We present a case of pemphigus vulgaris developed during pregnancy. The clinical features of this patient were similar to those of hetpes gestationis. By immunofluorescence studies we found that the patient's serum contained autoantibodies to intercellular substance of epidermis. Direct immunofluorescence microscopy of a perilesional skin also demontrated immunoglobulin deposition in the intercellular areas. Additionally we did in vitro C3 staining for further confirmation of the diagnosis but it was negative in basement membrane zone. This patient was initially treated with corticosteroid and azathioprine. Several months later gold compound was given instead of azathioprine and corticosteroid with good therapeutic response.
Autoantibodies ; Azathioprine ; Basement Membrane ; Diagnosis ; Epidermis ; Fluorescent Antibody Technique ; Fluorescent Antibody Technique, Direct ; Humans ; Immunoglobulins ; Microscopy ; Pemphigus* ; Pregnancy* ; Skin

An automated percutaneous lumbar discectomy(APLD) have been apphed for contained lumbar disc herniation. But suggested that more exclusion criteria than disc containment was needed to improve success rate. The purposes of this study are to evaluate cIinical outcome of more than 4 years follow up of APLD, to analysis the cause of failure for longer follow up period, and to define prognostic factor of APLD. The l04 patients with contained lumbar disc herniation were treated with APLD from March 1990 to November 1992 in National Medical Center. The surgical candidates were contained focal disc herniation in MRI, sciatica than back pain, failure to conservative management at least 6 weeks and clinical and radiological correlation. And patient were excluded from this data if they had history of previous lumbar surgery and compensation claims. Among them 74 cases were followed up for over 4 years (Mean: 5.3 years). The results were accessed by questionnaire using telephone or OPD follow up. The overall success rate was 84% on 3 months follow up, but 68.9% on more than 4 years follow up by four subjective criterias (Onik, 1987). Causes of decreasing success rate were reoperation, recurrence without specific cause or after sprain and heavy work. 76% of failed cases occurred within 1 year and 40% of them underwent open discectomy. The patient sex, treated level, duration of symptom were not influenced on success rate, but age was factor related to success rate. In this study we can assess the effectiveness of APLD within 3 months in most cases and then change treatment option according to patients status, and it seems that we need more exclusion criteria than disc containment in MRI and refined patient selection in order to decrease the failures.
Back Pain ; Compensation and Redress ; Containment of Biohazards ; Diskectomy* ; Follow-Up Studies* ; Humans ; Magnetic Resonance Imaging ; Patient Selection ; Surveys and Questionnaires ; Recurrence ; Reoperation ; Sciatica ; Sprains and Strains ; Telephone

No abstract available.
Infectious bursal disease virus*

Anaphylaxis is a life - threatening syndrome elicited in a hypersensitive individual on subsequent exposure to a sensitizing antigen with, reactions ranging widely in severity from mild pruritus and criteria to shock and death. Anaphylaxis occurs in the United States at rates estimated to be as high as one in every 3000 inpatients and may account for more than 500 deaths annually. Preparations of kelp Laminaria digitata are used as tents in gynecologic procedures to dilate the cervix, and the kelp consists principally of a glucagon carbohydrate called laminarin. Laminarin is thought to function as the active ingredient in dilatation by changing osmotic pressure or uterine prostaglandin metabolism. The tent is inserted into the cervix several hours before the procedure. As the cervix desiccates and dilates, the tent develops an hourglass shape. Recently, we experienced one patient with anaphylaxis to laminaria diagnosed by skin test and showing good response to treatment.
Anaphylaxis* ; Cervix Uteri ; Dilatation ; Female ; Glucagon ; Humans ; Inpatients ; Kelp ; Laminaria* ; Metabolism ; Osmotic Pressure ; Pruritus ; Shock ; Skin Tests ; United States

A 52-year-old woman with esential mixed cryoglobulinemia (type II ), which was confirmed by cryoglobulin elcct,rophoresis and immunofixation elect,rophoresis, had purpuric skin lesions on the legs. The lesions had a tendency of recurrence for the past 2 years, and moderate degrees of arthralgia and myalgia were accompanied in each time. However, the patient had not been suffered from any internal organ distress caused by the disease proress. Histological examinations of a skin lesions revealed a feature of leukocytoclatic vasculitis, and deposits of IgM, IgG and C; were also recognized. A regimen of small doses of prednisolone was effective for the cutaneous lesions in this patient for 4 months follow-up until this writing. It, seems that the patient has had a mild form of the disease among the clinical spectrum of mixed cryoglobulinemia, with a cryocrit value of 2.4% at the time of her initial visit..
Arthralgia ; Cryoglobulinemia* ; Female ; Follow-Up Studies ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Leg ; Middle Aged ; Myalgia ; Prednisolone ; Recurrence ; Skin ; Vasculitis ; Writing

Sclerosing stromal tumor of the avary(SST) is a rare benign tumor first described as a distinct neoplasm by Chalvardjian and Scully(1973) and confirmed as such by Scully(1977) and Gee and Russell(1979). This tumor was separated from the thecoma fibroma group on the basis of characteristic histolog ic features. We present two caaes of postmenopausal women in seuentieth decades with SST, other reported cases of SSTs are discused.
Female ; Fibroma ; Humans ; Ovary* ; Thecoma

External fixation was improved in its material, design and techniques as a specific method of open fracture treatment. Seventy-three, tibial open fracture, patients were treated with external fixator in Korea Veterans Hospital from January 1983 to April 1988. Each fixation method was divided into two types;one-plane unilateral frame and one-plane bilateral frame. 1. The duration of external fixation was 14.3 weeks in averge, 15.4 weeks in one plane unilateral frame and 13.2 weeks in one plane bilateral frame. 2. Secondary operation for bony union was performed 19 cases in one plane unilateral frame and 8 cases in one plane bilateral frame. 3. The union time was 23.6 weeks in average, 26.8 weeks in one plane unilateral frame and 21.4 weeks in one plane bilateral frame. 4. The common complications were delayed union and nonunion (7 cases) and pin tract infection (5 cases) in one plane unilateral frame, and pin tract infection ( 9 cases), joint stiffness (4 cases) and delayed union and nonunion (3 cases) in one plane bilateral frame. 5. External fixation gave rigid fixation and easy wound access, but did not give excellent bony union. 6. One plane bilateral frame showed more or less better result than one plane unilateral frame except some complications.
External Fixators ; Fractures, Open ; Hospitals, Veterans ; Humans ; Joints ; Korea ; Methods ; Wounds and Injuries

No abstract available.
Synovitis, Pigmented Villonodular*

No abstract available.

Unilateral or, particularly, bilateral congenital agenesis of the internal carotid artery is a rare anomaly. We report an occurrence of the condition, arising bilaterally, and report the findings of magnetic resonance imaging and magnetic resonance angiography.
Carotid Artery, Internal* ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging