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

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

BACKGROUND: Epinephrine used in surgery to provide hemostasis may elicit ventricular arrhythmias. A desirable anesthetic would not sensitize the myocardium to exogenously administered epinephrine. So the effect of sevoflurane, which was introduced to clinical anesthesia recently, on cardiac arrhythmias induced by the infusion of epinephrine was compared with those of halothane which was already known to epinephrine-induced arrhythmia in the 14 mongrel dogs. METHODS: The authors compared the arrhythmogenicity (three or more premature ventricular contractions, PVCs)of intravenously administered epinephrine in 14 mongrel dogs who were randomly assigned to receive sevoflurane (1.7 vol%) or halothane (0.75 vol%) anesthesia equipotently. The arrhythmogenic doses of epinephrine determined in this comparative study were expressed by both infusion rates of epinephrine during sevoflurane and halothane anesthesia. RESULTS: The mean values of the arrythmogenic infusion rates of epinephrine were 27.1 7.6 g/kg for sevoflurane and 2.7 0.8 g/kg for halothane. CONCLUSIONS: We concluded that the arrythmogenic doses of epinephrine during sevoflurane were significantly higher than those during halothane anesthesia.
Anesthesia* ; Animals ; Arrhythmias, Cardiac ; Dogs* ; Epinephrine* ; Halothane* ; Hemostasis ; Myocardium ; Ventricular Premature Complexes

A 40-year-old man attended our hospital with presenting symptoms of an acutely swollen, tender testicle and bulging mass on the inguinal area. Considered it as urgent conditions no demonstrating blood flow to the involved testicle on Color Doppler ultrasonography, we underwent scrotal exploration right away. On operative finding the right testis was so enlarged and engorged secondarily to the irreversible ischemic damage, but torsion of spermatic cord was not found. Another inguinal approach revealed herniated mass protruding from internal inguinal ring and compressing the spermatic cord. For further evaluation abdominal ultrasonography and CT scan was done and huge mass occupying right lower quadrant of abdomen and pelvic cavity was noted. The resected tumor through surgical exploration was proved to be a retroperitoneal liposarcoma pathologically. Herein we report an uncommon case of testicular infarct, mimicking torsion of spermatic cord that is a urological emergency, caused by herniated retroperitoneal mass. So the present report suggest that, when adult men attend with symptoms of acutely swollen painful testicle, we pay a more careful attention to patient,s physical findings and recommend further diagnostic evaluation.
Abdomen ; Adult ; Emergencies ; Humans ; Inguinal Canal* ; Liposarcoma* ; Male ; Spermatic Cord ; Testis ; Tomography, X-Ray Computed ; Ultrasonography ; Ultrasonography, Doppler, Color

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

It is the most important to select optimal culture conditions to promote safe embryo growth in the technique of human in vitro fertilization and embryo transfer. It has been shown that the addition of biologic fluids, such as blood serum, of various origins, improved fertilization and early cleavage rates in numerous species. The purpose- of this study is to attempt to measure developmental potential of mouse eggs fertilized and cleaved in Ham's F10 culture medium containing a chelating agent, EDTA and fetal cord serum. hi this study, we selected 40 female mice and 20 male mice, and investigated optimal serum concentration' for mouse embryo growth. Two cell stage mouse embryos were cultured in Ham's F-10 medium, Ham's F-10 medium with various concentrations of EDTA, or Ham's F-10 medium with EDTA and 10% human cord serum. Developmental ratios to morula in Ham's F-10 medium containing various concentrations of EDTA and/or 10% fetal cord serum were significantly higher than in unsupplemented Ham's F-10 medium (p<0.05). Developmental ratios to blastocyst in Ham's F-10 containing 10% fetal cord serum and 5011M or 100pM EDTA were significanldy higher than in unsupplemented Ham's F-10 medium (p<0.05). Developmental ratios to morula in Ham's F-10 containing 10% fetal cord serum and 100,uM EDTA were significanitly higher than in Ham's F-10 with 10% fetal cord serum used commonly in many human IVF centers(p<0.05). Developmental ratio to blastocyst in Ham's F-10 containing 10% fetal cord serum and 100pM EDTA was significanity higher than in Ham's F-10 with 200pM EDTA(p<0.05).
Animals ; Blastocyst ; Edetic Acid* ; Eggs ; Embryo Transfer ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro ; Humans ; Male ; Mice* ; Morula ; Ovum ; Serum