Bleomycin, a tumoricidal antibiotic agent, may produce unusual cutaneous manifestations such as pigmentation scleroderma, and gangrene. We report a case of the development of linear streaky pigmentation and cutaneous scleroderma in a patient treated with bleomycin for choriocarcinoma of undescented testis. The patient was 45-year-old male presented with linear brown and slate gray streaking over the trunk and extremities after three cycles of chemotherapy(bleomycin, etoposide, cisplatine). After the fourth cycle of the same chemotherapy, 18 weeks after initiation of bleomycin, the development of cutaneous scleroderma-like conditions was observed involving the same sites. Histopathologic examination showed increased basal pigmentation and thick collagen bundles through the entire dermis, extending to the subcutis. Herein, we describe a case of streaky pigmentation and scleroderma in association with bleomycin anticancer chemotherapy simultaneously in a patient.
Bleomycin* ; Choriocarcinoma ; Collagen ; Dermis ; Drug Therapy ; Etoposide ; Extremities ; Female ; Gangrene ; Humans ; Hyperpigmentation ; Male ; Middle Aged ; Pigmentation* ; Pregnancy ; Testis

Primary germ cell tumor of the testis is rare, which occupies 1 to 2% of all reported malignant male neoplasms. Combined primary germ cell tumor of the testis composed of embryonal carcinoma and seminoma is more rare tumor. The authors experienced a case of 50-year old male who presented with painless enlargement of right testicle. He has had radical orchiectomy and diagnosed by pathologically as combined germ cell tumor of testis. The testicle is measuring 180 gm in weight and 9×6×5 cm in dimension, and almostly replaced by tumor mass. Grossly the tumor is rubbery solid smooth tumor mass, with variegated cut surface with geographically outlined diffuse necrotic area. Histologically the tumor is composed of two components of tumor, which are solid growth pattern of large round to polyhedral cells with clear or granular cytoplasm and distinct cell border, and anastomosing glandular and papillary arrangement of anaplastic epithelial cells. The former corresponds to seminoma, and the latter to embryonal carcinoma. Each tumor lobule is separated by abundant fibrous stroma.
Carcinoma, Embryonal ; Cytoplasm ; Epithelial Cells ; Germ Cells* ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal* ; Orchiectomy ; Seminoma ; Testis*

BACKGROUND: The chronic disease patients have various psychological problems during the treatment. Therefore, it is needed about understanding and support for chronic disease patients. The main purposes of this study are to identify the psychometric characteristics. METHODS: To evaluate the psychometric characteristics of chronic disease patients-liver cirrhosis, chronic pulmonary disease, etc. -a questionnaire(SCL-90-R) survey was performed toward 100 chronic disease patients in admission to 2 general hospital. 100 persons without any disease were investigated by the same questionnaire for comparison. The survey was performed from June to August 1996. RESULTS: The disease history among the patients, 31% of patients suffered from liver disease, 19% of patients suffered from chronic respiratory disease. 30% of patients reported that they were not expected a recovery from the disease. The patients have a significant higher score in the somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism than normal control (p<0.05). Most of the psychometric characteristics were associated with expectancy of the recovery, education about the disease, number of admission, duration of admission and type of disease(p<0.05). CONCLUSIONS: The chronic disease patients showed higher score psychological symptoms in various characteristics than normal control. Therefore it will be needed that is an proper treatment and psychological support continuously.
Anxiety ; Chronic Disease* ; Depression ; Education ; Fibrosis ; Hospitals, General ; Hostility ; Humans ; Liver Diseases ; Lung Diseases ; Psychometrics* ; Surveys and Questionnaires

BACKGROUND: The chronic disease patients have various psychological problems during the treatment. Therefore, it is needed about understanding and support for chronic disease patients. The main purposes of this study are to identify the psychometric characteristics. METHODS: To evaluate the psychometric characteristics of chronic disease patients-liver cirrhosis, chronic pulmonary disease, etc. -a questionnaire(SCL-90-R) survey was performed toward 100 chronic disease patients in admission to 2 general hospital. 100 persons without any disease were investigated by the same questionnaire for comparison. The survey was performed from June to August 1996. RESULTS: The disease history among the patients, 31% of patients suffered from liver disease, 19% of patients suffered from chronic respiratory disease. 30% of patients reported that they were not expected a recovery from the disease. The patients have a significant higher score in the somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism than normal control (p<0.05). Most of the psychometric characteristics were associated with expectancy of the recovery, education about the disease, number of admission, duration of admission and type of disease(p<0.05). CONCLUSIONS: The chronic disease patients showed higher score psychological symptoms in various characteristics than normal control. Therefore it will be needed that is an proper treatment and psychological support continuously.
Anxiety ; Chronic Disease* ; Depression ; Education ; Fibrosis ; Hospitals, General ; Hostility ; Humans ; Liver Diseases ; Lung Diseases ; Psychometrics* ; Surveys and Questionnaires

High dose intravenous methyl prednisolone was administered to patients with multiple sclerosis (4), transverse myelitis (6), and arachnoiditis (I). Almost complete remission was noted in 5 cases (4 with transverse myelitis and one with multiple sclerosis) and partial improvement in 3 patients (2 with multiple sclerosis and I with arachnoiditis ) within 3 days after therapy. The benefits of this therapy, however, was not that dramatic when started late after the onset of neurologic deficits.
Arachnoid ; Arachnoiditis ; Humans ; Multiple Sclerosis ; Myelitis, Transverse ; Neurologic Manifestations ; Prednisolone

Electrodiagnostic studies were carried out in 4 patients with neurological complications of acute hemorrhatic conjunctivitis at Severance Hospital on 1983. Both motor and sensory nerve conduction studies were normal even in the involved limbs. The electromyography, however, reveals denervation potentials and neuropathic MUPs. The somatosensory evoked potentials taken in median nerve stimulated at the wrist and peroneal nerve stimulated around the knee showed normal latencies, shapes and amplitudes almost symmetrically.
Adult* ; Conjunctivitis ; Conjunctivitis, Acute Hemorrhagic* ; Denervation ; Electromyography ; Evoked Potentials, Somatosensory* ; Extremities ; Humans ; Knee ; Median Nerve ; Neural Conduction ; Peroneal Nerve ; Wrist

BACKGROUND: Overstimation of blood pressure(BP) by clinic measurements occur in about 20 to 30% of subjects(white-coat hypertension) who may, consequently, be misdiagnosed as hypertensives and received unnecessary medications. The clinical significance of white-coat hypertension and its effects on the cardiovascular wystem have not been studied systematically.This study was designed to evaluate the influences of white-coat hypertension and white-coat effect, defined as difference between clinic and ambulatory BP, on the LV mass and diastolic function. METHODS: LV mass index was calculated and LV systolic and diastolic function were assessed by the analysis of mitral and pulmonary venous flow velocity in 45 untreated essential hypertensives and 20 normotensives(NT). Ambulatory BP monitoring classified hypertensives as white-coat hypertensives(WCHT,n=20) and sustained hypertensives(SHT, n=25). RESULTS: 1) Left ventricular systolic indices were not different among the three groups. 2) Left ventricular mass inedx of WCHT(114.5+/-36.3g/m2) was similar to that of SHT(115.6+/-34.9g/m2) and was significantly greater than that of NT(86.5+/-37.7g/m2)(p<0.05). 3) Some of left ventricular diastolic parameters(isovolumic relaxation time, E/A ratio, A velocity, pulmonary systolic fraction, ratio of systolic to diastolic forward flow velocity) of WCHT and SHT were significantly different from those of NT(p<0.05), but there were no differences between two hypertensive groups. 4) Even though both systolic and diastolic white-coat effect in WCHT were significantly greater than those of SHT(o<0.05),white-coat effect did not influence on the left ventricular mass or function in both groups. CONCLUSION: An increased left ventricular mass and diastolic dysfunction in WCHT suggests that white-coat hypertension could not be considered as an entirely innocuous clinical condition.
Blood Pressure Monitoring, Ambulatory ; Hypertension* ; Relaxation

BACKGROUND: Diverticulosis of the cecum and ascending colon is a rare disease in Western countries, it is more common in the Orient. Making the diagnosis preoperatively could be difficult, and the intraoperative assessment and decision of optimal treatments are difficult. METHODS: Therefore, we reviewed the patient's charts of diverticulosis of the cecum and ascending colon at our hospital from 1992 to 1997. RESULTS: During the past 5 years, a total of 53 cases of diverticulosis of the cecum and ascending colon had been treated at this hospital. Mean age was 41.8 years (range 20-70). The male to female ratio was 1.8 : 1. Frequent complaints were abdominal pain (46 cases, 86.8%), followed by diarrhea (5 cases, 9.3%), indigestion (4 cases, 7.5%), and bowel habits change (2 cases, 3.8%). Mean duration of illness was 3.5 days(range 24 hours~15 days). In non-surgical cases, diagnoses were established with barium enema, CT scan, or ultrasonography. The accuracy of these methods was 91%, 75%, and 25%. In surgical cases, the preoperative diagnoses were appendicitis(13 cases, 50.1%), diverticulitis (7 cases, 31.8%), and abscess (2 cases, 9.1%). Treatments of the cecum and ascending colon diverticulitis were conservative management (3 teases,58.5%) and surgical treatment (22 cases,41.5%). The operative procedures were right hemicolectomies (2 cases), ileocecal resections (2 cases), diverticulectomies (6 cases) and appendectomies only (11 cases). CONCLUSION: These results suggest that correct diagnosis of the diverticulitis of the cecum and ascending colon made before treatment is very important because correct assessment of diverticulitis intraoperatively is difacut. Liberal use of diagnostic modalities could facilitate to make correct diagnosis to set a proper plan for treatment.
Abdominal Pain ; Abscess ; Appendectomy ; Barium ; Cecum* ; Colon, Ascending* ; Diagnosis ; Diarrhea ; Diverticulitis ; Diverticulum* ; Dyspepsia ; Enema ; Female ; Humans ; Male ; Rare Diseases ; Surgical Procedures, Operative ; Tomography, X-Ray Computed ; Ultrasonography

Tuberculous spondylitis is not rare disease. Today the posterior instrumentation and posterior or posterolateral fusion concomitant with the anterior decompression and anterior interbody fusion have been used for the treatment of spinal tuberculosis. The authors experienced a case of tuberculous spondylitis complicated with descending aortic pseudoaneurysm. An aneurysm is defined as a localized dilatation of an artery that is at least one-half the size greater than is expected for that artery. Pseudoaneurysm occurring after previous operation, trauma, and infection. Erosion of the thoracic aorta with the development of an fistula in the presence of infection is an unusual and difficult problem to manage. We report a case and review related articles briefly.
Aneurysm ; Aneurysm, False* ; Aorta, Thoracic ; Arteries ; Decompression ; Dilatation ; Fistula ; Rare Diseases ; Spondylitis* ; Tuberculosis, Spinal

No abstract available.
Thrombocytopenia, Neonatal Alloimmune*