Total 76 patients with acute painful musculoskeletal problems were treated with piroxicam, newly developed non steroidal-anti-inflammatory drug. Patients were divided into three groups, i.e. 1) acute low back strain or sprain group, 2) acute bursitis group, and 3) acute muscle sprain or strain group. The results were as following. 1. The effect of piroxicam on the various inflammatory changes was noticed promptly with initial 40 mg dose and pain control action was most prominent. 2. The drug was very well tolerated and side effect were generally mild. Three gastrointestinal symptoms and one skin eruption were developed. Over-all results of the piroxicam on the patient were evaluated as excellent in 51.3%, and good in 38.21%.
Acute Pain ; Bursitis ; Humans ; Piroxicam ; Skin ; Sprains and Strains ; Therapeutic Uses

A method for exact evaluation of ligament integrity of the knee joint would be of clinical importance from the diagnostic point of view as well as from the desire to introduce objective measurement of stability either pre-and postoperatively, or before and after conservative treatment. Assessment of the posterior cruciate injury has been considered by numerous authors over the past decades. Even stress machine, such as Gonylaxometer, knee ligament arthrometer(KT-l000) and Genucome, have many problems such as soft tissue error, expansiveness and low popularity. Generally, orthopedic surgeons use passive tests, in which the displacing force is applied externally, to evaluate the integrity of the ligaments of the knee. Posterior tibial displacement of knee was measured at quadriceps neutral angle using a specially designed frame which minimized the rotational error to negate the quadriceps pulling effect. Posterior displacement of both sides of knee was measured in 15 patients who had posterior cruciate ligament injury and 40 adults who had normal knee. The following results were obtained. l. In the normal knee, the mean score of posterior tibial displacement was 3.0875mm in left, 2.8125mm in right each other and there was a mean of 1.05mm posterior displacement of tibia compared to the contralateral knee(range: 0–2.5mm). 2. More than 6mm displacement of lateral femoral condyle compared to the uninjured knee suggested posterior cruciate ligament injury. 3. This radiological measurement seems very efficient in detecting the posterior cruciate ligament instability of knee because of its simplicity, inexpensiveness and easy reproducibility with minimal error.
Adult ; Humans ; Knee ; Knee Joint ; Ligaments ; Methods ; Orthopedics ; Posterior Cruciate Ligament ; Surgeons ; Tibia

Both eruptive vellus hair cyst and steatocystoma multiplex are uncommon conditions. There are clinical similarities between these two entities, but histological features are distinctive. We describe a patient with multiple subcutaneous nodules on the chest and both axilla, showing combined histological features of both an eruptive vellus hair cyst and steatocystoma multiplex. This case suggests that eruptive vellus hair cyst and steatocystoma multiplex are variants of one disorder which originate in the pilosebaceous duct.
Axilla ; Hair* ; Humans ; Steatocystoma Multiplex* ; Thorax

Squamous cell carcinomas and adenosquamous carcinomas are rarely originated from the stomach, thus the limited and sporadic informations about their clinico-pathologic characteristics as well as histogenesis have been elucidated. Six cases of primary squamous cell carcinoma (3 cases) and adenosquamous carcinoma(3 cases) in the stomach were examined during a period of 4 years from 1981 to 1984. After pertinent review of both clinical data and morphology through extended histotopographic study performed on 4 cases, their clinicopathologic characteristics were described. Male to female sex ratio was 4 : 2 and average age was 58.6 years. Clinical presentations or physical findings were not different from those of adenocarcinoma. Tumor masses of all cases were located in the body or phloric antrum. In all cases except for the early gastric carcinoma, each tumor was larger than 8 cm in long axis, and showed expansile and intraluminal endophytic growing tendencies with sharp margin. Simple Borrmann's macroscopic classification was applicable to none of 6 cases because of irregular and multicentric ulceration pattern and occasional submucosal growth which were reminiscent of those in submucosal tumors such as malignant lymphoma and leiomyosarcoma. Virtually four out of all six cases were diagnosed as submucosal tumor at the time of radiological examination. Microscopically three cases were composed of pure squamous cell carcinoma and remaining three contained both adeno and squamous components. Metastatic regional lymph nodes revealed only squamous element in case of pure squamous cell carcinoam, while both components were identified in adenosquamous carcinomas. Surrounding non-tumors mucosa exhibited moderate to severe degree of intestinal metaplasia accompanied by multifocal mucin pool formation. Growth pattern and surrounding mucosal changes as with older age prevalence of these tumors might express the biological behavior of intestinal type of gastric carcinoma.
Female ; Male ; Humans ; Neoplasm Metastasis

PURPOSE: Cerebral cortical dysplasias are one of the important causes for epileptic seizures and developmental disabilities in children, particularly in diffuse or bilateral cases. These developmental malformations are generally regarded as a group of neuronal migration disorders, however, the classification system and pathogenetic mechanisms of cortical dysplasias are not yet entirely clear. Even a novel entity, congenital bilateral perisylvian syndrome, characterized by speech delay, pseudobulbar Palsy, intractable seizures, and bilateral perisylvian abnormalities on imaging studies, have rather diverse figures on morphology and symptomatology than initially considered. We have studied the clinical features and correlations of clinical outcomes 3nd magnetic resonance imaging(MRI) findings of bilaterally involved cortical dysplasias. METHODS: 20 cases of bilateral cortical dyspalsias were grouped into three categories on the basis of MRI findings; centroparietal dysplasias(6 cases), diffuse dysplasias with (5) or without white matter lesions(4), and schizencephaly(5). EEGs, motor and language development, epilepsy, and outcomes were reviewed in each groups. RESULTS: Language delay(100%), motor developmental delay(94.7%), motor deficit(65%), epilepsy(40%) were the main reasons for their initial hospital visits. A meaningful word expression was possible at the mean age of 2 years and 2 months(1 to 4 years of age). Hypotonia and spastic motor paralysis were evident in all the cases of diffuse dysplasia with white matter lesions and the schizencephaly groups. All but one case of centroparietal dysplasia showed motor developmental delay. Epilepsies were developed in 8 cases at the mean age of 5 years and 5 months(2 months to 12 years of age) and the seizures were relatively well controlled with anticonvulsants. EEG findings were variable; normal, focal or diffuse abnormalities. High amplitude diffuse fast activities were only noted in the diffuse dysplasia group. CONCLUSION: The severity of neurological deficits and developmental delay had correlated to the size of cortical abnormalities. The epilepsies were relatively well controlled during childhood and the EEG finding of high amplitude diffuse fast activities was specific for the diffuse cortical dysplasias. Bilateral centroparietal dysplasias should be included on consideration of the causes for developmental aphasia.
Anticonvulsants ; Aphasia ; Child ; Classification ; Developmental Disabilities ; Electroencephalography ; Epilepsy ; Humans ; Language Development ; Language Development Disorders ; Magnetic Resonance Imaging* ; Malformations of Cortical Development* ; Muscle Hypotonia ; Muscle Spasticity ; Neuronal Migration Disorders ; Paralysis ; Pseudobulbar Palsy ; Seizures

The authors have reviewed 16 cases of the fracture of the femoral neck in children which were treated at Pusan Gospel Hospital during the period of 5 years from March 1975 to January 1980. 12 of the 16 fractures of femoral neck had sustained the injury by automobile accidents. The ratio between boy and girl was 1.6:1. There were five Type-II (Transcervical), nine Type-III (Cervicotrochanteric) and two Type-IV (In-tertrochanteric) femoral fractures by Delbets classiflcation. 2. cases of undisplaced and displaced Type-IV were treated with abduction plaster spics cast. 14 cases, which were displced and had associated injury, were reduced by closed reduction and internal fixation with hagie pin, cortical screw and cancellous screw under general anesthesia. 11 of 16 cases were followed for 7 months to 29 months, average 14 months. The results were rated according to criterias of the Ratliff. Satisfactory results were obtained in 9 cases and those of 5 cases were treated by closed reduction and internal fixation wlth cancellous screw. Pain was developed in a Type-II and Type-II due to loosening of metal devices for internal fixation.
Anesthesia, General ; Automobiles ; Busan ; Child ; Female ; Femoral Fractures ; Femur Neck ; Humans ; Male ; Spine

This report presents a case with gastric ulcer whose gastric mucosal biopsy revealed heavy aggregations of Russell body containing plasma cells in the lamina propria and in peptic detritus. A sixty four year old female received an endoscopic examination for currently aggravated peptic ulcer symytoms, It revealed a small round ulcer with nodular margin along the greater curvature of high body, suggesting of early gastric carcinoma. Endoscopic biopsies (two times) confirmed heavy collections of Russell body-containing plasma cells which were once misinterpreted as signet ring cell carcinoma. Immonohistochemically they were strongly positive to both kappa and lambda light chains by pgtroxidase-antiperoxidase method. Each infiltrated cell contained one or more refractile intracytoplasmic eosinophilic globules, bcing associated with extracellular ones and heavy matare lympho-plasma cell infiltration. Differential diagnosis from neoplastic signet ring cells in endoscopic biopsy was diseussed.
Biopsy ; Carcinoma, Signet Ring Cell* ; Diagnosis, Differential ; Eosinophils ; Female ; Humans ; Mucous Membrane ; Peptic Ulcer ; Plasma Cells* ; Plasma* ; Stomach Ulcer ; Stomach* ; Ulcer

The second case of this serial reports under the title of unusual cutaneous manifestations of connective tissue diseases is a woman with primary idiopathic dermatomyositis who developed cutaneous ulcerations on her arms and legs, which is thought to b a rare manifestation of adult dermatomyositis. These multiple ulcerations are about bean sized, polymorphous, and grouped on the poikilodermatous lesional skin. In this patient these ulcerative lesions became regressive and healed with disfiguring scars after the activity of the disease has controlled by prednisolone and methotrexate.
Adult ; Arm ; Cicatrix ; Connective Tissue Diseases* ; Connective Tissue* ; Dermatomyositis* ; Female ; Humans ; Leg ; Methotrexate ; Prednisolone ; Skin ; Ulcer*

Majocchi's disease is one of chronic vascular disorders of the skin, histologically showing capillaritis with lymphoid cell infiltration. Although the hypothesis of delayed type hypersensitivity reaction against foreign antigen is proposed as the mechanism producing this condition, there are much yet to be defined. We tried to examine the lesional skin of five patients with Majocchi's disease by the direct immunofluorescence with anti-human immunoglobulins, C 3, and fibrin. As a result we found the deposition of immunoglobulins (M, and G) in papillary blood vessels in four patients, and C 3 and fibrin were found in all five patients. C3 was also found at the dermoepidermal junction in three patients. These findings suggest the posssibility that antibody mediated immunologic processes may alsobe involved in the pathogenesis of this disorder. With this observation Majocchis disease could be considered as a chronic immune vasculitis.
Blood Vessels ; Fibrin ; Fluorescent Antibody Technique, Direct ; Humans ; Hypersensitivity ; Immunoglobulins ; Lymphocytes ; Skin ; Vasculitis

Granulocytic sarcoma is a rare localized tumor composed of granulocytic precusor cells. Granu-locytic sarcoma occurs in a variety of clinical conditions and it is often misdiagnosed histologically. Differential diagnosis frorh lymphoma or nonhematopoietic malignancies such as undifferentiated carcinoma or sarcoma is difficult in the routing histologic examination. An evaluation of clinical and histopathologic features was done on 4 cases of granulocytic sarcoma which were diagnosed at Pusan Paik Hospital from 1988 to 1992. During the period, 282 cases of myelogenous leukemia were diagnosed. Immunohistochemical reaction for lysozyme, myelopero-xidase, leukocyte common antigen, epthelial membrane antigen and cytokeratin was assessed comparing to lymphoma and undifferentiated carcinoma. The histologic features of the granulocytic sarcoma revealed thin nuclear membrane, fine chromatin pattern and one or two small nucleoli. It also often involved the vascular wall and infiltrated the native structures without destruction. Immunohistochemical stain revealed that all(4 cases) of granulocytic sarcoma showed diffuse and strong positivity for myeloperoxidase, and partial but strong positivity for lysozyme. One case of granulocytic sarcoma was negative and 3 cases revealed focal positive reaction for LCA, and all 4 cases was negative for cytokeratin and EMA. In summary, careful observation under light microscopy with immunohistochemical stain for myeloperoxidase, lysozyme, and LCA is helpful in the differential diagnosis of granulocytic sarcoma from malignant lymphoma and cytokeratin and EMA is useful for differential diagnosis from undifferentiated carcinoma.
Diagnosis, Differential