Twenty-nail dystrophy is an idiopathic nail dystrophy in which all twenty nails are uniformly and simultaneously affected with excess longitudinal ridging and loss of lustre. The pathogenesis is controversial, and the treatment is unsuccessful. It is thought to have a self-limiting and reversible nature when it develops in childhood, but in adults, it is unusual and exists persistently. We re-port here two cases of adult patients with dystrophy of all twenty nails, whose ages were 58 and 55. The disease had been present for one year and may be associated with alopecia areata in the 58 year old and an idiopathic condition in the 55 year old. Negative results were obtained on mycological studies. Biopsies taken from the nail bed revealed marked hyperkeratosis consistent with nail dystrophy.
Adult ; Alopecia ; Alopecia Areata ; Biopsy ; Humans

BACKGROUND: All though the cause of alopecia areata is not known, many studies have recenty focused on the autoimmunity of alopecia areata. OBJECTIVES: The objectives of this study were to detect autoantibodies against hair follicular antigens and compare the autoantibody level before and after treatment of alopecia areata. METHODS: We collected serum from: (a) 7 alopecia areata patients with good therapeutic responses, (b) 5 alopecia areata patients with poor therapeutic responses (c) 5 normal control people. First, we detected the antigens of hair follicles with SDS-PAGE. Secondly we reacted the antigens with the patients' and normal control serums by Western blotting. RESULTS: The follicular antigens were seen in the range of 44kD-57kD. Autoantibodies obviously apparent in patients of alopecia areata but not in the normal control. High concentrations of were Autoantibodies against follicular antigens seemed to be present in the patients with good therapeutic responses and as they had been treated well, the level of autoantiboies has decreased. Autoantibodies, however, were present in small amounts and were almost an changed between before and after treatment in the patients with poor therapeutic responses except for one case. CONCLUSION: There are kinds of autoantibodies against hair follicles in the serums of alopecia areata patients, and the titers of antibodies may be correlated with therapeutic responses.
Alopecia Areata* ; Alopecia* ; Antibodies ; Autoantibodies* ; Autoimmunity ; Blotting, Western ; Electrophoresis, Polyacrylamide Gel ; Hair Follicle* ; Hair* ; Humans

We report a case of disseminated cutaneous metastatic carcinoma from stomach carcinoma in a 66-year-old male who complained chiefly of widespread cutaneous nodules. He had been admitted to the Department of Internal Medicine for stomach carcinoma. A radiological examination revealed a diffuse stomach wall thickening from the fundus to the antrum, and enlargement of paraaortic and pericaval lymph nodes during an abodominal CT scan. The clinical findings manifested above may suggest cutaneous metastasis from stomach carcinoma. A histological examination of the skin and stomach biopsies showed atypical cells with pleomorphic, hyperchromatic nuclei and bubble-like cytoplasm, which are consistent with poorly differentiated adenocarcinoma. Immunohistochemical stainings showed that these cells were positive for epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA) and low molecular weight cytokeratin.
Adenocarcinoma ; Aged ; Biopsy ; Carcinoembryonic Antigen ; Cytoplasm ; Humans ; Internal Medicine ; Keratins ; Lymph Nodes ; Male ; Molecular Weight ; Mucin-1 ; Neoplasm Metastasis ; Skin ; Stomach* ; Tomography, X-Ray Computed

Radiographic measurement of cervical spine is very important in cervical spine injury especially those without fracture. Authors measured the retropharyngeal space, retrotracheal space, lordortic curve and sagittal diameter of cervical spinal canal in 148 cases of normal adult male. The results are as follows: 1 . In normal Korean adult male maximum retropharyngeal space is 7mm in C, level and Smm in Cs level. Maximum retrotracheal space is 16mm in C, level. 3. Loss of normal lordotic curve is shown in 21 cases(14.2%), 4. Average sagittal diameter of C, level is 21.27mm-it's the largest of all the cervical spinal cana1s, and that of C, level is 16.15mm-it's the smallest.
Adult ; Humans ; Male ; Spinal Canal ; Spine

There are many experiences and principles about posterior approach in the spine as surgical procedure in the treatment of the patients with low back pain. And the anterior approach to the disc with its excision and bone graft, less known to others, has become a relatively safe procedure with the increasing experience. The greatest advantage of anterior lumbar interbody fusion is that the reduction of lumbar vertebral slipping is possible, the distance between the involved bodies is well maintained and the rate of fusion increases by spreading the vertebral bodies and putting into the measured bone bloc especially in the patients with severe segmental instability or spondylolisthesis. We analysed 48 patients having anterior interbody fusion by using a specially designed reduction-spreader during eight years, from January 1.978 to December 1985. The results were as follows: 1. Among 48 cases, 20 cases were male and 28 cases were female; 12 cases were in the fourth decade and 19 cases were in the fifth decade-most common in the fifth decade. 2. 28 cases were at the level of L4–L5, 16 cases were L5–S1, and 4 cases were two levels(L3–L4 L4–L5 and L4–L5 LS–Sl). 3. Retroperitoneal approach was used for the L3–L4 and L4–L5, and transperitoneal approach was used for the L5–S1. 4. After distraction between the involved vertebral bodies using an effective device, reduction-sprea-der, a pair of full thickness iliac bone grafts were impacted into the interspace, maintaining the reduction after removal of the reduction-spreader. 5. Fusion was achieved between 3 months and 6 months in 46 cases except 2 cases. 6. Overall clinical results were as follows: good in 42 cases, fair in 6 cases. 7. The anterior interbody fusion using the reduction-spreader is found to be useful method in the treatment of low back pain with spinal instability diagnosed by lumbar flexion-extension lateral roentgenograms.
Clinical Study ; Female ; Humans ; Low Back Pain ; Male ; Methods ; Spine ; Spondylolisthesis ; Transplants

From Nov. 1986 to May 1988, we experienced 5 patients of bilateral recurrent patellar dislocation and obtained the following results:1. The age at operation raaged from 17 to 25 years. Among 5 patients, four were female and one, male. 2. The age at the onset of symptom ranged from 7 to 16 years. 3. The common presenting symptoms were pain(5 knees), giving way(4), grating(4), swelling (3), and weakness(2). 4. The roentgenographic findings were lateral patella tilt(9 knees), lateral femoral condyle hypoplasia(6), patella alta(2), patella dysplasia(2), and accessory ossification center(2). 5. All knees were treated by Hughston technique:One patient(2 knees) was treated with proximal realignment only, and the others(7 knees) were with proximal and distal realignments. 6. Follow up period ranged from 1 to 2 years. And the excellent to good result was obtained from the patients treated with proximal and distal realignments(excellent in 4 knees, good in 2 knees), the fair result from the patient treated with proximal realignment only(2 knees), and the poor result from the patient slipped down at 6 weeks postoperatively(1 knee).
Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Patella ; Patellar Dislocation

No abstract available.
Adult* ; Humans ; Tibia*

We report herein a case of acral lentiginous melanoma in a 65-year-old female. An about 2x3cm sized erythematous to brownish mass with central ulceration was located on the left heel accompanied by enlargement of the left inguinal lymph nodes. Histopathologic findings showed lentiginous proliferation of atypical melanocytes with pseudoepithliomatous hyperplasia and invasion of tumor cells from the epidermis into the dermis. Focal pigmented melanocytes were also noted. Complete surgical excision and chemotherapy with DTIC were done. Marked edematous swelling on the left lower leg was developed after 8 months and 1 month later she was expired.
Aged ; Dacarbazine ; Dermis ; Drug Therapy ; Epidermis ; Female ; Heel ; Humans ; Hyperplasia ; Leg ; Lymph Nodes ; Melanocytes ; Melanoma* ; Ulcer

PURPOSE: In evaluation of the limb fracture, MR scan has been used in limited roles as evaluating the associated soft tissue injury not the fracture itself. This study aims at understanding the possible role of MR in fracture. METHODS AND MATERIALS: thirty three sets of MR scans in twenty nine patients were retrospectively analyzed. They included twelve tibial plateau fractures, four pateliar fractures, four distal femur fractures, five epiphyseal fractures and four others. RESULTS: All MRs except two showed better image and more information about the extent of the injury (93.9%). Evaluation of cartilage (which was impossible on other modalities) was possible in 28 MR scans (84.8%). Surrounding marrow change associated with fracture was also able to be evaluated. Associated soft tissue injury or other abnormality could be evaluated-cruciate or collateral ligament injury, meniscus tear, chodromalacia or osteonecrosis. In epiphyseal injury, direct demonstrability of premature bony fusion on MR took a critical role in making a management plan. CONCLUSION: MR scan in fracture has its value in evaluating the extent and degree of the injury and it is especially advantageous in detecting cartilage injury and early complication of growth plate injury.
Bone Marrow ; Cartilage ; Collateral Ligaments ; Extremities* ; Femur ; Growth Plate ; Humans ; Osteonecrosis ; Retrospective Studies ; Soft Tissue Injuries

No abstract available.
Spine*