Herein we report a 51-year-old male with angioimmunoblastic lymphadenopathy who had developed rnaculopapular eruptions after the administration of crystalline penicillin, acetylsalicylic acid and sulpyrine. Skin biopsy showed mild lyrnphohistiocytic infiltration and extravasated RBCs around the blood vessels in the upper dermis. He had run a progressively downhill course in spite of vigorous chemotherapy and ultimately died.
Aspirin ; Biopsy ; Blood Vessels ; Crystallins ; Dermis ; Dipyrone ; Drug Therapy ; Humans ; Immunoblastic Lymphadenopathy ; Lymphatic Diseases* ; Male ; Middle Aged ; Penicillins ; Skin

No abstract available.
Facial Nerve* ; Fetus*

The ankle stability has a vital role in normal gait and walking. An accurate and anatomic reduction with rigid fixation has been emphasized as important regimens as well as early motion and weight bearing exercises. The authors analysed 90 cases(88 patients) of ankle fractures which were admitted and treated in orthopedic department, Chung-Ang Gil General Hospital from March 1987 to May 1992. Males were affected 1.7times than female and the age group of third and fourth decades constituted 60.2%. The most common cause was vehicle accident(35 cases; 38.9%). According to Lauge-Hansen classification, supination-external rotation type was most common(32 cases; 35.6%). Accoompanyng injuries were noted on 45 cases(50%) and fractures in lower extremities were most common(17 cases; 18.9%). According to meyer's assessment of result, the clinical and radiologic results were better in operative method than conservative ones. From the evaluation of clinical results, anatomic reduction and rigid internal fixation of lateral malleoli and distal tibiofibular joint are more important factors. Complications are resulted in 19cases(21.1%) and traumatic arthritis is the most common (10 cases; 11.1%). The extent and degree of injury was an important factor in an overall results of treatment as well as the anatomic reduction of fracture alignment.
Ankle Fractures ; Ankle ; Arthritis ; Classification ; Exercise ; Female ; Gait ; Hospitals, General ; Humans ; Joints ; Lower Extremity ; Male ; Methods ; Orthopedics ; Walking ; Weight-Bearing

Pulmonary artery sling is an uncommon and potentially lethal vascular anomaly that can produce airway obstruction. Despite the availibility of a corrective operation, the mortality rate remains very high due to the high incidence of associated obstructive anomalies of the tracheobronchial tree. We experienced a 70-day-old male infant who was admitted to our unit because of sudden dyspnea, cyanosis, coarse expiratory wheezing and inspiratory stridor. At first, he was treated with bronchodilator and steroid under the impression of infantile asthma, but the symptoms went on without interval change. We performed magnetic resonance imaging study followed esophagography and two dimensional echocardiography. Finally he was diagnosed as a vascular sling. We report this with a brief review and related literatures.
Airway Obstruction ; Asthma ; Cyanosis ; Dyspnea ; Echocardiography ; Humans ; Incidence ; Infant ; Magnetic Resonance Imaging ; Male ; Mortality ; Pulmonary Artery ; Respiratory Sounds

No abstract available.
Exostoses* ; Toes*

No abstract available.
Exostoses* ; Toes*

Myotonic dystrophy is an autosomal-dominantly inherited neuromuscular disorder characterized by slowly progressive muscular dystrophy, muscle weakness and myotonia. The clinical features may vary from just cataracts to involvement of multiple organ systems such as various muscles, heart, lung and intestine. During pregnancy and delivery, serious maternal and obstetrical complications may occur. The myotonia is often aggravated during pregnancy and it leads to obstetrical complications such as fetal loss, preterm premature delivery, hydrops, in-utero fetal death, difficulties in fetal expulsion, postpartum hemorrhage and/or anesthetic accidents. The affected neonate may display severe hypotonia, facial displegia and respiratory distress. This report presents a woman with myotonic dystrophy complicated with congestive heart failure and preterm delivery during pregnancy.
Cataract ; Edema ; Estrogens, Conjugated (USP)* ; Female ; Fetal Death ; Heart Failure* ; Humans ; Infant, Newborn ; Intestines ; Lung ; Muscle Hypotonia ; Muscle Weakness ; Muscular Dystrophies ; Myocardium ; Myotonia ; Myotonic Dystrophy* ; Obstetric Labor, Premature* ; Postpartum Hemorrhage ; Pregnancy*

The recent introduction of chemotherapy in the treatment of the gynecologic malignancies has gained wide acceptance along with preoperative and postoperative adjuvant therapy and with preradiation and concurrent chemoradiaton therapy. But, the side effects of chemotherapy including bleeding and infection due to bone marrow suppression have resulted in increased morbidity and mortality of the patients and delayed treatment and a reduction in the chemotherapeutic agents used. In spite of the development of antibiotics and the supportive care of infection, sustained leukopenia in the patients during chemotherapy accounts for the high mortality rate due to sepsis. The early detection of the leukopenia during chemotherapy may enable clinicians to overcome infection problems by timely use of prophylactic broad spectrum antibiotics and G-CSF or GM-CSF. The author investigated the grade, duration, time of onset and other clinical features of the leukopenia and the effects of the age (> or =60 years vs <60 years), the number of the cycle of chemotherapy (> or =3 cycles vs < 3 cycles), fever and performance scale on the leukopenia. 79 cases (32 patients) of the leukopenia during chemotherapy of various gynecologic malignancies at the Department of Obstetrics and Gynecology at Hanyang University between January, 1996 and December, 1998 entered to this study. The results were as follows; 1. Leukopenia occurred at 14.2+/-6.1 day from the first day of chemotherapy, 2. The duration of leukopenia was 2.5+/-1.6 days 3. No significant difference was found between eldely patients ( > or =60 years, n=13) and younger patients ( <60 years, n=66) about the severity, duration and time of onset of leukopenia. 4. No significant difference was found between the patients with more than 3 cycles of chemotherapy (n=40) and less than 3 cycles (n=39) about the severity, duration and time of onset of leukopenia. 5. Febrile leukopenic cases (n=6) had significantly lower granulocyte count, longer leukopenic period and earlier onset of leukopenia than afebrile (n=73). 6. It is thought that performance status scale does not affect the grade of leukopenia, onset of leukopenia and the leukopenic period.
Anti-Bacterial Agents ; Bone Marrow ; Drug Therapy* ; Fever ; Granulocyte Colony-Stimulating Factor ; Granulocyte-Macrophage Colony-Stimulating Factor ; Granulocytes ; Gynecology ; Hemorrhage ; Humans ; Leukopenia* ; Mortality ; Obstetrics ; Sepsis

No abstract available.
Information Management* ; Occupational Health*

BACKGROUND: Cognitive impairment often goes unrecognized by physicians because the many previous tools to evaluate cognitive function in the clinical setting are difficult and time-consuming. The purpose of this study was to compare the Clock Drawing Test(CDT) with the Mini-Mental State Examination (MMSE) as a cognitive screening tool for elderly patients. METHODS: In a haspital-based outpatient clinic, 99 patients aged 65 or older were administered with the MMSE and were asked to mark the digits in the pre-drawn clock. They are also evaluated with the Geriatric depression scak, the Activities of Daily Living, and the Instrumental Activities of Daily Living. RESULTS: Correlation between CDT and MMSE was high (r=-(~0.606; p<0.001). With respect to CDT, there were significant correlations with all subscales of MMSE except registration of memory(p<0.01). CDT with scores of 2 had a sensitivity of 68.2% and a specificity of 70.9% for mild cognitive impairment. CDT with scores of 4 had a sensitivity of 80.8% and a specificity of 84.8% for severe cognitive impairment. CONCLUSIONS: CDT can be an effective and simple cognitive screening tool for the elderly patients in the primary care outpatient clinic, if campensated for registration of memory among the cognitive function.
Activities of Daily Living ; Aged ; Ambulatory Care Facilities ; Dementia ; Depression ; Humans ; Mass Screening* ; Memory ; Mild Cognitive Impairment ; Primary Health Care ; Sensitivity and Specificity