No abstract available.

No abstract available.
Adult* ; Humans ; Life Style*

Carcinoma of the breast can produce cutaneous metastases which sbow highly diversified clinical pictures. The cutaneous metastases produce four definite clinical types: inflammatory carcinoma, telangiectatic carcinoma, nodular carcinoma, and carcinoma, en cuirasse. We present a case of 78-year-old nulliparous woman who had several painful dark purplish colored zosteriform papulovesicular eruptions, suggestive of herpes zoster, on the right breast, right axilla, scapular area, and upper arm for three month. Two month later, well dermacated linearly arranged erysipeloid eruptions appeared around the previous skin lesions and the right chest wall. Histopathological findings showed metastatic ductal carcinoma with massive vascular permeation but the primary focus was undetermined.
Female ; Humans ; Neoplasm Metastasis

Although extrahepatic metastasis of hepatocellular carcinoma are frequent as about 64%, implants involving the peritoneum are rare. We presented a cases, whieh is hepatocellular carcinoma with metastasis to visceral peritoneum revealing multiple, hard, variable-sized and nodular mass including large mass over 10 cm in size. The presence of tumor was diagnosed by serum alpha fetoprotein, abdaminal CT, celiac and SMA angiography and biopsy with laparoscopy.
alpha-Fetoproteins ; Angiography ; Biopsy ; Carcinoma, Hepatocellular* ; Laparoscopy ; Neoplasm Metastasis* ; Peritoneum

Cardioplegic myocardial protection has become the most popular method for coronary artery bypass surgery. In contrast, we reported 17 consecutive coronary artery bypass operations with ventricular fibrilation, nitroglycerine infusion, and moderate hypothermia. The average patients age was 55 years. 11 patients had stable angina, 4 patients unstable angina, 2 patients varient angina, and 6 patients had prior myocardial infarcation. On cardiac catheterization, the mean LVEDP was 17.32+/-2.13mmHg, EF was 0.67, and abnormal LV wall motion was noted in 5 patients. Premedication usually consisted of hydroxyzine 1~3mg/kg with or without morphine 0.05~0.1mg/kg IM. Induction agents was morphine sulfate, diazepam, lidocaine and pancuronium for muscle relaxant. Maintaninance agents were nitrous oxide, morphine with small dose of halothane or enflurane. Almost all case (15 patient) was infused nitroglycerine 0.5~1.5 microg/kg throughout entire procedure. After bypass, average patient's temperature maintained 25~28 degrees C, and ventricular fibrillation were induced with or without cold saline irrigation around the heart. Average mean arterial pressure were maintained 60~80 mmHg during bypass period. At the end of bypass, if spontaneous beating were not occurred under normal temperature, defibrillation were used. After bypass stop, methylprednisolone were injected in 15 patients. Average anesthetic time was 585 min., surgery time was 529 min, bypass time was 237 min. Arterial blood gas and electrolyte was acceptable range during all period. Complication implicated with anesthesia was myocardial infarction (3 patient), arrhythmia and transient vocal cord paralysis, 1 patient, respectively and no mortality. In all cases the anginal pain was improved.
Anesthesia ; Angina, Stable ; Angina, Unstable ; Arrhythmias, Cardiac ; Arterial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Artery Bypass* ; Coronary Vessels* ; Diazepam ; Enflurane ; Halothane ; Heart ; Humans ; Hydroxyzine ; Hypothermia ; Lidocaine ; Methylprednisolone ; Morphine ; Mortality ; Myocardial Infarction ; Nitroglycerin* ; Nitrous Oxide ; Pancuronium ; Premedication ; Ventricular Fibrillation* ; Vocal Cord Paralysis

The lung and stomach are very unusual sites for teratoma. The histologic findings of intrapulmonary and gastric teratomas are not different from those arising in usual sites, such as the ovary or testis. However, preoperative diagnosis is sometimes difficult to make partly because of unusual location. We report here two cases of teratoma, one intrapulmonary teratoma and the other gastric. The intrapulmonary teratoma in our study had an endobronchial tumor growth, which rules out mediastinal teratoma. Meanwhile gastric teratomas usually present as a submucosal tumor and most cases are reported in infancy and childhood. Gastric teratoma in this study occurred in a 27-year-old man. To the best of our knowledge, this case of intrapulmonary teratoma is the eighth and the gastric teratoma is the first to be reported in Korea.
Adult ; Case Report ; Gastrectomy ; Human ; Lung Neoplasms/surgery ; Lung Neoplasms/radiography ; Lung Neoplasms/pathology* ; Male ; Middle Age ; Stomach Neoplasms/surgery ; Stomach Neoplasms/radiography ; Stomach Neoplasms/pathology* ; Teratoma/surgery ; Teratoma/radiography ; Teratoma/pathology* ; Tomography, X-Ray Computed

Early and longterm prognosis depended on the extents of acute myocardial infarction and residual myocardial function. Many clinical methods have been evaluated to determine their ability to estimate the size of myocardial infarcts. But because of many disadvantages simplified QRS scoring system, used with standard 12-lead EKG, was developed, which is noninvasive, inexpensive and easily releatible. Therefore, the correlation between QRS and peak CK,killip classification were evaluated in 55 patients with initial acute myocardial infarction at the Chung-Ang University, Yong-San and Pil-Dong Hospital during the period from January 1983 to December, 1986. The results were as follows : 1) The average QRS score of the anterior wall infarction is 7.1 and that of the inferior wall infarction is 4.5 and there is a statistical significance(p<0.01). 2) In the acute myocardial infarction, the correlation coefficeient between the QRS score and the killip classification is 0.66(p<0.05). 3) In the acute myocardial infarction, the average QRS score is 6.3 and the correlation coefficient between the leak CK and the QRS score is 0.52(p<0.05). 4) In the anterior wall infarction, the average QRS score is 7.1 and the correlation coefficient between the peak Ck and QRS score is 0.48(p<0.05). 5) In the inferior wall infarction, the average QRS score is a 4.5 and the correlation coefficient between the leak CK and QRS score is 0.79(p<0.05).
Classification ; Electrocardiography ; Humans ; Infarction ; Myocardial Infarction* ; Prognosis

A 37-year-old woman was admitted for chief complaints about primary amenorrhea and multiple bone pains. She was raised phenotypically female but her chromosomal study was no-rmal male karyotype(46 XY). On pelvic examination, she showed relatively normal female ex-ternal genitalia except short blind-ending vagina. There were also no uterus and tubes in operation field. Even though rare disorder, she was diagnosed male pseudohermaphroditism due to 17-beta -hydroxysteroid dehydrogenase deficiency. This disorder is the most common enzyme defect in biosynthesis of testosterone and involves the last step. The serum level of sex steroid: test osterone, estradiol were decreased and FSH, LH were increased. Androstenedione was increased and we could obtain that Androstenedione / Testosterone ratio was increased. Because of 17-beta-HSD deficiency, estrogen was not converted to estradiol, and so estradiol was markedly decreased. Same as above, we experienced a case of male pseudohermaphroditism due to 17-beta-hydroxysteroid dehydrogenase deficiency with multiple osteoporosis. So we report this case with a brief review of literatures.
46, XY Disorders of Sex Development ; Adult ; Amenorrhea ; Androstenedione ; Estradiol ; Estrogens ; Female ; Genitalia ; Gynecological Examination ; Humans ; Male ; Osteoporosis* ; Oxidoreductases* ; Testosterone ; Uterus ; Vagina

Abdominal pregnancies are classified as primary and secondary. The incidence varies from one in 372 to one in 9714 live birth. When this occurs, perinatal morbidity and mort-ality are high, usually as a result of growth restriction and congenital anomalies such as fetal pulmonary hypoplasia, pressure deformities, facial and limb asymmetry. Omental pregnancy is an extremely rare form of abdominal pregnancy that may cause life-threatening massive hemorrhage in case of rupture. A case of this rare entity is prese- nted after dilatation and curettage in which gestational tissue was found to arise from the edge of greater omentum, requiring partial omentectomy. The diagnosis of omental pregnancy is hardly ever made prior to laparotomy. This case of omental pregnancy, believed to be secondary, was recently experienced and it is reported here with a brief review of the literature.
Congenital Abnormalities ; Diagnosis ; Dilatation and Curettage* ; Dilatation* ; Extremities ; Female ; Hemorrhage ; Incidence ; Laparotomy ; Live Birth ; Omentum ; Pregnancy* ; Pregnancy, Abdominal ; Rupture

Essential thrombocythemia is a kind of myeloproliferative disorder characterized by primary elevation in the number of platelet and by multiple episodes of bleeding or thrombotic complications. Rarely, thrombocythemia itself causes coronary arterial occlusion and leads to ischemic heart disease. Fewer than twenty cases of coronary artery occlusive disease in thrombocythemia have been reported since Cheitlin et al had included thrombocythemia in their review of rare causes of myocardial infarction. We experienced a case of coronary artery disease in a 53-year-old woman with thrombocythemia, who had not coronary artery disese risk factors at all. Presence of multiple thrombus in the coronary artery was suggested in coronary angiography.
Angina, Unstable* ; Blood Platelets ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Female ; Hemorrhage ; Humans ; Middle Aged ; Myeloproliferative Disorders ; Myocardial Infarction* ; Myocardial Ischemia ; Risk Factors ; Thrombocythemia, Essential ; Thrombocytosis* ; Thrombosis