A case of stasis dermatitis with hepatomegaly is reported. The patient is 50 year old male. About 3 years ago a dark-brownish macule on the left shin was appeared with the severe itching sensation and spread to the margin with edema, ulceration, and appeared the varricous veins on the margin, Biopsy on the ulceration revealed the hemociderin deposition and fibrosis in the dermis. The physical examination revealed that the liver was enlarged 3cm, below the right costal margin and liver biopsy showed early cirrhotic change, but without impairment of liver function. He was treated with massage, elastic bandage for 2 weeks with good response.
Biopsy ; Compression Bandages ; Dermatitis* ; Dermis ; Edema ; Fibrosis ; Hepatomegaly ; Humans ; Liver ; Male ; Massage ; Middle Aged ; Physical Examination ; Pruritus ; Sensation ; Ulcer ; Veins

The pathologic changes of verrucae and molluscum contagiosum are limitted chiefly to epidermis, therefore treatment with cantharidin which forms acantholytic bulla is successful. Canthrides is dried, powdered blister beetle, and cantharidin is its purified active ingredient. Its primary cutaneous effect is acantholysis and death of epidermal cells. For topical treatment, catharidin was prepared as a 0.9% solution in mixture of 50% of acetone, 25% of ether and 25% flexibIe collodion U.S.P. The therapeutic efficacy of cantharidin was excellent to eliminate the lesions of verrucae and molluscum contagiosum, showing the complete recovery of 114 out of 117 lesions of verrucae, and 520 out of 550 lesions of molluscum contagiosum with 1 to 3 topical applications. From the above results, it should be pointed out that cantharidin has the several advantages at clinical uses for the treatment of verrucae and molluscum contagiosum: 1 No residual scarring. 2. No pain. 3. Excellent therapeut!c efficacy.
Acantholysis ; Acetone ; Beetles ; Blister ; Cantharidin* ; Cicatrix ; Collodion ; Epidermis ; Ether ; Molluscum Contagiosum* ; Warts*

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

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 secondary cleft lip nasal deformity can be corrected by many procedures including central lip tissue transfer, forked flap, nasal floor and alar base advancement, nasal skin flaps and composite graft. These procedures have been applied for many years, but each one has some conspicuous residual problems. We propose triple V-Y advancement flaps, which we have performed on 13 secondary cleft lip and nasal deformity patients over the past 6 years. The W-shaped triple reverse V-shaped incision easily exposed the alar cartilages. We made the advancement and rotation of the nasal skin flap to lengthen the columella and project the nasal tip. Postoperatively, the columella length and nasolabial angle were found to be increased by an average of 3.7 mm and 42 degrees, respectively. In lateral view, a relatively natural nasal line was achieved. The scar in the nasal tip posed few problems. This procedure should be useful for the correction of the secondary cleft lip nasal deformity.
Cartilage ; Cicatrix ; Cleft Lip* ; Congenital Abnormalities* ; Humans ; Lip ; Skin ; Transplants

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*

A case of multiple hamartomas of the unilateral chest wall in a four month old infant is presented. There have been a few reports on the CT findings of the chest wall hamartoma in infancy. We describe bone changes of the ribs and mineralization of this rare tumor on the CT scan, and the locations of two separate masses.
Hamartoma ; Humans ; Infant ; Miners ; Ribs ; Thoracic Wall* ; Thorax* ; Tomography, X-Ray Computed

OBJECTIVE: To assess the changes of ultrasonographic findings of median nerve according to wrist position change in normal and carpal tunnel syndrome hands. METHOD: We studied 31 carpal tunnel syndrome and 34 normal hands that were diagnosed by nerve conduction study and evaluated crossectional area, flattening ratio and distance to ulnar artery with diagnostic ultrasound. The parameters were tested according to the change of wrist position with neutral, extension and flexion in normal control and carpal tunnel syndrome. RESULTS: Crossectional area of carpal tunnel syndrome was larger than that of control. Flattening ratio of carpal tunnel syndrome was larger than that of control at extended position. Flattening ratio was greater in neutral and extended position than flexed position in carpal tunnel syndrome. Distance to ulnar artery were greater in flexed position than other positions in carpal tunnel syndrome. Frequency of least flattening ratio at flexion position in carpal tunnel syndrome was 64.52% and frequency of longest distance to ulnar artery at flexion position was 58.05%. CONCLUSION: Ultrasonography of median nerve showed no consistent findings according to change of wrist position between control and patients. Ultrasonographic diagnosis of carpal tunnel syndrome need further study for anatomical variations.
Carpal Tunnel Syndrome ; Diagnosis ; Hand ; Humans ; Median Nerve* ; Neural Conduction ; Ulnar Artery ; Ultrasonography ; Wrist*

The free flaps have been used for reconstruction of the head and neck because of their superior results comparing with other types of flaps. Among them, radial forearm free flap has many advantages, its thinness, pliablilty, long vascular pedicle, large sensory flap, and compound flap including tendons and bone. We report 28 cases of head and neck reconstruction with radial forearm free flap between March 1991 and March 1997. Patient's age ranged from 21 to 76 years(mean 50.5 years). There were 23 men and 5 women. Mean follow-up period was 14 months. The most common cause was malignant tumor of the head and neck, especially squamous cell carcinomas(18 cases). We used this flap to reconstruct the oral cavity in 13 cases, the hypopharyngoesophagus in 6 cases, external surface of the head and neck in 7 cases, and the orbit in 2 cases. All of these flaps survived without complication. Two cases of fistula developed, in which forearm flaps were used for tongue and hypopharyngoesophageal reconstruction, and they were treated with conservative manners. Partial losses of skin graft at donor site of the forearm developed in 3 cases. They healed with split-thickness skin graft or local flap. The function of reconstructed upper aerodigestive tract and eye socket was good. The cosmetic result was not good in cases of reconstruction for external surface of the face with this flap, but it was better than other free flaps. So, we concluded the radial forearm free flap is available for reconstruction of the head and neck.
Female ; Fistula ; Follow-Up Studies ; Forearm* ; Free Tissue Flaps* ; Head* ; Humans ; Male ; Mouth ; Neck* ; Orbit ; Skin ; Tendons ; Thinness ; Tissue Donors ; Tongue ; Transplants

No abstract available.
Humans ; Physicians, Family*