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

PURPOSE: To evaluate the usefulness, patterns and appearances of false positive lesions, and technical problems of CTAP(CT Arterioportography). MATERIALS AND METHODS: CTAP was done in 45 patients in whom hepatic lesions were suggested on other radiologic studies. CTAP findings were compared with the informations obtained by operations, biopsies, and follow-up imagings. Additional findings, which were not detected in other radiologic studies, false positive manifestations, and technical errors were analyzed. RESULTS: CTAP detected 51 additional hepatic lesions which are not detected in other imaging studies. Of the 51 lesions, ten were true positive hepatic tumors, 2 were inflammatory lesions and 39 were false positive .lesions. False positive lesions included perfusion defects of periportal and perifissural areas, subcapsular perfusion defects and nonlobar, nonsegmental geographic perfusion defects. In 2 cases, CTAP aided in deciding the surgical strategy. On the other hand, there were 4 cases causing interpretational confusion and 6 cases of improper imaging due to technical errors. CONCLUSION: CTAP was valuable in detection of additional hepatic cancer lesion as well as in making the treatment plan. However, since many false positive lesions and improper imaging due to technical error occur during the examination, the understanding of such problems is essential for correct interpretation of CTAP.
Biopsy ; Follow-Up Studies ; Hand ; Humans ; Liver Neoplasms ; Perfusion

We report a case of rosacea in a 65 year old female with a 14 year history of polycythemia vera. The patient suffered from several constitutional symptoms and signs suggestive of polycythemia vera. Six years prior to our initial examination, erythematous lesions were first noted on the center of the face. These lesions exhibited periodic improvement and exacerbation without specific treatment. Histopathologic examination of the facial lesions showed nodular infiltration of lymphocytes and histiocytes and dilation of blood vessels. On the basis of laboratory examination, the patient was diagnosed as polycythemia vera. The patient has received metronidazole, tetracycline, and topical steroids to control rosacea-like facial lesions. The treatment results were not significant. However, phlebotomy markedly improved the skin lesion. To our knowledge, there are no reports describing the clinical course of rosacea lesions following the treatment with phlebotomy.
Blood Vessels ; Female ; Histiocytes ; Humans ; Lymphocytes ; Metronidazole ; Phlebotomy ; Polycythemia Vera* ; Polycythemia* ; Rosacea* ; Skin ; Steroids ; Tetracycline

No abstract available.
Endometriosis* ; Female

Churg and Strauss established the clinicopathologic features of allergic angiitis and granulomatosis. The condition is rare and is characterized by involvement of vessels of all sizes(including veins and venules), especially the pulmonary vessel. intra- and extravascular granuloma formation, eosinophil infiltration of tissue and an association with asthma and peripheral eosinophilia. Churg Strauss syndrome (CSS) involves the GI tract, the skin, the heart, the lungs etc. We report a case of CSS in 38 year old male patient, who presented acute peritonitis and who had had 4-year history of bronchial asthma. An emergency laparotomy revealed multiple impending perforations in small intestine. A skin lesion and neuropathy developed postoperatively. Microscopic exammination of the appendix and the skin lesion showed thrombs in the lumens of vessels, vasculitis and eosinophilic infiltration to the lesion and the vessel wall.
Adult ; Appendix ; Asthma ; Churg-Strauss Syndrome* ; Emergencies ; Eosinophilia ; Eosinophils ; Gastrointestinal Tract ; Granuloma ; Heart ; Humans ; Intestine, Small ; Laparotomy ; Lung ; Male ; Peritonitis ; Skin ; Vasculitis ; Veins

Churg and Strauss established the clinicopathologic features of allergic angiitis and granulomatosis. The condition is rare and is characterized by involvement of vessels of all sizes(including veins and venules), especially the pulmonary vessel. intra- and extravascular granuloma formation, eosinophil infiltration of tissue and an association with asthma and peripheral eosinophilia. Churg Strauss syndrome (CSS) involves the GI tract, the skin, the heart, the lungs etc. We report a case of CSS in 38 year old male patient, who presented acute peritonitis and who had had 4-year history of bronchial asthma. An emergency laparotomy revealed multiple impending perforations in small intestine. A skin lesion and neuropathy developed postoperatively. Microscopic exammination of the appendix and the skin lesion showed thrombs in the lumens of vessels, vasculitis and eosinophilic infiltration to the lesion and the vessel wall.
Adult ; Appendix ; Asthma ; Churg-Strauss Syndrome* ; Emergencies ; Eosinophilia ; Eosinophils ; Gastrointestinal Tract ; Granuloma ; Heart ; Humans ; Intestine, Small ; Laparotomy ; Lung ; Male ; Peritonitis ; Skin ; Vasculitis ; Veins

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

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

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*