Carcinoma of the breast can produce cutaneous metastases which sbow highly diversified clinical pictures. The cutaneous metastases produce four definite clinical types: inflammatory carcinoma, telangiectatic carcinoma, nodular carcinoma, and carcinoma, en cuirasse. We present a case of 78-year-old nulliparous woman who had several painful dark purplish colored zosteriform papulovesicular eruptions, suggestive of herpes zoster, on the right breast, right axilla, scapular area, and upper arm for three month. Two month later, well dermacated linearly arranged erysipeloid eruptions appeared around the previous skin lesions and the right chest wall. Histopathological findings showed metastatic ductal carcinoma with massive vascular permeation but the primary focus was undetermined.
Female ; Humans ; Neoplasm Metastasis

No abstract available.
Bandages* ; Gentian Violet* ; Gentiana* ; Methicillin-Resistant Staphylococcus aureus* ; Wounds and Injuries*

Tuberculosis of the esophagus is rare. We experienced four patients with esophageal tuberculosis proven by esophagoscopic biopsy or surgical specimens. Case 1 was a patient with primary esophageal tabereulosis, case 2 was a patient with teberculous esophagobronchial fistula and case 3,4 were patients with esoyhageal perforation due to tuberculous traetion diverticulum of the esophagus. The clinical, radiological and esapbagoscopic findings may be nonspecific in diagnosis of esophageal tuberculosis. Therefore early diagnosis should be rested on a high index of suapieion and a cautious attention.
Biopsy ; Diagnosis ; Diverticulum ; Early Diagnosis ; Esophagus* ; Fistula ; Humans ; Tuberculosis

Early and longterm prognosis depended on the extents of acute myocardial infarction and residual myocardial function. Many clinical methods have been evaluated to determine their ability to estimate the size of myocardial infarcts. But because of many disadvantages simplified QRS scoring system, used with standard 12-lead EKG, was developed, which is noninvasive, inexpensive and easily releatible. Therefore, the correlation between QRS and peak CK,killip classification were evaluated in 55 patients with initial acute myocardial infarction at the Chung-Ang University, Yong-San and Pil-Dong Hospital during the period from January 1983 to December, 1986. The results were as follows : 1) The average QRS score of the anterior wall infarction is 7.1 and that of the inferior wall infarction is 4.5 and there is a statistical significance(p<0.01). 2) In the acute myocardial infarction, the correlation coefficeient between the QRS score and the killip classification is 0.66(p<0.05). 3) In the acute myocardial infarction, the average QRS score is 6.3 and the correlation coefficient between the leak CK and the QRS score is 0.52(p<0.05). 4) In the anterior wall infarction, the average QRS score is 7.1 and the correlation coefficient between the peak Ck and QRS score is 0.48(p<0.05). 5) In the inferior wall infarction, the average QRS score is a 4.5 and the correlation coefficient between the leak CK and QRS score is 0.79(p<0.05).
Classification ; Electrocardiography ; Humans ; Infarction ; Myocardial Infarction* ; Prognosis

No abstract available.
Gastroparesis*

No abstract available.
Helicobacter pylori* ; Helicobacter* ; Stomach Neoplasms*

Enemas are sometimes used in hospital and domicilliary practice and occasionally by patients themselves without a valid indication. The present repart is one in which enernas were done for 3 months by a patient himself to treat his hemorrhoid and resulted in severe inflamimatory change with large-siaed illdefined shallow ulceration in rectum and sigmoid colon. This patient, a 53 year old male, entered the hospital with the complaint of diarrhea with passage of bloody muct.. Colonoscopic examination revealed severe inflammatory change, friable mucosa and several relatively large-sized ill-defined shallow ulceration in rectum and sigmoid colon. A biopsy was performed and microscapic examination revealed intense infiltrates and plasma cells and crypt abscess with decreased goblet cells in the lamiina propria. The submucosa showed edema with infiltrates of chronic inflammatory cells and neutrophils. Conservative treatment with discontinue of enemas and fluid supply was performed. And his symptoms were improved. After second week, follow-up colonoscopy revealed inflammatory changes were improved.
Abscess ; Biopsy ; Colitis* ; Colon, Sigmoid ; Colonoscopy ; Diarrhea ; Edema ; Enema* ; Follow-Up Studies ; Goblet Cells ; Hemorrhoids ; Humans ; Male ; Middle Aged ; Mucous Membrane ; Neutrophils ; Plasma Cells ; Rectum ; Ulcer

PURPOSE: To evaluate the values of C-reactive proteins(CRP) for predicting the severity and results of treatment for acute pyelonephritis in women, we compared the severity of symptoms and signs, the laboratory findings and the initial serum CRP according to the early response to treatment. MATERIALS AND METHODS: We retrospectively analyzed 298 female patients who were diagnosed with acute uncomplicated pyelonephritis between January 2002 and Match 2007. All the medical records were reviewed for a variety of factors, and the baseline characteristics and CRP level were compared between the patients with an early response to treatment and those without according to the 3rd hospital day urine analysis. RESULTS: The initial white blood cell(WBC) counts, the CRP level, the neutrophil ratio and severity of symptoms were significantly higher in the delayed response groups than those in the early response groups. The age, history of previous pyelonephritis, symptom duration, body mass index(BMI), and the number of positive blood and urine cultures were not different between the two groups. According to the results of the multivariate logistic regression analysis, the CRP level, neutrophil ratio and mild symptoms were independent predictive variables that affected the delayed response. The odds ratios(95% CI) were 1.078(1.028-1.131) for the CRP, 1.030(1.001-1.060) for the neutrophil ratio and 9.268(1.072-80.166) for the severe symptoms. The differences between the areas under the ROC curves for CRP and the WBC counts and for the CRP level and neutrophil ratio were statistically significant(p<0.001 and p<0.05, respectively). CONCLUSIONS: We found that the discriminatory power of the initial CRP level was high with regard to predicting an early response. So, we were able to determine a CRP level that would be useful in guiding hospitalization.
Acute-Phase Proteins ; C-Reactive Protein* ; Female ; Hospitalization ; Humans ; Logistic Models ; Medical Records ; Neutrophils ; Pyelonephritis* ; Retrospective Studies ; ROC Curve

Mitomycin C (MMC) trabeculectomy combined with extracapsular cataract extraction and posteor chamber intraocular lens implantation (glaucoma triple procedure, 30 eyes) was clinically compared with MMC trabeculectomy alone (30 eyes). The age, type of glaucoma, and preoperative number of medications were matched with the previous group (P>0.05). The mean preoperative intraocular pressures (IOPs) were 30.2+/-8.3mmHg (range, 22~56mmHg) in the glaucoma triple procedure group and 31.6+/-8.9mmHg (range, 22~57mmHg) in the trabeculectomy alone group (p=0.55). The mean postoperative IOPs were significantly higher in the glaucoma triple procedure group compared with the trabeculectomy alone group at all postoperative vistis (one month to nine months) (p<0.05). However, there were no statistically significant differences in the mean number of postoperative rise exceeding 30 mmHg within the postoperative one month tended to occur more frequently in the glaucoma triple procedure group (7 eyes (23%)) than the trabeculectomy alone group (2 eyes(7%)) (p=0.13). Conjunctival filtering blebs were significantly frequently observed in the trabeculectomy alone group than the glaucoma triple procedure group (28 eyes (93%), 20 eyes (67%), respectively, P=0.02) at 6 months postoperatively. The common postoperative complications were hyphema (4 eyes) and posterior capsular opacification (4 eyes) in the glaucoma triple procedure group and shallow anterior chamber(4 statistical difference was noted between these two groups (p>0.05). Although hypotensive effect of MMC on the glaucoma triple procedure was less than on the trabeculectomy alone, glaucoma triple procedure using MMC could be recommended to be safe and effective on controlling the high IOP for treating glaucoma patients with coexisting cataract.
Blister ; Cataract ; Cataract Extraction ; Glaucoma* ; Humans ; Hyphema ; Intraocular Pressure ; Lens Implantation, Intraocular ; Mitomycin* ; Postoperative Complications ; Trabeculectomy*

Systematic review and meta-analysis is a research method that tries to provide the best evidence by comprehensive searching, combining of results, and evaluating methodological quality of studies focused on the undetermined clinical question. By keeping credibility of the research process and minimizing potential bias, authors can provide precise pooled estimates. Recently, meta-analysis publications have been increasing and there is a need for critical appraisal of this flow. This review aims to provide an overview of recent trends of meta-analysis in the upper gastrointestinal diseases by quantitative and qualitative analysis.
Bias (Epidemiology) ; Gastrointestinal Diseases* ; Meta-Analysis as Topic ; Upper Gastrointestinal Tract