We herein report a case of therapy-resistant dermatomyositis treated with oral prednisolone and chlorambucil combination therapy. Concurrently, she showed cervical carcinoma in situ(CIS). Initially, we started to treat her with combination oral prednisolone, intramuscular methotrexate, hydroxychloroquin, and removal of cervical CIS. However, our patient failed to respond to these regimens. Thus, we had have another combination treatment of oral prednisolone and chlorambucil. After the treatment of this combination regimen, her recalcitrant dermatomyositis improved dramatically without recurrence. There were no significant adverse side effects with chlorambucil therapy.
Chlorambucil* ; Dermatomyositis* ; Humans ; Methotrexate ; Prednisolone ; Recurrence

BACKGROUND: The clinical and histopathological classification of erythema multiforme(EM) and Stevens-Johnson syndrome (SJS) are difficult due to a lack of clear-cut criteria. In recent studies, some authors suggested that erythema multiforme and Stevens-Johnson syndrome were clinically and histopathologically different disorders. OBJECTIVE: The purpose of this study was to review the clinicopathological characteristics of the EM and SJS and to suggest specific findings for differentiating between the two diseases. METHODS: Fifty four patients with EM and SJS diagnosed in the Department of Dermatology of Dong-San Hcepita1 from January 1987 through to December 1996 were studied retrospectively. RESULTS: The results were summarized as follows. l. In view of causal factors, 54 cases were classified as drug-induced (n=22, 41%), herpes-induced (n=16, 30%), tuberculosis (n= 2, 3%), pneumonia (n=l, 2%), unknown (n=13, 24%). 2. Fifty four cases were clinically classified as SJS (n= 29, 54%), EM minor (n=-15, 2S%) and EM major (n = 10, 18%). 3. Erythema multiforme was found to be more related to herpes (13 of 25 cases) than to drugs (3 of 25 cases), while SJS was more related to drugs (19 of 29 cases) than to herpes (3 of 29 cases). 4. Varying degrees of necroti changes of keratinocytes were found in all the cases. The severity of degree or extent of necrosis was higher in patients with SJS than EM. 5. In demial changes, EM showed differences from SJS by having a denser and deeper lymphocytic infiltrate, and increased amount of extravasated erythrocytes. CONCLUSION: Taken together, although our findings could not provide a defmite clue to determine whether EM and SJS are different distinet entities or not, this study may be useful to differentiate and to understand the pathogenesis of EM and SJS. A prospective large scaled study should be conducted to definitively characterize these entities.
Classification ; Dermatology ; Erythema Multiforme* ; Erythema* ; Erythrocytes ; Humans ; Keratinocytes ; Necrosis ; Pneumonia ; Retrospective Studies ; Stevens-Johnson Syndrome ; Tuberculosis

No abstract available.
Neurilemmoma* ; Stomach*

A 55-year-old female experienced acute left shoulder pain without specific trauma. Radiography showed calcific deposits in the inferior part of the glenoid fossa. Magnetic resonance arthrography showed calcific deposits in the origin of the long head of triceps brachii muscle. Conservative treatment failed to resolve the symptoms; therefore, arthroscopic surgery was performed. The patient experienced immediate and dramatic pain relief, and normal shoulder motion was demonstrated 1 year after surgery. In conclusion, although rare, calcific tendinitis of the triceps brachii muscle, which causes shoulder pain, should be included in the differential diagnosis of acute shoulder pain. Arthroscopic surgery is a treatment option for chronic cases and those resistant to conservative treatment.
Arthrography ; Arthroscopy ; Diagnosis, Differential ; Female ; Head* ; Humans ; Middle Aged ; Radiography ; Shoulder ; Shoulder Joint ; Shoulder Pain ; Tendinopathy*

No abstract available.
Decompression* ; Intestinal Obstruction*

No abstract available.
Pleasure*

Nocodazole is an anticancer agent, well-known for its antimetastatic activity that acts on microtubules, microfilaments and extracellular matrix proteins. Hela, Hep G2, A549, L929, and NIH/3T3 cell lines were cultivated in alpha-MEM with 3microM or 30microM nocodazole. To investigate the mechanism of nocodazole preventing tumor cell metastasis, the influences of nocodazole on the amounts of glycoprotein, fibronectin, laminin and actin were investigated using PAS staining and PAP technique at light microscopic level. Two designed models ; coverglass and 3-day-old rat heart fragments models, were used in observing the invasiveness of cancer cells. Partitularly the three-dimensional model coculturing cell lines and heart fragment was used in evaluating the migration and/or proliferation or the invasiveness of cell around the fragment, and observed under inverted or bright field light microscope. The amount of glycoprotein of all cell-lines increased in cells of groups treated with nocedazole for 1, 2 and 3 day. The amounts of fibronectin usually increased in cells of groups treated with nocodazole for 1, 2 and 3 day. The amounts of laminin increased in cells of groups treated with nocodazole. The amounts of actin usually increased in cells of groups treated with nocodazole for 1, 2 and 3 days. With the prolonging of nocodazole-treatment time in two dimensional model using coverglass, the cells of control group except Hep G2 cells formed monolayer in cell-free zone according to migration or proliferation of many cells. But only a few cells of experimental groups migrated or proliferated into cell-free zone. In rat heart fragment model the cells of control group showed the invasiveness into the fragment but few or none of the cells from experimental groups attached around the fragment. Taken together, nocodazole increased the synthesis of fibronectin and laminin in cells in place of depolymerizing microtubules. Therefore, the amounts of extracellular matrix proteins in the extracellular space increased. And the increase amounts of actin connected to the extracellular matrix proteins through the integrin of plasma membrane seemed to strengthen cell attachment because of accordance between the orientation of actin and extracellular matrix proteins. Since it is important for cancer cells` metastasis to secrete various enzymes to pass through extracellular matrix proteins, it is expected more difficult for the cells to metastasize into other regions due to the increase of extracellular matrix proteins. As a result of confirmation of antiinvasive actions using two kinds of model, nocodazole seems to be a valuable anti-metastatic agent by supressing the cell motility and consequently, the invasiveness into the fragment. Nocodazole at concentration of 3microM will be probably anticipated antimetastatic activity reflecting that the effects of nocodazole between 3microM and 30microM groups had no differences.
Actin Cytoskeleton ; Actins ; Animals ; Cell Line* ; Cell Membrane ; Cell Movement ; Extracellular Matrix Proteins* ; Extracellular Matrix* ; Extracellular Space ; Fibronectins ; Glycoproteins ; Heart ; Hep G2 Cells ; Laminin ; Microtubules ; Neoplasm Metastasis ; Nocodazole* ; Rats

Osteoporosis causes a decrease in bone mineral density. To overcome the decrease in fixation strength, a variety of techniques and devices have been developed, including cement augmentation of pedicle screws. Polymethyl methacrylate (PMMA), is commonly known as bone cement, and is widely used for implant fixation in various orthopaedic and spine surgery. In general, PMMA augmentation of pedicle screws is simple and safe if performed with technical precautions. PMMA is a safe agent, but it may rarely lead to significant foreign body reactions. In this report, we present a patient who developed bone cement-related epidural space foreign body granuloma
Osteoporosis

We reviewed the records of thirty-four patients who had been managed with the Ilizarov technique for the comminuted intra- and extra-articular fractures and nonunion of the long bones with or with-out bone defect. The goal of this study is to analysis the clinical complications of the Ilizarov technique, and to find out the methods solving them. 1. This study comprises 34 patients who were treated by Ilizarov technique at the Chonbuk National University Hospital from March, 1992 to June, 1993. 2. Among 34 cases, 22 were comminuted intra- and extra-articular fractures, and 12 were nonunion of the long bones. 3. The complications were divided intd problem, obstacle and complication; problem in 16 cases, obstacle in 11 cases and complication in 6 cases. 4. We conclude that the Ilizarov technique is a useful method in management of the severe commi- nuted fractures and the nonunion of the long bones, but we have to consider the complication sincerely and endeavor to reduce them.
Fractures, Comminuted ; Humans ; Ilizarov Technique ; Jeollabuk-do ; Methods

Tamoxifen is a nonsteroidal triphenylethylene delivative that has been widely used in the treatment of breast cancer. tamoxifen is indicated for the adjuvant treatment of breast cancer in women following total mastectomy or segmental mastectomy, breast irradiation and chemotherapy. tamoxifen has been shown to have significant benificial effect in the treatment of breast cancer patient as hormonal therapy. However ,there is mounting evidence that tamoxifen may affect other hormon sensitive organs, including the uterus and ovaries. An increased risk of endometrial polyps, endometrial hyperplasia and adenocarcinoma has been reported in tamoxifen treated women. We have met cases of endometrial polyp and endocervical polyp which were associated with tamoxifen use, after modified radical mastectomy for infilterating ductal carcinoma of breast . So we report these cases with the brief review of literatures.
Adenocarcinoma ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Drug Therapy ; Endometrial Hyperplasia ; Female ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Ovary ; Polyps* ; Tamoxifen* ; Uterus