No abstract available.

No abstract available.
Histiocytosis*

Malposition of the extracorporeal membrane oxygenation (ECMO) venous cannula in the azygos vein is not frequently reported. We hereby present such a case, which occurred in a neonate with right-sided congenital diaphragmatic hernia. Despite ECMO application, neither adequate flow nor sufficient oxygenation was achieved. On the cross-table lateral chest radiograph, the cannula tip was identified posterior to the heart silhouette, which implied malposition of the cannula in the azygos vein. After repositioning the cannula, the target flow and oxygenation were successfully achieved. When sufficient venous flow is not achieved, as in our case, clinicians should be alerted so they can identify the cannula tip location on lateral chest radiograph and confirm whether malposition in the azygos vein is the cause of the ineffective ECMO.
Azygos Vein* ; Catheters* ; Extracorporeal Membrane Oxygenation* ; Heart ; Hernias, Diaphragmatic, Congenital* ; Humans ; Infant, Newborn* ; Oxygen ; Radiography, Thoracic

Osteoma cutis is a primary cutaneous ossification, which has no preceding trauma or skin disease and no evidence of Albrights hereditary osteodystrophy n the patient or his family. The lesion appears as hard, round to irregular, sharply defined tumor of varying size within the skin or subcutis, and color ranges from flesh-colored to purple or brown. We report herein a case of osteoma cutis in a 32-year-old female, who had a 1 x 1cm sized, asymptomatic, round, flesh colored, hard nodule on the right side of her forehead for 5 years. Histopathologic examination showed mature bone with many ostocytes, osteoblasts, cement lines and Haversian canals in the dermis.
Adult ; Dermis ; Female ; Forehead ; Haversian System ; Humans ; Osteoblasts ; Osteoma* ; Skin ; Skin Diseases

We report a case of atypical eruption due to chemotherapeutic agent in a 60-year-old man who presented with asymptomatic, erythematous, 0.5cm in diameter, confluent, and elevated papules and plaques confined to the face. The patient was previously diagnosed with small cell carcinoma of the lung with liver metastasis. Two months after the diagnosis, a first course of chemotherapy including etoposide was started. Five days after starting the chemotherapy, the patient developed a facial eruption. Histopathologic examination demonstrated increased epidermal mitotic figures, cells in metaphase arrest, basal cell layer hyperpigmentation, prominent dyskeratosis, and squamous atypia. The most distinctive histologic feature was the presence of starburst cells, which are markedly enlarged pale staining keratinocytes containing small basophilic fragments of nuclear debris haphazardly scattered throughout the cytoplasm in a starburst pattern.
Basophils ; Carcinoma, Small Cell ; Cytoplasm ; Diagnosis ; Drug Therapy ; Etoposide ; Humans ; Hyperpigmentation ; Keratinocytes ; Liver ; Lung ; Metaphase ; Middle Aged ; Neoplasm Metastasis

BACKGROUND AND OBJECTIVES: One of problems for the management of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) is the difficulty of determining the affected ear using Ewald's second law. The purpose of this study is to develop the new "Bow and Lean Test (BLT)" to determine easily the affected ear of HSC-BPPV and evaluate its efficiency. MATERIALS AND METHOD: We compared the efficiency between the classical method and BLT in 26 patients with HSC-BPPV. The classical method is based on Ewald??s second law comparing the intensity of nystagmus or symptoms in head roll test. BLT is based on the direction of both "bowing nystagmus" and "leaning nystagmus" at head's bowing and leaning state on sitting position. The affected ear is the same direction of bowing nystagmus in canalolithiasis and the same direction of leaning nystagmus in cupulolithiasis. RESULTS: In 26 patents (15 canalolithiasis, 11 cupulolithiasis), 3 (11.5%) patients did not show a prominent affected ear in the classical method, and 7 (26.9%) patients showed the different affected ear between two methods. All 10 patients were successfully treated with just one trial of barbecue rotation based on the affected ear in BLT. Three patients did not show any bowing or leaning nystagmus. The side with canal paresis in all 4 patients, who showed significant canal paresis in bithermal caloric tests, was equal to the affected ear based on BLT. CONCLUSION: "Bow and Lean Test" (also called "Choung's test") is a new method which can easily determine the affected ear of HC-BPPV.
Caloric Tests ; Ear ; Head ; Humans ; Jurisprudence ; Paresis ; Semicircular Canals ; Vertigo*

BACKGROUND AND OBJECTIVES: One of problems for the management of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) is the difficulty of determining the affected ear using Ewald's second law. The purpose of this study is to develop the new "Bow and Lean Test (BLT)" to determine easily the affected ear of HSC-BPPV and evaluate its efficiency. MATERIALS AND METHOD: We compared the efficiency between the classical method and BLT in 26 patients with HSC-BPPV. The classical method is based on Ewald??s second law comparing the intensity of nystagmus or symptoms in head roll test. BLT is based on the direction of both "bowing nystagmus" and "leaning nystagmus" at head's bowing and leaning state on sitting position. The affected ear is the same direction of bowing nystagmus in canalolithiasis and the same direction of leaning nystagmus in cupulolithiasis. RESULTS: In 26 patents (15 canalolithiasis, 11 cupulolithiasis), 3 (11.5%) patients did not show a prominent affected ear in the classical method, and 7 (26.9%) patients showed the different affected ear between two methods. All 10 patients were successfully treated with just one trial of barbecue rotation based on the affected ear in BLT. Three patients did not show any bowing or leaning nystagmus. The side with canal paresis in all 4 patients, who showed significant canal paresis in bithermal caloric tests, was equal to the affected ear based on BLT. CONCLUSION: "Bow and Lean Test" (also called "Choung's test") is a new method which can easily determine the affected ear of HC-BPPV.
Caloric Tests ; Ear ; Head ; Humans ; Jurisprudence ; Paresis ; Semicircular Canals ; Vertigo*

Ambulatory BP monitoring was performed in a patients with pheochromocytoma before and after removal of the tumor. Before surgery, it did not show any significant diurnal variation. But, after surgery the diurnal variation was restored.
Blood Pressure Monitoring, Ambulatory* ; Blood Pressure* ; Humans ; Pheochromocytoma*

PURPOSE: This study evaluated the treatment effectiveness and proper radiation dose of helical tomotherapy (HT) in spine oligometastases from gastrointestinal cancers. MATERIALS AND METHODS: From 2006 to 2010, 20 gastrointestinal cancer patients were treated with HT for spine oligometastases (31 spine lesions). The gross tumor volume (GTV) was the tumor evident from magnetic resonance imaging images fused with simulation computed tomography images. Clinical target volume (CTV) encompassed involved vertebral bodies or dorsal elements. We assumed that the planning target volume was equal to the CTV. We assessed local control rate after HT for 31 spine metastases. Pain response was scored by using a numeric pain intensity scale (NPIS, from 0 to 10). RESULTS: Spine metastatic lesions were treated with median dose of 40 Gy (range, 24 to 51 Gy) and median 5 Gy per fraction (range, 2.5 to 8 Gy) to GTV with median 8 fractions (range, 3 to 20 fraction). Median biologically equivalent dose (BED, alpha/beta = 10 Gy) was 52 Gy10 (range, 37.5 to 76.8 Gy10) to GTV. Six month local control rate for spine metastasis was 90.3%. Overall infield failure rate was 15% and outfield failure rate was 75%. Most patients showed pain relief after HT (93.8%). Median local recurrence free survival was 3 months. BED over 57 Gy10 and oligometastases were identified as prognostic factors associated with improved local progression free survival (p = 0.012, p = 0.041). CONCLUSION: HT was capable of delivering higher BED to metastatic lesions in close proximity of the spinal cord. Spine metastases from gastrointestinal tumors were sensitive to high dose radiation, and BED (alpha/beta = 10 Gy) higher than 57 Gy10 could improve local control.
Disease-Free Survival ; Gastrointestinal Neoplasms ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Radiotherapy, Intensity-Modulated ; Recurrence ; Spinal Cord ; Spine ; Treatment Outcome ; Tumor Burden

BACKGROUND: Herpes zoster is characterized by vesicular skin lesions over the unilateral sensory dermatomes being caused by the reactivation of varicella-zoster virus and its incidence seems to be increasing recently. OBJECTIVE: The purpose of this study was to elucidate the epidemiology and the clinical characteristics of herpes zoster. METHODS: The authors observed 877 cases of herpes zoster clinically for annual incidence, age, sex, monthly distribution, predilection site, associated disease, and complications at the Department of Dermatology in Chung-Ang University Hospital during a 10 years period(1982.9-1992.8). RESULTS: 1) The annual incidence averaged over 10 years was 2.26%(877 cases of total 38.717 outpatients) being on the increase recently. 2) The age distribution was in the range of 2-86 years old being most prevalent in the 6th decade and there was equal sex ratio(444:433). 3) There was no statistically significant monthly or seasonal variation in the incidence of herpes zoster. 4) The most common anatomical distribution was thoracic dermatome(51.7%), followed by trigeminal(17.1%), cervical(16.1%), lumbar (10.6%), sacral(1.4%)and multiple deramatomic involvement(3.1%). Left or right side was affected in about the same ratio(439:437), and bilateral involvement was in 1 case. 5) Associated disease of herpes zoster were observed in 210 patients(23.9%) ; hypertension(7.0%), diabetes mellitus(4.1%), tuberculosis(1.8%), postoperative status(0.7%), malignancy(0.7%), gastric ulcer(0.7%), and so on, 6) The most common complication of herpes zoster was postherpetic neuralgia(7.4%), followed by eye complication(2.1%), bacterial infection(1.4%), scar formation(0.7%), neurogenic bladder(0.2%), Ramsay-Hunt syndrome(0.2%), motor paralysis(0.1%), herpes zoster generalisatus(0.1%) 7) The incidence of postherpetic neuralgia increased with age and was highest in trigeminal dermatome. 8) Recurrence of herpes zoster was observed in 4 patients(0.5%). CONCLUSION: According to this study, the annual incidence of herpes zoster showed a tendency to increase recently but there was no significant monthly or seasonal variation. The anatomical distribution was most commom on the thoracic dermatome. The incidenc of postherpetic neuralgia increased with age being most common in trigeminal nerve.
Age Distribution ; Cicatrix ; Dermatology ; Epidemiology ; Herpes Zoster* ; Herpesvirus 3, Human ; Incidence ; Neuralgia, Postherpetic ; Recurrence ; Seasons ; Skin ; Trigeminal Nerve