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

Angiokeratoma circumscriptum is present at birth or early childhood and is an uncommon dermatosis characterized by papules and small nodules that may coalesce to form plaques. Histopathologically, there are varying degrees of hyperkeratosis, papillomatosis, and irregular acanthosis. In the papillary dermis, greatly dilated capillaries are observed, The acanthotic epidermis encircles the vascular spaces(blood cysts) where, occasionally, organized thrombi may be found. The use of pulsed-dye lasers to treat cutaneous vascular lesions is based on the theory of selective photothermolysis. We report a case of an angiokeratoma circumscriptum in an 48-year-old woman for whom the flashlamp pulsed tunable dye laser proved to be a highly successful means of treatment.
Angiokeratoma* ; Capillaries ; Dermis ; Epidermis ; Female ; Humans ; Lasers, Dye* ; Middle Aged ; Papilloma ; Parturition ; Skin Diseases

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

The issues concerning the disability evaluating system in Korea are controversial to say the least. Evaluating systems are so complicated that they continually cause confusion to medical examiners even though they must evaluate patient's medical status accurately, objectively and reasonably to provide adequate compensation for patients. However, controlling associations or educating curricula for disability evaluation are not in place. This study investigates the impending problems of disability evaluation in Korea and discussed what should be done to improve the situations. Social environments, evaluating standards, examiners' capability and education are reviewed in an effort to present an adequate proposals to Korean medical examiners.
Compensation and Redress ; Coroners and Medical Examiners ; Curriculum ; Disability Evaluation ; Humans ; Hypogonadism ; Korea ; Mitochondrial Diseases ; Ophthalmoplegia ; Social Environment

The development of pentylenetetrazol (PTZ) kindling has been controversial, authors confirmed the development of kindling phenomenon in experimental rats following every second or third day intraperitoneal administration of PTZ(20-25mg/kg) to experimental rats and same amount of saline to control rats. The developmental stage of motor seizure could be categorized into five stages (stage I; clonic seizure of face and neck, stage II; clonic seizure of face, neck and forelimbs, stage III; clonic seizure of forelimbs and body with brief rearing, stage IV; falling and generalized clonic seizure, stage V; falling and generalized tonic-clonic seizure with tonic extension of hindlimbs). Linear regression analysis showed that the stages of motor seizure were increased with the number of PTZ injections (Y=0.1361X + 0.1943, p < 0.05). The persistence of kindling state was also observed after a 5-months pause of PTZ injection. This study suggested that PTZ kindling model in rats could be a good animal model of generalized epilepsy.
Animals ; Epilepsy, Generalized ; Forelimb ; Linear Models ; Models, Animal ; Neck ; Pentylenetetrazole* ; Rats* ; Seizures

Core decompression is still widely used in avascular necrosis of the femoral head but the results are unpredictable and the indications are not settled yet. The reparative process of the decompressed femoral head is poorly understood. Seven cases in 5 patients were undertaken THRA following failed decompression and these were studied for the radiological and pathological changes of the core tracts. The lesions of failed cases were involved more than 1/3 of femoral head on MRI and all cases were stage II A or B. The extent of the necrotic area in MRI was enlarged with crack, sclerosis and sometimes gas collection. Depression of the subchondral plates were also observed. Capillary ingrowth or neovascularization was not found at all and there were only fibrosis, inflammatory response and foreign body reactions.
Capillaries ; Decompression* ; Depression ; Fibrosis ; Foreign Bodies ; Head* ; Humans ; Magnetic Resonance Imaging ; Necrosis* ; Sclerosis

On rare occasions, sudden hearing loss may be associated with a migraine. To our knowledge, there have only been two prior reports of sudden hearing loss attributed to migraines. A 40 years old man had suffered from recurrent headaches with hemiparesis, vertigo, and hearing loss for the past three years. At this time, he presented with severe bilateral sensorineural hearing loss of sudden onset, anarthria, right hemiplegia, tinnitus, and vertigo. An audiogram showed a down-sloping sensorineural hearing loss of 77dB by pure tone average on the right side and 72dB on the left. Sixteen days later, audiographic findings improved to 30dB of pure tone average on both sides. Vasospasm of the labyrinthine arteries instigated by migraine might explain these inner ear symptoms. A history of migraine should be sought in patients with sudden hearing loss and when found, anti-migraine medications such as calcium channel block-ers should be considered.
Adult ; Arteries ; Calcium Channels ; Ear, Inner ; Headache ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden* ; Hemiplegia ; Humans ; Migraine Disorders* ; Paresis ; Tinnitus ; Vertigo

BACKGROUND: Information on the long-term fate of patients with prosthetic valve is limited. Cerebral embolism is a major cause of late morbidity and mortality in patients with prosthetic valves even though recent prostheses are less thrombogenic and anticoagulants are administered. We investigated the long-term risk of the first ischemic and hemorrhagic stroke and effect of presumed risk factors on the development of stroke in patients with prosthetic valves. METHODS: In a retrospective study, 554 patients who survived the 30-days after cardiac valve replacement between June, 1985 and May, 1995 were included. End points were attacks of ischemic and hemorrhagic stroke. Risk of stroke at end points was calculated according to Kaplan-Meier method. The influence of several clinical variables on these stroke events was analyzed by univariate and mutivariate analyses. RESULTS: Thirty seven of 554 patients had 42 stroke events(34 ischemic stroke, 8 hemorrhagic stroke) during follow-up periods(mean: 52.9months). Six of these patients died from stroke. The cumulative stroke-free probability was 92.4% at 5years and 87.7% at 10years. The cumulative ischemic stroke-free probability was 93.7% at 5years and 89.4% at 10years. No or irregular use of anticoagulants was the only significant independent predictor(RR:4.99, 95%CI:2.01-12.41, p<0.01) of ischemic stroke. The cumulative hemorrhagic stroke-free probability was 98.7% at 5years and 98.1% at 10years. CONCLUSION: Regardless of the type of prostheses, patients with prosthetic valves, notably those without anticoagulants, are at high risk for ischemic stroke.
Anticoagulants ; Follow-Up Studies ; Heart Valves ; Humans ; Intracranial Embolism ; Mortality ; Prostheses and Implants ; Retrospective Studies ; Risk Factors ; Stroke* ; Thromboembolism

The infrapatellar fat pad (IPFP) is one of three fat pads located about the anterior knee. Injury in this region is relatively common. Damage to the IPFP is caused mostly by an iatrogenic injury from a surgical procedure or repeated small collision trauma. The authors experienced a case of an IPFP injury, that has not been reported in the domestic or international literature. In this case, acute IPFP separation followed by a contusion at the anterior aspect of knee in the kneeling position, confirmed using magnetic resonance imaging. The patient was fully recovered with conservative treatment.

No abstract available.