Stasis eczema is one of the important skin manifestations caused by venous stasia. dueto vascular disturbances. Until now a few casses of stasis eczema accornpanied with inferior vena cava obstruction were reported in the literatures. The patient, 31-year old barber, has been suffered from right upper guadrant abdominal pain and tenderness for 6 years, and had dark brownish mottled scaly eczematoid patches of both lower extremitiea for 6 yrs. Inferiorvenacavogram through the right fernoral vein showed complete obstruction of inferior vena cava above the level of T10, and well developed several collateraI veins. Findings of skin biopsy on the right ankle joint area revealed moderate acanthosis, increased pigrnentation of the basal cell layer in the epidermis, capillary proliferation and hemosiderin granules in the dermis, that is consistent with stasis eczema. Possible etiological factor of inferior vena cava obstruction waa discussed and also reviewed with literatvre.
Abdominal Pain ; Adult ; Ankle Joint ; Biopsy ; Capillaries ; Dermis ; Eczema* ; Epidermis ; Hemosiderin ; Humans ; Skin ; Skin Manifestations ; Veins ; Vena Cava, Inferior

Characteristic dermatoglyphic patterns are found on the volar aspect of the skin of the primates including, man, apes, monkeys and some kinds of marsupiaIs. It is the delieate continuous or discontinuous and sometimes interrupted or branched, variable shaped configuration of ridged skin patterns, which is composed of the unit pattern of arch, loop and whorl. It is characteristically unique for any individuals so it has been used popularly as a convenient method of personal ideatification or for use in studies of inheritance epecially i the field of Iegal medicine. Besides that, there are statistieal differences between left and right finger, males and femals and different races. Of particular interest is the fct the distortion of the dermatoglypbic patterns occur in relation to cbromosomal aberrations, for exarnple, in mongolism,Klinefelter's syndrome and Turner'e syndrome. In addition to that, dermatoglyphic features may prove and aid to diagnree in dermatology, such as, in alopecia areata, psoriasis and leprosy. Thus, authors studied on the dermatoglyphic pattern types in the 234 cases of healthy normal males, 44 male psoriatic patients and 58 male alopecia areata patients during the period of 10 months from Novernber, 1977 to August, 1978, The resulta are as follows: A. Psoriasis 1. In the analysis of the total fingertip ridges, there are significant differences (p<0.01) between the alopecia areata (141.66+/-8.36) and the control group (152.93+/-9.50). 2. A significant statistical difference between the psoriasis and the control group does not exist with respect to the pattern intensity. 3. In the incidence of simian lines, the psoriatic patients (15.91%) showed more incidence rate than those of control group (8.98%). 4. With respect to the proportional distance (mm.) between the distal flexion crease of the wrist to the base of the middle finger with the distance (mm.) of the same point of the wrist to the axial triradius, a significant statistical difference (p<0.05) between the left hands of the control gorup (15.24+/-0.37%) and, those of psoriasis (17.35+/-1.01%) was existed. 5. As for the and angle, there is no significant differences between the control and psoriasis group. 6. There is no statistical differences in view point the pattern types between the psoriasis and the control group, however in psoriasis group, double whorls are decreased than those of control gorup (6.8%). B. Alopecia areata 1. In the analysis of the total fingertip ridges, there is significant difference (P<0.01) between the Alopecia areata (138.40+/-5.03) and the control group (152.93+/-9.50). 2. A significant statistical differences (P<0.005) between the alopecia areata (14.193+/-0.487) and the control group (14.728+/-0.182) exist with respect to the pattern intensity. 3. In the incidence of simian lines, the alopecia areata patients (3.44%) showed lower incidence rate than those of control group (8.98%). 4. With respect to the proportional distance (mm.) between the distal flexion crease of the wrist to the base of the middle finger with the distance (mm.) of the same point of the wrist to tbe axial triradius, a significant statistical difference(p<0.05) between the left hands of the control group (15.24+/-0.37%) and those of alopecia areata (16.66+/-0.70%) was existed. 5. As for the and angle, it is increased significantly (P<0.01) in both hands of alopecia areata, especially in the right hands of alopecia areata, it is increased about twice that of control group. 6. There is no statistical differences in the pattern types between alopecia areata and control group, however in alopecia areata patients, whorls in the right index finger are decreased (39.66%) than those of control gorup (50.16%), Whereas loops in the right index finger are more freguently found (50%) than those of control group (37.44%).
Alopecia Areata* ; Alopecia* ; Continental Population Groups ; Dermatoglyphics* ; Dermatology ; Fingers ; Hand ; Haplorhini ; Hominidae ; Humans ; Incidence ; Leprosy ; Male ; Primates ; Psoriasis* ; Skin ; Wills ; Wrist

Dermatoglyphics has been studied in various diseases including mongolism, ruhella syndrome, congenital heart disease, selected neurologic diseases and other disorders. However, reports of derrnatoglyphic studies in patients with leprosy have not been evcountered a lot. Although Ieprasy is an infectious disease due to the hfycobacterium leprae, the hereditary susceptibility of the host to the organism is proposed as an additional predisposing factor. Thia concept has been proposed to reconcile the low incidence of lisease among large numbers of contacts. Most reports delving into the role of heredity in leprosy have been related ta epidemiological studies. Prasad and Mohamad suggest, on the basis of data related to rnultiple patient families, that the acquisition of leprosy may be determined genetically on the assumption of incomplete dominance of genes; on the other hand, Spickett suggested that if there is any genetic effect, it is but a component af the familial effect. This study of dennatoglyphics in 77 male leprosy patients was undcataken to determine if there might be significance in the analysis of dermal patterns af the hands as related to the hereditary susceptibility of individuals to the disease comparing with those of 234 healthy Korean soldiers. Results are as follows: 1. In the analysis of the total fingertip ridges, there is significant difference (P<0.01) between the leprosy (137.66+4.7) and the control group (152.93+9.50). 2. A aignificant statistical difference between the leprosy and the control group (14.73+2.79) does not exist with respect to the pattern intensity, however that af the borderline group of leprosy (12.00+5.09)is decreased (P<0.025). 3. In the incidence of simian lines, the leprosy group (5.20%) shows lower incidence rate than that of control group (8.98%). 4. As for the a-b ridge count, it is decreased significantly (P<0.05) in the left hand of leprosy group (34.71+0.87) than that of the eontrol group (37.11+0.52), Also there is significant difference(P<0. 05) in the right hands of tuberculoid type of leprosy (34.64+1.38). 5. With respect to the propoetional distance (mm.) between the distal flexion crease of the wrist to the base of the middle finger with the distance (mm.) of the same point of the wrist to the axial triradius, a significant statistical difference between the leprosy and the control group does not exist, but significantly longer distance (mm.) exists in the tuberculoid type of leprosy (P<0.05). 6. No significant fingertip pattern differences are noted between the leprosy and the control group.
Causality ; Communicable Diseases ; Dermatoglyphics* ; Down Syndrome ; Epidemiologic Studies ; Fingers ; Hand ; Heart Defects, Congenital ; Heredity ; Humans ; Incidence ; Korea* ; Leprosy* ; Male ; Military Personnel ; Wrist

As the use computed tomographic (CT) scanning spread, the diagnosis of blowout fractures of the medial orbital wall increased. Now, the diagnosis of blowout fracture in the medial wall are not uncommon. Conventionally, the surgery of blowout fractures in medial orbital wall was performed by the various approach with external incision. The conventional method had seveal possible disadvantages, including an external scar, incomplete reduction, increased mobidity rate and general anesthesia. Recently, endoscopic reconstruction of the medial orbital wall has provided good functional and cosmetic results. We performed endoscopic transnasal reduction surgery without external incision in 12 cases of medial blowout fracture under local anesthesia. The fractured bony fragments were removed after the intranasal ethmoidectomy and the entrapped medial rectus was released. And then a sheet of silicone late or uncinate process were placed on the fracture site. For the maintain of the position of fractured wall, Merocel packing or urinary ballon catheter were used in orbital fracture site for 1-3 weeks. There were no specific complications related to this procedure. Result of the surgery in all cases were satisfactory. In this article, we discussed the surgical procedure, the benifit of the transnasal endoscopic approach, the indications for surgery, and possible comlications.
Anesthesia, General ; Anesthesia, Local ; Catheters ; Cicatrix ; Diagnosis ; Orbit* ; Orbital Fractures ; Silicones

BACKGROUND: The purpose of this study is to investigate the effects of volume and concentration in a constant dose of subarachnoid bupivacaine on the extent and duration of sensory and motor blocks. METHODS: Forty parturients scheduled for cesarean section were randomly assigned to two groups for spinal anesthesia. In group 1, 3.5 ml of hyperbaric 0.25% bupivacaine (8.75 mg) with 0.25 mg morphine and 10 microgram fentanyl were injected into the subarachnoid space; in group 2, 1.75 ml of hyperbaric 0.5% bupivacaine (8.75 mg) with 0.25 mg morphine and 10 microgram fentanyl were injected. Dural punctures were performed at the L3-L4 or L2-L3 interspaces with a 25 gauge needle in the sitting position after which the patients were turned to the supine horizontal position. The level and extent of the sensory and motor block were measured at 3, 5, 10, and 15 minutes. The onset, duration and regression of sensory and motor blocks were studied. RESULTS: There were no significant differences between two groups in the level and extent of sensory and motor blocks. From onset time to maximal sensory block took 12.1 +/- 3.0 min in group 1, and 13.3 +/- 3.7 min in group 2, and from onset time to complete motor block took 10.2 +/- 2.7 min in group 1 and 11.4 +/-2.6 min in group 2. There was no significant difference in the time taken to complete the regression of seosory block, and the complete resolution of the motor block. CONCLUSIONS: A constant 8.75 mg dose of subarachnoid hyperbaric bupivacaine produced, in all groups, a similar, statistically insisnificant, level and extent of sensory and motor block, in spite of different volumes and concentrations.
Anesthesia, Spinal* ; Bupivacaine* ; Cesarean Section ; Female ; Fentanyl ; Humans ; Morphine ; Needles ; Pregnancy ; Punctures ; Subarachnoid Space

BACKGROUND: The purpose of this study is to investigate the effects of volume and concentration in a constant dose of subarachnoid bupivacaine on the extent and duration of sensory and motor blocks. METHODS: Forty parturients scheduled for cesarean section were randomly assigned to two groups for spinal anesthesia. In group 1, 3.5 ml of hyperbaric 0.25% bupivacaine (8.75 mg) with 0.25 mg morphine and 10 microgram fentanyl were injected into the subarachnoid space; in group 2, 1.75 ml of hyperbaric 0.5% bupivacaine (8.75 mg) with 0.25 mg morphine and 10 microgram fentanyl were injected. Dural punctures were performed at the L3-L4 or L2-L3 interspaces with a 25 gauge needle in the sitting position after which the patients were turned to the supine horizontal position. The level and extent of the sensory and motor block were measured at 3, 5, 10, and 15 minutes. The onset, duration and regression of sensory and motor blocks were studied. RESULTS: There were no significant differences between two groups in the level and extent of sensory and motor blocks. From onset time to maximal sensory block took 12.1 +/- 3.0 min in group 1, and 13.3 +/- 3.7 min in group 2, and from onset time to complete motor block took 10.2 +/- 2.7 min in group 1 and 11.4 +/-2.6 min in group 2. There was no significant difference in the time taken to complete the regression of seosory block, and the complete resolution of the motor block. CONCLUSIONS: A constant 8.75 mg dose of subarachnoid hyperbaric bupivacaine produced, in all groups, a similar, statistically insisnificant, level and extent of sensory and motor block, in spite of different volumes and concentrations.
Anesthesia, Spinal* ; Bupivacaine* ; Cesarean Section ; Female ; Fentanyl ; Humans ; Morphine ; Needles ; Pregnancy ; Punctures ; Subarachnoid Space

Sodium hypochlorite is commonly used as a household bleaching agent (for example, the Clorox brand). Sodium hypochlorite poisoning with ingestion of a bleaching agent is often observed in clinical practice.Current Concepts: Ingestion (intentional or accidental) is the most common route of exposure to household bleaching agents. Accidental ingestion of household bleaching agents is rarely clinically important. However, ingestion of a large amount of a dilute formulation or a high-concentration preparation of bleaching agents can result in severe and rarely fatal corrosive injury. Therefore, prompt supportive care is essential because a specific antidote is currently unavailable. Severe poisoning requires hospital admission. Emergency endoscopy and thoracic and abdominal computed tomography are warranted to aid with diagnosis and management of hypochlorite-induced corrosive injury in patients with severe poisoning, who develop clinical features suggestive of corrosive injury.Discussion and Conclusion: Intentional poisoning, which accounts for most cases of household bleaching agent poisonings in Korea, is likely to cause severe corrosive injuries. Therefore, it is necessary to gain deeper and accurate understanding of the clinical aspects and treatment of poisoning by household bleaching agents.

Small osteophytes are frequently encountered in the foot and ankle, and not to be confused with true osteochondromas, which are relatively uncommon in this region. Osteochondromas are the most common benign osseous neoplasm, occurs in the metaphysis of the long bone. It is rarely found in bones of the foot. Treatment of the osteochondroma is usually conservative, unless symptoms usually pain, are progressive rapid growth, and malignant transformation is suspected. We experienced a rare case of hallux rigidus with osteochondroma of the hallucal proximal phalanx which cause pain and corn of the plantar.
Animals ; Ankle ; Foot ; Hallux ; Hallux Rigidus ; Osteochondroma ; Osteophyte ; Zea mays

BACKGROUND: Left ventricular function and left ventricular hypertrophy often show weak correlation with the degree of blood pressure in hypertensive patients. So we assessed correlation of hemodynamic load to left ventricular hypertrophy and left ventricular performance, and whether left ventricular wall stress is the major factor on the regulation of left ventricular function. METHODS: Relationships between echocardiographic hemodynamic parameters and indices of left ventricular hypertrophy and left ventricular function were evaluated in 40 patients with essential hypertension who have not been previously treated. RESULTS: Left ventricular mass index correlated weakly with blood pressure, cardiac index, and stroke volume. End-diastolic left ventricular relative wall thickness, as an index that assess the severity of concentric hypertrophy showed significantly negative correlation with cardiac index (r=-0.49, p<0.001),stroke index(r=-0.46, p<0.001) and a positive correlation with total peripheral resistance (r=0.55, p<0.001). Furthermore, patient with cardiac indices tend to have higher end-diastolic wall thickness at any given level of blood pressure. Fractional shortening suggesting left ventricular systolic function was not related with blood pressure. stroke volume, cardiac index, left ventricular mass index, and peak systolic wall stress. In contrast there were significant negative correlations between fractional shortening with mean wall stress index (r=-0.42, p<0.005) and with end-systolic wall stress (r=-0.72, p<0.001). CONCLUSIONS: These results suggest that anatomic and hemodynamic changes may be pathophysiologically interdependent and left ventricular function was regulated by the level of left ventricular wall stresses reflecting afterload (blood pressure).
Blood Pressure ; Echocardiography ; Hemodynamics* ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Stroke Volume ; Vascular Resistance ; Ventricular Function, Left

PURPOSE: We conducted this study in order to determine clinical features and prognostic factors in adults with acute tetrodotoxin (TTX) poisoning caused by ingestion of puffer fish. METHODS: In this retrospective study, 107 patients were diagnosed with TTX poisoning. The subjects were divided into two groups according to duration of treatment; Group I, patients were discharged within 48 hours (n=76, 71.0%), Group II patients were discharged after more than 48 hours (n=31, 29.0%). Group II was subsequently divided into two subgroups [IIa (n=12, 11.2%), IIb (n=19, 17.8%)] according to the need for mechanical ventilation support. RESULTS: In multivariable logistic regression analysis, the predictors of the need for treatment over 48 hours were dizziness (odds ratio [OR], 4.72; 95% confidence intervals [CI], 1.59-12.83), time interval between onset of symptom and ingestion (OR, 0.56; 95% CI, 0.16-0.97), PaCO2<35 mmHg (OR, 8.37; 95% CI, 2.37-23.59). In addition, predictors of the need for mechanical ventilation were a time interval between onset of symptoms and ingestion (OR, 0.54; 95% CI, 0.11-0.96) and PaCO2<35 mmHg (OR, 5.65; 95% CI, 1.96-18.66). CONCLUSION: Overall, dizziness, time interval between onset of symptoms and ingestion, DeltaDBP and PaCO2<35 mmHg predict the need for treatment over 48 hours, time interval between onset of symptoms and ingestion and PaCO2<35 mmHg predict the need for mechanical ventilation support after acute TTX poisoning.
Adult* ; Dizziness ; Eating ; Humans ; Logistic Models ; Poisoning* ; Respiration, Artificial ; Retrospective Studies ; Tetraodontiformes* ; Tetrodotoxin