The nevus sebaceus of Jadsssohn is an organoid nevus generally noted on the scalp or the face as a single lesion. A 26-year-old man has suffered from a pea sized, pedunculated cherry red colored papule on the back ground of yellowish colored verrucous plaque on the vertex. Clinically, pedunculated papule was similar to granuloma pyogenicum, but histopathologic examination showed the features of tubular apocrine adenoma with focal areas of syringocystadenoma papilliferum, suggesting that might be a variant or could be associated with syringocystadenoma papilliferum.
Adenoma* ; Adult ; Granuloma, Pyogenic ; Humans ; Nevus* ; Nevus, Sebaceous of Jadassohn ; Organoids ; Peas ; Prunus persica ; Scalp

Malignant Melanoma is rare, occupied less than about 0.5% of malignant skin cancer, in Korea. We have experienced three cases for recent 2 years. Case 1 was a 65-year-old woman suffered from 2.0 × 3.0cm sized fungating mass with central ulceration on the left heel for 1 year duration. Left inguinal lymph node was enlarged. She expired 9 months later in spite of treatment with surgical excision, lymph node dissection, and chemotherapy with DTIC. Case 2 was a 37-year-old woman showed 1.0 × 1.5cm sized lobulated, black papules on the right preauricular area for 8 years duration. Satellite lesions developed 1 year ago. There were recurrences on the excisional sites after treatment with wide surgical excision. Case 3 was a 45-year-old woman had 0.5 × 2.Ocm sized, black pigmented patch with satellite lesions on the left sole for 2 years duration. Surgical excision and follow-up for 1 year after treatment showed no recurrence yet.
Adult ; Aged ; Dacarbazine ; Drug Therapy ; Female ; Follow-Up Studies ; Heel ; Humans ; Korea ; Lymph Node Excision ; Lymph Nodes ; Melanoma* ; Middle Aged ; Recurrence ; Skin Neoplasms ; Ulcer

No abstract available.
Brain Injuries* ; Brain* ; Disability Evaluation* ; Humans ; Perfusion* ; Technetium Tc 99m Exametazime* ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: To evaluate MRI(Magnetic Resonance Imaging) findings of miliary tuberculosis of the brain. MATERIALS AND METHODS: Six patients with miliary tuberculosis of the brain diagnosed by characteristic clinical or laboratory findings were studied with spin echo MRI before and after contrast enhancement. We retrospectively evaluated MRI findings acording to the appearance, distribution, location, and enhancement pattern of the granulomas as well as associated other abnormalities. RESULTS: In six patients, contrast-enhanced MRI of thebrain showed numerous punctate, contrast enhancing lesions scattered throughout the brain. Unenhanced MRI failed to demonstrate small granulomas except a few small foci of high signal intensity on T2-weighted images. The shapes of enhancing granulomas were homogeneous nodular enhancement in 86% of cases and small ring enhancement in 14%.98% of granulomas were smaller than 3-mm and 2% were larger. Although several lesions were located in the basalganglia, thalamus, and brain stem, the majority were located in the subpial and subarachnoid space. There was no significant difference in distribution of granulomas between the supratentorial and the infratentorial areas. Other associated abnormalities were focal meningitis in five cases and focal cerebritis in one. On chest radiograph, all patients had miliary tuberculosis in the lungs. CONCLUSION: Contrast-enhanced T1-weighted MRimaging showed numerous round, very small enhancing lesions scattered throughout the brain. The majority of lesions were located in the subpial and subarachnoid space. Contrast-enhanced T1-weighted images are helpful inthe detection and diagnosis of miliary disseminated tuberculous granulomas and meningitis.
Brain Stem ; Brain* ; Diagnosis ; Granuloma ; Humans ; Lung ; Magnetic Resonance Imaging* ; Meningitis ; Subarachnoid Space ; Thalamus ; Tuberculosis, Central Nervous System ; Tuberculosis, Miliary*

PURPOSE: To compare the usefulness of double-dose contrast-enhanced CT (DDCE-CT) and conventional contrast-enhanced CT (CCE-CT) in the detection of metastatic brain lesions. MATERIALS AND METHODS: Sixteen patients with brain metastases were evaluated with both CCE-CT and thinslice DDCE-CT. For CCE-CT, an initial injection of 100 ml contrast medium was given, and DDCE-CT with both 10-mm and 5-mm thickness was performed after the addition of an extra 100 ml of contrast medium. The numbers of metastatic lesions detected by CCE-CT and by DDCE-CT were compared, as were the findings of contrast-enhanced MRI (CE-MRI) and thin-slice DDCE-CT in seven patients who underwent both these procedures. RESULTS: Fourteen metastatic brain lesions were detected by CCE-CT, 22 by 10-mm-thickness DDCE-CT, and 36 by 5-mm thickness DDCE-CT. Thus, almost 2.6 times more lesions were detected by thin-slice DDCE-CT than by CCE-CT. Metastatic lesions were detected by 10-mm-thickness DDCE-CT in 16 patients and by CCECT in seven; in five, edema only was detected, while in four there were no detectable metastases. CCE-CT detected four lesions of less than 5 mm in diameter, while 10-mm-thickness DDCE-CT and 5-mm-thickness DDCE-CT detected seven and 18 lesions, respectively. Eleven lesions were detected by thin-slice DDCE-CT and 17 by CE-MRI in the seven patients who underwent both CE-MRI and DDCE-CT. The lesions detected only by CE-MRI were less than 5 mm in diameter and were discovered in the cerebellum or inferior temporal lobe. CONCLUSION: Thin-slice DDCE-CT was superior to CCE-CT in detecting metastatic brain lesions.
Brain* ; Cerebellum ; Edema ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis* ; Temporal Lobe ; Tomography, X-Ray Computed*

PURPOSE: To investigate the spontaneous cerebral microbleeding occurring at gradient-echo MRI, and its relationship with associated stroke lesions and risk factors. MATERIALS AND METHODS: Between September 2001 and December, 2002, 32 patients (21 men and 11 women; mean age 63 years) in whom cerebral microbleeding occurred at gradient-echo MRI were retrospectively investigated. Using a 1.5 T MR imager, spin-echo T1-weighted, fast spin-echo T2-weighted, diffusion-weighted, and gradient-echo images were obtained. The number and location of microbleeds seen on gradient echo images, patient data, and associated stroke lesions such as intracerebral hemorrhage and lacunar and territorial infarction were assessed. RESULTS: Among the 32 patients, 563 microbleeds and between 1 and 66 (mean, 17.6) were noted at gradientecho imaging. Microbleeding occurred in the cortical/subcortical area (n=216), the basal ganglia (n=173), thalamus (n=92), cerebellum (n=41), brainstem (n=36) and corpus callosum (n=1), and in 20 patients was bilateral. Patients had a history of hypertension (n=26), hypertriglycemia (n=12), heart disease (n=4), and diabetes mellitus (n=3). Stroke lesions were seen in 27 patients, intracerebral hemorrhage in ten, lacunar infarction in 24, and territorial infarction in four. CONCLUSION: The incidence and number of microbleeds was greater in older patients and in those with hypertension, hypertriglycemia, and stroke lesions such as intracerebral hemorrhage or lacunar infarction. The detection of microbleeding at gradient-echo imaging is helpful, since it predicts the possibility of cerebral hemorrhage in these patients.
Basal Ganglia ; Brain Stem ; Cerebellum ; Cerebral Hemorrhage ; Corpus Callosum ; Diabetes Mellitus ; Female ; Heart Diseases ; Humans ; Hypertension ; Incidence ; Infarction ; Magnetic Resonance Imaging* ; Male ; Retrospective Studies ; Risk Factors ; Stroke* ; Stroke, Lacunar ; Thalamus

A retrospecive clinical observation was done on 325 cases of hypertension admitted to Department of internal Medicine of Seoul Red Cross Hospital from January, 1979 to December, 1982. The following results have been obtained. 1) The observed patients were 157 males and 168 females, and the prevalence rate of malignant hypertension among 325 hypertensions was 16 cases (4.9 percent). Among 16 cases of malignant hypertension 9 cases were male and 7 cases were female. Most frequently in 50, 60 and 40 years of age in this order each sex. 2) The average admitted dates are 7 days. 27 cases (8.3percent) were readmitted above 2 times after one discharged. 3) The most freqeuntly observed duration of Known hypertension 37.9 percent was 6-10 years and the next frequently observed duration 37.4 percent was 3-5 years. 4) The highest percentage of malignant hypertension had systolic blood pressure between 190-209mmHg and diastolic blood pressure between 150-169mmHg. 5) The highest percentage of seasonal number was spring (31.1 percent) and the next autumn, summer, winter in this order and the prevalence rates of hypertention are increased average 1.9% of each year. 6) The 78.5 percent of the patients were found that their blood pressure were abnormaly high when they were examined with related symptoms on admission, and they major symptorms were headache and dizziness. 7) The physical examination on admission, tachycardia (56percent), tachypnea (15.1percent), semicoma to coma (12.9 percent) in this order. 8) The status of treatment in hypertension on admission was as follows; imtermittent treatment 54.5 percent, no treatment 31 percent and continuous treatment 14.5 percent in this order. 9) In the chest X-ray on admission, the most frequent finding was cardiomegaly, and normal finding was the next frequency. The pulmonary Tbc was noted in 12.6 percent. 10) According to the degree of fundoscopic abnormality by K-W classification stage III was 68.8 percent and stage IV was 31.2 percent. 11) Electrocardiogram abnormalities were 44.9 percent, and 87.5 percent of malignant hypertension revealed electrocardiographic abnormalities and left ventricle hypertrophy was observed in 70.5 percent. 12) Hypercholesterolemia 78 percent, Hypernatremia 69.8 percent, Hypokalemia 22.8 percent, serum chloride 34.5 percent (<95m Eg/l), BUN 53.8 percent (>20mg/dl) and creatinine 45.8 percent (>3mg/dl) on admission. 13) Proteinuria was observed in 87.5 percent of malignant hypertension. 14) Marked improved for clinically was 24 percent and mortality rate was 5.2 percent, most common cause of death are cardiovascular accident (64.7percent) and renal failure (23.5percent).
Blood Pressure ; Cardiomegaly ; Cause of Death ; Classification ; Coma ; Creatinine ; Dizziness ; Electrocardiography ; Female ; Headache ; Heart Ventricles ; Humans ; Hypercholesterolemia ; Hypernatremia ; Hypertension ; Hypertension, Malignant ; Hypertrophy ; Hypokalemia ; Internal Medicine ; Male ; Mortality ; Physical Examination ; Prevalence ; Proteinuria ; Red Cross ; Renal Insufficiency ; Seasons ; Seoul ; Tachycardia ; Tachypnea ; Thorax

No abstract available.
Catheters*

The Korean hemorrhagic fever (KHF) is an acute febrile disease with characteristic of fever, bleeding tendency, and renal failure. There are many complications of Korean hemorrhagic fever such as infection, anemia, internal bleeding, hypopituitarism, respiratory, and neurologic complication. A few cases were reported on acute pancreatitis with hemorrhagic fever abroad, but there was no case about Korean hemorrhagic fever with acute pancreatitis in this country. We experienced a case of Korean hemorrhagic fever associated with suspected acute pancreatits. With review of articles, we report a case of 51 year-old woman with KHF, where acute pancreatitis developed during management.
Anemia ; Female ; Fever ; Hantavirus ; Hemorrhage ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Hypopituitarism ; Middle Aged ; Pancreatitis* ; Renal Insufficiency

BACKGROUND: Surveillance of surgical site infection is a main component of nosocomial infection surveillance. To perform a valid comparison of rates among hospitals, among surgeons, across time, surgical site infection rates must account for the variation in patient's underlying severity of illness and other important risk factors. So, a risk index was developed to predict a surgical patient's risk of acquiring a surgical site infection. The risk index score, ranging from 0 to 3, was the number of risk factors present among the following: (1) a patient with an American Society of Anesthesiologists preoperative assessment score of 3,4,5, (2) an operation classified as contaminated or dirty-infected, and (3) an operation lasting over T hours, where T depends upon the operative procedure being performed. METHOD: We performed surgical site infection surveillance according to patient risk index after cardiovascular surgery from Mar 1, 1997 to May 31, 1997. In addition, we also monitored nosocomial infection of all patients after cardiovascular surgery Data was collected prospectively, Surgical site infection rate was classified according to patient risk index and compared with NNIS (National Nosocomial Infections Surveillance) semiannual report of 1995. RESULT: Overall nosocomial infection rate was 18.9% and among all patients detected by surveillance protocols, pneumonia was the most common (6.3%) nosocomial infection after cardiovascular surgery, and the remaining infections were distributed as follows: surgical site infection 45%, urinary tract infection 3.2%, bloodstream infection 3.2%. Surgical site infection rate for patient with scores of 0, 1, 2 and 3 were 0%, 3.1%, 4.6%, 66,7%, respectively and increased according to patient risk index (P<0.05). There is no statistical difference between our surgical site infection rate and 1995 NNIS semiannual report of surgical site infection rates (P>0.05). CONCLUSION: The patient risk index is a better predictor d surgical site infection risk than the traditional wound classification system and surgical site infection surveillance with patient risk index is useful for nosocomial infection surveillance after surgery.
Classification ; Cross Infection ; Humans ; Operative Time ; Pneumonia ; Prospective Studies ; Risk Factors ; Surgical Procedures, Operative ; Urinary Tract Infections ; Wounds and Injuries