Retinoid, Ro l0-9359 is an aromatic analog of vitamin A acid or retinoic acid. The orally administrable retinoid has a therapeutic effect on the treatment of psoriasis, ichthyosis, Darier's disease, pustulosis palmoplantaris and skin cancer. However, some results have been reported previously, indicating that oral retinoid alone does not clear psoriatic lesions although some improvement may he noted. Morcover, promising results of combination treatment of psoriasis with the retinoid and local dithranol or PUVA have been reported. In the present study we report the clinical results obtained in 16 psoriatics after oral retinoid treatment, with and without the addition of topical cotricosteroid. We employed a new retinoid regimen orally in 16 adults with widcspread psoriatic lesions, Most of them bad been treated earlier with topical corticosteroids without beneficial effect. Of 16 cases 8 were treated with retinoid alone and the other 8 patients with topical corticosteroids in addition to the oral regimen, The results are summarized as follows: 1. Complete to good clearing of the lesions was seen in 5 of 8 patient with retinoid alone and in 7 of 8 patients using the combination treatment. 2. Side-effects appeared in all patients, the most prominent being dryness of the mouth or cheilitis in cases and pruritus in 10 cases. However, there were no abnormalities shown in liver function tests during or after treatment. From the above results the combination treatment with topical corticosteroids seems to be more effective than retinoid alone in the treatment of psoriasis. It is considered that the oral retinoid could be an alternative on the treatment of psoriasis.
Adrenal Cortex Hormones ; Adult ; Anthralin ; Cheilitis ; Darier Disease ; Humans ; Ichthyosis ; Liver Function Tests ; Mouth ; Pruritus ; Psoriasis* ; Skin Neoplasms ; Tretinoin

It has been well known that ischemia reperfusion injury to skeletal muscle following an acute arterial occulusion causes significant morbidity and mortality. The skeletal muscle, which contains high energy phosphate compounds, has ischemic tolerance. During the ischemia, the ATP is catalyzed to hypoxanthine anaerobically and hypoxanthine dehydrogenase is converted to xanthine oxidase. During reperfusion, the hypoxanthine is catalyzed to xanthine by xanthine oxidase under O2 presence and that results in production of cytotoxic oxygen free radicals. The authors perform the present study to investigate the effects of allopurinol, the inhibitor of xanthine oxidase, on reperfused ischemic skeletal muscles by measuring of the immunoreactivities and exzyme activities of superoxide dismutase(SOD) and the formation of malondialdehyde(MDA). A total of 104 healthy Sprague-Dawley rats weighting from 200 gm to 250 gm were used as experimental animals. Under urethane(3.0mg/kg., IP) anesthesia with 3.0mg/kg of urethane, lower abdominal incision was made and the right and left common iliac artery were ligated by using vascular clamp for 2 hours. Both the quandriceps femoris muscles were obtained at 0 hour, half hour, 1 hour, 3 hours, 6 hours and 12 hours after the removal of vascular clamp. In the allopurinol pretreated group, 50mg/kg of allopurinol was administered once a day for 2 days and before 2 hours of ischemia. The specimens were sectioned in 14µm thickness with cryostat and homogenated ischemia. The specimens were sectioned in 14 µm thickness with cryostat and homegenated in the phosphate buffer. The immunoreactivities and enzyme activities of SOD were observed. The results were as follows: 1. The immunoreactivitiy and enzyme activity of SOD are decreased and the MDA level is increased in the 2 hours inchemic quadriceps femoris muscle of rats. 2. During the reperfusion of ischemic quadriceps femoris muscle of rats, the immunoreactivities of SOD in the half hour reperfused ischemic group and the enzyme activities of SOD in the 1 hour reperfused group are the highest and the immunoreactivities and enzyme activities of 6 hours reperfused ischemic group are the lowest. 3. Pertreatment of allopurionl decreased the immunoreactivities and enzyme activities of SOD during the ischemia and reperfusion of the quadriceps femoris muscles of rat. This results suggest that the allopurinol decreases the damages of skeletal muscles of rate during ischemia and reperfusion.
Adenosine Triphosphate ; Allopurinol ; Anesthesia ; Animals ; Free Radicals ; Hindlimb ; Hypoxanthine ; Iliac Artery ; Ischemia ; Mortality ; Muscle, Skeletal ; Muscles ; Oxygen ; Quadriceps Muscle ; Rats ; Rats, Sprague-Dawley ; Reperfusion ; Reperfusion Injury ; Superoxide Dismutase ; Superoxides ; Urethane ; Xanthine ; Xanthine Oxidase

The methods of reconstruction for chronic Iigamentous instability of the knee have changed much since the concept of rotary instability was introduced by Slocum and Larson in 1968. The first step to successful management of these probrams is the accurate dlagnosis of the type or types of the instability that exist. Appropriate operative procedures should then be selected according to the type and degree of the instability as well as the age, general conditlon and the function demand of the patient. The stability can be restored passively by a near anatomical. repair of the injured ligaments, and can be reinforced actively by a proper muscle or tendon transplantation, such as the five-one procedure for anteromedial rotary instability. Nineteen knees of active, well motivated patients were operated on for chronic knee instabilities according to these new concepts. Although the follow-up period was relatively short, the results of the procedures was generally satisfactory.
Follow-Up Studies ; Humans ; Knee ; Ligaments ; Surgical Procedures, Operative ; Tendons

The purposes of this study were to survey the present state and problems related to curriculum and clinical clerkship of diagnostic radiology and to find out alternatives for the improvement of curriculum design in diagnostic radiology. The results of this study are as following: First, 43.3% out of professors, 70.6% out of residents and 69.4% out of students reply that they don't attain the objectives of classwork, although they finish all their classwork successfully. Second, most of them reply that classwork is oriented by professors and least participated in by students. Third, PBL(Problem-based Learning) by small group is very effective to learning. Fourth, the reasons why clinical clerkship isn't systematic are that there aren't professors-in-charge of clinical clerkship and that the schedule of clinical clerkship is irregular. Fifth, students' participation in clinical clerkship is not substantial participation, such as interpretation and procedure, but simple observation. Based on these results the points which the improvement is called for are as follows: First, professors must achieve the objectives of classwork by thorough analysis on those within limited class hours. Second, it is desirable that they apply learning methods to improve students' thinking by small group activities to their classwork. Third, professors-in-charge of clinical clerkship are surely needed.
Appointments and Schedules ; Clinical Clerkship ; Curriculum* ; Humans ; Learning ; Thinking

No abstract available.
Abortion, Spontaneous* ; Female ; Humans ; Pregnancy

Carcinosarcoma is a rare malignant tumor composed of a mixture of neoplastic epithelial and mesenchymal elements, which has been reported in many organ systems, but its occurrence is very rare in the skin. An 81-year-old female patient presented with aml-year-history of a painful exophytic mass on the tip of the middle finger of the right hand involving the distal part of the nail bed. The mass was 1 × 1 × 0.6 cm in size, hard, flesh colored, ulcerated and easily bleeding. Microscopically, the epidermis at the margin of the tumor showed the characteristic findings of squamous cell carcinoma and the carcinomatous component was mixed with malignant mesenchymal components focally differentiating into chondrosarcoma. This combination of squamous cell carcinoma and chondrosarcoma has not been reported yet in the skin. She had a distal interphalanx amputation and no recurrence appeared for 1 year on follow-up.
Aged, 80 and over ; Amputation ; Carcinoma, Squamous Cell* ; Carcinosarcoma ; Chondrosarcoma* ; Epidermis ; Epithelial Cells* ; Female ; Fingers ; Follow-Up Studies ; Hand ; Hemorrhage ; Humans ; Recurrence ; Skin* ; Ulcer

No abstract available.
Cervix Uteri* ; Female

PURPOSE: This study evaluated the efficacy of an intra-articular injection of sodium hyaluronate in the treatment of early stage osteoarthritis of the ankle. MATERIALS AND METHODS: Early stage ankle osteoarthritis (Takakura stage I and II) patients who received hyaluronic acid injection therapy were retrospectively reviewed. Patients underwent intra-articular injections of 2 mL of sodium hyaluronate for 3 consecutive weeks. Clinical evaluation and Visual Analogue Scale (VAS) scoring were performed at every three months after treatment. RESULTS: Total 27 patients were involved and mean age was 55 year old (range 33 to 77 years). There were 13 male and 14 female patients. Mean follow up duration was 13 month and. Pre-intra-articular VAS score was 8.9+/-0.7 and three month follow up score was 3.8+/-2.8. VAS score of last follow up was 3.2+/-3.4. The effect of hyaluronic acid continued about one year when analyzed the VAS score change of the patients followed for more than one year. Patients' satisfaction was "very satisfied" in nine, "satisfied" in 12, "fair" in one, and "not satisfied" in five patients. Overall satisfaction rate was 82%. There were no ankle osteoarthritis stage changes in serial follow up radiograph. CONCLUSION: Symptomatic relief of signs and symptoms of osteoarthritis of the ankle was achieved by injection of an intra-articular hyaluronate injection. Efficacy of Hyaluronate acid injection persisted more than 1 year in our study. Intra-articular hyaluronate injection to ankle osteoarthritis is safe and effective as knee joint and should be considered as a valid conservative treatment for ankle osteoarthritis.
Animals ; Ankle ; Female ; Follow-Up Studies ; Humans ; Hyaluronic Acid ; Injections, Intra-Articular ; Knee Joint ; Male ; Osteoarthritis ; Retrospective Studies

No abstract available.
Tumor Necrosis Factor-alpha*

To investigate the process of angiogenesis in the cardiac tissue of neonatal rats, the levels of von Willebrand factor (vWf) produced by endothelial cells were observed. At days 1 to 7 after birth, whole heart obtained from neonatal rats was frozen sectioned, stained with anti-vWf and biotinylated rabbit anti-goat IgG antibodies, followed by immunohistochemical examinations. The results were as follows: 1. At day 1 after birth, extracellular matrix of endocardium and epicardium was stained with anti-vWf at the intermediate level, but that of myocardium was at the low level. 2. At day 2 after birth, a few blood islands were detected. At day 4 after birth, blood island was formed in most parts of heart and extracellular matrix was stained with ant-vWf at the intermediate level. 3. At day 7 after birth, a few blood vessels were formed, and endothelial cells and extracellular matrix was stained with ant-vWf at the intermediate level. These results suggest that mesenchymal cells were differentiated to blood islands and myocardiac cells, which are responsible for the distribution of vWf in extracellular matirx and for angiogenesis.
Animals ; Antibodies ; Blood Vessels ; Endocardium ; Endothelial Cells ; Extracellular Matrix ; Heart* ; Immunoglobulin G ; Islands ; Myocardium ; Parturition ; Pericardium ; Rats* ; von Willebrand Factor*