BACKGROUND: The diabetic patients have a tendency to develop onychomycosis more frequently than non-diabetic populations have. The overall risk ratio of individuals with diabetes having onychomycosis is 2.77 compared with age- and sex- matched non-diabetic controls. OBJECTIVE: This study was performed to find out whether the nail growth rates of diabetic patients are more slower than those of non-diabetic persons with or without onychomycosis and to observe the differences of the toenail growth rates according to the affected area of onychomycosis (less than 50% and more than 50%) within the diabetic and non-diabetic groups respectively. METHOD: The growth rates of the great toenails of 74 diabetic patients and 121 non-diabetic controls with or without onychomycosis were measured. To compare the toenail growth rates between the two groups, we classified the patients in each group into 3 subgroups according to the presence and degree of onychomycosis. Thus the two groups were divided into 6 groups. RESULTS: The growth rates of diabetic toenails without onychomycosis were slower than those of non-diabetic controls with statistical significance (p< 0.05). And the growth rates of the great toenails in non-diabetic patients were more slower according to their affected area, so to say, the more, the slower (p< 0.05). But, in diabetic patients, the growth rates of the great toenails were not different according to the affected area of onychomycosis (p> 0.05). CONCLUSION: Slow nail growth may play a role in the development of onychomycosis because the nail growth rate was slower in diabetic patients than non-diabetics. But the treatment of onychomycosis in diabetic patients should be encouraged because the toenail growth rates are not different statistically between diabetic and non-diabetic patients when the great toenails are affected.
Diabetes Mellitus ; Humans ; Nails* ; Odds Ratio ; Onychomycosis*

No abstract available.
Arteriovenous Malformations* ; Hematoma*

We present a rare case of a pituitary adenoma revealing a sedimentation level on MRI, which has not been previously documented. This 55-year-old woman was referred with the diagnosis of craniopharyngioma. She presented with four-month history of progressive headache and visual dimness. Neurological examination revealed a bitemporal hemianopsia and decreased visual acuity. Laboratory data including endocrine examination were unremarkable. An additional three-dimensional MRI was taken for further evaluation, and demonstrated a sedimentation level within the tumor. The patient underwent transcranial removal of the tumor. About 12cc of dark-red blood was aspirated from the tumor. Histological examination revealed a pituitary adenoma with hemorrhage. Postoperatively, the patient showed gradual improvement of visual function. Considering that the pituitary adenoma is one of more common tumors that cause tumoral bleeding, a cystic sellar tumor that has a sedimentation level should be sought first for a pituitary adenoma rather than a craniopharyngioma. This may have an important impact when deciding surgical approach.
Craniopharyngioma ; Diagnosis ; Female ; Headache ; Hemianopsia ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Middle Aged ; Neurologic Examination ; Pituitary Apoplexy ; Pituitary Neoplasms* ; Visual Acuity

No abstract available.
Head Injuries, Penetrating*

No abstract available.
Astrocytoma* ; Tuberous Sclerosis*

In order to define the prognostic implications of cervical myelopathy, we conducted a morphometrical analysis of spinal cords in patients suffering from this condition. Twenty patients who had undergone laminoplasty for their cervical myelopathy were the subject of this study. Cervical spondylosis was diagnosed in 14 patients and ossification of the posterior longitudinal ligament in six. Signal change of the spinal cord, its anteroposterior diameter, and the number of stenotic segments were determined by pre- and postoperative magnetic resonance imaging and simple X-ray. The patients' neurological status before and after surgery was evaluated by the Neurosurgical Cervical Scale. Patients whose cord revealed no signal change had better recovery rates than those who showed change (77.5% vs. 60.5%). The wider the diameter of the cord, the better the outcome of surgery(p<0.05 on one-way ANOVA). The number of stenotic segments was not significantly related to recovery rate. In conclusion, focal morphological changes of the spinal cord, regardless of the general stenotic area, are the main factors determining the outcomes of surgery.
Humans ; Longitudinal Ligaments ; Magnetic Resonance Imaging ; Spinal Cord ; Spinal Cord Diseases* ; Spondylosis

Annular pustular psoriasis(APP) is a rare variant of the generalized pustular psoriasis characterized by subacute onset of annular lesion with peripheral advancing pustules. Histologically, it is characterized by spongiform and/or subcorneal pustules which are also found in subcorneal pustular dermatosis(SPD). SPD is very difficult to differentiate from APP, although SPD is thought to be a separate and distinctive entity because of its clinical appearance, characteristic histology, and response to dapsone. We herein report a case of APP showing clinical and histologic features of SPD developed in a patient who had a history of generalized pustular psoriasis.
Dapsone ; Humans ; Psoriasis* ; Skin Diseases, Vesiculobullous*

Churg-Strauss syndrome is a clinicopathologic disorder of severe asthma, fever , and eosinophilia together with systemic vasculitis involving various organ systems. Characteristic cutaneous lesions include erythematous maculopapules resembling erythema multiforme, hemorrhagic lesions, and cutaneous and subcutaneous nodules. Histologically, extravascular granuloma and leukocytoclastic vasculitis are the most common findings. We report a case of 40-year-old woman who presented with generalized multiple hemorrhagic bullae that had developed 1 month ago. Previously, She had allergic rhinitis and asthma. Laboratory studies revealed peripheral blood eosinophilia, and positive p-ANCA. Skin biopsy revealed eosinophilic infiltrates and leukocytoclastic vasculitis.
Adult ; Antibodies, Antineutrophil Cytoplasmic ; Asthma ; Biopsy ; Churg-Strauss Syndrome* ; Eosinophilia ; Eosinophils ; Erythema Multiforme ; Female ; Fever ; Granuloma ; Humans ; Rhinitis ; Skin ; Systemic Vasculitis ; Vasculitis

Tufted angioma is a rare, acquired vascular tumor, most commonly presenting in the first year of life, which was first described by Wilson Jones in 1979. Spontaneous resolution of this tumor are known to be very rare and local recurrence often occurs unless the tumor is excised completely. We present two cases of tufted angioma developed in two 1-year-old girls. Skin biopsy in a case showed compatible findings with tufted angioma and the other was diagnosed at an other hospital. The lesions were treated with intralesional injections of triamcinolone acetonide and showed marked improvement. During follow up period, the lesions kept improving.
Biopsy ; Female ; Follow-Up Studies ; Hemangioma* ; Humans ; Injections, Intralesional* ; Recurrence ; Skin ; Triamcinolone Acetonide

Anterior cervical fusion has enjoyed an increasing acceptance and frequency of utilization in the treatment of symptomatic degenerative, traumatic, and neoplastic disorders. Since the introduction of plate systems, cervical fusion with fixation has become popularized. We present our experiences of 152 cases of cervical fusion in degenerative and traumatic lesions, focusing on their surgical results and complications, along with our opinions about the various plate systems we used. Between March 1993 and May 1996, 152 patients with symptomatic degenerative and traumatic cervical lesions between C3-4 and C7-T1 levels were treated with anterior cervical fusions. These patients were retrospectively studied according to their medical records and radiological studies. A comparison between various plate systems were also done. There were 110 men and 42 women, aged from 21 to 77 years. Mean follow up period was 17 months. Mean fused segments were 1.4. Various plate systems were used: Caspar plate system in 14 patients; Top plate in 102; Orion plate in 21; and none in 15. Dislodgement of bone graft, screw loosening, and fusion failure that required reoperation were occurred in 8 cases. None of them were initially treated with unicortical type screws. Asymptomatic esophageal perforation was developed in one case among them. In conclusion, anterior cervical fusion with screw plate system can be carried out with acceptable complication rate. Although relative follow up period was short, we concluded that the locking type screw plate system was superior than the classic bicortical screw system in their procedural simplicity, unnecessary penetration of posterior cortex, and elimination of the fear for the neurological complication.
Esophageal Perforation ; Female ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Reoperation ; Retrospective Studies* ; Transplants