Partial Unilateral Lentiginosis (PUL) is a rare pigmentary disorder characterized by the numerous lentigines confined to a body segment, with a sharp demarcation at the midline. We report two cases of PUL. A 38-year-old woman had asymptomatic discrete small hyperpigmented macules that were scattered on the T7~L1 dermatomes on the left side of her trunk and were clearly demarcated in the midline on both anterior and posterior sides. In the other case, an 18- year-old woman had hyperpigmented macules that were scattered on the left neck, shoulder, and anterior chest. Other anomalies including neurofibromatosis, neurologic anomalies, and multiple lentiginous syndrome were not related in both cases. We report two cases of PUL having no other anomalies.
Adult ; Female ; Humans ; Lentigo* ; Neck ; Neurofibromatoses ; Shoulder ; Thorax

PURPOSE: To determine the plain film findings of acute neuropathic joint in diabetic foot. MATERIALS AND METHODS: Acute neuropathic joint in diabetic foot was considered when fragmentation of the articular ends of bone and subluxation of the affected joint developed within eight weeks after clinical onset of diabetic gangrene. Eight toes of six diabetics were satisfactory to our criteria. We analyzed plain radiographic findings of the affected joint and soft tissue, interval changes in follow-up radiographs, and deformities after healing. RESULTS: The time interval between clinical onset of gangrene and bone destruction ranged from 2 weeks to 4 weeks(mean 2.6 weeks). Plain radiographs showed fragmentation of the articular ends, subluxation, and soft tissue swelling of the metatarsophalangeal joint or interphalangeal joint. The significant feature of these patients was rapid progression of the lesions. Clinically, all patients had diabetic gangrene in affected toes, however, there was no evidence of osteomyelitis in our series. Amputation was done in 2 cases, and lesions in 3 of the remaining 4 cases were repaired spontaneously with regression of gangrene, leaving radiological residua such as pointed-end, tapered-end, and ball and socket deformity. CONCLUSION: Rapid disorganization of the joint with associated evidence of soft tissue gangrene in plain radiograph is believed to be valuable for the diagnosis of diabetic osteoarthropathy.
Amputation ; Congenital Abnormalities ; Diabetic Foot* ; Diagnosis ; Follow-Up Studies ; Gangrene ; Humans ; Joints* ; Metatarsophalangeal Joint ; Osteomyelitis ; Toes

No abstract available.
Female ; Laparoscopy* ; Methotrexate* ; Pregnancy ; Pregnancy, Ectopic*

The aim of the spine fusion is to obtain the stability of the spine. Spinal fusion have been used for the treatment of tuberculosis and arrest of the progress of spinal deformity such as scoliosis. Nowadays the spine fusion is used often in conditions which present the instability; spondylosis, spondylolisthesis and the unstable postlaminectomy spine. Unilateral posterolateral fusion plus hemiposterior fusion were done only in the cases who had wide hemilaminectomy, while in rest of cases bilateral posterolateral fusion was indicated in this series. Fifty-two cases, treated with posterolateral lumber fusion during the period from June 1980 to Dec. 1985, were analysed clinically and radiologically and the following results were obtained. l. Among the 52 cases, 25 cases(48.1%) were male; and 27 cases(51.9%) were female; The youngest was 16 years of age and the oldest one was 63 years of age. Average age of the patient was 39.6 years. 2. Fifteen patients had spinal stenosis, 14 cases of spondylolisthesis, 11 cases of H.N.P., 6 cases of spondylolysis, 4 cases of tuberculous spondylitis and 2 cases of fracture-dislocation of lumbar spine. 3. As a method immobilization after operation, postoperatively hips spica cast was applied in 4 cases for 12 weeks, Norton-Brown back brace in 9 cases following 6 weeks of posloperative hip spica cast immobilization and Norton-Brown brace 39 cases following 2 weeks of postoperative bed rest. 4. In 41 cases bilateral posterolateral fusion was done, and in 11 cases unilateral posterolateral fusion plus hemiposterior fusion were done. The bony union was established within 4 months after bilateral posterolateral fusion in 37 cases and after unilateral posterolateral fusion in 9 cases. In 2 cases complete union was obtained within 6 months after fusion. 5. The union rate was 92.7% in bilateral posterolateral fusion and 90.9% in unilateral posterolateral fusion. There was no significant differences of the union rate between bilateral and unilateral fusion groups. Therefore, the unilateral posterolateral fusion is a suitable method in the treatment of mild spinal instability regardless of its causes. The procedure has benefits, such as short operation time, less blood loss, and less surgical burden to the patient.
Arthrodesis ; Bed Rest ; Braces ; Clinical Study ; Congenital Abnormalities ; Female ; Hip ; Humans ; Immobilization ; Male ; Methods ; Scoliosis ; Spinal Fusion ; Spinal Stenosis ; Spine ; Spondylitis ; Spondylolisthesis ; Spondylolysis ; Spondylosis ; Tuberculosis

A 53-year-old man had skin-colored linear serpiginous plaque within brownish patch on his left thigh for one year. He habitually drank natural spring water for 3 years. We diagnosed this case as sparganosis infiltrated within dermis by histologic and parasitologic diagnosis. The skin lesion mimicked the cutaneous larva migrans by showing dermal migration of sparganum to pro-duce itchy linear serpiginous plaque. We report an interesting case of sparganosis mimicking cutaneous larva migrans.
Dermis ; Diagnosis ; Humans ; Larva Migrans* ; Middle Aged ; Natural Springs ; Skin ; Sparganosis* ; Sparganum ; Thigh ; Water

PURPOSE: Algorithms to get cross-sectional bone density pattern(transverse histogram) to predict the loosening of hip prosthesis using DXA(Dual X-ray Absorptiometry) have been developed. We performed this study to analyze the correlation between radiologic findings and densitometric pattern of the THRA(Total Hip Replacement Arthroplasty) patients. MATERIALS AND METHODS: Thirty-six hips of 32 THRA patients were evaluated. The duration between THRA and DXA was from 1 year 7 months to 15 years. On transverse histogram, the periprosthetic bone density patterns were classified as 3 types;type I, rigid fixation in 17, type II, definite loosening in 8, and type III, partial loosening in 11 cases. Surgical findings, plain X-ray findnings and transverse histogram using DXA were correlated. RESULTS: Among 14 cases performing revision for acetabular prosthesis loosening, 5 cases revealed loosening of fernoral stems while 9 cases revealed rigid fixation of femoral stems. Sensitivity was 100% for either plain X-ray or DXA. Specificity was 88%, 77% for plain X-ray and DXA respectively. CONCLUSION: This preliminary study reveals that periprosthetic bone density pattern on transverse histogram on DXA may be useful in the evaluation of the loosening. However, further study will be needed for clinical application.
Acetabulum ; Arthroplasty, Replacement, Hip* ; Bone Density ; Hip ; Hip Prosthesis ; Humans ; Prosthesis Failure ; Sensitivity and Specificity

The folling results were obtained through the clinical review and Virology Laboratory of 100 cases of meningitis seen at ward of the pediatric department of Has Sung Hospital during the period from May to June, 1993. 1) Early childhood period was the most frequent age group and male was predominant in aseptic meningitis. 2) The common chief complaints were fever, vomiting, headache in order. 3) On physical examination meningeal irritation signs were not prominent. 4) On admission, leukocytosis (WBC count>10.000/mm(3)) on peripheral blood was showed in 36%. 5) The findings of cerebrospinal fluid showed that cells (Mean WBC count 671.8/mm(3)) were increased in all cases, and protein and sugar were mostly within normal limit. 6) Echovirus 9 was thought to be main causative agent according to the cerebrospinal fluid culture and antibody test. 7) On follow up study 2 months after discharge, 14 cases showed minimal abnormalities of EEG but no abnormal finding in BERA.
Cerebrospinal Fluid ; Echovirus 9 ; Electroencephalography ; Fever ; Follow-Up Studies ; Headache ; Humans ; Leukocytosis ; Male ; Meningitis ; Meningitis, Aseptic* ; Physical Examination ; Virology ; Vomiting

Forty five patients with inferior vena cava (IVC) thrombosis were studied with the use of ultrasonography (US) and computed tomography (CT). Thirty seven cases were cased by tumor extension and the primary neoplasms were hepatocellular Ca. (26cases), renal cell Ca. (6 cases), Wilms' tumor (1 case), IVC leiomyosarcoma (1 case) and retroperitoneal metastatic tumor (3 cases). Non-tumor thrombus were 8 cases which included 5 cases of Budd-Chiari syndrome and 3 cases of thrombophlebitis. US and CT both were good for the diagnosis of IVC thrombosis. Cranial extension was better demonstrated by US whereas CT yielded better delineation of the lower extension. Even though, differentiation of tumor non-tumor thrombi by the echogenecity and density of the thrombus was not possible, the finkdings of adjacent tumor mass, complete obstructive thrombus within dilated lumen with bulging wall, and nontapered acute margin of thrombus made the possibility of tumor thrombus more likely.
Budd-Chiari Syndrome ; Diagnosis ; Humans ; Leiomyosarcoma ; Thrombophlebitis ; Thrombosis* ; Ultrasonography ; Vena Cava, Inferior* ; Wilms Tumor

BACKGROUND: Leptin, the product of ob gene, is an important circulating hormone for the regulation of homeostasis of body weight and enegy expenditure. There was a previous reports that thyroid hormone is one of regulating factors of leptin gene expression in vitro. The aim of this study was designed to evaluate the role of thyroid hormone levels in the regulation of circulating leptin concentrations in human. METHODS: A total 16S subjects were studied; 76 patients with Graves disease, 49 patients with Hashimoto disease and 43 control sujjects. The correlation between thryoid hormone and leptin levels were analyzed and serum leptin levels were compared among the groups which was classified by thyroid functional status. Serum leptin concentratios were measured by radioimmunoassay. RESULTS: There were no significant differences in serum leptin levels between the groups of control, Graves disease and Hashimoto disease. The hypothyroid groups of Graves disease which was induced by excessive antithyroid drug treatment showed significant low levels(5.6 +/-2.8 ng/mL) compared to control(9.6 +/- 5.2 ng/ml) and thyrotoxic groups(10.0 +/- 5,0 ng/mL) CONCLUSION: The hypothyroid patients showed low levels of serum leptin concentrations it may indicate that thyroid horrnone play a role in the appropriate secretion of leptin in human.
Body Weight ; Gene Expression ; Graves Disease ; Hashimoto Disease ; Health Expenditures ; Homeostasis ; Humans ; Leptin* ; Radioimmunoassay ; Thyroid Gland*

The present study was performed to observe the time course of behavioral signs of painful sensations in sciatic neurectomy animal model and to test the effects of sympathectomy and saphenous nerve section on these behavioral signs. Sciatic nerve was ligated and cut at the mid-thigh level under gaseous anesthesia. The application of von Frey filaments to the medial plantar surface of foot revealed weak and long-lasting mechanical allodynia (until end of test period, 20 weeks PO). Acetone application to the plantar surface of foot was used ti measure the sensitivity to cold stimulation. Cold allodynia which is interpreted as increased response to acetone application developed fairly well and lasted the end of test period (20 weeks PO). The cumulative duration of foot lifts off neutral or cold plate was used to test spontaneous, ongoing pain and was increased until 16 weeks PO and 20 weeks PO respectively. These results suggest that sciatic neurectomy which has been widely used as chronic pain model shows behavioral signs suggsting painful sensations except autotomy, which has been used as index of pain in experimental animal. Surgical sympathectomy performed 1 week after sciatic neurectomy partially reduced the behavioral signs of mechanical allodynia and cold allodynia, suggesting behavioral changes developed following section of sciatic nerve was partially sympathetic dependent. Saphenous nerve section 1 week after sciatic neurectomy almost completely reduced mechanical allodynia and cold allodynia, but did not change spontaneous, ongoing pain. These results suggest that evoked responses such as mechanical and cold allodynia are mediated by saphenous nerve activity and activating and/or maintaining mechanisms of spontanous, ongoing pain and evoked pain may be different.
Acetone ; Anesthesia ; Animals ; Chronic Pain ; Cold Temperature ; Foot ; Hyperalgesia ; Models, Animal ; Neuralgia ; Rats ; Sciatic Nerve ; Sensation ; Sympathectomy