No abstract available.
Bowen's Disease ; Fingers

No abstract available.
Thorax* ; Tomography, X-Ray Computed*

No abstract available.
Dermatitis, Allergic Contact

PURPOSE: The purpose of this study is to compare CO2 DSA and nonionic contrast media angiography in respect to the quality of the opacification of collaterals and incidence of side-effects in peripheral occlusive arterial disease. MATERIALS AND METHODS: Sixteen patients who were suspected to have peripheral occlusive arterial disease were performed angiography with nonionic contrast media and CO2 at the same location with the same catheter. The causes of the lesions were atherosclerosis(n=7) and Buerger's disease(n:9). CO2 DSA was compared with nonionic contrast media angiography in respect to the quality of image in the diagnosis of the lesions, opacifications of collaterals and side-effects. RESULTS: In atherosclerosis;quality of the images of CO2 DSA was same as that of nonionic contrast media angiography in 6 patients and was poor in 1 patient;opacifications of collaterals of CO2 DSA were same as that of nonionic contrast media angiography in 5 patients and was poor in 2 patients. In Buerger's disease;quality of the images of CO2 DSA was same as that of nonionic contrast media angiography in 2 patients and was poor in 7 patients;opacifications of collaterals of CO2 DSA were same as that of nonionic contrast media angiography in 1 patient and was poor in 8 patients. Leg pain was the only side-effect after CO2 injection occuring in 4 out of 16 patients. CONCLUSION: CO2 could be used as safe contrast media in patient with risk factors for nonionic contrast media and for diagnosis of the atherosclerosis in lower extremity. For the procedures such as vascular intervention reguiring large amount of contrast media CO2 could effectively replace nonionic contrast media.
Angiography* ; Atherosclerosis ; Catheters ; Contrast Media ; Diagnosis ; Humans ; Incidence ; Leg ; Lower Extremity* ; Risk Factors

No abstract available.
Child* ; Esophageal and Gastric Varices* ; Humans ; Hypertension, Portal* ; Portal Vein*

Unilateral absence of a pulmonary artery is an uncommon anomaly, which presents as an isolated lesion or in combination with other congenital heart disease such as TOF or PD^. We encountered three cases of isolated unilateral absence of a pulmonary artery;one was left pulmonary artery agenesis with right sided aortic arch and the others were right pulmonary artery agenesis with left sided aortic arch. Plain chest radiograph showed considerable loss of unilateal lung volume and lack of ipsilateral hilar shadow. Pulmonary angiogram which was done in two cases, revealed proximal interruption of a pulmonary artery. Chest CT was done in only one case, on which right pulmonary artery was absent and was replaced by adipose tissue. CT with its clean demonstration pulmonary artery without any evidence of aquired obstruction of a pulmonary artery by pulmonary embolism or tumor invasion, maybe a valuable method for evaluaton of the unilateral absence of a pulmonary artery.
Adipose Tissue ; Aorta, Thoracic ; Heart Defects, Congenital ; Lung ; Pulmonary Artery* ; Pulmonary Embolism ; Radiography, Thoracic ; Tomography, X-Ray Computed

Hepatoblastoma usually occurs in children under the age of 2 years, with very few cases reported in adults. We experienced a case of adult hepatoblastoma in a 36-year-old female with chronic hepatitis B . She had experienced sudden onset abdominal pain. Her serum alpha-fetoprotein level was markedly elevated, and abdominal CT showed a 9-cm mass with internal hemorrhage in the right hepatic lobe with hemoperitoneum, so an emergency hepatic central bisectionectomy was performed. The initial histologic examination revealed that the mass mimicked combined hepatocellular carcinoma and cholangiocarcinoma with spindle-cell metaplasia of the cholangiocarcinoma element. Follow-up abdominal CT performed 3 months later showed a 5.5-cm metastatic mass in the left subphrenic area. Laparoscopic splenectomy with mass excision was performed, and hepatoblastoma was confirmed histologically. A histologic re-examination of previously obtained surgical specimens also confirmed the presence of hepatoblastoma. Metastatic hepatoblastoma was found at multiple sites of the abdomen during follow-up, and so chemotherapy with cisplatin, 5-fluorouracil (5-FU), and vincristine was applied, followed by carboplatin and doxorubicin . Despite surgery and postoperative chemotherapy, she died 12 months after symptom onset.
Adult ; Carcinoma, Hepatocellular/pathology ; Cholangiocarcinoma/pathology ; Cisplatin/therapeutic use ; Diagnostic Errors ; Doxorubicin/therapeutic use ; Drug Therapy, Combination ; Female ; Fluorouracil/therapeutic use ; Hepatitis B, Chronic/complications/diagnosis ; Hepatoblastoma/drug therapy/*pathology/radiography ; Humans ; Liver Neoplasms/drug therapy/*pathology/radiography ; Tomography, X-Ray Computed ; Vincristine/therapeutic use

The sensitivity and specificity of ST segment change on ECG for detection of coronary artery disease(CAD) by pacing stress test were assessed. Among 28 cases with chest pain(mean age 52, M/F : 21/7), 10 patients had normal coronary angiographic finding(Group I), and 18 had coronary artery disease(Group II). Pacing stress test showed high specificity(100%), but low sensitivity(61%) for the diagnosis of CAD. Especially in patients with 1 vessel disease, the sensitivity was only 50%, and positive results were not attained unless there was at least 90% or more stenosis in any of the major branches(LAD, RCA or LCX). But in patients with multivessel disease, the sensitivity was much higher(83%). Lateral(V4-6) or inferior leads(2, 3, aVF) showed ischemic ST segment depression most commonly. Therefore one of the inferior lead and V5 may be a minimum requirement for monitoring pacing-induced ST segment changes. Time constant during isovolumic relaxation showed statistically significant prolongation after pacing only in CAD patient group, suggesting pacing-induced impairment of early left ventricular relaxation.
Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Depression ; Diagnosis* ; Electrocardiography ; Exercise Test ; Humans ; Relaxation ; Sensitivity and Specificity ; Thorax

Acral metastasis to the finger is a very rare phenomenon. We report herein a case of cutaneous acrometastasis to the right 5th finger tip in a 36-year-old woman with metastatic breast cancer. The patient underwent a right modified radical mastectomy for T3N3 invasive ductal carcinoma and received adjuvant chemotherapy and radiotherapy. After 2 years, she developed metastasis to the brain, bones, and lungs. She was found to have a growing tender mass on the tip of right 5th finger. A well-demarcated, soft tissue mass was identified on sonography. Under the clinical impression of a possible benign process, the nodule was surgically removed. The pathologic finding was consistent with metastatic breast cancer. Immunohistochemical staining for estrogen receptor, progesterone receptor, and HER2 were all negative, as in the primary tumor. Radiation was given to the finger tip and systemic chemotherapy with capecitabine was tried for systemic metastatic disease.
Adult ; Brain ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Chemotherapy, Adjuvant ; Deoxycytidine ; Estrogens ; Female ; Fingers ; Fluorouracil ; Humans ; Lung ; Mastectomy, Modified Radical ; Neoplasm Metastasis ; Receptors, Progesterone ; Capecitabine

Gynecomastia is the most common condition affecting the male breast due to enlargement of both ductal and stromal tissue. Growth of the male breast can be manifested at any age, but 40% of cases present in adolescent boys. The condition depends mainly on the balance between serum estrogens and androgens. Gynecomastia represents a source of embarrassment, and optimal correction is difficult to achieve. Numerous methods of gynecomastia repair are available. Our method is a combination of liposuction and the pull-through technique. The purpose of this treatment is to resect excess tissue and restore the normal chest contour with minimal scarring. We report a case of gynecomastia treated with a combination of tumescent liposuction and the pull-through technique.
Adolescent ; Androgens ; Breast ; Cicatrix ; Estrogens ; Gynecomastia ; Humans ; Lipectomy ; Male ; Thorax