A 36-year-old female patient with sarcoidosis is presented showing lupus pernio, papular skin lesions, cervical lymph node enlargement and lung lesions. Diagnosis was confirmed by characteristic histologic findings of noncaseating granulomas in skin and cervical lymph node, supported by compatible clinical and laboratory features. Methatrexate was administered orally, which resulted in considerable improvement of skin lesions.
Adult ; Diagnosis ; Female ; Granuloma ; Humans ; Lung ; Lymph Nodes ; Methotrexate ; Sarcoidosis ; Skin

The study comprises 127 inpatients with drug eruption, treated at the Department of Dermatology, Seoul National University Hospital, during a 10-year period. The results are summarized as follows: 1. Out of 1,434 dermatologic inpatients, 127(8. 9%) patients were diagnosed as drug eruption. 2. The cutaneous manifestations of drug eruptions in the order of frequency were as follows: exanthematous eruption, urticaria, erythema multiforme, Stevens Johnson syndrome, TEN, exfoliative dermatitis, fixed drug eruption and purpura. 3. Antibiotics and antimicrobials were the most common causative agents followed by antipyretics and analgesics, CNS depressant drugs and herb drugs. 4. The 5 most common drugs causing drug eruptions were ampicillin, acetyl salicylic acid, diphenylhydantoin, sulfonamide and phenacetin.
Ampicillin ; Analgesics ; Anti-Bacterial Agents ; Antipyretics ; Dermatitis, Exfoliative ; Dermatology ; Drug Eruptions* ; Erythema Multiforme ; Humans ; Inpatients ; Phenacetin ; Phenytoin ; Purpura ; Salicylic Acid ; Seoul ; Stevens-Johnson Syndrome ; Urticaria

No abstract available.
Hand*

No abstract available.

PURPOSE: This study attempted to assess the treatment outcomes after microsurgical varicocelectomy in non-obstructive azoospermic patients and correlate the surgical outcomes with the histopathological patterns of their testes. MATERIALS AND METHODS: Fourteen non-obstructive azoospermic men who underwent testicular biopsy and varicocelectomy, between September 2001 and December 2002, were reviewed. Varicocelectomy was unilaterally and bilaterally performed in 12 and 2 patients, respectively, using an inguinal approach with a microsurgical technique. Postoperative semen analyses were performed in each patient four months after the varicocelectomy. RESULTS: In the testicular histology, hypospermatogenesis was identified in three, maturation arrest in five and Sertoli-cell-only syndrome in six of the subjects. After a mean follow-up of 7.4 months, motile sperm in the ejaculate was identified in 6(43%) of the non-obstructive azoospermic patients. These included 2 in hypospermatogenesis, 3 in maturation arrest and 1 in Sertoli-cell-only syndrome, in terms of their histopathology. These six had improvements in their sperm concentration and motility, which were 0.45x10(6)/ml and 51.3%, respectively. However, of these six, with motile sperm after varicocelectomy, 1 with maturation arrest and 1 with Sertoli-cell-only syndrome returned to their previous azoospermic state on their second postoperative semen analyses. A pregnancy was achieved by natural intercourse for 1 of the men(7.1%) with hypospermatogenesis. CONCLUSIONS: Microsurgical varicocelectomy offers non-obstructive azoospermic patients the chance to have sperm in their ejaculate, and therefore, the possibility of natural pregnancy. Microsurgical varicocelectomy may be considered with the initial treatment modality in selective non- obstructive azoospermic patients with varicocele prior to intervention with assisted reproductive technology.
Azoospermia ; Biopsy ; Follow-Up Studies ; Humans ; Male ; Oligospermia ; Pregnancy ; Reproductive Techniques, Assisted ; Semen Analysis ; Spermatozoa ; Testis ; Varicocele

The objective of this paper is to introduce the schematic protocol of radiofrequency (RF) ablation for the treatment of varicose veins. Indication: anatomic or pathophysiologic indication includes venous diameter within 2-20 mm, reflux time > or =0.5 seconds and distance from the skin > or =5 mm or subfascial location. Access: it is recommended to access at or above the knee joint for great saphenous vein and above the mid-calf for small saphenous vein. Catheter placement: the catheter tip should be placed 2.0 cm inferior to the saphenofemoral or saphenopopliteal junction. Endovenous heat-induced thrombosis > or =class III should be treated with low-molecular weight heparin. Tumescent solution: the composition of solution can be variable (e.g., 2% lidocaine 20 mL+500 mL normal saline+bicarbonate 2.5 mL with/without epinephrine). Infiltration can be done from each direction. Ablation: two cycles' ablation for the first proximal segment of saphenous vein and the segment with the incompetent perforators is recommended. The other segments should be ablated one time. During RF energy delivery, it is recommended to apply external compression. Concomitant procedure: It is recommended to do simultaneously ambulatory phlebectomy. For sclerotherapy, it is recommended to defer at least 2 weeks. Post-procedural management: post-procedural ambulation is encouraged to reduce the thrombotic complications. Compression stocking should be applied for at least 7 days. Minor daily activity is not limited, but strenuous activities should be avoided for 2 weeks. It is suggested to take showers after 24 hours and tub baths, swimming, or soaking in water after 2 weeks.
Baths ; Catheter Ablation* ; Catheters ; Consensus* ; Heparin ; Knee Joint ; Lidocaine ; Saphenous Vein ; Sclerotherapy ; Skin ; Stockings, Compression ; Swimming ; Thrombosis ; Varicose Veins* ; Walking

No abstract available.
Mediastinal Emphysema*

Cardiovascular disease (CVD) is the major cause of mortality in type 2 diabetes mellitus. CVD is a clinical manifestation of atherosclerosis, a chronic and progressive inflammatory disease characterized by a long asymptomatic phase. Progression of atherosclerosis can lead to the occurrence of acute cardiovascular events. Atherosclerosis can be identified during the subclinical phase by several methods, including using biomarkers, pulse wave velocity, augmentation index, flow-mediated dilation, carotid ultrasound, and calcium score. The appropriate criteria for identifying asymptomatic patients with type 2 diabetes who should undergo CVD screening and therapeutic intervention remain controversial. Non-invasive methods, such as markers of subclinical atherosclerosis, may aid in risk stratification and the design of tailored therapies for patients with type 2 diabetes mellitus.
Atherosclerosis ; Biomarkers ; Calcium ; Cardiovascular Diseases ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Humans ; Mass Screening ; Pulse Wave Analysis ; Risk Assessment

The branches of the axillary artery have been studied in 38 Korean female cadavers. 1. The superior thoracic artery arose from the first part and the second part of the axillary artery in 84% of sides. 2. The thoracoacromial artery arose from the axillary artery near the superomedial border of the axillaly artery more often (91%) than from any other source. 3. The lateral thoracic artery was found on 64% of the sides as a main axillary artery, usually arising from the second part of the axillary artery(61%). It arose from the subscapular artery in 28%. 4. The subscapular artery was seen as the lagrgest of the axillary artery. It arose from the second part (42%) and the third (58%) of the axillary artery. 5. The posterior circumflex humeral artery was a direct branch of the third part of axillary artery in 37% of sides. In 21% fo sides the posterior circumflex humeral artery arose by a common stem from the third part of the axillary artery. In 33% of sides the posterior circumflex humeral artery arose from the subscapular artery. 6. The anterior circumflex humeral artery was found more constantly at the third part of the axillary artery than the posterior circumflex humeral artery was. It arose from a direct branch of the third part of the axillary artery in 70% of sides.
Arteries ; Axillary Artery* ; Cadaver ; Female* ; Humans ; Thoracic Arteries

We performed this study to analyse the morbidity and mortality of stoma formation in infants and children over a 17-year period. Thirty-seven stoma formations were performed in 37 patients: 21 for anorectal malformation, 9 for Hirschsprung's disease, 3 for necrotizing enterocolitis, 2 for multiple ileal atresia, 1 for volvulus neonatorum with perforation, and 1 for diaphragmatic hernia with colon perforation. There were 26 boys and 11 girls with a mean age of 0.4 years. Complications after stoma formation were encountered in 12 patients(32.4%) and included stomal prolapse, stenosis, retraction, dysfunction, skin excoriation and parastomal hernia. Four patients(10.8%) required stomal revision. The incidence of complications was neither related to the age nor to the primary indication for the stoma formation, but sigmoid colostomy was associated with a lower complication rate compared to transverse colostomy(22.1% versus 42.1%, P<0.05). Five patients died, but only one(2.7%) was dead, which was directly related to stoma formation. Eighteen of these children subsequently underwent stoma closure which was associated with complications in six patients(33.3%). The most common complication after stoma closure was wound sepsis in 4 children. In conclusion, because the significant morbidity of stoma formation still exists the refinements in surgical technique may help in reducing the incidence of complications and a sigmoid loop colostomy should be used whenever possible.
Child* ; Colon ; Colon, Sigmoid ; Colostomy ; Constriction, Pathologic ; Enterocolitis, Necrotizing ; Female ; Hernia ; Hernia, Diaphragmatic ; Hirschsprung Disease ; Humans ; Incidence ; Infant* ; Intestinal Volvulus ; Mortality ; Prolapse ; Sepsis ; Skin ; Wounds and Injuries