A umbilical omphalomesenteric duct polyp is the result of incomplete closure of the omphalomesenteric duct, which connects the midgut with the yolk sac of the embryo. It may be associated with underlying embryologic anomalies such as Meckels diverticulum and umbilical enteric fistula, the complications of which may at times be fatal. This rare malformation should be clinically discerned from persistent granulation tissue or pyogenic granuloma. Histologically, it shows a polypoid lesion consisting of ectopic gastrointestinal epithelium with the appearance of gastric, intestinal, or colonic mucosa. We report a case of an umbilical omphalomesenteric duct polyp in an 8-year-old male patient, who had had a bright-red polyp on the umbilicus from the age of 1 month and had not had any other types of underlying abnormalities.
Child ; Colon ; Diverticulum ; Embryonic Structures ; Epithelium ; Fistula ; Granulation Tissue ; Granuloma, Pyogenic ; Humans ; Male ; Mucous Membrane ; Polyps* ; Umbilicus ; Vitelline Duct* ; Yolk Sac

No abstract available.
Child* ; Humans ; Mycobacterium bovis* ; Skin* ; Tuberculin Test* ; Tuberculin*

A 51-year-old Korean woman presented with a non-tender, well-demarcated, reddish, edematous patch on the right anterior chest where a previous mastectomy and radiation therapy had been performed. She had been diagnosed as having infiltrating ductal carcinoma of the right breast about 1 year ago. Histopathological findings of the skin lesions were consistent with inflammatory metastatic carcinoma of the breast. Inflammatory carcinoma or carcinoma erysipeloides is a well-established entity most frequently associated with carcinoma of the breast. It is characterized by dermal lymphatic invasion by malignancy and clinically should be distinguished from erysipelas or cellulitis. We describe a case of inflammatory metastatic carcinoma derived from an infiltrating ductal carcinoma of the breast which can be clinically confused with radiation dermatitis.
Breast* ; Carcinoma, Ductal ; Cellulitis ; Dermatitis ; Erysipelas ; Erysipeloid ; Female ; Humans ; Mastectomy ; Middle Aged ; Skin ; Thorax

Essential thrombocythemia, a subcategory of chronic myeloproliferative disorder, is characterized by absolute thrombocytosis due to excessive clonal proliferation of platelets, hyperaggregability of platelets and increased incidence of thrombosis and hemorrhage. Essential thrombocythemia may cause frequent vascular thrombosis, but it can be a rare cause of acute ischemic heart diseases such as acute myocardial infarction without atherosclerosis, unstable angina and angina pectoris. We report a case of essential thrombocythemia complicated by acute myocardial infarction. A patient with a previous history of vascular thrombotic complications (such as transient ischemic attack and deep vein thrombosis) was managed with 2.8 million units of intravenous urokinase, antiplatelet agent, ACEI, antianginal medications and hydroxyurea. There were clinically remarkable improvements and no further episodes of thrombotic ischemic vascular complications, including acute myocardial infarction.
Angina Pectoris ; Angina, Unstable ; Atherosclerosis ; Hemorrhage ; Humans ; Hydroxyurea ; Incidence ; Ischemic Attack, Transient ; Myeloproliferative Disorders ; Myocardial Infarction* ; Myocardial Ischemia ; Thrombocythemia, Essential* ; Thrombocytosis ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Veins

BAKGROUND AND PURPOSES: Spasm of epicardial coronary arteries has been shown to play an important role in the pathogenesis of ischemic heart diseases. Spasm occurs in angiographically normal coronary arteries or arteries with organic atherosclerotic lesion and can result in rest angina, exertional angina or even myocardial angina or even myocardial infarction. However, pathogenetic mechanism of coronary artery spasm still remains unclear. The purpose of present study is to investigate characteristics of pharmacologically induced spasm of epicardial coronary artery in patient with ischemic heart disease with normal coronary angiogram or insignificant coronary artery disease (<25% narrowing), and to determine the relationship of coronary risk factors with coronary artery spasm in these patients group. METHODS: One hundred patients(male 47, female 53, age : 19-75 years) with ischemic heart disease(stable angina, unstable angina, myocardial infarction) who had normal coronary angiogram or angiographically insignificant coronary artery stenosis(<25% narrowing) were included for pharmacological provocation test for coronary artery spasm. Acetylcholine(ACH) and Ergonovine(Erg) were given intracoronarily(IC) in incremental doses(Ach : A1, 20micro, A2 50microg, A3 100microg and Erg : E1 5microg, E2 10microg, E3 25microg) either into coronary artery concordant with ECG leads showing ischemic ST-T changes in exercise ECG and/or 24-hour ambulatory ECG, or otherwise into right coronary artery. Erg provocation test was done after completion of acetylcholine provocation test. Constriction of coronary artery by more than 50% induced by either or both of the drugs were analysed in terms of incidence, degree, location of spasm and relation to risk factors. Coronary vasodilatory reserve function was tested by IC Doppler method for those patients with no spasm of epicardial coronary artery but with chest pain and ST-segment changes during provocation test. Relationship of spasm with various risk factors were investigated. RESULTS: 1) Ach or Erg test were positivie in 50 patients(50%). Among 75 patients who were tested by both drug, both test were positive in 17 patients(22.6%), and negative in 39 patients(52%), and Ach test was positive but Erg test was negative in 15 patients(20%). : The responses of Ach and Erg test were concordant in 75% of patients, the sensitivity and specificity of Ach test with reference to Erg test were 81% and 72%, respectively. 2) The characteristic features of spasm induced by Ach or Erg is focal narrowing in 34 patients and diffuse narrowing in 16 patients. The sites of spasm were LAD(23 cases), RCA(19 cases), LCX(5 cases), and in 3 cases, both LAD and LCX were narrowed. 3) In 50 patients showing no spasm, the typical chest pain or EKG changes was noted in 6 cases(12%). Of 6 patients, coronary vasodilatory reserve was decreased in 4 cases(66.7%). 4) Number of smoker was larger among spasm positive group(42%) than those among spasm negative group(12%)(p<0.01). CONCLUSION: The findings we observed in a limited series of patients suggest that in patients with normal or insignificant coronary angiogram, coronary spasm plays a role in the pathogenesis of broad spectrum of ischemic heart disease and that in patients with no coronary spasm but chest pain and ST-segment changes, coronary vasodilatory reserve is impaired, causing angina pectoris. Smoking may be one of the risk factors for coronary arterial spasm.
Acetylcholine ; Angina Pectoris ; Angina, Unstable ; Arteries ; Chest Pain ; Constriction ; Coronary Artery Disease ; Coronary Vessels ; Electrocardiography ; Female ; Heart ; Humans ; Incidence ; Myocardial Infarction ; Myocardial Ischemia* ; Risk Factors* ; Sensitivity and Specificity ; Smoke ; Smoking ; Spasm

BAKGROUND AND PURPOSES: Spasm of epicardial coronary arteries has been shown to play an important role in the pathogenesis of ischemic heart diseases. Spasm occurs in angiographically normal coronary arteries or arteries with organic atherosclerotic lesion and can result in rest angina, exertional angina or even myocardial angina or even myocardial infarction. However, pathogenetic mechanism of coronary artery spasm still remains unclear. The purpose of present study is to investigate characteristics of pharmacologically induced spasm of epicardial coronary artery in patient with ischemic heart disease with normal coronary angiogram or insignificant coronary artery disease (<25% narrowing), and to determine the relationship of coronary risk factors with coronary artery spasm in these patients group. METHODS: One hundred patients(male 47, female 53, age : 19-75 years) with ischemic heart disease(stable angina, unstable angina, myocardial infarction) who had normal coronary angiogram or angiographically insignificant coronary artery stenosis(<25% narrowing) were included for pharmacological provocation test for coronary artery spasm. Acetylcholine(ACH) and Ergonovine(Erg) were given intracoronarily(IC) in incremental doses(Ach : A1, 20micro, A2 50microg, A3 100microg and Erg : E1 5microg, E2 10microg, E3 25microg) either into coronary artery concordant with ECG leads showing ischemic ST-T changes in exercise ECG and/or 24-hour ambulatory ECG, or otherwise into right coronary artery. Erg provocation test was done after completion of acetylcholine provocation test. Constriction of coronary artery by more than 50% induced by either or both of the drugs were analysed in terms of incidence, degree, location of spasm and relation to risk factors. Coronary vasodilatory reserve function was tested by IC Doppler method for those patients with no spasm of epicardial coronary artery but with chest pain and ST-segment changes during provocation test. Relationship of spasm with various risk factors were investigated. RESULTS: 1) Ach or Erg test were positivie in 50 patients(50%). Among 75 patients who were tested by both drug, both test were positive in 17 patients(22.6%), and negative in 39 patients(52%), and Ach test was positive but Erg test was negative in 15 patients(20%). : The responses of Ach and Erg test were concordant in 75% of patients, the sensitivity and specificity of Ach test with reference to Erg test were 81% and 72%, respectively. 2) The characteristic features of spasm induced by Ach or Erg is focal narrowing in 34 patients and diffuse narrowing in 16 patients. The sites of spasm were LAD(23 cases), RCA(19 cases), LCX(5 cases), and in 3 cases, both LAD and LCX were narrowed. 3) In 50 patients showing no spasm, the typical chest pain or EKG changes was noted in 6 cases(12%). Of 6 patients, coronary vasodilatory reserve was decreased in 4 cases(66.7%). 4) Number of smoker was larger among spasm positive group(42%) than those among spasm negative group(12%)(p<0.01). CONCLUSION: The findings we observed in a limited series of patients suggest that in patients with normal or insignificant coronary angiogram, coronary spasm plays a role in the pathogenesis of broad spectrum of ischemic heart disease and that in patients with no coronary spasm but chest pain and ST-segment changes, coronary vasodilatory reserve is impaired, causing angina pectoris. Smoking may be one of the risk factors for coronary arterial spasm.
Acetylcholine ; Angina Pectoris ; Angina, Unstable ; Arteries ; Chest Pain ; Constriction ; Coronary Artery Disease ; Coronary Vessels ; Electrocardiography ; Female ; Heart ; Humans ; Incidence ; Myocardial Infarction ; Myocardial Ischemia* ; Risk Factors* ; Sensitivity and Specificity ; Smoke ; Smoking ; Spasm

PURPOSE: To evaluate the results from arthroscopic repair versus debridement for full-thickness tears of the upper subscapularis tendon. MATERIALS AND METHODS: Ninety-nine patient outcomes were evaluated and compared prospectively. Sixty-nine patients with full-thickness tears of the upper subscapularis tendon underwent arthroscopic repair (group I) and thirty patients underwent simple debridement (group II) between May 2003 and October 2007. In all patients, the tear was localized to the superior one third of the upper subscapularis tendon. The results of the treatment were assessed by evaluating the UCLA, ASES, and VAS for pain and internal rotation strength scores before and after the operation. RESULTS: In groups I and II, UCLA, ASES, VAS, and internal rotation muscle power (perfect score = 5) scores were improved after surgery. In comparing group I and group II, the UCLA and VAS scores were not significantly different (p>0.05), while the ASES and internal rotation strength scores were significantly different (p<0.05). CONCLUSION: The arthroscopic repair of full-thickness tears of the upper subscapularis tendon was a better surgical method than simple debridement.
Debridement ; Humans ; Muscles ; Prospective Studies ; Shoulder ; Tendons

BACKGROUND AND OBJECTIVES: The effects of estrogen in the myocardium of aged ovariectomized rats, relating to the estrogen replacement onset time following an ovariectomy, and the replacement duration have not yet been established. The object of this study was to investigate the effects of estrogen replacement in the myocardium of aged ovariectomized rats. MATERIALS AND METHODS: 52 Female Sprague Dawley rats, about 3 months old, were subjected to sham surgery only (Group 1 ; control, n=9) ; a bilateral ovariectomy (OVX) and maintained untreated for a period of 12 weeks following surgery (Group 2 ; OVX only, n=16) ; estrogen conjugate 25 microgram/kg daily for 4weeks from the 8th post ovariectomy week (Group 3 ; OVX+estrogen replacement therapy : ERT 4weeks, n=10) ; estrogen conjugate 25 microgram/kg daily p.o for 12weeks directly post ovariectomy (Group 4 ; OVX+ERT 12weeks, n=17). We measured the left ventricular wall thickness (LVWT), the number of cardiomyocytes and interstitial fibrosis, edema, using light and electron microscopy. RESULTS: The LVWT in group 4 was 2.25 mm, which was significantly decreased compared to groups 2 and 3, which were 2.45 mm (p=0.014) and 2.46 mm (p=0.008), respectively. The LVWT in group 4 was not significantly different to that of group 1. Interstitial edema was significantly decreased in group 4 (41.2%) compared to that of group 3 (62.0%) (p=0.019). The electron microscopic findings showed a decrease of crystae and a loss of matrix, resulting in a whitish discoloration of the mitochondria in groups 2 and 3. A similar finding was not observed in groups 1 and 4. CONCLUSION: These results suggest that early administration and maintenance of estrogen following a bilateral ovariectomy could prevent the myocardial changes caused by estrogen deficiency.
Animals ; Edema ; Estrogen Replacement Therapy ; Estrogens* ; Female ; Fibrosis ; Humans ; Hypertrophy ; Infant ; Microscopy, Electron ; Mitochondria ; Myocardium* ; Myocytes, Cardiac ; Ovariectomy ; Rats* ; Rats, Sprague-Dawley

BACKGROUND: Onychomycosis, especially toenail onychomycosis has become one of the common fungal infection and has historically been regarded as a cosmetic rather than medical problem by many patients, even by physicians. Recently, however, there are several reports that this is a refractory disease which may cause a deleterious effect on patients' quality of life (QOL). OBJECTIVE: The purpose of this study was to investigate the impact of toenail onychomycosis on QOL in Korea and to assess the changes of QOL after treatment. METHODS: Total 1004 patients with toenail onychomycosis which was confirmed by clinical findings and KOH preparation were enrolled at 47 dermatologic centers in Korea, and interviewed with standardized QOL questionnaire before and after systemic antifungal treatment. Responses to the questionnaire were scored by f-point scale (0~4) and averaged, and were analyzed for 5 dimensions of emotional impact, social impact, symptom and functional impact, patients' views concerning treatment, and relationship with doctor. RESULTS: 1. Before and after treatment, the most serious impact was emotional dimension showing 1.90 and 1.30 in average score (AS), and social (AS: 1.14 and 0.83) and symptom and functional impact (AS: 1.05 and 0.92) was also affected. 2. In female rather than male, statistically more significant impact on patients' QOL was observed in all dimensions. 3. After treatment, 3 of 5 dimensions were improved significantly - emotional dimension (AS: from 1.90 to 1.30), social dimension (AS: from 1.14 to 0.83), patients' view concerning treatment(AS: from 1.34 to 1.02) 4. The degree of patients' satisfaction at the therapeutic effect was very high - 62.4% (immediately after. treatment) and 65.8% (9 months after initiation of treatment) of patients answered excellent or good. CONCLUSION: This study confirms that toenail onychomycosis has significant Impact on the overall QOL of patients. Also the effect of antifungal therapy on patients' QOL were satisfactory. Therefore, both doctor and patient should pay more attention to the treatment of onychomycosis.
Female ; Humans ; Korea* ; Male ; Nails* ; Onychomycosis* ; Quality of Life* ; Social Change ; Surveys and Questionnaires