A 73-year-old female patient, who had been treated with antituberculous drugs for 4 months, was referred to our department because of generalized macules and papules present for 15 days. Clinical examination revealed polygonal, flat papules of erythematous to violaceous hue on the entire skin. Histopathologic findings were similar to those of lichen planus. In a provocation test with ethambutol, the skin lesions were aggravated and the new lesions developed. We considered this case to be a lichenoid drug eruption due to ethambutol. The skin lesions gradually cleared after ethambutol was eliminated from the patient's tuberculosis therapy.
Aged ; Drug Eruptions* ; Ethambutol* ; Female ; Humans ; Lichen Planus ; Skin ; Tuberculosis

Two cases of epidermal nevi treated with systemic etretinate are presented. Case 1, a 21-year-old female, had been suffered from brownish verrucous papules and plaques on the left inguinal area, thigh, lower leg and dorsum of the foot since her first month of life; and case 2, a 4-year-old boy, had been suffered from brownish verrucous papular plaques on the left chest, axilla and back since birth. In both cases, there was no family history of similar disease. On histopathological examination, case 1 showed the findings of epidermolytic. hyperkeratosis but case 2 did not, with the exception of clumping of keratohyaline granules. In the treatment with systemic etretinate, we observed marked clinical improvement in case 1, but not in case 2. Any particular side effects of etretinate were not observed during treatment. We consider that etretinate therapy is useful in treating epidermal nevus with epidermolytic hyperkeratosis histopathologically.
Acitretin* ; Axilla ; Child, Preschool ; Etretinate* ; Female ; Foot ; Humans ; Hyperkeratosis, Epidermolytic ; Leg ; Male ; Nevus* ; Parturition ; Thigh ; Thorax ; Young Adult

BACKGROUND: Osteoporosis results from bone loss due to menopause [estrogen(E) deficiency] and aging. Initial skeletal effect of menopause is accelerated bone resorption with an increase in seurm calcium(Ca) and compensatory but inadequate bone formation. Secretion of parathyroid hormone(PTH) is suppressed at this time. Postmenopausal osteoporosis results in fractures predominantly of trabecular bone, i.e., vertebra. With aging, secondary hyperparathyroidism by low serum Ca and vitamin D deficiency superim poses. Senile osteoporosis produces hip fractures, area of cortical bone. The aim of this study was to- examine the association of vitamin D[25(OH)D] and intact(i) PTH with bone mineral density(BMD) after controlling for suggested confounding factors, and the possibility of low serum vitamin D and high serum iPTH concentration could impact bone loss in Korean postmenopausal women. METHODS: Data from 188 postmenopausal Korean women aged 42 to 69 were analyzed through BMD, serum 25(OH)D, iPTH, Ca, phosphorus(P), alkaline phosphatase(ALP) and clinical characteristics. Factors affecting BMD was determined by Pearson correlation and the relationship between lumbar and femoral neck BMD and vitamin D[25(OH)D] and iPTH was assessed by multiple regression analysis after adjus- ting for suggested confounding factors. RESULTS: Lumbar and femoral neck BMD, serum Ca, P were decresaed and serum iPTH was increased with aging. In Pearson`s correlation, significant contributing factors to lumbar BMD was age, height, weight, menarche, year since menopause(YSM) and ALP. And significant contributing factors to femoral neck BMD was age, height, weight, menarche, YSM and iPTH. No relationship could be demonstrated between serum vitamin D[25(OH)D] and lumbar and femoral neck BMD. How ever, after controlling for potential confounding factors, a correlation was found between vitamin D[25(OH)D] and both of lumbar (p=0.013) and femoral neck BMD(p=0.077). iPTH was inversely related to femoral neck BMD(p=0.004) only in multiple linear regression. CONCLUSION: Serum vitamin D[25(OH)D] was influencing both of vertebral and femoral neck BMD, which suggests a significant role of vitamin D deficiency in the pathogenesis of postmenopausal osteo- porosis. In age related remodeling and loss of bone, increased serum iPTH might have additive role in cortical bone of femur. These findings suggest that vitamin D is very important for optimal bone health and a deleterious effect of increased iPTH on cortical bone loss. Adequate calcium and vitamin D status have to be maintained to prevent osteoporosis in postmenopausal Korean women.
Aging ; Bone Density* ; Bone Resorption ; Calcium ; Female ; Femur ; Femur Neck ; Hip Fractures ; Humans ; Hyperparathyroidism, Secondary ; Linear Models ; Menarche ; Menopause ; Osteogenesis ; Osteoporosis ; Osteoporosis, Postmenopausal ; Parathyroid Hormone* ; Spine ; Tolnaftate ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*

No abstract available.
Dermatitis, Contact*

BACKGROUND: To evaluate the changing pattern of liver abscess treatment, we did a retrospective analysis of 80 patients with liver abscess, treated surgically and medically at the Department of Surgery and Internal Medicine, Wonkwang University Hospital from January 1985 to December, 1995. RESULTS: Among 80cases of liver abscess, 59 cases(76%) were pyogenic abscess and 21 cases(24%) were amebic abscess. The liver abscess was more commonly located in the right lobe. In the 59cases of pyogenic liver abscess, etiologic factors were biliary stones with cholangitis(19 cases), cholecystitis(6 cases), hepatobiliary cancer(4 cases), diabetes mellitus(3 cases). All 21 cases of amebic abscess were treated with percutaneous catheter drainage and metronidazole administration; 20 cases were treated successfully and 1 case died of sepsis. Among the 59 cases of pyogenic liver abscess, 38 cases were treated with percutaneous catheter drainage; 30 cases were successful, but 8 cases were not. Operations were performed in 21 cases because of underlying intraabdominal conditions requiring surgical correction( 19cases) and panperitonitis due to rupture of liver abscess(2cases). CONCLUSION: In the treatment of amebic abscss, percutaneous catheter drainage and metanidazole adminstration should be considered first. Percutaneous catheter drainage and antibiotic treatment tend to increase more than surgical treatment in the pyogenic liver abscess therapy. The liver abscess is no more surgical indication, unless it is associated with underlying intraabdominal conditions requiring surgical correction and panperitonitis due to rupture of liver abscess.
Abscess ; Amebiasis ; Catheters ; Drainage ; Humans ; Internal Medicine ; Liver Abscess* ; Liver Abscess, Amebic ; Liver Abscess, Pyogenic ; Liver* ; Metronidazole ; Retrospective Studies ; Rupture ; Sepsis

No abstract available.
Clone Cells* ; Cloning, Organism* ; Thymidine*

The dendriform pulmonary ossification (DPO) is a rare condition of unknown origin in which branching mature bony spicules, usually containing marrow, are found within the alveolar septa. DPO manifests slow progression over many years or may remain unchanged; spontaneous regression has not been recorded. Most patients have no symptoms directly attributed to the ossification, although they may have symptoms due to the underlying fibrotic process. We experienced a case of DPO in 38 year-old-man who presented with cough and sputum for a month. The chest X-ray showed marked coarsened interstitial lung markings in both lungs, especially in the lower lobes. Open lung biopsy was done. Grossly, there were significant dendriform osseous structures. Histologically, branching arrays of mature bone were found in the interstitium and occasionally in alveolar spaces. Some bony trabeculae contained fatty or cellular marrow. The alveolar septa showed fibrous thickening with chronic inflammation. The transition between fibrosis and bone tissue was observed. Our case suggests that dendriform pulmonary ossification may be a rare special manifestation of chronic fibrosing interstitial inflammation of the lung. Osseous structures seem to derive from metaplastic bone formation in the vicinity of undergoing fibrous process.
Biopsy ; Bone and Bones ; Bone Marrow ; Cough ; Fibrosis ; Humans ; Inflammation ; Lung ; Lung Diseases, Interstitial ; Osteogenesis ; Sputum ; Thorax

Myofibrosarcoma of the breast is a rare malignant mesenchymal tumor that has been reported in only four well documented cases so far. We report a case of myofibrosarcoma of the breast in an 88-year-old man who complained of a palpable mass for 1 year. Microscopically, the tumor consisted mainly of spindled cells, arranged in irregular fascicles and embedded in broad bands of dense hyalinized collagen. It showed ill-defined border infiltrating the adjacent adipose tissue, moderate cellular pleomorphism, and high mitotic rate (8~9/10 HPF). Immunohistochemical study confirmed myofibroblastic differentiation of the tumor cells with diffuse strong reaction for vimentin, smooth muscle actin, and fibronectin.
Actins ; Adipose Tissue ; Aged, 80 and over ; Breast* ; Collagen ; Fibronectins ; Humans ; Hyalin ; Muscle, Smooth ; Myofibroblasts ; Vimentin

Significant traumatic disruption of the ligaments about the knee can occur in a child. Recently several reports have described knee ligament, injuries with open growth plates. And these reports contradict the notion that complete tears of knee ligaments occur only after growth plates have closed. The youngest patient with medial collateral ligament injury reported before was a 4-year-old boy by Joseph and Pogrund in 1978. But authors experienced a case of ruptured medial collateral ligament of the knee in a 2-year and 1-month old boy, who seemed to be youngest with the ligament injury.
Child ; Child, Preschool ; Collateral Ligaments ; Growth Plate ; Humans ; Infant, Newborn ; Knee ; Ligaments ; Male ; Rupture ; Tears

The "flosting knee" is the term applied to the flail knee joint segment resulting from a fracture of the shaft of adiacent metanhysis of the ipsilateralfemur and tibia. The various methods of treatment of the "floating knee" were adapted by many authors according to degree of the comminution, degree of the soft tissue injury, general condition state of the fracture. Authors experienced the floating knee in 52 cases on 51 patients who were treated at Soon Chun Hyang University Hospital in the period of 4 years and 5 months from January 1985 to June 1989 and among them, 45 cases were treated by operative method and 7 cases by conservative methods at least one of the femur and tibia, The results were as follews;1. Floating Knee occured six times more in male and the peak age was third and fourth decades. 2. The most common cause of fractures was traffie aecident and there was difficulty in diagnosis of ligamentous disruption of the ipsilateral knee. 3. The common fracture site were middle one third and the most common fracture shape was comminuted in both femur and tibia. 4. A good or excellent functional result was aohieved in treated with open reduction and rigid fixation of both fracture and there were no significant difference in group of the internal fixation of both femur and tibia. 5. Intramedullary nailing on the femur and plate fixation on the tibia provided rigid fixation of fracture and the it made possible early joint motion exercise and ambulation and the average healing time of fracuture was much shortened. 6. The most common concomitant injury were soft tissue injury and delayed or nonuion and osteomyelitis were developed more frequently in the plate and screw fixation group of the open fracture.
Clinical Study ; Diagnosis ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Open ; Humans ; Joints ; Knee ; Knee Joint ; Ligaments ; Male ; Methods ; Osteomyelitis ; Soft Tissue Injuries ; Tibia ; Walking