Among previously proposed etiological factors of chondromalacia patellae, abnormality in the extensor mechanism of the knee joint has been attributed as a cause of chondromalacia patellae by many authors Malalignment in the extensor mechanism of the knee joint is supposed to cause the positional change of patella. This positional change of patella can be measured by Q angle and P/PT ratio. Hereby we intened to classify the relationahip between the above measurement lenoting the positional change of patella and chondromalacia patellae. These values were obtained from 60 patients found to have chondromalacia patellae in Han Gang Sacred Heart Hospital, from Jan. 1977 to Sep. 1978. Values were also obtained from 60 normal persons as a control group. Thus a statistical analysis was made for the possible relationship between extensor mechanism of the knee joint and chondromalacia patellae. The following conclusion were made, 1. The sex ratio was 1:1.3 with female preponderance. There was 26 male and 34 female patients, common age group of chondromalacia patellae was age 20-40 years. 2. The average value of Q angle was 11 in control group, while 18 in chondromalacia patellae, having the difference of 7. 3. The average values of Q angle among different sexes were reviewed. The male control group had 9 of average value of Q angle, while male chondromalacia patellae had 16. The female control group had 12 of average value of Q angle, while female chondromalacia patellae had 20. 4. The average value of P/PT ratio was 1.03 in control group, while 0.9 in chondromalacia patellae, having the difference 0.13. For P/PT ratio in different sexes, the average value was 1.01 in male control group. while 0.9 in male chondromalacia patellae. The average value of P/PT ratio was 1.04 in female control group, while 0.89 in female chondromalacia patellae, 5. For statistical survey for these differences, P value was examined by t-test methods. The statistical diffrences of Q angle in male control group and chondromalacia patellae was 3.4 and it was 2.06 in he female. The difference between control group and the chondromalacia patellae in the overall seves was 2.61, thus having statistical significance.
Cartilage Diseases ; Chondromalacia Patellae ; Female ; Heart ; Humans ; Knee Joint ; Knee ; Male ; Patella ; Sex Ratio

No abstract available.
Hirschsprung Disease*

No abstract available.

Primary cutaneous monomorphous lymphoma is rare compared to the more usual involvement of skin secondary to internal monomorphous lymphoma. The histopathological diagnosis of the primary cutaneous monomorphous lymbhoma (PCML) requires differentiation from cutaneous lymphoid hyperplasia. The authors observed 3 cases of PCML. Case 1 was 21 year-old woman, who had an initial lesion on her left arm. Histopathologically it was diagnosed as poorly differentiated. lymphocytic lymphoma and was treated by surgical excision. Six months after onset she developed new lesions on her skin elsewhere, histopathologically diagnosed as well differentiated lymphocytic lymphoma. She died of infiltration of the bone marrow 19 months after the initial onset, even though combination of radiotherapy and chemotherapy resulted in clinical improvernent. Case 2 was a 70 year-old woman having an unusual cutaneous manifestation of an adult palm sized ulcerative, indurated tumor on her right forearm, histopathologically diagnosed as histiocytic lymphoma. There was no evidence of extracutaneous in volvement except right axillary lymphadenopathy. Case 3 was 72 year-old man, who had a clinical manifestation to that of case 2, histopathologically diagnosed as histiocytic lymphoma and received radiotherapy with good improvement. The patient did not show any evidence of extracutaneous involvement five months after the onset.
Adult ; Aged ; Arm ; Bone Marrow ; Diagnosis ; Drug Therapy ; Female ; Forearm ; Humans ; Hyperplasia ; Leukemia, Lymphocytic, Chronic, B-Cell ; Lymphatic Diseases ; Lymphoma* ; Lymphoma, Large B-Cell, Diffuse ; Radiotherapy ; Skin ; Ulcer ; Young Adult

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

Papulonecrotic tuberculid (PNT) and Pityriasis lichenoides et varioliformis acuta (PLEVA) have been in controversy in their pathogeneses and entity itselves. Authors reviewed litera,tures of the two dermatoses with observation of nine casea of PNT from 1979 to 1981 and evaluated whether PNT could be also classified as PLEVA. The results were a,s follows: 1. By the review of literatures PNT and PLEVA showed great similarities in their clinical aspects including shape of cutaneous lesions, course, favorite age and subjecive symptoms. Histopathological overlappings were also found. 2. Of the nine cases of PNT authors observed, seven cases were histopathologically PLEVA and four cases could be thought PLEVA also clinically. But way six cases were treated by anti-tuberculous drugs. 3. The incidence of other tuberculous signs and results of tuberculin skin tests were all significant in the nine cases above. With the above observations it seems that PNT is one of the causes of PLEVA and thus could be a kind of PLEVA.
Child* ; Dermatitis* ; Humans ; Incidence ; Pityriasis Lichenoides ; Skin Diseases ; Skin Tests ; Tuberculin ; Tuberculosis, Cutaneous

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

BACKGROUND: The initiation of treatment seems to be important in provoking preemptive analgesia and to provide excellent postoperative pain control. To verify the effectiveness of postoperative analgesia and preemptive effects, pre-incisional and post-incisional epidural infusion of morphine and bupivacaine mixture were compared. METHODS: Patients scheduled for elective upper abdominal surgery were divided into 2 groups. Each group received 2 mg of morphine in 10 ml of 0.25% bupivacaine as a bolus followed by 0.1 mg/ml/hr of morphine infusion in 0.125% bupivacaine epidurally. In post-incisional group, the epidural injection of mixture was started 15 minutes after skin incision and in pre-incisional group, the epidural infusion of mixture was started 15 minutes before skin incision. Each groups were evaluated in visual analogue scales (VAS) for pain, pain scores in movement, and total administered doses in postoperative 1, 2, 4, 8, 24, 48, and 72 hours and compared with each others. RESULTS: There were no differences between pre-incisional and post-incisional start of continuous epidural mixture infusion of morphine and bupivacaine in VAS for pain, pain scores at movement, and total amount of infused doses for 72 hours postoperatively. Also, there were no differences in the incidence of complications and satisfactions of patients between two groups. CONCLUSIONS: The continuous epidural mixture infusion of morphine 0.1 mg/ml/hr in 0.125% bupivacaine following a bolus dose of 2 mg morphine in 0.25% 10 ml bupivacaine has no difference in postoperative analgesic effect whether it starts after or before surgical incision.
Analgesia ; Bupivacaine ; Humans ; Incidence ; Injections, Epidural ; Morphine* ; Pain, Postoperative ; Skin ; Weights and Measures

No abstract available.
Bleomycin* ; Lymphangioma, Cystic*

Bilateral jumped facets dislocation in upper thoracic spine is rare injury because the thoracic spine is relatively immobile structure. We experienced a case of T2-3 dislocation without fracture and successfully reduced the dislocation after partial resection of the superior articular process of the third thoracic spine and performed fixation and fusion from T1 to T4 with pedicle screw system.
Dislocations* ; Spine