A 58-year-old male presented with a pruritic, erythematous hread-like eruption on the right chest, which appeared as a small papule since 6 months prior to his visit. Histopathologic examination showed a burrow containing numerous eosinophiles and a few mononuclear cells in the epidermis. There was focal spongiosis unde the burrow. In the dermis, there was a diffuse and occasionally dense perivascular and periadnx 1 inflammatory cell infiltration consisting of eosinophiles and some lymphocytes. Multiple histologic sections were made without success in deizo strating parasitic tissue in the epidermis, however, the clinical and histopathologic features we onsistent with cutaneous larva migrans.
Dermis ; Eosinophils ; Epidermis ; Humans ; Larva Migrans* ; Lymphocytes ; Male ; Middle Aged ; Thorax

Supravalvular aortic stenosis may be defined as an obstructive congenital deformity of the ascending aorta which originates just distal to the level of the origins of the coronary arteries. It may be localized or diffuse, and includes a wide spectrum of pathologic changes. A 16 years old school boy was admitted because of exertional dyspnea for 6 years. Clinical diagnosis of supravalvular and valvular aortic stenosis with bicuspid aortic valves and myocardial hypertrophy was made by echocardiography and angiocardiography. Surgical correction was performed successfully. We presented a case of supravalvular and valvular aortic stenosis with a review of literatures.
Adolescent ; Angiocardiography ; Aorta ; Aortic Stenosis, Supravalvular ; Aortic Valve ; Aortic Valve Stenosis* ; Bicuspid ; Congenital Abnormalities ; Coronary Vessels ; Diagnosis ; Dyspnea ; Echocardiography ; Humans ; Hypertrophy ; Male

BACKGROUND: renal artery stenosis (RAS) is a major cause of renovascular hypertension and renal function due to ischemic atrophy of kidney. There are several methods to treat the RAS, including are surgery, percutaneous transluminal renal angioplasty, and medical treatment. The purpose of this study is to evaluate the usefulness, safety, and efficacy of percutaneous transluminal stent deployment in RAS. METHOD: From January 1995 to July 1996, 17 patients underwent renal stent implantation due to renal artery stenosis (11 male, 6 female). the mean age was 49 years old, one patient had both renal artery stenosis and total lesions were 18. The causes of renal artery stenosis were atherosclerosis in 12, fibromuscular dysplasia in 2, Takayasu's disease in 2, and autoimmune disease (Bechet's) in one case. Renal artery stenting was performed via femoral artery in 12 lesions and brachial artery in 6 lesions. Follow up was performed by renogram, renal angiogram, and clinical examination. RESULT: the degree of renal artery stenosis was 83% (70-95%). the lesion sites were 12 ostial and 6 non-ostial lesions. The used renal stents were Palmaz-biliary stent in 17 lesions and Micro-2 stent in one lesions. All stents were implanted successfully and there was no residual stenosis in all patients except one case showed 20% residual stenosis due to huge renal artery size. The transstenotic pressure gradients after renal artery stenting was decreased markedly from 74mmHg to 2mmHg. There no serious complications such as a death, emergency surgery, or nephrectomy. There were two minor complications which were one case of pyelonephritis and one case of inguinal hematoma. After stenting, blood pressure was decreased partially in 13 patients and completely in 2 cases. CONCLUSION: Renal artery stenting appears to be safe and feasible and the alternative treatment modality to surgery for renal artery stenosis.
Angioplasty ; Atherosclerosis ; Atrophy ; Autoimmune Diseases ; Blood Pressure ; Brachial Artery ; Constriction, Pathologic ; Emergencies ; Femoral Artery ; Fibromuscular Dysplasia ; Follow-Up Studies ; Hematoma ; Humans ; Hypertension, Renovascular ; Kidney ; Male ; Middle Aged ; Nephrectomy ; Pyelonephritis ; Renal Artery Obstruction* ; Renal Artery* ; Stents*

BACKGROUND: Canine scabies is caused by an infestation of Sarcoptes scabiei var. canis (S. canis) in dogs and they can be transmitted to humans. Recently pet raising has been increasing in Korea and various parasitic infestations contracted from them have also been increasing including canine scabies. OBJECTIVE: The purpose of this study was to examine the clinical and histopathological features of experimental canine scabies. METHODS: Two dogs experimentally infested were observed for a year. They were examined physically and the numbers of S. cans were counted from scraping samples of the ear, leg and abdomen every 3 to 7 days and skin biopsies were taken. One was given systemic corticosteroids(Dogl) and the other was observed in its natural course(Dog2). RESULTS: Dogl-Clinically severely pruritic, markedly thick hyperkeratotic scales, crust and generalized erythema on the whole body developed with huge numbers(up to 754.9/100mg from scales of the abdomen) of mites, and histopathologically showed features similar to human crusted scabies. Dog2-Clinically showed milder features than Dogl including the number of S. canis(up to 242.6/100mg from scales of the ear), but histopathologically showed similar features with Dogl. Dog2 also showed a prompt response to one topical application of 20% benzyl benzoate solution. CONCLUSIONS: 1) The number of S. canis increased markedly in both normal and corticosteroidtreated dogs, although it was more significantly increased in the corticosteroid-treated one. 2) Histopathology showed features similar to classical scabies in the early stage but features of human crusted scabies in the full-blown stage. 3) Morphologically Sarcoptes canis differs from Sarcoptes scabiei var. hominis.
Abdomen ; Animals ; Benzoates ; Biopsy ; Dogs ; Ear ; Erythema ; Humans ; Korea ; Leg ; Mites ; Sarcoptes scabiei ; Scabies* ; Skin ; Weights and Measures

BACKGROUND: A stenosis of left main coronary artery has critical prognostic importance. Recent reports on successful left main stenting are now challenging traditional treatment patterns for this lesion. We evaluated recent four-year trends in incidence, clinical, angiographic findings and treatment modalities in patients with left main coronary artery stenosis(LMS). METHODS: Patients who were diagnosed as a significant LMS at Yonsei cardiovascular hospital between 1996 and 1999 were analyzed retrospectively. RESULTS: The incidence of LMS during the period of 1996 to 1999 was 3.3%(n=24) and it was significantly higher than that of previous 15 years before 1996(p<0.01). The incidence of isolated ostial lesion was 0.28% and this lesion was more prevalent in young female patients with less risk factors compared with other types of LMS(p<0.01). After exclusion of the patients with an isolated ostial lesion, patients were grouped according to the lesion site: ostium, shaft, and shaft lesion extended to distal vessels. There were no differences in clinical and hemodynamic findings among these groups. Coronary artery bypass graft was performed in 141 patients(63%) and stent implantation in 16 patients(14%). CONCLUSION: The incidence of LMS has been increased. There was no difference in clinical and hemodynamic findings according to the types of LMS. Surgery is still a standard treatment, but in selected patients percutaneous coronary intervention can be another treatment option.
Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Stenosis* ; Coronary Vessels* ; Female ; Hemodynamics ; Humans ; Incidence ; Percutaneous Coronary Intervention ; Retrospective Studies ; Risk Factors ; Stents ; Transplants

Adenosquamous carcinoma originating in the stomach is relatively rare, and the occurrence of such tumor is interesting with respect to its histogenesis. We describe three cases of gastric adenosquamous carcinoma in a 39-year-old man, a 58-year-old woman and a 52-year-old man. They were grossly classified as Borrmann type III or II, revealing no difference from usual advanced gastric adenocarcinomas. Microscopically three cases showed well or moderately differentiated squamous cell carcinoma component occupying large areas of the tumors. Areas of transition from glandular to squamous epithelium were frequently observed. Metastatic foci in the regional lymph nodes also were consisted of two elements. On immunohistochemical study, CEA immunoreactivity was found not only in adenocarcinoma component but also in squamous cell components, in comparison to cytokeratin which was detected only in squamous areas. The immunohistochemical findings of CEA reactivity in both components, and the presence of microscopic transitional zones support the hypothesis of squamous metaplasia occurring in an already existing adenocarcinoma in the development of adenosquamous carcinoma of the stomach.
Female ; Male ; Humans ; Adenocarcinoma ; Neoplasm Metastasis

PURPOSE: To determine the magnetic resonance (MR) imaging findings of tuberculous arthritis, and the frequency-in such cases-with which tuberculoma occurs. MATERIALS AND METHODS: MR images of 26 patients (M:F, 14:12; mean age, 46.2 years) with pathologically proven tuberculous arthritis were retrospectively reviewed. The presence of joint effusion, subchondral erosion, synovial proliferation and soft tissue abscess, and whether the inner wall of this abscess was smooth, were assessed. In particular, we determined whether a nodular lesion which showed low SI on T1WI, central low SI with peripheral high SI on T2WI, and rim enhancement on contrast study, was a tuberculoma. RESULTS: The joints involved were those of the knee (n=7), hip (n=7), shoulder (n=4), sacroiliac region (n=3), elbow (n=3), and ankle (n=2). Joint effusion was noted in 15 cases (58%), and subchondral erosion in 24(92%). synovial proliferation was found in 23 cases (88%), and soft tissue abscess in 24 (92%). The inner wall of this abscess was irregular in 17 cases (71%). A tuberculoma was present in intra- or extra-articular soft tissue in 18 cases (69%). CONCLUSION: The MR findings of tuberculous arthritis were subchondral erosion, synovial proliferation, and soft tissue abscess. The presence of a tuberculoma in intra- or extra-articular soft tissue, a specific finding in tuberculous arthritis, was noted in 69% of our cases.
Abscess ; Ankle ; Arthritis* ; Elbow ; Hip ; Humans ; Joints ; Knee ; Retrospective Studies ; Shoulder ; Tuberculoma*

No abstract available.
Animals* ; Fever* ; Hantaan virus*

BACKGROUND: Improvements in catheter equipments and increasing experience of the operators have brought about a broadening of the indications and applications of percutaneous transluminal coronary angioplasty(PTCA). In particular, coronary angioplasty has been employed in total occlusions.We evaluated the initial success rate and safety of PTCA total occulsive coronary artery disease. METHODS: To assess the success rate and safety of PTCA total coronary artery occlusion, the data of 24 patients(male 19, female 5, mean age 55+/-9 years), in whom PTCA for total occlusion were performed, were examined. RESULTS: Primary success rate of procedure was 66.7%(16 out of 24 lesions).The success rate according to the duration of total occlusions was 8 out of 11(72.7%) with occlusions<4 weeks duration and 3 out of 7(42.9%) with occlusions>4 weeks duration(p=0.07). There was no difference in success rate according to vassel dilate(left anterior descending 75.0%, right coronary 44.4%) and length of occluded lesion(0.93%+/-0.47%cm, p=0.35). Eight procedural failures included inability to cross the lesion with a guide wire in 6 and inability to dilate the lesion in 2, but there was no emergency coronary bypass surgery or cardiac death. CONCLUSION: Even though the recanalization of occluded coronary arteries has a lower initial success rate than angioplasty for stenotic arteries, PTCA in total occlusion can be performed as a safe and effective therapeutic modality in selective patients.
Angioplasty ; Angioplasty, Balloon, Coronary* ; Arteries ; Catheters ; Coronary Artery Disease ; Coronary Vessels* ; Death ; Emergencies ; Female ; Humans

BACKGROUND: Indications and applications of percutaneous transluminal coronary angioplasty(PTCA) have been broaden recent years. We evaluated the initial success rate and safety of PTCA in mulitiple lesions and vessels. METHODS: To assess the success rate and safety of PTCA In mulitiple lesions and vessels, the data of 60 lesions from 28 patients(male 23, female 5, mean age 56+/-12 years), in whom PTCA for multiple lesions and vessels were performed, were examined. Initial results and complications were compared in 37 lesions undergoing multivessel and 23 lesions undergoing multilesion PTCA. RESULTS: Overall primary success rate of procedure was 82%(49 out of 60 lesions). Angioplasty was attempted in mean 2.1 stenotic lesions per patient. Primary success rate per lesion was 84%(31 of 37) among those who underwent multivessel and 78%(18 of 23) among those who underwent multilesion PTCA(p>0.05). Success rate according to the combination of dilated vessels was 85.7%(12 of 14) in left anterior descending(LAD) and left circumflex(LCX), 83.3%(10 of 12) in LAD and right coronary artery(RCA), 100.0%(4 of 4) in LAD and diagonal branch, RCA and LCX in 75.0%(3 of 4), and 66.7%(2 of 3) in LAD, LCX and diagonal branch. Eleven failures(18.3%) included inability to pass the guide wire cross the lesion or inability to locate the balloon catheter in 5(8,3%), abrupt closure in 2(3,3%), coronary spasm in 1(1.7%) and major branch occlusion in 3(5.0%), but there was no emergency coronary bypass surgery or cardiac death. CONCLUSION: Coronary angioplasty in selected patients with multivessel and multilesion coronary artery disease might be useful and have relatively good initial results, but the long-term efficacies with other forms of treatment must be evaluated prospectively.
Angioplasty* ; Catheters ; Coronary Artery Disease ; Death ; Emergencies ; Female ; Humans ; Spasm