BACKGROUND: In autoimmune bullous dermatoses, such as pemphigus and bullous pemphigoid, variations in the expression of the antigen in different body locations are recognized. OBJECTIVE: The degree of expession of epidermolysis bullosa acquisita (EBA) antigen in different sites on the body surface was estimated from the highest dilution factor of EBA sera that gave a positive reaction at a site by indirect immunofluorescence (IF). METHODS: Two sera, obtained from EBA patients with inflammatory and mechanobullous skin lesions, having antihody titers of 160 against the dermal component of the NaCl split skin, were used by indirect IF techniques with 20 specimens (2 from each of 10 locations) of normal human skin from different sites. These 20 skin samples were obtained from 10 healthy adults (1-3 from each individual). RESULTS: The greatest expression of the antigen was in the skin taken from the upper back with the titer of 160. EBA antigen was least recognized in skin specimens from the inner thigh and calf. Skin from the scalp, abdomen, and anterior chest and others demonstrated intermediate degrees of expression. CONCLUSION: There was some moderate degree of variation in the expression of EBA antigens in skin samples obtained from different locations on the body. It seems however that there is not any positive correlation between the degree of expression of EBA antigen in each location and predilection sites (possibly the trunk) of clinical lesions in EBA.
Abdomen ; Adult ; Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa* ; Fluorescent Antibody Technique, Indirect ; Humans ; Pemphigoid, Bullous ; Pemphigus ; Scalp ; Skin ; Skin Diseases, Vesiculobullous ; Thigh ; Thorax

We describe five patiens with autoimmune bullous der matosis who presented cutaneous lesions localized on the face. In these patients iuumunopathologically confirmed diagnoses were penphigus erythematosus, bullous pemphigoid, cicatricial pernphigoid(Brunsting-Perry variant), epidemic lysis bullosa acquisita and bullous systemic lupus erythematosus in each. Except, for the case of pemphigus erythematosus, facelimited cutnious lesions can be seen rarely with these imrnunobullous diseases. We suggest that some external, in malfactors such as UV light and photosensitivity might be regarded as the precipitating factors fo the clinical rnanifestations of those skin lesions, and which should be included in the differential diingosis of vesiculobullous diseases involving the face.
Diagnosis ; Humans ; Lupus Erythematosus, Systemic ; Pemphigoid, Bullous ; Pemphigus ; Precipitating Factors ; Skin ; Ultraviolet Rays

Limb-Body Wall complex is a complicated with the essential features of neural-tube defects, body-wall disruption, and limb abnormalities. This complex should be distinguished from other body-wall defects including omphalocele and gastroschisis since the prognosis for limb-body wall is uniformly poor. We have experienced one case of limb-body wall complex in a 22-year-old primigravida, which is presented with a brief review of the literature.
Extremities ; Gastroschisis ; Hernia, Umbilical ; Humans ; Prognosis ; Young Adult

BACKGROUNDS: Korean Activities of Daily Living(K-ADL) scale was developed to measure the elderly function. The aim of the present study was to establish the validity and reliability of Korean Activities of Daily Living(K-ADL) scale. METHODS: Clinical validity and convergent validity was tested. Reliability was tested by internal consistency(Cronbach's alpha), two weeks test-retest method, and interrator correlation. RESULTS: Cronbach's alpha was 0.937. 2 weeks test-retest correlations in all 7 items were higher than 7.0. Interrator agreements were high in all 7 items(h=0.86~1.0). Nonnal control group had lower scores than patients group in all 7 items(p=0.000). Correlation coefficients between K-ADL score and braindisability grade was between -0.465(eating) and -0.696(bathing)(p=0.000). CONCLUSIONS: Korean Activities of Daily Living(K-ADL) scale is a valid and reliable instrument. In the future, the studies showing an association between K-ADL and mortality, prognosis are needed.
Activities of Daily Living ; Aged ; Humans ; Korea ; Mortality ; Prognosis ; Reproducibility of Results*

BACKGROUND: Korean Instrumental Activities of Daily Living(K-IADL) scale was developed to measure the elderly function. The aim of the present study was to establish the validity and reliability of K-IADL scale. METHODS: Clinical validity and convergent validity was tested. Reliability was tested by internal consistency(Cronbach`s alpha), two weeks test-retest method, and interrator correlation. RESULTS: Cronbach`s alpha was 0.938. 2 weeks test-retest correlations in all 10 items were higher than 0.674. Interrator agreements were high in all 10 items(H=0.808~0.947). Normal control group had lower scores than patients group in all 10 items(p=0.000). Correlation coefficient between K-IADL score and brain-disability grade was between -0.336(laundry) and -0.663(using transportation)(p=0.000). CONCLUSIONS: Korean Instrumental Activities of Daily Living(K-IADL) scale is a valid and reliable instrument. In the future, the studies showing an association between K-IADL and mortality, prognosis are needed.
Aged ; Humans ; Mortality ; Prognosis ; Reproducibility of Results*

No abstract available.
Blepharoplasty*

By the human is getting older, the factors which can the reason of the aging process in the frontal region are divided, static factor and dynamic factor. the static factor is gravity, and the dynamic factor is repeatitive competition of depressosr muscles and elevator muscles. the depressor muscles are corrugator muscle, procerus muscle and orbicularis oculi muscle and the elevator muscle is frontalis muscle. Correction methods of this aging process are divided to non-surgical and surgical method. Non-surgical method are Atecoll and fat injection, and using botulinum toxin. But the effect of these method is temporary and limited, and if the skin laxity is great, this method cannot be used. Surgical methods are laser, chemical peeling, dermabrasion, classical forehead lift which is dissected superficial to galea aponeurosis or subperiosteal plane through coronal or hairline incision, and endoscopy method that the corrugator muscle and procerus muscle are transected by using endoscope, and then the posterior elevation of forehead flap is induced. the endoscopy method is the most popular method in recent years, which has the many advantages of minimal incision, less amount of bleeding and lower complication, but expensive equipment, adaptation and training period are needed. We present the result of 10 patients from May. 1996 to Jan. 1997. After the superior orbital rim exposed through upper eyelid incision, the corrugator muscle was resected while careful attention to the supraorbital n. which was located behind the orbicularis oculi muscle. A communication was made through both sided of medial canthal area, and after the procerus muscle was resected, the fat graft was inserted between them. Finally, we made periosteal incision superiorly, and subperiosteal forehead lift was done without using endoscope.
Aging ; Botulinum Toxins ; Dermabrasion ; Elevators and Escalators ; Endoscopes ; Endoscopy ; Eyelids ; Fibrinogen ; Forehead* ; Gravitation ; Hemorrhage ; Humans ; Muscles ; Orbit ; Skin ; Transplants

Cellular schwannoma is a variant of schwannoma, and is diagnosed as malignant tumor in over one fourth of cases because of its cellularity, mitotic activity and the occasional presence of bone destruction. This tumor is a tumor with low malignant potential and usually occurs in peripheral nervous system, mainly in the posterior mediastinum and retroperitoneal space. But pelvic retroperitoneal cellular schwannoma is very rare. Recently, we experienced a case of pelvic retroperitoneal cellular schwannoma in a 42-year-old woman; in reporting the case a brief review of the literature is included.
Adult ; Female ; Humans ; Mediastinum ; Neurilemmoma* ; Peripheral Nervous System ; Retroperitoneal Space

Autograft is frequently used to restore anatomic morphology and functional properties in bone defects. Disadvantages of the autograft are related to donor site morbidity and include the risk of wound infection, increased blood loss and additional postoperative discomfort. Allograft and xenograft, which are currently employed as the most common alternative to autografts, encounter the complications such as fracture, resorption and nonunion secondary to immunologic rejection. These volumetric and immunologic concerns with biologic implants have stimulated interest in the potential for synthetic, bioinert materials as bone graft substitutes. Hydroxyapatite (HA), a calcium phosphate ceramic, is a well known biocompatible artificial bone substitite without induction of systemic toxic and foreign body reactions. Bone conduction usually occurrs by the implanted HA but biodegradation of HA is poor and the bone formation around HA is slow. Carbonate apatite has been known as that the physicochemical properties are similar of the natural bony apatite and demonstrates no toxic reactions with better biodegradation. Carbonate apatite collagen composite was reported to show more bone formation and biodegradation than hydroxyap atite. In this study, the composite (CA-C) consisted of carbonate apatite and type I collagen was implanted in rabbit tibiae to evaluate the possibility as an artificial bone substitute. Forty HA (HA group) and forty CA-C (CA-C group) were applied in 80 dissected rabbit tibiae and fixed by external fixators. For biomechanical study, the rabbits were sacrificed and the specimens were obtained in 2, 4, 6 and 8 weeks after implantation. Tensile load was applied to the prepared tibiae in Instron and biomechanical properties were investigated. The fracture at the callus occurred as transverse or short oblique fracture in the vertical direction to the axis of applied tensile load. In each group, the tensile strength at breaking point increased significantly with time and at 4 weeks more prominent increase in break strength was observed (p<0.05). HA group showed higher mean strength before 6 weeks and at 8 weeks CA-C group higher mean strength but statistical significance could not be found. There was no significant difference in extension length at breaking point between both groups and time intervals. In summary, carbonate apatite collagen composite revealed similar biomechanical properties as hydroxyapatite, suggesting its clinical usefulness as a bone substitute, but it will be necessary to improve biodegradational property, stiffness of carbonate apatite collagen composite.
Allografts ; Autografts ; Axis, Cervical Vertebra ; Bone Conduction ; Bone Substitutes ; Bony Callus ; Calcium ; Carbon* ; Ceramics ; Collagen Type I ; Collagen* ; Durapatite* ; External Fixators ; Foreign Bodies ; Heterografts ; Humans ; Osteogenesis ; Rabbits ; Tensile Strength ; Tibia* ; Tissue Donors ; Transplants ; Wound Infection

the ineidence of abdominal subcutaneous endometriosis is quite rare we have experienced one case of subcutaneous endometriosis. The typical clinical bistory and local findings of endometriasis enabk us to make the conect diagnosis. the treatment of choice is complete surgical excision of endometrial tissue and post operative medical therapy. This case was reported with a brief review of the comcemed literatures.
Diagnosis ; Endometriosis* ; Female ; Subcutaneous Tissue*