No abstract available

Reactive perforating collagenosis, first described by Mehregan et al in ]967, is a skin disorder characterized by transepidermal eliniination of altered collagen fibers. This rare disease appears as recurrent, umbilicated, crusted papules in response to minor trauma. We report here a case of reactive perforating collagenosis in a 21-year-old man. Examination of the skin revealed a number of centrally umbilicated, asymptomatic papules filled with keratotic plugs in various development and regression. The lesions were distributed on the dorsa of the hands, face, and neck. The biopsy spccimen showed a few of thin bundles of collagen which v ere extruded from the dermis through the atrophic epidermis and the turinels within the epidermis, reaching the buttom of the plug.
Biopsy ; Collagen ; Dermis ; Epidermis ; Hand ; Humans ; Neck ; Rare Diseases ; Skin ; Young Adult

Apert syndrome, or acrocephalosyndactyly is a complex of associated malformations, which are craniosynostosis and symmetric complex syndactyly of the hands and feet. The syndrome was first described by Apert in 1906. Review of the worlds literature disclosed about 200 similar cases and 9 Cases in Korea. Authors experienced one case of Apert syndrome and treated surgically for acro-syndactyly and polydactyly of both hands and feet. The case was compared with the other previously reported cases in Korea.
Acrocephalosyndactylia ; Craniosynostoses ; Foot ; Hand ; Korea ; Polydactyly ; Syndactyly

A case of pathological hip dislocation in a child, aged 2 years 6 months, who had surgical treatment, is reported. The boy has history of osteomyelitis of right ilium at age of 10 month, which ended up with the right hip dislocation. Postoperatively cephalocotyloid relation of the right hip was very well reestablished during five years of postoperative observation. Through this case, it is reconfirmed that a child hip has a natural remodelling power even in case of hip joint destruction.
Child ; Dislocations ; Hip Dislocation ; Hip Joint ; Hip ; Humans ; Ilium ; Male ; Osteomyelitis

No abstract available.
Animals ; Brain* ; Glutamic Acid* ; Glycine* ; Rats*

BACKGROUND: Balloon mitral valvuloplasty is a favorable procedure as a therapy for mitral stenosis because it minimizes morbidity and shorten hospital stay compared with surgical mitral commissurotomy or mitral valve replacement. Recent reports about concomitant transesophageal echocardiography guide in addition to fluoroscopy suggest that transesophageal echocardiograpy can provide additional benefits during balloon mitral valvuloplasty especially in transseptal puncture, balloon positioning, evaluation of immediate result, and early detection of complications. We performed this study to identify the potential benefits of on-line transesophageal echocardiography guide during balloon mitral valvuloplasty. METHOD: We performed balloon mitral valvuloplasty under on-line transesophageal echocardiography guide in addition to fluoroscopy in 70 patients(male:14, female:56, mean age:44+/-13) with rheumatic mitral stenosis from May 1995 to May 1996. Thirty-two(46%) patients had atrial fibrillation. Included patients were symptomatic with more than NYHA class 2 symptom. Patients with mitral valve score more than 11 and mitral regurgitation more than 2/4 were excluded. Inoue balloons were utilized in all cases. RESULTS: The average mitral valve area increased from 0.9+/-0.2cm2 before valvuloplasty to 1.8+/-0.4cm2 after valvuloplasty(p<0.0001). The averagetransmitral pressure gradient measured by continuous wave Doppler decreased from 14+/-6mmHg before valvuloplasty to 5+/-2mmHg after valvuloplasty(p<0.0001), and the average left atrial pressure measured by catheterization decreased form 22+/-8 mmHg before valvuloplasty to 11+/-5mmHg after valvuloplasty(p<0.0001). The average procedure time was 64+/-22 minutes(ranged from 13 to 150 minutes) and the average fluoroscopy time was 19+/-15 minutes(ranged from 1 to 94 minutes). Two patients underwent surgery due to severe mitral regurgitation associated with papillary muscle rupture which developed after valvuloplasty. In one patient, transesophageal echocardiography detected pericaridal tamponade during the procedure and the transducer was quickly switched to transthoracic transducer to guide the pericardial puncture site. The pericardial tamponade was drained with pigtail catheter and the patient underwent balloon mitral valvuloplasty successfully a week later. Four patients were pregnant at the time of the valvuloplasty procedure and the valvuloplasty was successfully performed with minimal fluoroscopy time(1-3 minutes) without complications in all four patients. Five patients had thrombus in left atrial appendage, but the transesophageal echocardiography was useful in monitoring the ballon position during the procedure and the valvuloplasty was successfully performed without embolic complications in all five patients. CONCLUSION: The transesophageal echocardiography is a very useful guiding adjunct during balloon mitral valvuloplasty in transseptal puncture, balloon positioning, evaluation of immediate result, early detection of complications, and shortening fluoroscopy time especially in pregnant women.
Atrial Appendage ; Atrial Fibrillation ; Atrial Pressure ; Cardiac Tamponade ; Catheterization ; Catheters ; Echocardiography, Transesophageal* ; Female ; Fluoroscopy ; Humans ; Length of Stay ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Papillary Muscles ; Pregnant Women ; Punctures ; Rupture ; Thrombosis ; Transducers

BACKGROUND: Percutaneous mitral balloon valvuloplasty(PMV) is a good treatment modality for patient with mitral stenosis(MS). But it is considered relatively contraindicated in patients with left artrial thrombi because of high risk of embolism. Limitted studies have suggested the feasibility of PMV in patients with left atrial appendage(LAA) thrombi. This study was performed to evaluate the feasibility and safty of PMV in patients with LAA thrombi using Inoue balloon under the transesophageal echocardiographic (TEE) monitoring. METHOD: PMV was performed in 5 patients diagnosed as MS with LAA thrombi from October, 1995 to July, 1996. Four cases were female, and one case was male. Their mean age was 525(46-58years old). Two of them had history of cerebrovascular accident(CVA). The duration of anticoagulant treatment was 6-49 moths. All patients underwent PMV using Inoue balloon catheter under the TEE monitoring. RESULTS: EKG finding of all 5 patients were atrial fibrillation(Af). Their mitral valve score were 5-10(Mean score was 82). Transmitral mean pressure gradient was decreased from 14.62.1 to 5.82.0mmHg, and mitral valve increased from 0.840.43 to 1.720.19 after PMV. There was no procedure related complication. In 3 cases of them LAA thrombi diappeared in the follow up TEE. In two patients, the LAA thrombi were calcified and remained unresolved at the time of follow up TEE( 6month-and 12 month-F/U, eath). CONCLUSION: Although the reported number of PMV in patients with LAA thrombi is small in this study, we believe that, with special precaution and TEE monitoring, LAA thrombi is no longer an absolute contraindication to PMV.
Atrial Appendage* ; Balloon Valvuloplasty* ; Catheters ; Echocardiography ; Electrocardiography ; Embolism ; Female ; Follow-Up Studies ; Humans ; Male ; Mitral Valve ; Moths

No abstract available.
Animals ; Rats*

Small and large airways functions were studied in patients with hypertensive heart disease in slightly ro moderately compromised state functionally. In this study, the forced vital capacity and various flow paramaeters reflecting expiratory flow rate were determined from simultaneously recorded forced expiratory volume and maximal expiretory flow volume curves in 86 cases. The closing volume was measured by a single breath nitrogen mrthod in 57 cases and airway resistance with its related parameters by a body plethysmograph in 11 cases. These results were compared with those obtained from the same numbers of healthy controls matched for sex, age and height. In the patient group, the forced vital capadity and all the observed values of flow parameters, execpt for the ratio of the first second vital capacity to the forced vital capacity, were significantly reduced than those in the controls. When the remainder of flow parameters was volume-adjusted to the forced vital capacity, however, the mean of the peak expiratory flow rate and the maximal expiratory flow rate at the 75 percent of the vital capacity were not significantly different from that of controls. In contrast, the volume-adjusted values of maximal expiratory flow were remained significantly smaller than those in the controls. The closing volume and its ratio to the vital capacity were significantly larger in the patient group. Airway resistance and its related parameters revealed no significant differences between two groups. These findings suggest that the patients with hypertensive heart disease in a mild to moderate failure are associated with restrictive ventilatory impairment and a small airways obstruction, but with little or no large airway dysfunction.
Airway Resistance ; Closing Volume ; Forced Expiratory Volume ; Heart Diseases* ; Heart* ; Humans ; Maximal Expiratory Flow Rate ; Nitrogen ; Peak Expiratory Flow Rate ; Vital Capacity

Cystadenoma of the liver is a rare neoplasm. Although many cystadenomas are asymptomatic, symptoms can include abdominal pain, postprandial epigastric discomfort, and nausea. Dramatic changes in hepatic imaging techniques have been helpful for diagnosing cystic lesions of the liver, such as simple cyst, hydatid cyst, cystadenoma, cystadenocarcinoma, and metastatic neuroendocrine tumors. However, it remains difficult to differentiate cystadenoma from cystadenocarcinoma for multiseptated cystic hepatic lesions with papillary projection on computed tomography (CT) and magnetic resonance imaging (MRI). Here we report the case of a 47-year-old woman with several months of postprandial discomfort and abdominal fullness. CT and MRI revealed multiseptated cystic lesions with papillary excrescences. A left hemihepatectomy was performed. Histology showed a benign mucinous cystic tumor with ovarian-like stroma.
Abdominal Pain ; Cystadenocarcinoma ; Cystadenoma ; Cystadenoma, Mucinous ; Cystadenoma, Papillary ; Echinococcosis ; Female ; Humans ; Liver ; Magnetic Resonance Imaging ; Middle Aged ; Mucins ; Nausea ; Neuroendocrine Tumors