BACKGROUND: Pemphigus is a rare, chronic blistering disease of the skin and mucous membranes with severe morbidity and occasional mortality. The clinical data of Korean pemphigus patients are quite limited, and an appropriate treatrnent regimen is not yet established. OBJECTIVE: Our purpose was to analyze the clinical characteristics of, and establish an appropriate treatment regimen for Korean pemphigus patients. METHODS: A retrospective analysis was conducted for 24 pemphigus patients seen between 1992 and 1996. RESULTS: Pemphigus vulgaris(PV) was the most common type with 17 cases, followed by seven cases of pemphigus foliaceus(PF). There were no sexual preferences, and the average age at onset for PV and PF was 46 and 50 years old, respectively. Mucosal involvement was noted in 14 cases(82%) of PV and only in one case(14/o) of PF. There was no correlation between the extent of involvement and the titer of anti ICS(intercellular substance) antibody. Most patients received prednisolone of lmg/kg, and 12 PV patients also received immunosuppressive agents. Systemic side effects were noted in 10 cases of PV, and seven PF cases did not manifest any systemic side effects. CONCLUSIONS: The clinical manifestations and results of imrnunofluorescent studies of 24 Korean pemphigus patients were similar to those of the previous studies. For treatment of pemphigus, the lowest possible doses(less than 1mg/kg) of corticosteroid in combination with immunosuppressive agents appears to be more effective and less toxic than high doses of corticosteroid. We propose a regimen for treatment of Korean pemphigus patients based on these experiences. Further rnulti-center clinical trials are advocated to confirm an effective management protocol for Korean pemphigus patients.
Blister ; Humans ; Immunosuppressive Agents ; Middle Aged ; Mortality ; Mucous Membrane ; Pemphigus* ; Prednisolone ; Retrospective Studies ; Skin

This authors reviewed the radiographs of 20,057 patients with spinl radiculomyelopathy from April 1983 August 1990. The incidence and distribtion of the ossification of the spinal ligaments were analized as following. 1) The overall incidence of spinal ligaments ossification was 3.6% among 20,057 patients. 2) The most frequently occurs at lumbar area(67.1%), and then cervical(27.5%) thoracic(0.4%) area as in orders. 3) The OPLL was most common type(2.19%) of these spinal ligaments ossification, and then OALL(0.7%), OLF(0.24%) as in orders. 4) OPLL (1) OPLL was most frequent at lumbar area(58.6%) and then cervical(37.0%), thoracic(0.4%) area as in orders. (2) The cervical OPLL was commonly found at C5 & C6 area and morphologically, the multiple segmented type was most common then continuous type, mixed type and single segmented type in orders. (3) The multiple segmented type was more frequently found at upper cervical area, but the continuous type was more frequent at lower cervical area. 5) OALL (1) OALL was most frequent at lumbar area(86.0%) but thoracic(1.4%) and cervecal area(5.3%) were relatively low in frequency. (2) Of the lumbar OALL, the L4/5 area was most frequent site(37.8%) but the L3/4(25.3%) and L5/S1 area(24.5%) also had relatively high occurance rate. 6) OLF (1) OLF was most frequent at lumbar area(92.7%), but the incidence of OLF was relativerly rare at cervical(2.1%) and thoracic area(5.2%). (2) Of the lumbar OLF, the L4/5 area was most common site(33.1), but L5/S1 area had also high occurance rate(27.2%).
Humans ; Incidence ; Ligaments*

Authors experienced a 59-year-old male patient with the lymphoma of the small iritestine which involved the adjoining mesenteric lymph nodes, the parietaI pleura, and the skin. The skin lesions, simulating necrotizing angiitis, were deep purple colored, asymptomatic, tense, hemorrhagic bullae with soft consistency on the both thighs and left infraorbital area. He had extranodal type, and diffuse, poorly differentiated lymphocytic lymphoma by the Rappaport classification, and stage IV by the Ann Arbor staging classification. After about 50 days of clinical manifestations, he was died mainly due to massive intestinal bleeding.
Classification ; Hemorrhage ; Humans ; Intestine, Small* ; Leukemia, Lymphocytic, Chronic, B-Cell ; Lymph Nodes ; Lymphoma* ; Male ; Middle Aged ; Pleura ; Skin ; Thigh ; Transcutaneous Electric Nerve Stimulation ; Vasculitis

No abstract available.
Transplants*

he Magnetic. resonance imaging has been used widely to evaluate the disk position without any interruption of the TMJ structures, and the dynamic MRI presenting computed serial imaging or the video-recorded simulation images is thought to be very effective to evaluate the disk position under function. This is to study the correlation between the clinical diagnosis and the findings of dynamic MRI for diagnosis of internal derangement of the 7 patients were examined clinically, and the movement of TMJ meniscus was reviewed in the dynamic MRI. MRI was very reliable to diagnose the amount of anterior displacement of articular disc, the structural abnormality of temporomandibular joint, the cause of functional limitation, and to differentiate the muscle related pain & dysfunction.
Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Temporomandibular Joint Disorders* ; Temporomandibular Joint*

No abstract available.
Rectal Prolapse* ; Surgical Procedures, Operative*

Traumatic dislocation of the first metatarso-phalangeal joint is rare injury. The mechanism of this injury is hyperextension of the great toe, causing displacement of the proximal phalanx on the dorsum of the first metatarsal head and neck. The complex soft tissue anatomy surrounding this joint interferes with the closed reduction of the dislocation. This paper describes a patient with complete dorsal dislocation of the first metatarsophalangeal joint treated at the Paik hospital which cannot be reduced by closed manipulation.
Dislocations ; Head ; Humans ; Joints ; Metatarsal Bones ; Metatarsophalangeal Joint ; Methods ; Neck ; Toes

Agnogenic myeloid metaplasia (AMM) is a myeloproliferative disorder characterized by leukoerythroblastosis, tear-drop erythrocytes, extramedullary hematopoiesis with hepatosplenomegaly, and varying degrees of myelofibrosis. The mean age at presentation is about 60 years, and pediatric cases are rare. We experienced a case of AMM in a 9 months old female who was presented with pallor, huge splenomegaly and intermittent fever. Peripheral blood showed leukoerythroblastosis poikilocytosis, and tear drop cells. Bone marrow was difficult to aspirate, and biopsy specimen showed increased reticulin with decreased cellularity, which was compatible with myelofibrosis. We presented a case of AMM with brief review of the literatures.
Biopsy ; Bone Marrow ; Erythrocytes ; Female ; Fever ; Hematopoiesis, Extramedullary ; Humans ; Infant ; Myeloproliferative Disorders ; Pallor ; Primary Myelofibrosis* ; Reticulin ; Splenomegaly

BACKGROUND: Paraquat is a widely used herbicide, known to cause lethal toxicity in humans. Most studies about paraquat have concentrated on systemic toxicity, however several cases of paraquat-induced dermatitis have been reported. OBJECTIVE: The purpose of this study was to confirm the cutaneous toxic effect of paraquat and to select potential antidotes in paraquat-induced dermatitis. METHODS: Keratinocyte toxicity due to paraquat and the toxicity reduction capacity of several drugs were investigated in eitro. Topical effects of these drugs on paraquat-induced dermatitis in guinea pig skin was also investigated. RESULTS: Over 50% of keratinocytes failed to survive at a concentration of 2X10-4M paraquat by a neutral red uptake assay. Skin irritation by paraquat was observed at 2% concentration by non-invasive methods as well as a skin biopsy. Dexamethasone, glutathione and tocopherol showed some capacity to reduce paraquat-induced keratinocyte toxicity in vitro. Only dexamethasone, however, showed a reduction of cutaneous blood flow volume and dermal inflammatory cell infiltration in the guinea pig study. CONCLUSION: This result indicates the possible in eitro protective effect of paraquat toxicity in glutathione and tocopherol. Dexamethasone was capable of reducing paraquat-induced cytotoxicity and dermatitis both in vitro and in vivo.
Animals ; Antidotes* ; Biopsy ; Dermatitis ; Dexamethasone ; Glutathione ; Guinea Pigs ; Humans ; In Vitro Techniques ; Keratinocytes ; Neutral Red ; Paraquat* ; Skin* ; Tocopherols

BACKGROUND: The effects of a muscle relaxant may differ in elderly compared with young adult patients for a variety of the pharmacokinetic and pharmacodynamic reasons. Atracurium is eliminated by nonorgan dependent pathway, Hofmann elimination and ester hydrolysis. So there are some arguments for age-related differences. The purpose of this study was to compare the differences of the onset and duration of atracurium in young and elderly. METHODS: Eighteen young adults (21-54 yr) and 18 elderly (>65 yr) patients anesthetized with nitrous oxide and enflurane. Atracurium (0.5 mg/kg) was given and then intubation was performed after T1 response was blocked more than 80%. Neuromuscular relaxation was measured by the first twitch of train-of-four (T1) response at the adductor pollicis after supramaximal stimulation of ulnar nerve at 2Hz every 12 sec. The onset (disappearance of T1) and duration of 5, 25, 50, 75% recovery time of T1 and recovery index (time for 25-75% recovery of T1) were recorded. RESULTS: Onset of block was not significantly different between the young and elderly. Recovery time of 5, 25, 50, 75% and recovery index were not prolonged in elderly compared with young adults. CONCLUSIONS: There were no significant differences between young and elderly adults in onest time, recovery time of 5, 25, 50, 75% and recovery index when atracurium is used in a single bolus dose. The results suggest that atracurium in elderly patients has similar onset and action duration compared with younger patients.
Adult ; Aged* ; Atracurium* ; Enflurane ; Humans ; Hydrolysis ; Intubation ; Nitrous Oxide ; Relaxation ; Ulnar Nerve ; Young Adult