We report a case of morphea profunda in a 21-year-old male who had diffuse brown sclerotic plaques on his extremities. Laboratory findings showed peripheral eosinophilia and an increased titers for anti-DNA and anti-nuclear antibodies. Histopathologic findings showed diffuse fibrosis and a thickening of the lower dermis and subcutaneous tissue. He has been treated with hydroxychloroquine 400mg per day and the sclerosis of the skin improved.
Antibodies ; Dermis ; Eosinophilia ; Extremities ; Fibrosis ; Humans ; Hydroxychloroquine ; Male ; Scleroderma, Localized* ; Sclerosis ; Skin ; Subcutaneous Tissue ; Young Adult

No abstract available.
Pulmonary Embolism*

The clinical studies were performen on 304 patients with heart disease who had been received corrective heart surgery at Kosin Medical Center from July, 1984 to December, 1991. The results were as follows: 1) Out of 304 patients, 162 cases (53.3%) were male and 142 cases (46.7%) were female and sex ratio was 1.15:1. 35 cases (11.5%) had clinical cyanosis and 269 cases (88.5%) had no evidence of cyanosis. 2) As age distribution of patients, under 2 years, 3~5 years, 6~10 years, 11~15 years, 16~18 years consist of 22.0%, 26.0%, 29.0%, 16.1% and 6.9%, respectively. 3) As disease distribution, out 304 patients, ventricular septal defect (57.9% of all) was the most common disease, and then atrial septal defect (13.2%), tetralogy of Fallot (11.2%), patent ductus arteriosus (9.9%) and pulmonic stenosis (5.3%), in their order. 4) As sex distribution of each disease, ventricular septal defect, atrial septal defect and tetralogy of Fallot were more common in male and patent ductus arteriosus and pulmonic stenosis were more common in female. 5) The most frequent cardiac anomaly associated with ventricular septal defect and atrial septal defect was pulmonic stenosis. In the case of subarterial ventricular septal defect, aortic insufficiency was associated in 13.3%. 6) Respiratory problems (11.3%), tricuspid regurgitation (9.5%), arrhythmia (6.2%) and congestive heart failure (5.8%) were the major complications after surgery. 7) Case fatality reat was 4.4%. Mortality rate in ventricular septal defect, tetralogy of Fallot and tricuspid atresia were 1.7%, 20.6% and 100%, respectively, Majority (75.0%) of expired patients were died within 24 hours after sugery and the cause of death was hypoxia due to low cardiac output syndrome.
Age Distribution ; Anoxia ; Arrhythmias, Cardiac ; Cardiac Output, Low ; Cause of Death ; Cyanosis ; Ductus Arteriosus, Patent ; Female ; Heart Diseases* ; Heart Failure ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Male ; Mortality ; Pulmonary Valve Stenosis ; Sex Distribution ; Sex Ratio ; Tetralogy of Fallot ; Thoracic Surgery ; Tricuspid Atresia ; Tricuspid Valve Insufficiency

We analysed the results of total knee replacement arthroplasty without patellar resurfacing in 20 patients(28 knees) retrospectively. The patella was not resurfaced when it maintained relatively healthy cartilage in osteoarthritis or the patella was too thin to be replaced in rheumatoid arthritis. The diagnoses were osteoarthritis in 11 and rheumatoid arthritis in 17 cases. The follow up period was 30.3 months in average(12-70 months). A lateral retinacular release was performed in 22 knees(78.6%). The mean knee society score improved from 45.4 preoperatively to 84.1 postoperatively and the functional score improved from 21.4 preoperatively to 63.3 postoperatively. The modified Kujala score was 43.2 points in osteoarthritis and 43.6 points in rheumatoid arthritis. We conclude the total knee replacement arthroplasty without patellar resurfacing shows good results, without high risk of postoperative peripatellar complication.
Arthritis, Rheumatoid ; Arthroplasty* ; Arthroplasty, Replacement, Knee* ; Cartilage ; Diagnosis ; Follow-Up Studies ; Knee ; Osteoarthritis ; Patella ; Retrospective Studies

BACKGROUND: The pathogenesis of confluent and reticulated papillomatosis(CRP) is still unknown, although many theories have been suggested. It is stressed that abnormal host response to colonization of pityrosporum orbiculare might play a role in the pathogenesis of CRP, but is not completely understood. Frequently, we have observed bacterial colonies in the stratum corneum and, especially, within the hair follicles from biopsy specimens of patients with CRP. In addition, successful treatment for CRP with minocycline, a derivative of tetracyclines, has been reported continuously. OBJECTIVE: The purpose of this study was to document the possible association of bacterial factors in the pathogenesis of CRP and to elucidate the effectiveness of minocycline. METHODS: We performed Brown and Brenn gram staining in 12 biopsy specimens, bacterial cultures, identification of microorganisms and antibiotics sensitivity testing including minocycline. We administered oral minocycline with an initial dose of 100mg per day for 1 to 3 months and a maintenance dose 50mg per day for I to 2 months, then evaluated the response of treatment. RESULTS: 1. On Brown and Brenn staining, the gram positive bacterial colonies that stained dark bluish or nearly black were observed within the infundibulum of hair follicles in 10 out of 12 biopsy specimens(83.3%) and on the keratotic invagination of stratum corneum in 11 out of 12 biopsy specimens(91.7%). 2. Histological features of regions where bacterial colonies were observed showed, hyperkeratosis and keratotic invagination on the stratum corneum in all cases. Hyperkeratosis(66.7%), parakeratosis(16.7%), inflammatory cell infiltration(25.0%), perifollicular fibrosis(33.3%), and abnormal keratin in sebaceous ducts(50.0%) were shown in hair follicles. 3. In anaerobic cultures, no bacteria was grown. In aerobic cultures, staphylococcus species were identified in 6 cases, streptococcus viridans in one case, sternotrophomonas maltophilia in one case. In the susceptibiliity test, minocycline was sensitive in 7 from 8 cases. 4. The therapeutic response to minocycline was observed within one month in all cases, and the time to clear the lesions was 1/2 month in 2 cases, 1 month in 4 cases, 2 months in 5 cases, 3 months in one case, respectively. CONCLUSION: Form these results, we suggest that bacterial factors may play an important role in the pathogenesis of CRP and that the action mechanism of minocycline in the treatment of CRP may be due to antibacterial effects.
Anti-Bacterial Agents ; Bacteria* ; Biopsy ; Colon ; Hair Follicle ; Humans ; Malassezia ; Minocycline ; Papilloma* ; Staphylococcus ; Tetracyclines ; Viridans Streptococci

No abstract available.

Idiopathic CD4+ T lymphocytopenia (ICL) is a new disease entity characterized by depletion of helper T cells apparently without any evidence of HIV infection. We report a case of ICL associated with Kaposis sarcoma (KS) and pneumocystis carinii pneumonia (PCP) in a 34-year old woman. She developed violaceous, protruding masses on scalp, back, both extremities, palms, soles, left. first toe and peritonsillar region for 2 months. These lesions were confirmed as KS by histopathologic findings. Chest X-ray and HRCT findings represented PCP and KS. Absolute deficiency of CD4+ T cell was detected in the count of T cell subsets. Serologic tests for HIV-1, 2 and HTLV I, -II were negative. And she was absent any defined immunodeficiency or therapy associated with decreased levels of CD4+ T cells. By CDC criteria, a diagnosis of ICL was made. Because of aggravation of PCP and lung involuement of KS, she died at 22nd day after admission.
Adult ; Centers for Disease Control and Prevention (U.S.) ; Diagnosis ; Extremities ; Female ; HIV Infections ; HIV-1 ; Humans ; Lung ; Lymphopenia* ; Pneumonia, Pneumocystis ; Sarcoma, Kaposi* ; Scalp ; Serologic Tests ; T-Lymphocyte Subsets ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer ; T-Lymphocytopenia, Idiopathic CD4-Positive ; Thorax ; Toes

No abstract available.
Humans ; Pityriasis* ; Tinea Versicolor* ; Treatment Outcome*

Bone grafts are an integral and important aspect of craniofacial reconstruction. Rips, tibia, and iliac bone have traditionally used as donor site but each of these has various problems, however using to the calvarial bone as a donor site has several advantage. These are as follows; there are abundance of material, easy to reach the donor site through coronal incision, minimal pain of donor area, less functional inability, shorter hospitalization, no need of immobilization, hidden scar at donor site, no secondary deformity and appropriate curvature obtained properly selected. From March to December 1987, we experienced three cases of autogenous calvarial bone graft such as congenital saddle nose deformity, fibrous dysplasia on the right side frontal bone, and deviated nose. The results were very excellent without any significant complication. The detail technique of autogenous calvarial bone graft and its advantages compared with the traditional methods of bone grafts are discussed.
Cicatrix ; Congenital Abnormalities ; Frontal Bone ; Hospitalization ; Humans ; Immobilization ; Nose ; Tibia ; Tissue Donors ; Transplants*

BACKGROUND: We designed this study to determine whether trauma history and initial assessment anticipate the injury severity of the free-fall patient. METHODS: Two hundred patients who admitted emergency department of Severance hospital because of the fall from a height were enrolled in this study. The height of fall, the body orientation, and the characteristics of impacted material, and the Injury Severity Score(ISS) were evaluated by retrospective chart reviews. And regression equations were determined for predicting ISS on the basis of clinical parameters using multiple regression analysis. RESULTS: According to the characteristics of impacted material, the ISS was higher in the hard surface(13.7+/-9.5) than the sort surface(10.5+/-8.8)(p<0.05). There were correlations between height of fall and ISS(p<0.01, r=0.5). To the body orientation, the ISS was higher in the head-to-feet orientation(18.211.7) than the feet-to-head(10.9+/- 7.0) or other position(8.5+/-5.8)(p<0.01). The regression equations were as follows, ISS=2 +0.082xage(year)-1.54x(Glasgow Coma Scale)-3x(feet-to-head orientation)+0.65x height of fall(m)+2.7 x (hand surface)(p<0.01, R2=0.53). CONCLUSION: This study suggest that the injury severity of patient with free fall are significancy related to the height of fall, the characteristics of impacted material and the body orientation.
Coma ; Emergency Service, Hospital ; Humans ; Retrospective Studies