The authors experienced a case of typical pellagra in 45-year old male. He has been a heavy alcoholic history about 30 years duratian. Well-marginated erythematous created scaly patches, hyperpigmentation and fissures developed on both forearms and both ear lobes, both periorbicular areas, and Casals and klace on the aa0erior neck repeatedly. The skin leaions were aggravated in summers, improving a little in winters from 3 years ago. The psychoneurotic symptoms, neurologic disturbances, and GI troubles accompanied the skin lesions. Diagnosis was made by the characteristic clinical findings. He was treated with nicotinamide and vitamin B complex, and most of symptoms improved much. Authors reported the case and reviewed the literatures.
Alcoholics ; Diagnosis ; Ear ; Forearm ; Humans ; Hyperpigmentation ; Male ; Middle Aged ; Neck ; Neurologic Manifestations ; Niacinamide ; Pellagra* ; Skin ; Vitamin B Complex

No abstract available.
Congenital Hypothyroidism*

Pfeiffer syndrome, an unusual type of acrocephalosyndactyly, is a complex of associated malformations, first described by Pfeiffer in 1964. In addition to the common head and face anomalies seen in other acrocephalosyndactylies, its characteristics are broad thumbs and big toes, minimal syndactyly and normal intelligence. It is inherited in autosomal dominant pattern and shows various clinical features. The author's case was a 7-year old boy, who had been managed since birth for bilateral congenital resistant clubfeet including cast correction for six months and two operations. At present he represents not only the common features described above but also some unique features, e.g. pectus excavatum, posterior dislocation of both elbows, mild genu valgum, metatarsus adductus and complex malalignment of carpal and tarsal bones. To our knowledge, there is no report on Pfeiffer syndrome in Korea. The authors report a case of Pfeiffer syndrome with review of literatures.
Acrocephalosyndactylia ; Dislocations ; Elbow ; Funnel Chest ; Genu Valgum ; Head ; Humans ; Intelligence ; Korea ; Male ; Metatarsus ; Parturition ; Syndactyly ; Tarsal Bones ; Thumb ; Toes

STUDY DESIGN: A case report is presented of a symptomatic sacral perineural cyst with lumbar disc herniation that has reported a few case in the literature. We report the case of symptomatic perineural cyst with lumbar disc herniation. SUMMARY OF LITERATURE REVIEW: Symptomatic sacral perineural cyst is rare and some cases of sacral perineural cyst associated with disc herniation were reported. But it is not well known that the correlation between clinical symptoms caused by mass itself and concomittant lumbar disc herniation. METHODS: A 34-year-old male presented with low back pain, both leg dysesthesia and bilateral radiating pain. Clincal sign and symptom, physical examination, diagnostic imaging studies including MRI, myelography and pathologic findings of surgical specimens were evaluated. RESULTS: After the decompressive partial laminectomy and discectomy, the patient who had diapnosed with herniated nucleus pulposus of L4-5 and L5-S1 complained residual both leg paesthesia and hypoesthesia. Patient's clinical symptom was correlated with sacral perineural cyst. So we removed the cyst. Postoperatively neurologic symptoms and signs were completely relieved. Pathologically, Sacral perineural cyst composed of meningoepithelial cell and neural tissue within cystic wall were confirmed. CONCLUSION: We could find that sacral perineural cyst sufficiently evoked a clinical symptom. So, careful observation was needed in that case of sacral perineural cyst associated with disc herniation.
Adult ; Diagnostic Imaging ; Diskectomy ; Humans ; Hypesthesia ; Laminectomy ; Leg ; Low Back Pain ; Magnetic Resonance Imaging ; Male ; Myelography ; Neurologic Manifestations ; Paresthesia ; Physical Examination ; Tarlov Cysts*

No abstract available.
Ameloblastoma*

Vitiligo is a common acquired Thypornelanotic disease but the pathogenesis is still unknown and also the traatment is still unsatisfactory. The introduction in 1947 of psoralen therapy in vitiligo by El Mofty announced a new era in the treatment of this cosmetically disfiguring disease. Many investigators have developed therapeutic regimens for both topical and systemic poralen using various ligbt sources. The erythema action spectrum in UVA range of psoralen were defined, which consequently enabled the development of a more accurate regimen, namely psoralen and UVA(FUVA, exposure. The present study was undertaken to evaluate the efficacy of topical PUVA therapy in patients with vitiligo and to compare the result of PUVA therapy according to the age, sex, type of disease, total exposure dose, duration of disease nd involved site. Twenty one patients selected in the Department of Dermatology of Kyung hee University Hospital with various clinical types of vitiligo were treated with 03% 8-MOP ointment followed by exposure to longwave ultraviolet energy. Clinical response was graded as follows: Grade 0: No repigmentation Grade 1; Up to 25% repigmentaton Grade 2; 25% to 50% repigmentation Grade 3; 50% to 90% repigmentation Grade 4; Greater than 90% repigmentation A responsive case wss defined as a case with greater than 25% repigmentation. A effective case was defined as a case with greater than 50;o repigmentation.
Dermatology ; Erythema ; Ficusin ; Humans ; Methoxsalen* ; Photochemotherapy* ; PUVA Therapy ; Research Personnel ; Ultraviolet Rays* ; Vitiligo*

Vaginitis is one of the most common disease in gynecologic field in recent days. About 90% of these patients suffer from the infection of the vagina caused by Gardnerella vaginalis, Candida, or Trichomonas, either alone or in combination. For the effective diagnosis and management, it is essential to get an accurate identification of the causative agent. Applying simple and easy diagnostic methods such as pH of vaginal discharge, amine test and microscopic examination of wet mount preparation of normal saline and 10% KOH to 549 cases of randomly selected patients visiting Out-patient Department of Obstetrics and Gynecology of Yeungnam University Hospital through May 1st to Sept. 31st, 1987, the following results were obtained. 1. In the Gardnerella vaginitis vaginal pH was more than 5.0 in 81.0% of total cases, positive amine test in 62.8%, decreased lactobacilli in 77.4% & decreased WBC counts in 70.1%, In the Trichomonas vaginitis vaginal pH more than 5.0 was noted in 93.3% of the cases, negative amine test in 90%, decreased showed vaginal pH of 3.0~4.0 in 83.2%, negative amine test in 90%, decreased lactobacilli in 90% & increased WBC counts in 93.3%, whereas Candida vaginitis and normal groups showed vaginal pH of 3.0~4.0 in 83.2%, negative amine test in 100%, normal distribution of lactobacilli in 89.7%, normal WBC counts in 72.4%. 2. The accuracy rates of physical diagnosis by wet mount preparation of normal saline and 10% KOH revealed 26.3%, 47.5%, 70.0% in Gardnerella vaginitis, Candida vaginitis, and Trichomonas vaginitis, respectively. The vaginal pH and amine test showed 83.2% of accuracy rate in Candida vaginitis group, 60.6% in Gardnerella vaginitis group and 83.3% in Trichomonas vaginitis group. 3. In 23 cases of Gardnerella vaginitis showing vaginal pH of 3.0 or 4.0 and positive amine test, the clue cells were observed in 10% or less in 12 cases, 30% in 5 cases, 50% in 4 cases and 50% or more in 2 cases. In summary vaginal pH and amine test could be useful in screening and differentiating the different types of infectious vaginitis. Furthermore by adding microscopic examination of normal saline and 10% KOH wet mount preparation to them, they not only could obtain higher diagnostic accuracy rate but would be more valuable in selecting the patients requiring cultures to confirm the diagnoses.
Candida ; Diagnosis ; Gardnerella ; Gardnerella vaginalis ; Gynecology ; Humans ; Hydrogen-Ion Concentration* ; Mass Screening ; Obstetrics ; Outpatients ; Trichomonas ; Trichomonas Vaginitis ; Vagina ; Vaginal Discharge* ; Vaginitis*

Syringoma is not a uncommon tumor of the skin. It is a benign adenoma, of intraepidermal eccrine ducts. It occurs predominantly in women at puberty or adolescence. The lesions usually are multiple and small, skin colored or slightly yellowish payules, usually only 1 or 3mm in size. The lesions usually are limited to the lower eyelids but may occur on cheek, axilla, abdomen, neck, anterior chest and vulva. Rarely these are generalized in distributior. A 23 years old healthy man has had widespread lesions over the face, anterior chest and abdomen. The lesions appeared at the age of 13 on the anterior chest and abdomen. These increased in number and extended slowly to the face On visiting our department, there were numerous, angular or round, skin colored papules on his face and anterior chest as well as yellowish brown colored papules on his abdomen. Diagnosis was confirmed by clinical and histopathological findings as generalized syringoma.
Abdomen ; Adenoma ; Adolescent ; Axilla ; Cheek ; Diagnosis ; Eyelids ; Female ; Humans ; Neck ; Puberty ; Skin ; Syringoma* ; Thorax ; Vulva ; Young Adult

Authors investigated the possible role of intravascular hypercoagulable states on the etiology of Kegg-Clave-Perthes diesease. Forty-five patients with Legg-Clave-Perthes disease(31 avascular stages and 14 reossification stages) and twenty-two normal control patients were subjected to study for evaluation of coagulation and fibrinolysis system by means of the tests which included antiphospholipid antibody(APA), Protein C, Protein S and antithrombin- III (AT- III) for evaluation of coagulation system, and tissue type PIasminogen activator(tPA), Plasminogen activator inhibitor(PAI), D-dimer for fibrinolytic system. APA increased significantly in Legg-Clave-Perthes patients(p=0.016) as compared with control group, while Protein C(p=0.040) and Protein S(P=0.0001) decreased significantly in Legg-Clave- Perthes disease. AT- III increased in Legg-Clave-Perthes disease(p=0.0000). In contrast, there were no statistically significant differences in PAI, tPA, D-dimer between the Legg-Clave-Perthes disease and control group. There were no differences in all parameters between the avascular stage and reossification stage in patients with Legg-Clave-Perthes disease, Suggestive of possible inherent effect in coagulation system(hypercoagulable states) which does not change with time. Based on the above findings authors presumed that hypercoagulable state may contribute to the development of Legg-Calve-Perthes disease. However, to elucidate the etiology of Legg-Calve-Perthes disease, further extensive investigation should be followed, which include the familial tendency of hypercoagulable state, relationship with other multifactorial causes such as alcohol and steroids, and confirmation of intravascular thrombosis or decreased blood perfusion in the femoral head. Also, the significance of abnormally elevated AT-III on the disease should be answered.
Fibrinolysis ; Head ; Humans ; Legg-Calve-Perthes Disease ; Perfusion ; Plasminogen Activators ; Protein C ; Protein S ; Steroids ; Thrombosis

Recently, methionyl-hGH was produced in the E. coil K-12, W3110 by recombinant DNA technology in Korea. In this paper, the clinical efficacy and immunogenicity of this GH were studied in 43 patients with growth hormone deficency.The subjects of this study were aged 4.3-18.5 years and each patient received GH 0.5-0.71U/kg week subcutaneously, 6-7 times a week for 1 year. During treatment, height, body weight and bone age were checked. Blood count, urinalysis, blood chemistry and thyroid hormonal concentrations were checked before and every 3 months. The measurement of IGF-1 was performed and assay of antibody against hGH was performed before and every 6 months.The height velocities significantly increased from 3.7+-3.0 cm/year to 11.0+-4.2 cm/year and 9.9+-3.2 cm/year at 6 and 12 months after GH therapy, respectively. The Height SDS were significantly improved after GH therapy with increasing ratio of bone age to chronological age from 0.60+-0.19 at pretreatment to 0.68+-0.16 at 6 month, 0.69+-0.16 at 12 month of therapy. The plasma IGF-1 levels significantly increased during treatment. Three out of 35 patients(8.3%) showed antibody against hGH after 1 year of treatment. Thoughout study, we could not observe any remarkable side effect with GH treatment.These results indicate that this E. coli derived methionyl recombinant growth hormone is effective in improving the index of linear growth in the children with growth hormone deficiency without significant side effect.
Body Height ; Chemistry ; Child ; DNA, Recombinant ; Growth Hormone ; Human Growth Hormone ; Humans ; Insulin-Like Growth Factor I ; Korea ; Plasma ; Thyroid Gland ; Treatment Outcome ; Urinalysis