Bowens disease is generally regarded as a premalignant dermatosis. If untreated, 3% to 5% of patients may develop squamous cell carcinoma. However, sebaciou carcinoma arising from Bowens disease is very rare. We presented a case of quarnous cell carcinoma and sebaceous circ s disease in a 68 year-old male. He had multiple bowenoid skin lesi nsties. A bean-sized nodule as developed on the bowenoid lesion of the he had a large yellow crust.ed exudative tumor on the Rt. thigh. We took a biopsy specimen of these three discrete lesions. The nu lipid stain of frozen section revealed Bowens disease, squarnous concllnoma arising from Bowen on the trunk and extremi Rt. lower abdomen. Almost of routine histology and carcinoma, and sebaceous carcinoma, respectively.
Abdomen ; Aged ; Biopsy ; Bowen's Disease ; Carcinoma, Squamous Cell* ; Frozen Sections ; Humans ; Male ; Skin ; Skin Diseases ; Thigh

No abstract available.
Child* ; Humans ; Seizures, Febrile* ; Spinal Puncture*

The persistent left superior vena cava (LSVC) is not rare cardiovascular developmental anomaly occurring both in association with congenital heart disease and as an isolated anomaly of no hemodynamic importance. We have studied 73 cases of the LSCV out of 1,060 cases of congenital heart disease catheterized at Yonsei Cardiovascular Center. We conducted the study with a view point of position of the heart and abdominal organs and segmental analysis of the underlying congenital heart disease. We also analysed the associated extracardiac vascular anomalies. The following results were obtained: 1) The incidence of this anomaly among congenital heart disease was 6.9% and 41 cases(56.2%) had cyanosis. 2) We observed 20 cases(27.3%) with the malposition of the heart and 17 cases(23.3%) with malposition of the abdominal organs. The ventricular loops revealed D-loop in 60 cases, L-loop in 7 cases and in the remaining 6 cases, it was uncertain. 3) With a view point of type of LSVC by Lucas & Krabill, type A was in 50 cases(68.5%), type D in 14 cases(19.2%), type B in 5 cases(6.8%) and type C in 4 cases(5.5%). 4) Associated cardiovascular anomalies were as follows: ventricular septal defect; 42 cases(57.5%), atrial septal defect; 33 cases(45.2%), patent ductus arteriosus; 27 cases(36.9%), and tetralogy of Fallot; 18 cases(24.7%). In conclusion, LSVC usually has no hemodynamic importance, but this cardiac anomaly is frequently combined with complex intracardiac anomalies. Therefore, it is important to making accurate diagnosis and successful management for preventing the risk of it.
Catheters ; Classification* ; Cyanosis ; Diagnosis ; Ductus Arteriosus, Patent ; Heart ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Hemodynamics ; Incidence ; Tetralogy of Fallot ; Vena Cava, Superior*

No abstract available.

The surgical management of patients whose pulmonary arteries are discontinuous from the ventricular mass depends in part on adequate visualization and quantification of the pulmonary arteries. Pulmonary vein wedge angiography has proven effective technique in demonstrating the true mediastinal(intrapericardial) pulmonary arteries(when present) when standard anterograde injections do not suffice. Pulmonary vein wedge angiography was performed in 11 patients during cardiac catheterization at Serverance Hospital Yonsei University College of Medicine between June, 1984 and December, 1985. In all the patients, venous angiography gave a more complete, clear picture of the pulmonary arteries. We feel that pulmonary venous wedge angiography often is superior to and at least complements standard angiographic methods of opacifying the pulmonary artries in patients with pulmonary atresia or occluded pulmonary arteries. We recommend it as a routine part of the evaluation of these patients.
Angiography* ; Cardiac Catheterization ; Cardiac Catheters ; Complement System Proteins ; Humans ; Pulmonary Artery* ; Pulmonary Atresia* ; Pulmonary Veins*

PURPOSE: The solid variety of cerebella r tumors in adult is relatively uncommon. This study is to describe the characteristic MR findings of various solid cerebellar tumors in adult. METHODS: Twenty three cerebellar solid tumors from 22 consecutive patients over age of 15 with surgical confirmations were retrospectively evaluated with MR imaging. H istologic diagnosis included hemangioblastoma (n=6), metastasis (n=6), high-grade astrocytoma (n=3), and medulloblastoma (n=8). The MR findings were reviewed with attention to the size, the signal intensity of the tumors, pattern of enhancement, tumoral margin, degree of peritumoral edema, signal void vascular structures within and/or around the tumor, and location in relation to attachment to the pial surface of the tumor. RESULTS: Solid hemangioblastomas consistently showed slightly low or iso signal intensity on T1 -weighted images and high intensity on T2-weighted images, dense homogeneous enhancement, and signal void vessels within and/or around the mass. Metastatic tumors showed various find ings with predominantly low or iso signal intensity on T2-weighted images. Medulloblastomas was midline and/or paramidline in location, and had larger mass formation. High-grade astrocytomas revealed nonspecific MR findings with no signal void vessels. CONCLUSION: Hemangioblastoma, metastasis, malignant astrocytoma, and medulloblastoma should be included in differential diagnosis of solid cerebellar tumors in adult. Dense homogeneous enhancement and signal void vessels are characteristic of hemangioblastoma. The signal intensity of the tumor, and presence of signal void vessels, location and enhancement pattern can be some value in differential diagnosis of solid cerebellar tumors in adult.
Adult* ; Astrocytoma ; Cerebellar Neoplasms* ; Diagnosis ; Diagnosis, Differential ; Edema ; Hemangioblastoma ; Humans ; Magnetic Resonance Imaging ; Medulloblastoma ; Neoplasm Metastasis ; Retrospective Studies

BACKGROUND: The sources of pulmonary blood flow in patients with pulmonary atresia and ventricular septal defect (PA/VSD) are very diverse, and detailed informations for the pulmonary circulation are essential for successful treatment. The purpose of this study is to examine and define the origins, distributions and characteristics of collateral circulations in patients with PA/VSD and major aortopulmonary collateral arteries (MAPCAs). METHODS: 34 patients diagnosed as PA/VSD and MAPCA were studied between May 1992 and April 1996. 85 MAPCAs were investigated for the sites of origin, distributions and characteristics by review of biplane angiograms. The characteristics of MAPCAs were examined in the aspects of anastomosis sites and sites/types of stenosis. RESULTS: 1) In 34 subjects, a total of 85 MAPCAs existed which supplied blood to 344 bronchopulmonary segments (4.1 BPS/MAPCA). 2) The origin sites of MAPCAs were the descending aorta (72%), the branch of aortic arch (16%), and the aortic arch or ascending aorta (12%). 3) The BPSs which frequently take primary blood supply from MAPCA were the 3 BPSs of upper lobe and superior / posterior basal segment of lower lobe in the right lung, and the superior / posterior basal segment of lower lobe in the left lung. 4) The BPS having apparent dual blood supply was 13.4% and the most frequent was the superior and posterior basal segment of the right lower lobe. 5) In total, 64% of MAPCA had anastomosis, and anastomosis in the lobar pulmonary artery was 48% to be the most frequent. 6) Stenosis was observed in 61% of MAPCAs. The site of stenosis was midportion (33%), originating portion (27%), multiple (26%), peripheral (14%), and the type of stenosis was focal (53%), segmental (31%), diffuse (16%), in the order of frequency. CONCLUSION: In PA/VSD and MAPCA, selective angiogram should be performed in all the different blood-supplying sources of the lung for detailed information of the pulmonary circulation. When the blood sources of the pulmonary circulation is uncertain, elaborated efforts to find the blood sources, by angiograms in the frequent locations of MAPCA, are neccessary. We believe this study to be useful for precise planning in the diagnosis and treatment of PA/VSD and MAPCA.
Angiography ; Aorta ; Aorta, Thoracic ; Arteries ; Collateral Circulation* ; Constriction, Pathologic ; Diagnosis ; Heart Septal Defects, Ventricular* ; Humans ; Lung ; Pulmonary Artery ; Pulmonary Atresia* ; Pulmonary Circulation

PURPOSE: Functional MR imaging is the method of demonstrating changes in regional cerebral blood flow produced by sensory, motor, and any other tasks. Functional MR of visual cortex os performed as a patient stares a photic stimulation, so adaptable photic stimulation is necessary. The purpose of this study to evaluate whether the size of photic stimulation can affect the degree of visual cortex activation. MATERIALS AND METHODS: Functional MR imaging was performed in 5 volunteers with normal visual acuity. Photic stimulator was made by 39 light-emitting diodes on a plate ,operating at 8 Hz. The sizes of photic stimulator were full field, half field and focal central field. The MR imager was Siemens 1.5-T Magenton Vision system, using standard head coil. Functional MRI utilized EPI sequence (TR/TE=1.0/51. 0msec, matrix No.=98x128, slice thickness=8mm) with 3sets of 6 imaging during stimulation and 6 imaging during stimulation and 6 imaging during rest, all 36 scanning were obtained. Activated images were obtained using postprocessing software(statistical analysis by Z-zone, and these images were combined with T-1 weighted anatomical images. The activated signals were quantified by numbering the activated pixels, and activation index was obtained by dividing the pixel number of each stimulator size with the sum of the pixel number of 3 study using 3 kinds of stimulators. The correlation between the activation index and the stimulation size was analysed. RESULTS: Mean increase of signal intensities on the activation area using full field photic stimulator was about 9.6%. The activation index was greatest on full field. second on half field and smallest in focal central field in 4, The index of half field was greater than that of full field in 1. The ranges of activation index were full field 43-73%(mean 55%), half field 22-40%(mean 32%), and focal central field 5-24%(13%). CONCLUSION: The degree of visual cortex activation increases with the size of photic stimulator.
Head ; Humans ; Magnetic Resonance Imaging* ; Photic Stimulation ; Visual Acuity ; Visual Cortex* ; Volunteers

Malignant histiocytosis is a rare, usually fatal malignant neoplasm of reticuloendothelial systems. The disease is associated with fever, malaise, weight loss, hepatosplenomegaly, lymphadenopathy, pancytopenia, jaundice, and purpura. A 44-year-old female patient is described who had multiple, purple crusted nodules and plaques in the skin. In the laboratory study, pancytopenia was noted on the peripheral blood. In addition many atypical histiocytes were seen on the bone marrow aspiration. A lesional biopsy showed nodular infiltrations of atypical histiocytes in the dermis and some erythrophagocytosis was seen. Immunohistochemically, the histiocytes were weakly stained for lysozyme and α-l-antichymotrypsin, but were unstained for S-100 protein, cytokeratin, CEA(carcinoembryonic antigen), pan T/B marker CD30(ki-1), UCHL-1 LCA(leukocyte common antigen), and α-l-antitrypsin.
Adult ; Biopsy ; Bone Marrow ; Dermis ; Female ; Fever ; Histiocytes ; Histiocytic Sarcoma* ; Humans ; Jaundice ; Keratins ; Lymphatic Diseases ; Mononuclear Phagocyte System ; Muramidase ; Pancytopenia ; Purpura ; S100 Proteins ; Skin ; Weight Loss

Nine-month-old female infant was seen with a 7-month history of a nodule on the right temporal scalp, which had gradually increased in size. Stroking of the lesion resulted in urtication and blistering and there were no other cutaneous lesions. The histology showed subepidermal bulla formation and a dense infiltration of mast cells in the papillary and reticular dermis. We present an infant with solitary mastocytoma on the scalp, a rare site.
Blister ; Dermis ; Female ; Humans ; Infant ; Mast Cells ; Mastocytoma* ; Scalp* ; Stroke