We report a case of pityriasis rotunda occurring in a patient with pancreatic adenocarcinoma. The patient was a 64-year old female who had a pancreatic adenocarcinoma. The skin lesions were asymptomatic, multiple, various sized (1 to 15cm in diameter), isolated or confluent and finely scaly light brownish to grayish colored patches on the lower abdomen, back and thigh. Histopathologic findings shawed mild hyperkeratosis, atrophy, loss of granular layer, increased melanin pigments in basal layer of the epidermis and mild perivascular monocytic infiltration in the upper dermis.
Abdomen ; Adenocarcinoma* ; Atrophy ; Dermis ; Epidermis ; Female ; Humans ; Melanins ; Middle Aged ; Pancreas* ; Pityriasis* ; Skin ; Thigh

No abstract available.
Child* ; Humans ; Purpura*

BACKGROUND : Borame hospital nuns geriatric wards with 120 beds (40 beds for patients in Dept. of Internal Medicine, 40 for patients in Dept. of Orthopedics 40 for patients in Dept. of Neurology) from December 1996. We studied clinical characteristics of admissions to acute geriatric wards in Borame hospital in order to assess current status of geriatric wards in Korea. METHODS : 334 patients admitted from December 1996 to May 1997 were studied. By reviewing clinical records of these patients, we studied clinical characteristics of patients in geriatric wards retrospectively. RESULTS : 1) Age distribution: 8.6% of patients were over 85 years old. 16.4% of patients were between age of 80-84. 20.0% between 75-79, 31.3% between 70-74, 26.3% between 65-69, respectively. 2) Disease: 43% of patients have single disease, 67% of patients have multiple disease(23% of patients with 2 disease, 25% with 3 disease, 6% with 4 disease, 3% with over 5 disease respectively). 3) Mortality rate :Total mortality rates were 4.3% with 6.1% of patients in Internal medicine, 3.2% of patients in Neurology. These rates were much higher compared with mortality rates of 2.4% in general wards but similar to those (6.7%) in general wards in Internal medicine. 4) Causes of admission: Malignancies were most common causes of admissions in males, and then cerebrovascular diseases, infectious diseases, musculoskeletal diseases, in order. Musculoskeletal diseases were most common causes, and then diabetes mellitus, infectious diseases, cerebrovascular diseases. CONCLUSION : The elderly patients tend to have multiple diseases, longer hospital stays and higher mortality rates compared with younger patients in general wards. but differences of hospital stays and mortality rates are less than be expected.
Age Distribution ; Aged ; Aged, 80 and over ; Communicable Diseases ; Diabetes Mellitus ; Humans ; Internal Medicine ; Korea ; Length of Stay ; Male ; Mortality ; Musculoskeletal Diseases ; Neurology ; Orthopedics ; Patients' Rooms ; Retrospective Studies

The ankle joint is a modified complex hinge joint which plays an important role in weight bearing, walking and standing. Hence, the ankle injuries include not only fractures of bone but often also the rupture of ligaments and soft tissues, so if the structures were not accurately repaired, many complications may be developed. The authors have reviewed a series of 70 cases of ankle fractures which were treated in department of orthopaedic surgery of Inha hospital from January 1988 to February 1992. Among the seventy cases, 41 patients (59.4%) were male, and 28 patients (40.6%) were female. Average age was 41.4 years and 3 cases (4.35%) were open fracture. The most common cause was slipping 34 cases (48.6%) and the other causes were traffic accident 23 cases (32.9%), fall from height 6 cases (8.6%), direct blow 5 cases (7.0%) and sports injury 2 cases (2.9%) in order. The rusults obtained form this study were as follows. l. According to the classification fo Lauge-Hansen, the most common fracture mechanism was supination-external rotation injury (24 cases: 34.4%). 2. Among them, 51 cases were treated by operative treatment and 19 cases by conservative treatment. 3. Ten cases (14.3%) in this series were complicated; traumatic arthritis in 7 cases, infection in 2 cases and nonunion 1 case. 4. Open reduction and internal fixation and early anatomical reduction were better than closed reduction and delayed reduction. 5. The incidence of traumatic arthritis occured higher in the cases treated with closed method.
Accidents, Traffic ; Ankle Fractures ; Ankle Injuries ; Ankle Joint ; Ankle ; Arthritis ; Athletic Injuries ; Classification ; Female ; Fractures, Open ; Humans ; Incidence ; Joints ; Ligaments ; Male ; Methods ; Rupture ; Walking ; Weight-Bearing

No abstract available.
Activities of Daily Living* ; Aged* ; Humans ; Mental Health* ; Rural Population*

No abstract available.
Activities of Daily Living* ; Aged* ; Humans ; Mental Health* ; Rural Population*

Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of probable autoimmune etiology. The MR images of patients with clinically suspected ADEM were retrospectively reviewed. The clinical symptoms occurred 5 days to 1 month after viral upper respiratory infection (4) and Coxsakie viral infection(1). The symptoms had begun with fever(3), headache(3), sore throat(1), and drowsy mental state (1), which progressed with monophasic course to altered mental change(2), extremity weakness(2), seizure(1) and/or cerebellary symptom(I) MRI findings of ADEM showed patchy(4), nonhemorrhagic(5), asymmetric(5) high signal intensity lesions on T2-weighted images. The number of the lesions was mostly multiple(4). The lesions mainly involved the brain stem(3) and subcortical white matter(3). Follow-up MR images of 13 days to 20 days after high dose steroid therapy showed marked improvement in two of three, which well correlated with clinical manifestations. MR findin of multiple, patchy, nonhemorrhagic and asymmetric lesions in subcortical white matter and brain stem on T2-weighted images seem to be characteristic features of ADEM, but nonspecific. Therefore, clinical correlation is required in evaluating ADEM.
Brain ; Brain Stem ; Demyelinating Diseases ; Encephalomyelitis, Acute Disseminated ; Extremities ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies ; White Matter

Emphysematous cystitis is a rare condition characterized by gas collection in the wall and lumen of the bladder. We experienced three cases of emphysematous cystiris. All patients were female; one was associated with a long term history of diabetes mellitus and another with urinary indwelling catheter. All of the cases were easily diagnosed on plain radiograph and CT scan, and were successfully treated with antibiotic therapy. In one of the cases, however, associated abscess due to perivesical extension of inflammation was treated by combined external drainage.
Abscess ; Catheters, Indwelling ; Cystitis* ; Diabetes Mellitus ; Drainage ; Female ; Humans ; Inflammation ; Tomography, X-Ray Computed ; Urinary Bladder

A retrospective study of 274 patients who presented with constipation was done. The following results were obtained by recording colonic transit time. The male to female ratio was 72 : 197, and most patients were in their third and fifth decade, each age group accounting for 21% of total number. Associated symptoms were anal discomfort(33%), abdominal discomfort (25%), hematochezia (23%), reduced stool caliber (11%), and tenesmus (8%). As a result, 223 patients had normal transit time and 51 patients had abnormal transit time. Eighty-six patients with normal transit time and 51 patients with abnormal transit time underwent barium enema or colonoscopic examination. Abnormal lesions such as polyps and diverticulums were found in 10 patients with normal transit time and 7 patients with abnormal transit time. Therefore barium enema and colonoscopic examination in the patients with abnormal transit time were meaningful (P=0.024). Eighteen out of 25 patients with normal transit time and 8 (67%) of 12 patients with abnormal transit time showed abnormal defecogram results. The rectocele was the most frequent cause of abnormality in defecogram. Abnormal anal manometry results were obtained in 5 (22%) of 23 patients with normal transit time and 3 (50%) of 6 patients with abnormal transit time. Three types were classified in the patients with abnormal transit time. With type II patients, anal manometry findings were normal and 2 patients showed abnormal results in defecogram. With type III patients, 5 (43%) of 12 patients showed abnormal results in defecogram and 3 (50%) of 6 patients had abnormal anal manometry findings. Conclusively, if abnormal transit time is found in the patients with chronic consipation, further evaluations such as barium enema or colonoscopic examination are necessary. And even in the patients without any abnormality in transit time, selected performance of defecogram and anal manometry depending on clinical symptoms are preferable.
Barium ; Colon* ; Constipation* ; Diverticulum ; Enema ; Female ; Gastrointestinal Hemorrhage ; Humans ; Male ; Manometry ; Polyps ; Rectocele ; Retrospective Studies

BACKGROUND: It has been reported that one or more intermittent reperfusion(s) during ischemia may be beneficial to the myocardium by washing out catabolites that have accumlated during ischemia. We evaluated the effect of four cycles of ichemia (2 minutes) and reperfusion (3 miutes), i.e., preconditioning on sustained ischemia (20 minutes) and reperfusion (60 minutes) using isolated Langendorff-perfused rabbit hearts. METHODS: After a fifty-minutes recovery phase, LVP , dLVP/dt and ECG were simultaneously recorded and ultrastructure of the stunned(or risk) area of the left ventricle was examined with conventional methods. RESULTS: In the preconditioned hearts, functional parameters such as LVPP(peak pressure), LVPP recovery rate and LVEDP(end-diastolic pressure) reached to 99.6+/-4.38mmHg, 98.0+/-4.67% and 14.0+/-2.90mmHg (109.3+/-2.91mmHg, 109.4+/-1.29mmHg and 10.7+/-2.67mmHg for the controls), respectively, after 30 minutes from the onset of reperfusion and maintained as in the controls(p>0.01). In contrast, in the ischemia-reperfusion hearts, LVPP and LVPP recovery rate were significantly reduced(81.6+/-6.83mmHg and 85.7+/-5.30%;p<0.05) and LVEDP elevated(21.2+/-3.00mmHg) but dP/dtmax, heart rate and ECG patterns were not significantly different between the preconditioned and the ischemia-refusion hearts during reperfusion. Furthermore, irreversible myocardial injury was homogeneous(both subendo- and subepicardial) in the ischmia-reperfusion hearts but only focal(subendocardial) in preconditioned hearts. CONCLUSION: These results suggest that preconditioning induced by very short periods of ischemia and reperfusion may enhance recovery of the left ventricular function and delay ultrastructhral changes to a certain extent during reperfusion.
Electrocardiography ; Heart Rate ; Heart Ventricles ; Heart* ; Ischemia ; Myocardium ; Reperfusion ; Ventricular Function, Left