Eccrine spiradenoma is clinically characterized by a solitary, movable, tender nodule occurring most frequently on the ventral surface of the upper body. A striking symptom is paroxysmal pain. Occasionally multiple lesions may be present and may occur in a linear or zosteriform pattern. A 48-year-old female was seen with painful or tender, nomal skin colored, firm nodules distributed in a zosteriform pattern on the right thigh for 10 years, which had been slowly growing. The histopathological features were quite a characteristic of eccrine spiradenoma. We report a rare case of zosteriform network of eccrine spwadenoma occurred on the right thigh.
Female ; Humans ; Middle Aged ; Skin Pigmentation ; Strikes, Employee ; Thigh

Clinical and histopathological studies were made on 202 cases of malignancy of cervix, that were visited to the Department of Obstetrics and Gynecology, Yeungnam University Hospital, during 5 years from 1983 to 1987. The results were summarized as follows. 1. Malignancies of the uterine cervix were 10% of total female malignancies. 2. Among 202 cases, 195 cases (96.5%) were squamous cell carcinoma, in which 60 cases (30.0%) of carcinoma in situ, 9 cases (4%) of microinvasive, and 126 cases (62.5%) of invasive carcinoma were included. 3. The average age of the patients with squamous cell carcinoma was 49.4 years old; In case of carcinoma in situ, it was 43.8, microinvasive, 40.0, invasive 52.1 years old. 4. Clinical symptoms of the patient with squamous cell carcinoma in order of frequency were as follows; vaginal bleeding (47.5%), abnormal cytology (15.4%), and abnormal vaginal discharge (9.4%). 5. Duration of the chief complaints was most commonly less than 6 months (73.2%), and the average duration was 3.8 months. 6. The most common age of marriage was between 19 to 22 years old (46.5%). The average was 21.5 years old. 7. The gravity was 51.5% in 5-8 times, and average 6.2 times. The parity was 61.9% in 1-4 times, and average 3.9 times. 8. The subdivision of 126 cases of invasive carcinoma was made according to FIGO stage classification, stage I, 40 cases (31.8%), stage II, 54 cases(42.9%), stage III, 11 cases (8.7%), and stage IV, 8 cases (6.3%). 9. The histologic subtypes of invasive squamous cell carcinoma were distributed as follows; large cell keratinizing type, 25 cases (19.8%), large cell nonkeratinizing type, 101 cases (80.2%). 10. In the cytologic diagnosis, class I was 2 cases (1.9%), class II was 16 cases (15.1%), class III was 33 cases (31.1%), class IV was 31 cases (29.3%), class V was 24 cases (24.6%). 11. The frequency of lymph node metastasis was 7.5% in stage I, and 11.1% in stage II.
Carcinoma in Situ ; Carcinoma, Squamous Cell ; Cervix Uteri* ; Classification ; Daegu* ; Diagnosis ; Female ; Gravitation ; Gynecology ; Humans ; Lymph Nodes ; Marriage ; Neoplasm Metastasis ; Obstetrics ; Parity ; Uterine Hemorrhage ; Vaginal Discharge

BACKGROUND: The APACHE scoring system of the Health Care Financing Administration (HCFA) has been being used for serious patients. The scoring system is composed of acute physiologic variables and chronic disease. METHODS: Among patients who underwent emergency operations from 1992 to 1997 because of gastrointestinal perforation, we analyzed 110 cases with five kinds of diseases: duodenal ulcer perforation, small bowel perforation, perforated appendicitis, gastric ulcer perforation and colon perforation. RESULTS: The results were as follows: 1) The preoperative APACHE II scores ranged from 0 to 21. The scores of 64 cases (60.9%) were from 0 to 5. 2) There were no death in case for which pre-peration APACHE II score was from 0 to 10, 25% of the mortality occurred in cases with scores from 11 to 15, 50% in those with scores from 16 to 20, and 100% in those with scores above 21. 3) The APACHE II score decreased continuously from the 3rd to the 7th postoperative day. 4) The preoperative APACHE II scores in gastric ulcer perforation patients were significantly higher than those in duodenal ulcer perforation patients. In the cases of gastric and duodenal ulcer perforations, the APACHE II scores in patients who underwent primary closure were higher than the scores in those who underwent a more definitive operation. 5) In death cases, all of their APACHE II scores were higher at the 3rd postoperative than at the 7th postoperative day, but their APACHE III scores continuously increased postoperatively. CONCLUSIONS: It is thought that the APACHE scoring system is more reliable than clinical experience in the classification of patients by operative risk and in estinating the result and giving a prognosis. Thus, the principle of treatment should be established by estinating patient's score before the operation. Careful preoperative management is necessary for patients with scores more than 10. Because patientswith scores more than 21 have very a high mortality, operative time and method must be carefully decided. The APACHE III scoring system seems to be more sensitive than the APACHE II scoring system in predicting deaths and further investigations and clinical applications should be performed.
APACHE* ; Appendicitis ; Centers for Medicare and Medicaid Services (U.S.) ; Chronic Disease ; Classification ; Colon ; Duodenal Ulcer ; Emergencies ; Humans ; Mortality ; Operative Time ; Prognosis ; Stomach Ulcer

PURPOSE: Residual head tilt has been reported in patients with superior oblique muscle palsy (SOP) after surgery to weaken the inferior oblique (IO) muscle. The treatments for these patients have not received appropriate attention. In this study, we evaluated the superior rectus (SR) muscle recession as a surgical treatment. METHODS: The medical records of 12 patients with SOP were retrospectively reviewed. Each of these patients had unilateral SR muscle recession for residual head tilt after IO muscle weakening due to SOP. The residual torticollis was classified into three groups on the basis of severity: mild, moderate, or severe. Both IO muscle overaction and vertical deviation, features of SOP, were evaluated in all patients. The severity of the preoperative and postoperative torticollis and vertical deviation were compared using a paired t-test and Fisher's exact test. RESULTS: The torticollis improved in nine of 12 (75%) patients after SR muscle recession. The difference between the preoperative and postoperative severity of torticollis was statistically significant (p = 0.0008). After surgery, the mean vertical deviation was significantly reduced from 12.4 prism diopters to 1.3 prism diopters (p = 0.0003). CONCLUSIONS: Unilateral SR muscle recession is an effective method to correct residual head tilt after IO muscle weakening in patients with SOP. This surgical procedure is believed to decrease head tilt by reducing the vertical deviation and thereby the compensatory head tilt.
Adolescent ; Adult ; Child ; Child, Preschool ; Diplopia/*surgery ; Female ; Head Movements ; Humans ; Infant ; Male ; Oculomotor Muscles/*surgery ; Retrospective Studies ; Strabismus/*surgery ; Torticollis/*surgery ; Treatment Outcome ; Trochlear Nerve Diseases/*surgery

PURPOSE: Mu agonists can be used in clinical conditions where threr is a risk of hypoxic neurosusceptibility. Fentanyl, one of mu agonists may serve as neuroprotection from brain ischemic injury and protects against some kinds of brain injury and appears to play an important role in the regulation of brain excitability, especially in hippocampus during seizure. We investigated the effects of mu agonists - fentanyl and DAGO([D-Ala2, N- Me-Phe4, Gly-ol]-enkephalin) on electroconvulsive seizures. METHODS: The study was done with Sprague-Dawley rats(7-30 days), weighting from 20.4 g to 78.7 g. The animal were kept in-groups with mother rat in cages, and had free access to food and tap water. The temperature of the animal room is room temperature. Hippocampal slices were taken. Hippocampal slices were exposed to DAGO. Then, we began to record electrical activity of slices every 10 minutes in artificial cerebrospinal fluid. We observed the frequency and duration of electrical activity. RESULTS: The mean duration and frequency of fentanyl 50 ng/mL-treated ictal activity was 23.1+/-2.4 seconds and 85.98.1(n=7). These results were significant differences compared with control. The mean duration and frequency in fentanyl 50 ng/mL-treated interictal activity was 518.5+/-64.0 seconds, 132.0+/-14.0(n=5). There were also significant differences in the duration and frequency of onset in fentanyl 50 ng/mL-treated interictal activity compared with control showing interictal activity. The mean duration of latency time of onset in fentanyl 50 ng/mL-treated interictal activity was 143.0+/-11.3 seconds(n=5), and there was a significantly different latency of onset time in fentanyl 50 ng/mL-treated interictal activity compared with control showing interictal activity. The mean duration and frequency of DAGO 1M-treated ictal activity was 12.72.8 seconds and 87.3+/-11.1(n=7). These results were significant differences compared with control. The mean duration and frequency in DAGO 1M-treated interictal activity was 464.6+/-42.5 seconds, 64.2+/-23.0(n=5). There were also significant differences in the duration and frequency of onset in DAGO 1M-treated interictal activity compared with control showing interictal activity. The mean duration of latency time of onset in DAGO 1 microM-treated interictal activity was 28.49.4 seconds(n=5), and there was a significantly different latency of onset time in DAGO 1 microM- treated interictal activity compared with control showing interictal activity. CONCLUSION: Fentanyl 50 ng/mL showed a decrease of electroconvulsive seizures, so did DAGO 1 microM. These exogenous mu agonists suppress electroconvulsive seizures, and with increased levels of mu agonists, there may be a functional anticonvulsant effect through mu agonists, there may be a functional anticonvulsant effect through mu receptors. Also, these seem to modulate the convulsions. The study suggests that mu agonists may play a role in the pathogenesis of electroconvulsive seizures and shows a positive clue to the relationship between anticonvulsive effects and mu agonists.
Animals ; Brain ; Brain Injuries ; Cerebrospinal Fluid ; Enkephalin, Ala(2)-MePhe(4)-Gly(5)- ; Fentanyl ; Hippocampus* ; Humans ; Mothers ; Rats ; Rats, Sprague-Dawley ; Receptors, Opioid, mu ; Seizures* ; Water

OBJECTIVES: The purpose of this study was to evaluate the optimal distance and angle of observers by modulation transfer functions(MTFs) and receiver operating characteristics(ROCs). MATERIALS AND METHODS: Digital periapical radiograms were taken from 43 patients who have dental diseases(19 patients : dental caries, 12 patients : periapical lesions, 12 patients : periodontal diseases). Segmental images(4x4cm) were evaluated by 4 MTFs and ROC analysis. RESULTS: The optimal distance(magnification) using MTF by Mannos & Sakrison was 12.97, and those by Nill, Ngan and Rao were 8.39, 4.78, 5.84 respectively. The optimal distance obtained from 4 radiologists by ROC analysis was 32cm(Az value : 0.89), and it was 40cm(Az value : 0.78) from 4 non-radiologists. There were significant differences of Az values between 4 radiologists and 4 non-radiologists at 24, 32 and 40cm (p<0.05). No significant differences of optimal distances were observed using 4 MTFs among +20, +10, 0, -10, -20 degrees(p>0.05). The optimal angle obtained from 4 radiologists by ROC analysis was +20 degrees (Az value : 0.91), and no significant differences of Az values were observed among +20, +10, 0, -10 and 20 degrees(p>0.05). The optimal angle obtained from 4 non-radiologists by ROC analysis was 0 degree(Az value : 0.81), and no significant differences of Az values were observed among +20, +10, 0, -10 and 20 degrees(p>0.05). And there was significant difference of Az value between 4 radiologists and 4 non-radiologists at +20 degree(p<0.05), but no significant differences of Az values were observed among +10, 0, -10 and -20 degrees(p>0.05).
Dental Caries ; Humans ; ROC Curve

Analyses were done on one hudred and twenty caaes of bleeding gastric ulcers diagnosed by emergency endoscopy for the past five years. The reaults are as the following: Much more cases were found in male than female and the most prevalent age group was 6th decade. The body of stomach along the lesser curvature was the most common bleeding site. No age related difference was noted in bleeding sites. Most common type of ulcer was in the round and shallow form. Five of six cases with exposed vessels showed atrophic changes in surrounding mucosa. Among the probable precipitating factors, analgesica, alcohols and certicosteroids were found in such order,
Alcohols ; Emergencies ; Endoscopy ; Female ; Hemorrhage* ; Humans ; Male ; Mucous Membrane ; Precipitating Factors ; Stomach ; Stomach Ulcer* ; Ulcer

A 28-year-old female devei,oped five rice-sized erythematous telaniectatic solid papules of her left side of cheek and numerous light brownish flat papules of her face two years before visiting our department of dermatology. Biopsy results of the erythematous papule vere dermal infiltration by well-differentiated, however, somewhat atypical and varying sized plasma cells involving epidermis, and the flat papule was that of verwca plana. Bone marrow aspirate was essentially normal. Primary cutaneous plasmacytoma is a rare disease. A significant proportion of patients with this ent on to develop systemic disease with a poor prognosis. Our patient was not treatead, bit only excised partially for biopsy. All skin lesions involuted two years later spontaneously and rema ns well until now six years later without recurring.
Adult ; Biopsy ; Bone Marrow ; Cheek ; Dermatology ; Epidermis ; Female ; Humans ; Plasma Cells ; Plasmacytoma* ; Prognosis ; Rare Diseases ; Skin

Fibro-osseous pseudotumor is an extremely rare benign lesion which is fast-growing and painful. It is often misdiagnosed as a malignancy, but it is a noninvasive entity and can be cured by simple resection. We report a case of fibro-osseous pseudotumor of the distal phalanx of great toe in 20-year-old female patient who present with painful mass.
Female ; Humans ; Toes ; Young Adult

PURPOSE: To evaluate the efficacy of the arterial phase of dynamic spiral CT in the detection of pancreatic adenocarcinoma compared with the late phase. MATERIALS AND METHODS: Two phase spiral CT images of seventeen patients with pathologically proven pancreatic ductal adenocarcinomas were compared retrospectively. CT scans were performed with 5mm collimation at 1:1 pitch table speed. Images of arterial and late phases were obtained at 35 seconds and 180 seconds after initiation of administration of 100mL of contrast material(3mL/sec), respectively. Images of the arterial phase were compared with those of the late phase. RESULTS: Images of the arterial phase showed sufficient contrast between the tumor and adjacent pancreatic parenchyma in 12 cases, insufficient in four cases, and no significant contrast in one case. Images of the late phase showed sufficient contrast in five cases, insufficient in five cases, and no significant contrast in seven cases. Images of the arterial phase was superior to that of the late phase in 12 patients(70.6%). In six of the 12 patients, only the images of the arterial phase showed contrast between the tumor and the adjacent parenchyma. The images of late phase showed only one case of three metastasis detected on the images of the arterial phase. CONCLUSION: The arterial phase of spiral CT is superior to the late phase that is comparable with conventional CT in the detection of pancreatic adenocarcinoma.
Adenocarcinoma* ; Humans ; Neoplasm Metastasis ; Pancreatic Ducts ; Retrospective Studies ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed