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

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

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: The purposes of this study were to measure the degree of uncertainty in illness, hope, and spiritual well-being and to examine the relationship among uncertainty in illness, hope, and spiritual well-being of cancer patients. METHOD: The data were derived from answers to questionnaires obtained from 93 cancer patients at one general hospital in J area from April 6, 2004 to May 8, 2004. The collected data were analyzed by SSPS 10.0. RESULTS: The mean score of uncertainty in illness of cancer patients was 55.96. The mean score of hope of cancer patients was 79.77, and spiritual well-being was 55.20. Uncertainty in illness of cancer patients was related negatively to hope(r=-.57, p=.000). Also uncertainty in illness of cancer patients was related negatively to spiritual well-being(r=-.57, p=.000). However, hope of cancer patients was related positively to spiritual well-being(r=.67, p=.000). CONCLUSION: Higher uncertainty in illness was related to lower hope and spiritual well-being of cancer patients. Based upon these results, nurses should help patients to improve their hope and spiritual well-being through mediation of uncertainty in illness.
Hope* ; Hospitals, General ; Humans ; Negotiating ; Uncertainty* ; Surveys and Questionnaires

Lichen aureus is a variant of pigmented purpuric lichenoid dermatitis. The skin lesions usually appear asymptomatic rusty, copper, or orange colored roundish lichenoid erythematous-purpuric papules and patches on the lower extremities. Histologically, the epidermis shows minimal changes, with a dense lymphohistiocytic infiltrate observed in the superficial derrnis, typically distributed in a band-like fashion. The typical lesion is a single patch localized on the lower extremity. We report a rare case of segmental lichen aureus localized on the right lower extremity.
Citrus sinensis ; Copper ; Dermatitis ; Epidermis ; Lichens* ; Lower Extremity ; Skin

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

Pigmented lesions of palmar and plantar skin may cause diagnostic problems, because some features of benign lesions in these sites may raise the suspicion of melanoma if considered alone. Transepidermal elimlnation is a mechanism by which a substance is eliminated through the epidermis, and it is apt to be confused with a feature of melanoma that tumor cells are located at all layers of the epidermis. We report a case of transepidermal elimination of nevus cells in acral letiginous nevus which needs a differential dignosis of melanoma.
Epidermis ; Melanoma ; Nevus* ; Skin

Trichoadenoma is a rare cutaneous tumor that was first described by Nikolowski in 1958. It usually occurs as a single tumor on the face and its size varies from 3 to 50mm in diameter. It may arise any time during adult life. This tumor is less mature than trichofolliculoma and more differentiated than trichoepithelioma, and it is considered as a benign tumor with differentiation toward the infundibular portion of the pilosebaceous canal. In this report, we describe a 61-year-old women who developed trichoadenoma on the left shoulder of 3 years duration. The lesion was asymptomatic and had grown slowly. Histopathological findings showed numurous horn cysts with central keratinous material and solid tumor islands reaching to the deep dermis. Immunohistochemical studies showed negative findings for eccrine differentiation.
Adult ; Animals ; Dermis ; Female ; Horns ; Humans ; Islands ; Middle Aged ; Shoulder

PURPOSE: To evaluate the utility of high-resolution computed tomography(HRCT), as used to determine the activity of tuberculosis, and to analyze the HRCT findings in active and in inactive tuberculosis. MATERIALS AND METHODS: We analyzed the HRCT findings of 100 patients (54 men, 46 women; average age, 54 years) who according to the results of chest radiography had pulmonary tuberculosis of undetermined activity. We assessed HRCT findings such as the presence of a entrilobular, macro-, or micronodule; consolidation, ground-glass opacity, cavity, interlobular septal thickening, irregular linear opacities, bronchial wall thickening, bronchovascular bundle distortion, bronchiectasis, atelectasis, and pericicatrical emphysema. We compared the ratio of the area of nodule and consolidation to that of whole lung, and compared the findings between active and inactive tuberculosis. RESULTS: Eleven of 100 patients were excluded because the final diagnosis was other than tuberculosis. In 59 patients, the presence of active pulmonary tuberculosis was proven by positive sputum smear and/or culture for Mycobacterium tuberculosis. On the basis of the negative results of these tests, pulmonary tuberculosis was found to be inactive in 30 patients; serial chest radiographs indicated that their condition remained stable over a 6-month period. For HRCT, sensitivity was 96.6%, specificity 56.7%, positive predictive value 81.4%, negative predictive value 89.5%, and accuracy 83.1%. For active tuberculosis, the presence of centrilobular nodules, tree-in-bud, macronodules, cavity within the nodule, and consolidations was statistically significant, while for inactive tuberculosis, that of irregular linear opacities, micronodules, bronchiectasis, and cicatrization atelectasis was similarly significant. The CT score for the area of nodules and consolidations was higher in active than in inactive tuberculosis, but only the nodule score showed statistical significance. CONCLUSION: HRCT can be a useful diagnostic tool for evaluating the activity of pulmonary tuberculosis
Bronchiectasis ; Cicatrix ; Diagnosis ; Emphysema ; Female ; Humans ; Lung ; Male ; Mycobacterium tuberculosis ; Pulmonary Atelectasis ; Radiography ; Radiography, Thoracic ; Sensitivity and Specificity ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary*

Aplasia cutis congenita(ACC) is a rare congenital anomaly characterized by a well-demarcated skin defect. In the majority of cases it is limited to the scalp especially on the vertex although other areas of the body may also be involved. We report a case of aplasia cutis congenita, in a month-old female infant born with a round shaped hairless transparent menbrane on the left temporal area of the scalp. No associated other congenital anomalies were in this case.
Ectodermal Dysplasia* ; Female ; Humans ; Infant ; Scalp ; Skin