A 6-year-old male patient had been suffering from angular cheilitis and paronychia with fragmentation and dystrophic change of the finger nails. Laboratory findings showed low serum iron level and anemia. Immunologic studies revealed defects in cell mediated immunity. KOH examination and culture of specimens from the lesions showed hyphal elements and growth of Candida albicans respectively. Concomitantly itraconazole and iron sulfate were administered. Four months after treatment he was free of any clinical evidence of the disease.
Anemia ; Candida albicans ; Candidiasis, Chronic Mucocutaneous* ; Cheilitis ; Child ; Fingers ; Humans ; Immunity, Cellular ; Iron ; Itraconazole ; Male ; Paronychia

No abstract available.
Follow-Up Studies* ; Spinal Stenosis*

Revascularizations of 14 occlusive arterial diseases in the lower extremities with the Transluminal Endarterectomy Catheter was done successfully. The causes of occlusions were atherosclerosis in 9 cases and cardiogenic thromboembolism in 5 cases. The site of lesions were at the common femoral artery in 1 case, the superficial femoral artery in 6 cases and the popliteal artery in 7 cases. The length of the lesion were below 5cm(n=3), 5-10cm(n=2), 11-20cm(n=6) and 21-30cm(n=3). Complications were distal embolism(n=1) and hematoma at the puncture site(n=1). No symptoms recurred in any cases during 2 months -15 months followup. Endarterectomy with Transluminal Endarterectomy Catheter was found to be an effective method for revasculizations of occlusive arterial disease in the lower extremity, especially in long segmental occlusion.
Atherosclerosis ; Catheters ; Endarterectomy* ; Femoral Artery ; Follow-Up Studies ; Hematoma ; Lower Extremity* ; Methods ; Popliteal Artery ; Punctures ; Thromboembolism

BACKGROUND/AIMS: The endoscopic mucosal resection has now been adopted for a useful modality in both curative therapy and accurate diagnosis of early gastric cancer. A retrospective study was done to evaluate the indication and the limitation of endoscopic mucosal resection of early gastric cancer. METHODS: We studied 20 cases of early gastric cancer treated by endoscopic mucosal resection in Chungnam National University Hospital from November, 1995 to July, 1997. RESULTS: 1) The size affected the curability: 83. 3% of lesions less than 2 cm and 50. 0% of those larger than 2 cm were resected completely. 2) The depth of cancer invasion affected the curability: 87. 5% of lesion confined to mucosa were resected completely, while all of submucosal cancers were resected incompletely. 3) Among fourteen cases resected completely, three cases of lesions larger than 2 cm were residual cancer and two of those less than 2 cm were recurred locally. CONCLUSIONS: To be a curative therapy by endoscopic mucosal resection of early gastric cancer, we think that careful selection of the lesion, that is lesion less than 2cm and confined to mucosa, is necessary
Chungcheongnam-do ; Diagnosis ; Mucous Membrane ; Neoplasm, Residual ; Retrospective Studies ; Stomach Neoplasms*

BACKGROUND: Superficial fungal infections are common diseases acid the prevalence of superficial fungal diseases are not static but change under the influence of various forces such as climate, migration of peoples and development in prophylaxis and therapy. OBJECTIVE: To investigate the present status of superficial dermatiphytoses and some changes on the frequency of the diseases, sex distributions and varieties of the casiative organisms. MEHTODS: The clinical and rnycological aspects of superficial fungal diseases of 3,222 patients from July 1989 to June 1992 were analyzed. Results : 1) The incidence of superficial fungal diseases was 25.4% of total out-patients. 2) The superficial fungal diseases showed a higt incidence in the third(26.4%) and the fourth decade(24.3%). 3) The ratio of male to female was 2.11:1(2,188:1,034). 4) The monthly prevalence of super ficial fungal diseases was high inhuly(17.8%), August(15.2%) and June(1.7%). 5) The incidence of superficial fungal diseases in order of frequency were tinea pedis ,28.1%, tinea cruris(19.5%), onychomycosis(15.6%), tinen orporis(11.5%), tinea manus(7.8%), tinea versicolar(7.8%), candidiasis(7.4%) and tinea capitis(2.3%), 6) Coexisting fungal infections were found in 644 patients(19.9%) and the case of tinea pedis with onychomycosis was the most common. 7) The positive rate of KOH scraping was 54.0% and the positive rate of culture on ordinary Salourauds dextrose agar media was 42.7%. 8) Trichophyton rubr,im was the most common causative orantism of superficial dermatophytes(38.4%), and other in decreasing frequency were Candida albicans(36.9%), Trichophyton mentagrophytes(23.6%) Microsporum canis(0.7%), Trichophyton ferrvgiteum(0.3%) and Epidermophyton floccosum(0.1%). CONCLUSION: These results are not significantly different from those iif previous studies. But the incidence rate of the superficial pungal diseases(25.4%) were higher thar, previous studies and showed a high incidence in young male patients and in the summer. The positiv rate of KOH scraping(54.0%) was lower than previous studies. The most common causative organism was Trichophyton rubrum(38.4 %).
Agar ; Candida ; Climate ; Epidermophyton ; Female ; Glucose ; Humans ; Incidence ; Male ; Microsporum ; Onychomycosis ; Outpatients ; Prevalence ; Sex Distribution ; Tinea ; Tinea Pedis ; Trichophyton

There are many advantages in treating long bone fractures with interlocking intramedullary nail and its advantages are well known. Although it is used widely, many major and minor complication can develop in spite of meticulous operation techniques. Frist fifty consecutive interlooking intramedullary nail of two different surgeon, total of 100 cases that were operated in Seoul Paik Hospital from January, 1991 to July, 1994, were reviewed and the complications were analyzed with various factors. 1. Among the 100 cases, a total of 30(30%) major and minor complications had developed. But only 4 major complications which needed reoperation or poor result occurred. 2. Among the complications that had developed, angulation and rotation deformity being 10 cases were the most common, other complications were delayed union in 5 cases, nonunion in 2 cases, problem of screw in 4 cases, metal failure in 2 cases, misentry point in 2 cases and others in 5 cases. 3. There were no remarkable difference between surgeon A and surgeon B. The complications decreased abruptly after 30th case for each surgeon and only a few complications, probably due to complex fracture pattern, occurred. In conclusion, complications after interlocking intramedullary nailing can be reduced by meticulous preoperative planning and learning process of surgeon.
Congenital Abnormalities ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Learning ; Reoperation ; Seoul

Gold Sodium Thiomalate (Myochrysine) used for rheumatoid arthritis has been known that it can cause the long term remission by its antimicrobial action, cell metabolism, complement activation and by activating the cell related to immunologic response. Accordingly the effect and side effect of gold theraphy has long been an object of concern. Authors clinically analyzed cases of 49 rheumatoid arthritis patients who were treated with gold and the mean duration of follow-up was 2.7 years. 50mg of Gold Sodium Thiomalate was injected intramuscularly in accordance with weekly based check up of symptom improvement & side effect. The interval of injection was prolonged and maintained to 4 weeks or 6 weeks when the total amount of injected gold was reached to 1gm or 1.2gm. The over-all symptom remission was forty (82%) and twenty five (51%) showed symptom remission and its maintenance. In symptom remission group, the change of laboratory findings was the reduction of erythrocyte sedimentation rate (ESR) from 59.7 to 32.3. As for side effects, dermatitis found in 16 cases was the most common and stomatitis found in 8 cases. There were others such as irritation symptom of gastrointestinal system & nephritis and 7 cases where the injection was stopped because of side effects was found out. Considering the above results, Gold Sodium Thiomalate is regarded as one of the effective methods for the treatment of rheumatoid arthritis when it is used electively paying heed to side effect.
Arthritis, Rheumatoid ; Blood Sedimentation ; Complement Activation ; Dermatitis ; Follow-Up Studies ; Gold Sodium Thiomalate ; Humans ; Metabolism ; Nephritis ; Stomatitis

The fractures of tibial shaft are common and open injury are also frequenly accompanied. Since the AO unreamed interlocking nail is solid type compared to present tubular type nail, it has no dead space, and without reaming the intramedullary blood supply can be preserved and the soft tissue trauma can be minimized. Therefore it can be used with minor risk of infection in the treatment of open tibial shaft fractures without secondary operation such as in the cases using external fixaters. Especially in Orientals, whose tibial medullary canal is narrower than Smm, it can be used ideally. From October 1991, we have experienced 14 cases of tibial shaft fractures treated with AO unreamed interlocking nail. Among 14 cases, the open fractures were 8, 4 cases were type 1 and 4 cases were type 2 by Gustilo classification. Among 6 cases of closed fractures, 4 cases had risk of post operative infection due to accompanying soft tissue injuries, such as abrasion or bulla and 2 cases had narrow intramedullary canal less than 8mm. There was no postoperative infection in all cases including open fractures, and the soft tissue defect could be reconstruted by muscle transfer, etc. The AO unreamed interlocking nail is thought to be recommendable in the treatment of open tibial shaft fracture, closed fracture with risk of postoperative infection, and also the fracture with narrow canal diameter less than 8mm.
Classification ; Fractures, Closed ; Fractures, Open ; Soft Tissue Injuries ; Tibia

Recently, tuberculosis of bone and joint is decreased with good nutrition and environment, development of preventive medicine and improvement of treatment regimen. But it is still one of the common inflammatory diseases in Korea, and must be considered in the differential diagnosis of common orthopedic complaints. There are few reports on extraspinal tuberculosis of bone and joint. Forty one cases of extraspinal tuberculosis of bone and joint were studied in our department from January 1988 to August 1993. The results were as follows; l. Extraspinal tuberculosis of bone and joint were 41 cases (39 patients, 27.8% of 147 tuberculosis of bone and joint including spine). 2. The proportion of children and young adults was 56%, hips were involved in 11 cases, knee joints in 8 cases, ankle joints in 6 cases, feet in 6 cases and elbow joints in 5 cases. 3. Coexisting pulmonary tuberculosis was found in 19 patients and active lesion in 15 patients. 4. Confirmative diagnosis could be made by smear and culture of the lesion or pathologic findings or recently available polymerase chain reaction(PCR) method. 5. Various treatment, such as antituberculous medication, external immobilization, synovectomy, curettage and bone graft, arthrodesis, had been carried out. 6. Reactivation of other site was found in 7.3%(3 cases) and resistant tendency was found in 9.7%(4 cases).
Ankle Joint ; Arthrodesis ; Child ; Curettage ; Diagnosis ; Diagnosis, Differential ; Elbow Joint ; Foot ; Hip ; Humans ; Immobilization ; Joints ; Knee Joint ; Korea ; Methods ; Orthopedics ; Preventive Medicine ; Transplants ; Tuberculosis ; Tuberculosis, Pulmonary ; Young Adult

To evaluate the results of anterior decompression and fusion with autogenous bone graft for cervical disc disease, the authors reviewed 18 cases of cervical disc herniation which were treated surgically at Inje Univ. Paik Hosp. from 1990 to 1994 with special interest in the thickness of the bone graft. All cases have been followed for more than 12 months. We try to know the clinical results of anterior decompression and fusion with autogenous bone graft. At this treatment, controversial point is a ideal thickness of graft and the width of distraction. Therefore, we follow up the correlation between thickness of graft on roentgenogram and clinical results. The clinical results were satisfactory as excellent in 11 cases, good in 5 cases according to criteria of Robinson et al. Successful fusion occured in 16 cases within 3 months after their initial procedure, and fusion failure resulted in 2 cases. 3mm distraction from baseline disc height was considered ideal thickness of graft after anterior decompression and all cases healed successfully. We concluded that 3mm distraction from baseline disc height is necessary for successful decompression & fusion.
Decompression ; Follow-Up Studies ; Transplants