OBJECTIVE: To evaluate the maternal complications and perinatal outcomes in twin pre-gnancies with one fetal demise PATIENTS: From January 1990 to December 1996, 20 twin pregnancies with single fetal death were observed in Seoul National University Hospital : in 6 cases(group 1) between 20 ~26 weeks and in 14 cases(group 2) after 26 weeks gestation by gestational age of fetal death ; in 7 cases of monochorionic and in 13 cases of dichorionic placentation. RESULTS: The incidence of one fetal death was 5.4% in twin pregnancy. Diagnosis-to- delivery interval of group 1 was longer than group 2(61.0 days : 8.9 days). So it was thou- ght that the gestational age of delivery in group 1 was not always earlier than in group 2. And other parameters(chorionicity, preterm delivery, cesarean section, coagulopathy, IUGR, perinatal mortality, neurologic sequelae, IVH) didn't show the statistical differences between group 1 and group 2. According to chorionicity, it seemed that the perinatal mortality rate of monochorionic group was higher than dichorionic(86% : 62%) and that cesarean section rate was higher in dichorionic group(54% : 14%). But there were no statistical significances between two gruops. All other parameters also didn't show differences statistically. CONCLUSION: We fail to demonstrate that monochorionic placentation is associated with increased risks for the survivor in twin pregnancies of single fetal demise. It may be part- ially explained due to small numbers of cases in this study.
Cesarean Section ; Chorion ; Female ; Fetal Death ; Fetal Growth Retardation ; Gestational Age ; Humans ; Incidence ; Perinatal Mortality ; Placentation ; Pregnancy ; Pregnancy, Twin* ; Seoul ; Survivors

Contact Dermatitis due to cosmetics is also common in Korea. as in other developed countries. However. detection of the causative antigens is in a difficult situation due to many reasons. We have routinely patch tested with Japanese cosmetic series patch test allergens, Types 17 and 18 in addition to Hollister standard battery and patients own cosmetics to 4Q cases of suspected cosmetic contact dermatitis who have visited our Environmental and Occupational Clinic during the past one year. The study result was as follows. Total 55% ositive reaction related to cosmetics was observed in 4p patch tested patients. 2 The most frequently observed antigens were hydroxycitronellal, benzyl saliylate and cinnamic alcohol.
Allergens ; Asian Continental Ancestry Group ; Dermatitis, Contact* ; Developed Countries ; Humans ; Korea ; Patch Tests*

The ability of nicotinic acid and its substitutes to increase cutaneous blood flow has been measured by laser Doppler flowmeter in 30 healthy human volunteers. We applied nicotinarnide, nicotinic acid ethyl ester, nicotinic acid methyl ester, hexyl nicozinate each in an acqeous solution at a concentration of 10 mM/liter for 10 minutes occlusion on the forearm. The change of blood flow was serially checked at 5 to 10 minutes intervals for one hour. The study results were as follows : l. The relative maximum cutaneous blood flow response was in following order nicotinic acid methyl ester(100%), nicotinic acid ethyl ester(98%), hexyl nicotinate (84%) and nicotinic acid(63%). However, there was no statistically significant difference(p>0.05) between each drug. There was statististically significant difference between nicotinamide and all other nicotinic acid substitutes(p<0.05). 2. The time required to reach maximum blood flow response was 6.7 minutes for hexyl nicotinste, 10 minutes for nicotinic acid ethyl ester, 12.5 minutes for nicotinic acid methyl ester and 20 minutes for nicotinic acid. However, there was statistically significant difference between hexyl nicotinate and nicotinic acid only(p<0.05). 3. Significant decrease of cutaneous blood flow was observed one hour after the removal of the patches in all drugs.
Flowmeters ; Forearm ; Healthy Volunteers ; Niacin* ; Niacinamide

Achilles tendon is the most powerful and the biggest tendon of the body and its rupture is frequently sports-related. Many authors reported the effects of mobilization, electricity, ultrasound and various drugs as factors influencing the injured tendon. We studied the effects of early passive mobilization after firm suture using plantaris tendon as tension suture material and reinforcing membrane on the repair of a ruptured Achilles tendon. From March 1992 to December 1995, twenty-two operations on the Achilles tendon were carried out in our hospital. 1. Fourteen patients were male and eight patients were female. The mean patient age was 38 years, ranging from 13 to 68 years. Average follow-up periods was 2 years and 7 months, ranging from 12 months to 3 years and 8 months. 2. The rupture site was 4.7cm proximal to the tendon insertion into the calcaneus on average. 3. We performed the operations with end to end suture technique. After approximation of the ruptured ends of the tendon with a No. 5 Ethibond tension suture using a modified Kessler stitch, placed plantaris tendon in a fascial needle and pass it circumferentially and distal plantaris tendon is fanned out and tacked over the repair. 4. Postoperative treatment was done as following protocol Short leg cast was done with equinus position for initial 3 weeks, and then cast was removed, hydrotherapy and passive exercises was employed. About 6 weeks after operation when the foot can be brought to right angle, a reverse 90degrees ankle stop short leg brace was applied for additional 6 weeks and partial weight bearing was aUowed. 5. Follow-up results were classified according to the Arner-Lindholm scale. We had 16 excellent results and 6 satisfactory results. After rigid suture it may be possible to introduce a regimen of progressive isometric stimulation and protected loading and streching combined with removable orthosis. Such early exercises are likely to improve the rate of rehabilitation over plaster immobilization.
Achilles Tendon* ; Ankle ; Braces ; Calcaneus ; Electricity ; Exercise ; Female ; Follow-Up Studies ; Foot ; Humans ; Hydrotherapy ; Immobilization ; Leg ; Male ; Membranes ; Needles ; Orthotic Devices ; Rehabilitation ; Rupture* ; Suture Techniques ; Sutures ; Tendons ; Ultrasonography ; Weight-Bearing

This study was undertaken to observe the difference of patch test and prick test positive reactions in three groups, 20 atopic dermatitis patients, 20 chronic urticaria patients, and 20 normal controls, Twenty commercial antigens (ToriiCo.) and twenty three frozen and boiled antigens of fishes and shellfishes were used as test materials. The results were as follows: 1. No positive reaction was observed in all sixty subjects in patch test. 2 In prick test, difference in reactivity was observed among atopic dermatitis (14. 7%), chronic urticaria (8.7%), and normal control(1. 5%) 3. There was significant difference in reactivity between Torii and frozen antigens in atopic dermatitis group, but no significance in chronic urticaria and control groups. 4. Boiling altered the reactivity in tested materials in all three groups of subjects singificantly. 5. Patients with past or family history of allergic diseases showed double fold higher reactivity tban patients without any history.
Dermatitis, Atopic* ; Fishes ; Humans ; Patch Tests ; Shellfish* ; Urticaria*

Recently, people living in a rapidly industrializing country such as Korea seems to have less opportunity to be exposed to Rhus and Ginkgo trees than before, which may cause a lower prevalence of sensitivity to such allergens than those reported in the past. To prove the prevalence of sensitivity in Koreans, we have tested 0. 002g and 0.0l%, Urushiols and 10% Ginkgo leaves produced by Torii company to 72 atients with or suggesting contact dermatitis. The results were as follows: 1) Twelve of 72 patients(13, 9%) showed positive reactions and two patients(2. 8 %) showed active sensitization to both 0. 002% and 0. 0l% Urushiols. Only one patient(]. 4%) reacted to 10g Ginkgo leaves, and she was also reacted to the Urushiols. 2) Age and sex distribution of the positive reactors were none under thirty, 2 in thirties, 3 in forties, 4 in fifties, one over sixty, and seven female patients outnumber three male patients. 3) Out of 5 patients having past history cf contact dermatitis to Rhus tree, only patients showed positive reactions. Out of 67 patients without past history of allergy to Rhus, 8(ll, 9%) showed positive reactions and 59(88. 1%) showed negative reactions.
Allergens ; Dermatitis, Contact ; Female ; Ginkgo biloba* ; Humans ; Hypersensitivity ; Korea ; Male ; Prevalence* ; Rhus* ; Sex Distribution ; Trees

Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease) is a familial disease that is characterized by delicate, ectatic vessels in the skin, mucous membrane and viscera. These patients have a generalized vascular derangement including pulmonary A-V fistula and angiomatosis. Episodes of hemorrhage in cornbination with a familial history and cutaneous telangiectasia are diagnostic. We preaented a typical case of hereditary hemorrhagic telangieetasia in a 3-year-old female who had. two episodes of hemoptysis and compatible telangiectatic skin lesion. Her pulmonary and hepatic angiornas were also proved by pulmonary and aortic angiography.
Angiography ; Angiomatosis ; Child, Preschool ; Female ; Fistula ; Hemoptysis ; Hemorrhage ; Humans ; Mucous Membrane ; Skin ; Telangiectasia, Hereditary Hemorrhagic* ; Telangiectasis ; Viscera

Resorcin is widely being used in the fields of the therapeutics, cosmetics, industry, but allergic contact dermatitis is an infrequent adverse reaction. We have experienced a case of allergic contact dermatitis to resorcin. A 59-year-old male with Kaposi's sarcoma on the right foot developed linear erythematous vesicular eruption along the marking areas 4 days after application of Castellanis paint, used as a skin marking solution for radiation therapy. He showed patch test positive reaction to Castellani's paint as well as its individual components, resorcin and phenol.
Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Foot ; Humans ; Male ; Middle Aged ; Paint ; Patch Tests ; Phenol ; Sarcoma, Kaposi ; Skin*

54-year-old male patient with acute lymphocytic leukemia was consulted to our department. He had had a few painful erythematous necrotic plaques on the chest, which suggested initslly vasculitis or pyoderma. On histological examination, characterisitic histological findings of non-septated large hyphae were observed in the dermis and subcutaneoustissue, Although organism was not isolated on Sabouraud agar media containing cycloheximide, the diagnosis of cutaneous mucormycosis was made by the characteristic histological nattlre. He died after 2 weeks with amphotericin B intravenous injections so that additional fungus culture was not performed.
Agar ; Amphotericin B ; Cycloheximide ; Dermis ; Diagnosis ; Fungi ; Humans ; Hyphae ; Injections, Intravenous ; Male ; Middle Aged ; Mucormycosis* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Pyoderma ; Thorax ; Vasculitis

The pinch graft is one type of skin graft and is indicated in small, chronic stubborn wounds or ulcers where cosmetic results are not paramount. It is a common procedure for the rapid healing of leg ulcers in countries where these are very common, such as in western society. However, it is an unfamiliar procedure to dermatologists in Korea where leg ulcers are quite rare. We treated a case of leg ulcer in systemic sclerosis using pinch grafts with satisfactory results. The pinch graft may be a useful treatment method for skin ulcers in dermatologic surgery under adverse conditions.
Dermatologic Surgical Procedures ; Korea ; Leg Ulcer* ; Leg* ; Scleroderma, Systemic* ; Skin ; Skin Ulcer ; Transplants* ; Ulcer ; Wounds and Injuries