A 15-year-old female patient had malignant atrophic papulosis(Degos' disease) that affected the skin and probably intestinal tract. She had multiple erythematous papules with porcelain-white atrophic centers on the trunk and extremities. Also she suffered from intermittent nausea, vomiting and abdominal pain. She received appendectomy for abdominal pain 2 months ago. Histopathologic studies showed atrophic epidermis and necrobiotic dermis. There were endothelial thickening, fibrinoid necrosis of bload vessels, perivascular lymphocytic infiltation in the lower dermis. She was treatd with acetyl salicylic acid and dipyridamole, but there was no improvement.
Abdominal Pain ; Adolescent ; Appendectomy ; Dermis ; Dipyridamole ; Epidermis ; Extremities ; Female ; Humans ; Malignant Atrophic Papulosis* ; Nausea ; Necrosis ; Salicylic Acid ; Skin ; Vomiting

BACKGROUND: This study was performed in order to investigate the changes of Na+ transport system in the red blood cells of patients with essential hypertension. METHODS: Na(+)-Li(+) countertransport and Na(+)-K(+) pump activity were measured in 30 cases of essential hypertension and 20 healthy normal controls. And these measurements were analyzed in terms of some important clinical parameters in the patients, i.e., body mass index(BMI), status of hypertension and plasma lipids. RESULTS: Na(+) and K(+) contents of red cells in hypertensive patients were 16.9+/-1.4 and 77.8+/-2.1mmol/L cells, respectively, and no significant difference was found compared with respective value of normal control(14.2+/-0.9 and 82.2+/-2.8mmol/L cells). Na(+)-Li(+) countertransport in the patients group was significantly ancreased compared with control group(62.5+/-4.5 and 46.8+/-3.0umol/L cells.hr), and Na(+)-K(+) pump activity was also showed a significant depression(8.72+/-0.80 and 12.79+/-0.52umol Pi/mg.hr). In the analysis regarding the relationship between Na(+) transport system and some important clinical parameters of the patients with essential hypertension, Na(+)-Li(+) countertransport was related to BMI, and the level of triglyceride. On the other hand, Na(+)-K(+) pump activity was related to the WHO stage and the levels of total cholesterol and triglyceride. But level of blood pressure did not show a significant correlation with either are of the two Na(+) transport system. CONCLUSION: These resluts suggest that Na(+)-Li(+) countertransport and Na(+)-K(+) pump activity in patients with essential hypertension were significantly altered compared with heathy normal controls, and these Na(+) transport system were also influenced by BMI, WHO stage, and the levels of cholesterol and triglyceride. And the individual variation in Na(+) transport system were also suggested by the findings being overlapped between hypertensive patients and controls.
Blood Pressure ; Cholesterol ; Erythrocytes* ; Hand ; Humans ; Hypertension* ; Plasma ; Triglycerides

The clinical study was performed to 28 patients with the pericardiac effusion who were admitted in Busan university Hospital and Paik Hospital, In-Je Medical College, Busan, korea during March 1976 and July 1981. The results were as following; 1) 12 cases(42.9%) of total 28 pericardiac effusion occured in 3rd decade, 8(28.5%) in 2nd decade and 5 cases(17.9%) in 4th decade. Sex distribution showed male to female 2.5:1. 2) With etiological distribution there were 15 cases(53.6%) tuberculous, 5(17.9%) nonspecific, 3(10.7%) malignant, 2(7.1%) pyogenic, 2 traumatic and 1(3.6%) rheumatic. 3) On admission 28 cases(100%) complained of dyspnea, 24(85.7%) distant heart sound, 20(71.4%) each engorged jugular vein and edema, 18(64.3%) each cough and abdominal fullness, 17(60.7%) each sputum and chest discomfort and pain, 12(42.9%) fever, 11(39.1%) orthopnea, 10(35.7%) chilling, 7(25%) oliguria, 4(14.6%) palpitation and 3(17.2%) headache. Increased cardiac dullness was observed in 26 cases(71.4%), hepatomegaly 18(64.3%), pulmonary rales 17(60.7%), ascites 13(46.1%), fever 12(42.9%), pericardiac friction rub 10(35.7%), splenomegaly 7(25%), paradoxical pulse 6(21.4%) and jaundice 2(7.1%). 4) On amission SGOT and SGPT level was increased each in 15(53.6%) and 13(46.7%), TTT and CCF abnormal in 10(35.7%), and 8(28.5%), serum NPN, BUN, creatinine increased in each 10(35.7%), 11(39.1%), 8(28.5%), WBC increased in 6(21.4%), RBC decreased in 8(28.5%) and ESR increased in 16(57.1%). 5) Characteristics of pericardiac effusion showed hemorrhagic 17(60.7%), serosangeous 6(21.4%), sangeous 3(17.2%) and pyogenic 2 cases(7.1%). 6) The ECG on admission revealed low voltage in 25(89.1%), depressed ST segment in 13(46.1%) and inverted T wave in 12(42.9%). 7) Chest X-ray showing cardiomegaly 28(100%), pleural effusion in 20(71.4%), and pulmonary congestion in 16(57.1%). 8) The m mode and 2-D Echocardiogram showed echo free space in 28 cases and after pericardiocentesis the space was reduced or disappeared. 9) 19 cases of 28(67.5%) were improved clinically, while 5 cases(17.9%) were not improved and 4 cases(14.6%) died.
Alanine Transaminase ; Ascites ; Aspartate Aminotransferases ; Busan ; Cardiomegaly ; Cough ; Creatinine ; Dyspnea ; Edema ; Electrocardiography ; Estrogens, Conjugated (USP) ; Female ; Fever ; Friction ; Headache ; Heart Sounds ; Hepatomegaly ; Humans ; Jaundice ; Jugular Veins ; Korea ; Male ; Oliguria ; Pericardiocentesis ; Pleural Effusion ; Respiratory Sounds ; Sex Distribution ; Splenomegaly ; Sputum ; Thorax

BACKGROUND: Understanding the differentiation and migrating character of the tympanic membrane, external auditory canal as well as cholesteatoma pathogenesis needs knowledge about epithelial generation center. OBJECTIVE: We investigated the distribution of the epithelial generation center in the tympanic membrane and external auditory canal using 5-bromo-2-deoxyuridine(BrdU) immunohistochemistry. MATERIALS AND METHODS: BrdU was injected into peritoneum of 10 Mongolian gerbils and gerbil's temporal bones were obtained and serial section was done. Anti-BrdU antibody immunohistochemical stain was done. RESULTS: The labeling index was highest at posterosuperior quadrant of pars tensa, higher at malleus handle attached area and annulus region. On pars flaccida, labeling index was high at entire area. The labeling index of deep meatal skin was higher than that of lateral meatal skin, especially near annulus area. According to results, epithelial generation centers are thought to be on pars flaccida, posterosuperior quadrant of pars tensa, malleus handle attached area and annulus region. CONCLUSION: These findings are similar to those of human tympanic membrane and external auditory canal, and gerbils can be used as a animal model for study of normal human tymapnic membrane, external auditory canal and cholesteatomas.
Bromodeoxyuridine ; Cholesteatoma ; Ear Canal* ; Gerbillinae* ; Humans ; Immunohistochemistry ; Malleus ; Membranes ; Models, Animal ; Peritoneum ; Skin* ; Temporal Bone ; Tympanic Membrane*

No abstract available.

No abstract available.
De Lange Syndrome*

We report a case of atypical eruption due to chemotherapeutic agent in a 60-year-old man who presented with asymptomatic, erythematous, 0.5cm in diameter, confluent, and elevated papules and plaques confined to the face. The patient was previously diagnosed with small cell carcinoma of the lung with liver metastasis. Two months after the diagnosis, a first course of chemotherapy including etoposide was started. Five days after starting the chemotherapy, the patient developed a facial eruption. Histopathologic examination demonstrated increased epidermal mitotic figures, cells in metaphase arrest, basal cell layer hyperpigmentation, prominent dyskeratosis, and squamous atypia. The most distinctive histologic feature was the presence of starburst cells, which are markedly enlarged pale staining keratinocytes containing small basophilic fragments of nuclear debris haphazardly scattered throughout the cytoplasm in a starburst pattern.
Basophils ; Carcinoma, Small Cell ; Cytoplasm ; Diagnosis ; Drug Therapy ; Etoposide ; Humans ; Hyperpigmentation ; Keratinocytes ; Liver ; Lung ; Metaphase ; Middle Aged ; Neoplasm Metastasis

Idiopathic gingival fibromatosis is associated with other abnorma ities of which the most striking is hypertrichosis of variable degree. Gorlin and Pindborg described this condition as a distinct syndrome termed idiopathic gingival fibromatosis and hypertrichosis. We report a case of idiopathic gingival fibromatosis and hypertrichosis occuring in 34-year-old woman with enlarged gingival tissue, hypertrichosis, and enlargenment of the breasts, ears and nose. Laboratory tests including hormonal and chromosomal studies were all within normal limits. Histologically, the gingival hyperplastic tissue showed thick bundle of collagen fibers with few fibroblasts or capillaries and little or no inflammatory infiltrate.
Adult ; Breast ; Capillaries ; Collagen ; Ear ; Female ; Fibroblasts ; Fibromatosis, Gingival* ; Humans ; Hypertrichosis* ; Nose ; Strikes, Employee

Idiopathic gingival fibromatosis is associated with other abnorma ities of which the most striking is hypertrichosis of variable degree. Gorlin and Pindborg described this condition as a distinct syndrome termed idiopathic gingival fibromatosis and hypertrichosis. We report a case of idiopathic gingival fibromatosis and hypertrichosis occuring in 34-year-old woman with enlarged gingival tissue, hypertrichosis, and enlargenment of the breasts, ears and nose. Laboratory tests including hormonal and chromosomal studies were all within normal limits. Histologically, the gingival hyperplastic tissue showed thick bundle of collagen fibers with few fibroblasts or capillaries and little or no inflammatory infiltrate.
Adult ; Breast ; Capillaries ; Collagen ; Ear ; Female ; Fibroblasts ; Fibromatosis, Gingival* ; Humans ; Hypertrichosis* ; Nose ; Strikes, Employee

BACKGROUND: Combined spinal epidural anesthesia (CSE) often produces a more extensive spinal block than expected. This study was designed to evaluate the effects of CSE on subarachnoid block in patients undergoing lower extremity surgery. METHODS: Thirty-three patients who undergone lower extremity surgeries were randomly allocated to three groups of 11 patients each. Using needle through needle technique, all patients received a subarachnoid injection of hyperbaric 0.5% bupivacaine 1.6~2.0 ml through a 25G Whitacre spinal needle. Group 1 received no extradural injection for 25min, but group 2 and 3 received extradural saline 10 ml and bupivacaine 10 ml 5min after the subarachnoid injection, respectively. Levels of sensory and motor block were assessed at 4, 6, 8, 10, 15, 20, and 25 min after subarachnoid injection. RESULTS: The median values of maximum sensory block level were T7 in all groups. Levels of sensory blockade and the time to onset of maximum sensory blockade were similar among the three groups. There was no significant difference in the degree of motor block among three groups. CONCLUSIONS: This study suggests that extradural saline 10 ml or 0.5% bupivacaine 10 ml which injected 5min after subarachnoid injection does not significantly influence the level of subarachnoid block in lower extremity surgical patients. However, further study is required to declare the safety or optimal dose of extradural injection during CSE.
Anesthesia, Epidural* ; Bupivacaine ; Humans ; Injections, Epidural ; Lower Extremity* ; Needles