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

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

The clinical use of topical antimicrobial substances is common in clean wounds as well as contaminated and chronic wounds. This use is based on the observation that the reduction of superficial bacterial contamination promotes wound healing. While the antibacterial efficacy of topical antimicrobials has been well documented, their effects on living tissue and the process of wound healing remain controversial. Recently, there have been several trials to detect the toxicity of various antimicrobial materials by using cultured fibroblasts and keratinocytes. In this study the cytotoxicity of several commonly used antimicrobials and the cytotoxic concentrations of antimicrobials on cultured human keratinocytes and fibroblasts were compared using 3 different METHODS: 1) the MTT method showing the ability of the cells to clear the cytotoxic agents, 2) LDH release indicating damage of cell membrane, and 3) tritiated thymidine incorporation measuring DNA synthesis. In the MTT method all topical antimicrobials in their usual clinical concentration showed cytotoxicity on both keratinocytes and fibroblasts by suppressing cell proliferation. Keratinocytes were more sensitive to certain antibiotics. When the 50% inhibition concentration (IC50) of topical antimicrobials were compared, the cytotoxicity to keratinocyte was, in the decreasing order, chlorhexidine, hydrogen peroxide, povidone iodine, sulfadiazine, fusidic acid, ethanol. Gentamicin and bacitracin. The cytotoxicity to fibroblasts was, in decreasing order, chiorhexidine, hydrogen peroxide, povidone iodine, fusidic acid, ethanol, sulfadiazine, bacitracin, and gentamicin. Most of the antimicrobials tested increased LDH release by keratinocyte in IC50.Chlorhexidine, hydrogen peroxide and povidone iodine showed statistically significant increase in LDH release. The tritiated thymidine incorporation study showed the order of cytotoxicity to keratinocyte in IC50 of each antimicrobials was similar to that of the MTT method. Tritiated thymidined incorporation, however, appeared to be a more sensitive method in detecting cytotoxicity than MTT because the IC50 was lower in the former. In conclusion, all topical antimicrobials are cytotoxic to keratinocytes and fibroblast in their usual concentration. Because of their cytotoxicity it is suggested that one should use topical antimicrobials in a dilution of up to 1 : 1,000 of commonly used concentration for a short period only especially when applied directly on a skin graft or wounds without a protective barrier. Bacitracin or gentamicin appear to be less cytotoxic among all the antimicrobials tested.
Anti-Bacterial Agents ; Bacitracin ; Cell Membrane ; Cell Proliferation ; Chlorhexidine ; Cytotoxins ; DNA ; Ethanol ; Fibroblasts* ; Fusidic Acid ; Gentamicins ; Humans* ; Hydrogen Peroxide ; Inhibitory Concentration 50 ; Keratinocytes* ; Povidone-Iodine ; Skin ; Sulfadiazine ; Thymidine ; Transplants ; Wound Healing ; Wounds and Injuries

BACKGROUND: Generalized aggressive periodontitis (GAP) is a destructive periodontal disease that can develop in young age. Only a few cases of full mouth rehabilitation, using dental implants, have been reported in a patient with aggressive periodontitis. CASE DESCRIPTION: This clinical report describes the treatment procedures and results of full mouth rehabilitation in a patient with aggressive periodontitis. After all teeth were extracted, 6 implants were placed in the maxilla and mandible, respectively. Fixed detachable implant prostheses were made. The patient was satisfied with the final results. She was followed for 10 months postloading. CLINICAL IMPLICATION: For a long-term success, continuous maintenance care is critical, as the contributing factors of the disease (such as immune factors or periodontal pathogens) may not be controlled adequately.
Aggressive Periodontitis ; Dental Implants ; Humans ; Immunologic Factors ; Mandible ; Maxilla ; Mouth ; Mouth Rehabilitation ; Periodontal Diseases ; Prostheses and Implants ; Tooth

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