We report a case of pulmonary infarction probably related with Henoch-Schönlein purpura, which presented with purpura on both lower extremities in a 27-year-old woman. The purpura had developed 4 days previously and it had no itching or tend'erness. She complained of mild fatigue, chest tightness, but no dyspnea or hemoptysis. On routine examination, chest radiography showed a poorly defined nodular opacity on the left lung field, and it was diagnosed by a follow up chest CT as a pulmonary infarction secondary to pulmonary vasculitis.
Adult ; Dyspnea ; Fatigue ; Female ; Follow-Up Studies ; Hemoptysis ; Humans ; Lower Extremity ; Lung ; Pruritus ; Pulmonary Infarction* ; Purpura* ; Radiography ; Thorax ; Tomography, X-Ray Computed ; Vasculitis

The clinical observation was made on 174 patients with congestive heart failure among the admitted patients in Chung Ang university hospital between 1971 and July, 1978. The results were summarized as follows: 1. There were 89 females and 85 males and the incidence was the highest in the 6th decade. 2. The common causes of congestive heart failure were hypertensive heart disease 44.8%, valvular heart disease 21.3% and ischemic heart disease 9.2%. 3. The precipitating factors of congesive heart failure were found in 73.6% of cases and the major factors were arrhythmia 25.3% and infection 15.5%. 4. The important symptoms and signs were dyspnea 86.8%, hepatomegaly 53.4%, pulmonary rales 49.4%, cardiac murmur 46%, tachycardia 35.1% cough 35.1% and orthopnea 34.5%. 5. The ECG findings were abnormal in 92.1% of cases and the frequent abnormal findings were inverted or flat T wave 47.3%, atrial fibrillation 40.6% and left ventricular hypertrophy 33.3%. 6. The chest PA on admission revealed abnormalities in 159 cases, including cardiomegaly 74.6%, pulmonary congestion 66.9% and pleural effusion 26.6%. 7. The major abnormalities of laboratory data were proteinuria and the increase of globuline, BUN, TTT, alkaline phosphatase and SGOT.
Alkaline Phosphatase ; Arrhythmias, Cardiac ; Aspartate Aminotransferases ; Atrial Fibrillation ; Cardiomegaly ; Cough ; Dyspnea ; Electrocardiography ; Estrogens, Conjugated (USP)* ; Female ; Heart Diseases ; Heart Failure* ; Heart Murmurs ; Heart Valve Diseases ; Hepatomegaly ; Humans ; Hypertrophy, Left Ventricular ; Incidence ; Male ; Myocardial Ischemia ; Pleural Effusion ; Precipitating Factors ; Proteinuria ; Respiratory Sounds ; Tachycardia ; Thorax

The paramount importance of breast feeding for the health of the infants has been recognized by untritionists and physicians. Although many advantages of the breast feedng, exclusive breast feeding without weaning diet or supplement food during prolonged perind in infants may produce iron deficiencyh anemia. This study was conducted to find out the hematologic state in exclusively prolonged breast-fed infants among these anemic patients and the way of thinking about their baby's feeding method in their mothers. Mothers of the anemic patients has been surveyed with questionare. The results and problems obtained from this study are summerized as follows. 1) Among 40 patients of this study, 27 were male (67.5%) and 13 were female (32.5%). Mean age was 12.6+/-2.7 month and 9 & 11 month of age were the most common, respectively (15.0%). 2) Mean age of mothers was 29.5 year. The 25 34 year-old group was most common. 3) Education levels of mothers were primary 10%, middle 10%, high 60%, and college graduate 20%. 4) In motivatins of breast feeding. Persuasion of husband or the parent of husband' 19(47.5%). 'Convenience for use' 12 (30.0%), and 'Through mass media or public information' 9 (22.5%). 5) In the causes of prolonged breast feeding, 'Think that satisfactory nutrition for baby is possible with breast milk alone' 4(10.0%), 'Due to persuasion of husband or the parents of husband' 11 (27.5%), 'Baby did no suck milk bottle or eat other diet except breast milk' 25 (62.5%). 6) In whether or not acknowledgment of the necessity of weaning diet, 'Know it but not consider so important 22 (55.0)%, 'Do not know at all) 15 (37.5%), and 'Breast milk, that will do' 3(7.5%). 7) Hb level in patient group, from 6 to 6.9g/dl was 2 (50.0%), from 7 to 7.9g/dl was 3 (7.5%), from 8 to 8.9%g/dl was 15 (37.5%), and from 9 to 10 g/dl was 20 (50.0%). From 9 to 10g/dl was the most common. Hematologic findings were Hb 8.8+/-0.9g/dl, Hct 28.8+/-3.0%, MCV 64.7+/-6.7 fl, MCH 20.0+/-2.5pg, MCHC 30.8+/-1.5g/dl. Platelet 452.5+/-142.9x103/mm3, Reticulocyte count 1.4+/-0.6%, Fe 28.6+/-14.1 g/dl, TIBC 446.7+/-66.2 g/dl, Ferritin 10.5+/-7.0ng/ml. Transferrin saturation 6.6+/-3.5%. 8) In association with duration of breast milk feeding and hematologic findings, as duration was prolonged, Hb, Hct, MCV & MCH were significantly decreased (p<0.01).
Adult ; Anemia* ; Blood Platelets ; Breast Feeding* ; Breast* ; Diet* ; Education ; Feeding Methods ; Female ; Ferritins ; Humans ; Infant ; Iron ; Male ; Mass Media ; Milk ; Milk, Human ; Mothers ; Parents ; Persuasive Communication ; Reticulocyte Count ; Spouses ; Thinking ; Transferrin ; Weaning*

No abstract available.
Adult* ; Child* ; Humans ; Palatine Tonsil*

We describe the case of a 45-year-old woman who had self-regressing livedo reticularis on the lower extremities. Examination of a biopsy specimen from the mottled area revealed myxomatous emboli in the deep dermal arterioles. Echocardiography showed a myxoma in the left atrium. After the tumor was surgically excised, the patient had no further evidence of the disorders during the 3-year period of follow-up. Livedo reticularis caused by an peripheral arterial embolism, which in turn was caused by the tumor fragments in our patient with left atrial myxoma, is considered to be unusual.
Arterioles ; Biopsy ; Echocardiography ; Embolism ; Female ; Follow-Up Studies ; Heart Atria ; Humans ; Livedo Reticularis* ; Lower Extremity ; Middle Aged ; Myxoma*

PURPOSE: We performed the study prospectively to evaluate the advantage of fat suppression MR in the diagnosis of rotator cuff injury. MATERIALS AND METHODS: Ten symptomatic patients were studied with both conventional T2WI and FST2WI using chemical shift technique. Each image was analyzed for the assessnent of injuries, conspicuity of the lesion, the presence of effusion in subacromial bursae and joint space, and presence of humeral head injury. Arthroscopy was done in 4 patients following MRI. RESULTS: We could made presumptive diagnoses on FSMR as identical as on conventional MR in six cases(1 normal, 2 tendinitis, 2 partial thickness tear, 1 full thickness tear), two of them were confirmed by arthroscopic procedures. Two cases of partial thickness tear proved by arthroscopy were detected on FST2WI, whereas they were considered tendinitis on conventional T2Wl. There were another 2 cases who showed tendinitis on FSMR, but normal on conventional T2Wl. They, however, were not confirmed by either arthroscopy or surgical procedure. CONCLUSION: We found the FSMR were superior to conventional T2Wl in the conspicuity of lesions and detection of joint effusion and abnormalities on the humeral head. We think FSMR of the shoulder could have significant diagnostic advantages over the conventional spin-echo MR imaging.
Arthroscopy ; Diagnosis ; Humans ; Humeral Head ; Joints ; Magnetic Resonance Imaging ; Prospective Studies ; Rotator Cuff* ; Shoulder ; Tendinopathy

Most insects including the honeybee cause erythema and edema at the site of a sting in non-allergic individuals. This reaction usually resolves within a few days. However, in certain cases, the persistence of inciting materials in the cutaneous tissue may promote a local inflammatory foreign body reaction. Localized nodular lesions were seen in our two patients and erythemstous patches were present in one patient due to rarely encountered complications induced by retained sting materials. In these cases histopathology showed multiple foci of foreign body granuloma containing yellow refraetile material in the center surrounded by histiocytes and foreign body giant cells. The granulomatous skin lesions in these patients were treated with intralesional injections of triamcinolone acetonide and partial excisions of the nodular masses were performed.
Bites and Stings ; Edema ; Erythema ; Foreign-Body Reaction ; Giant Cells, Foreign-Body ; Granuloma* ; Granuloma, Foreign-Body ; Histiocytes ; Humans ; Injections, Intralesional ; Insects ; Skin ; Triamcinolone Acetonide

Bowens disease is a precaicerous lesion and may transform into in asive squamous cell carcinoma. We present a case of a 67 year-old male with Bowens disease on the buttock from which squamous cell carcinoma developed. He had anerythematous, scaly and crusted slaque with a nodule on the left buttock. Skin biopsy specimen taken from the plaque and nodule revealed typical histopathological findings of Bowens disease and squlamous cell carcinoma, respectieels. The patient was treated with excision and skin graft under general anesthesia.
Aged ; Anesthesia, General ; Biopsy ; Bowen's Disease ; Buttocks ; Carcinoma, Squamous Cell ; Humans ; Male ; Skin ; Transplants

A 5 year-old girl was admitted to the hospital on April 18, 1967 to be investigated for genital anomalies such as greatly enlarged clitoris, sexual hair in axillae and on pubic region, acne on the face, and excessive somatic growth which were first noticed by her parents at the age of two(Figures 1 and 2). She measured 118 cm in height (normal, 96 cm), and 20kg in weight (normal, 11kg) and was very muscular (Fig. 2 and table 1). The enlarged clitoris measured 3 cm long and showed a groove on its ventral surface communicating with a small opening from the urogenital sinus. The urogenital sinus was persitted and the labia minora are small, but the labia majora are large and resemble an open scrotum. the two labio-scrotal folds were separated and contained no exteriorized gonads. Pubic and axillary hair were scanty but acne on the face was moderately developed (Fig. 3). Nuclear sexing was female type. Her blood pressure and strum electrolytes were normal. Her bone age was around 9 years of a girl. Cystogram and vaginogram were found to be normal (Figure 4,5 and 6). Three consecutive urinary 17-ketosteroid outputs per day were 9.0, 14.0 and 11.4 mg prior to treatment. On cortisone suppression test, the amount of it dropped from 14.0 to 3.7 mg, but it was not significantly suppressed on the third to seventh days of the test to a value below two-third of the pretest level (Fig. 7). Constructive operation of feminine external genitalia including vaginoplasty and clitoridectomy was performed following a vaginogram being taken under general anesthesia on April 28. 1967 (Fig. 8). Both adrenal glands were explored on May 16, 1967 by Young's bilateral approach under general anesthesia and they were found to be hyperplastic almost three times bigger than the normal size but no tumor man was seen. After having decided that both adrenals were in a condition of marked hyperplasia, outer halves of both adrenals were excised. The removed specimens measured 4.0X1.5X 0.5 cm in the right side and 3.5X2.0X0.4 cm in the left. Histological examination showed simple cortical hyperplasia of both adrenals, but the severity was more marked in left than in right (Fig. 9-A, B). Acne subsided and hirsutism decreased one month after the initiation of cortisone therapy in addition to the subtotal adrenal resection. Although it is too early to evaluate the ultimate value of long-term suppressive therapy, clinical results at this time are encouraging.
Acne Vulgaris ; Adrenal Glands ; Adrenogenital Syndrome* ; Anesthesia, General ; Axilla ; Blood Pressure ; Child, Preschool ; Circumcision, Female ; Clitoris ; Cortisone ; Electrolytes ; Female ; Genitalia ; Gonads ; Hair ; Hirsutism ; Humans ; Hyperplasia ; Male ; Parents ; Scrotum

Transient hyperkalmia following intravenous administration of succinylcholine chloride is well known in normal patients. Increase in serum potassium(K+) can be greater in disease state, such as burn, massive trauma, uremia, neuromuscular disease, and tetanus. In the present study, changes in serum potassium and sodium level in 20 control group and 20 patients with infections of varying severity were measured after administration of SCC. The following results were obtained. 1) In all infected patients, serum potassium concentration was increased, hile wonly 70% of the control group was increased. 2) Serum potassium levels after administration of succinylcholine chloride increased in the control group(average 0.40+/-0.9mEq/L) and in the infected group(average 0.68+/-0.15 mEq/L). 3) The paek elevation of serum potassium level was 5 min. after administration of succinylcholine chloride in both groups. 4) There was asignificantly increased serum potassium concentration(p<0.01) in the infected group compared to the control group. 5) Serum K was increased above 0.5mEq/L in serum potassium level regardless of duration of infection. 6) Serum sodium concentration after administration of succinylcholine chloride was slightly decreased in both groups, but statistically this was not significant(p>0.05).
Administration, Intravenous ; Burns ; Humans ; Neuromuscular Diseases ; Potassium* ; Sodium* ; Succinylcholine* ; Tetanus ; Uremia