Basal cell carcinoma is the most common skin cancer, but it rarely metastasizes. Metastatic basal cell carcinoma (MBCC) is rare in terms of incidence as well as absolute numbers. We present a case of 67-year-old woman who had a dirty oozing, ulcerated, tumor mass on the vertex and suffered from dyspnea and mild lumbago. The diagnosis of MBCC was based on clinical, radiological, and histopathological findings. To our knowledge, the occurrence of MBCC has not been reported in the Korean literatures. So we reported herein this case of MBCC of the lung and the bone.
Aged ; Carcinoma, Basal Cell* ; Diagnosis ; Dyspnea ; Female ; Humans ; Incidence ; Low Back Pain ; Lung ; Skin Neoplasms ; Ulcer

Lead is one of the most widespread environmental toxins and its poisoning in children was considered a rarity, usually resulting from unique circumstances such as inappropriate use of leadbased body cosmetics or direct administration of lead-containing folk medicines. The increasing concern about children with lower levels of lead exposure has developed, but there are no data regarding the mean blood lead levels and the incidence of symptomatic or asymptomatic lead poisoning in Korean children. We analyzed the zinc protoporphyrine (ZPP) values and blood lead concentrations in 163 pediatric inpatients for a prospective study of lead exposure. The blood lead concentrations in all 163 children were 15~54 g/dl, of whom 111 children (68.1%) were 25~54 g/dl which needs decision to chelate based on the EDTA provocation test. Among 111 children whose blood lead concentrations are 25~54 g/dl, 59 children(53.2%) were between 7 months and 3 years of age, which revealed no significant higher incidence of lead exposure than any other age group. The ZPP values in 126 children (77.3%) were above 35 g/dl. The mean blood lead concentration and ZPP values are 27.8 g/dl and 48.8 g/dl, respectively. We conclude that there are many asymptomatic children with increased absorption of lead in the urban area of Korea, and we need further studies regarding lead poisoning. It is important that there must be a national counterplan and that pediatricians continue to pay attention to lead posioning in children.
Absorption ; Child ; Edetic Acid ; Humans ; Incidence ; Inpatients* ; Korea ; Lead Poisoning ; Poisoning ; Prospective Studies ; Zinc

It is well known that the cell type and histopathological grading of gliomas correlate well with clinicalcourse and prognosis. Therefore, it is tempting to set certain criteria that could predict the histopathologiccharacteristics of the gliomas before the surgical intervention. With a total of 56 cases of gliomas which wereverified histopathologically in Seoul National University Hospital between July 1978 and May 1983, a statisticalanalysis of the computed tomographic findings was done with the particular emphasis on the correlation withhistopatholoigcal features. The results are as follows; 1. The calcification is observed in 27 cases (48.2%) intotal: in 20 cases (62.5%) among low grade group, in 6 cases (46.1%) among high grade group and in 1 case (9.1%)among glioblastoma multiformed group respectively. 2. The mass effect, especially surrounding low densitycorrelates well with the grade of malignancy. 3. The contrast enhancement is observed in 43 cases (76.8%). Thepattern of enhancement provides clues for the assessment of cell type and grade with fair degree of reliability.Among low grade group, 10 cases (31.3%) show no enhancement and 10 cases show solid enhancement. Among high gradegroup, 6 cases (46.8%) show solid enhancement and nodular or ring enhancement are not observed. Among glioblastomamlultiform group, 8 cases (72.7%) show characteristic thick irregular ring enhancement. 4. Plain CT densities arenot useful in differentiating each group in statistically significant level. 5. Neither the margin of the mass northe degree of contrast enhancement contributes for the differentiation of each group. 6. Summarizing the abovementioned findings it is concluded that CT is very helpful in differentiating the gliomas with regard tohistopathological cell type and the grade of malignancy as well.
Glioblastoma ; Glioma ; Prognosis ; Seoul

No abstract available.
Blister* ; Cluster Analysis* ; Skin Diseases*

A pathological study was done to elucidate sequential changes of the lungs in various time intervals following experimental paragonimiasis in 15 dogs and 15 cats. The dogs and cats were fed with 30-50 metacercariae of Paragonimus westermani, and were sacrificed at 15, 20, 30, 45, 60, 90 and 120 days after infection respecively. Autopsies were performed immediately after death. Gross and microscopic examination of the lungs showed following findings: There were no qualitative difference in pathological findings between dogs and cats. Pathological findings were first noticed at 20 days of infection in thoracic cavity, which consisted of fibrinous plueritis along with superficial hemorrhage. Although no worm was found in the lung parenchyma at this period, juveniles were seen in pleural cavity together with turbid effusion. Paragonimus juveniles were first recognized inside the lung parenchyma by 30 days of infection. This was the period when the lungs showed multiple areas of hemorrhage and probably active penetration by smaller worms. Hemorrhagic bronchopneumonia was quite pronounced from this stage through 45 days of infection. Paragonimus worm cyst was essentially composed of fibrous scar and heavy inflammatory cellular infiltrate. The lining epithelial cells were first became noticed by 2 months of infection. And these epithelial cells were thought to be probably transformed alveolar lining cells rather than bronchiolar epithelial cells. As the infection progress, the cyst wall became more stabilized and often showed squamous metaplasia. Fibrinous pleuritis with pleural effusion was very prominent finding in early periods of infection. Bronchiolitis and focal vascular sclerosis were often seen in experimental paragonimiasis.
parasitology-helminth-trematoda ; Paragonimus westermani ; paragonimiasis ; pneumonia ; cyst ; hemorrhage ; pleuritis ; effusion ; bronchiolitis ; sclerosis

It can be speculated that the thinned and flattened central cornea after excimer laser photorefractive keratectomy (PRK) might give a falsely low Goldmann applanation tonometer(GAT) reading. We studied 353 eyes of 264 patients who underwent PRK to determine the effect of excimer laser PRK on the accuracy of Goldmann applanation tonometry. PRK was done with a VISX 20/20 excimer laser and topical fluorometholone was used after PRK. The intraocular pressure(IOP) was measured with the GAT before surgery and 1, 3, 6, 9, and 12 months postoperatively. The mean ablation depth of the cornea was 71.4 +/- 22.0 micrometer, and the eyes were divided into three groups according to their ablation depths. The mean postoperative IOP measured with the GAT decreased as compared with the mean preoperative IOP(P<0.01). The mean postoperative IOP at 9 or 12 months was lower than that at 1, 3, or 6 months(p<0.05). The mean IOP(11.9 +/- 2.5 mmHg) at 12 months was 2.8 mmHg lower than the mean preoperative IOP(14.7 +/- 2.7 mmHg). There was no statistically significant difference in the amount of postoperative IOP decrease among the three groups.
Cornea ; Fluorometholone ; Humans ; Lasers, Excimer* ; Manometry* ; Photorefractive Keratectomy*

The authors' clinical experience has suggested that the noncontact tonometer (NCT) has a tendency to record a lower intraocular pressure(IOP) than the Goldmann applanation tonometer(GAT) after excimer laser photo refractive keratectomy(PRK). This study was done to verify this tendency. We performed PRK on 177 eyes of 122 patients using a VISX 20/20 excimer laser, and topical fluorometholone was used after PRK. The eyes were divided into three groups according to their ablation depths, and the IOP was measured with the GAT and the Topcon NCT before surgery and 1, 3, 6, 9, and 12 months postoperatively. The mean postoperative IOP measured with the GAT or the NCT decreased as compared with the mean preoperative IOP(GAT: 1.67 ~ 2.90 mmHg, NCT:5.27 ~ 6.54 mmHg). The mean NCT reading was 1.12 mmHg higher than the mean GAT reading preoperatively, but was 2.48 ~ 2.88 mmHg lower than the mean GAT reading postoperatively. Difference between GAT and NCT measurements postoperatively was more prominent in the group of deeper ablation. These results suggest that we should be cautious of evaluating the IOP measured with the GAT or the NCT after PRK.
Fluorometholone ; Humans ; Intraocular Pressure ; Lasers, Excimer* ; Photorefractive Keratectomy*

Changes of power spectrum of R-R interval variabilty during recovery from N2O-O2 - halothane anesthesia have been studied in 20 patients. Power spectral analysis of R-R intervals during awake period and recovery period have been performed with newly developed R-R interval variability, we compared the power of each frequency range(low: 0.04-0.08 Hz, middle 0.10-0.15 Hz, high: above 0.3 Hz) between awake period and recovery period. There was no difference between awake period and recovery period in the power of low and high frequency ranges, but there was remarkable difference in power of midfrequency range. During awake period the power of midfrequency range changed with cyclic pattern, but there was no cyclic change during recovery period even after the regain of consciounss(30+/-3.2 min.). The power of midfrequency range during recovery period began to change with cyclic pattern only after 45 minutes. It is concluded that the power of midfrequency range is useful index of recovery from N2O-O2 -halothane anesthesia.
Anesthesia* ; Halothane ; Humans

Analysis of R-R interal variability is a useful method of obtaining many information about cardiovascular control mechanisms. Among the many methods of analyzing R-R variability, power spectral analysis(PSA) is said to be the most powerful and acurate tool. Although application of computer techniques in analysing R-R interval variability were introduced, as most of the studies on the R-R interval variability have been off-line and invasively, they were not suitable for practical use. So we prepared a program for non-invasive on-line perioperative assessment of R-R interval variability. We used Turbo C++(ver 1.0, Borland International, USA) and Turbo Assembler(ver 2.0, Borland International, USA) for programing. Data were collected by A/D converter(PCL 718,, Taiwan) by interrupt mode and transferred to TBM386 compatibie computer with VGA color monitor. By applying PSA to R-R interval variation, we can get an almost as confident information about the cardiovascular system as analysis of arterial waveform, In addition to this we can get data that requires very reduced momory size, and get them non-invasively. So analysing R- R interval variability may be the most suitable method for on-line continuous assessment of cardiac parameters.
Cardiovascular System

The angiolipoma is well circumscribed, benign neoplasm, composed of mature fat cells and well developed arterioles, venules and capillaries, in which fibrin thrombi often form. We experienced 4 adult male patients who had free movable, subcutaneous nodular masses on the upper extremities, the abdomen, the back and the buttock. All of them were confirmed as angiolipoma by the clinical and histopathological findings.
Abdomen ; Adipocytes ; Adult ; Angiolipoma* ; Arterioles ; Buttocks ; Capillaries ; Fibrin ; Humans ; Male ; Upper Extremity ; Venules