The cutaneous metastaaes from carcinoma of breast produce four definite clinical types: inflammatory carcinoma, telangiectatic carcinoma, nodular carcinoma, and carcinoma en cuirasse. We present a case of 51-year-old woman who had purpuric, hard, sclerotic plaque with ulceration, crust and. several pea-sized hemorrhagic papulovesicular eruptions on the right chest wall for one year. Histopathological findings show metastatic ductal carcinoma but, the primary focus was not determined.
Breast ; Carcinoma, Ductal ; Female ; Humans ; Middle Aged ; Thoracic Wall ; Ulcer

BACKGROUND: The erythemal response and delayed tanning of the skin to UV radiations which are used as diagnostic phototest and guideline of phototherapy are different according to the races and light sources. OBJECTIVE: The MED and MMD induced by UVB radiation were measured in 130 normal young adult Koreans. METHODS: In this study, a high pressure mercury are lamp(Burdick UV-800) and a sunlight fluorescent lamp(Waldmann UV 800) were used as UVB light sources. Multiple sites of the lower baek or buttock skin were irradiated with an increasing dose by a constant, anount. The minimal doses of erythema response and delayed tanning of the skin were assessed visaually at 24 hours and 7 days after irradiation, respectively. RESULTS: MED and MMD of Burdick UV-800 are 18.0+/-9.8mJ/cm2 (mean+/-S.D.), 29.7+/-12.5mJ/cm2, respectively. MED and MMD of Waldmann UV 800 are 70.8+/-28.5mJ/cm2 and 91.2+/-33.1mJ/cm2, respecively. The most frequent MED by Burdick UV-800 is 10mJ/cm2 and those by Waldmann UV 800 are 50m J/cm2 and 60m J/cm2. CONCLUSION: In this study MED and MMD of young adult Koreans by two kinds of UVB light sources were assessed. The RESULTS: how that MED is less than MMD and the levels of MED under which the photosensitivity is suggested are 5.6mJ/cm2 by Burdick UV-800 anr 32.4mJ/cm2 by Waldmann UV 800.
Buttocks ; Continental Population Groups ; Erythema* ; Humans ; Phototherapy ; Skin ; Sunlight ; Tanning ; Triacetoneamine-N-Oxyl ; Young Adult*

No abstract available in English.
Arthropathy, Neurogenic

Canaliculitis is an uncommon condition. It is often difficult to diagnose because of its chronicity and its multitude of clinical presentations. We reviewed the nature, the diagnosis and therapy of six patients of chronic lacrimal canaliculitis. Bacteriologic investigation showed one case of E. coli, one case of alpha-hemolytic streptococcus, two of coagulase-negative staphylococcus and no growth to be seen in two cases. On dacryocystography, canalicular diverticulum were found in three cases. Five patients were treated with conservation therapy and one case improved with surgical treatment. Canaliculitis can be diagnosed by clinical features and dacryocystography. Conservative therapy should take priority to surgical treatment.
Diagnosis* ; Diverticulum ; Humans ; Staphylococcus ; Streptococcus ; Canaliculitis

Lower lid retraction can be caused by many etiologies but few require surgical intervention except for cosmetic reasons and exposure deratitis due to lagophthalmos. We report three lower lid retraction patients who underwent lower lid reconstruction was due to congenital etiology or was secondary to excessive inferior rectus muscle recession or lower lid blepharoplasty due to orbital neurofibroma. All three patients found their results satisfactory and showed no severe side effects during the follow-up period. It is suggested that the use of scleral spacer combined with lateral canthoplasty be an effective surgical procedure for correction of lower lid retraction.
Blepharoplasty ; Follow-Up Studies ; Humans ; Neurofibroma ; Orbit

BACKGROUND: Smoking-related chronic obstructive pulmonary disease and chronic asthmatic bronchitis, which are the most important causes of chronic airflow obstruction (CAO), can occur together in a pat,ient and the prognoses of these two diseases are different each other. OBJECTIVE AND METHOD: To estimate the extent of asthmatic component in patients with CAO and to evaluate the role of atopy as a predictable index for reversibility of airflow obstruction, 89 CAO patients who were older than 40 years were examined retrospectively. RESULT: Only 15 patients (16.8%) showed an increase of >15% in FEV20 to inhaled salbutamol (short-term responder). However, 18 out of 32 patients (56.3%), who were not responded significantly to inhaled bronchodilator and performed a follow-up lung function study, showed an increase of ) 15% in FEV20 to anti-asthmatic therapy including corticosteroid for 3-4 weeks (long-term responder). Peripheral blood eosinophil count only was different between short-term responder and short-term nonresponder, and there was no difference in all of the measurements between short-term responder and long-term responder. However, there were significant differences in smoking, wheezing on auscultation, peripheral blood eosinophil counts, serum total IgE levels, and MAST atopy score between long-term responder and long-term nonresponder. The increase in FEV, following shortor long-term therapy was related to peripheral blood eosinophil counts and MAST atopy score, and it was significantly great,er in patients with high eosinophil counts or high atopy score. CONCLUSION: About 2/3 of patients with CAO who were older than 40 years had an asthmatic component ap atopy may be useful to predict good bronchodilator response to anti-asthmatic therapy.
Albuterol ; Auscultation ; Bronchitis ; Eosinophils ; Follow-Up Studies ; Humans ; Immunoglobulin E ; Lung ; Prognosis ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Sounds ; Retrospective Studies ; Smoke ; Smoking

We found an error in this article. The author's name should be corrected as following: from "Younsuk Koh" to "Younsuck Koh".

BACKGROUND: Critical care physician staffing is a crucial element of the intensive care unit (ICU) organization, and is associated with better outcomes in ICUs. Adult ICUs in Korea have been suffering from inadequate full-time intensivists and nurses because of insufficient reimbursement rates (<50% of the original critical care cost) from the National Health Insurance System. Recently, full-time intensivists have been introduced as a prerequisite for adult ICUs of tertiary hospitals in Korea. The purpose of this study was to examine the perception of intensivist staffing among critical care program directors regarding the barriers and solutions when implementing an intensivist model of critical care in Korea. METHODS: An email survey of critical care program directors in designated teaching hospitals for critical care subspecialty training by the Korean Society of Critical Care Medicine was performed. The survey domains included vision, culture, resources, barriers, and potential solutions to implementing intensivist physician staffing (IPS). RESULTS: Forty-two critical care program directors were surveyed. A total of 28 directors (66.7%) responded to email queries. Of these, 27 directors (96.4%) agreed that IPS would improve the quality of care in the ICU, although half of them reported a negative perception of relevant clinical colleagues for the role of full-time intensivists and poor resources for IPS in their hospitals. Increased financial burden due to hiring full-time intensivists and concerns regarding exclusion from the management of their critically ill patients in the ICU, together with loss of income for primary attending physicians were stated by the respondents to be major barriers to implementing IPS. Financial incentives for the required cost from the health insurance system and enhancement of medical law relevant to critical care were regarded as solutions to these issues. CONCLUSIONS: Critical care program directors believe that intensivist-led critical care can improve the outcome of ICUs. They indicated the financial burden due to IPS and underestimation of a full-time intensivist's role to be major barriers. The program directors agreed that a partnership between hospital leaders and the Ministry of Health and Welfare was needed to overcome these barriers.
Adult* ; Critical Care ; Critical Illness ; Electronic Mail ; Hospitals, Teaching ; Humans ; Insurance, Health ; Intensive Care Units ; Jurisprudence ; Korea ; Motivation ; National Health Programs ; Personnel Staffing and Scheduling ; Surveys and Questionnaires ; Tertiary Care Centers

Pulmonary blastoma is a rare lung tumor resembling fetal lung tissue. Pathologically the tumor can be classified to 2 groups, well-differentiated fetal adenocarcinoma(WDFA) and biphasic blastoma. WDFA has more favorable prognosis with fewer metastasis at initial presentation and fewer recurrence after treatment. We experienced a case of pulmonary blastoma in 32-year-old female patient. The patient was referred to our hospital because of abnormal mass shadow in right middle lobe. The diagnosis of pulmonary blastoma(WDFA type, Stage I T2NOMO) was confirmed after right middle lobectomy. We followed up 22 months without an evidence of recurrence.
Adult ; Diagnosis ; Female ; Humans ; Lung ; Neoplasm Metastasis ; Prognosis ; Pulmonary Blastoma* ; Recurrence

No abstract available.
Humans ; Kidney Transplantation*