Breast cancer is a common cancer in women and the most common primary tumor metastatic to the skin. Cutaneous metastasis from breast cancer occurs predominently through lymphatic dissemination. Alopecia neoplastica is rare and probably caused by the hematogenous spread of the internal carcinoma. It has diagnostic importance because it may be the first sign of an undiscovered internal malignancy. We report a case of a 40-year-old female who showed alopecia neoplastia secondary to an invasive intraductal carcinoma of the breast.
Adult ; Alopecia* ; Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Female ; Humans ; Neoplasm Metastasis* ; Skin

Evaluation of a fever of unknown origin (FUO) is complex. Recently, PET scanning has been approved for screening in FUO evaluation. We treated three cases of FUO associated with increased FDG uptake in the bone marrow of the femur and tibia on the fusion PET/CT; all three had the same pattern of uptake. Bone marrow biopsies revealed mature lymphocyte and histiocyte infiltration and myxoid changes in one case, and cortical bone involvement in another case. The cases were all young females who had fever with neutropenia and relative lymphocytosis that lasted for several weeks and then remitted spontaneously. Even though the results of the studies were not diagnostic, the unique uptake pattern on PET/CT and the histology might be related to the cause of the illness and should be studied further to assess the association with classic FUO.
Biopsy ; Bone Marrow ; Female ; Femur ; Fever ; Fever of Unknown Origin ; Histiocytes ; Humans ; Lymphocytes ; Lymphocytosis ; Mass Screening ; Neutropenia ; Positron-Emission Tomography ; Tibia

No abstract available.
Lymphoma*

PURPOSE: To determine which perinatal risk factors influence neurodevelopmental outcome, we try to investigate which perinatal risk factors are correlated with Baley mental or psychomotor developmental index using BSID-II test (Baley Scales of Infant Development, II) in long term follow up of very low birth weight who received neonatal intensive care. METHODS: This study was performed on 56 very low birth weight infants with corrected age 24 months who were admitted to the neonatal intensive care unit. We analyzed correlation between perinatal risk factors and neurodevelopmental outcome assessed by mental and psychomotor developmental index. RESULTS: Mean birth weight was 1317.8+/-168.5g : Small for gestational age was 11 cases and appropriate for gestational age was 45 cases : Mean mental developmental index was 93.8+/-10.3 and psychomotor developmental index was 99.9+/-13.2. Mean developmental scale did not show any significant difference between perinatal risk factors, such as sex, ventilator care and its duration, hospitalization days, birth weight, small for gestational age. Mental or psychomotor developmental score was significantly delayed in the subgroup with grade III intraventricular hemorrhages and periventricular cyst. On cranial ultrasonogram, sinificantly low mental, psychomotor developmental score was found on the subgroup with grade III intraventricular hemorrhages and periventricular cyst formation larger than 3mm size (P<0.01). CONCLUSIONS: These findings suggest that grade III intraventricular hemorrhage and periventricular cyst larger than 3mm size are associated with poor prognostic risk factors regarding to low neurodevelopmental index score.
Birth Weight ; Child ; Child Development ; Follow-Up Studies ; Gestational Age ; Hemorrhage ; Hospitalization ; Humans ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Risk Factors* ; Ultrasonography ; Ventilators, Mechanical ; Weights and Measures

OBJECTIVES: Contemporary understanding of schizophrenia has evolved over the last century, yet its pathogenesis is not clear. Environmental stresses in early gestational period, which in turn, can cause neurodevelopmental abnormalities, is one possible etiologic factors in the development of schizophrenia. Heat shock protein 70(HSP70), which is thought to be a protective factor against environmental stresses in a cell, might be involved in the development of schizophrenia. Abnormal immunoreactivity to HSP70 has been identified in patients with schizophrenia. Therefore, genes for HSP70 might be candidates that affect susceptibility to schizophrenia. Three genes encoding HSP70 such as HSP70-1, HSP70-hom and HSP70-2 have been identified in the MHC class III region and they have been known to have genetic polymorphisms. We examined the association of schizophrenia and polymorphisms of HSP70-1, HSP70-hom and HSP70-2 genes in this study. METHODS: We investigated 161 patients with schizophrenia and 165 controls. DNA analysis with polymerase chain reaction(PCR) followed by enzyme restriction was used for the allelic typing of each polymorphism of HSP70-1, HSP70-hom and HSP70-2. The significances of genetic association of the polymorphisms with the disease and with clinical variables were estimated by chi-square test and analysis of variances. RESULTS: 1) There were no significant differences in allelic or genotype frequencies of HSP70-1 and HSP70-hom between the group of patients with schizophrenia and controls. 2) There was a tendency of difference in genotype frequency of HSP70-2, and a significant difference in allelic frequency of HSP70-2 between the group of patients with schizophrenia and controls. 3) There were no significant differences in terms of severity of symptoms and age at onset among the three HSP70 genotypes in the group of patients with schizophrenia. CONCLUSION: These results suggest that polymorphism of HSP70-2 might be related to the pathogenesis of schizophrenia.
DNA ; Genotype ; Heat-Shock Proteins* ; Hot Temperature* ; HSP70 Heat-Shock Proteins* ; Humans ; Polymorphism, Genetic ; Schizophrenia*

PURPOSE: To evaluate the air contamination of the gelfoam in the angio-intervention room. MATERIALS AND METHODS: After exposing four groups of gelfoam(group A1 : gelfoam fragment, group A2 : gelfoam fragment+ saline +contrast media, group B1 : gelfoam powder, group B2 : gelfoam powder + saline + contrast media) to air in the angio-intervention room, we inoculated gelfoam in each group to 30 agar plates each at every fifteen minutes for one hour with aseptic cotton buds. Cultivating them in the incubator for one day, we evaluated the growth of bacteria or fungus. RESULTS: Out of 480 inoculated agar plates, the growth of coagulase(-) staphylococci was visible in 14 ; in group A1, two at 30 minutes, three at 45 minutes, and four at 60 minutes ; in group A2, one at 45 minutes and two at 60 minutes ; in group B1 and B2, one each at 45 minutes. The stastical analysis on bacterial contamination according to time sequence and group revealed no significance(p<0.05). CONCLUSIONS: If gelfoam is exposed to room air for less than 30 minutes, it is possible to reduce contamination by air-borne bacteria. Since coagulase-negative Staphylococci resistant to commonly used antibiotics, it is ideal to reduce exposure of gelfoamto room air for less than 30 minutes.
Agar ; Anti-Bacterial Agents ; Bacteria ; Fungi ; Gelatin Sponge, Absorbable* ; Incubators

BACKGROUND: Definite criteria for determining severity of organophosphate poisoning have not been made. Discovery of the third neuromuscular syndrome, the intermediate syndrome, have made it more complicating then ever. Objectives of this study is to determine early prognostic factors of outcome and development of a new treatment algorithm. METHOD: 74 patients admitted to Severance hospital with acute organophosphate poisoning during 5 years were included. We made a protocol concerning the initial consciousness level, QTc interval, PVC, serum cholinesterase, the intermediate syndrome, total hospital, ICU day, length of ventilator support, disposition and have done a study retrospectively. Multiple regression and Chi-square was used as statistical analysis. Significant statistical P-value was 0.05. RESULTS: The total hospital days were prolonged as serum cholinesterase levels were lower, the age was older and mental status graver.(p<.05) The length of ventilatory support was prolonged when patient's serum cholinesterase level was very low, they were unconscious and serum cholinesterase level not recovered to 500 IU/ml within initial 3 days. The intermediate syndrome was significantly related to the prolonged cholinesterase inhibition. CONCLUSION: As an early prognostic factor for the length of ventilatory support in organophosphate poisoning, 1) level of concsiousness and 2) serum cholinesterase level at admission, 3) recovery to more than 500 IU/ml within initial 3 days are useful. Especially when the serum cholinesterase level is not recovered to more than 500 IU/ml within initial 3 days, it is essential to observe closely for the possibility of an intermediate syndrome.
Cholinesterases ; Consciousness ; Humans ; Organophosphate Poisoning* ; Retrospective Studies ; Ventilators, Mechanical

PURPOSE: This study was conducted to describe the postopertive MRI findings with contrast enhancement following anterior cervical fusion(ACF). MATERIALS AND METHODS: Thirteen patients after anterior cervical fusionsfor disc herniation or traumatic injury were studied with MRI 1 month to 10 months after operation. MRI findings were analysed with attention to the remained vertebral body, disc material, retropharyngeal soft tissue, grafted bone fragment, and biological orthopedic prosthesis(BOP). RESULTS: In 8/13 cases(62%), enhancement of the retropharyngeal soft tissue was seen with good demarcation between soft tissue and surrounding vertebra or disc.In 9/13 cases(69%), grafted bone or BOP was well defined by intersurface with low signal intensity. In 4 cases ofACF with bone graft, 2 cases(50%) showed heterogeneous or homogeneous enhancement of grafted bone fragments. Remained vertebral bodies and discs showed enhancements in 8/13 cases(62%). CONCLUSION: Postoperative MR findings after ACF included good margination of enhanced retropharyngeal soft tissue, grafted bone, and remained vertebral bodies/discs. The MRI could be a useful study to differentiate findings after ACF from posoperative inflammations such as spondylitis or discitis, and be a good imaging modality for follow up of grafted bony fragment or BOP.
Discitis ; Humans ; Magnetic Resonance Imaging ; Orthopedics ; Spine ; Spondylitis ; Transplants

OBJECTIVE: Serotonin is a neurotransmitter which might play an important role in the pathophysiology of schizophrenia. As atypical antipsychotics, which antagonize serotonin receptors, exert effects on negative symptoms of schizophrenia, perturbation of serotonin system has been thought as a good indicator to probe the pathogenesis of schizophrenia. Serotonin transporter is crucial for regulating serotonergic neurotransmission and has a deletion/insertion polymorphism of the gene's transcriptional initiation site. This study was designed to examine the association of schizophrenia and polymorphism of serotonin transporter gene (5-HTTLPR). METHODS: Genomic DNA analysis with polymerase chain reaction (PCR) was used for genetic typing of polymorphism of 5-HTTLPR. It was carried out among a total of 111 patients with schizophrenia and 208 normal controls. The significances of genetic association of the polymorphisms with the disease and with clinical variables were estimated by chi-square test and analysis of variances. RESULTS: The results were as follows: 1) There were no significant differences in allelic or genotype frequencies between the group of patients with schizophrenia and controls. 2) There were no significant differences in positive syndrome scale score of positive and negative syndrome scale (PANSS), duration of illness and number of admission according to 5-HTTLPR genotypes. 3) There was a difference in age at onset according to 5-HTTLPR genotypes. 4) There was a significant difference in negative syndrome scale score and general psychopathology score of PANSS according to 5-HTTLPR genotypes. CONCLUSION: These results suggest that polymorphism of serotonin transporter gene might be related to the pathophysiology of schizophrenia.
Antipsychotic Agents ; DNA ; Genotype ; Humans ; Neurotransmitter Agents ; Polymerase Chain Reaction ; Psychopathology ; Receptors, Serotonin ; Schizophrenia* ; Serotonin Plasma Membrane Transport Proteins* ; Serotonin* ; Synaptic Transmission

PURPOSE: With the recent increase in underwater activity, the number of people at risk for decompression sickness has greatly increased. However, an organized medical system for emergency treatment, evacuation, and hyperbaric oxygen therapy of decompression sickness has not been established yet. We collected information about domestic hyperbaric chambers available for treating decompression sickness. METHODS: We identified 95 hyperbaric chambers in hospitals, hydrospace construction corporations, military, maritime police, 119 rescue services, and other organizations through a telephone survey. We visited the 95 chambers and collected information about location, operating institutes, chamber specifications, and operational status. Twenty-four oxygen capsules were excluded from the study because of inadequate working pressure. RESULTS: Seventy-one hyperbaric chambers available for hyperbaric oxygen therapy were identified among 59 organizations. The hyperbaric chambers were distributed evenly along coastal lines; that is, 21 on the east coast, 26 on the west coast, 21 on the southern coast, and three on Jeju Island. Thirty-eight chambers with maximal working pressure of > or =5 atm could be used for severe decompression sickness and arterial gas embolism treatment. Twenty-nine chambers had a seating capacity equal to-or more than three patients. Twenty-eight chambers had two or more compartments; thus, they could handle complex medical situations. Thirty-eight chambers with medical locks were useful for severe decompression sickness treatment. CONCLUSION: A sufficient number of domestic hyperbaric chambers available for treating decompression sickness were distributed evenly along the coastal lines. However, potential barriers need to be overcome to establish an efficient decompression sickness treatment system.
Academies and Institutes ; Capsules ; Decompression ; Decompression Sickness ; Diving ; Embolism, Air ; Emergency Treatment ; Humans ; Hyperbaric Oxygenation ; Military Personnel ; Oxygen ; Police ; Republic of Korea ; Telephone