Balloon-tipped, flow-directed (Swan-Ganz) catheters are used commonly for monitoring of cardiac function in patients undergoing cardiac surgical procedures. We report a case of pulmonary hypertension with hypoxemia which may be caused by incorrect positioning of pulmonary artery catheter (PAC) during CABG. Pulmonary arterial pressure (PAP) of 70/40 mmHg which was nearly high as systemic pressure was measured when we tried to wean patient from cardiopulmonary bypass. But, TEE (transesophageal echocardiography) showed nonspecific finding. PAP decreased soon and maintained about 33/16 mmHg for a few minutes. But, the PAP elevated high to 70/40 mmHg again and the arteral oxygen tension (PaO2) decreased to 61.2 mmHg. When we withdrew the PAC to the depth of 35 cm, the PAP and systolic pressure returned to normal range and PaO2 elevaed to 320 mmHg. End tidal CO2 was elevated from 30 mmHg to 35 mmHg.
Anoxia* ; Arterial Pressure ; Blood Pressure ; Cardiac Surgical Procedures ; Cardiopulmonary Bypass ; Catheters* ; Coronary Artery Bypass* ; Coronary Vessels* ; Humans ; Hypertension, Pulmonary* ; Oxygen ; Pulmonary Artery ; Reference Values

No abstract available.
Drug Eruptions*

Solitary morphea profunda is a rare form of scleroderma, characterized clinically by a solitary sclerotic plaque, and histologically by marked dermal and subcutaneous fibrosis with an inflammatory infiltrate. We describe another case of this entity presented with an ulcerative, indurated plaque on the left iliac crest, which histologically revealed a focal incidental acantholysis in the overlying epidermis and a marked eosinophilic infiltration through the dermis to the sub-cutaneous tissue.
Acantholysis* ; Dermis ; Eosinophils ; Epidermis ; Fibrosis ; Scleroderma, Localized* ; Ulcer

No abstract available.
Mandibular Reconstruction*

Syndactyly is one of most common congenital anomalies of the limb. We reviewed 89 webs of 40 patient with syndactyly which had been treated at Seoul National University Hospital from 1979 to November 1984. It is the purpose of this article to compare the operative methods used in the treatment of syndactyly. In our hands, using the volar interdigital flap in the treatment of syndactyly gives the most excellent postoperative result in both function and cosmesis.
Extremities ; Hand ; Humans ; Seoul ; Syndactyly

Recently, the frequency of meniscal injury of knee has been increasing due to increase of sports activities. It has been known that bucket handle tear is the most common type of the entire injuries of the meniscus. We found 127 cases of meniscal tears and experienced 42 cases of bucket handle tears in the arthroscopic findings from Jan. 1991 to April 1994 in our hospital. We analysed 31 cases which were followed up for at least 1 year. The purpose of this study is to analyse the locking history and frequency, to discuss the several types of bucket handle tear in arthroscopic view, to introduce three portal techniques using posteormedial or posterolateral portal to resect the meniscus, and to analyse our clinical results. So we concluded as follows. 1. Among the 31 cases, 23 cases(74%) had an episode of locking. 2. We found many different types of bucket handle tears in arthroscopic view and the most common type was complete tear in a classic type(11 cases). 3. We were able to resect the meniscal fragment very easily using posteromedial or posterolateral portal. 4. We obtained satisfactory results in 24 cases(77%).
Knee ; Sports ; Tears

Acrokeratoelastoidosis of Costa is a rare palmoplantar keratoderma with autosomal dominant inheritance. It is clinically charaeterized by small, firm, yellowish, shiny, translucent papules occumng over the dorsal hands, the knuckles, and the lateral margine of the palms and soles. Histologically, the characteristic features are hyperkeratosis, aeanthosis, and most strikingly, fragmentation of coarse elastic fibers within the dermis. The lesions usually begin in early childhood and progress slowly. We herein report two familial cases of acrokeratoelastoidosis of Costa showing typical clinic1 and histopathological features.
Dermis ; Elastic Tissue ; Hand ; Keratoderma, Palmoplantar ; Wills*

Terbinafine is now widely used for the treatment of dermatophytic infections of the skin and nails. Cutaneous side effects of terbinafine are rare and mild. They includes erythema, pruritus, urticaria, desqumation, and macular exanthem. In addition, fixed drug eruption, erythema multiforme, Stevens-Johnson syndrome, and erythema annulare centrifugum-like psoriatic drug eruption were recently described in the literatures. Herein, we reported a case of acute generalized exanthematous pustulosis induced by terbinafine.
Acute Generalized Exanthematous Pustulosis* ; Drug Eruptions ; Erythema ; Erythema Multiforme ; Exanthema ; Pruritus ; Skin ; Stevens-Johnson Syndrome ; Urticaria

Subepidermal calcified nodule, a form of idiopathic calcinosis cutis, typically present as a hard, 3 to 11 mm, solitary lesion on the exposed area of the head and the extremities. Here we re-port an unusual case of subepidermal calcified nodule occurring on the buttock. A 15-year-old girl presented with a 6-month history of a 12 × 6 mm, oval, hard, erythematous nodule on the right buttock. Histopathologic examination of an excision biopsy specimen revealed extensive deposition of calcium in the whole dermis as large multilobulated masses.
Adolescent ; Biopsy ; Buttocks* ; Calcinosis ; Calcium ; Dermis ; Extremities ; Female ; Head ; Humans

We report a 33-year-old woman with a 1-year history of typical skin features of dermatomyositis without any evidence of muscle involvement. Her skin eruption of the face (heliotrope erythema) and hands (Gottron's papules) and skin biopsy findings were typical of dermatomyositis. Levels of serum muscle enzymes were within normal ranges and electromyography showed no signs of muscle involvement. During a 1-year follow-up, she had no signs of muscle weakness. Based on these clinical and laboratory findings, our case can be diagnosed as amyopathic dermatomyositis.
Adult ; Biopsy ; Dermatomyositis* ; Electromyography ; Female ; Follow-Up Studies ; Hand ; Humans ; Muscle Weakness ; Reference Values ; Skin