A 25-year-old man with familial benign chronic pemphigus presented with a one-year history of a localized pruritic recurrent eruption on his perianal area, Physical examination showed moist, macerated, fissured and scaly patches on erythematous base, A biopsy specimen showed extensive intraepidermal separation containing acantholytic cells. Electron microscopic observation showed widened intercellular space, detachment of the tonofilaments from the desmosomes, and subsequent concentration of the tono filaments around the nucleus. Microvilli were elorigated, thinned and branehed. 1)esmosomes were reduced in number. This case is unique in its clinical location, showing no family tendency.
Adult ; Biopsy ; Desmosomes ; Extracellular Space ; Humans ; Intermediate Filaments ; Microvilli ; Pemphigus, Benign Familial* ; Physical Examination

No abstract available.
Ciprofloxacin* ; Enoxacin* ; Humans* ; Metabolism* ; Theophylline*

It is essential to define the accurate location and extent of bony bridge in relation to the epiphyseal plate for operation of partial epiphyseal plate closure by bony bridge resection. Since magnetic resonance imaging(MRI) provides excellent tissue contrast and multiplaner image, it could be applied to the diagnosis and mapping of bony bridge of epiphyseal plate. A thirteen year old female with post-traumatic epiphyseal injury of ankle was diagnosed by MRI. We could assess the bony bridge accurately by direct sagittal and coronal images and excellent tissue contrast of MRI.
Ankle ; Diagnosis ; Female ; Growth Plate ; Humans ; Magnetic Resonance Imaging

During the period from January 1980 to September 1988, 59 patients suffering from brachial plexus injury, have admitted to Seoul National University Hospital. Fifty-four patients were male and 5 patients were female, and age ranged from 6 to 58 years (mean:26.8 years). The most common cause of injury was traffic accident accounting for 66% (39patient), and among them 24 patients(62%) had the motor cycle accident. Birth injury, stab or gun shot wound, fall down and industrial hazard were following causes. Fracture and dislocation of involved limb accompanied in 19 patients(32%) and 2 patients of arterial injury were also found. EMG and cervicsl myelography with or without CT were performed in almost all the patients and MRI was performed in selected patients. Forty-five patients(76%) had supra-clavicular lesion and 14 patients (24%) had infra-clavicular lesion. In supra-clavicular lesion, upper roots or whole roots were involved in most of cases. Forty-nine cases were treated with conservative treatment for more than 8 months and operative procedures were performed in 36 cases. In operative cases, 30 patients were followed up for more than 1 year (average 24.3 months). Signs of root avulsion were found in 25 out of 31 cases of cervical myelography. MRI was performed in 7 cases, but it was inconclusive in diagnosis of root involvement. Infra-clavicular lesion showed better prognosis than supra-clavicular lesion. In supra-clavicular lesion, upper root involvement had the best prognosis. A pseudocyst detected by myelography usually precluded recovery in the root at the level of pseudocyst. Result of reparative treatment was better than that of conservative treatment. Overall satisfactory result in reparative treatment was 36%. However, if we include neurological improvement, positive result was 53%. Complete recovery was gained in half cases of neurolysis and other half showed no recovery, but all the cases of neurotization showed poor result. Reconstructive surgery including arthrodesis or muscle transfer can be effective treatment method, if it is performed properly on a selective patient.
Accidents, Traffic ; Arthrodesis ; Birth Injuries ; Brachial Plexus ; Diagnosis ; Dislocations ; Extremities ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Methods ; Myelography ; Nerve Transfer ; Prognosis ; Seoul ; Surgical Procedures, Operative ; Wounds and Injuries

One hundred and twenty patients with symptomatic lumbar disc herniation were treated with automated percutaneous lumbar discectomy(APLD) from June 1988 to October 1989 in Seoul National University Hospital. Among them, 95 patients were followed up for more than 6 months. Number of male patients was 58 and female 37. Age ranged from 15 to 57 years with average 28 years. L4-L5 was the most commomly involved level comprising 80%, and 2 level involvement was 9%. Average duration of procedure was 38 minutes, and average amount of tissue aspirated was 5.2 grams and average hospital stay was 2.4 days. The average follw up was 10.8 months. Eighty seven percent of patients were satisfactory and 13% unsatisfactory and there was no major complication. There was no significant disc space narrowing in all the cases and the size of herniation revealed no significant change in all the patients, even the patient had a satisfactory result. APLD was compared with chemonucleolysis performed during 1988 in terms of clinical results, disc space narrowing on plain films and herniation size change on follw up CT. Chemonucleolysis also had satisfactory result in 89% with reduction of herniation size in 41% but induced significant disc space narrowing in 84%. Authors experienced some special cases, which are generally considered poor indication for percutaneous discectomy. Those were degenerative, calcified and possibly ruptured discs. Satisfactory results were obtained in 10 of 14 these patients.
Diskectomy ; Diskectomy, Percutaneous ; Female ; Humans ; Intervertebral Disc Chemolysis ; Length of Stay ; Male ; Seoul

The biomechanical responses, such as nucleus pulposus pressure, facet contact force, stress distribution among ligaments in the cervical spine under static loading like flexion and extension, were examined with 3-D nonlinear finite element model. Finite element model consisted of whole cervical spines with intact discs and ligaments was developed from 1mm thick CT-cross sections of a 25-year-old healthy young man. Geometrical nonlinearity was considered for the large deformation and ABAQUS package was used for calculation. Results were verified comparing with those of existing in vivo and in vitro experiments. Results indicated that, developed cervical spine FEM was well consistent with other experiments. Nucleus pulposus pressure increased in flexion and extension more in lower cervical region. Facet contact force increased more in lower cervical spine in extension. In addition, capsular ligament was the most important one among 7 cervical ligaments surrounding cervical spine both in flexion and extension. We could better understand the biomechanics of whole cervical spine with developed finite element model and it might be applied to dynamic or postoperative study.
Adult ; Humans ; Ligaments ; Spine*

No abstract available.
Brain* ; Hemangioendothelioma* ; Lung* ; Mediastinum*

No abstract available.
Doxorubicin* ; Drug Therapy* ; Small Cell Lung Carcinoma*

Primary hypothyroidism can result in reactive enlargement of the pituitary gland which is indistinguishable from primary pituitary lesions in clinical presentation and on magnetic resonance imaging. A 17-year-old girl came to the hospital due to short stature, general weakness and galac-torrhea. The magnetic resonance imaging (MRI) study showed pitutary enlargement. The hormone study showed hyperprolactinemia, decreased basal growth hormone level and primary hypothyroi-dism. By thyroid replacement therapy only, mass was successfully regressed on follow up MRI after 4 months, and growth acceleration could be achieved.
Acceleration ; Adolescent ; Female ; Follow-Up Studies ; Growth Hormone ; Humans ; Hyperplasia* ; Hyperprolactinemia ; Hypothyroidism* ; Magnetic Resonance Imaging ; Pituitary Gland ; Thyroid Gland

We present a case of epidermodysplasia verruciformis a.ssociated with Bowen's disease. Patient was 33 year-old male and his skin lesions showed diffuse flat papules on face and neck, many brownish papules on trunk and papillomatous tumors also appeared un scalp and post auricular area, Skin biopsy findings from the flat papular lesion showed histopathologic features of verruca plana and from the papillomatous lesion showed the feature of Bowen's disease. Electron microscopic finding from the flat papular lesion showed marked aggregates of viral particles around the nuclei of epidermal keratinocytes.
Adult ; Biopsy ; Bowen's Disease* ; Epidermodysplasia Verruciformis* ; Humans ; Keratinocytes ; Male ; Neck ; Scalp ; Skin ; United Nations ; Virion ; Warts