No abstract available.
Adenocarcinoma* ; Epidermal Growth Factor* ; Recurrence*

No abstract available.
Acidosis*

Dermatofibrosarcoma protuberans is an uncommon, locally aggressive fibroblastic tumor, characterized by infrequent metastasis and a marked tendency of local recurrence after excision. Histologically, it shows large uniformed spindle shaped cells arranged in a cartwheel or storiform pattern. We report a case of dermatoribrosarcoma protuberans on the lower abdomen of a man aged of thirty, treated with Mohs micrographic surgery and purse-string suture repair.
Abdomen ; Dermatofibrosarcoma* ; Fibroblasts ; Mohs Surgery* ; Neoplasm Metastasis ; Recurrence ; Sutures*

A 33 year old woman with tuberous sclerosis and pulmonary lymphangiomyomatosis was undertaken bilateral sequential lung transplantation. Due to the progressive dyspnea and recurrent pneumothorax, she could not handle her normal daily life without oxygen supplements. The natural history of a patient with tuberous sclerosis and symptomatic lung involvement says the mean expected survival is 4 years. Such guidelines as severe obstructive lung disease, unavailable medical therapy, substantial limitation in activities of daily living, and limited life expectancy made her be a recipient of lung transplantation expecting both prolongation of life and the better quality of life. In this transplantation case, we have experienced such delicate problems as gross ventilation-perfusion mismatch, reperfusion pulmonary edema, much decreased renal function, etc.
Activities of Daily Living ; Adult ; Dyspnea ; Female ; Humans ; Life Expectancy ; Life Support Care ; Lung Diseases, Obstructive ; Lung Transplantation* ; Lung* ; Lymphangioleiomyomatosis ; Natural History ; Oxygen ; Pneumothorax ; Pulmonary Edema ; Quality of Life ; Reperfusion ; Tuberous Sclerosis

BACKGROUND: In 1987, the British Thoracic Society (BTS) subjected an extensive list of patient variables to statistical analysis in a prospective study of prognosis in 453 adults with communityacquired pneumonia and, subsequently published guidelines for management of severe community acquired pneumonia. It was hoped that those at risk of dying from community acquired pneumonia could be easily identified and treated appropriately, thereby reducing mortality. To date, severe community acquired pneumonia has not been well studied in Korea. Therefore, we studied retrospectively 10 patients dying of severe community acquired pneumonia in Dongsan Hospital to see clinical manifestations of .dying of severe community-acquired pneumonia. METHODS: Between July 1987 and july 1993, 498 patients were admitted to Keimyung University Dongsan Hospital with community acquired pneumonia, and 77 of them received intensive care. Of the 77 patients, 10 patients died. We reviewed medical records of these patients. RESULTS: 1) The mean age of the patients was 56.2 years(range, 25 to 75 years). There were 7 men and 3 women. Seven patients(70%) were older than 60years of age. 2) The clinical features on admission were as follows: tachypnea, hypoxemia, mental change, cyanosis, leukopenia, leukocytosis, azotemia, hypotension, hypoalbuminemia in order of frequency. Three patients had one abnormal physical finding, 3 patients had 2, 2 patients had 3, and 2 patients had none of these abnormal physical findings. All patients had at least one of the abnormal laboratory findings. 3) A potential bacterial pathogen was isolated in sputum culture from 2 patients. One was E.coli, the other Enterobacter species. Sputum stain were positive in eight cases (G(+)cocci in six, G(+)cocci and G(-)bacilli in two). 4) Features of respiratory failure were the main reasons for ICU transfer, but two patients were transferred only following a cardiac or respiratory arrest in the general ward. 5) The mean of 2.7 different antibiotics were given to the patients. The aminoglycoside and first generation cephalosporin were the most frequently prescribed antibiotics, followed by the third generation cephalosporin and vancomycin. The most frequently prescribed antibiotics combination was a 1st generation cephalosporin plus an aminoglycoside. 6) Save patients death(70%) occured after admission within the first five days, and a mean duration of hospitalization was 11.2 days. CONCLUSION: As the results show most death occured within the first days after admission and aged patients; consequently, an aggressive intensive treatment should be provided early to the patients with severe community acquired pneumonia, and we should pay more attention to the aged patients.
Adult ; Anoxia ; Anti-Bacterial Agents ; Azotemia ; Cyanosis ; Enterobacter ; Female ; Hope ; Hospitalization ; Humans ; Hypoalbuminemia ; Hypotension ; Critical Care ; Korea ; Leukocytosis ; Leukopenia ; Male ; Medical Records ; Mortality ; Patients' Rooms ; Pneumonia* ; Prognosis ; Prospective Studies ; Respiratory Insufficiency ; Retrospective Studies ; Sputum ; Tachypnea ; Vancomycin

The usual sites of the bladder cancer metastases are lymph nodes, liver, lungs and bone. The incidence of metastases to the skin from bladder cancer has been reported to be between 0.2 and 2%. Cutaneous metastases from transitional cell carcinoma (TCC) of the bladder occur infrequently. Metastatic skin cancers vary in type, in rare instances, zosteriform metastases may occur. A 77-year-old man with transitional cell carcinoma of the bladder presented with multiple grouped erythematous papuloplaques and nodules which had developed on the right abdomen, flank and back in zosteriform distribution. Histopathologic examination revealed dermal pleomorphic cellular infiltration and tumor cells in lymphatic vessels. It represents a case of zosteriform cutaneous metastasis from transitional cell carcinoma of the urinary bladder.
Abdomen ; Aged ; Carcinoma, Transitional Cell* ; Humans ; Incidence ; Liver ; Lung ; Lymph Nodes ; Lymphatic Vessels ; Neoplasm Metastasis* ; Skin ; Skin Neoplasms ; Urinary Bladder Neoplasms ; Urinary Bladder*

A glomus tumor is a benign neoplasm of neuromyo-arterial glomus, composed of vascular channels surrounded by proliferating glomus cells and nerve fibers. Occasionally it displays unusual histopathologic features such as a large size, deep location, infiltrative growth, mitotic activity, nuclear pleomorphism, or necrosis. It can be diagnosed as an "atypical" glomus tumor, including malignant glomus tumor, glomus tumor of uncertain malignant potential, symplastic glomus tumor, or glomangiomatosis. Glomangiomatosis and symplastic glomus tumors reveal benign biologic behavior. We report a typical case of a symplastic glomus tumor, showing only marked nuclear atypia, compared with a classical glomus tumor.
Glomus Tumor* ; Necrosis ; Nerve Fibers

Osteoma cutis is a rare disorder characterized by compact bone formation in the dermis and subcutaneous tissue. It is classified in primary and secondary forms according to the presence or absence of previous cutaneous lesions. Multiple miliary osteomas of the face is a form of primary miliary osteoma cutis that generally occurs in middle-aged and older women. We report a typical case of multiple miliary osteomas of the face in a 63-year-old woman.
Dermis ; Female ; Humans ; Middle Aged ; Osteogenesis ; Osteoma* ; Subcutaneous Tissue

No abstract available.
Helicobacter pylori* ; Helicobacter* ; Stomach Neoplasms*

BACKGROUND: Recent studies have shown that Mohs micrographic surgery (MMS) decreased the recurrent rate of tumors and conserved the normal, unaffected tissue. Therefore, MMS is accepted as the first choice treatment modality for cutaneous malignant tumors. OBJECTIVE: The purpose of this study was to review the use of MMS and reconstruction of cutaneous malignant tumors over the past 10 years. METHOD: We retrospectively evaluated 104 patients who had been diagnosed with cutaneous malignant tumors between January 1994 and December 2003, and had been treated with MMS and tumor reconstruction. RESULTS: There were 54 males and 50 females. The mean age was 62. Basal cell carcinoma was the most common skin tumor, and the most common anatomical site was the face. Mean number of stages of MMS were 1.91, and the mean size of the final defect after MMS was 19.46x25.4 mm. A local flap was most commonly used to repair the surgical defects (59%). Recurrent cases totalled 2 out of 104 over the 4-60 months of follow up. CONCLUSION: MMS and proper reconstruction are a reliable and effective method for the treatment of cutaneous malignant tumors and offers the lowest functional and cosmetic morbidity in skin cancer treatment.
Carcinoma, Basal Cell ; Female ; Follow-Up Studies ; Humans ; Male ; Mohs Surgery* ; Retrospective Studies ; Skin ; Skin Neoplasms