A case of dermatitis herpetiformis resembling atopic dermatitis is reported. The patient is 45 year-o1d male, who 6 months ago developed the pruritic erythematous vesicular eruptions on the left side of back and it gradually spread to the margin. He was treated with steroid but the lession had undergone exacerbation and remissions. Biopsy was performed on the vesicular lesion and revealed non-acantholytic subepidermal bulla with mild inflammatory cells infiltration and then he was treated with DDS for 2 months with good response.
Biopsy ; Dermatitis Herpetiformis* ; Dermatitis* ; Dermatitis, Atopic* ; Humans ; Male

No abstract available in English.
Arthroplasty ; Elbow ; Fascia Lata ; Fascia

No abstract available.

No abstract available.
Cryptorchidism* ; Incidence* ; Male ; Parturition*

So many modalities have been suggested for the treatment of servere pain and ankylosis of the elbow with destruction of the articular surfaces. Among them, two major methods which have been widely used are resection arthroplasty and prosthetic replacement arthroplasty. However prosthetic replacement arthroplasty has some problems. Its indications are limited in the elderly inactive subjects. And there have been many kinds of complications including loosening and infection. Also, resection arthroplasty in now rarely indicated due to severe instability. From July 1980 to July 1987, we tried distraction arthroplasty in 8 cases of elbow with severe destruction of its articular surfaces, mainly in the young active persons. The average follow-up period was 45 months. The effect of distraction arthroplasty on relief of pain was not remarkable. The average increase in ROM, including that of one reankylosed elbow, was 51 ±22 degrees in flexion-extension and 48 ±23 degrees in pronstion-supinstion. No deep wound infection and instability which was main complication of resection arthroplasty were observed with our method of distraction arthroplasty. On the basis of functional results, the the results were excellent in 4, good in 1, fair in 2 and poor in 1 cases. In conclusion, distraction arthroplasty of the elbow can be one of the of effective methods reconstruction for the young active patients with the destruction of the elbow, if they are intelligent and motivated.
Aged ; Ankylosis ; Arthroplasty ; Arthroplasty, Replacement ; Elbow ; Follow-Up Studies ; Humans ; Methods ; Wound Infection

The cytologic examination of voided urine and bladder washings was done in 220 patients with bladder tumors from January, 1986 to June, 1989. Sixty hundred and thirty six specimens including 415 voided urine specimens and 221 bladder washings were examined. Among those, 160 paired specimens of both voided urine and bladder washings were taken from one patient on the same day. Specimens were stained by the Papanicolaou method, and they were interpreted as being negative when the cytologic examination was normal or showed benign atypia and positive when malignant cells were suspected or clearly evident. Sensitivity and specificity of the cytologic examination were 41.8%, 91.9% as a whole, and 34,6%, 96.6% in voided urine and 54.4%, 82.4% in bladder washings. The sensitivity of voided urine and bladder washings was increased as the tumor size, number, grade and stage were increased. A positive urine cytology without a visible tumor in voided urine was seen in 5 cases and the tumor recurred in all 3 patients who were followed up for more than 3 months. Among fifteen cases of a positive cytology without a visible tumor in bladder washings, 9 cases were followed up for more than 3 months, and the tumor recurred in 2 of 9 cases. In conclusion, the voided urine and bladder washings were complementary for the diagnostic accuracy of cytologic examination, and careful follow-up is necessary for a patient with a positive cytology without a visible tumor.
Diagnosis* ; Follow-Up Studies* ; Humans ; Sensitivity and Specificity ; Urinary Bladder Neoplasms* ; Urinary Bladder*

We analyzed 57 patients with tuberculous nonfunctioning kidneys, which were diagnosed pathologically or bacteriologically at Seoul National University, from October 1981 to December 1989. The patients were divided into 3 groups according to the treatment ; Group 1 : 12 patients, only chemotherapy for more than 12 months ; Group 2 :32, nephrectomy and chemotherapy for more than 6 months ; Group 3 . 13, nephrectomy and chemotherapy only for 3 months. As a standard antituberculous regimen, isoniazid, rifampin, and ethambutol were used, and pyrazinamide was added in 15 patients. The follow-up tests were urinalysis, urine AFB smear and culture, and intravenous pyelography. The duration of the follow-up was 6 to 1O8 months, with a mean of 23.3 months. There was no evidence of recurrence in any patient among the 3 groups. Two postoperative complications (hematoma and fistula formation) occurred in 45 nephrectomized patients. Pathologic examination of the resected kidneys revealed findings compatible with tuberculosis in all patients of Groups 2 and 3. Coexisting cortical adenomas were found incidentally in 2 patients. Final diagnoses of the other 2 patients were hydronephrosis and chronic pyelonephritis without any evidence of tuberculosis, although these 2 patients were excluded in this study. Severe drug toxicity occurred in 7 patients that belonged to Groups 1 and 2. In conclusion, early nephrectomy for accurate diagnosis and removal of infective foci was the justifiable initial procedure, and this should be followed by postoperative antituberculous chemotherapy for the shortest acceptable period in tuberculous nonfunctioning kidneys. In highly selective cases where the lesion is completely localized in one kidney, we can consider early nephrectomy and a 3-month course of chemotherapy as one treatment modality.
Adenoma ; Diagnosis ; Drug Therapy ; Drug-Related Side Effects and Adverse Reactions ; Ethambutol ; Fistula ; Follow-Up Studies ; Humans ; Hydronephrosis ; Isoniazid ; Kidney* ; Nephrectomy ; Postoperative Complications ; Pyelonephritis ; Pyrazinamide ; Recurrence ; Rifampin ; Seoul ; Tuberculosis ; Urinalysis ; Urography

In certain low-grade malignant tumors such as chondrosarcoma and giant cell tumor, radical treatments may provide a good chance for cure. And large bony defect after the radical treatment can be filled with the massive bone graft. Recent advances in clinical microsurgery have made free tissue transfer a clinical reality, and Taylor in 1975, first reported the technique of free vascularized fibula graft for the reconstruction of large tibial defects with excellent clinical results. We tried wide excision and free vascularized bone graft in 6 patients with malignant or aggressive bone tumor from April 1981 to November 1985 and followed up for more one year. Mean follow up of free vascularized bone graft is 26.4 months and that of devascularized bone graft is 22.6 months. The results of the free vascularized bone graft were compared with 10 patients who were treated with the wide excision and the devascularized bone graft. In this analysis, free vascularized bone graft is superior to devascularized bone graft in bony union, complications and functional results.
Chondrosarcoma ; Fibula ; Follow-Up Studies ; Giant Cell Tumors ; Humans ; Microsurgery ; Transplants

Clinical observation was done on 302 cases of cerebrovascular accidents admitted at Sung-Sim hospital, Chung-Ang University from January, 1968 to August, 1976. 1) Of 302 cases of cerebrovascular accidents, the incidence of cerebral hemorrhage was 28.8, cerebral thrombosis 47,7 Subarachnoid hemorrhage 20.2% and cerebral embolism 3.3%. 2) The peak age incidence was in the fifth decade in cerebral hemorrhage, subarachnoid hemorrhage, whereas in cerebral thrombosis, it was in the sixth decade. 3) The most frequent predisposing factor in cerebral hemorrhage and subarachnoid hemorrhage were physical activity and emotional stress, whereas in thrombosis and embolism, it was rest. 4) Among disease preceding the onset of cerebrovascular accidents, hypertension were presented 65.4% in cerebral hemorrhage, 63.6% in cerebral thrombosis, 56.6% in subarachnoid hemorrhage and valvular heart disease was presented 40.0% in cerebral embolism. 5) Serum cholesterol level over 200mg% was seen in 33.0% of cerebrovascular accidents. 6) Leukocytosis was seen 58.6% of cerebrovascular accidents which was predominantly found in the hemorrhagic group. 7) The pressure of cerebrospinal fluid was elevated in 61.7% of cerebrovascular accidents, predominantliny the hemorrhagic group. 8) The peak duration of admission was present in 51.7% of cerebrovascular accidents within 7 days and mortality rate during hospitalization was 38.0% in cerebral hemorrhage, 10.4% in cerebral thrombosis and 27.8% in subarachnoid hemorrhage. 9)The mortality rate during hospitalization was 35.3% in all cerebrlavascular accidents within 24 hours.
Causality ; Cerebral Hemorrhage ; Cerebrospinal Fluid ; Cholesterol ; Embolism and Thrombosis ; Heart Valve Diseases ; Hospitalization ; Hypertension ; Incidence ; Intracranial Embolism ; Intracranial Thrombosis ; Leukocytosis ; Mortality ; Motor Activity ; Stress, Psychological ; Stroke ; Subarachnoid Hemorrhage

From August l985 through June l987, ll patients were performed urinary diversion with Skinner`s modified Kock continent ileal reservoir. Postoperative follow up presently is between 2 months and 20 months. The following results were obtained. l. This operation was performed in 9 bladder cancers, I vesicovaginal fistula and l neurogenic bladder. 2. Early complications were acute pyelonephritis, wound infection, urine leakage of reservoir difficult self catheterization, acute renal failure, hepatic dysfunction and ileocutaneous fistula. 3. Late complications were asymptomatic bacteriuria, stone formation in reservoir, intestinal obstruction, incontinence and ureteral reflux. 4. Surgical management was applied for correction of incontinence or difficult self catheterization but the latter patient died of acute renal failure. 5. Progressive renal deterioration, metabolic disturbance, nutritional deficiency and electrolyte imbalance not been encountered in any cases.
Acute Kidney Injury ; Bacteriuria ; Catheterization ; Catheters ; Colonic Pouches* ; Fistula ; Follow-Up Studies ; Humans ; Intestinal Obstruction ; Malnutrition ; Pyelonephritis ; Ureter ; Urinary Bladder Neoplasms ; Urinary Bladder, Neurogenic ; Urinary Diversion ; Vesicovaginal Fistula ; Wound Infection