A 51-year-old female had disseminated, symmetrically distributed, brownish black pigmentation and papillary hypertrophy on the intertriginous and flexural areas for 6 months, and gastric adenocarcinoma was confirmed during the evaluation of internal malignancy, The cutaneous finding of acanthosis nigricans was a significant cutaneous marker of internal malignancy in this case.
Acanthosis Nigricans* ; Adenocarcinoma* ; Female ; Humans ; Hypertrophy ; Middle Aged ; Pigmentation

Although joint infection with severe destruction remains a serious problem and severe bone loss is relative contraindication of arthrodesis, knee arthrodesis is most commonly a salvage procedure. Its goals are to relieve pain and restore the patient to functional level of activity. The purpose of this study is to evaluate the results and complications of Ilizarov method for knee arthrodesis in the presence of infection. We retrospectively reviewed the records of twelve patients who had managed with knee arthrodesis with Ilizarov method. Indications for the operation included a infected skeletal defect secondary severe open trauma in four patients, an infection at the site of an arthroplasty in three (with failure of previous arthrodesis with monofixator in one), an infected charcot joint in four and one pyogenic arthritis spreading from osteomyelitis of proximal tibia. The average age of the patients at the time of operation was fifty-three years (range twenty-two to eighty years). Follow-up averaged 17 months. The minimum follow up periods was 9 months. Average duration of Ilizarov fixator application was 7.2 months. In 3 cases we performed corticotomy and internal bone transport to treat large bone defect (17cm, 8cm, 6.5cm). Autoiliac bone graft was done in fusion site in two cases, and in three cases we performed bone graft at the docking site. Solid osseous union occured in each patient. There was no reinfection and nonunion. Average shortening was 3.4 cm. Complications were related to pin tract. When last seen, all patients were free of pain and could walk without cruthes or cane. Despite its pin tract problems, bulky cumbersome and expensive apparatus, the Ilizarov method is one of effective method for knee arthrodesis in the presence of infection and large bone loss especially.
Arthritis ; Arthrodesis* ; Arthropathy, Neurogenic ; Arthroplasty ; Canes ; Follow-Up Studies ; Humans ; Ilizarov Technique* ; Joints ; Knee Joint* ; Knee* ; Osteomyelitis ; Retrospective Studies ; Tibia ; Transplants

In the surgery of central area, identifying the motor cortex in front of central sulcus is imperative to prevent loss of motor function. Twenty five patients with tumors or intractable epilepsy near the central sulcus were operated on at the Department of Neurosurgery of Chonbuk National University Hospital, from September. 1991 to December 1993. An estimated localization of lesions was performed with Callosal Grid System, which is a methodolgy made available by the development of high quality of magnetic resonance imaging, digital subtraction angiography and high resolution computerized tomography. This system allowed us to be oriented to the motor cortex as well as permitted assessment of the extent of resection. This was further delineated by direct electrical stimulation, which confirmed the functional motor cortex and made it possible to maximized the tumor resection near and in the motor cortex. The combination of direct cortical stimulation(functional mapping) and the use of the Callosal Grid System(anatomical mapping) allowed us to identify the spatial relationship between them as well as to maximize the tumor resection in most cases without injury to the central area, so that the better outcome is guaranted.
Angiography, Digital Subtraction ; Brain Neoplasms ; Electric Stimulation ; Epilepsy ; Humans ; Jeollabuk-do ; Magnetic Resonance Imaging ; Motor Cortex ; Neurosurgery

We experienced a case of generalized granuloma annular e in a 68-year-old man. Many factors have been implicated in the genesis of this disease, but in this case no etiologic factors were identified. He was treated successfully with systemic corticosteroid for about l year.
Aged ; Granuloma Annulare* ; Granuloma* ; Humans

Great difficulty may be encountered in the differentiation of basal cell carcinoma from trichoepithelioma snd, in some cases, it may even be irnpossible. Immunohistochemical methods using peanut agglutinin(PNA) which is glycoprotein of non-immune origin selectively binding to galactose-N-acetyl-galactosa-mine are increasingly used in dermatopathology to improve the diagnosis and differential diagnosis. Using PNA, anti-PNA antibody, and peroxidase antiperoxi-dase(PAP) technique, normal skin specimens, basal cell carcinomas, trichoepitheliiomas, and a variety of different skin tumors were studied, and different PNA Ibinding sites between basal cell carcinomas and trichoepitheliomas were observed. The results were as follows : l. In normal skin, except the basement membrane, epidermis and hair follicle epithelium showed a cell membrane staining of PNA, which stained weakly in the Ibssal cell layer. Sebaceous glands revealed membranous and cytoplasmic staining of PNA, but sweat ducts and duct coi1s were mostly negative. 2. 34 of 36(94.4%) basal cell carcinoma sections demonstrated peritumorous PNA-positive bands, and none of 5 trichoepithelioma sections showed peritumorous PNA-binding. 3. Peritumorous PNA-positive bands were strongly positive in solid and keratotic basal cell carcinomas, but decreased or absent in the vicinity of the ulceration or the dense inflammatory infiltration. 4. None of the other skin tumors(squamous cell carcinoms, keratoscanthoma, Bowens disesse and actinic keratosis} showed a periturnorous PNA-positive band. Therefore, we believe that the PNA staining on paraffin-embedded sections using PAP technique can be a useful probe for the differentiation of basal cell carcinoma from trichoepithelioma.
Actins ; Basement Membrane ; Carcinoma, Basal Cell* ; Cell Membrane ; Cytoplasm ; Diagnosis ; Diagnosis, Differential ; Epidermis ; Epithelium ; Glycoproteins ; Hair Follicle ; Peanut Agglutinin* ; Peroxidase ; Sebaceous Glands ; Skin ; Sweat ; Ulcer

No abstract available.
Tuberculosis*

Silver sulfadiazine, an antibacterial agent, has been used successfully in the praphylaxis and treatment of burn infection. 42 volunteers with herpes zoster were enrolled in a clinical trial to evaluate the effectiveness of topical silver sulfadiazine cream. 1% silver sulfadiazine cream was applied 4 times daily until crust removal and epithelialization on 21 patients. As the control, wet compress with 1: 5,000-1: 10,000 KMnO4 solution was done 4 times daily on 21 patients. ln treated group with silver sulfadiazine cream, the durations needed for marked reduction of erythema and edema of lesions, striking control of pain and burning sensation, complete drying of vesicles and crust formation, and crust removal and epithelialization were significantly decreased as compared to the control group. The rate of postherpetic neuralgia was also decreased markedly. The sooner the treatment began after the onset of symptoms, the more dramatic the response was. Signs of local or systemic side effects were not observed.
Burns ; Edema ; Erythema ; Herpes Zoster* ; Humans ; Neuralgia, Postherpetic ; Sensation ; Silver Sulfadiazine ; Silver* ; Strikes, Employee ; Volunteers

We report a case of familial benign chroinic pemphigus in a 47 year old man. We had tried various treatments but no effect had been noted with systemic steroids, tetracycline, cephalosporin, rifampin, dapsone, and local application with antibiotic ar..d eteroid ointment. Thus the patient was started on 50mg of etretinate(Tigason) daily and almost complete resolution of the skin lesions was noted two moths after treatment. He was maintained on 15mg of etretinate daily and follow up evaluations for six months revealed no recurrence and no exacerbation of the lesions.
Acitretin* ; Dapsone ; Etretinate* ; Follow-Up Studies ; Humans ; Middle Aged ; Moths ; Pemphigus ; Pemphigus, Benign Familial* ; Recurrence ; Rifampin ; Skin ; Steroids ; Tetracycline

We performed an epidemiologic survey to investigate the dermatologic problems from cutting oils in metal workers. The personal questionnaires and dermatologic examinations were performed on 360 metal workers who were working at 50 metal industries. The pH meter (HANNA 8520) and the atomic absorption spectrometer(G.B.C. 902) were employed to measure the pH values of cutting oil and the concentration of heavy metals contained in cutting oil respeetively. The results were as follows : 1. The prevalence rates of the dermatologic disorders from cutting oil were 46.0% of eontact dermatitis, 10.9% of black comedone, and 7.1% of paronychia in orders. The dermatologic disorders that seemed to be not directly associsted with cutting oil were callosity(19.1%), burn by metal chips(9.8%), and mechanical injury(5.7%). 2. The localizations of the contact dermatitis and the black cemedone from cutting oil were 84% of hands, 6.6% of face, and 5% af forearms. More detailed localizations of the contact dermatitis and black comedone that developed in hand were 29.6% if finger tip, 27.6% of palm and palm finger, and 19.1% of palm finger only in orders. 3. The prevalence rates of the dermatologic disorders by the of cutting oil were 51.5% of soluble oil, 68.8% of insoluble oil, and 80.8% of mixed cutting oil which containing both soluble and insoluble oil. 4. The mean pH value of aoluble cutting oil was 8.0 and that of insoluble cutting oil was 7.0. 5. The concentrations of heavy metals contained in soluble oil were 32.2 mg/m3 of chrome, 6.42 mg/m3 of nickel, and 4.85 mg/m3 of cobalt. The concentrations of heavy metals contained in inspluble oil were 24.11 mg/m of chrome, 4.63 mg/m3 of nickel, and 2.30 mg/m3 of cobalt.
Absorption ; Burns ; Cobalt ; Dermatitis ; Dermatitis, Contact ; Epidemiologic Studies* ; Fingers ; Forearm ; Hand ; Humans ; Hydrogen-Ion Concentration ; Metals, Heavy ; Nickel ; Oils ; Paronychia ; Prevalence ; Surveys and Questionnaires

No abstract available.
Asthma*