There are many complications related to paralyzed patients. Heterotopic ossification in pressure sore patients is reported to be rarely developed, but once it occurs, it frequently causes joint stiffness which may aggrevate the pressure sore wound. This paper was based on a clinical study of heterotrophic ossification in 6 quadriplegic and paraplegic patients from 1988 to 1997 at St. Paul's Hospital. All were males aged between 22 and 58 years (mean age, 45.5 years). The sites of pressure sore were in the ischial and trochanteric areas. Heterotopic ossification had developed around the hip joint and the ischial area. The mean onset time was 3.6 years (minimum 10 months maximum 8 years) after trauma. Plain X-ray, bone scan CT and pathological examination were helpful in confirming the diagnosis of heterotopic ossification. The mechanism of heterotopic ossification is not exactly known, but chronic trauma or inflammation could be one etiology. There are still many difficulties in management of heterotopic ossification, but prevention is the most important treatment.
Diagnosis ; Femur ; Hip Joint ; Humans ; Inflammation ; Joints ; Male ; Ossification, Heterotopic* ; Pressure Ulcer* ; Wounds and Injuries

Livedo vasculitis or vasculitis of atrophie blanche is a clinical entity which can be distinguished from cutaneous vasculitis by distinctive pathology and immunopathologic study. A 18-year-old female with erythematous, telangiectatic, purpuric or hyperpigmented patches, intermingled with white atrophic ivory patches on her legs of 3 years duration was seen in June 3, 1982. The histologic examination of an atrophic patch showed proliferation and occlusion of blood vessels in the upper dermis with patchy atrophy of the epidermis. The immunopatbologic features of an atrophic patch revealed deposits of IgM, Ca and fibrin as a definitive immunofluorescence vessel pattern. This suggests that the livedo va.sculitis or vasculitis of atrophie blanche may he considered one of the immune vasculitides. This patient had received aspirin and persantine for 4 months, and moderate therapeutic effects could be noticed.
Adolescent ; Aspirin ; Atrophy ; Blood Vessels ; Dermis ; Dipyridamole ; Epidermis ; Female ; Fibrin ; Fluorescent Antibody Technique ; Humans ; Immunoglobulin M ; Leg ; Pathology ; Vasculitis*

Lymphomatoid papulosis is a strange disease; clinically benign, histologically malignant. Clinically, it may simulate pityriasis lichenoides et varioliformis acuta. The diagnosis is based on the typical histopathological features suggestive of malignant lymphoma, due to the presence of polymorphous lymphoid infiltrate consisting of small lymphocytes intermingled with conspicuous large atypical cells. We experienced a case of lymphomastoid papulosis in 35-year-old woman. Initially, her skin lesions developed as erythematous papules on the extremities, gradually spreading centrifugally with a tendency to involute slowly without treatment, leaving brown wrinkled surface and shallow ulceration. These skin lesions tended to become worse in warm weather and better in cold weather. At first visit, multiple erythematous grouped, ulcerated papules and nodules are seen. 18 months after first visit, most skin lesions are regressed except 5 erythematous pinhead sized papules on right leg in spite of no treatrnent. Labcratory examiniations of CBC, VDRL, urinatlysis, blood chemistry and chest X-ray were all within normal limits. Histopathologically there were hygerkeratosis, mild acanthosis, exocytosis in epidermis, and numerous lymphoid cells were infiltrated especially on perivascular and periappendegeal area, and many atypical cells showing hyperchromatic nuclei, kidney-shaped nuclei and mitotic figures in dermis.
Adult ; Chemistry ; Dermis ; Diagnosis ; Epidermis ; Exocytosis ; Extremities ; Female ; Humans ; Leg ; Lymphocytes ; Lymphoma ; Lymphomatoid Papulosis* ; Pityriasis Lichenoides ; Skin ; Thorax ; Ulcer ; Weather

No abstract available.
Humans ; Urinalysis*

This study was conducted to evaluate prevalence of intestinal helminthic infections and skin tests and Paragonimus and Clonorchis in tuberculosis(TB) patients in Korea. Stool examinations by formalin-ether technique and intradermal tests were carried out in 2 areas; Masan TB hospital and Kong-Ju TB hospital. The positive rate of intestinal helminths of any kind was 51.7 percent among 329 patients in Masan hospital, but 18.1 percent among 215 patients in Kong-Ju hospital. The infection rates of Trichocephalus trichiurus and Clonorchis sinensis were 20.7 percent and 17.6 percent respectively in Masan hospital patients, but the infection rates of T. trichiurus and C. sinensis were 6.5 percent and 6.0 percent respectively in Kong-Ju hospital patients. In skin tests, positive reactions to Paragonimus and Clonorchis antigens were 22.0 percent and 37.6 percent respectively in Masan hospital patients. On the contrary, Kong-Ju hospital patients showed the positive rates of 15.2 percent for Paragonimus and 27.2 percent for Clonorchis respectively.
parasitology-helminth-trematoda ; Ascaris lumbricoides ; Trichuris trichiura ; hookworm ; Trichostrongylus orientalis ; Clonorchis sinensis ; Paragonimus westermani ; Metagonimus yokogawai ; Taenis sp. ; Hymneolepis nana ; epidemiology ; skin test

BACKGROUND: Abnormal umbilical artery Doppler velocimetry is one of the important findings of intrauterine growth restriction (IUGR) and IUGR is associated with high perinatal morbidity and mortality. In addition, this abnormal Doppler velocimetry is correlated with placental insufficiency. The aim of this study was to determine the pathologic differences in the placentas from IUGR pregnancies with and without the absent or reversed end diastolic velocity (AREDV). METHODS: Among the cases that had undergone prenatal follow-up in our institute, a retrospective slide review was conducted for 18 cases of IUGR with AREDV and 17 cases with IUGR that had normal end-diastolic flow of the umbilical artery. RESULTS: The birth weight and the other clinical parameters were not different among the two groups. Grossly, the placental weight percentiles were significantly smaller in AREDV group when they were adjusted according to gestational age. Histologically, chronic deciduitis, mural hypertrophy of the decidual arteries, an intimal fibrin cushion of the large fetal vessels, increased syncytial knots, villous agglutinations, avascular villi, villous stromal-vascular karyorrhexis, and acute atherosis were more frequently found in the AREDV group and their presence showed statistical significance. CONCLUSIONS: These findings suggest that pathologic abnormalities due to fetal and maternal vasculopathies in the placenta may be the cornerstone for inducing AREDV in the umbilical artery.
Arteries ; Birth Weight ; Fetal Growth Retardation ; Fibrin ; Follow-Up Studies ; Gestational Age ; Hypertrophy ; Placenta ; Placental Insufficiency ; Pregnancy ; Retrospective Studies ; Rheology ; Umbilical Arteries

BACKGROUND: Acute myocardial infarction is one of major cardiovascular disease that increases according to the changes of diet and life style. Early diagnosis and treatment of acute myocardial infarction is critical for better prognosis and for reducing mortality. But early diagnosis of acute myocardial infarction is limited by several factors. Recently it was reported that measurements of several serum cardiac enzymes were useful for early diagnosis of acute mocardial infarction. This study was performed to investigate which method of serum creatine kinase measurement is the faster and accurate and whether serum creatine kinase is an early noninvasive predictor of coronary artery patency following thrombolysis in patients with acute myocardial infarction by means of analysis of serial changes in serum creatine kinase. METHODS: This study included 32 patients who had acute myocardial infarction. Serum CK-MB was measured by electrophoretic method and enzymatic immuoasssay method. and compared with EKG and total CK activity which measured by photoabsorbance method. Also we studied whether CK time-activity could be predictor for reperfusion. RESULTS: Immunoassay method accurately measures the serum CK-MB and correlates well with that of electrophoretic method in patients with acute mocardial infarction. Immunoassay method is more sensitive than EKG and has the similar sensitivity to electrophoretic method in diagnosis of acute myoardial infarction. Reperfusion of an occluded coronary artery results in early elevation of serum creatine kinase and CK-MB reflected by earlier appearance time, peak, and onset of clearance. CONCLUSION: Because immunoassay measurement of serum creatine kinase is faster than electrophoresis and requires less technical expertise, it is possible to make diagnosis in patients with acute myocardial infarction in a more timely and cost effective manner and creatine kinase is good predictor of recanalization of an occluded coronary artery after intravenous thrombolytic therapy.
Cardiovascular Diseases ; Coronary Vessels ; Creatine Kinase* ; Creatine* ; Diagnosis ; Diet ; Early Diagnosis* ; Electrocardiography ; Electrophoresis ; Humans ; Immunoassay ; Infarction ; Life Style ; Mortality ; Myocardial Infarction* ; Professional Competence ; Prognosis ; Reperfusion* ; Thrombolytic Therapy

The purpose of this study was to observe the additive effect of halothane anesthesia and propranolol, and also the effect of atropine and isoproterenol on the heart rate and the blood pressure after propranolol during halothane anesthesia in human-volunteers. The results were as follows: 1) In conscious patients, 10 minutes after intravenous administration of 1.0mg propranolol the heart rate was slower but there was no significant change in the blood pressure. 2) Twenty-thirty minutes after halothane anesthesia, the heart rate was slower by 6 to 8 beats per minute: systolic and diastolic blood pressure was lower by 20.4 torr and 10.5 torr, respectively. 3) 10 minutes after intravenous administration of 1.0mg propranolol during halothane anesthesia, the heart rate was decreased by 7.8, 7.0 per minute: systolic and diastolic blood pressure decreased by 6.7, 5.7 torr and 3.0, 3.9 torr in the atropine and isoproterenol group, respectively. 4) One minute after intravenous administration of atropine 0.5mg after propranolol 1.0mg during halothane anesthesia, the heart rate increased by 12.1 per minute and persisted so far 10 minutes, but the blood pressure did not increase. 5) One minute after intravenous administration of isoproterenol 0.025mg after propranolol 1.0mg during halothane anesthesia, the heart rate had markedly increased by 35, but normalized 10 minutes later. The systolic blood pressure was increased by 13.4 torr but normalized 10 minutes later. 6) The above results indicate: Atropine increases the heart rate which has been slowed with propranolol during halothane anesthesia: isoproterenol increases the heart rate and blood pressure but the duration of action was short. Therefore, authors considered that atropine is useful for the maintenance of heart rate, and continuous administration of isoproterenol for maintenance of blood pressure and heart rate after propranolol during halothane anesthesia.
Administration, Intravenous ; Anesthesia* ; Atropine* ; Blood Pressure* ; Halothane* ; Heart Rate* ; Heart* ; Humans ; Isoproterenol* ; Propranolol*

Asymmetrical Septal Hypertrophy(ASH), Characterized by interventricular septal hypertrophy, is not an uncommon cardiac disease. Arrythmia occuring in ASH are supraventricular tachycardia, atrial premature beats, and ventricular premature beats. In about 10% of patients, there is a short P-R interval and a partial delta wave, suggestive of a variant of the Wolff-Parkinson-White syndrome. We reported here a case of ASH associated with W-P-W syndrome and paroxysmal atrial fibrillation with review of pertinent literatures.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Cardiac Complexes, Premature ; Heart Diseases ; Humans ; Hypertrophy* ; Tachycardia, Supraventricular ; Wolff-Parkinson-White Syndrome

Asymmetrical Septal Hypertrophy(ASH), Characterized by interventricular septal hypertrophy, is not an uncommon cardiac disease. Arrythmia occuring in ASH are supraventricular tachycardia, atrial premature beats, and ventricular premature beats. In about 10% of patients, there is a short P-R interval and a partial delta wave, suggestive of a variant of the Wolff-Parkinson-White syndrome. We reported here a case of ASH associated with W-P-W syndrome and paroxysmal atrial fibrillation with review of pertinent literatures.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Cardiac Complexes, Premature ; Heart Diseases ; Humans ; Hypertrophy* ; Tachycardia, Supraventricular ; Wolff-Parkinson-White Syndrome