Clear cell hidradenoma is a much less common primary cutaneous tumor originated from sweat gland. Clinically this tumor occurs more frequently in female than in male and in patients of any age although there is a predilection for the middle and older age groups. The lesion is solitary and represents a cutaneous nodular and cystic mass of slow expansible growth. By light microscopy the lesion has been characterized as a solid cataneous tumor composed of clear epithelial cells which are focally arranged in glandular and cystic patterns. We observed a 37-year-old housewife who had suffered from a tumor on her back for 3 years. The tumor was a pedunculated, soft, fixed mass and 3. 5 * 3 * 1. 5 cm in size. Histopathologic finding showed the tumor to be composed of two main types of cells, fusiform and clear cells.
Acrospiroma* ; Adult ; Epithelial Cells ; Female ; Humans ; Male ; Microscopy ; Sweat Glands

Carbon monoxide is colorless, oolorless, tasteless and non-irritating gas produced by the incomplete combustion of carbonaceous rnaterial. It combines with hemoglobin and displaces oxygen because the affinity of hemoglobin for carbon monoxide is two hundred times greater than oxygen. Symptoma and signs of carbon monoxide poisoning include headache, nausea, vomiting, dizziness, collapse, unconsciousness, blindness, convulsion, coma and skin lesions. Recently we have observed seven patients with carbon monoxide poisoning who expressed cutaneous syrnptoms. In this work we investigated the pathogenesis of cutaneous manifestations of carbon monoxide poisoning through clinical, histologic and electronmicroscopic study. The results are summarized as follows: 1. Mental states of the patients were comatose in two, Semicomatcse in two, stuporous in two, and drowsy in one patient. In routine laboratory tests, we observed elevated blood sugar in six, elevated sorum creatinine phosphokinase in four and abnormal findings in urinalysis in all patients. 2. Cutaneous lesions were vesicobullae, plaque or swelling, erythema, gangrene and 'ulceration in order of frequency and located in the dependent areas in six caies. 3. Histopathologically, the sites of the bullae were subepidermal in four cases and intraepidermal in. one case and there was one case with ulceration. 4. In electronmicroscopic findings, secretory and ductal cells showed degenerative
Blindness ; Blood Glucose ; Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Coma ; Creatinine ; Dizziness ; Erythema ; Gangrene ; Headache ; Humans ; Nausea ; Oxygen ; Seizures ; Skin ; Stupor ; Ulcer ; Unconsciousness ; Urinalysis ; Vomiting

PURPOSE: To evaluate surface configuration of intervertebral disc on three dimensional CT. MATERIALS AND METHODS: Three dimensional surface images reconstructed from CTscans(1 mm thick) of 20discs in 14 healthy adults were reviewed. Disc surface was classified into peripheral and central zones in contact with consecutive peripheral ring and central endplate. Local irregularity incidence, pattern in radial, concentric, or mixed form, size, location, and extension were observed. Incidence and severity ranges in 4 grades of general irregularity, and peripheral width relative to central radius were evaluated. RESULTS: Normal disc mostly showed smooth surface with few display of small local irregularity(6/20) which was mainly radial in pattern(4/5), posterolaterally located(4/6), and confined within peripheral zone(5/6). General irregularity displayed(5/20) was all grade I and peripheral width was 0.82 of central radius. CONCLUSION: Normal disc shows smooth surface but few may display small local irregularity maybe due to very early degenerative change.
Adult ; Humans ; Incidence ; Intervertebral Disc* ; Radius

Subcutaneous form of neuromuscular hamartoma is extremely rare and histologically different from the conventional neuromuscular hamartoma of the peripheral nerve or benign Triton tumor by an indistinct nodular growth with ill-defined margin and marked collagen interposition. It is usually not associated with a major nerve. We report a case of subcutaneous neuromuscular hamartoma developed in the forehead of 24-year-old man. The tumor showed proliferation of dense, hyalinized fibrous tissue, in which single or group of mature skeletal muscle fibers and nerve fibers were haphazardly intermixed. Recognition of abnormally arranged muscle and nerve fibers is important not to miss this lesion.
Collagen ; Forehead ; Hamartoma* ; Humans ; Hyalin ; Muscle Fibers, Skeletal ; Neptune ; Nerve Fibers ; Peripheral Nerves ; Skin ; Young Adult

Fat containing masses, except mediastinal lipomatosis, of the thorax are uncommon. In spite of uncommonoccurences, as CT can detect not only the fat content but also the presence and character of the non-fattycomponent of the mass, accurate preoperative diagnosis can usually be made in most cases of fat containingmediastinal masses. Authors report 6 cases of fat containing mediastinal masses, that were diagnosedpreoperatively by CT scan, comprising 2 cases of limpoma(combined with plexiform neurofibroma in a case), 1liposarcoma, 1 thymolipoma, and 2 cases of omental hernia through Morgagni foramen.
Diagnosis ; Hernia ; Lipomatosis ; Neurofibroma, Plexiform ; Thorax ; Tomography, X-Ray Computed

Since the introduction of percutaneous mitral valvotomy(PMV) in 1984, PMV was an effecive alternative to surgical commissurotomy in selected patients with severe mitral stenosis. Also PMV was an excellent palliative strategy in such patients who were high risk for operative management or longterm anticoagulation was not feasible. We performed PMV in a patient with very tight mitral stenosis and severe pulmonary hypertension under the general anesthesia because the patient was anticipated to be uncooperative due to mental problem, who was diagnosed as schizophrenia 16 years ago. Robinol was used for premedication and i.v fentanyl was used for maintenance of anesthesia. Inoue balloon was introduced into the LV and gradual ballooning was performed with favorable results. Total anesthesia time and interval from internal jugular vein puncture to the completion of valvuloplasty were 1 hour 45 min and 40 minutes respectively. Hemodynamic variables were improved immediately after intervention and mitral valve area was increased from 0.5cm2 to 1.3cm2.
Anesthesia ; Anesthesia, General* ; Fentanyl ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Jugular Veins ; Mitral Valve ; Mitral Valve Stenosis* ; Premedication ; Punctures ; Schizophrenia*

PURPOSE: To compare image quality of storage phosphor digital radiography(DR) with film-screen radiography in portable chest imaging, and to assess the minimum X-ray dose that can be applied to DR in adults without image degradation, and also to compare image qualities of low dose and standard dose DR. Materials and Methalos: A geometrical phantom similar to the human thorax was imaged by a portable radiographic unit with fixed kVp and variable m^s in both film-screen and DR systems. Three radiologists scored the images by four grades in four categories of 1) contrast between mediastinum and lung, 2) definition of the nodule in the lung, 3) definition of another nodule through the mediastinal shadow, and 4) grainess(noise : assessed only in DR). Additionally, portable chest images were obtained in 10 patients in a intensive care unit by film-screen, standard dose and half dose DR in consecutive days. The same readers scored the images by four grades in six categories of 1) the lungs and hila, 2) the mediastinum, 3) subphrenic area. 4) musculoskeletal shadow, 5) tubes and lines, and 6) grainess (only in DR). The images with superior quality were assessed by paired t-test. RESULTS: In phantom study, the minimum dose of digital images scored 3 or more by all readers was 39% of the standard dose. In patient study, DR was superior to film-screen radiography in all categories except tube and line. Low dose DR was not inferior to standard dose DR in five categories other than grainess to two readers or more. CONCLUSION: In portable chest imaging, storage phosphor DR image was superior to conventional film-screen radiography and half dose DR was comparable to standard dose DR despite of more noise.
Adult ; Humans ; Intensive Care Units ; Lung ; Mediastinum ; Noise ; Radiographic Image Enhancement* ; Radiography ; Thorax*

PURPOSE: To compare image quality of storage phosphor digital radiography(DR) with film-screen radiography in portable chest imaging, and to assess the minimum X-ray dose that can be applied to DR in adults without image degradation, and also to compare image qualities of low dose and standard dose DR. Materials and Methalos: A geometrical phantom similar to the human thorax was imaged by a portable radiographic unit with fixed kVp and variable m^s in both film-screen and DR systems. Three radiologists scored the images by four grades in four categories of 1) contrast between mediastinum and lung, 2) definition of the nodule in the lung, 3) definition of another nodule through the mediastinal shadow, and 4) grainess(noise : assessed only in DR). Additionally, portable chest images were obtained in 10 patients in a intensive care unit by film-screen, standard dose and half dose DR in consecutive days. The same readers scored the images by four grades in six categories of 1) the lungs and hila, 2) the mediastinum, 3) subphrenic area. 4) musculoskeletal shadow, 5) tubes and lines, and 6) grainess (only in DR). The images with superior quality were assessed by paired t-test. RESULTS: In phantom study, the minimum dose of digital images scored 3 or more by all readers was 39% of the standard dose. In patient study, DR was superior to film-screen radiography in all categories except tube and line. Low dose DR was not inferior to standard dose DR in five categories other than grainess to two readers or more. CONCLUSION: In portable chest imaging, storage phosphor DR image was superior to conventional film-screen radiography and half dose DR was comparable to standard dose DR despite of more noise.
Adult ; Humans ; Intensive Care Units ; Lung ; Mediastinum ; Noise ; Radiographic Image Enhancement* ; Radiography ; Thorax*

BACKGROUND: Left ventricular hypertrophy is a major cardiovascular risk factor for sudden death, acute myocardial infarction and congestive heart failure. The left ventricle is generally thought to adapt to sustained arterial hypertension with increased total peripheral resistance by developing concentric hypertrophy. In recent years, the echocardiogrphy has been developed as a noninvasive method for evaluation of left ventricular geometry and left ventricular mass. However, left ventricular adaptation to hypertension has been shown to be more complex than expected. In fact, many patients with mild to moderate hypertension exhibit normal left ventricular mass and wall thickness, other hypertensive patients have eccentric ventricular hypertrophy that is not related to systolic dysfunction, but rather to increased cardiac output and preload and in some hypertensive patients absolute and relative wall thickness is increased with normal ventricular mass(concentric remodeling). There are differences in the hemodynamics, systolic function and diastolic function in each group. METHODS: From september 1992 to August 1994, in 144 patients with untreated essential hypertension and 50 age and gender matched normal adults studied by two-dimensional, M-mode and Doppler echocardiography. In the present study we used echocardiographically derived left ventricular mass and relative wall thickness to assess the patterns of ventricular geometric adaptation to systemic hypertension and their relations to systemic hemodynamics, left ventricular load and contractile performance. RESULTS: Hypertensive group was 144 cases(M:F=68:76), the mean age 56+/-13years. Normotensive group was 50 cases(M:F=22:28), the mean age 52+/-9years. Among hypertensive patients, left ventricular mass index and relative wall thickness were normal in 42 cases(29%), 24 cases(17%) had increased relative wall thickness with normal ventricular mass(concentric remodelin),48 cases(33%) had both increased relative wall thickness and ventricular mass(concentric hypertrophy), 30 cases(21%) had increased left ventricular mass with normal relative wall thickness(eccentric hypertrophy). Concentric hypertrophy and normal left ventricle group are more common in untreated hypertensive patients in Korea. Systemic hemodynamics showed tendency to paralleled ventricular geomety. In groups with concentric remodeling and hypertrophy, perpheral resistance was increased. Cardiac index was midly increased in eccentric hypertrophy. Diastolic dysfunction was prominent tn concentric hypertrophy. CONCLUSION: Each patterns of left ventricular geometry had different systemic hemodynamics, ventricular pressure overload and ventricular volume overload. Therefore, appropriate selection of antihypertensive agent for the patients with each patterns of hypertrophy reduce the left ventricular hypertrophy and may improve the prognosis.
Adult ; Cardiac Output ; Death, Sudden ; Echocardiography ; Echocardiography, Doppler ; Heart Failure ; Heart Ventricles ; Hemodynamics ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Korea ; Myocardial Infarction ; Prognosis ; Risk Factors ; Vascular Resistance ; Ventricular Pressure

Radiological investigation in patients with clonorchiasis is very important as this is the only method of evaluating the severity of clonorchiasis. In order to correlate the radiologic and pathologic findings of clonorchiasis, fourteen rabbits infested with Clonorchis sinensis and five control rabbits were examined radiologically by ultrasonography, computed tomography and cholangiography and the results were correlated with pathologic findings. Dilatation of the intrahepatic small bile ducts of the liver was due to obstruction by flukes: oval or elliptical small filling defects or irregular margin of the bile ducts on cholangiogram or intraluminal echoes on sonogram represented flukes per se; periductal thickening on sonogram and periductal enhancement of bile ducts on CT were due to inflammatory cell infiltration, adenomatous hyperplasia and periductal fibrosis: band like enhancement at the periphery of the liver on CT represented proliferated bile ducts, destruction of liver cells and resultant fibrosis. The study confirmed the pathological bases for the radiological findings of clonorchiasis in liver and bile ducts and will, perhaps, serve as a basis for the future radiologic-pathological correlation of clonorchiasis and in further clinical and experimental researches in the biliary tract diseases.
Bile Ducts ; Biliary Tract Diseases ; Cholangiography ; Clonorchiasis* ; Clonorchis sinensis ; Dilatation ; Fibrosis ; Humans ; Hyperplasia ; Liver ; Methods ; Rabbits* ; Trematoda ; Ultrasonography