Pityriasis rotunda is characterized by perfectly circular to oval brownish scaly patch on the trunk and extremities. This disease is considered to be a form of acquired ichtkyosis of unknown etiology and develops usually in association with certain systemic diseases, such as tuberculosis, malignant neoplasrn, leprosy, ovarian cyst and uterine myoma etc, We experienced 2 cases of pityriasis rotunda on the abdomen, chest and back associated with liver cirrhosis in 66 year old man 43 year old woman and clinical presentation was made with review of related literatures.
Abdomen ; Adult ; Aged ; Extremities ; Female ; Humans ; Leiomyoma ; Leprosy ; Liver Cirrhosis* ; Liver* ; Ovarian Cysts ; Pityriasis* ; Thorax ; Tuberculosis

A 22-year-old-male patient has numerous brownish-black, soft follicular papules which compatible with acne are scattered on the chest, scapular regions, back and buttocks for 4 5 years duration. Biopsy specimen revealed cystic structures in the mid-dermis lined by squamous cell epithelium w4ich contained laminated keratinous material and varying number of vellus hairs, histopathologically, compatible with diagnosis of eruptive vellus hair cysts. Related literatures and histogenesis were discussed,
Acne Vulgaris ; Biopsy ; Buttocks ; Diagnosis ; Epithelium ; Hair* ; Humans ; Thorax

No abstract available.
Adult* ; Humans ; Obesity*

PURPOSE: To evaluate abnormal neurosonographic (NSG) findings of thalami and basal ganglia in full term babies with hypoxic-ischemic encephalopathy and to correlate the findings with follow-up studies and prognosis. METHODS: We evaluated 13 full term babies with abnormal NSG findings of thalarni and basal ganglia. NSG was performed within 7 days after clinical abnormalities. Follow-up NSG was done in 11 cases; CT scan in 4 and MRI in 7. We classified NSG findings as diffuse, unilateral, and focal types according to increased echogenicity and evaluated prognosis based on follow-up studies and neurological sequelae. RESULTS: Nine cases of diffuse type had diffuse echogenic changes of bilateral thalami and basal ganglia, slit-like lateral ventricles suggesting cerebral edema, and increased parenchymal echogenicity. In diffuse type, follow-up studies showed more prominent echogencities and ventricular dilatations and cerebromalacia. One case of unilateral type caused by thromboembolism had unilateral echogenicity of right thalamus and basal ganglia with increased echogenicity of the ipsilateral cerebral hemisphere and compression of the lateral ventricle, suggesting cerebral infarction. Follow-up study showed unilateral cystic cerebromalacia. Three cases of focal type had a localized echogenic area in thalamus with lacunar infarction, which decreased in size during follow-up. Among nine cases of diffuse type, one died within 2 days, two were discharged against medical advice, and six had severe neurologic sequelae. One case of unilateral type had a moderate degree of neurologic sequelae. All 3 cases of focal type had normal development. CONCLUSION: Pattems of abnormal echogenicity in thalami and basal ganglia in fullterm infants with hypoxic-ischemic encephalopathy are correlated with the outcome and may be helpful for treatment planning.
Basal Ganglia* ; Brain ; Brain Edema ; Brain Ischemia* ; Cerebral Infarction ; Cerebrum ; Dilatation ; Encephalomalacia ; Follow-Up Studies ; Humans ; Hypoxia-Ischemia, Brain ; Infant* ; Lateral Ventricles ; Magnetic Resonance Imaging ; Prognosis* ; Stroke, Lacunar ; Thalamus* ; Thromboembolism ; Tomography, X-Ray Computed

Monilethrix is a rare familiar disorder of unknown cause, occurring in either sex, and ueually confined to the scalp. In most cases it is manifested in early childhood. lt is characterized by localized or widespread dystrophy of hair and follicles, the shafts showing regular variations in diameter producing alternate "nodes" and "internodes" which confer a striking beaded or moniliform appearance on the hair. We experienced a case of monilethrix, which was associated with keratosis pilaris and occurred in three generations. The patient's one sibling, mother, 4 uncles and 2 aunts of mother side and grandmother with her sister were all affected with a similar diaorder of hair.
Family Characteristics ; Hair ; Humans ; Keratosis ; Monilethrix* ; Mothers ; Scalp ; Siblings ; Strikes, Employee

BACKGROUND: Ketamine use in emergency room has been increased. It has rapid onset of action and appropriate duration of action. It does not need endotracheal intubation and produces potent analgesia, sedation, and amnesia. The object of this study is to determine the safety and the degree of physician's satisfaction in relation to ketamine use. MATERIALS AND METHODS: This is a prospective study using protocol. Pediatric trauma patients who need sedation were given IM ketamine(4mg/kg) and atropine(0.01mg/kg) in a same syringe. Monitoring of patients was done by EM residents and complications of ketamine use were recorded. Physician's satisfaction was also recorded after the procedure. RESULTS: Intramuscular ketamine was administered 54 times, mainly for laceration repair. Physicians completed protocol for 51 of treated children. The median time for onset of sedation was 6.5+/-2.4 min, and duration of action was 32.4+/-10.8 min. Hypersalivation occurred in 9.8%(n=5); random movement 3.9%(n=2), emesis during procedure(n=1), emesis at home(n=1), and transient oxygen desaturation(n=1). All were quickly identified and treated without specific airway management and sequelae. Of 84% of physicians was satisfied with ketamine use for pediatric sedation. CONCLUSION: Intramuscular ketamine can be administered safely and satisfactorily in emergency room to facilitate pediatric procedures in conjunction with a defined protocol and appropriate monitoring.
Airway Management ; Amnesia ; Analgesia ; Child ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Intubation, Intratracheal ; Ketamine* ; Lacerations ; Oxygen ; Prospective Studies ; Sialorrhea ; Syringes ; Vomiting

Intraocular pressures (IOP)were measured following Neodymium (Nd): YAG laser posterior capsulotomy in 51 pseudophakic eyes which had been treated with phacoemulsification and intraocular lens in the bag.Group 1 was no medical treated, group 2 was treated with 0.5%apraclonidine preoperatively, group 3 was treated with fluorometholone postoperatively, and group 4 was treated with 0.5%apraclonidine preoperatively and with fluorometholone postoperatively.IOP was measured preoperatively and 1, 3, 24 hours and 1 week postoperatively.Four eyes (7.8%)had greater than 5 mmHg elevation of IOP (1 eye in group 1, 3 eyes in group 3)and all of them decreased IOP to normal level within 3 hours.In summary, there was no or little IOP elevation without any medical treatment in eyes which had been treated with phacoemulsification and intraocular lens in the bag and had intact posterior lens capsule.
Cataract* ; Fluorometholone ; Intraocular Pressure* ; Lasers, Solid-State* ; Lenses, Intraocular ; Neodymium ; Phacoemulsification ; Posterior Capsulotomy*

In this study, silicone intubation was performed for punctal stenosis in 26 eyes (group 1), incomplete nasolacrimal duct obstruction in 65 eyes (group 2), and complete nasolacrimal duct obstruction in 62 eyes (group 3).Follow up period was 3~14 months (mean 6 months).After intubation, 22 eyes (84.6%) in group 1, 50 eyes (76.9%)in group 2, and 25 eyes (40.3%)in group 3 showed no epiphora.The success rates based on age were 100%under 10 years, 67.2%between 10 years and 50 years, and 65.4%above 50 years.81.8%in male patients and 58.3%in female patients showed improvement.The most common complication was itching sensation.In summary, silicone intubation can be an alternative to dacryocystorhinostomy in patients who have punctal stenosis and incomplete obstruction of nasolacrimal duct system.
Constriction, Pathologic ; Dacryocystorhinostomy ; Female ; Humans ; Intubation* ; Lacrimal Apparatus Diseases* ; Male ; Nasolacrimal Duct ; Pruritus ; Silicones*

A case of metastatic tumor of the skin is described with literature review. Cutaneous metastases of malignant tumor is rarely seen but lung cancer in male and breast cancer in female are not infrequently reported. This patient, 37 year old male, had lung cancer, had several chest tappings for pleural effusion and a pleural biopsy. 8 months later, skin manifestation of diffuse erythematous sclerotic patches and confluent nodules was noted on pleural biopsy site, right lateral chest wall. Histopathological finding was compatible with metastatic carcinoma. This metastatic skin tumor is considered to be arisen from the lung probably due to pleural biopsy.
Adult ; Biopsy* ; Breast Neoplasms ; Carcinoma, Bronchogenic* ; Female ; Humans ; Lung ; Lung Neoplasms ; Male ; Neoplasm Metastasis* ; Pleural Effusion ; Skin Manifestations ; Skin* ; Thoracic Wall ; Thorax

Wegener's granulomatosis is a disease of unknown etiology that is characterized by the clinicopathologic complex of necrotixing granulomatous vasculitis of the upper and lower respiratory tract, glomerulonephritis, and variable degrees of small vessel vasculitis. Recently Antineutrophil Cytoplasmic Antibody (ANCA) has been reported to be a highly specific test for the diagnosis of Wegener's granulomatosis. We have experienced a patient of Wegener's granulomatosis in a 11 year old girl who was admitted with complaints f arthralgia, hematuria, convulsion and associated with otitis media and sinusitis. Serologic test of C-ANCA was positive and histologic findings of the kidney showed crescentic glomerulonephritis with sclerosis and surrounding infiltration of multinucleated giant cells. Patient was treated with pulse methylprednisolone without improvement. The clinical course progressed rapidly and expired due to the renal failure, gastrointestinal bleeding and status epilepticus. A brief review of literatures was made.
Antibodies, Antineutrophil Cytoplasmic* ; Arthralgia ; Child ; Diagnosis ; Female ; Giant Cells ; Glomerulonephritis ; Hematuria ; Hemorrhage ; Humans ; Kidney ; Methylprednisolone ; Otitis Media ; Renal Insufficiency ; Respiratory System ; Sclerosis ; Seizures ; Serologic Tests ; Sinusitis ; Status Epilepticus ; Vasculitis ; Wegener Granulomatosis*