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

We had observed 60 patients with scabies in Kangwon province around Wonju area from June to Aug. 1981. The purpose of our present study was the evaluation of the clinical manifestations and laboratory findings in patients with scabies. The results were summarized as follow; 1) The sex ratio of male to female patients was 1. 9: 1 and the most frequent affected age was 10-29 year-old group. 2) Family history was positive in 72.4% of all patients. 3) Ninety per cents of the patients had a history of previous treatment for their kin lesiona, but only 30. 0% of the patients were treated under the diagnosis of scabies. 4) We found the itch mite and it's eggs in 16. 7% of patients and the most frequent detection site was the burrow of interdigital webs, 5) Secondary infection and dermatitis were the most frequent associated complications. 6) The severity of thedisease was correlated with the rate of peripheral eosinophil count. 7) Oniy 4(22.2%) of 18 patients were sensitized to DNCB. 8) The result of VDRL test of the 40 patients whose age were over 17 years old was non-reactive in all.
Adolescent ; Coinfection ; Dermatitis ; Diagnosis ; Dinitrochlorobenzene ; Eggs ; Eosinophils ; Female ; Gangwon-do ; Humans ; Male ; Mites ; Ovum ; Scabies ; Sex Ratio

No abstract available.
Pulmonary Aspergillosis*

It was well known that atrial myocytes systhesize atrial natriuretic peptide[ANP], and secrete it into the atrial lumen through the atrial endocardium. But the mechanism for regulation of ANP secretion has not been clearly elucidated, because there was little information of the atrial morphology concerning basal lamina. Basal lamina is surmised as one of barriers that control the movement of ANP, a large molecule. This study was attempted to elucidate the morphological characteristics of basal lamina and connective tissue fibers of atrial endocardial layer by scanning electron microscopy. Basal lamina was exposed by removal of the overlying endothelium. This was achieved by using OsO4 maceration, immersion in aqueous boric acid or EDTA treatment. After removal of the endothelial cell, the specimens were exposed to ultrasonic vibration in case of need. The external surface of basal lamina showed a fairly smooth appearance on the whole, although a few irregular folds are often encountered. Fenestrations, 0.1-1 micrometer in diameter, were randomly observed on the basal lamina, and they were circular to oval in shape. Margin of fenestrations was somewhat distinct and some was divided into two parts by linear structures. The structural differences of fenestrations between right and left atria were not found. The fibroreticular lamina under the basal lamina was revealed by removal of the endothelial cells and their basal lamina. This layer was consisted of interwoven fine fibers. These fine fibers were repeatedly divided and fused, forming reticular network. Some fine fibers connected with basal lamina. Some connective tissue fibers below fibroreticular layer were collected into thick bundles running parallel to myocytes. Above results may serve as a basis for the physiological and morphological studies of atrium.
Animals ; Atrial Natriuretic Factor ; Basement Membrane* ; Connective Tissue ; Edetic Acid ; Endocardium* ; Endothelial Cells ; Endothelium ; Immersion ; Microscopy, Electron, Scanning ; Muscle Cells ; Rats* ; Running ; Ultrasonics ; Vibration

No abstract available.
Aneurysm*

Broncho-gastric fistula caused by benign gastric ulcer perforation after esophagectomy is very rare. In general anesthesia of a patient with broncho-gastric fistula, in spite of hyperventilation, leakage of the anesthetic gases through fistula may make the patient hypercapneic, and positive pressure ventilation may increase the risk of the pulmanary aspiration by the regurgitation of gastric fluid by stomach distension. For that reason, in this patient, denitrogenation was performed during patient's voluntary respiration with 100% oxygen for 5 minutes, and induction was performed without positive pressure ventilation, and one lung ventilation was carried out. Hypoxemia was followed by one lung ventilation because his pulmonary function was moderate obstructive type and his lung was damaged by aspiration of gastric fluid via broncho-gastric fistula. A low level of continuous positive airway pressure (CPAP) has no significant hemodynamic effect and can maintain the patency of nonventilated lung, so hypoxemia induced by one lung ventilation may be reduced. Thus we carried out one lung ventilation with CPAP (10 cmH2O) in nonventilated lung and blocked broncho-gastric fistula with a bronchial blocker for prevention of both regurgitation of gastric fluid and leakage of anesthetic gases. One lung anesthesia was performed without any problem in this case.
Anesthesia ; Anesthesia, General* ; Anesthetics, Inhalation ; Anoxia ; Continuous Positive Airway Pressure ; Esophagectomy ; Fistula* ; Hemodynamics ; Humans ; Hyperventilation ; Lung ; One-Lung Ventilation ; Oxygen ; Positive-Pressure Respiration ; Respiration ; Stomach ; Stomach Ulcer

No abstract available.

Annular pustular psoriasis is a rare variant of the generalized pustular psoriasis characterized by annular lesions with rapidly evolving pustules, associated mild toxicity, and rapid response to therapy. We present a case of annular pustular psoriasis in a 17-year-old male, in whom no previous history of psoriasis was found. The skin lesions were characterized clinically by annular to gyrate erythematous lesions with pinpoint pustules near the periphery on both shoulders, upper arms, and back areas. The histology showed large intraepidermal spongiform pustules. Most of the skin lesions disappeared within 1 week with topical corticosteroid cream.

No abstract available.

Fractures of the tibial condyles, involving as they do weight-bearing articular surfaces and important soft tissues such as collateral ligaments, cruciate ligaments and semilunar cartilages present a variety of problems in treatment and prognosis. Apley, Slee, and others maintained the opinion that most fractures of the tibial condyles could be managed conservatively. On the other hand, Rombold, Schatzker, and others seemed to consider closed treatment to be virtually a form of therapeutic nihilism and adviced open reduction. But recently most authors agree that the method of treatment has to be selected in each individual case, and recommend anatomical reduction of the fracture as possible and early knee motion. During 7 years period from January 1974 to July 1981, of the tibial condylar fractures treated at the department of orthopaedic surgery, Han Gang Shim Hospital, 41 cases that could be followed have been analysed according to the cause, classification, method of treatment and result. The following results were obtained from the analysis of 41 tibial condylar fractures. l. Of the 41 cases, 34 (83%) were male and 7 (17%) were female. 2. Of the 41 cases, 32 (78%) were due to traffic accident, 25 pedestrian, 7 occupant, 8 (20%) were due to fall from height. 3. Of the 41 cases, 31 (76%) were associated with other injuries. 4. Of the 41 cases, 30 were treated by conservative method with functionally acceptable result in 22 cases (73%) and 11 were treated by open reduction with functionally acceptable result in 9 cases (82%). 5. According to the Hohl and Luck's criteria, acceptable functional result was obtained in 31 (76%) cases.
Accidents, Traffic ; Classification ; Clinical Study ; Collateral Ligaments ; Female ; Hand ; Humans ; Knee ; Ligaments ; Male ; Menisci, Tibial ; Methods ; Prognosis ; Weight-Bearing