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*

The etiologic factors causing low back pain are numerous and variable. Orthopaedic sugreons tend to focus attention to any defects of structural and functional origins such as pine, discs and facet joints. Clinically, however, the fact remains that not all abnormal findings produce back pain and vice vera. Among the many modalities of investigation to determine the etiology of back pain, plain X-ray of the lumbosacral spine is the single most important acreening method. In addition to antero-posterior, lateral and oblique views, stress view of the spine gives certain clue to predict the disc degeneration. The X-ray findings of a total of 503 patients with low back pain (the study group). admitted during the year of 1977 to the Department of Orthopaedic Surgery, National Medical Center, were reviewed and compared with the control group of 100 patients without relevance to back pain (the control group). Our intention was to explore the relationship between the abnormal findings of plain X-rays and occurence of back pain. and to further entrance the diagnostic value of the spine. The study group of 503 patients (86 cases of which were operated on) were diagnosed not only by routine plain X-rays but also by contrast myelography and tomography in addition to detailed physical examination. Following observations were made: 1. The sex was nearly equally distributed in the atudy group of 503 patients. The age ranged from the second to the eighth decade, dominant group being the third to fifth decades. 2. The causes of the low back pain were herniated disc, spondylosis, spondylolysis, and infection, in that order. 119 patients (23.7%) out of the 503 showed no roentgenologicaI abnormal findings. 3. 384 cases out of the 503 revealed abnormal findings, mainly congenital or developmental and degenerative changes in that order. 4. In a comparative study with the control group, congenital or developmental anomalies and degenerative changes were not related to low back pain. Disc. space narrowing, supposed to be valuable in establishing the diagnosis of low back pain was present in 26% of the cases in study group and in 11% in the control group. 5. The age incidence of the low back pain with congenital or developmental anomalies was mainly in th second and third decades, while that of disc space narrowing was in the third to fifth decade. The degenerative changes of the spine appeared after the fourth decade. 6. Transitional vertebra and tropism are supposed to plsy a role on the degenerative change of the spine. 7. The stress study of the spine had some benifit it the diagnosis of disc degeneration. The mobility of the L4-5 lesion with low back pain was increased to mean 15.1 and standard deviation 3.7, in comparison to the mean 12.3 and standard deviation 3.7 in the control group.
Back Pain ; Diagnosis ; Humans ; Incidence ; Intention ; Intervertebral Disc Degeneration ; Intervertebral Disc Displacement ; Low Back Pain ; Methods ; Myelography ; Physical Examination ; Spine ; Spondylolysis ; Spondylosis ; Tropism ; Zygapophyseal Joint

In 1974, bipolar endoprosthesis was first introduced by Bateman & Giliberty. It has theoretical advantages including minimizing acetabular wear, possible reduction of incidence of stem loosening, lessening of dislocation and easy revision procedure. Various methods for the treatment of fracture of the femur neck have been developed & performed, but it is still called “the unsolved fracture” in certain situation. But the role of it as primary treatment of fracture of the femur neck continues to be controversial. Current clinical results encourage its continued use and expansion of indication. Authors reviewed and analysed 21 cases of bicentric endoprosthesis and 1 case of Giliberty endoprosthesis those have been operated at the Department of Orthopaedic Surgery, National Medical Center from 1981 to 1983. Following results were obtained, l. According to disorder distribution, 14 cases were neglected fracture of femur neck, 2 old fracture, 1 idiopathic femoral head necrosis and 2 avascular necrosis & 1 non-union complicated by femoral neck fracture. 2. Among 20 cases, 8 cases were operated within 1/2 1 month after injury and 6 cases within 1 3months 3. Harris lateral appmach was used in 16 cases (80%) and Modified Gibson approach in 4 cases (20%). There were no significant differences in morbidity during operation and postoperative complication. 4. We used femoral stems those head diameter was 22 and 32mm(Charnley & Miiller type) and head pieces those diameter was 48-51 mm in male and 44–48 mm in Ifemale. 5. 3 cases were stiff in inner bearing without acetabular erosion. 6. In 6 cases more than 2 years followup 1 degree CE angle of Wiberg was increased in 2 cases of youngage respectively without associated hip joint pain. 7. Although inclination of head piece was vertical in 8 cases, fracture and dislocation were not found. 8. The circumference of head piece and opposite femoral head was measured and compared. There were 12 cases (mean 12.6 mm) that of head piece larger than opposite femoral head and 3 cases smaller than opposite femoral head. 9. There was 4 cases of complication (3 patients) and still no reoperation and revision converted to T.H.R. 10. With regard to average 18 months of follow-up, 7 cases of 81–90 Harris hip-rating score, 6 of 91–100, 4 of 71–80 and 3 of 61–70.
Acetabulum ; Dislocations ; Femoral Neck Fractures ; Femur ; Femur Neck ; Follow-Up Studies ; Head ; Hip Joint ; Humans ; Incidence ; Male ; Neck ; Necrosis ; Postoperative Complications ; Reoperation

Gas gangrene is a potentially lethal dissease, but fortunately uncommon. Profound toxicity and rapid progression are characteristic of this disease. Therefore the success of the treatment in this disease is largely depended on early diagnosis and treatment. The treatment includes debridement and decompression, amputation if ncessary, adequate entibiotic therapy, administration of antitoxin, hyperbarit oxygen therapy and general supportive therapy. The authors have reviewed 9 cases of gas gangrence, which were identified by bacteriologically out of 14 cases of suspicious gas gangrene. All cases were treated in our department from 1981 to 1985. The results are summarized as follows: 1. The culture studies of clostridium were specified in 5 cases of Cl. perfringens, 2 cases of Cl. septicum, 1 case of Cl. bifermentans and 1 case of Cl. sporogenes. 2. All 9 patients underwent debridement, antibiotic therapy, hyperbaric oxygen therapy and general supportive therapy. We had not used gas gangrene anti-toxin, beceuse of the value of antitoxin is uncertain and subjects the patient of the danger of hypersensitivity reactions. 3. In 7 patients involving only the extremities, amputations were inveitable on 3 patients due to irreversible gangrenous changes on the involved extremities. And one of them died due to septic shock. 4. In 2 patients involving the trunk, one of them died due to renal failure.
Amputation ; Clinical Study ; Clostridium ; Debridement ; Decompression ; Early Diagnosis ; Extremities ; Gas Gangrene ; Humans ; Hyperbaric Oxygenation ; Hypersensitivity ; Oxygen ; Renal Insufficiency ; Shock, Septic

Marjolin's ulcer seated upon an old cicatrix, especially old burn scar, which may chiefly degenerated into a squamous cell carcinoma with propensity for metastasis. We are experienced two cases of Marjolins ulcer recently. A 54-year-old male who had a Marjolins ulcer(15x40cm) on his left lower extremity. He was experienced burn at the age of eight and rice sized ulcer was developed at the site of burn scar about 21 years ago. The ulcer progressively enlarged in size to reach 15x40cm for 21 years. The pathologic diagnosia was squamous cell carcinoma grade 1, but cancer cells invaded to deep dermie and subcutaneous tissues. Severe skin lesion and irreversible osteoporotic degeneration on knee joint of affected limb were present. So he was treated by high above knee amputation. Another 58-year-old female who had a Marjolins ulcer(10x20cm) on her right lower extremity. She was experienced burn at the age of forty eight and bean sized ulcer was developed at the site of burn scar about 1 year ago. The pathological diagnosis was squamous cell carcinoma grade 1 and invasian of cancer cells was limited upper dermis. On lymph node biopsy, the histological diagnosis was within normal limit. So she was treated radical surgical excision with split thickness skin graft(Mesh).
Amputation ; Biopsy ; Burns ; Carcinoma, Squamous Cell ; Cicatrix ; Dermis ; Diagnosis ; Extremities ; Female ; Humans ; Knee ; Knee Joint ; Lower Extremity ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis ; Skin ; Subcutaneous Tissue ; Ulcer*

Interdigitating reticulum cell sarcoma is a neoplasm that shows differentiation similar to that of non-neoplastic interdigitating reticulum cells, which normally reside in the paracortical region of the lymph node. Interdigitating reticulum cell sarcoma is extremely rare and its definite identification requires a multiparameter study, including microscopic, enzymatic histochemical, immunophenotypic and molecular findings of the tumor cells. We report a case of interdigitating reticulum cell sarcoma in the right upper jugulodigastric lymph node of a 42-year-old male. The patient wad initially diagnosed as metastatic undifferentiated carcinoma, so we tried to find primary site but failed. The patient was treated by radiation therapy under the diagnosis of metastatic neck node. Two years later, the patient was finally diagnosed to interdigitating reticulum cell sarcoma by pathological review and immunohistochemical studies. The patient has been alive well at 55 month of follow-up.
Adult ; Carcinoma ; Diagnosis ; Follow-Up Studies ; Humans ; Lymph Nodes* ; Lymphoma, Non-Hodgkin* ; Male ; Neck ; Reticulum*

Partial outlet obstruction induced by benign prostatic hypertrophy or urethral stricture are common urologic conditions showing voiding dysfunction. This study was performed to compare the effects of short-term partial outlet obstruction on the contractile responses to different stimuli and to elucidate the mechanism of altered contractile response during the development of significant voiding dysfunction. Sprague-Dawley rats, 10 week old, were subjected to partial outlet obstruction for 7 days. Contractile responses of the urinary bladder detrusor muscle strips to electrical field stimulation (1, 2, 5, 10 and 20 Hz), KCl (50 and 100 mM) and carbachol (10(-9 to 5) M) were measured. Total protein and DNA contents of the bladder were measured. Connexin 43 mRNA expression was measured using RT-PCR and connexin 43 protein was observed in the fixed bladder tissue using immunohistochemistry. The electrical field stimulation-induced contractile response and KCl-induced contraction was not changed after partial outlet obstruction. Contraction induced by carbachol was enhanced by the partial outlet obstruction. Total protein and DNA contents were increased in the partial outlet obstruction group. Connexin 43 mRNA and protein expression were detectable in the normal bladders and increased after 7 days of obstruction. These results suggest that the altered contractile responses during the early stage of the partial outlet obstruction are the result of the changes of the contraction mechanisms or structure of bladder muscle. Connexin 43 may play an important role in those alterations.
Animals ; Carbachol ; Connexin 43 ; DNA ; Immunohistochemistry ; Prostatic Hyperplasia ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger ; Urethral Stricture ; Urinary Bladder*

The Cornelia de Lange syndrome is characterized by severe growth and mental retardation; typical facies; low-pitched, weak, growling cry, and various bone abnormalities, as was first described by Cornelia de Lange in 1933. On the other hand, Legg-Perthes disease is the condition, in which avascular necrosis of the femoral head develops, as was first described by Legg, Calve and Perthes in 1910. Review of the worlds literature disclosed only one case of Legg-Perthes disease associated with Cornelia de Lange syndrome. We experienced a case of Legg-Perthes disease associated with Cornelia de Lange syndrome in a 8 years old boy, which was treated surgically for Legg-Perthes disease. A brief review of literature was made.
De Lange Syndrome ; Facies ; Hand ; Head ; Humans ; Intellectual Disability ; Legg-Calve-Perthes Disease ; Male ; Necrosis

The purpose of this study is to observe and compare the dynamic change of artificially demineralized enamel by remineralization solutions of different degrees of saturation at pH 4.3. In this study, 30 enamel specimens were demineralized artificially by lactic acid buffered solution. Each of 10 specimens was immersed in pH 4.3 remineralization solution of three different degrees of saturation (0.22, 0.30, 0.35) for 10 days. After demineralization and remineralization, images were taken by a polarizing microscope (x 100). The density of lesion were determined from images taken after demineralization and remineralization. During remineralization process, mineral deposition and mineral loss occurred at the same time. After remineralization, total mineral amount and width of surface lesion increased in all groups. The higher degree of saturation was, the more mineral deposition occurred in surface lesion and the amount of mineral deposition was not much in subsurface lesion. Total demineralized depth increased in all groups.
Dental Enamel ; Hydrogen-Ion Concentration ; Lactic Acid

OBJECTIVE: It is well-known that antipsychotics are widely used in the treatment of bipolar disorder. So, the aim of this study was to examine the subjective response to antipsychotics in acute manic patients. METHODS: Data were gathered through the study for feasibility testing of Korean Medication Algorithm for Bipolar Disorder (KAMP-BP), which 17 nationwide clinical centers were entered into the study. A total 126 bipolar patients were enrolled and then 92 were treated according to the treatment algorithm. The data of 58 patients were completely recorded from baseline to 2 weeks of treatment and were entered into analysis. Drug Attitude Inventory-10 (DAI-10) was used for evaluating patient's subjective response to antipsychotics and patients were grouped as subjective non-dysphoric and dysphoric as the total score of DAI-10. For assessing the clinical status, Young Mania Rating Scale (YMRS), Clinical Global Impression- Severity scale (CGI-S), Hamilton Rating Scale for Depression (HAM-D), Global Assessment of Functioning (GAF) and Liverpool University Neuroleptic Side-Effect Rating Scale (LUNSERS) were used. RESULTS: Dysphoric group was younger and has more females in sex distribution than non-dysphoric group. YMRS and CGI-S were severer in dysphoric group. The prescription patterns were not different between two groups: Combinations of mood stabilizers and antipsychotics were administered to all patients and atypical antipsychotics were prescribed over 90% of the patients. At 2 weeks of treatment, more patients were turned into remission in non-dysphoric group. Dysphoric patients showed more changes of positive subjective response in DAI-10 from baseline and more patients turned toward the non-dysphoric group. CONCLUSION: Although the subjective response to antipsychotics using DAI-10 was not typically characterized in acute manic patients, it seems that atypical antipsychotics may have a role in determining the subjective feelings of the acute bipolar manic patients.
Antipsychotic Agents* ; Bipolar Disorder ; Depression ; Female ; Humans ; Prescriptions ; Sex Distribution