A 52-year-old man with multiple myeloma developed cutaneous nodules while being treated with melphalan and prednisolone. A biopsy specimen showed dermal infiltration by well differentiated plasma cells similar to those found on bone marrow biopsy. The use of peroxidase anti-peroxidase to demonstrate the monoclonality or polyclonality of the cytomplasmic immunoglohulins in the tumor cells revealed a positivity for IgG and 1 chain (ie, monotypic staining). Ultrastructurally, each plasmacytoma cell contained varyting amounts of rough endoplasmic reticulum and Golgi-apparatus. The cutnneous nodules completely disappeared after radiotherapy
Biopsy ; Bone Marrow ; Endoplasmic Reticulum, Rough ; Humans ; Immunoglobulin G ; Melphalan ; Middle Aged ; Multiple Myeloma* ; Peroxidase ; Plasma Cells ; Plasmacytoma* ; Prednisolone ; Radiotherapy

The immunoreactivities of surgically removed 16 cardiac myxomas were studies for factor VIII-related Ag (F VIII-RA), Ulex europaeus agglutinin I (UEA-I) and desmin alpha1-antichymotrypsin, and this study was accompained by a clinicopathologic review. More than 50% of the patients with cardiac myxomas were in their fourth and fifth decades, and cardiac myxomas were much more common in women than in men. All but on occurred in the left atrium, and the majority were attached to the atrial septum, usually in the region corresponding to the fossa ovalis. In one case, an atrial myxoma recurred 37 months after the initial excision. Microscopically, the myxomas contained a myxoid matrix composed of acid mucopolysaccharides within which were embedded polygonal cells. The cells forming both the surface and complicated vascular like channels throuhout the myxoid stroma tested positive for F VIII-RA and UEA-I. The outer cell layers of the complex vascular structures demonstrated variable staining for F VIII-RA, while isolated bundles of smooth muscle cells were present and stained for desmin. A small number of the so-called myxoma cells, immunoreactive for alpha1-antichymotrypsin which were not laden with hemosiderin pigment but were similar to histiocytes, were present particularly around the areas of hemorrhage. These findings support the current view that cellular and histologic heterogeneity arose from the divergent differentiation of multipotential mesenchymal cells. In particular, it remains to be confirmed by further study whether or not true histiocytic differentiation occurs.
Female ; Male ; Humans

No abstract available.
Posterior Cruciate Ligament*

During the period from March 1990 to November 1993, 22 children with diplaced supracondylar fracture of humerus were treated by closed reduction and percutaneous K-wire fixation at department of Orthopaedic surgery in Yeungnam University. All fracture were treated with closed reduction under the general anesthesia and percutaneous pinning. After the fracture was internally fixed, intraoperative anteroposterior reontgenograms of each distal humerus were compared. Only anatomical reduction ensured good result,, because the main cause of late cubitus varus was medial tilting of distal fragment. We could follow up 10 patients more than one year. By Flynn's criteria, satisfactory result were obtained in 9 of the 10. Unsatisfactory one had a limitation in flexion of elbow joint, but had no problem in cosmetic feature. In short term follow up of 7 patients, 5 patients had a satisfactory result, too. There were no neurovascular complication and hospitalization was shortened to 11.4 days. Closed reduction and percutaneous pinning provided stabillity, vascular safty, simplified management, reduced hospital stay. This is safe and reliable technique for obtaining and maintaining an exellent reduction.
Anesthesia, General ; Child* ; Elbow Joint ; Follow-Up Studies ; Hospitalization ; Humans ; Humerus* ; Length of Stay

Posterior capsule opacification(PCO) is a common complication of cataract surgery. The presence of a posterior chamber intraocular lens has been shown to decrease the incidence of the development of PCO. Moreover, there are evidences that the design of intraocular lens may also alter its development. Extracapsular lens extraction with implantation of posterior chamber lens were operated on a consecutive series of 230 eyes. These were evaluated in the viewpoint of PCO development after surgery. All were sulcus fixed and their optic designs were devided into two groups; a group of convex-plano lens with continuous laser ridge including convex-concave lens and a group of biconvex lens. The incidence of PCO was lower in convex-plano lens with continuous laser ridge group(6.7%) than that of boconvex lens group(18.9%). The incidence of Nd:YAG posterior capsulotomy marked 0.0% in continuous ridged group and 1.8% in biconvex group(p<0.05, p Capsule Opacification* ; Cataract ; Incidence ; Lenses, Intraocular* ; Posterior Capsulotomy

The posterior cruciate ligament is the primary static restraint to posterior translation of the tibia and provides proprioception within the knee. The goals of treatment in the injuries of PCL are restoration of normal tibiofemoral stability and reduction of long term osteoarthrosis of the knee. The purpose of this study is to cornpare functional outcome, muscle power, and posterior stability between conservative treatment and reconstruction with autogenous RPTB augmented with Kennedy LAD in PCL injuries. Twenty-seven patients with PCL rupture who have been treated from November 1990 to May 1996 were reviewed. The patiens were divided into conservative group and reconstruction group. Conservative treatment was done in 15 patients and reconstruction by autogenous bone patellar tendon bone with Kennedy LAD was performed in 12 patients. All patients were evaluated with posterior stress x-ray films, KT-2000 knee ligament arthrometer, Cybex 340 isokinetic dynamometer, subjective Cincinnati symptom rating scale and Lysholm knee score, complication. The results were as follows; 1. Mild and moderate posterior instability was remained in spite of BPTB graft and need more stable fixation technique and vigorous rehabilitation program. 2. At the angular velocity of 90 degree/sec and 180 degree/sec, the muscle strenth of quadriceps was decreased after PCL injury in both group in the test of Cybex 340 isokinetic exercises. The power of hamstrings were not changed after PCL injuries. 3. Average Lysholm knee score was 89 points in reconstruction group and 78 points in conservative group and average Cincinnati symptom-rating scale was 8.4 points in reconstruction group and 7.1 points in conservative group. More satisfied functional results and subjective symptoms were revealed in the reconstruction group and statiscal significancy (p<0.05) was showed when comparing conservative group with reconstruction poup. 4. Good clinical results did not always coincidence with lesser posterior instability and clinical results were influenced by associated injury of the knee. The more combined ligament injury of the knee, the worse clinical results.
Exercise ; Humans ; Knee ; Ligaments ; Osteoarthritis ; Patellar Ligament ; Posterior Cruciate Ligament ; Proprioception ; Rehabilitation ; Rupture ; Tibia ; Transplants ; X-Ray Film

There have been many debates concerning operative decompression of treatment of thoracolumbar burst fractures with retropulsed bone fragment. From March 1988 to February 1992, authors treated thirty-three thoracolumbar burst fractures by using transpedicular screw fixation and posterior fusion via the posterior approach. We attempted to reduce retropulsed fragment by ligamentotaxis alone and not to do posterolateral nor anterior decompression. After the reduction of fractured spine by posterior instrumentation, we tried to determine the efficiency of reduction of the retropulsed fragment by ligamentaxis along. As a method, we compared the change of anteroposterior, transverse to diameter and area of spinal canal of fractured spine between preoperative and the postoperative situation. The results were as follows; 1. The mean anteroposterior and transverse diameter of the spinal canal on computed tomogram film was 10.1mm & 21.8mm preoperatively & 12.4mm & 23.2mm postoperatively, showing an increase. 2. The area of spinal canal of involved spine on CT film was evaluated preoperatively & post-operatively, the mean spinal canal invasion rate decreased from 36.3% preoperatively to 14.3% postoperatively. 3. The degree of reduction of middle height on plain x-ray and reduction of spinal canal invasion on computed tomogram were statistically correlated(p < 0.01). 4. There was no correlation between the degree of canal narrowing and degree of neurologic impairment. also, there was no correlation between the reduction of retropulsed fragments and subsequent neurologic impairment. 5. There was the relatively satisfactory enlargement of the spinal canal on computed tomogram at the follow-up So we suggest that it is possible to get enough decompression through reduction of retropulsed fragment by ligamen to taxis alone without posterolateral decompression.
Decompression ; Follow-Up Studies ; Methods ; Spinal Canal ; Spine

No abstract available.
Child* ; Humans ; Neurilemmoma* ; Neurofibromatosis 1

Ataxia telangiectasia is an autosomal recessive disorder characterized by progressive cerebellar degeneration, cancer predisposition, immune defects, radiosensitivity and genetic instability. Ataxia telangiectasia is rare and has not been reported in Korea. We present a 9-year-old girl with early onset progressive cerebellar ataxia. Neurologic examination showed gaze apraxia, bulbar dysfunction, retained tendon reflexes and conjunctival telangiectasia. Alpha-feto protein was elevated and serum IgA was decreased. Brain MRI showed prominent cerebellar atrophy. Literatures were reviewed.
Apraxias ; Ataxia Telangiectasia* ; Ataxia* ; Atrophy ; Brain ; Cerebellar Ataxia ; Child ; Female ; Humans ; Immunoglobulin A ; Korea ; Magnetic Resonance Imaging ; Neurologic Examination ; Radiation Tolerance ; Reflex, Stretch ; Telangiectasis

A total of 127 cases of seborrheic keratosis examind at the Dept. of Pathology, Yonsei University School of Medicine during 1980~1986 was reviewed. The results were as follow; 1) Sex distribution showed without preponderance with male; Female ratio of 1.05:1. 2) Age distrubution were 10~19 years 0.8%, 20~29 years 4.7%, 30~39 years 14.2%, 40-49 years 25.2%, 50~59 years 29.1%, 60~69 years 17.3%, 70~79 years 6.3% and neck (3.7%). 3) The most common site was face (44.8%), followed by trunk (29.8), lower extremities (10.4%), scalp (6.7%) and neck (3.7%). 4) The clinical diagnoses were sebrorrheic keratosis (47%), nevus (15.4%), verruca (12%), malignant melanoma (7.7%), actinic keratosis (3.4%), pyogenic granuloma (2.6%), mass (2.6%), basal cell epithelioma (0.9%), corn (0.9%), leproy (0.9%), and angiokeratoma (0.9%). 5) The distributions of the light microscopic diagnosis were acanthotic 52 cases (42.9%), hyperkeratotic 33 cases (30%), irritated 17 cases (13.4%), adenoid 15 cases (11.8%), clonal 3 cases (2.4%), melanoacanthoma 1 case (0.8%) and mixed 6 cases (4.7%). 6) The lesions measured from 0.2 cm to 3 cm in maximum diameter and its color was light brown to black with sharply demarcated papule, pladque or nodule.
Female ; Male ; Humans