No abstract available.

Previously we reported the result of topical immunotherapy of warts with I -chloro-2,4-dinitrobenzene(DNCB) solution using two different methods. In this study, we treated the warts with DNCB ointment and compared the therapeutic result with previous study. In addition, in order to evaluate the possible rnechanlarn of DNCB-induced wart regression by histologic rnethod, 5 regressing warts were biopsied and we observed the histopathologic findings. Thirty-six patients with various warts which were resistant to the conventional measures were treated by challeng application with 100mg% or 10mg% DNCB ointment directly on several randomly selected wart lesions after sensitization. with l?000mcg of DNCR in solution on normal skin of upper arm. In 5 pat:ients showing regression of warts, one wart lesion which was not challenged with DNCR was biopsied. The results are summarized as follows; 1. We treated the 36 patients having various warts with DNCB ointment and 25 patients (69.4%) were cured. Most(72%) of the eured warts began to regress within one month. 2. We cornpared the therapeutic result in this study with the results in theprevious study in which we used DNCB solution with two different methods, Comparing the results obtained by the R different methods, we found no statistically different cure rate, however the present method might be more convement because the ointment can be maintained longer without any change of the ingredient concentration and can be applied more easily than the solution. 3. On histologic examination, we observed moderate to severe patchy perivasce
Arm ; Dinitrochlorobenzene* ; Humans ; Immunotherapy* ; Skin ; Warts*

No abstract available.
Pneumonia*

No abstract available.
Drug Therapy* ; Empyema*

We presented two cases of bullous dermatoses in childhood. The first case was a 13-year-old boy who had numerous tense bullae on the scalp, both forearms and dorsa of hands, trunk and both thighs in symmetrical distribution, but he had not any oral lesion. On histologic examination, subepidermal bullae containing many neutrophils and only a few eosinophils were demonstrated. The lesions began to subside prornptly since 2 days after ornl administration of prednisolone and there was no evidence of recurrence during the follow-up studies of 4 months. The second case was a 14-year-old boy who had erythematous macules, vesicles, bullae and crusts scattered irregularly on almost entire body surface and had some oral lesions. Histologically erythematous macular lesions revealed many microabscesses composed almost entirely oi neutrophils on the tip of dermal papillae but vesicular lesions showed intraepidermal bulla containing numerous eosinophils exclusively. His skin lesions were well suppressed by DDS but reappeared one or two days after cessation of DDS. We thought these two cases were not the typical cases of bullous pemphigoid or dermatitis herpetiforrnis. We did not perform immunologic studies, so we cannot assure that these two cases were belong to either bullous pemphigoid or dermatitis herpetiformis and the so-called benign chronic bullous dermatosis of childhood.
Adolescent ; Dermatitis ; Dermatitis Herpetiformis ; Eosinophils ; Follow-Up Studies ; Forearm ; Hand ; Humans ; Male ; Neutrophils ; Pemphigoid, Bullous ; Prednisolone ; Recurrence ; Scalp ; Skin ; Skin Diseases ; Skin Diseases, Vesiculobullous* ; Thigh ; Transcutaneous Electric Nerve Stimulation

BACKGROUND: Family physicians help the patients to be adapted to a new life cycle with anticipatory guidance. But the later life of empty nest stage seems to be the most stressful since during this time is made preparation of his/her own death. Anticipatory guidance in later life for death is not encouraged because after death, the patient no longer exists. METHODS: From August 1, 1995 to August 31,1995, we gathered the data by the means of questionnaire to persons aged over 60 who visited the department of family medicine and geriatric center in Yong-dong Severance Hospital. The questionnaire was consisted of demographic factors, attitude toward death, fear of death, preparation of death in aspect of his/her own and also in his/her family. RESULTS: The total 104 subjects responded to the questionnaire, consisting of 58 males and 46 females. To the question asking the attitude tpward death, 71(67.6%)answered death as a spiritually new life, 39(37.1%)as an end of life and 11(10.5%)as just and event in life. 75(72.1%)persons insisted the need of preparation of death, and the content of the preparation were consideration of the family 35(33.3%), preparation of mind 34(32.4%), devotion to religion 33(31.4%), arrangement of fortune 19(18.1%). The answer about the fear of death was 42(40.0%)and the reasons for fear were pain of death 26(24.8%), separation from the family 19(18.1%), uncertainty of the nature after death 17(16.2%), suffering of the family 10(9.5% ) in rank order. The contents of preparation of death as family were being together with dying person 57(45.7%), evangelizm 32(30.5%), helping arrangement of life 30(28.6%), and the answer about fear of death of family were pain of death 40(37.1%), regret 31(26.5%), lack of preparation of after death 22(21.1%), loneliness after separation 14(13.3%). CONCLUSIONS: Family physicians should recognize death as one of the life cycles because the most persons insist of the need of preparation of death. So family physician can help the the patient prone to death by anticipatory guidance with stimulation of performance of developmental tasks.
Demography ; Female ; Humans ; Life Cycle Stages* ; Loneliness ; Male ; Physicians, Family ; Uncertainty ; Surveys and Questionnaires

We presented a case of perifolliculitis capitis abscedens et suffodiens associated with acne conglobata in 40-year-old rnale. He had a sausage-shaped plaque containing many fistular tracts on right temnporal area and cicatrizing alopecia on occiput. On the middle portion of upper back he had a adult fist-sized plaque containing many fistular tracts. Histopathologically epidermis showed mild byperkeratosis and keratotic plugging and in the dermis most hair follicles were destroyed and replacel by fibrous tissue but there were moderxte cellular infiltration composed of neutrophils, lymphocytes a.nd hist.iocytes around the remained hair follicles. On serum electrophoresis alpha,-globulin was elevated and gamna globulin was the upper liviit of nornal variation. Skin tests with murnps vaccine, dinitrochloro benzene (DNCB) and old tuberculin disclosed the evidence of de reased c "ll-mediated immunity(CMI). All th se findings suggest thzt immune rriechanisni r,-ay be concerned ivith the pathogenesis in this case. He wa.s treated with th internal administration of antibiotic and corticosteroid and with surgical opening and curettage of fistular tracts
Acne Vulgaris ; Adult ; Alopecia ; Benzene ; Curettage ; Dermis ; Electrophoresis ; Epidermis ; Hair Follicle ; Humans ; Lymphocytes ; Neutrophils ; Skin Tests ; Tuberculin

No abstract available.
Adult* ; Bronchoscopy* ; Foreign Bodies* ; Humans

The Ilizarov technique has been used successfully in the treatment of nonunion of long bone accompanied by infection, severe bone and soft tissue defects, and deformity. We report the results of treatment of 21 cases of nonunion using the Ilizarov technique. There were 20 males and 1 female with an average age of 34.2 years (range, 8-72 years). The average follow up period was 45 months (range, 12-74months). Infected nonunion(15/21 cases) was the most common cause of nonunion. The treatment methods include simple compression method(4 cases) and internal and external bone transport method(17 cases). Bony union was achieved in 20 cases out of 21 cases. One case is still having difficulty in achieving union. The mean time to union was 7.3 months in femurs and 6.3 months in tibias. The amount of bone defect that developed after the removal of infected bone fragments and soft tissue averaged 3.8cm (range, 2.3-9cm). The healing index, in cases of bone transport, was an average of 45 days per cm (range, 30-62 days per cm). Complications developed in 17 cases out of 21 cases. Pin site infection occurred in 5 cases, premature consolidation in ~1 case, angulation deformity in 2 cases, LOM of the knee in 2 cases, equinus deformity in 2 cases, ankle stiffness in 3 cases, and nonunion in 1 case. The Ilizarov technique is thought to be effective in the treatment of complicated nonunion combined with shortening, deformity, bone defect and infection. However, in order to reduce complications caused by the Ilizarov method, accurate surgical techniques and postoperative care are necessary.
Ankle ; Congenital Abnormalities ; Equinus Deformity ; External Fixators* ; Female ; Femur ; Follow-Up Studies ; Humans ; Ilizarov Technique ; Knee ; Male ; Postoperative Care ; Tibia

Hepatolithiasis is said to exist when stones are present in the right or the left hepatic ducts or their tributaries. Although it is a pathophysiologically benign disease, it causes frequently serious problems-recurrent cholangitis, liver abscess, obstructive jaundice, liver cirrhosis, and sepsis - and has challenged surgeons. Until recently, its fundamental pathogenetic mechanisms have not been elucidated, but bile duct stenosis, bile stasis, and secondary infection are considered as important pathogenetic factors. Therefore, the ultimate goal of the treatment is directed to the correction of these factors. We were retrospectively reviewed 119 cases of patients with hepatolithiasis treated by various surgical methods from Jul. 1989 to Dec. 1996 at the Department of Surgery of Maryknoll Hospital, Pusan. There were 72 women and 47 men, and the mean age was 45.5 years. Thirty-nine patients (32.8%) had previous histories of operations related to biliary stone diseases - cholecystectomy (n=13), T-tube choledocholithotomy (n=21), choledochoduodenostomy (n=9), Roux-en-Y choledochojejunostomy (n=6), and transduodenal sphincteroplasty (n=1). Operative procedures were 24 (20.2%) lithotomy, 60 (50.4%) drainages, and 35 (29.4%) hepatectomies and determined by the location of the stones, the general condition of the patient, and the anatomical change (stenosis or cystic dilatation) in intrahepatic duct. Postoperative complications occurred in 33 (27.7%) patients : wound infection (n=23), atelectasis (n=5), intra-abdominal bile collection (n=3), choledochocutaneous fistula (n=2), hemobilia (n=1), and adhesive ileus (n=1). Residual stones were detected in 39 (32.7%) patients by T-tube cholangiography, ultrasonography, computed tomography. The instances of residual stones was the lowest (17.1%) for hepatectomy compared to 45.8% for a lithotomy and 39.3% for a drainage. The follow-up study showed symptom improvement in 91.5% of the patients with a hepatectomy compared to 58.3% for a lithotomy and 71.7% for a drainage which was statistically significant(P<0.05). Since incomplete stone removal in hepatolithiasis and presence of stenosis in intrahepatic duct frequently require a repeat operation or other invasive management, the authors conclude that a hepatectomy, as an initial treatment for hepatolithiasis, is a safe, satisfactory treatment where possible.
Adhesives ; Bile ; Bile Ducts ; Busan ; Cholangiography ; Cholangitis ; Cholecystectomy ; Choledochostomy ; Coinfection ; Constriction, Pathologic ; Drainage ; Female ; Fistula ; Follow-Up Studies ; Hemobilia ; Hepatectomy ; Hepatic Duct, Common ; Humans ; Ileus ; Jaundice, Obstructive ; Liver Abscess ; Liver Cirrhosis ; Male ; Postoperative Complications ; Pulmonary Atelectasis ; Retrospective Studies ; Sepsis ; Sphincterotomy, Transhepatic ; Surgical Procedures, Operative ; Ultrasonography ; Wound Infection