatrixoma* ; Skin ; Upper Extremity ; Young Adult

BACKGROUND: Total occlusion of the infrarenal abdominal aorta is a very rare disease in clinical practice. The clinical outcome may be poor unless management is attempted promptly. Surgical bypass has been recommended as the treatment of choice for these lesions. However, there was relatively high surgical mortality and morbidity associad with aorto-bifemoral bypass graft in patients with other systemic disease, especially coronary artery disease. As a result, the use of, thrombolysis with percutaneous transluminal angioplasty (PTA) has recently been extended to this disease as an alternative method to surgery. PTA is technically simpler with less morbidity and mortality than surgery.We report our experience with thrombolysis and balloon angioplasty of total aortic occlusion in 14 patients between March 1991 and December 1996. METHODS: Fourteen patients, whose mean age was 59+/-13 years (11 male, 3 female), serve as the study's patients. Aortography was introduced via transbrachial artery. The end hole multipurpose catheter with guidewire was introduced into the thrombotic portion of the total occlusion. Urokinase was infused into the thrombus through the catheter if there were no contraindications. in sysremic thrombolysis. Thrombolytic therapy was continued until the thrombi was resolved and flow was restored. Balloon dilatation was followed in residual stenotic lesions. Stents were implanted in case of suboptimal results after ballooning. RESULTS: Clinical findings were resting leg pain in 6 patients, gangrene in 5 patients, and claudication in 3 patients. The causes of aortic occlusion were thromboembolism in 4 patients and thrombosis of an atherosclerotic aorta in 10 patients. Location of obstruction was below the renal artery in all cases. The clinical outcome of interventional therapy was successful in all cases except one patients. Operative treatment was undertaken in 2 cases because they could not received thrombolytic therapy due to contraindication and complication of thrombolytic therapy (gastrointestinal bleeding). Near normal revascularization was achieved in 3 patients by thrombolytic therapy only. PTA was performed at the stenotic after thrombolytic therapy in 4 patients. Stenting were performed at the stenotic sites after balloon dilatation in another 4 patients. There was bleeding complication in one case. CONCLUSIONS: Interventional therapy such as thrombolytic therapy with PTA is an effective and safe treatment modality for abdominal aortic total occlusion in selected cases. These techniques were very useful in some high risk patients who received surgical bypass procedures.
Angioplasty ; Angioplasty, Balloon ; Aorta ; Aorta, Abdominal* ; Aortography ; Arteries ; Catheters ; Coronary Artery Disease ; Dilatation ; Gangrene ; Hemorrhage ; Humans ; Leg ; Male ; Mortality ; Rare Diseases ; Renal Artery ; Stents ; Thromboembolism ; Thrombolytic Therapy ; Thrombosis ; Transplants ; Urokinase-Type Plasminogen Activator

No abstract available.
Child* ; Humans

Upper gastrointestinal(UGI) bleeding was critical disease that was commonly found in emergency department and needed more early diagnosis and rapid treatment for decreasing mortality and morbidity. It's causes and frequencies here affected by many factors, but the majorities were caused by peptic ulcers and esophageal-gastric varices. With development of economy and medical services, new drugs and endoscopic interventions, the treatment of patients with UGI bleeding was more improved. So I would like to evaluate the change of causes and frequencies of UGI bleeding and the associated clinical findings. A total of 1,546 patients presented with UGI bleeding in emergency department of Yeungnam university hospital during the five years from Jan. 1991 to Dec. 1995 were clinically reviewed by charts and compared with previous seven years report from Jan. 1984 to Dec. 1990 in the same hospital. The ratio of male to female was 6.1:1 and slightly increased in comparison with previous seven years. The incidences in 6th and 5th decades were highest(54.4%) as like as previous seven years. Age distribution of duodenal ulcer bleeding, Mallory-Weiss tear and acute gastric mucosal lesion were developed in lower decades than the others. The causes of UGI bleeding were caused by esophageal varix(45.4%), peptic ulcer(38.8%), Mallory-Weiss tear(4.3%), gastric cancer(3.8%), others(3.1%), acute gastric mucosal lesion(2.7%), undetermined causes(1.8%) in defending order of frequencies. The proportion of esophageal varices was increased from 36.6% to 45.4%, but that of peptic ulcer was relatively decreased from 47.6% to 38.8%. And the annual distribution of varices was increased, however the annual distribution of peptic ulcers was increased. Although the ranking of annual distribution of gastric ulcers and duodenal ulcers were not changed compared to previous study and the frequency of gastric ulcers was increased since 1992, but additional follow-up was needed. Seasonal variations were found that upper gastrointestinal bleeding was increased in fall and peptic ulcer bleeding was increased significantly in summer and fall, however, varix bleeding was less frequent in summer time as like as previous seven years. Emergency endoscopic examination was performed within 6 hours far 54.5%, 24 hours for 90.8% and this reacts were to be like previous results, 57.5% and 90.7% respectively. Findings of emergency endoscopic examination were active bleeding focus(21.2%), blood clot(7.9%), exposed vessels(13.3%), flat blood spot(6.4%) and lesion without evidence of bleeding(51.3%). Endoscopic findings of active bleeding were easily seton when examination was perfomed within 24 hours. Blood transfusion was performed in 67.3% with average 2.1 units. When the causes of bleeding were due to varix and marginal ulcer, more amounts of blood were transfused than the others. In previous seven years, blood transfusions were performed in 71.2% with average 5 units and more amounts of blood were transfused in gastric cancer and varix bleeding.
Age Distribution ; Blood Transfusion ; Duodenal Ulcer ; Early Diagnosis ; Emergencies ; Emergency Service, Hospital ; Esophageal and Gastric Varices ; Female ; Follow-Up Studies ; Hemorrhage* ; Humans ; Incidence ; Male ; Mallory-Weiss Syndrome ; Mortality ; Peptic Ulcer ; Seasons ; Stomach Neoplasms ; Stomach Ulcer ; Varicose Veins

OBJECTIVE: This study was conducted to compare the safety and efficacy of transdermal glyceryl trinitrate (GTN) in initial therapy for preterm labor with those of intravenous ritodrine hydrochloride and the effects of tocolytics in uteroplacental circulation, as assessed by uterine artery doppler velocimetry. METHODS: Patients between 24 and 34 weeks gestation with documented preterm labor were randomly assigned to receive transdermal GTN (n=24) or intravenous ritodrine (n=35) as initial tocolytic therapy. Patients in the GTN group were administered 0.2 mg/h released transdermal patch on the pregnant women's abdomen directly. Patient in the ritodrine group were treated 0.025 mg/min as initial dose. The dose increased at 15 minute intervals until uterine contractions were inhibited or side effects become intolerable. The maximum recommended dose was 0.20 mg/min. The main outcome examined were failure of tocolysis, time to uterine quiescence, time gained in utero, and frequency of adverse effects. We obtained both right and left uterine artery doppler velocity waveform before and after tocolytics therapy. The mean values of the right and left uterine artery systolic and diastolic ratio were calculated and used for analysis. RESULTS: There were no significant difference in maternal demographic between the groups. Successful tocolysis was observed in 79.2% in the GTN group, and 85.7% in the ritodrine group (p=0.726). Time to uterine stop contraction was 5.5 +/- 5.3 hr in ritodrine group and 1.1 +/- 0.3 hr in GTN group. There were no different in time to gain in uterus between the two groups. The patient in the ritodrine group had more adverse side effects, mainly maternal tachycardia (p=0.002), chest pain and tremor (p=0.035). There was no significant difference in uterine S/D ratios between the pretherapy and posttherapy GTN group. However, we found statistically significant difference between the pretherapy and 24 hr-posttherapy in ritodrine group. CONCLUSION: Transdermal GTN was effective, safe, and well tolerable tocolytic agent. Patients who received ritodrine hydrochloride were more likely to have adverse effects. We also conclude that GTN do not affect uteroplacental circulations as measured by S/D ratios but ritodrine does. This results suggest that progressively increasing dose of ritodrin and GTN maybe associated with a statistically significant decrease S/D ratios. However, further investigations needs to be performed.
Abdomen ; Chest Pain ; Female ; Humans ; Nitroglycerin* ; Obstetric Labor, Premature* ; Placental Circulation ; Pregnancy ; Rheology ; Ritodrine* ; Tachycardia ; Tocolysis* ; Tocolytic Agents* ; Transdermal Patch ; Tremor ; Uterine Artery ; Uterine Contraction ; Uterus

In the past two decades, the incidence of rubella infection has decreased due to a nation-wide rubella vaccination program. Therefore the rate of rubella Ig G antibody has decreased. This means an increasing vulnerability to rubella infection among the group, with negative Ig G antibodies. The study was conducted in January of 1992 to April of 1996. The subjects were 1,010 fertile women(ages 20/45 years). The study was performed at Park Women`s Clinic to investigate the status of rubella antibody in Korean fertile women. The results were as follows. 1. The positive rate of rubella Ig G and Ig M antibody were 80.5% and 1.5%, respectively. 2. The mean age of positive rubella Ig G group was 28.5+/-3.6 years. The positive rate of rubella Ig G antibody was decreased by an increase in age with a significant level at p < 0.05. 3. The positive rate of rubella Ig G antibody was 63.3% in 1992, 71.3% in 1993, 87.5% in 1994, 81.1% in 1995 and 83.8% in 1996. The increase in the positive rate of rubella Ig G antibody by year for 5 years was statistically significant at p < 0.05. 4. The positive rubella Ig M antibody was noted in 15 women. Among them, one woman was tested in 1993, 5 women in 1995 and 9 women in 1996. The incidence of rubella infection had increased by years, and was statistically significant at p < 0.05. 5. The mean titer of rubella Ig G antibody was 47.18+/-50.04 IU/ml. The titer of rubella Ig G antibody was decreased by the increased in at age(p < 0.05). We observed a low positive rate of rubella Ig G antibody as compaired with other studies that were performed before 1990. Therefore, to prevent sporadic rubella infections, rubella vaccinations should be given to unmarried women.
Antibodies ; Female ; Humans ; Incidence ; Rubella* ; Single Person ; Vaccination

Gottron's acrogeria syndrome is a rare genetic disease of unknown etiology with some features suggestive of accelerated aging. The typical clinical presentation consists of premature aging of the skin with atrophy of the cutis and the subcutis. After a brief review of the literature available on this syndrome, we report a case of Gottron s acrogeria syndrome in a 19 year-old man whose right rectus femoris muscle had a fibrotic contracture.
Aging ; Aging, Premature ; Atrophy ; Contracture ; Humans ; Quadriceps Muscle ; Skin ; Young Adult

Scoliosis has been reported in 40 to 60 percent of patients with Marfsn's syndrome. The tensile strength of tissues in which the collagen is a major component has been to be reduced in this disease. An abnormality of cross-linking in the α2(I) peptide chain of collagen is the simplest explanation for this observation. We experienced a case of scolisis with Marfan's syndrome in whom Cotrel-Dubousset instrumentation was csrried out successfully and bilateral pneumothorax was observed in 10 days postoperatively. The occurrence of this complication, which has not been previously reported in the literature, suggests that excessive distractional and rotational force during procedure may be harzsrdous in the patient with intrinsic collagen weakness.
Collagen ; Humans ; Marfan Syndrome ; Pneumothorax ; Scoliosis ; Tensile Strength