BACKGROUND: Becker's mealanosis is not an uncommon entity, and many cases are probably not reported because the diagnosis is usually made clinically and the condition is benign with cosmetic significance only. the etiology remains obscure. OBJECTIVE: The purpose of this study is to establish the clinicopathologic characteristics of Becker's melanosis in Korean. METHODS: Thirty-six patients with Becker's melanosis were retrospectively studied. RESULTS: The clinical and histopathologic findings observed in our cases were similar to previous reports except for the following. Nine patients(25%) had abnormal findings in their hair follicles : dilatation of the infundibular portion filled with abnormal keratin, Pityrosporum orbiculare and bacteria(19.4%); formation of intrafollicular cyst(5.6%). Three patients(8.3%) had granulomatous infiltration. Twenty-two patients(61.1%) had increased smooth muscle bundles. CONCLUSION: The findings associated with dermal hair follicles may be related to the pathogenesis of Becker's melanosis.
Diagnosis ; Dilatation ; Hair Follicle ; Humans ; Malassezia ; Melanosis* ; Muscle, Smooth ; Retrospective Studies

No abstract available.

Percutaneous cannulatien has become an accepted technique for monitoring central venous pressure and pulmonary wedge pressure via a Swan Gans catheter. The technique is not without hazard. Complications include thrombophlebitis, infection and hydrothorax. These are case reports demonstrating the complications of hydrothorax and broken catehters from central venous catheterization.
Catheterization, Central Venous* ; Catheters* ; Central Venous Catheters* ; Central Venous Pressure ; Hydrothorax* ; Pulmonary Wedge Pressure ; Thrombophlebitis

Many patients whose chief complaint is headache caused by accident such as traffic accident, falling, or assaults visit to emergency center. Majority of these patients has mild or moderate symptoms, and there is no need to treat surgically. However, the fact that head injury can cause SIADH(syndrome of inappropriate secretion of antidiuretic hormone) is likely to be overseen. Acute hyponatremia might have been associated with death or permanent brain damage. Hyponatremia is best handled by early recognition and correction of a downward trend in the serum sodium. Unfortunately, this is often difficult in the head-injured patient, where hyponatremia may occur fairly rapidly and is confused by symptoms of head injury. when moderate to severe hyponatremia occurs, it is important to determine its etiology and expeditiously initiate corrective action. There has not been any reported case of the occurrence of symptomatic SIADH after mild head injury in Korea yet. The authors report the experience of three cases of symptomatic SIADH after mild head injury with review of the literatures.
Accidents, Traffic ; Brain ; Craniocerebral Trauma* ; Emergencies ; Head* ; Headache ; Humans ; Hyponatremia* ; Inappropriate ADH Syndrome ; Korea ; Sodium

We have analyzed the patients who were admitted to ICU for postoperative care for over 36 hours and/or respiratory problems from July, 1981 to June 1982. 1) The total number of patients was 339, 198(57%) male and 146(43%) female. The mortality rate was 43.7% 2) Overall morality rate of patients in ICU was 49.7% and the 5th decade had the highest mortality rate. 3) The number of the patients who needed respiratory support was 217. 4) The number and type of airways were: orotracheal(174 cases, 96.4%), nasotracheal(9 cases, 4.1%) and trachestomy(34cases, 9.4%). 5) In the course of ventilator support, 72 patients (33.2%) among 217 could be weaned away from the ventilator. 6) The Mortality rate of ventilator supported patients was 59.9%(130). The mortality rate according to the type of the ventilator used was as follows: in Bird 73.2%, in Bourns 71.4% and in Servo 34.2%.
Birds ; Female ; Humans ; Male ; Morals ; Mortality ; Postoperative Care ; Ventilators, Mechanical

BACKGROUND: The pathogenesis of confluent and reticulated papillomatosis(CRP) is still unknown, although many theories have been suggested. It is stressed that abnormal host response to colonization of pityrosporum orbiculare might play a role in the pathogenesis of CRP, but is not completely understood. Frequently, we have observed bacterial colonies in the stratum corneum and, especially, within the hair follicles from biopsy specimens of patients with CRP. In addition, successful treatment for CRP with minocycline, a derivative of tetracyclines, has been reported continuously. OBJECTIVE: The purpose of this study was to document the possible association of bacterial factors in the pathogenesis of CRP and to elucidate the effectiveness of minocycline. METHODS: We performed Brown and Brenn gram staining in 12 biopsy specimens, bacterial cultures, identification of microorganisms and antibiotics sensitivity testing including minocycline. We administered oral minocycline with an initial dose of 100mg per day for 1 to 3 months and a maintenance dose 50mg per day for I to 2 months, then evaluated the response of treatment. RESULTS: 1. On Brown and Brenn staining, the gram positive bacterial colonies that stained dark bluish or nearly black were observed within the infundibulum of hair follicles in 10 out of 12 biopsy specimens(83.3%) and on the keratotic invagination of stratum corneum in 11 out of 12 biopsy specimens(91.7%). 2. Histological features of regions where bacterial colonies were observed showed, hyperkeratosis and keratotic invagination on the stratum corneum in all cases. Hyperkeratosis(66.7%), parakeratosis(16.7%), inflammatory cell infiltration(25.0%), perifollicular fibrosis(33.3%), and abnormal keratin in sebaceous ducts(50.0%) were shown in hair follicles. 3. In anaerobic cultures, no bacteria was grown. In aerobic cultures, staphylococcus species were identified in 6 cases, streptococcus viridans in one case, sternotrophomonas maltophilia in one case. In the susceptibiliity test, minocycline was sensitive in 7 from 8 cases. 4. The therapeutic response to minocycline was observed within one month in all cases, and the time to clear the lesions was 1/2 month in 2 cases, 1 month in 4 cases, 2 months in 5 cases, 3 months in one case, respectively. CONCLUSION: Form these results, we suggest that bacterial factors may play an important role in the pathogenesis of CRP and that the action mechanism of minocycline in the treatment of CRP may be due to antibacterial effects.
Anti-Bacterial Agents ; Bacteria* ; Biopsy ; Colon ; Hair Follicle ; Humans ; Malassezia ; Minocycline ; Papilloma* ; Staphylococcus ; Tetracyclines ; Viridans Streptococci

Lead is one of the most widespread environmental toxins and its poisoning in children was considered a rarity, usually resulting from unique circumstances such as inappropriate use of leadbased body cosmetics or direct administration of lead-containing folk medicines. The increasing concern about children with lower levels of lead exposure has developed, but there are no data regarding the mean blood lead levels and the incidence of symptomatic or asymptomatic lead poisoning in Korean children. We analyzed the zinc protoporphyrine (ZPP) values and blood lead concentrations in 163 pediatric inpatients for a prospective study of lead exposure. The blood lead concentrations in all 163 children were 15~54 g/dl, of whom 111 children (68.1%) were 25~54 g/dl which needs decision to chelate based on the EDTA provocation test. Among 111 children whose blood lead concentrations are 25~54 g/dl, 59 children(53.2%) were between 7 months and 3 years of age, which revealed no significant higher incidence of lead exposure than any other age group. The ZPP values in 126 children (77.3%) were above 35 g/dl. The mean blood lead concentration and ZPP values are 27.8 g/dl and 48.8 g/dl, respectively. We conclude that there are many asymptomatic children with increased absorption of lead in the urban area of Korea, and we need further studies regarding lead poisoning. It is important that there must be a national counterplan and that pediatricians continue to pay attention to lead posioning in children.
Absorption ; Child ; Edetic Acid ; Humans ; Incidence ; Inpatients* ; Korea ; Lead Poisoning ; Poisoning ; Prospective Studies ; Zinc

Hemoptysis is quite common in primary pulmonary disease, including tyberculosis and carcinoma, as well as in congenital heart disease. Rescently the authors had experienced a case of massive hemoptysis soon after extracorporeal circulation during open heart surgery. The patient had been diagnosed as pulmonary tuberculosis and triology of Fallot. After surgical procedure for pulomonary stenosis and A.S.D, massive hemoptysis occurred abruptly through the endotracheal tube and B.P. took a sudden fall by 40 Torr/systolic pressure. Bleeding source was proved to be on the left upper lobe. So left upper lobetomy had to be performed to control this massive hemoptysis.
Constriction, Pathologic ; Extracorporeal Circulation* ; Heart Defects, Congenital ; Heart* ; Hemoptysis* ; Hemorrhage ; Humans ; Lung Diseases ; Thoracic Surgery* ; Tuberculosis, Pulmonary

This is a ease report of intraluminal partial obatructian of an endotracheal tube after cuff ballooing, a complication of a malfunctioned endotracheal tube, This 18 year old female patient with herniated intervertebral disc of L4-5 was anesthetized for archotomy and removal of disc. Aneethesia was maintained with N2O-O2-halothanepancuronium after endotracheal intubation with a Murphy tube. (Porges-Latex-tube No. 7), manufactured in France. A few minutes later, airway obstruction signs such as sudden hypertension, tachycardia, resistance of the researvoir bag in inspiration, and delayed filling time of the reservoir bag in expiration appeared. We suspected kinking of the tube, tubal obstruction from secretions, bronchospasm etc, but we could not find the exact cause of airway obstruction in spite of detailed checking. After recovery of the patient from anesthesia we checked the extubated tube. There was intraluminal partial obstruction of the endotracheal tube according to increase of intracuff volume and pressure because of the thin walled, flexible tube and diffusion of N2O into the cuff. After extubation the patient returned to normal. We surmmerized this case and also reviewed with the literature.
Airway Obstruction ; Anesthesia ; Bronchial Spasm ; Diffusion ; Fallopian Tube Diseases ; Female ; France ; Humans ; Hypertension ; Intervertebral Disc ; Intubation, Intratracheal ; Tachycardia

It is well known that the medullary carcinoma of the breast is one of the special types of breast carcinoma with a good prognosis. At present, the medullary carcinoma of the breast is subclassified into 3 types: typical medullary, atypical medullary and nonmedullary carcinoma. Among them, the former has the best prognosis. We reviewed the film mammographic and ultrasonomammographic findings of 13 patients according to the reevaluated histopathologic diagnosis. Typical medullary carcinoma shows a well circumscribed mass with surrounding halo on film mammogram, and well defined mass with central intermediate echogenicity and peripheral low echogenicity and posterior acoustic enhancement on ultrasonomammogram. Atypical medullary carcinoma shows relatively well circumscribed mass with partial marginal obliteration on film mammogram, and irregular bordered mass with inhomogeneous echogenicity due to focal necrosis in the mass and associated findings of thick boundary, asymetrical lateral shadowing on ultrasonomammogram. Nonmedullary carcinoma shows lobulated mass with surrounding parenchymal distortion and skin thickening on film mammogram, and relatively well defined lobulating mass with surrounding parenchymal distortion and marked heterogeneous internal echogenicity on ultrasonomammogram. Therefore, differentiation between typical medullary carcinoma with good prognosis and atypical medulary or nonmedullary carcinoma with poor prognosis, may be possible by various diagnostic imaging modalities preoperatively. But further collective study shall be needed in near future.
Acoustics ; Breast Neoplasms ; Breast* ; Carcinoma, Medullary* ; Classification* ; Diagnosis ; Diagnostic Imaging ; Humans ; Necrosis ; Prognosis ; Shadowing (Histology) ; Skin