A 26-year-old male has experienced repeated pruritic and burning erythema and edema over the exposed areas of the skin, especially on the face and hands, after sunlight exposure. He stated that his father, three aunts, and three sisters had similar sunlight sensitivity. The face showed tiny whitish scars. And also there were hypopigmented scars on the dorsum of the hands. Characteristic laboratory findings were as followa: RBC, plasma and stool fluoresced coral red color under the Woods light. 100ml of the RBC contained 245 pg of protoporphyrin. On photosensitive test using sunlight for 60 rninutes, there developed painful sensation at 4 minutes and 40 seconds after exposure, erythema at 12 minutes after, and edema at 20 minutes after. Pathological findings of the specimen obtained from erythematous lesion of the forehead revealed hypergranulosis and acanthosis in the epidermis and perivascular thickening and hyalin deposit around the capillaries in the upper dermis. For treatment, avoidance of exposure to sunlight was recomrnended and symptomatic therapy was tried.
Adult ; Anthozoa ; Burns ; Capillaries ; Cicatrix ; Dermis ; Edema ; Epidermis ; Erythema ; Fathers ; Forehead ; Hand ; Humans ; Hyalin ; Male ; Plasma ; Protoporphyria, Erythropoietic* ; Sensation ; Siblings ; Skin ; Sunlight ; Wood

We presented here a case of an 80-year-old male patient who was, confirmed in the typical tumor stage of Mycosis fungoide by skin biopay. Relatively well-defined, brown-colored, round patches were found about 3 years ago on the chest, abdomen and inguinal area. He had received some treatment at several private clinics uder the impression of seborrheic dermatitis, paoriaais and eczematoid dermatitis. However, the skin manifestations were not improved t.ut rarther increased in eize, similarly to tinea corporis. Two months ago, firm nodules and tumors developecl a new on the lesinn sites, assoviated with intense pruritus and ulcerative tendency. We tried radiation therapy, but due to old age the patient chose to discontinurue.
Abdomen ; Aged, 80 and over ; Dermatitis ; Dermatitis, Seborrheic ; Humans ; Male ; Mycosis Fungoides* ; Pruritus ; Skin ; Skin Manifestations ; Thorax ; Tinea ; Ulcer

The present study reports two cases of femoral component fracture using Whiteside Ortholoc prosthesis(Dow Corning Wright, Arlington, Tennessee) with cement. The causes of the fracture were investigated by radiological findings, prosthetic design and metallurgical study using scanning electron microscope(SEM) and energy dispersive spectrometer(EDS). Respectively, the findings from this study are summarized as follows. In X-ray study, one case had valgus 3 mechanical axis(normal: valgus 7 axis) while the other case had 10 tibial anterior slope(normal: 10 posterior slope). The medial side of femoral component fractured in both cases. The fracture site was in the junction between the posterior bevel and distal surface of the medial side of femoral component. The analysis of the prosthetic design showed that the Whiteside Ortholoc femoral stem was thinner, and shorter at the site of posterior bevel surface of the femoral stem than other TKA(Total Knee Arthroplasty) system. The metallurgical study by SEM showed that the crack was developed initially near the inner surface of fractured femoral component and was extended to the outer surface. Carbon particles were detected in the fractured femoral component by EDS. The findings imply that operating technique is very important especially during bone cutting and soft tissue balance in TKA. It is also proposed from this study that a minor design modification such as a thicker and longer Whiteside Ortholoc femoral component would be better and that the cast-iron ware of TKA system has to he produced by careful metallurgical process, that precludes the incorporation of any foreign material such as carbon particles.
Arthroplasty* ; Carbon ; Knee* ; Prostheses and Implants* ; Zea mays

Facial nerve schwannomas are uncommon tumors that involve the facial nerve. They are frequently misdiagnosed due to subtle and variable clinical presentations. The aim of management of facial nerve schwannoma is the complete removal of tumor, combined with preservation or restoration of facial nerve continuity. The site, size of the tumor, age, preoperative hearing level and facial nerve function are consider as decision making factors. But, it is management dilemma to decompress or resect the tumor. The purpose of this paper is to discuss to surgical management of complete removal of tumor and successful facial nerve reconstruction. Recently, we experienced three patients with facial nerve schwannoma with relatively good surgical result.
Decision Making ; Facial Nerve* ; Hearing ; Humans ; Neurilemmoma*

An open multicenter trial was conducted to assess the efficacy and tolerability of oral terbinafine in the treatment of onychomycosis during 10 months from April, 1992 to February, 1993. Of patients with clinically and mycologically proved onychomycosis recruited from the Department of Dermatology of 29 university and training hospitals in the Korea, 143 patients who could be followed up at the end of the study were evaluated. The group of fingernail infection received orally terbinafine 250mg once daily for 8 weeks and the group of toenail infection for 16 weeks. After stopping treatment, all patients were followed up for 12 weeks. The results were as follows: 1. On the mycological study at the initial visit, 101 causative organisms were isolated from 99 pateints and Trichophyton rubrum was common organism (40 strains). 2. The length of healthy, unaffected nail were increased significantly more than two-fold after the end of treatment and at the follow-up investigation, those were 11.8mm in fingernail group and 9.8mm in toenail group. 3. The mean of all clinical symptom scores on entry diminished significantly by the time of the end of treatment and cleared mostly at the follow-up. 4. The mycological cure rate(negative microscopy and culture) was 56.5% for fingernails and 69.3% for toenails at the end of treatment and 100% for fingernails and 89% for toenails at the follow-up investigation. 5. overall efficacy assessed by the patient and by the investigator were evaluated as more than moderate in 93.1% and 94.5% of patients and overall tolerability were evaluated as more than moderate in 100% of patients by both of them. 6. The adverse effects of terbinafine were noted in 10 patients(7%) out of the 143. The most frequent drug-related adverse events were mild-to-moderate gastrointestinal disturbances. Any changes in liver biochemical tests were not considered clinically relevant. In conclusion, oral terbinafine is effective and safe in the treatment of onychomycosis. Our results demonstrate that a treatment period of 8 weeks for fingernail onychomycosis and 16 weeks for toenail onychomycosis is sufficient.
Dermatology ; Follow-Up Studies ; Humans ; Korea ; Liver ; Microscopy ; Nails ; Onychomycosis* ; Research Personnel ; Trichophyton

The authors present an analysis of publications on Journal of Korean Neurosurgical Society in 2002. Total 219 articles were published and the contents were clinical articles 94(42.9%), laboratory investi-gations 22(10.0%), case reports 102(46.6%), and review article one(0.5%), respectively. We hope that this analysis might be one of the stimuli to improve Journal of Korean Neurosurgical Society.
Hope

This study investigated the effects of LactoPlanta(R) (Lactobacillus plantarum (L. plantarum), 2.0 x 10(9) colony forming units (CFU)/kg) on reduction of noxious gas emission in pig houses as well as improvement of carcass weight and quality in finishing pigs. A total of 850 finishing pigs were assigned to four treatment groups: control (CON, basal diet) (n=190), LP-0.1, 0.1% LactoPlanta(R) (n=210), LP-0.2, 0.2% LactoPlanta(R) (n=230), and LP-0.4, 0.4% LactoPlanta(R) (n=220). Ammonia and hydrogen sulfide concentrations were significantly reduced in all treatment groups compared to CON. Mercaptan contents and carcass weights of LP-0.2 and LP-0.4 were significantly decreased compared to CON, whereas there were no significant differences between LP-0.1 and CON. Carcass weight of LP-0.1 was slightly higher than that of CON, but there was no significant difference. However, carcass weights of LP-0.2 and LP-0.4 were significantly higher than that of CON (P<0.05). The prevalence of grade A carcasses in groups administered with L. plantarum (46.7~63.3%) was higher than that in CON (43.3%) and increased in a dose-dependent manner. Based on the results of this study, L. plantarum could be an effective candidate to reduce noxious gas emissions in finishing pig houses as well as improve carcass weight and quality in finishing pigs.
Ammonia ; Hydrogen Sulfide ; Lactobacillus plantarum* ; Prevalence ; Stem Cells ; Swine* ; Weights and Measures

As the osteoporotic patient population grows, various periprosthetic fractures that cannot be classified appropriately can occur around the femur after hip arthroplasty. We experienced two cases of periprosthetic insufficiency fractures at subtrochanteric area of the femurs around radiographically loose cemented femoral stems. The ages of the patients were 75 years and 83 years. Both patients could not recall any history of trauma before the onset of pain. Both were treated non-operatively. Both healed uneventfully and did not recur after two years of follow up. When the osteoporotic patient with cemented stem showed sudden hip or thigh pain without a history of trauma, great attention should be focused to find this lesion.
Arthroplasty ; Femur ; Follow-Up Studies ; Fractures, Stress* ; Hip ; Humans ; Periprosthetic Fractures ; Thigh

Femoral stem fracture is an uncommon reason for the failure of total hip arthroplasty, with only 16 cases of fully coated stem fractures reported to date. Here we report a case in which a fully coated primary femoral stem fracture occurred after conversion to total hip arthroplasty for the non-union of an intertrochanteric fracture of the femur. Metallurgic evaluation of the etiology and mechanism revealed that the fracture was initiated by fatigue-related failure and completed by ductile failure on the posterior side of the fracture. Considering the recent trend of treating an intertrochanteric fracture with hip arthroplasty, possible stem failure should be considered, since most patients will have at least one of the known risk factors for stem fracture.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Femur ; Hip ; Humans ; Risk Factors

BACKGROUND: Left ventricular hypertrophy is common in chronic renal failure patients and may contribute increased risk of cardiovascular morbidity and mortality. We evaluated the left ventricular morphology and function in renal transplant recipients to find the relationship between hemodynamic changes and morphologic and functional improvement after transplantation. METHODS: Serial echocardiographic evaluations were performed in 27 adults(20 men and 7 women) at the time of transplantaion and posttransplantation 1 month and 4 months. The average duration of hemodialysis was 16+/-24 months(mean+/-S.D.). RESULTS: At the time of transplantation, the hematocrit level was 21+/-6% and posttransplantation 1 month and 4 months, that was increased to 39+/-5% and 42+/-7%, respectively(p<0.001). Left ventricular mass index by echocardiography was decreased significantly from 246+/-87g/m2(pre-KT) to 169+/-38g/m2(post-KT 1 month) and 153+/-40g/m2(post-KT 4 months), respectively (p<0.001). Interventricular septal thickness and left ventricular posterior wall thickness were decreased significantly after 4 months of transplantation. Left ventricular systolic and diastolic dimensions were also decreased significantly after 1 month and 4 months of transplantation. Left ventricular volumes and cardiac output were also decreased significantly. But A/E ratio, ejection fraction and fractional shortening did not change significantly. CONCLUSION: These findings showed that pretransplant high output state was resolved radipidly(within 1 month) but the diastolic function did not improved after transplantation 1 month and 4 months.
Cardiac Output ; Echocardiography* ; Hematocrit ; Hemodynamics ; Humans ; Hypertrophy, Left Ventricular ; Kidney Failure, Chronic ; Kidney Transplantation ; Male ; Mortality ; Renal Dialysis ; Transplantation*