We report a case of congenital candidiasis confined to the rail plates in a 57-day-old girl whose infected nails exhibited the rough, yellow-white, thickened, opaque distal ends and pink-colored, normal healthy plates at their proximal bases. Numerous pseudohyphae and spores were demonstrated by KOH microscopic examination. Candida albicans was identified by culture on Sabourauds glucose agar and API 20C Aux system. Histopathologic findings of nail crippings also showed mutiple hyphae beneath the hyperkeratot,ic nail plate on PAS stain. Shedding of the infected distal portion of the ungual plates ws caused by growing out of the healthy nails, resulting in spontaneous healing of the disease rithin 2 months.
Agar ; Candida albicans ; Candidiasis* ; Female ; Glucose ; Humans ; Hyphae ; Spores

This is a retrospective clinical analysis of 156 patient with colorectal cancer who were surgically treated from January 1988 to June 1996 at the Department of Surgery, Seoul Adventist Hospital. The results are as follows: 1) The peak age incidence was in the 7th decade (31.4% of the cases), and the sex ratio of males to females was 1.03 : 1. 2) The most common location of the tumor was the rectum in 77 cases (49.4%); next were the sigmoid colon in 25 cases (16.0%) and the ascending colon in 25 cases (16.0%). 3) In the right colon, the most frequent symptoms and signs were abdominal pain, a palpable mass, weight loss; in the left colon and rectum, bloody tarry stool and bowel- habit change were the most common symptoms and signs. 4) The duration of the symptoms and signs prior to admission was most commonly less than 3 month (46.8% of the cases). 5) The diagnostic methods were digital rectal examination, sigmoidoscopy, colonofiberoscopy, barium enema, and abdominal CT. In two cases,an exploratory laparotomy was done. Also, 2.8 studies were done per patient. 6) The operations performed included an abdominoperineal resection in 36 cases (24.0%) and a right hemicolectomy (18.7%). The operability was 96.2%, and the total resectability was 79.5%. 7) The staging of the tumor was performed during the initial operation according to the Aster Coller classification and the TNM classification. Stages C2 (33.8%) and B2 (29.1%) and T3N0M0 were the most frequent stages in both classification. 8) The most common histologic type was an adenocarcinoma (96.8%). 9) The most common macroscopic finding was of the annular type (59.6%) 10) The most common distant metastasis sites were the pelvic organs and the liver. 11) The most frequent postoperative complication was wound infection (14.7%). The complication rate and perioperative mortality were 32.7% and 2%, respectively.
Abdominal Pain ; Adenocarcinoma ; Barium ; Classification ; Colon ; Colon, Ascending ; Colon, Sigmoid ; Colonic Neoplasms ; Colorectal Neoplasms* ; Digital Rectal Examination ; Enema ; Female ; Humans ; Incidence ; Laparotomy ; Liver ; Male ; Mortality ; Neoplasm Metastasis ; Postoperative Complications ; Rectal Neoplasms ; Rectum ; Retrospective Studies ; Seoul ; Sex Ratio ; Sigmoidoscopy ; Tomography, X-Ray Computed ; Weight Loss ; Wound Infection

PURPOSE: To evaluate the predictability of amount of hemothorax in the patients with blunt chest trauma, supine chest AP radiographs of 66 patients were reviewed and statistically analyzed. MATERIALS AND METHODS: In 66 patients, rib fractures were present in 53 patients, hemothorax in 46 patients, pneumothorax in 25 patients, and pulmonary contusions in 18 patients. Width and length of hemothorax were measured on supine chest AP radiograph, and were correlated with known drained amount of hemothorax. The presence and number of rib fracture, pulmonary contusion, subcutaneous emphysema, fracture of scapula and clavicle, and total opacification of hemithorax were also correlated with the drained amount of hemothorax. RESULTS: In multiple logistic regression analysis, width of hemothorax had the highest correlation with drained amount of hemothorax(regression coefficient 0.718, p value 0.00005). The presence and number of rib fracture, scapular fracture, subcutaneous emphysema were also correlated with drained amount of hemothorax. But length of hemothorax, pulmonary contusion, clavicular fracture, total opacification of hemithorax were not correlated with drained amount of hemothorax. CONCLUSION: Measured width of hemothorax in supine chest AP radiograph is the most reliable predictor for estimation of the amount of hemothorax, and may also be used as an indication for the application of closed thoracostomy in the treatment of hemothorax.
Clavicle ; Contusions ; Hemothorax* ; Humans ; Logistic Models ; Pneumothorax ; Rib Fractures ; Scapula ; Subcutaneous Emphysema ; Thoracostomy ; Thorax*

We report a case of infantile acute hemorrhagic edema in a 15-month-old boy. The patient showed multiple, bean to walnut-sized, red to purple-colored, indurated purpura with a cockade pattern on the face, earlobes, and extremities. Edema of the hands, feet, and earlobes was also observed. Laboratory examinations showed thrombocytosis, decreased serum CH50, and ketone in the urine. A skin biopsy taken from indurated purpura on the lower leg exhibited findings of acute leukocytoclastic vasculitis. Direct immunofluorescence examination showed deposition of IgM along the dermo-epidermal junction and C3 in the dermal vessel walls. With-out specific management except for fluid therapy to correct dehydration, the skin lesions cleared completely in 2 weeks, and recurrence has not observed.
Biopsy ; Dehydration ; Edema* ; Extremities ; Fluid Therapy ; Fluorescent Antibody Technique, Direct ; Foot ; Hand ; Humans ; Immunoglobulin M ; Infant ; Leg ; Male ; Purpura ; Recurrence ; Skin ; Thrombocytosis ; Vasculitis

PURPOSE: To evaluate the degree of contrast enhancement of intracranial tumors on delayed (6-8min.) MR imaging after administration of Gd-DTPA. MATERIALS AND METHODS: Both immediate and delayed post-contrast MR imagings were studied prospectively in 35 patients. with brain tumors (11 gliomas, 6 meningiomas, 4 neurinomas, 5 parencymal metastases, 5 hemangioblastoma, 4 others) at either 0.5 T or 2.0 T unit. After precontrast TI-, proton-density, and T2-weighted spin echo images were obtained, each patient underwent Tl-weighted imaging immediately following infusion of 0.1 mmol/Kg of Gd-DTPA. Subsequently, the second postcontrast Tl-weighted images were obtained with no additional injection of the contrast media. Time-interval between the postcontrast immediate and the delayed images was approximately 6-8 minutes. Degree of contrast enhancement of the lesions was assessed both visually and quantitatively. For quantitative study, contrast enhancement ratio(CER) of tumors was calculated in both immediate and delayed post-contrast images. RESULTS: There was stronger visual enhancement in 7 of 11 cases with gliomas and 3 of 5 cases with parenchymal metastasis on delayed images when compared with immediate images, whereas all 10 cases of extraaxial tumors(meningiomas and neurinomas) showed decreased enhancement on delayed images. Quantitatively, mean CERs of gliomas and metastases were higher on delayed study than on immediate study by 20. 5% and 49.2%, respectively. Extraaxial tumors showed decrease of CER on delayed study by 19.7% as compared with that of immediate study. Hemangioblastomas showed visually poor enhancement on delayed image in 4 cases and equal enhancement on both immediate and delayed images in remaining one case, and quantitatively demonstrated decrease of CER on delayed study by 15.4%. CONCLUSION: Since there was more conspicuous contrast enhancement in many intraaxial tumors such as gliomas and metastases on 6-8 minutes delayed post-contrast MR study, the delayed post-contrast study may be needed in some intraaxial tumors for their characterization, and may also be helpful for the differential diagnosis between intraaxial and extraaxial tumors.
Brain Neoplasms* ; Brain* ; Contrast Media ; Diagnosis, Differential ; Gadolinium DTPA ; Glioma ; Hemangioblastoma ; Humans ; Magnetic Resonance Imaging* ; Meningioma ; Neoplasm Metastasis ; Neurilemmoma ; Prospective Studies

Blue rubber bleb nevus syndrome is a rare disease of cutaneous hemangioma of a variant of the carvenous type which is clinically characterized by multiple, protuberant, dark blue, generally soft, rubbery, and compressible cutaneous masses usually associated with similar lesions of the gastrointestinal tract. Most cases are sporadic, although autosomal dominant inheritance has been described. We report herein a cases of blue rubber bleb nevus syndrome in a 49-year-old, who had multiple, dark blue, slightly tender, easily compressible vascular tumors on the face, right postauricular area, tongue, neck, and right had and foot, measuring from 0.5 to 1.0 cm in diameter. Endoscopic examination also revealed several similar lesions on the upper third of the esophagus. Biopsy specimen from the lesion of the neck showed irregularly dilated vessels containing red blood cells and fibrinous material. The vascular space was lined by a single layer of flattened endothelial cells.
Biopsy ; Blister* ; Endothelial Cells ; Erythrocytes ; Esophagus ; Fibrin ; Foot ; Gastrointestinal Tract ; Hemangioma ; Humans ; Middle Aged ; Neck ; Nevus* ; Rare Diseases ; Rubber* ; Tongue ; Wills

No abstract available.
Urticaria*

A statistical study of soldiers who visited the outpatient ciepartment of the Capital Armed Forces General Fiospital from 1987 to 1989 was performed. The results were as follows : 1. The total number of outpatients was 9969 with peak clinic visits in June(11.2%) and the lowest number of clinic visits in February(6.4% ). 2. The most frequent age was 22 years(20.7% ). Soldiers between 19 and 24 years old comprised 68.1% of total patients. 3. By rank 69.3% of the outpatients were private', 16.0% sergeant and 14,4% officers. 4. The most common dermatoses were dermatophytosis, contact dermatitis, scabies, acne, seborrheic dermatosis, urticaria, alopecia, condyloma acuminatum, verruca, folliculitis, psoriasis, insect bite reactions, pityriasis rosea, herpes zoster and corns. 5. Frequent diseases, which occured during summer season, included dermatophytosis, contact dermatitis and inser,t bites. The incidence of scabies, pityriasis prsea was increased during winter and that of psoriasis was increased during spring.
Acne Vulgaris ; Alopecia ; Ambulatory Care ; Arm ; Callosities ; Dermatitis, Contact ; Folliculitis ; Herpes Zoster ; Humans ; Incidence ; Insect Bites and Stings ; Military Personnel* ; Outpatients ; Pityriasis ; Pityriasis Rosea ; Psoriasis ; Scabies ; Seasons ; Skin Diseases* ; Statistics as Topic* ; Tinea ; Urticaria ; Warts ; Young Adult ; Zea mays

Weber-Christian disease is an inflammatory disease of subcutneious fat tissue which is clinically characterized by relapsing, febrile, nodular, nonsuppurative pannicutilitiy. The cause is unknown, but the disease has been attributed to an autoimmune reaction, infectioris, halogen compounds, sarcoidosis, SLE and a-antitrypsin deficiency. We report here in a case of Weber-Christian disease in a 8-year-old girl, who had indurated erythemataus subcutaneous nodules on the extremities, buttock and trunk accompanied by various general symptoms such as fever, malaise, arthralgia and edema of the abclorren and legs. This case was successfully treated with dapsone,
Arthralgia ; Buttocks ; Child* ; Dapsone ; Edema ; Extremities ; Female ; Fever ; Humans ; Leg ; Panniculitis, Nodular Nonsuppurative* ; Sarcoidosis

Psoriasis is a multi-factorial disease with various clinical manifestations. We present a case of unilateral psoriasis associated with ipsilateral lymphedema that developed after mastectomy for breast cancer. A 42-year-old Korean woman was referred to our clinic with a 1-month history of multiple erythematous scaly patches on the right arm, back, and breast and was diagnosed with psoriasis by a skin biopsy. Three years previously, she had been diagnosed with breast cancer (T1N2), underwent a right quadrantectomy and axillary lymph node dissection, and completed adjuvant chemotherapy followed by high-dose adjuvant radiotherapy. She had started rehabilitation therapy on the right arm for secondary lymphedema 30 months previously. Because of the long interval between radiation and psoriasis, we speculated that changes in the local milieu caused by the lymphedema might be a causative factor. We hereby report a rare case of unilateral psoriasis following post-mastectomy lymphedema.
Adult ; Arm ; Biopsy ; Breast ; Breast Neoplasms ; Chemotherapy, Adjuvant ; Female ; Humans ; Lymph Node Excision ; Lymphedema ; Mastectomy ; Psoriasis ; Radiotherapy, Adjuvant ; Skin