Two cases with generalized G.A. were described. The first case was 42 years, old farmer representing slightly erythematous multiple papulonodular lesions on the face, neck, scapular areas, arms and dorsal hands. Coalescence of lesions in some areas of the dorsal hands and neck produced circinate or polycyclic pattern. The second case was 4 years old girl who developed purple to brown muliple papulonodular lesions and polygonal or round plague on the arms, dorsal hands, palms, neck, iliac crests, lower legs, dorsal feet and sole. The plague lesions mimick lichen planus.
Arm ; Child, Preschool ; Female ; Foot ; Granuloma Annulare* ; Granuloma* ; Hand ; Humans ; Leg ; Lichen Planus ; Neck ; Plague

The t(3;21) (q26;q22) is associated with chronic myelogenous leukemia in blast crisis, leukemia evolving from therapy-related myelodysplasia, and with leukemia following other hematopoietic proliferative diseases. The t(3;21) is rare secondary aberration in blast crisis of Philadelphia(Ph)-positive chronic myeloid leukemia, which may be restricted to patients entering myeloid blast crisis. We report here in one case of chronic myeloid leukemia in blast crisis which reveals both t(9;22) (q34;q11), and t(3;21) (q26 ;q22). A 62-year-old male was diagnosed as chronic myeloid leukemia 5 years ago, received hydroxyurea therapy, and admitted because of gingival bleeding and fever. On examination, splenomegaly and leukocytosis with proliferated blasts(91%) in peripheral blood were noted. Bone marrow aspirate showed hypercellularity with severe blast proliferation(92.5%) which revealed all negative in peroxidase and PAS stain. Cytogenetic study of bone marrow cells showed the karyotype 46, XY, t(3;21) (q26;q22), t(9;22) (q34;q11), which might be suspected as myeloid blast crisis. Above finding was confirmed by the result of immunophenotyping(CD13 43.6%, CD34 68.2%, HLA-DR 91.6%). He received intensive chemotherapy, but still sustained proliferation of blasts was noted . The follow up cytogenetic study was as follows: 46, XY, 4(3;21) (q26:22), t(9;22) (q34;q11)/46, XY, t(3;21)(q26;q22), del(8) (q22), t(9:22) (q34,q11)/46, XY (16/3/1). He died soon from severe pancytopenia and sepsis.
Blast Crisis* ; Bone Marrow ; Bone Marrow Cells ; Cytogenetics ; Drug Therapy ; Fever ; Follow-Up Studies ; Hemorrhage ; HLA-DR Antigens ; Humans ; Hydroxyurea ; Karyotype ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Leukocytosis ; Male ; Middle Aged ; Pancytopenia ; Peroxidase ; Sepsis ; Splenomegaly

A 36-year-old woman was presented with extensive anterior wall myocardial infarction. We tried to perform direct coronary angiography for the purpose of primary stenting. However, coronary angiogram revealed normal coronary arteries without intracoronary thrombi. We continued further evaluations to find out the cause of normal coronary myocardial infarction. The findings of severe hypertensive retinopathy and concentric left ventricular hypertrophy suggested that she had secondary hypertension. The detailed history, laboratory and radiological findings revealed the pheochromocytoma. The tumor was successfully removed by operation.
Adult ; Anterior Wall Myocardial Infarction ; Coronary Angiography ; Coronary Vessels ; Female ; Humans ; Hypertension ; Hypertensive Retinopathy ; Hypertrophy, Left Ventricular ; Myocardial Infarction* ; Pheochromocytoma* ; Stents

BACKGROUNG AND OBJECTIVES: Diabetes mellitus is a significant risk factor for adverse outcome after PTCA, which is associated with an increased late mortality and target lesion revascularization (TLR) rates. The beneficial role of coronary stenting on the clinical and angiographic outcomes of diabetic patients is not clearly defined. The aim of this study was to evaluate the early and mid-term outcomes in diabetic patients undergoing elective stenting of native coronary lesions compared with those in non-diabetic patients. MATERIALS AND METHODS: Between July 1997 and June 1998, coronary stenting was performed on 46 lesions in 38 diabetic patients and 126 lesions in 117 non-diabetic patients. Follow-up angiography at mean day of 189+/-45 was performed in 58.7% (91 patients) and analysed by quantitative coronary angiography (QCA). RESULTS: There was a higher incidence of multi-vessel disease in diabetic patients than non-diabetic patients but not statistically significant (71.1% vs 51.3%, p=0.106). There were no differences in major procedural complications and in-hospital events (myocardial infarction, angina and death) in diabetics and non-diabetics. During the follow-up, the incidence of target lesion revascularizton (TLR) and cardiac event free survival did not differ between two groups. CONCLUSION: Coronary stenting in diabetics resulted in a low rate of immediate procedural com-plications and early major adverse cardiac event (MACE), similar to non-diabetics. There were no differences in the mid-term clinical and angiographic outcomes in diabetics and non-diabetics.
Angiography ; Coronary Angiography ; Diabetes Mellitus ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Infarction ; Mortality ; Risk Factors ; Stents*

Ganglioneruroblastoma and neuroblastoma are among commonest types of childhood malignancy and a number of unique paraneoplastic syndromes have associated with both localized and disseminated neuroblastoma. The coincidence of neuroblastoma and myoclonic encephalopathy or other paraneoplastic syndromes occurs relatively rare, and therefore, failure to recognize this association could result in delays in both diagnosis and treatment, and the result could prove to be unfortunately fatal. The mechanism which underlies the remote damaging effect of neural crest tumor, especially neuroblastoma, on the nervous system resulting in myoclonic encephalopathy is by no means clear. In addition the nature and the extent of the pathologic lesion are inconsistent. We experienced a case of myoclonic encephalopathy associated with an occult mediastinal ganglioneuroblastoma in a 22-month-old girl who was hospitalized for inability to walk without support and tilting of the head to the left side. She became increasingly ataxic, and during the hospitalization myoclonic jerks of upper extremities and head along with chaotic, rapidly flickering, multidirectional spontaneous eye movements, were noted. Laboratory data included normal complete blood count, urinalysis, BUN and creatinine, electrolytes and bone marrow. Chest X-ray and chest CT revealed a relatively well marginated right posterior mediastinal mass. In a 24 hours urine excretion test, VMA and catecholamines were increased. Over the next 2 weeks, a surgical exploration revealed a right posterior mediastinal mass. Microscopically the mass proved to be a ganglioneuroblastoma, extending to right innominate artery and right axillary lymph nodes. Within 2 weeks after the surgery, radiotherapy (2,400 rads) and chemotherapy (CTX, DTIC, VCR) were started, but corticosteroid was not used. She has been free of tumor and abnormal neurological systemic symptoms and signs for 1 1/2 year since the completion of chemotherapy. In the 3 1/2 years follow-up period, her neurologic symptoms has completely resolved by the completion of 2 years chemotherapy. We report a case of mycoclonic encephalopathy associated with hidden ganglioneuroblastoma in 22-month-old girl.
Blood Cell Count ; Bone Marrow ; Brachiocephalic Trunk ; Catecholamines ; Creatinine ; Dacarbazine ; Diagnosis ; Drug Therapy ; Electrolytes ; Epilepsies, Myoclonic* ; Eye Movements ; Female ; Follow-Up Studies ; Ganglioneuroblastoma* ; Head ; Hospitalization ; Humans ; Infant ; Lymph Nodes ; Myoclonus ; Nervous System ; Neural Crest ; Neuroblastoma ; Neurologic Manifestations ; Paraneoplastic Syndromes* ; Radiotherapy ; Thorax ; Tomography, X-Ray Computed ; Upper Extremity ; Urinalysis

No abstract available.
Hemolytic-Uremic Syndrome* ; Mycoplasma Infections* ; Mycoplasma*

Excimer laser photorefractive keratectomy(PRK) for myopia has been performed recently by refractive surgeons, in spite of myopic regression and corneal opacity following excimer PRK. We analyzed refractive change, corneal opacity, and uncorrected visual acuity of 313 eyes (233 patients) for one year and 115 eyes(83 patients) for two years after excimer PRK. The patients were divided tnto 3 groups accordign to theit refractive errors [group 1 (n=123 eyes): from -2.25D to -6D, group 2 (n=145 eyes) : from -6.25D to -10D, and group 3 (n=45 eyes): less than -19.25D]. Mean refractive errors one year after excimer PRK were -0.31+/-0.57D, -0.54+/-0.90D, and -1.71+/-2.01D in group 1, 2, and 3, respectively. These errors were increased to -0.45+/-0.68D, -0.90+/-1.20D, and -3.37+/-3.20D two years after excimer PRK in group 1, group 2, and group 3, respectively. These changes were staistically significant in group 2 (p=0.000) and group 3 (p=0.015), not in group 1 (p=0.426). Corneal opacity was more severe in group 3 than in group 1 and 2 and decreased depending on time passing by. Diopteric error within +/-1.0D from the attempted correction one year after excimer PRK was found in 89% of group 1, 74% of group 2, and 40% of group 3. These percentages were after excimer PRK. Uncorrected visual acuity equal to or better than 0.5 were 95% in group 1, 87% in group 2, and only 44% in group 3 two years after excimer PRK. With these results we thought that excimer PRK was effective and safe for myopia more than -6D, while unpredictable for myopia less than6D.
Corneal Opacity ; Follow-Up Studies* ; Humans ; Lasers, Excimer* ; Myopia ; Photorefractive Keratectomy* ; Refractive Errors ; Visual Acuity

Excimer laser photorefractive keratectomy(PRK) for myopia has been performed recently by refractive surgeons, in spite of myopic regression and corneal opacity following excimer PRK. We analyzed refractive change, corneal opacity, and uncorrected visual acuity of 313 eyes (233 patients) for one year and 115 eyes(83 patients) for two years after excimer PRK. The patients were divided tnto 3 groups accordign to theit refractive errors [group 1 (n=123 eyes): from -2.25D to -6D, group 2 (n=145 eyes) : from -6.25D to -10D, and group 3 (n=45 eyes): less than -19.25D]. Mean refractive errors one year after excimer PRK were -0.31+/-0.57D, -0.54+/-0.90D, and -1.71+/-2.01D in group 1, 2, and 3, respectively. These errors were increased to -0.45+/-0.68D, -0.90+/-1.20D, and -3.37+/-3.20D two years after excimer PRK in group 1, group 2, and group 3, respectively. These changes were staistically significant in group 2 (p=0.000) and group 3 (p=0.015), not in group 1 (p=0.426). Corneal opacity was more severe in group 3 than in group 1 and 2 and decreased depending on time passing by. Diopteric error within +/-1.0D from the attempted correction one year after excimer PRK was found in 89% of group 1, 74% of group 2, and 40% of group 3. These percentages were after excimer PRK. Uncorrected visual acuity equal to or better than 0.5 were 95% in group 1, 87% in group 2, and only 44% in group 3 two years after excimer PRK. With these results we thought that excimer PRK was effective and safe for myopia more than -6D, while unpredictable for myopia less than6D.
Corneal Opacity ; Follow-Up Studies* ; Humans ; Lasers, Excimer* ; Myopia ; Photorefractive Keratectomy* ; Refractive Errors ; Visual Acuity

The chest X-ray findings of 20 cases of pulmonary opportunistic infections were analyzed according tocausative agents. The results we as follows; 1. Final diagnoses of 20 cases of opportunistic infections weretuberculosis in 6 cases, pneumocystis carinii pneumonia in 5 cases, bacterial infection in 7 cases, and fungalinfection in 2 cases. 2. The underlying diseases were leukemia in 6 cases, kidney transplantation in 6 cases,lymphoma in 3 cases, nephrotic syndrome in 1 case, nasopharyngeal cancer in 1 case, multiple myeloma in 1 case,agranulocytosis in 1 case, and hypogammaglobulinemia in 1 case. 3. In tuberculosis, all the 6 cases showed severemanifestations such as miliary tuberculosis, tuberculous pneumonia, moderately advanced tuberculosis andtuberculous pericarditis. 4. In pneumocystis carinii pneumonia, the most frequent findings were bilateral alveolardensities and peripheral field of the lung was saved in most cases. 5. In 2 cases of fungal infections bilatarealmultiple cavitary nodules were noted. 6. In cases of bacterial infection there were more cases of gram negativeinfection than gram positive and 2 cases of pseudomonas revealed bilateral multiple cavitary nodules.
Agammaglobulinemia ; Bacterial Infections ; Diagnosis ; Kidney Transplantation ; Leukemia ; Lung ; Multiple Myeloma ; Nasopharyngeal Neoplasms ; Nephrotic Syndrome ; Opportunistic Infections ; Pericarditis ; Pneumonia ; Pneumonia, Pneumocystis ; Pseudomonas ; Thorax ; Tuberculosis ; Tuberculosis, Miliary

No abstract available.
Humans