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

While advancements in microsurgical technique and suture material have led to meticulous wound closure in cataract surgery, excessive postoperative corneal astigmatism may delay visual recovery and compromise the ultimate optical outcome. Greater efforts to prevent and control surgically induced astigmatism have been made recently since the introduction and popularized use of intraocular lenses. Control of astigmatism has been attempted with intraoperative variations in the size, location, and type of incision, the selection of suture material, attention to suture depth and technique, the use of preplaced sutures to facilitate wound closure, and most recently, the application of surgical keratometers. We reviewed follow up records to evaluate and compare the influences on corneal astigmatism after extracapsular cataract extraction(ECCE) with intraocular lens implant in 100 cases of polyglactin 9l0(vicryl) group and 50 cases of polydioxanone (PDS) group, and results were as follows; 1. In planned ECCE group, mean corneal refractive power changes was -0.14D +/- 0.47 in vicryI group and -0.17D +/- 0.78 in PDS group, there was no significant correlation between two. In phacoemulsification(KPE) group, mean corneal refractive power changes was 0.05D +/- 0.49 in vicryl group and 0.27D +/- 0.82 in PDS group. There was no significant correlation between two. 2. In total group, mean corneal refractive power changes was 0.02D +/- 0.48 in vicryl group and 0.08D +/- 0.74 in PDS group. There was no significant correlation between two groups. 3. Mean power of cylindrical lens for correction of astigmatism was -0.76D +/- 0.98 in vicry I group and -0.67D +/- 0.71 in PDS group, there was no significant correlation between two.
Astigmatism* ; Cataract* ; Follow-Up Studies ; Lenses, Intraocular ; Polydioxanone ; Polyglactin 910 ; Sutures* ; Wounds and Injuries

Glaucoma triple procedure of extracapsular cataract extraction and posterior chamber intraocular lens implantation combined with trabeculectomy which was undergone in 21 eyes(20 cases) since May 1984, were reviewed. The results as follows. 1. In the distribution of sex and age of 20 patients, 16 patients(75%) were male, and seventies, which were most common, were 9 patients(45.0%); fifties, 5; forties, 1; thirties, 1. The average age was 63.9 years old. 2. In type of glaucoma, chronic open angle glaucoma which was most common, were 14 eyes(66.7%); chronic angle closure glaucoma, 5 eyes(23.8%); aphakic glaucoma, 1 eye(4.8%); secondary glaucoma, 1 eye(4.8%). 3. Visual acuity improved in 20 eyes but unchanged in 1 eye, and 14 eyes(66.7%) achieved visual acuity 0.5 or better. 4. Preoperative mean intraocular pressure(IOP)was 20.9mmHg and postoperative mean IOP was 6.1, 4.5mmHg lower than preoperative level at 2 and 6 months res pectively. 5. 2.1 glaucoma medications was needed preoperatively and 0.7, 0.8 was needed at postoperative 2 and 6 months respectively. 6. There were no serious complications that affected the visual acuity. However minor complications were as follows. Hyphema were 4 eyes(19.0%); mydriasis, 3 eyes(14.3%); flat chamber, 1 eye(14.3%); flat chamber, 1 eye(4.8%); cystoid macular edema, 1 eye(4.8%).
Cataract Extraction* ; Cataract* ; Glaucoma* ; Glaucoma, Angle-Closure ; Glaucoma, Open-Angle ; Humans ; Hyphema ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Macular Edema ; Male ; Mydriasis ; Trabeculectomy* ; Visual Acuity

PURPOSE: To evaluate anatomic variations and pitfalls of the labral-capsular-ligamentous complex in the shoulder joint for the proper interpretation of magnetic reasonance arthrographic images. MATERIALS AND METHODS:To determine the presence of sublabral sulci, undercutting of the base of the glenoid labrum by the articular cartilage, and the proximity of the middle glenohumeral ligament to the anterior glenoid labrum, 56 MR arthrograms of 41 asymptomatic volunteers were prospectively evalvated for labral shape and capsular insertion. We also evaluated the axillary fold, which was often confused with a loose body. RESULTS: The anterior and posterior parts of the labra, varied but their shape showed several dominant features; triangular(72%, 36%, respectively), rounded(13%, 35%), cleaved(8%, 1%), notched(2%, 0%), flat(5%, 24%), and absent(0%, 4%). Anterior capsular insertion was type 1 in 82% of cases, type 2 in 13% and type 3 in 5%, whereas posterior insertion was type 1 in 62%, type 2 in 36% and type 3 in 2%. We could also detect many pitfalls, such as undercutting of the base of theglenoid labrum by the articular cartilage(29%), sublabral sulci(25%), a prominent axillary fold(38%), and the middle glenohumeral ligament in proximity to the anterior labrum(5%). CONCLUSION: Our study revealed wide variability in the MR arthrographic appearance of the labral-capsular-ligamentous complex in asymptomatic shoulders. A good understanding of normal variation and pitfalls of the normal shoulder may be helpful pathologic condition in case of glenouhumeral instability.
Arthrography* ; Cartilage, Articular ; Ligaments ; Prospective Studies ; Shoulder ; Shoulder Joint ; Volunteers

Intravenous pyogenic granuloma (IVPG), also known as intravenous lobular capillary hemangioma, is an extremely rare form of vascular tumor which derives from the lumen of a vein of the head and neck and upper extremities. The treatment of choice is complete local excision of a small portion of the vein. Since first report in 1979, IVPG has been reported in no more than 60 reports abroad. To our knowledge, IVPG originating in the external jugular vein has never been reported in Korea but has important clinical implication. Accurate preoperative diagnosis of neck mass originating in jugular vein is important to plan operative procedures to avoid vascular injury, excessive bleeding, or incomplete excision. Preoperative radiologic examinations such as ultrasonography, computed tomography are useful as first-line diagnostic tools for differential diagnosis of movable neck mass. With a review of literature, the author reports a case of IVPG arising from the left external jugular vein in a 31-year-old male who complained about a palpable neck mass. This patient was successfully managed by ligation and excision of the vein without any complication and no recurrence was found after 6 months.
Adult ; Diagnosis ; Diagnosis, Differential ; Granuloma, Pyogenic ; Head ; Hemorrhage ; Humans ; Jugular Veins ; Korea ; Ligation ; Male ; Neck ; Recurrence ; Surgical Procedures, Operative ; Ultrasonography ; Upper Extremity ; Vascular System Injuries ; Veins

Intravenous pyogenic granuloma (IVPG), also known as intravenous lobular capillary hemangioma, is an extremely rare form of vascular tumor which derives from the lumen of a vein of the head and neck and upper extremities. The treatment of choice is complete local excision of a small portion of the vein. Since first report in 1979, IVPG has been reported in no more than 60 reports abroad. To our knowledge, IVPG originating in the external jugular vein has never been reported in Korea but has important clinical implication. Accurate preoperative diagnosis of neck mass originating in jugular vein is important to plan operative procedures to avoid vascular injury, excessive bleeding, or incomplete excision. Preoperative radiologic examinations such as ultrasonography, computed tomography are useful as first-line diagnostic tools for differential diagnosis of movable neck mass. With a review of literature, the author reports a case of IVPG arising from the left external jugular vein in a 31-year-old male who complained about a palpable neck mass. This patient was successfully managed by ligation and excision of the vein without any complication and no recurrence was found after 6 months.

BACKGROUND: Invasive pulmonary aspergillosis (IPA) is one of the major complications encountered by patients receiving chemotherapy for hematologic malignancies. The prolonged period of intense immunosuppression following allogeneic hematopoietic stem cell transplantation (HSCT) may increase the risk of IPA recurrence in patients with a history of IPA. We evaluated the impact of a history of IPA on allogeneic HSCT outcome, and examined the incidence of IPA after HSCT. METHODS: This retrospective study included 22 patients with a history of IPA prior to receiving allogeneic HSCT at the Samsung Medical Center from 1995 to 2007. Diagnosis of IPA was defined as proven (N=5), probable (N=0), or possible (N=17). RESULTS: All 22 patients received amphotericin-based regimens to treat pre-transplant IPA. Secondary antifungal prophylaxis was administered to 10 patients during HSCT. The development of post-transplant IPA was observed in 2 patients. One of the patients died from septic shock within 2 days of the diagnosis of possible IPA. The other patient recovered from IPA, but eventually had a relapse of the primary disease. Of the 22 patients, the overall 2-year survival rate was 63% (95% confidence interval [CI]: 41-85), and the transplant-related mortality rate was 19% (95% CI: 0-38). CONCLUSION: Our results suggest that a history of IPA prior to HSCT does not have an adverse impact on transplant outcomes, although the small number of cases was a limitation in this study. Future studies involving a larger number of cases are needed to further examine this issue.
Hematologic Neoplasms ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Immunosuppression ; Incidence ; Invasive Pulmonary Aspergillosis ; Recurrence ; Retrospective Studies ; Shock, Septic ; Survival Rate ; Transplants

This study was conducted to investigate the mothers' nutritional knowledge on weaning of 101 infants (8 for 4 mo, 44 for 5 mo, 45 for 6 mo, 4 for 7 mo) at a public health center of Incheon. Informations on the mothers' nutritional knowledge were obtained by questionnaires. In this survey 41.6% of infants were breast-feeding, 43.6% of them were bottle-feeding, and 14.9% of them were mixed feeding right after birth. The rate of breast-feeding right after birth was significantly higher in mothers of high school graduate than mothers of college/university graduate (p < 0.05). The infants of mothers graduated high school began to be weaned significantly earlier than the infants of mothers graduated college/university (p < 0.05). 95.1% of infants (n = 101) began to be weaned 4 to 6 months. 83.1% of infants were fed home-made weaning foods. 66.7% of infants were fed rice gruel, 18.5% of them were fruit juice, 6.2% of them were mixed grain, and 4.9% of them were commercially prepared weaning foods as their first supplementary foods. As main supplementary foods, 32.8% of infants were fed vegetable, 30.5% of them were rice gruel, and 27.7% of them were fruit juice. Mothers' nutritional knowledge related to weaning was significantly higher among mothers of college/university graduate than mothers of high school graduate (p < 0.05). 86.1% of mothers disagreed with the questionnaire in which breast-fed infants aged over 4 months needed to be fed iron sufficient food. For the improvement of nutritional status especially iron nutritional status of infants, nutritional education for mothers with weaning aged infants has to be increased and related programs have to be operated effectively.
Edible Grain ; Education ; Fruit ; Humans ; Incheon ; Infant* ; Iron ; Mothers ; Nutritional Status ; Parturition ; Public Health ; Vegetables ; Weaning*

BACKGROUND: Systemic lupus erythematosus(SLE) frequently has cardiovascular complications. Pericardial inflammation and effusion. ventricular dysfunction, valvular disease and coronary atherosclerosis may result in morbidity. While the pathologic findings in SLE have been well described, the antemortem documentation of the cardiac complications has been less frequent than the postmortem findings would support, we therefore sought to study how echocariography may improve the clinical assessment of cardiac involvement in 40 consecutive patients with SLE. SUBJECTS AND METHODS: This study began in 1990 with a prospective design. An appointment was scheduled with all patients whose SLE was diagnosed at the outpatient clinic and during the admission of the internal medicine service at the Kang Nam St Mary's hospital These were 40 female patients, with a mean age of 32+/-11 years(+/-SD). The average duration of disease was 37+/-32months, the average dosage of prednisolone per day was 20+/-17mg. M-mode and 2-D echocardiogram were carried out to the 40 SLE patients. RESULT: Seventeen(43%) of the SLE patients had pericardial effusion. Reduced left ventricular contractility was evident in 8 patients(20%). Abnormality of diastolic dysfunction to be checked by A/E ratio was in 3 patients(8%). No patients had echocardiographic evidence of pulmonary arterial hypertension. Clinical findings of myocardial dysfunction in these patients included dyspnea(30%), jugular venous distension(20%), rales(10%) and S3 gallop(8%). Valvular abnormality of SLE patients included mitral regurgitation in five patients(13%) and aortic regurgitation in two patients(5%). Electrocardiogram showed myocardial ischemia, atrial fibrillation and sick sinus syndrome in 3, 1 and 1 patients respectively. CONCLUSION: In this study, pericardial effusion were the most common echocardiopraphic abnormalities in Patients with SLE. The incidence of valvular and myocardial disease were relatively common.
Ambulatory Care Facilities ; Aortic Valve Insufficiency ; Atrial Fibrillation ; Cardiomyopathies ; Coronary Artery Disease ; Echocardiography* ; Electrocardiography ; Female ; Humans ; Hypertension ; Incidence ; Inflammation ; Internal Medicine ; Lupus Erythematosus, Systemic* ; Mitral Valve Insufficiency ; Myocardial Ischemia ; Pericardial Effusion ; Prednisolone ; Prospective Studies ; Sick Sinus Syndrome ; Ventricular Dysfunction

BACKGROUND/OBSECTIVE: Airway inflammation by eosinophils, neutrophils and alveolar macrophages is a characteristic feature of asthma that leads to pathological subepithelial thickening and remodeling. Our previous study showed that oxidative stress in airways resulted in eosinophilia and epithelial apoptosis. The current study investigated whether glutathione-containing dry yeast extract (dry-YE) ameliorated eosinophilia, goblet cell hyperplasia and mucus overproduction. MATERIALS/METHOD: This study employed 2 µg/mL lipopolysaccharide (LPS)- or 20 ng/mL eotaxin-1-exposed human bronchial epithelial cells and ovalbumin (OVA)-challenged mice. Dry-YE employed in this study contained a significant amount of glutathione (140 mg in 100 g dry yeast). RESULTS: Human bronchial epithelial cell eotaxin-1 and mucin 5AC (MUC5AC) were markedly induced by the endotoxin LPS, which was dose-dependently attenuated by nontoxic dry-YE at 10-50 µg/mL. Moreover, dry-YE inhibited the MUC5AC induction enhanced by eotaxin-1, indicating that eotaxin-1-mediated eosinophilia may prompt the MUC5AC induction. Oral supplementation with 10-100 mg/kg dry-YE inhibited inflammatory cell accumulation in airway subepithelial regions with a reduction of lung tissue level of intracellular adhesion molecule-1. In addition, ≥ 50 mg/kg dry-YE diminished the lung tissue levels of eotaxin-1, eosinophil major basic protein and MUC5AC in OVA-exposed mice. Alcian blue/periodic acid schiff staining revealed that the dry-YE supplementation inhibited goblet cell hyperplasia and mucus overproduction in the trachea and bronchiolar airways of OVA-challenged mice. CONCLUSIONS: Oxidative stress may be involved in the induction of eotaxin-1 and MUC5AC by endotoxin episode and OVA challenge. Dry-YE effectively ameliorated oxidative stress-responsive epithelial eosinophilia and mucus-secreting goblet cell hyperplasia in cellular and murine models of asthma.
Animals ; Apoptosis ; Asthma* ; Chemokine CCL11 ; Eosinophil Major Basic Protein ; Eosinophilia* ; Eosinophils ; Epithelial Cells ; Glutathione ; Goblet Cells ; Humans ; Hyperplasia ; Inflammation ; Lung ; Macrophages, Alveolar ; Mice ; Mucin 5AC ; Mucins ; Mucus* ; Neutrophils ; Ovalbumin ; Ovum ; Oxidative Stress ; Trachea ; Yeasts