A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.
Aged ; Bays ; Decompression, Surgical ; Deglutition ; Esophagus ; Gastrostomy ; Humans ; Hyperostosis ; Hypoxia, Brain ; Intensive Care Units ; Neck Pain ; Osteophyte* ; Pneumonia ; Pneumonia, Aspiration* ; Shock, Septic ; Spine ; Vomiting

No abstract available.

BACKGROUND: Pityriasis versicolor(PV) is a superficial mycosis, theoretically unusual in children. Epidemiologic and clinical data for children with PV under 14 years were collected. OBJECTIVE: The purpose of this study was to evaluate the clinical features of PV in the young. METHOD: We included all cases of PV in patients under 14 years of age observed in our department from 1981 to 1995. All cases were diagnosed on the basis of clinical criteria and were confirmed by microscopic examination. RESULTS: From 1981 to 1995 we encountered 32 cases of PV in children, compared with 637 cases in adults; thus children represented 4.7% of all cases. The ratio of male to female was l. 7:1. Among the age groups, the incidence was the highest in the 10-14 years(43%). The monthly prevalence was the highest in August. Distribution of the lesions were the face(40.9%), neck (25%), chest(13.6%), back(11.3%), extremities(6.8%) and abdomen(2.2%). The incidence of hypopigmented lesions was 70.4% and that of hyperpigmented lesions was 29.6%. CONCLUSION: This study confirms that the face is a predilectionl site for PV in children and all facial lesions are hypopigmented. Other clinical features are variable and similar to those of adults.
Adult ; Child ; Female ; Humans ; Incidence ; Male ; Neck ; Pityriasis* ; Prevalence ; Tinea Versicolor*

This study was performed to investigate the rate of occurrence of neonatal birthmarks and their clinical features. From October 1982 to September l983, 1,035 newborn babies were examined in the Keimyung University Dongsan Medical center and the results were summarized as follows. The main nevi in the newborn were salmon patch (28 9%), portwine stain (0.3%), strawberry mark (0.4%), pigmented lesions (1.0%) and mongolian spot (81. 2%). The salmon patch was present most frequently on the nape but no particular predilection sites were noted in portwine stain, strawberry mark and pigmented lesions. The mongolian spot developed on the sacral portion, buttocks and lower back, in decreasing order.
Buttocks ; Fragaria ; Humans ; Infant, Newborn ; Mongolian Spot ; Nevus ; Salmon

Vascular grafts are often required in clinical stiuations to bridge arterial or venous grafts. Numerous studies exist in the literature concerning the results of such arterial and venous graft of relatively large vessels. There are only a few reports dealing with experimental microvascular grafts. Histopathological features of the grafted vessels were studied after autogenous venous grafts,autogenous arterial grafts and venous allografts using microsurgical techniques. The results were summerized as follow. 1. The patency rate of grafted vessels by microsurgical techniques was 86.8%. 2. In autogenous venous grafts histopathological changes occur later, and to a less pronounced degree, than that in autogenous arterial grafts. 3. Venous allografts showed severe acute inflammatory reaction throughout the layer at 3~7 days postoperatively, but histopathological features of grafted vessels of autografts and venous allografts' did not differ each other in later results. 4. Autogenous venous grafts, autogenous arterial gtafts and venous allografts persist as living sucture but undergo certain histological changes consisting of fibrous reinforcement. 5. It may be said that histological examination of the specimen led general conclusion that the most useful microvascular graft to reestablish circulation of damaged vessels is the autogenous venous graft, but autogenous arterial graft and venous allograft are also applicable when autogenous venous tissue is not available.
Allografts ; Autografts ; Transplants

Progressive Muscular Dystrophy is a hereditary disorder characterized by progressive weakness and wasting of muscules. The etiology of muscular dystrophy is unknown, and no from of pharmacological treatment is considered effective. We report 2 cases of progressive muscular dystrophy occuring in a family, which were diagnosed by clinical findings, serum enzyme study and electromyography.
Electromyography ; Humans ; Muscular Dystrophies

Nevus sebaceus of Jadassohn is a hamartoma of the skin with the potential to develop benign and malignant neoplasms. This case was characterixed by multiple basal cell epitheliomas, clinically one reddish nodule and multiple pigmented papules, arising in the nevus sebaceus. Histologically, epithelial papillomatous hyperplasia and high-positioned hyperplastic sebaceous glands were found, and tumor nests consisting of basaloid cells with peripheral palisading arrangements were mainly situated in the upper dermis without significant infiltrative growth. We report a rare case of nevus sebaceus with multiple basal cell epitheliomas in the right cheek of a 49-year-old woman.
Carcinoma, Basal Cell* ; Cheek ; Dermis ; Female ; Hamartoma ; Humans ; Hyperplasia ; Middle Aged ; Nevus* ; Nevus, Sebaceous of Jadassohn* ; Sebaceous Glands ; Skin

No abstract available.
Foreign Bodies* ; Foreign-Body Reaction ; Granuloma ; Granuloma, Foreign-Body* ; Squalene*

A patient with extraskeletal cervical epidural Ewing's sarcoma who presented with cervical radiculopathy is reported. A 58-year-old woman presented with right posterolateral neck pain and upper extremity radiculopathy. The computed tomography myelography showed epidural and paravertebral masses on right side, with widening of the ipsilateral neural foramina at the C2-C3 level. On magnetic resonance images, the mass was isointense to soft tissue on T1-weighted images, hyperintense on T2-weighted images, and showed diffuse enhancement on GdTA enhanced T1-weighted images. The staged, combined posterior and anterior approach were done and the tumor mass was subtotally removed. During postoperative adjuvant chemotherapy with Cytoxane, Adriamycin, Vincristine, Prednisolone regimen, the patient died of severe compression of upper cervical cord by recurrent, extended tumor mass in the spinal canal.
Chemotherapy, Adjuvant ; Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Female ; Humans ; Middle Aged ; Myelography ; Neck Pain ; Prednisolone ; Radiculopathy ; Sarcoma, Ewing* ; Spinal Canal ; Upper Extremity ; Vincristine

To determine the value of ultrasonography for the diagnosis of testicular rapture due to blunt trauma, we reviewed 69 patients of blunt scrotal trauma, which were evaluated by ultrasound before treatment. Thirty patients were managed conservatively, of which 3 cases were explored lately due to persistent pain or mass, and 39 explored immediately. Of the 30 patients treated conservatively the injury was resolved in 27. Surgical exploration of the 42 cases revealed testicular rupture in 29 and simple hematocele in 13. Analysis of the 29 cases with testicular rupture demonstrated that orchiectomy rates were 20% in early exploration and 53% in delayed exploration. in the 27 cases the testicular rupture was correctly diagnosed by ultrasonography, and there were 4 false-positive and 2 false-negative diagnoses of rupture. The specificity and sensitivity for the diagnosis of testicular rupture are 70% and 93%, and the positive and negative predictive values are 87% and 82%, respectively. Ultrasonography used in conjunction with a thorough physical examination is highly sensitive in identifying testicular rupture, and can provide objective information supporting the need for early surgical exploration in patients with blunt scrotal trauma.
Diagnosis ; Hematocele ; Humans ; Male ; Orchiectomy ; Physical Examination ; Rupture* ; Sensitivity and Specificity ; Ultrasonography*