No abstract available.

A case of familiar benign chronic pemphigus is reported. A 41 years old housewife has recurrent history of developing grouped vesicular eruptions with erythematous erosion on the intertrigenous area since 29 years of her age. The lesions were used to aggrevated in summer and improved in autumn. Familiar history revealed same disease of her grand mother, father, 44 year old elder sister and 39 year old younger sister. All of whom had similar clinical signs and symptoms. Routine physical and Iaboratoryfindings were within normal limits. The histopathological findings, from vesicular eruption of the lateral aspect of neck, showed multilocular suprabasal clefts with acantholsis, villi formation and hyperkeratosis. The lesions were improved hy the local application of corticostcroidoid ointrnent only.
Adult ; Fathers ; Humans ; Mothers ; Neck ; Pemphigus, Benign Familial ; Psoriasis* ; Siblings

No abstract available.

Treatment of femoral shaft fractures in children is varying according to age. Satisfactory results have been obtained with longitudinal skin traction, split Russell traction, ordinary Russell traction, 90-90 skeletal traction, and immediate application of a spica cast(2,4,6,11,15). Most authors use one or more techinques routinely. It is safe and convenient to use single treatment protocol to treat all fractures of same type, Distal femoral skeletal traction with the knee and hip flexed 90 degrees and with the thigh hanging free, using the trunk as counter traction, has been used routinely for femoral shaft fractures in children(age 4-12). We reviewed 30 cases of femoral shaft fractures in children treated with 90-90 skeletal traction. 1. The average age of the patients was 6.8 years(range, 4-12 years), and almost all were caused by pedestrian injury. 2. The average time of traction was 48 days(range, 28-75), and 12 cases(40%) were treated without spica cast application. 3. Four among 30 cases developed angular deformity exceeding acceptable range(15° in AP view, 20° in lateral view), and three of them were proximal third fractures. 4. The older the patient, the longer the duration of limited activity and the more tendency of angular deformity. 5. 90-90 skeletal traction is easy, safe and convenient to treat all femoral shaft fractures of the children between four and ten years old.
Child ; Clinical Protocols ; Congenital Abnormalities ; Hip ; Humans ; Knee ; Skin ; Thigh ; Traction

We encountered the danger of the bleeding the vertex and posterior fossa epidural hematoma(EDH) operation which were related with large sinuses. Traumatic vertex EDH and posterior fossa EDH were usually accompanied by the fractures of coronal, sagittal suture or occipital bone. And frequently, sources of the bleeding were venous sinuses or fracture site. The patients who had vertex EDH were paraparetic soon after injury and the patients who had posterior fossa EDH were dangerous due to brain stem compression. We treated successfully the 13 patients who had vertex EDH(7 patients) and posterior fossa EDH(6 patients) by the method of one or two burr holes and urokinase irrigation. The authors represented this method may occasionally be preferable to craniotomy for these lesions. Advantages of the methods were : 1) More simple, cosmatic procedure and no need of cranioplasty. 2) Reduced operation time and morbidity. 3) Enable to operate under local anesthesia. 4) Reduced rate of delayed intracranial hematoma due to acute decompression of epidural hematoma. 5) Reduced the date of admission. 6) Possibly, prevention of rebleeding and air embolism.
Anesthesia, Local ; Brain Stem ; Craniotomy ; Decompression ; Embolism, Air ; Hematoma* ; Hemorrhage ; Humans ; Occipital Bone ; Sutures ; Urokinase-Type Plasminogen Activator*

No abstract available.
Dermatitis, Atopic* ; Killer Cells, Natural*

We report a case of Darier's disease occuring in 49-year-old female patient. She had hyperkeratotic crusted eruptions on her forehead, neck and posterior auricular area. The skin lesions aggravated in summer and improved in winter, but never been healed completely. Histopathologic features from neck lesions revealed hyperkeratosis with corps ronds and grains as well as formation of villi and laeunae. We treated her with oral etretinate, and she was almost completely free of disease after 3 months treatment. We suggested that etretinate is an importnat advance in the treatment of Darier's disease.
Acitretin* ; Edible Grain ; Darier Disease ; Etretinate* ; Female ; Forehead ; Humans ; Middle Aged ; Neck ; Skin

This study was performed to detect the hormonal abnormalities and to investigate the relationship between the levels of plasma testosterone and DHEA-S in 21 female patients with acne vulgaris using radioimmunoassay. The results were as follows : 1. The levels of plasma testosterone in patients group and control group(n=9) were 352+/-11.8 ng/dl, 223+/-9.7 ng/dl, respectively, and significantly elevated in patient group(p < 0.01), 2. The levels of plasma DHEA-S in patient group and control group were 286.6+/-126.8 pg/dl, 238.6+/-60.0 pg/dl, respectively, and did not show statistical significance. 3. The levels of plasma testosterones in patient subgroups classified by modified Pillsbury method were as follows minor group 32.6+5.3 ng/dl, mild group 33.4+/-15,5 ng/dl, moderate group 39.6+/-12.6 ng/dl. The testosterone levels in all the subgroups increased significantly than those in control group(352-t11.8 ng/dl) (p<0.05, p<0.05 p < 0.01) 4. The levels of plasrna DHEA-S in patient subgroups were follows minor group 242.5+/-412 pg/dl, mild group 263.9+/-166.1 pg/dl, moderate group 353.4+/-1273 pg/dl. The DE3EA-S levels in moderate group increased significantly than those in cotrol (238,6+/-60,0 pg/dl) and minor group(p<0.05). 5. There was no correlation between the plasma testosterone levels and the plasma DHEA-S levels in the acne patients.
Acne Vulgaris* ; Dehydroepiandrosterone* ; Female ; Humans ; Plasma* ; Radioimmunoassay ; Testosterone*

External fixation is regarded as the treatment of choice for type 2 and 3 open tibial fractures. However, external fixation alone, especially of an unstable fracture, can be complicated by high incidence of malunion, delayed union, loss of reduction, refracture, and pin-tract infection. Some surgeons tried to treat such problems by secondary intramedullary nailing, but they came to different results. The purpose of the present study is to eveluate our experience with secondary intramedullary nailing after external fixation of 6 cases of type 3B open tibia fractures and 1 case of type 3B femur fracture. These cases were followed for more than 13 months and the following results were obtained. 1. The external fixation had been maintained for an average of 62 days. 2. The mean interval between removal of the external fixator and intramedullary nailing was 23 days. 3. Antibiotics was injected for 2 weeks after removal of external fixator. 4. Reamed intramedullary nailing with static interlocking were done in all 13 cases. 5. Deep infections developed in 2 cases, one case which had been pin-tract infection was around intramedullary nail and the other in fracture site. 6. All cases were healed ultimately and average union time after nailing was 9 months.
Anti-Bacterial Agents ; External Fixators ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Incidence ; Surgeons ; Tibia ; Tibial Fractures

Contrast arteriography and phlebography remain the standard diagnostic techniques for evaluation of peripheral arterial and venous diseases. However, invasive angiographic techniques involve expense, time, discomfort, and potential risks to the patient which preclude their use as routine screening and followup procedures. In order to obtain accurate, objective information to complement the clinical diagnosis of peripheral vascular diseases, many noninvasive diagnostic techniques have recently become available to the clinican. Among these techniques, photoplethysmograph (PPG), strain gauge plethysmograph (SPG), and doppler ultrasound were adopted for our study. Fourty young volunteers were studied as a control group, and twenty peripheral vascular disease patients were studied as a patient group. We obtained average values of PPGa, blood flow, maximum PRT venous reflux folw (MVRF), maximum venous outflow (MVOF), pulse reappearance time (PRT), PRT/2 and pulsatility idex(PI) for control group. Results for patient group were analysed and compared with those of control group. 1. Normal PPGa wave has a steep upslope, a relatively narrow peak, and a dicrotic wave on the downslope which is concave toward the baseline. PPGa reflected skin blood flow sensitively than any other technique. 2. Average forearm blood flow by means of SPG was 5.7±2.0, and that of calf was 3.7±1.4ml/min/100cc tissue. MVOF of forearm was 32.9±10.4, and that of calf was 18.0±7.0ml/min/100cc tissue. Blood flow measurement was not useful for detection of arterial occlusive disease, but MV OF was useful for diagnosis of deep vein thrombosis. 3. PRT, PRT/2, over shooting reaction time by means of SPG have low diagnostic value and PI by means of doppler ultrasound was useful for localization of arterial narrowing or obstruction. 4. Noninvasive diagnostic techniques including PPG, SPG and doppler ultrasound are useful for screening and follow-up procedures in diagnosis of peripheral vascular disease. They are also valuable to supplement angiographic or physical findings.
Angiography ; Arterial Occlusive Diseases ; Complement System Proteins ; Diagnosis ; Follow-Up Studies ; Forearm ; Humans ; Mass Screening ; Peripheral Vascular Diseases ; Phlebography ; Reaction Time ; Skin ; Ultrasonography ; Vascular Diseases ; Venous Thrombosis ; Volunteers