Neutrophilic eccrine hidradenitis(NEH) was originally described in 1982 by Harrist et al. in a patient with myelogenous leukemia receiving chemotherapy. Clinically NEH represents various cutaneous manifestations with or without tenderness and pruritus. Histologic examination demonstrates a neutrophilic infiltrate within and around the eccrine gland and degeneration of the eccrine gland structures. Although the pathogenesis and possible cause of NEH remain unknown, it is probably an unusual cutaneous reaction to chemotherapeutic agents. A few cases of infection associated eccrine hidradenitis are found in the literature. We report three cases of neutrophilic eccrine hidradenitis. Two cases were associated with hematologic malignancy. The third case was associated with an infection of Vibrio vulnificus.
Drug Therapy ; Eccrine Glands ; Hematologic Neoplasms ; Hidradenitis* ; Humans ; Leukemia, Myeloid ; Neutrophils* ; Pruritus ; Vibrio vulnificus

No abstract available.
Adult* ; Decompression* ; Head* ; Humans ; Osteonecrosis*

Although it is well known that extension block in the injured knee is usually attributed to a meniscus tear or anterior cruciate ligament rupture, it is vary rare to cause mechanical extension block by the torn posterior cruciate ligament. We report a case of posterior cruciate ligament partial rupture who presented persistent extension block caused by a nodule formation in a 12-year-old boy after knee trauma and was treated with arthroscopic resection of the nodule.
Anterior Cruciate Ligament ; Child ; Humans ; Knee* ; Male ; Posterior Cruciate Ligament* ; Rupture*

Acute promyelocytic leukemia (APL) is characterized by a specific chromosome translocation t(15;17), which fuses the promyelocytic leukemia (PML) gene to the retinoic acid receptor alpha (RARalpha) gene, and by a unique response to the differentiating agent all-trans retinoic acid (ATRA). Although ATRA does not exhibit the conventional side effects of anticancer agents, it has its own unique side effects including retinoic acid syndrome, Sweet's syndrome, and myositis. Muscular involvement associated with ATRA therapy in APL has been rarely reported. We report a case of isolated myositis induced by ATRA in the induction treatment of APL. ATRA- induced myositis has distinctive clinical features and radiologic findings that should allow its recognition in order to treat promptly with steroid therapy.
Antineoplastic Agents ; Humans ; Leukemia ; Leukemia, Promyelocytic, Acute* ; Myositis* ; Receptors, Retinoic Acid ; Sweet Syndrome ; Tretinoin*

Fibroepithelial polyps are a benign neoplasm of mesodermal origin that usually occur in the urinary tract. However, a giant fibroepithelial polyp of the glans penis is very rare and is strongly linked with long-term condom catheter use. In this article, we report a case of a 45-year-old man who presented with a giant fibroepithelial polyp originating from the glans penis. Physical examination showed a 6x3 cm sized mass lesion overlying the ventral surface of the glans near the urethral meatus without urethral communication. For the previous 10 years, the patient had been required to use a condom catheter secondary to paraplegia sustained during a T12-L1 spinal cord injury. He was successfully treated by wide local excision of the mass and suprapubic cystostomy placement. There was no evidence of recurrence after 12 months of follow-up.
Catheters ; Condoms ; Cystostomy ; Follow-Up Studies ; Humans ; Male ; Mesoderm ; Middle Aged ; Neoplasms, Fibroepithelial ; Paraplegia ; Penis ; Physical Examination ; Polyps ; Recurrence ; Spinal Cord Injuries ; Urinary Tract

PURPOSE: To find out the relationship between the initial Magnetic Resonance Image (MRI) findings and the progression of vertebra collapse when treated with Jewett brace in osteoporotic stable thoracolumbar fractures. MATERIALS AND METHODS: We divided 38 cases of 37 patients of thoracolumbar osteoporotic stable thoracolumbar fractures who were treated with Jewett brace into two groups. One group was composed of those body collapse progressed more than 10% compared with the initial state, and the other group less than 10%. We analyzed the relationships between the progression of collapse and the superior endplate fractures, the fracture line extending to posterior cortex, the size of bone marrow edema, the signal intensity on T1 and T2 weighted MR images, the presence of paravertebral hematoma, and the degree of posterior extensor muscle atrophy using MR images. RESULTS: The body collapse was more likely to progress when there was superior endplate fracture, when it showed larger size of bone marrow edema on T1 weighted image, and transverse low signal on T2 weighted image. But extending of fracture line to posterior cortex, presence of paravertebral hematoma, and degree of posterior extensor muscle atrophy did not show any statistical correlations to progression of collapse. CONCLUSION: The body collapse is more likely to progress when there was superior endplate fracture, larger low signal on T1 weighted image and low signal on T2 weighted image at initial MRI treated with Jewett brace.
Bone Marrow ; Braces ; Edema ; Hematoma ; Humans ; Magnetic Resonance Spectroscopy ; Muscular Atrophy ; Osteoporosis ; Spine

The aim of this study was to identify the usefulness of pelviscopy in treatment besides its diagnostic value. The advantages of pelviscopic surgery are low cost, rapid recovery, good cosmetic effect, low incidence of complication and postoperative adhesion. So most of the pelvic exploration in gynecologic patients are replaced by the pelviscopic surgery these days. Pelviscopic surgery was performed on 136 patients at the Department of Obstetrics and Gynecology, College of Medicine, Yenungnam University from May 1991 to July 1993. The results obtained were as follows : The age distribution of the patients was from 19 to 55 with age of 31.2 years, and the mean parity was 0.96, the most common indication of pelviscopic surgery was tubal pregnancy(66.9%), the second most common indications was ovarian cyst(10.3%) and the other indications were endometriosis, corpus iuteum cyst rupture, parovarian cyst, foreign body, tubal ligation, hydrosalpinx, uterine myoma and in 16.3%. The mean duration of hospitalization was 2.1 days without specific complications. According to these results, it was postulated that the pelviscopic surgery was a useful operative tool in gynecologic treatment and its application could be extended to many other areas of gynecology with safety by the development of surgical techniques and instruments.
Age Distribution ; Endometriosis ; Female ; Foreign Bodies ; Gynecology ; Hospitalization ; Humans ; Incidence ; Leiomyoma ; Obstetrics ; Parity ; Parovarian Cyst ; Rupture ; Sterilization, Tubal

Pulsating exophthalmos, bruit, episcleral venous distention, conjunctival and (eye)lid edema, ophthalmoplegia, and ocular pain have long been regarded as the classic symptoms and signs of idiopathic dural carotid cavernous sinus fistula(CCF). We experienced a 39-year-old woman who presented with headache and cyclovertical diplopia. On neurologic examination, we found isolated left trochlear nerve palsy only. The past medical history was not remarkable. Intracranial magnetic resonance angiography revealed abnormal signals around the carotid siphon on both sides. Conventional angiography confirmed bilateral dural CCFs, leaking predominantly from the left side. Diplopia and headache had improved spontaneously over 3 weeks after the onset. Occasionally, isolated oculomotor or abducens nerve palsy has been reported as the sole clinical finding of symptomatic dural CCF. But isolated trochlear nerve palsy with dural CCF is extremely rare. Although the exact mechanisms of isolated trochlear nerve palsy by dural CCF is unclear, various mechanisms have been proposed, including compression of trochlear nerve by venous congestion or direct shunted flow in cavernous sinus, vascular steel phenomenon, and venous thrombosis.
Abducens Nerve Diseases ; Adult ; Angiography ; Carotid-Cavernous Sinus Fistula* ; Cavernous Sinus ; Diplopia ; Edema ; Exophthalmos ; Female ; Headache ; Humans ; Hyperemia ; Magnetic Resonance Angiography ; Neurologic Examination ; Ophthalmoplegia ; Steel ; Trochlear Nerve Diseases* ; Trochlear Nerve* ; Venous Thrombosis

We performed 1st day Tc-99m-sestamibi gated SPECT with dipyridamole/rest T1-201 SPECT and 2nd day 24 hour delay T1-201 SPECT/rest Tc-99m-sestamibi gated SPECT in 27 patients with coronary artery disease(24) or having chest pain(3). Stress and rest Tc-99m- sestamibi gated SPECT was acquired at 60min post-injection. A 4-point scoring system(0 to 3 for normal to absent tracer uptake) for 17 segments was used. Wall motion was scored on another 4 point scale(0 to 3 for normal to dyskinesia) in the lst day post-stress gated and the 2nd day rest gated SPECT. Post-stress gated SPECT showed wall motion abnormality in 94 segments(20%). Fifty-five segments among these 94 showed the same wall motion between post-stress and rest gated SPECT:i.e. 1-1: 23 segments, 2-2: 29 segments, 3-3: 3 segments. Re-maining 39 segments (41.5%) showed different wall motion between post-stress and rest Tc-99m-sestamibi gated SFECT. Twenty one segments with wall motion abnormality had normal perfusion(rest:15 segments, 24 hour delay: 6 segments) at either rest or 24 hour delay. Fifteen among these 21 segments showed persistent post-stress and the 2nd day rest wall motion abnormality(persistent stunning). However, in 6 segments with prolonged (1 hour after stress) stunning, abnormal wall motion did improve in the 2nd day rest Tc-99m-sestamibi gated SPECT(transient prolonged stunning). These 6 segments had normal perfusion at rest(n=4) or at 24 hour delay(n=2). Post stress wall motions showed significantly higher scores in persistent stunning than in prolonged transient stunning(P value<0.05). It was concluded that we could find stunned myocardium with gated Tc-99m-sestamibi SPECT at either post-stress or rest and that some myocardial walls of post-stress 1 hour gated SPECT did not show truly rest wall motion. So, we should be cautious if we use post-stress Tc-99m-sestamibi wall motion to assess rest wall motion.
Coronary Vessels ; Dipyridamole* ; Humans ; Myocardial Stunning ; Perfusion ; Thorax ; Tomography, Emission-Computed, Single-Photon*

We studied to investigate the predictive values of gated SPECT for the improvement of wall motion after bypass surgery. As we compared postoperative SPECT with preoperative ones, we defined viability as wall motion improvement. We performed rest 71-201/stress Tc-99m-MIBI gated SPECT in 25 patients before and 3 months after bypass surgery. Myocardial wall motion was graded as normal, hypokinesia, akinesia, and dyskinesia by pair-wise visual analysis of gated pre and postoperative SPECT's on the same monitor screen. Myocardial wall thickening was determined good or poor Among 92 segments with wall motion abnormalities before operation, 69 (75%) improved and 23 did not. Before operation, we could find segments with good systolic thickening in 64 segments among total 92. Thickening of the remaining 28 was poor. Wall motion improved postoperatively in 45 segments (70%) among 64 with good thickening. Twenty four(86%) among 28 segments with poor thickening had also improved. We grouped segments into mild(hypokinetic) and severe(akinetic/dyskinetic) ones. Among 33 segments with severe motion abnormalities, 14 had good thickening and 19 did not. Nine(60%) improved out of 14 segments having severe abnormality with good thickening. However, 16(84%) segments out of 19 having severe abnormality with poor thickening also improved. Neither degree of perfusion decrease nor severity of wall motion abnormalities could explain the high rate of false negatives. In conclusion, as we defined viability as wall motion improvement by comparing pre and postoperative SPECT, systolic thickening observed by gated Tc-99m-MIBI SPECT in myocardial segments with wall motion abnormalities predicted wall motion improvement after bypass surgery. However, poor thickening could not be referred as evidence of nonviable myocardium both in mild and severe contractile dysfunction, so that we might need stimulation study such as dobutamine echocardiography or dobutamine gated SPECT.
Dobutamine ; Dyskinesias ; Echocardiography ; Humans ; Hypokinesia ; Myocardium ; Perfusion ; Tomography, Emission-Computed, Single-Photon*