We report a case of erythema elevatum ditinum in a 6-year-old girl. Th symmetrically distributed skin lesions consisted of elevated purplish annular plaques and nodules on the elbows, knees, ankles and buttocks, and some of the lesions showed vesicles, hemorrhagic crusts, and necroses. Biopsy specimens from the knee and ankle revealed typical leukocytoclastic vasculitis. Ve performed a Multites CMI, a test for delayed r.utaneous hypersensitivity, in which the patient showed positive reaction to streptococcal antigen(Lancefield group C). We tried oral prednisolone and dapsone seperately and could see a remarkable response to both drugs.
Ankle ; Biopsy ; Buttocks ; Child* ; Dapsone ; Elbow ; Erythema* ; Female ; Humans ; Hypersensitivity ; Knee ; Necrosis ; Prednisolone ; Skin ; Vasculitis

From Oct. 1974 to Jun. 1979, 47 diaphyseal fractures of the forearm bones in 36 patients were treated with compression plates. Among them 36 diaphyseal fractures in 28 patients (23 with acute fractures. and 5 with non-union) followed for average 8.3 months from three months to thirty seven months were studied. 19 fractures of the radius and 17 fractures of the ulna were treated with compression plates. Fifteen fractures which were delayed for operation for more than 3 weeks or had severe comminution, had primary iliac bone grafts. The fracture unlon of the radius and ulna was obtained in all cases and average healing time for the radius was 11.9 weeks and for the ulna was 12.3 weeks. The final functional results were excellent, 16 and satisfactory,7. The over all rates of excellent and satisfactory results were 82.2 percent. Therefore compression plate is one of the excellent methods to treat diaphyseal fractures and non-union of the forearm bone.
Forearm ; Humans ; Radius ; Transplants ; Ulna

Ten feet from 6 idiopathic congenltal clubfoot patients which had failed to respond to conservative mearsured were treated by aggreasive posteromedial release during infancy with generally good results. A modltication of Denis-Browne splint by splitting both aides and using dial lock to hold the foot still ln correeted position was found quite useful for post-operative maintenance.
Clubfoot ; Foot ; Humans ; Splints

We investigated whether symptom-free period(mean response time) could be prolonged when diltiazem, one of the calcium-channel blocker, as a adjuvant was administered with botulinum toxin in blepharospasm and hemifacial spasm. The patients were 10 blepharospasms and 20 hemifacial spasms who had been treating with botulinum toxin injection in our hospital. When they received only botulinum toxin for treatment of blepharospasm and hemifacial spasm, their mean response times were 126.94 +/- 42.74 and 167.32 +/- 52.90 days, respectively. After start combination therapy of diltiazembotulinum toxin, mean response times were prolonged to 163.83 +/- 53.07 (p=0.0446) in patients with blepharospasm, on the other hand, 154.21 +/- 43.36(p=0.2156) days in patients with hemifacial spasm. This study suggests that a combination treatment of diltiazem and toxin may be effective especially when the mean response time is decreased due to antibody production and the local complications are possibly expected in some patients. Present study is meaningful in that it provides a new treatment modality for blepharospasm and hemifacial spasm.
Antibody Formation ; Blepharospasm* ; Botulinum Toxins* ; Diltiazem* ; Hand ; Hemifacial Spasm* ; Humans ; Reaction Time

Adult intussusception is a rare entity. Most adult intussusceptions require surgical intervention because they have a high rate of pathologic leading point. Mandatory laparotomy and en bloc resection is recommended in colonic intussusceptions due to the possibility of malignancy. We report herein 3 cases of adult colonic intussusceptions. The intussusceptions were located in the sigmoid and rectum, which were managed by laparoscopic colectomy. Case 1 was managed by laparoscopic anterior resection and diverting ileostomy combined with perineal reduction. Perineal approach facilitated laparoscopic reduction. In case 2, intraoperative colonoscopy was performed to determine the distal resection margin. Intraoperative colonoscopy showed edematous bowel mucosa as well as leading point after reduction of intussusceptions. Case 3 showed asymptomatic transient rectorectal colonic intussusceptions.
Adult ; Colectomy ; Colon ; Colon, Sigmoid ; Colonoscopy ; Humans ; Ileostomy ; Intussusception ; Laparoscopy ; Laparotomy ; Mucous Membrane ; Rectum

Segmental cystic disease of the kidney is a rare form of cystic disease of the kidney that manifests as variable sized, numerous cysts that are localized in a segment of one kidney. Morphologically and pathologically, it is indistinguishable from autosomal dominant polycystic kidney disease except for its unilateral localization, the lack of an autosomal dominant genetic background and the progressive deterioration of the renal function. We experienced a case of surgically confirmed segmental cystic disease of the kidney in a 49-year-old patient and we report on its ultrasonographic and CT findings, along with a brief review of the relevant literature.
Humans ; Kidney ; Kidney Diseases, Cystic ; Middle Aged ; Polycystic Kidney Diseases ; Polycystic Kidney, Autosomal Dominant ; Tomography, X-Ray Computed

No abstract available.
Free Tissue Flaps*

OBJETIVE: To elucidate 1) whether there are any differences in the urine concentrations of steroid hormone metabolites between patients with leiomyoma and normal controls 2) the correlation between urinary profiles of steroid hormones and leiomyomas of the uterus according to their type, location, volume, and weight. MATERIALS OF METHODS: The study population consisted of 37 premenopausal patients with uterine leiomyoma and the control group consisted of 25 premenopausal normal volunteer women without uterine leiomyoma. Confirmation of the existence of uterine leiomyoma was done by ultrasonography and histopathological examination after surgery. The volume of the leiomyoma was estimated by trans-abdominal and/or trans-vaginal ultrasonography. The Leiomyomas were divided into 3 types (subserosal, intramural and submucosal). Seventeen patients had subserosal type of leiomyoma, 10 with the intramural type and 10 with the submucosal type. The locations of the leiomyoma were also divided into 3 groups (fundus, body and isthmus). Seventeen patients showed a fundus location, 10 in body, and 10 in isthmus. We compared urinary profiles of the endogenous steroids between patients with leiomyomas and normal controls, and also investigated the relationship between urinary profiles of the endogenous steroids and leiomyomas according to their type, location, volume and weight by using highly sensitive Gas Chromatography-Mass Spectrometry (GC-MS) system. RESULTS: The mean ages of the patients with leiomyomas and the control group were 43.1+/-5.6 and 40.6+/-7.2 years, the weights were 63.4+/-7.3 and 59.4+/-8.1 kg, and their heights were 155.4+/-4.8 and 159.3+/-4.8 cm respectively. Seventeen patients had subserosal, 10 had intramural, and 10 had submucosal leiomyomas. There were 17 patients with leiomyoma located in fundus, 10 in body and 10 in isthmus. 17beta-estradiol, 5-AT, 11-keto ET, 11beta-hydroxy An, 11beta-hydroxy Et, THS, THA, THE, alpha-cortolone, alpha-cortol, beta-cortol, 11beta-OH Et/11beta-OH An and E2/E1 were significantly increased in patients with leiomyoma than in the control group. 17beta-estradiol was significantly increased in the intramural and the submucosal types than in the subserosal type. There was no significant difference in the concentrations of urinary steroids according to the locations of leiomyomas. There was no significant relationship between the concentration of urinary steroids and the volume of the leiomyomas. 17beta-estradiol significantly decreased as the weight of uterus increased (r=-0.322, p=0.04). CONCLUSION: The concentrations of steroid hormone metabolites were generally increased in patients with leiomyoma but were not significantly related to the volume and weight of the leiomyomas. Our study suggests that steroid hormones may be involved in the initiation of leiomyomas but may not be involved in their progression. In addition, the concentrations of steroid hormone metabolites are not related to the leiomyoma type and location.
Female ; Gas Chromatography-Mass Spectrometry ; Healthy Volunteers ; Humans ; Leiomyoma* ; Steroids ; Ultrasonography ; Uterus* ; Weights and Measures

Uterine leiomyoma is the most common solid pelvic tumor, occurring in 20~30% of women who are over 30 years of age1 and it accompanies with the symptoms such as uterine bleeding, dysmenorrhea, pain and the pressure on the urinary tract lead to blockage of the urinary tract. it some-times becomes a factor in sterility.2 Leiomyoma is a benign neoplasm that arises from uterine smooth muscle. it is hypothesized that leiomyoma originates from the somatic mutations in myometrial cells, resulting in progressive loss of growthregulation.3,4 Ovarian hormones are believed to stimulate the growth of leiomyoma because there is an increased incidence of leiomyoma after menarche and these tumors enlarge during pregnancy and regress after menopause. The growth of leiomyoma is variable among women with regular menstruation cycles and even among myoma nodules in the same uterus. One possible reason for this variation is thaovarian hormones, especially estrogen, stimulate individual myoma nodules by varying degree. 5 Therefore, therapeutic attempt based on over-come the state of hyperestrogenism have been tried. Treatment with competitive inhibitors of estrogen receptors (ER)6,7 or gonadotropin-releasing hor-mone agonist2,8,9 has been studied for those reasons. it was found that mean ER content was significantly greater in leiomyoma than in myometrium. 10~14 And ER content of the fibroid was reported to signifIcantly correlate wIth the myoma-shrinkage.15 But there were no consistent results as the concentration of estrogen in uterine leiomyoma.16,17 in this study, we determined the concentrations of urinary steroids, including estrogens as well as androgens, which are closely related to the estrogen biosynthesis, in premenopausal women with leiomyoma using Gas Chromatography-Mass Spectrometry (GC-MS). The urinary levels of the same endogenous steroids in age-matched healthy premenopausal women were also estimated by comparing urinary steroid levels between the two groups. From these results, we studied the effect of endogenous steroids and the metabolic changes in the leiomyoma, and we especially observed the difference in the estrogen level between the two groups to predict the role of estrogens in the prevention of and the therapy for leiomyoma
Androgens ; Animals ; Dysmenorrhea ; Estrogens ; Female ; Gas Chromatography-Mass Spectrometry ; Humans ; Incidence ; Leiomyoma* ; Menarche ; Menopause ; Menstruation ; Mice ; Muscle, Smooth ; Myoma ; Myometrium ; Pregnancy ; Receptors, Estrogen ; Steroids* ; Urinary Tract ; Uterine Hemorrhage ; Uterus

The subjects of the study were the 120 mothers who had children hospitalized in 6 hospitals in P city during the period from Feb. 1. to May 30. 1996. The purpose of the study are (1) the problem encountered when they carried out Home Care after discharge and (2) the degrees of demand that they had against Home Care Services. In order to investigate the purpose above-mentioned the researchers used the 55 items of Home Care services belonging to 10 areas selected by Korea Home-Care Association in 1994. The items were modified and supplemented to 4-point scale. The selected data were analyzed by SPSS:PC+ and the following results were derived. 1. The subjects payed great attention to 5 items such as "pain control, OPD visits, diet-control problems" among the 15 sources of anxiety that they had against Home Care services after discharge. Especially, "OPD visits and knowledge deficit" would to be overcome by the nursing activities of the Home Care Nurses. 2. The acknowledge level of the subjects to the Home Care Project that governmental plans to carry out was surveyed and found as under : 50.0% responded they heard about Home Care Nursing System. 60.8% said that they thought the system was "very necessary" and "somewhat necessary". 65.0% said they would like to use the system. However, the acknowledge level of 50.0% is still low and is thought to need further national promotion and propagation. 3. The demand of the subjects against 55 Home Care Services was investigated and found as

. "Assessment, Lab, basic nursing technology, relay & transfer, training & education and curative nursing" showed comparatively high scores. However, the items belonging to pediatric Home Care Services such as "umbilical cord care, breast=feeding, infant care, and post-parum care & loan of breast-pump" showed relatively low scores.
Anxiety ; Child ; Child, Hospitalized* ; Education ; Home Care Services* ; Humans ; Infant ; Infant Care ; Korea ; Mothers ; Nursing ; Child Health