The superior vena cava syndrome can occur when an extrnsc compression or intralurninal occlusion impedes blocxl flow through this vessel. We report a case of superior vena cava syndrome with tirc nbophlebitis on the right forearm in 57 year old male patient who used steroids (p.o) for 25 years.
Forearm ; Humans ; Male ; Middle Aged ; Steroids ; Superior Vena Cava Syndrome* ; Vena Cava, Superior*

To assess the pattern of psychiatric symptoms and to evaluate the relationship between exposure related variables(duration of work and urinary hippuric acid concenturation) and psychiatric symptoms in organic solvent exposed workers, case control study of forty-two solvent exposed workers and ninety-six non-exposed workers was conducted. The general health questionnaire 28(GHQ28) was administered to evaluate psychiatric symptoms and urinary hippuric acid concenturations was measured to estimate the present status of solvent exposure in exposed group and to estimate normal level in non-exposed group. The meand concenturation of urinary hippuric acid was significantly higher in exposed group (2.953g/creatinine g) than non-exposed group (0.395g/creatinine g) (P<0.01). The total positive rates of symptoms were significantly higher in exposed group(28.2%) than non-exposed group(17.5%) (P<0.05). The positive rates of symptoms for four sub-scales of GHQ 28 in exposed group were in the order of somatic symptoms, anxiety, social dysfunction, depression and in the order of social dysfunction, anxiety, depression, somatic symptoms in non-exposed group.The positive rates of symptoms for somatic symptoms and anxiety were significantly higher in exposed group than non-exposed group (P<0.05) and the proportion of workers with six or more positive symptoms(dysthymic states) in exposed group were significantly higher than non-exposed group (P<0.01). After the effect of age, sex, level of income, level of education, and duration of work were controlled, the total score of GHQ28 was still significantly different between exposed and non-exposed group(P<0.01). In multiple logistic regression analysis on the dysthymic state, the odds ratio of level of income was statistically significant in both group. The odds ratios of exposure related variables such as duration of work and hippuric acid concenturations were not statistically significant but there was a tendency that exposure related variables had an effect on dysthymic state in exposed group.In future, comtinuous evaluation of psychiatric symptoms on organic solvent exposed workers and studies to detect the factors that affect on psychiatric symptoms are required.
Anxiety ; Case-Control Studies ; Depression ; Education ; Logistic Models ; Odds Ratio ; Surveys and Questionnaires ; Solvents* ; Toluene

There has been few papers regarding the pathologic changes of kidney induced by contrast media, especially in terms of iodine concentration or osmolarity. In order to evaluate histopathologic changes, a series of rat kidneys, after injection of iodinated contrast media, were examined. A total of 220 rats were divided into two groups: those given Urografin-60% by 6.3 ml/Kg(1840mg/6.3ml):those given Urografin-76% by 5ml/Kg(1850mg/5ml). (the same amount of iodine but at different iodine concentration). The kidneys were removed and microscopically examined on 1, 2, 3, 5, 7, 10th days, 2nd, 3rd, 4th, 6th and 12th weeks after injection of contrast media, respectively. The results were as follows: Renal pathologic changes induced by contrast media were congestion and ectatic change of the interstitial vessels, epithelial degeneration and necrosis of the collectiong ducts. Congestion of interstitial vessels and epithelial degeneration and necrosis of the collecting ducts were severe in the higher iodine concentration Urografin-76% group(2100 Osm/Kg H2O) than the Urografin-60% group(1500 Osm/Kg H2O). And above pathological changes persisted for 12weeks without significant interval changes. The authors conclude that the renal damage induced by ionic contrast media becomes more severe in higher concentrations or osmolarities in spite of the same amount of iodine and that the pathologic changes persisted until 12 weeks without improvement.
Animals ; Contrast Media ; Diatrizoate* ; Estrogens, Conjugated (USP) ; Iodine ; Kidney ; Necrosis ; Osmolar Concentration* ; Rats*

BACKGROUND: Pilomatricoma(Benign calcifying epithelioma of Malherbe) is a uncommon benign tumor with differentiation toward hair cortex cells. It commonly manifests itself as a firm, deep seated nodule with normal Overlying skin, However, anetodermic cutaneous changes have also been described in the literature since 1943. Although the authors hypothesized this phenomenon as a chronic mechanical irritation or a step of transepidermal elimination of the tumoral mass, distinctive elucidation of pathomechanism of it remained. OBJECTIVE: The purpose of this study was to characterize the clinical and histopathologic features of 25 cases with pilomatricoma and to elucidate pathomechanism of the anetodermic cutaneous changes through the comparison of the anetodermic pattern of overlying skin with the changes of the tumoral mass or collagen and elastic fibers in the dermis. METHODS: Twenty-five cases with pilomatricoa have been collected at Chunganam National University Hospital and Kongju Medical Center during 15 years and 5 years, respectively, And we studied the clinical and histopathological characteristics of patients and tried to reveal the relationship between the cutaneous manifestations and the histologic changes through the test for independence. RESULTS: 1. In the age distribution, the patients lesser than 30 years old was 23 cases(92%). The mean age was 18.9 years old. The ratio of males to females was 1 : 2.6. 2. The duration of lesions was from 2 months to 7 years, with the mean duration of 11 months. The predilection sites were arm(40%), face(28%), neck(12%), shoulder(8%), scalp(4%) and back(4%) in order. All lesions were hard in consistency, and were from bean to walnut sized. Clinically, 10 cases (40%) showed reddish discoloration and/or anetodermic cutaneous changes. 3. Histopathologically, the typical patterns of pilomatricoma were commonly located at the dermis (23 cases) and consisted of the shadow cells predominantly(21 cases). Calcium deposits(21 cases, 84%) were noted within the shadow cells. Eight cases(32%) had the tumoral maese demarcated with fibrous capsules, and the foreign body reaction with giant cells and chronic mononuclear cell infiltrations around the shadow cells ruptured the fibrous capsules in 17 cases(68%). 4. When we compared the relationship between the inflammatory cell infiltrations around the tumoral mass and the changes of dermal collagen and elastic fibers, we observed that the changes of dermal fibers and foreign body reaction and mononuolear cell infiltrations were statistically co-related. When compared the cutaneous changes with the inflammatory cell infiltrations of the tumoral masses, we could also reveal that the anetodermic cutaneous changes of the overlying skin might be influenced by the foreign body reactions with chronic mononulcer cell. Based on the status of foreing body reaction, the average of onset was inversely proportional to the average of age. CONCLUSION: Pilomatricomas are slowly growing, firm, deep seated benign tumor which occurs commonly on the arm, face and neck. However, they often showed the anetodermic changes on the overlying skin. Anetodermic cutaneous changes or discoloration may be correlated with the degree of foreign body reactions without the evidences of transepidermal elimination histopathologically.
Adult ; Age Distribution ; Arm ; Calcium ; Capsules ; Carcinoma ; Chungcheongnam-do ; Collagen ; Dermis ; Elastic Tissue ; Female ; Foreign Bodies ; Foreign-Body Reaction ; Giant Cells ; Hair ; Humans ; Juglans ; Male ; Neck ; Pilomatrixoma* ; Skin

No abstract available.
Occupational Health*

PURPOSE: Defecography is a technique of examining the rectum and anal canal by using fluoroscopy during defecation. This study was done to determine the range of normal findings of defecography in young asymptomatic Korean volunteers. MATERIALS AND METHODS: Twenty-nine asymptomatic young volunteers underwent defecography. Anorectal angle, perineal descent, length and width of anal, rectocele, rectal intussusception and incontience were evaluated. RESULTS: The range of anorectal angle was 82 degrees-149 degrees in resting state, compared to the 63 degrees -116 degrees in squeezing state, and 95 degrees -116 degrees in straining state respectively. The pelvic floor in straining state descended on average of 1.62cm from the inferior margin of ischial tuberosity that its broad range of position from --5.2cm to 0.8 cm implies a wide variation of anorectal angle and periheal descent. Mild degree of rectocele with less than 2cm of depth was found in 12 out of 29 cases. Rectal intussusception was noted in six and rectal incontinence was seen in one case. Formation of rectocele and intussusception during defecation was common in asymptomatic young volunteers. CONCLUSION: The wide range of defecographic measurements warrants the necessity of other complementary studies on anorectal function to improve the diagnostic accuracy. The interpretation of defecographic measurement should therefore be made with caution and should not be used as the sole criteria for seliction of treatment modality.
Anal Canal ; Defecation ; Defecography ; Fluoroscopy ; Intussusception ; Pelvic Floor ; Rectocele ; Rectum ; Volunteers*

We present a case of generalized grannuloma annulare with perforating and subcutaneous forms which occurred in a 15-year-old girl. Two years ago, multiple umbilicated, match head to pea sized, erythematous papules were noted on the upper extremities. Then the patient also experienced crusted or ulcerated erythematous papular lesions on the lower legs. Recently, tender, subcutaneous nodules appeared on both soles. The biopsy specimens from the skin lesions of the hand and the sole showed typical findings of granuloma annulare in the dermis and the subcutis, respectively. On the histopathological examination of the calf lesion, palisading granuloma as well as transepidermally eliminating dermal collagenous and necrotic material were seen. The skin lesions were almost completely improved by treatment with dapsone, 100mg a day, for 8 weeks orally.
Adolescent ; Biopsy ; Collagen ; Dapsone ; Dermis ; Female ; Granuloma Annulare* ; Granuloma* ; Hand ; Head ; Humans ; Leg ; Peas ; Skin ; Ulcer ; Upper Extremity

Infantile digital fibromatoais is a rare benign tumor on fingers and toes of infants and childhood characterized by fibroblaatic proliferation. A 6 months old male infant had a bean sized, flesh nodule on th left 3rd finger. The lesion was noted at 3 days after birth and surgically removed at 7 months old, However, a new lesion developed at the margin of the ald lesion 2 months later. The second patient was a 21 months old female who had two bean sized, flesh nodules on the right 4th snd 5th fingers. The lesion was first noted at 12 months and regressed spontaneously at 30 months without specific interventiona. Histopathological examination of the two cases showed eosinophiric ntracytoplasmic inclusion bodies, charateristic for infantile digital fibromatosis.
Female ; Fibroma* ; Fingers ; Humans ; Inclusion Bodies ; Infant ; Male ; Parturition ; Recurrence ; Toes

No abstract available.
Pylorus*

Differential surgical procedures have been described on the treatment of patients with obstructing carcinoma of the left colon and rectum, and these vary from classical three stage approach to primary resection and anastomosis using intraoperative colonic irrigation or subtotal colectomy. Staged colonic prcedures are associated with significant morbidity and mortality eventhough its initial easy performance, and many patients, unfit for further surgery, are left with a permanent colostomy. We have already reported the initial results of intraoperative antegrade colonic irrigation for one-stage operation in obstructing left colorectal cancers. In this investigation, we evaluated the results of prospective trials of primary resection and anastomosis using intraoperative colon irrigation and subtotal colectomy in obstructing left colon and rectal carcinomas. During recent five years, 19 cases of obstructing left colon and rectal carcinomas which could not received regular colon preparation due to marked abdominal distension were enrolled to this study. There were 12 men and 7 women, and mean age was 61. 14 of the 19 patients which tumors located below mid-descending colon were subjected to primary resection and anastomosis using intraoperative antegrade colonic irrigation, 4 patients which tumors located above the mid-descending colon were treated with subtotal colectomy, and remaining one patient which tumor located upper rectum was performed subtotal coloectomy because of underlying colonic ischemia. There was no mortality and significant postoperative complications such as anastomotic lealrage, pelvic abscess or intraabdominal sepsis which seemed to be related with anastomotic dehiscence. Therefore, primary resection and anastomosis using intraoperative colonic irrigation or subtotal colectomy depending on tumor locations in cases of obstructing left colon and rectal carcinomas might be useful methods to obtain safe one-stage restorative colorectal resections.
Abscess ; Colectomy ; Colon* ; Colorectal Neoplasms ; Colostomy ; Female ; Humans ; Intestinal Obstruction ; Ischemia ; Male ; Mortality ; Postoperative Complications ; Prospective Studies ; Rectum ; Sepsis