Aplasia cutis congenita represents a congenital absence of all skin layers, and it may occasionally extend through the bone and dura of the skull. Since the first report was described in the extremity by Cordon 1767, and Campbell 1826, approximately over 500 cases have been reported. About eighty five percents of all cases are found in the scalp, with 15 to 30 percents involving the skull as well. Fifteen percents of all cases involve nonscalp locations and are often bilateral symmetrical. It has been relatively rarely reported disorder abroad as well as domestically. It has several clinical subtypes classified by the location and pattern of skin absence, the presence of associated malformation and the mode of inheritance with unknown cause. We had a new born female infant with this disorder, who presented with a full thickness skin defect on scalp and skull defect. No skin defect were reported in other family members, including a first child born several years previously. Chromosomal analysis revealed as normal female karyotype, but she had double pelvis and double ureter of both kidney The legions healed for five weeks by conservative treatment as moist wound dressing and systemic antibiotic administrations. As a relatively uncommon skin anomaly with congenital anomaly, one case of aplasia cutis congenita involving scalp and skull is reported with the review of reference.
Bandages ; Child ; Ectodermal Dysplasia* ; Extremities ; Female ; Humans ; Infant ; Karyotype ; Kidney ; Kidney Pelvis* ; Pelvis ; Scalp* ; Skin ; Skull ; Ureter* ; Wills ; Wounds and Injuries

OBJECTIVE: Rising from a sitting position is a very common, yet essential activity in daily life. The activity to perform the sit-to-stand (STS) transfer is a prerequisite for upright mobility. This study aims to provide fundamental data concerning the execution of the STS, and in particularly the followings: 1) how do the angles of the lower limbs change throughout the process of rising from a chair; 2) how much motion torque and power in each joint are required per kilogram of body weight to complete the STS transfer? METHOD: Twenty-one children who have developed normally and could understand the command requested are involved as subjects. Their age ranged from 3 to 5 years old. Motion analysis of STS transfer were assessed with the Vicon 370 M.A (Oxford Metrics Limited, United Kingdom). The changes in joint angle, maximal moment and power in lower limb were calculated throughout the STS transfer. RESULTS: A series of transition points was observed in the angles of the hip, knee and ankle joints throughout the sit-to-stand movements, which was classified into five stages. The first stage is trunk and hip flexion phase; second stage, buttock take-off; third stage, ankle dorsiflexion and knee extension; forth stage, just-standing; fifth stage, stabilizing phase. The extension moment of each joint is 0.65 Nm/kg on right, 0.71 Nm/kg on left in hip, 0.41 Nm/kg on right, 0.38 Nm/kg on left in knee and 0.21 Nm/kg on right, 0.22 Nm/kg on left in ankle joint. The extension power is 0.60 watt/kg on right, 0.68 watt/kg on left in hip, 0.59 watt/kg on right, 0.50 watt/kg on left in knee and 0.15 watt/kg on right, 0.15 watt/kg on left in ankle joint. CONCLUSION: A consistent pattern was observed throughout the sit-to-stand transfer and six transition points were observed in the angles of the hip, knee and ankle joints throughout the STS transfer. By these 6 points, the movement of the STS transfer was classified into 5 stages. Major changes in angle, moment, and power of each joint were observed in sagittal plane. There were no side to side difference during the STS transfer.
Ankle ; Ankle Joint ; Body Weight ; Buttocks ; Child* ; Child, Preschool ; Hip ; Humans ; Joints ; Knee ; Lower Extremity ; Torque

A clinical analysis was performed on 326 cases of the non-penetrating rib fractures experienced in the department of thoracic and cardiovascular surgery, Chosun University Hospital and 102 cases of the non-penetrating rib fractures those has been admitted and treated in the department of thoracic and cardiovascular surgery, Jeonnam Hwasoon Jung-ang Hospital during a period from Jan. 1994 to Dec. 1995. 1. Sex ratio was 3.4:1 in urban and 3.6:1 in rural communities with male predominance. 2. Most common cause were traffic accident in both communities. 3. Hemothorax, pneumothorax and hemopneumothorax which needed thoracostomy were observed in 146 cases(44.7%) in the urban and 12 cases(11.7%) in the rural communities. 4. Left thorax was the spell site of rib fractures in both communities. 5. Rib fracture was prevalent from 3rd to 6th rib in both communities. 6. Open thoracotomy was performed in 37 cases(11.3%) in urban and 3 cases(2.9%) in rural communities. 7. Overall mortality was 4.29%(14 cases) in urban area and, 1.96%(2 cases) in rural communities, and cause of death were hypovolemic shock, brain edema, sepsis, respiratory failure, asphyxia, and cardiogenic shock.
Accidents, Traffic ; Asphyxia ; Brain Edema ; Cause of Death ; Hemopneumothorax ; Hemothorax ; Humans ; Jeollanam-do ; Male ; Mortality ; Pneumothorax ; Respiratory Insufficiency ; Rib Fractures* ; Ribs* ; Rural Population* ; Sepsis ; Sex Ratio ; Shock ; Shock, Cardiogenic ; Thoracostomy ; Thoracotomy ; Thorax

BACKGROUND: The clinical presentation of lichen planus varies depending on the area involved. It occurs in less than 1% of the world's population: also, the prevalence in Korea is relatively low. However, the number of our outpatients has been increasing rapidly. OBJECTIVE: We studied the clinical characteristics of 100 patients with biopsy proven lichen planus. METHODS: We reviewed the medical records and clinical photographs of 100 patients who had been diagnosed with lichen planus during the last 10 years, from January 2002 to December 2011. RESULTS: Over the past 10 years, patients with Lichen Planus accounted for 0.196% among the new outpatients of this dermatology. The rate of Lichen Planus increased when it occurred on the skin, except for the Mucosal area. Of the 100 outpatients, 62% were men and 38% were women. The mean age at diagnosis was 54 years, and more than half of the patients were between 40 and 60 years of age. The most common site of lichen planus was the lip, which was found in 44% of the patients. Oral lesions were the second most commonly involved site at 28%, followed by the body at 20% and the genital area at 8%. The patients complained of various symptoms such as pain, burning sensation, pruritus, and irritation. Various treatments had been tried by all patients. CONCLUSION: This study of domestic patients with Lichen Planus is the biggest clinical research performed at a single center. The clinical features of patients in this survey share many similarities with those reported previously, but showed some differences too.
Biopsy ; Burns ; Dermatology ; Female ; Humans ; Korea ; Lichen Planus ; Lichens ; Lip ; Male ; Medical Records ; Outpatients ; Prevalence ; Pruritus ; Sensation ; Skin

PURPOSE: To determine optimal scan time for the early phase of two-phase spiral CT and to evaluate its usefulness in the detection and assessment of extension of urinary bladder lesions. MATERIALS AND METHODS: In four normal adults, we performed dynamic scanning and obtained time-density curves for internal and external iliac arteries and veins, and the wall of the urinary bladder. Sixty patients with 68 lesions of the urinary bladder or prostate underwent precontrast and two-phase spiral CT scanning. After injection of 100ml of noninonic contrast material, images for the early and delayed phases were obtained at 60 seconds and 5 minutes, respectively. We measured CT H.U. of the wall, the lesion, and lumen of urinary bladder as seen on axial scanning, in each image in which the lesion was best shown. For the detection of bladder lesions and assessment of their extension, precontrast, early-, and delayed phase images were compared. RESULTS: Dynamic study of normal adults showed maximum enhancement of bladder wall between 60 and 100 seconds. The difference of CT H.U. between bladder wall and the lesion was greatest in the early phase. The best detection rate (98.5%) was seen during this phase, and for the detection of bladder lesion, this same phase was superior or equal (66/68,97.1%) to the delayed phase. The precontrast image was also superior or equal (31/68,45.6%) to that of the delayed phase. For the assessment of extension of bladder lesion, the early phase was superior (36/68,52.9%) to the delayed phase, and precontrast image was superior (1/68, 1.5%) to that of the delayed phase. For determining the stage of bladder cancer, the early phase was most accurate if the stages was below B2 or D, while for stage C, the delayed phase was most accurate. CONCLUSION: In two-phase spiral CT scanning, we consider the optimal time for the early phase to be between 60 and 100 seconds after injection of contrast material. For the detection and assessment of extension of urinary bladder lesion, the early phase was superior to the late phase, and for evaluation of the ureter, the delayed phase was useful. The precontrast image was inferior to that of the delayed phase. We suggest that for the detection and assessment of extension of urinary bladder lesion without scanning of the precontrast image, two-phase spiral CT is reliable.
Adult ; Humans ; Iliac Artery ; Prostate ; Tomography, Spiral Computed* ; Ureter ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Veins

We investigated the surgical outcome of radical maxillectomy in advanced maxillary sinus cancers invading through the posterior wall and into the infratemporal fossa. Twenty-eight patients with maxillary sinus squamous cell carcinoma, who visited the Otorhinolaryngology Department at Severance Hospital from March, 1993 to February, 2001 and underwent the surgery, were analyzed retrospectively by reviewing clinical medical records and radiologic test results. The mean follow- up period was 78.8 months. (26 -162 months) Local recurrence, sites of local recurrence, and the 2-year disease-free survival rate were analyzed. Of the total 28 cases, 9 cases were T3, and 19cases were T4. Total maxillectomy was performed in 12 cases (42.9%) and radical maxillectomy in 16 cases (57.1%). Regardless of staging, radical maxillectomy was performed only when cancers invaded through the posterior wall and into the infratemporal fossa. When cancers only maginally or did not invade the posterior wall, total maxillectomy was performed. The 2-year disease-free survival rate was 75% for both total and radical maxillectomy, and the local recurrence rates were 8.3% and 18.7% respectively. All recurrence occurred at the posterior resection margin of the maxillectomy. We strongly recommend the use of radical maxillectomy in the cases of advanced maxillary sinus cancers invading the infratemporal fossa. Radical maxillectomy can provide sufficient safety margins and lower the local recurrence rate.
Adult ; Aged ; Carcinoma, Squamous Cell/mortality/pathology/*surgery ; Disease-Free Survival ; Female ; Humans ; Male ; Maxilla/blood supply/*surgery ; Maxillary Artery/surgery ; Maxillary Neoplasms/mortality/pathology/*surgery ; Maxillary Sinus/*surgery ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Retrospective Studies ; Survival Rate ; Tomography, X-Ray Computed ; Treatment Outcome

Mesalazine (5-aminosalicylic acid) and sulfasalazine are widely used in the treatment of inflammatory bowel disease. The pulmonary toxicity related to sulfasalazine was well-recognized complication and it was caused by sulfapyridine moiety in sulfasalazine. However, the lung injury related to mesalazine has rarely been reported. A thirty five-year-old man with Crohn's disease who was treated with mesalazine complained fever and dry cough. The finding of bilateral wandering pulmonary infiltration, peripheral eosinophilia and increased eosinophils in bronchoalvolar lavage were consistent with eosinophilic pneumonia. His symptoms and laboratory findings were markedly improved after the discontinuation of mesalazine. The mesalazine-induced eosinophilic pneumonia was diagnosed according to his clinical course. This report shows that the eosinophilic pneumonia should be considered in patients who develope pulmonary involvement with inflammatory bowel disease receiving mesalazine therapy.
Adult ; Anti-Inflammatory Agents, Non-Steroidal/*adverse effects/therapeutic use ; Crohn Disease/*drug therapy ; Humans ; Lymphocyte Activation ; Male ; Mesalamine/*adverse effects/therapeutic use ; Pulmonary Eosinophilia/chemically induced/*diagnosis/radiography ; Tomography, X-Ray Computed

Gastrointestinal stromal tumor (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract arising from Cajal's cells, expressing CD 117. The standard treatment for primary GIST is complete surgical resection. Imatinib mesylate, a specific tyrosine kinase inhibitor, is effective against locally advanced and metastatic GIST. There are several reports of the effect of preoperative imatinib in patients with unresectable and locally advanced primary GIST. We report a case of unresectable primary GIST of the ampulla of Vater, which we were able to completely resect after treatment with a dosage of imatinib 400 mg daily for 5 months. Twelve months later, the patient was treated with imatinib and doing well with no evidence of recurrence.
Ampulla of Vater/*pathology ; Antineoplastic Agents/*therapeutic use ; Duodenoscopy ; Gastrointestinal Stromal Tumors/diagnosis/drug therapy/*surgery ; Humans ; Male ; Middle Aged ; Piperazines/*therapeutic use ; Pyrimidines/*therapeutic use ; Tomography, X-Ray Computed

BACKGROUND: The first multicenter study on standard patenest results(1983-1986) was tried in Korea. Since then 10 years have elapsed and epidemiologi al data need be updated continuously. OBJECTIVE: To register and compile the results of patch the ig throughout the country and to compare the positivity ard trend with those of previous study. METHODS: Standard patch testings were performed using irachamper on Scanpor tape. The results were analysed by a personal computer program. RESULTS: A total of 2326 patch tested cases(male 539, female 1787) were compiled and analysed. The highest ag distribution was 3rd decade. As the job distribution, housewives and office workers were the mast frequent consisting 33.4% and 12.1% respectively. The face was the most frequently affected site comprising 49.6%. The highesteritization rates were foud with nickel(17.9%), cobalt(13.8%), fragrance mix(12.9%), potass ur dichromate(11.3%), ammoniated mercury(8.7%), neoaycin(7.2%). The lowest positivity inclured black rubber mix(1.0%), primin (1.2%), ethylenediarnine(1.3%), carba mix(1.4%), While nicel epoxy resin and 4-t-butylphenol formaldehyde resin showed increased reactivities, PPD, bacrubber mix, balsam of Peru, quaternium 15, ammceniatct mercury and captan showd a deceased tendency when compared with those of previous study. CONCLUSION: The large scale studies of epidemiology in cortat dermatitis have been performed and they need to be updated and analysed consecutively in the future.
Captan ; Dermatitis ; Dermatitis, Contact* ; Epidemiologic Studies* ; Epidemiology ; Female ; Formaldehyde ; Humans ; Korea* ; Microcomputers ; Patch Tests ; Peru ; Rubber

BACKGROUND AND OBJECTIVES: The effects of airflow cessation on the human nasal mucosa can be conveniently studied in laryngectomees and the blood flow to nasal mucosa is an important factor in maintaining normal nasal function. Therefore, we investigated the changes in nasal mucosa blood flow after a total laryngectomy with Laser Doppler flowmetry. MATERIALS AND METHOD: Twenty-four laryngectomees were studied and compared with 35 normal volunteers. Among 24 total laryngectomees, 9 were esophageal speakers. The Laser Doppler flowmetry was performed using a Periflux 4001 (Perimed, Jrtlla, Sweden) and Perfusion unit (PU), Velocity unit (VU), and Concentration Unit (CU) were measured. The laser Doppler flowmetry data in the laryngectomees were compared with those of the normal subjects, and between the esophageal and non-esophageal speakers. RESULTS: The difference between laryngectomees and normal subjects was statistically significant with the exception of the CU (p<0.05). Furthermore, no correlations were found between blood flow and age, and between blood flow and postoperative duration. The difference between esophageal speakers and non-esophageal speakers was statistically significant with the exception of the level of concentration (p<0.05). CONCLUSION: The nasal blood flow decreased after a total laryngectomy. When airflow improved, an increase in the level of blood flow was recorded. And the change of the nasal blood flow most likely occured within the first year after a total laryngectomy.
Healthy Volunteers ; Humans ; Laryngectomy* ; Laser-Doppler Flowmetry ; Nasal Mucosa ; Perfusion ; Rheology*