Subepidermal calcified nodules, consisting of solitary circumscribed deposits of insoluble calcium within the subepidermis, have generally been assumed to be idiopathic. As the disease is not associated with any systemic or cutaneous diseases, or any biochemical abnormalities, the pathogenesis is still unexplained, and it is thought to be a definite entity with only a characteristic histopathology. We report a 36-year-old female who has had subepidermal calcified nodules on both upper eyelids symmetrically for about 20 years. It is interesting that the lesions have xanthelasma-like appearance and are associated with syringomas. Excisional biopsy showed typical histopathologic and histochemical features of the sub epidermal calcified nodules.
Adult ; Biopsy ; Calcium ; Eyelids ; Female ; Humans ; Syringoma

No abstract available.
Carotid Arteries* ; Head and Neck Neoplasms* ; Head* ; Ligation* ; Rupture*

The fact that trochanteric hip fractures are best treated by internal fixation is generally accepted in recent time, since this method provides satisfactory positioning of the fragments and obviates the hazards of recumbency. Consecutive seventy-two cases of trochanteric hip fractures were treated at the Department ef Orthopaedic Surgery, National Medical Center from 1965 to 1974. Despite death and lack of follow-up of certain cases, the late results were analysed and presented in 41cases out of 72 cases. 1. In sex difference, 30 of the patients were males and 11 were females. Forty-one percents of the patients were over 51 years of age, and the most common age group was 4th decade. 2. The most common cause of fracture was due to traffic accident. 3. Among 41 cases, 36 were treated with open reduction and internal fixation, and the rest were treated conservatively. Various devices were available for internal fixation; 21 Smith-Peterson or Thornton nails with McLaughlin plates, 5 Jewett nailing, 4. Smith-Peterson nailing plus Multiple screwing, 5 compression screwing and one multiple pinning. 4. Early weight bearing was permitted in 6 cases provided firm internal fixation after anatomical reduction, in an average of 5 weeks postoperatively. Three unstable intertrcchanteric fractures were treated by primary medial displacement fixation in valgus position, and got satisfactory results. 5. The average time in fracture healing was 16 weeks roentgenologically. 6. Complications after internal fixation were most common in the patients of Boyd and Griffin Type III fracture. 7. Owing to short duration of follow up, the number of patients who were treated with various sliding nails and compression hip screws were excluded in this paper.
Accidents, Traffic ; Female ; Femur ; Follow-Up Studies ; Fracture Healing ; Hip Fractures ; Hip ; Humans ; Male ; Methods ; Sex Characteristics ; Weight-Bearing

No abstract available.
Biopsy, Fine-Needle* ; Thyroid Gland* ; Thyroid Nodule*

Herein we have analyzed retrospectively 24 patients with renal inflammatory mass lesions such as renal abscess, perirenal abscess, emphysematous pyelonephritis and xanthogranulomatous pyelonephritis managed at Seoul National University Hospital during 5-year period from January l980 to December l985. Major presentations were flank or abdominal pain (83%) and fever (79%) The most common organism was E. coli which was cultured in only 6 urine and 2 blood samples. The most common associated conditions were diabetes mellitus, renal and ureteral stone and recent abdominal operation. Ultrasonography of the kidney was the most available and accurate diagnostic method if combined with percutaneous aspiration which could be a therapeutic tool as well. Medical treatment was done in 9 patients and surgical treatment was done in l5 patients when there was no improvement with medical therapy, to remove the precipitating factor and to confirm the mass lesion. All patients were improved and discharged except one death due to upper gastointestinal bleeding and hepatic failure.
Abdominal Pain ; Abscess ; Diabetes Mellitus ; Fever ; Hemorrhage ; Humans ; Inflammation ; Kidney ; Liver Failure ; Precipitating Factors ; Pyelonephritis ; Pyelonephritis, Xanthogranulomatous ; Retrospective Studies ; Seoul ; Ultrasonography ; Ureter

No abstract available.
Laryngectomy*

No abstract available.
Adhesives* ; Cyanoacrylates* ; Fracture Fixation*

Objectives : Depression is a common psychiatric disorder in cancer patients. The Brief Edinburgh Depression Scale(BEDS), which is an abbreviated version of the Edinburgh Depression Scale, may serve as a useful tool in screening for the depression in patients with the medical illnesses. This report investigated the reliability and validity of the Korean Version of the BEDS(K-BEDS) for the depression in cancer patients. METHODS : One-hundred cancer patients were enrolled in this study. All subjects completed the K-BEDS, the Hospital Anxiety Depression Scale(HADS), and the Karnofsky Performance Status Scale(KPSS). Reliability, validity and Receiver Operating Characteristic(ROC) curve analysis measures were assessed. RESULTS : The K-BEDS showed good internal consistency(Cronbach alpha=0.77) and test-retest reliability(0.94, p<0.001). All item-total correlations were above 0.3. Also, it revealed moderate correlation with the depression subscale of the HADS(r=0.617), but no correlation with the KPSS. Exploratory factor analysis produced only one factor, accounting for 47.1% of the total variance. The most valid cutoff value to screen for depression was a total score of 5 on the K-BEDS, which showed sensitivity of 62.5% and specificity of 86.4% with a positive predictive value of 4.60 and a negative predictive value of 0.43. CONCLUSION : The present findings suggested that the K-BEDS would have good psychometric properties to screen for the depression in cancer patients.
Accounting ; Anxiety ; Depression ; Humans ; Karnofsky Performance Status ; Mass Screening ; Psychometrics ; Reproducibility of Results ; Sensitivity and Specificity

Malaria remains one of the most important infectious diseases in the world. For those not immuned to malaria, delayed diagnosis and treatment have been associated with an increase in morbidity and mortality, and development of severe complications. Pulmonary edema is one of the serious complications in falciparum malaria. It usually occurs in association with cerebral malaria, acute renal failure, high parasitemia, and delayed antimalarial treatment, as well as treatment-related side effects. We report two cases of severe falciparum malaria with rapidly developed pulmonary edema, which was not combined with cardiac decompensation or fluid overload. Both patients had a history of traveling to foreign countries, Thailand and Ghana, which chloroquine-resistant malaria is distributed. The first patient who developed hyperbilirubinemia, hypoglycemia, thrombocytopenia, decreased mentality, multi-organ failure, and pulmonary edema with acute respitatory distress syndrome, was treated with quinine, doxycycline, hemodialysis, and mechanical ventilation. The patient was recovered with a sequela of restrictive lung change. The second patient also developed anemia, thrombocytopenia, mental confusion, and pulmonary edema with aucte lung injury. Through the treatment of quinine, diuretics, and high concentration of oxygen via facial mask, the patient was successfully recovered without any sequela.
Acute Kidney Injury ; Anemia ; Communicable Diseases ; Delayed Diagnosis ; Diuretics ; Doxycycline ; Ghana ; Humans ; Hyperbilirubinemia ; Hypoglycemia ; Lung ; Lung Injury ; Malaria ; Malaria, Cerebral ; Malaria, Falciparum* ; Masks ; Mortality ; Oxygen ; Parasitemia ; Plasmodium falciparum* ; Plasmodium* ; Pulmonary Edema ; Quinine ; Renal Dialysis ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult* ; Thailand ; Thrombocytopenia

BACKGROUND: The purpose of this study is to evaluate the efficacy of computed tomography (CT) scans compared with plain radiographs on detecting the involvement of the sigmoid notch. METHODS: This study involved 121 cases diagnosed as the intra-articular distal radius fracture and performed post-reduction CT scans. We determined the presence of the sigmoid notch involvement with both plain radiographs and CT scans and compared findings of plain radiographs with CT scans about the incidence and the pattern of injuries. And the differences of results between arbeitsgemeinschaft fur osteosyntheses (AO) type C2 and C3 were compared. RESULTS: The incidences of sigmoid notch involvement detected in plain radiographs were 81 cases (66.9%), whereas CT scans were 99 cases (81.9%). The sensitivity of plain radiographs compared with CT scans was 74.7%, the specificity was 68.2%, the positive predictive value was 91.4%, the negative predictive value was 37.5%, the false negative value was 25.3%, and the false positive value was 31.8%. In comparison between AO type C2 and C3, the incidence of sigmoid notch involvement was not a significant difference, but the displacement of fracture fragment showed a significant difference. CONCLUSIONS: The intra-articular distal radius fracture usually accompanies the sigmoid notch involvement. Considering that the evaluation of sigmoid notch involvement by plain radiography often results in misinterpretation or underestimation, performing CT scan in intra-articular distal radius fracture is thought to be beneficial.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Intra-Articular Fractures/*radiography ; Male ; Middle Aged ; Predictive Value of Tests ; Radius Fractures/*radiography ; Sensitivity and Specificity ; *Tomography, X-Ray Computed ; Young Adult