Dynamic cardiomyoplasty is a recently introduced surgical method to improve myocardial performance. It consists of a placement of a skeletal muscle flap around the heart and stimulation of the flap in synchrony with ventricular contraction. We experienced a case of cardiomyoplasty in a 25 year old male patient with congestive heart failure. Anesthesia was induced and maintained with fentanyl, midazolam and isoflurane. The operation was performed for 8hrs without cardiopulmonary bypass and the patient was transferred to the intensive care unit. He was mechanically ventilated electively overnight and extubation was done 18hrs postoperatively. The patient was discharged home on the 40days after operation and improved in exercise tolerance. We report the anesthetic management and hemodynamic changes in a patient who underwent dynamic cardiomyoplasty.
Adult ; Anesthesia ; Cardiomyoplasty* ; Cardiopulmonary Bypass ; Exercise Tolerance ; Fentanyl ; Heart ; Heart Failure ; Hemodynamics ; Humans ; Intensive Care Units ; Isoflurane ; Male ; Midazolam ; Muscle, Skeletal

Leiomyoma is a benign solitary tumor which is originated from a smooth muscle cell and grows slowly. It is most commonly found in the uterus and can develop anywhere that smooth muscle is present, including esophagus, lower extremity, stroma of GI tract, and pleura. However, the occurrence of leiomyoma in the hand is so uncommon. We present one case of solid type leiomyoma found in the right 4th finger of a young woman.
Esophagus ; Female ; Fingers ; Gastrointestinal Tract ; Hand ; Humans ; Leiomyoma ; Lower Extremity ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Pleura ; Uterus

A case of toxic epidermal necrolysis (TEN) was presented in 46 year-old male patient. The characteristic skin lesions of TEN were developed after some medictions and tetanus anti-toxin (TAT) injection due to trauma. Probably, the cause of the disease was drugs, TAT injection or trauma inself. On the pathologic findings, lower epidermis and dermo-epidermal cleavage were noticed. He was treated with massive antibiotics and steroid. About 7 days after therapy, much improvement achived. However foul odorous yellowish discharge was noticed since 20 days of hospitalization. Wide debridement of necrotic tissue was carried without improvement. Patient expired on 48th hospital day due to sepsis and impending hepatic coma.
Anti-Bacterial Agents ; Debridement ; Epidermis ; Hepatic Encephalopathy ; Hospitalization ; Humans ; Male ; Middle Aged ; Odors ; Sepsis ; Skin ; Stevens-Johnson Syndrome* ; Tetanus

Pityriasis lichenoides chronica is considered to be a benign disease. Erythematous yelIowieh scaly maeulea appear insidiously, chiefly on the sides of trunk, thighs and upper arms. Acanthosis nigricans is a rare cutaneous disorder with peak incidence in puberty characterized by hyperkeratosis and, dark pigmentation. We report a case of pityriasis lichenoides chronica assaciated with pseudoacanthosis nigricans in a 14 year-old obeae male patient who has bean sized erythematoua scaly papules on the trunk and extremities, velvety black brownish colored patchea on the neck and both axillary regions.
Acanthosis Nigricans ; Adolescent ; Arm ; Extremities ; Humans ; Incidence ; Male ; Neck ; Pigmentation ; Pityriasis Lichenoides ; Pityriasis* ; Puberty ; Thigh

We observed a case of tuberculosis cutis orificialis, which occurred in 50 year-old man. He had been suffered from single markedly inflamed, erythematous painful ulcer, covered by dirty brown pseudomembranous material, around anus for 3 months. The laboratory findings (CBC, routine urinalysis, stool ova and parasite with occult blood) are within normal limits except elevated ESR (52mm/hr.). Staphyloeoccus aureus and proteus are observed on wound culture, and many AFB are seen on scrapings of wound but not on sputum for 3 times. Unfortunately culture was not done. Tuberculin skin test revealed strong reaction (36mm/hr.). Chest PA and small bowel series showed far advanced pulmonary tuberculosis and intestinal tuberculosis on ileocecal area. But the findings of upper gastro-intestinal series and barium enema are within normal limits. Histopathologic findings of skin lesion showed tuberculous and tuberculoid granuloma in the deep dermis and subcutaneous tissue. We observed a case of tuberculosis cutis orificialis, which occurred in 50 year-old man. He had been suffered from single markedly inflamed, erythematoas painful ulcer, covered by dirty brown pseudomembranous material, around anus for 3 months. The laboratory findings (CBC, routine urinalysis, stool ova and parasite with occult blood) are within normal limits except elevated ESR (52mm/hr.). Staphyloeoccus aureus and proteus are'observed on wound culture, and many AFB are seen on scrapings of wound but not on sputum for 3 times. Unfortunately culture was not done. Tuberculin skin test revealed strong reaction (36mm/hr.). Chest PA and small bowel series showed far advanced pulmonary tuberculosis and intestinal tuberculosis on ileocecal area. But the findings of upper gastro-intestinal series and barium enema are within normal limits. Histopathologic findings of skin lesion showed tuberculous and tuberculoid granuloma in the deep dermis and subcutaneous tissue. Treatment with INH, myambutol and rifampin resulted in some improvment on the chest and considerable improvement on the skin and intestine within 6 months.
Anal Canal ; Barium ; Dermis ; Enema ; Ethambutol ; Granuloma ; Humans ; Intestines ; Middle Aged ; Ovum ; Parasites ; Proteus ; Rifampin ; Skin ; Skin Tests ; Sputum ; Subcutaneous Tissue ; Thorax ; Tuberculin ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer ; Urinalysis ; Wounds and Injuries

Melanoma is relatvely uncommon malignant tumor arising in the skin from epidermal melanocytes, from the junctional component of a cellular nevus or, rarely within a blue nevus and frequently metastasizes to regional lymph nodes first, followed by hematogenous spread to lungs, liver, gastrointestinal tract, pancreas, adrenal, heart and brain. All melanoma patients are carefully evaluated according to several parameters. A complete history and physical examination are carried out, with particular attention being devoted to other pigmented tumors that the patient may have. The patient should be further evaluated to determine the presence or absence of metastases by chest X-ray examination, metastatic series or bone scan, liver function studies, liver scan, EKG, etc. Special factors such as age, sex, and race, as well as site, size, and growth rate of lesions are also evaluated. We had a case of 59 year-old male patient with disseminated malignant melanoma. Upon his first visit, we did not find any abnormality in his physical examination and routine laboratory findings except skin tumors on left heel and left leg.
Brain ; Continental Population Groups ; Electrocardiography ; Gastrointestinal Tract ; Heart ; Heel ; Humans ; Leg ; Liver ; Lung ; Lymph Nodes ; Male ; Melanocytes ; Melanoma* ; Middle Aged ; Neoplasm Metastasis ; Nevus ; Nevus, Blue ; Pancreas ; Physical Examination ; Skin ; Thorax

The serum level of immunoglobulin E (IgE) in 28 atopic patients and 41 healthy, normal, non-allergic subjects were measured by standard radial immunodiffusion method (RIDT). The correlation between IgE level and clinical manifestations are studied. The results are as follows. 1) IgE value was higher in atopic dermatitis than normal subjects. 2) IgE value in atopie dermatitis revealed no sigaificant difference between in male and in female. 3) IgE value was increased parallel with the severity of the disease. 4) IgE value was not correlated with the extent of disease. 5) IgE value was not correlated with the duration of disease. 6) IgE value was not correlated with the age of onset. 7) IgE value was not correlated with the eosinophil count of peripheral blood.
Age of Onset ; Dermatitis ; Dermatitis, Atopic* ; Eosinophils ; Female ; Humans ; Immunodiffusion ; Immunoglobulin E* ; Immunoglobulins ; Male

Serum zinc is an essential element in men and animals. Recently on the dermatologic fields, the serum and the skin levels and the roles of zinc have been studied especially in acne vulgaris, but the results were controversial. So to confirm the previous reports and for evaluation of the relationship between the various aspects of acne vulgaris and the serum levels of zinc, the serum levels of zinc were measured by atomic absorption spectrophotometer in 13 healthy controls and 46 patients with acne vulgaris. In the healthy controls, their mean values of zinc were 0.843+0.251 ppm in total, 0.920+0.219 ppm, in females and 0.777+0.260 ppm in males. There was no statistical difference attributable to sex. In the 46 patients with acne vulgaris, their mean value of zinc was 0.741+0.195 ppm. There was no significant difference in the mean serum zinc level compared with the controls. In the males with acne, the mean va1ue of zinc was 0.727+0.166 ppm, and 0.748+0.208 ppm in females with acne. There was no significant statistical difference between males and females with acne. And females, but not males, with acne had significantly lower serum zinc levelss than controls of the corresponding sex. (p<0.1) By clinical severity, classifying the 46 patients with acne vulgaris into three groups: mild type (only comedones), moderate type (comedones with pa.pules) and severe type (includes pustules, comedones, and papules, etc.), the serum zinc levels of each group were 0.774+0.185 ppm, 0.7880. 200 ppm and 0.666+0.176 ppm. The significant statistical difference was found only in the severe type of acne compared with the healthy controls (p<0.05). Also classifying the patients into three groups (acute, moderate and chronic types of acne) by duration of acne, the serum values of zinc were 0.738+0.158 ppm, 0.692+0.283 ppm and 0.769+0.241 ppm, respectively. Only in the moderate type of acne, the mean serum level of zinc was significantly reduced compared with the control group (p<0.1)
Absorption ; Acne Vulgaris* ; Animals ; Female ; Humans ; Male ; Skin ; Zinc*

No abstract available.
Histiocytoma, Benign Fibrous*

We report a case of calcinosis cutis following administration of 10% calcium gluconate, used for the treatment of a hypocalcemic seizure in a 5-week-old neonate. After administration of 10% calcium gluconate, subcutaneous induration developed at the infusion site. The histopathological findings taken from the dorsum of the left foot showed multiple foci of calcium deposits with infiltration of epitheloid histiocytes between collagen bundles and foreign body giant cells phagocyting calcific granules throughout the reticular dermis and subcutis.
Administration, Intravenous* ; Calcinosis* ; Calcium Gluconate* ; Calcium* ; Collagen ; Dermis ; Foot ; Giant Cells, Foreign-Body ; Histiocytes ; Humans ; Infant, Newborn ; Seizures