An 18-year-old man had suffered from intense burning with redness and an increased temperature of both the lower legs, forearms and hands since the age of 5. Symptoms were exacerbated by exposure to heat or walking. The patient obtained temporary relief by immersing his feet and hands in cold water. We observed the increase of skin temperature in relation to pain by thermography. No specific abnormalities were noted in laboratory studies. Treatment with aspirin was ineffective. We report a rare case of primary erythermalgia with typical features.
Adolescent ; Aspirin ; Burns ; Erythromelalgia* ; Foot ; Forearm ; Hand ; Hot Temperature ; Humans ; Leg ; Skin Temperature ; Thermography ; Walking ; Water

Spondylolisthesis is characterized by forward displacement of the vertebral body with bilateral defects of the partes interarticulares. Because the progression of slipping occurs in young adults, difficult problems are present in the treatment of this condition. Watkins(1953) described the technique of posterolateral fusion between transverse processes, which was accepted in the dynamics of spine motion. In this procedure, grafted bone is placed close to the center of axis of the spine motion and so, bony fusion is not affected by flexion motion but distracted by a Iateral shearing force. The role played by the Norton-Brown back brace is in the restriction of lateral bending. However it pormits somewhat flexion motion of the spine. It is suggested that early ambulation may be possible without the interference of bony union after the posterolateral fusion operation when this brace is applied instead of longterm cast immobilization. In clinical analyses and follow-up studies after operative treatments in 55 patients with spondylolisthesis, the following results were obtained: 1. 30 patients (54.6%) were distributed between 21 and 40 years of age. 2. Males (52.7%) were slightly more than females (47.3%). 3. Among clinical symptoms and signs, low back pain was most common (87.3%). Sciatica was present in 45.5% 4. Duration of symptoms at admission was variable. 5. 15 patients (27.3%) had a previous history of trauma. 6. 5th lumbar vertebra was most commonly involved (74.5%) followed by the 4th lumbar vertebra(23.6%). There was a case(1.9%) in which the 5th and 4th lumbar vertebrae were involved. 7. Degrees of slipping were divided into 4 grades (Grade I–IV) by Meyerdings method. Grade 1 was most common (72.2%), Grade II 22.2% and Grade III 5.6%. 8. In follow-up studies of the operative treatment, laminectomy & H-graft were satisfactory in 84.9% and posterolateral fuion in aII cases (13 patients). 9. Early ambulation was preferred without healng disturbance in a case in which the Norton-Brown back brace was applied after posteroIateraI fusion and also, other advantages were expected as follws: a) Elimination of prolonged cast immobiIization b) Financial aid c) Early return to work d) Mental comfort.
Braces ; Early Ambulation ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Laminectomy ; Low Back Pain ; Lumbar Vertebrae ; Male ; Methods ; Return to Work ; Sciatica ; Spine ; Spondylolisthesis ; Transplants ; Young Adult

Thoracic outlet syndrome is a collective term embracing previously described syndromes such as scalenus anticus, cervical rib, costoclavicular, hyperabduction and shoulder girdle compression syndromes. Its symptoms and signs are due to bony and soft tissue compression of the neurovascular bundle at the thoracic outlet. It is the purpose of this paper to evaluate the results of experience in treating the patient with thoracie outlet syndrome by surgical means. In this study, 3 cases: cervical rib (1 case), excessive callus formation after clavicular fracture (1 case), and hyperabduction syndrome with combined scalenus anticus syndrome (1 case), which had developed thoracic outlet syndrome were treated at Severance Hospital and gratifying results were obtained.
Bony Callus ; Cervical Rib ; Humans ; Shoulder ; Thoracic Outlet Syndrome

Acetabular fracture is severe injury and is associated with other body injuries severely. It's complications are traumatic arthritis and avascular necrosis of femoral head which induce severe permanent disability and its treatment is equivocal. A clinical study was performed on 70 patients with 65 fresh fractures and 5 old fractures of the acetabulum, who were hospitalized and treated at Severance Hospital from January 1971 to December 1980 and following results were obtained. 1. The prevalent age distribution was between 20 and 50 years of age (75.7%), and the ratio between males and females was 2.2:1. The most common cause of injury was traffic accident (70.%). 2. 56 patients (80.0%) were associated injuries of other parts and the most common associated fracture was pelvic bone fracture and the most common associated soft tissue injury was urological injury. 3. A classification of acetabular fracture was induced from Judet and Letournel's anatomical classification; simple fracture was 45 cases (64.2%), associated fracture was 25 cases (35.8%) and most common hip dislocation was posterior dislocation (31.4%). 4. The methods of treatment were; closed management by using traction for 53 patients, surgical management by open reduction and internal fixation for 12 patients, and hip reconstructive surgery by total hip replacement(2 patients), cup arthroplasty (2 patients), acetabular roof formation by using iliac bone graft (1 patient). 5. The satisfactory result of conservative treatment was (57.8%), surgical treatment was (72.7%), hip reconstructive treatment was (80.0%). 6. The complications of the acetabular fracture were traumatic arthritis (36.1%), avascular necrosis (23.0%), myositis ossificans (6.6%), infection (3.3%). 7. Finally, the results of treatment depend largely on anatomical reduction, early joint motion.
Accidents, Traffic ; Acetabulum ; Age Distribution ; Arthritis ; Arthroplasty ; Classification ; Clinical Study ; Dislocations ; Female ; Head ; Hip ; Hip Dislocation ; Humans ; Joints ; Male ; Myositis Ossificans ; Necrosis ; Pelvic Bones ; Soft Tissue Injuries ; Traction ; Transplants

PURPOSE: Neonatal hyperbilirubinemia has benign courses in most cases, but the possibility of toxicity of hyperbilirubinemia required courses examination of every newborn infant to identify the severity of hyperbilirubinemia progress. This study aims to see how the body surface area of newborns influences the decline rate of serum bilirubin level in conventional phototherapy. METHODS: Based on the charts of the Pediatrics Department, Dae-Dong Hospital from January 2003 to December 2006, we analyzed 168 neonates diagnosed as neonatal hyperbilirubinemia (serum bilirubin > or =15 mg/dL) in retrospective way. We excluded newborn infants under 37 weeks of gestation and under 2,500 g birth weight and classified neonates into four groups by the calculation results of body surface area:males above 75 percentile (group A), males below 25 (group B), females above 75 (group C), and females below 25 (group D). RESULTS: Out of 168 samples, the number of group A, B, C, D was 30, 20, 20, 15 respectively. In conventional phototherapy, the mean decline rates of serum bilirubin of group B and D recording 2.09 mg/dL/day and 1.77 mg/dL/day, were significantly faster than those of group A and C recording 1.63 mg/dL/day and 1.41 mg/dL/day (P<0.01). No significant differences were found in different duration of phototherapy between groups below 25 percentile and those above 75 in both genders. CONCLUSION: In conclusion, body surface area influences of infants the decline rate of serum bilirubin level in conventional phototherapy.
Bilirubin* ; Birth Weight ; Body Surface Area* ; Female ; Humans ; Hyperbilirubinemia ; Hyperbilirubinemia, Neonatal ; Infant ; Infant, Newborn ; Male ; Pediatrics ; Phototherapy* ; Pregnancy ; Retrospective Studies

BACKGROUND: It is controversial whether the delay of surgery for acute appendicitis by physician results in higher morbidity. Our present study explores this problem of physician delay on the postoperative outcome of patients with acute appendicitis. MATERIAL AND METHODS: Among 432 patients admitted for the presumptive diagnosis of acute appendicitis between Jan., 1995 and Dec., 1997, 358 patients with pathologically proven acute appendicits were analyzed. Physician delay from the hospital admission to the surgery was evaluated in relation to the stage of the disease at operation and postoperative outcome. RESULTS: Postoperative complications occurred signifficantly higher in advanced appendicitis group, than in simple appendicitis group. Postoperative oral consumption started significantly later and hospital days are significantly prolonged in those group. Both patient and physician delays significantly affect the stage of the disease. The finding that physician delay correlated with the stage, however, was denied by multivariate analysis. CONCLUSION: On the contrary to the patient delay, physician delay does not affect the stage of the acute appendicitis nor lead to increased incidence of postoperative complication. Physician delay to clarify the diagnosis is a reasonable strategy and it does not affect the outcome adversely.
Appendicitis* ; Diagnosis ; Humans ; Incidence ; Multivariate Analysis ; Postoperative Complications

A survey for nematode and cestode parasites of rodents in Korea has been carried out at the areas of Chulwon, Kumwha, Pochon, Paju and Chungpyong, Kyunggi-Do. A total of 300 rodents of seven species was examined, comprising of 219 A. agrarius, 33 R. norvegicus, 8 R. alexandrinus, 14 Mus musculus yamashinai, Microtus fortis pellceus, 21 Crocidura russula and a Cricetulus trition nester. The following fifteen species belonging to thirteen genera were identified: NEMATODA: Heterakis spumosa, Syphacia obvelata, Nippostrongylus muris, Protospirura muris, Capillaria hepatica, Capillaria sp., Heligmosomum sp., Heligmosomoides sp., Rictularia sp. and Gongylonema sp. CESTODA: Hymenolepis nana, Hymenolepis diminuta, Raillietina coreensis, Paranoplocephala sp. and Cysticercus fasciolaris(the larva of Taenia taeniaeformis).
parasitology-helminth-nematoda-cestoda ; Heterakis spumosa ; Syphacia obvelata ; Nippostrongylus muris ; Protospirura muris ; Capillaria hepatica ; Capillaria sp. ; Heligmosomum sp. ; Cysticercus fasciolaris ; Taenia taeniaeformis ; epidemiology ; rodent

Contact hypersensitivity (CH) responsiveness to 24-dinitro-l-fluorobenzene(DNFB)is depressed in mice sensitized through unexposed skin sites after exposure to high dose of ultraviolet B radiation(UVB). Exposure of mice to ultraviolet A(UVA) radiation in combination with 8-methoxypsoralen(8-MOP) also results in a systemic suppression of CH. Our study was designed to determine whether a high dose of UVA radiation alone can induce a systemic suppression of CH, and if so, which phase of CH response is influenced by UVA radiation. Relatively large doses of UVA(400, 600, 800J/cm²) induced significant systemic suppression of CH when DNFB was applied to UVA-unirradiated abdominal skin. The duration of the rest period after UVA exposure did not cause any significant change in systemic suppresion of CH. Functional analyses showed that lymph node cells(LNCs) obtained from donors that were sensitized on the unirradiated skin site with DNFB 5 days after UVA treatment transferred normal ear-swelling responsiveness to non-primed recipients, thus implying that high doses of UVA can induce systemic suppression which is not affected in the induction phase of CH but affected in the elicitation phase of CH. UVA irradiation de-creased Langerhans cell(LC) numbers significantly with a dose of 100J/cm² or greater. LNCs obtained from donors that were sensitized on the irradiated skin site with DNFB 5 days after UVA treatment did not transfer normal ear-swelling responsiveness to non-primed recipients. This phenomenon may be related to the decreased number of LC after UV treatment. To look for possible mediators impairing the elicitation phase of the CH reaction, we checked prostaglandin E(PGE) levels in serum after 800J/cm² irradiation. A high dose of UVA did not increase the serum PGE level in mice as much as UVB irradiation, in which a significant increase of PGE may affect CH response.
Animals ; Dermatitis, Contact* ; Dinitrofluorobenzene ; Humans ; Lymph Nodes ; Mice ; Prostaglandins E ; Skin ; Tissue Donors

Contact hypersensitivity (CH) responsiveness to 24-dinitro-l-fluorobenzene(DNFB)is depressed in mice sensitized through unexposed skin sites after exposure to high dose of ultraviolet B radiation(UVB). Exposure of mice to ultraviolet A(UVA) radiation in combination with 8-methoxypsoralen(8-MOP) also results in a systemic suppression of CH. Our study was designed to determine whether a high dose of UVA radiation alone can induce a systemic suppression of CH, and if so, which phase of CH response is influenced by UVA radiation. Relatively large doses of UVA(400, 600, 800J/cm²) induced significant systemic suppression of CH when DNFB was applied to UVA-unirradiated abdominal skin. The duration of the rest period after UVA exposure did not cause any significant change in systemic suppresion of CH. Functional analyses showed that lymph node cells(LNCs) obtained from donors that were sensitized on the unirradiated skin site with DNFB 5 days after UVA treatment transferred normal ear-swelling responsiveness to non-primed recipients, thus implying that high doses of UVA can induce systemic suppression which is not affected in the induction phase of CH but affected in the elicitation phase of CH. UVA irradiation de-creased Langerhans cell(LC) numbers significantly with a dose of 100J/cm² or greater. LNCs obtained from donors that were sensitized on the irradiated skin site with DNFB 5 days after UVA treatment did not transfer normal ear-swelling responsiveness to non-primed recipients. This phenomenon may be related to the decreased number of LC after UV treatment. To look for possible mediators impairing the elicitation phase of the CH reaction, we checked prostaglandin E(PGE) levels in serum after 800J/cm² irradiation. A high dose of UVA did not increase the serum PGE level in mice as much as UVB irradiation, in which a significant increase of PGE may affect CH response.
Animals ; Dermatitis, Contact* ; Dinitrofluorobenzene ; Humans ; Lymph Nodes ; Mice ; Prostaglandins E ; Skin ; Tissue Donors

Genital melanosis is an acquired, irregular, brown to black discoloration of the glans or shaft of the penis, or of the vulva and vagina. Although genital melanosis seems similar to malignant melanoma clinically, the histologic findings of genital melanosis show basal layer hyperpigmentation with or without melanocytic hyperplasia and no atypia of the melanocytes. We report a rare case of genital melanosis ; a vulvar melanosis.
Hyperpigmentation ; Hyperplasia ; Male ; Melanocytes ; Melanoma ; Melanosis* ; Penis ; Vagina ; Vulva