We are reporting a case of multiple dermatofibromas which occuired during the treatment of systemic lupus erythematous with prednisolone for 3 years in a 30-yenr-old woman, All of the 26 lesions were 0.5-2cm sized. and had the same appearanes ad usual dermatofibromas coccurring singly. Histopathologic examination showed typical findings of dermatofibroma which were characterized hy proliferation of fibroblasts intermingled with collagen in irregular arrangement and proliferation of small vessels and endothelial cells.
Collagen ; Endothelial Cells ; Female ; Fibroblasts ; Histiocytoma, Benign Fibrous* ; Humans ; Lupus Erythematosus, Systemic* ; Prednisolone

No abstract available.
Adrenocorticotropic Hormone* ; Humans ; Infant ; Infant, Newborn ; Spasms, Infantile*

In 5 cases of congenital coxa vara, 7 cases of acquired coxa vara and 4 hips in 3 cases of acquired coxa valga, we performed subtrochanteric osteotomies at Department of Orthopedic Surgery, SeoulNational University Hospital, from December 1980 to February 1984. At a relatively short interim follow-up, following observations were made on the correction of the femoral neck-shaft angle deformities. l. In the congenital coxa vara group, at an average follow-up of 1 year and 3 months, 97.9% of the correction obtained by osteotomy was maintained, based on the roentgenographic measurements of femoral neck-shaft angle. In the acquired coxa vara group, at an average follow-up of 1 year and 2 months, 93.3 % of the correction obtained by osteotomy was maintained. In the acquired coxa valga group, at an average follow-up of 1 year and 5 months, 92.9% of the correction obtained by osteotomy was maintained. 2. At final follow-up, leg length gain averaged 1.26cm in the congenital coxa vara group and 2.23cm in the acquired coxa vara group. An average 0.70cm decrease in leg length was noted in the acquired coxa valga group. 3. Trendelenburg sign, which was positive in all the cases of the congenital and acquired coxa vara group, reverted to negative in all. 4. Slight overcorrection in cases of the acquired coxa vara and undercorrection in cases of the acquired coxa valga, is recommended for later loss of surgically corrected femoral neck-shaft angle. In the congenital coxa vara, it appeared that loss of correction was relatively minor.
Congenital Abnormalities ; Coxa Valga ; Coxa Vara ; Follow-Up Studies ; Hip ; Leg ; Orthopedics ; Osteotomy

In 1973, Steel described triple innominate osteotomy in which the ischium, the superior pubic ramus and ilium superior to the acetabulum are divided and the acetabulum is repositioned anterolaterally and is stabilized by a bone graft and metal pins. Its goal is to establish a stable hip for dislocation or subluxation of the hips in older children and adults on whom it is impossible to correct effectively the instability by any one of the more conventional osteotomies, i.e. Salter's, Pemberton's or Chiari's, or by the capsular arthroplasty of Colonna. During the eleven years and eight months, from December 1973 to August 1985, at the Department of Orthopedic Surgery, Seoul National University Hospital, we performed Steel's triple innominate osteotomy on 41 cases, of which 37 were residual poliomyelitis and 4 septic hip residua. 4 cases of residual poliomyelitis were lost during follow up. The remaining 37 cases were reviewed for the efficacy and limitations of triple innominate osteotomy. We observed following conclusions: 1. Aside from congenital dislocation and dysplasia of the hip, paralytic conditions, such as residual poliomyelitis, are good indications of Steel's triple innominate osteotomy in older children, adolescents and young adults. Acetabular acclivity is adequately reduced and stability is improved. 2. Septic hip residua, including healed tuberculosis, is another indication of triple innominate osteotomy, particularly when total hip arthroplasty is contemplated. 3. When abductors are partially paralyzed, triple innominate osteotomy alone results in appreciable increase in abductor power, by providing a better muscle tension. 4. Substantial gain in leg length is an added advantage of triple innominate osteotomy. An average of 1.74 cm was gained at osteotomy site in our series. In adults, when limb shortening is relatively m i nor, triple innominate osteotomy alone can be a more convenient alternative to conventional, more formidable method of leg length equalization, such as femoral lengthening. This is particularly true when there is some instability or when abductors are weak. 5. Following improvement in mechanical stability by triple innominate osteotomy, weak abductors and extensors may be augmented by appropriate muscle transfer, resulting in more stable hip functionally. 6. In a hypermobile paralytic hip, iliopsoas tenotomy is neither necessary nor desirable at the time of osteotomy. When the hip is dislocated, or when the hip has marked flexion deformity, iliopsoas tenotomy fascillitates adequate correction, but this greatly increases the risk of neurological complication.
Acetabulum ; Adolescent ; Adult ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Child ; Congenital Abnormalities ; Dislocations ; Extremities ; Follow-Up Studies ; Hip ; Humans ; Ilium ; Ischium ; Leg ; Methods ; Muscle Tonus ; Orthopedics ; Osteotomy ; Poliomyelitis ; Seoul ; Steel ; Tenotomy ; Transplants ; Tuberculosis ; Young Adult

BACKGROUND: Esmolol is a short acting sympathetic beta receptor antagonist, and it was successfully applied to induced hypotension. Esmolol lowers blood pressure by decreasing cardiac output, and does not cause vasodilation. This property of esmolol may help to decrease bleeding during induced hypotension. In this study, we tried to elucidate the effect of esmolol on induced hypotension for total hip arthroplasty. METHOD: Twenty patients receiving total hip arthroplasty were randomly divided to two groups. Esmolol group (10 patients) received esmolol as a hypotensive agent, and sodium nitroprusside (SNP) group (10 patients) received SNP as a hypotensive agent. We measured arterial blood gas analysis, vital sign, amounts of bleeding, amounts of transfusion and administered fluid, and various laboratory findings. RESULTS: Induced hypotension was successfully performed in either esmolol and SNP group. Heart rate increased by SNP, and decreased by esmolol. There were no statistically significant differences between the two groups in amounts of bleeding, amounts of transfusion or administered fluid, and laboratory findings. Arterial oxygen tension was relatively constant in esmolol group, but decreased in SNP group. CONCLUSION: Esmolol can be used as a single hypotensive agent during induced hypotension without significant side effects during total hip arthroplasty.
Arthroplasty, Replacement, Hip* ; Blood Gas Analysis ; Blood Pressure ; Cardiac Output ; Heart Rate ; Hemorrhage ; Humans ; Hypotension* ; Nitroprusside* ; Oxygen ; Sodium* ; Vasodilation ; Vital Signs

Augmentation mammoplasty can be done in various manners according to the way of approach. the type of implant or implatation site depending on the status and demand of the patients or the operator's preferrence. In reviewing the many published reports about augmentation mammoplasty, they compare their surgical outcomes with mixed factors, so it is difficult to compare the results of mammoplasty simply with one factor under the same conditions. We think that analyzing the surgical results with one consistent method enables to compare and decide the influencing effect of one factor within it in augmentation mammoplasty. We could find the fact that the Korean women who wanted augmentation mammoplasty had same physical characteristics and demands, so developed the standardized method of augmentation mammoplasty among those debatable data for the purpose of increasing the patients' satisfaction, decreasing the complications, and shortening the operation time. The method we adopted was placing the implant through transaxillary subpectoral approach and using the endoscope auxiliarily in additional dissection and hemostasis. We employed saline-filled implants of round, textured type with the size ranging fro 125cc to 175cc and overinflated them by 10 to 30% beyond its original volume. After irrigation of the dissected pocket, we placed the suction drainage system into the subpectoral pocket. We educated the patients to massage their breasts right after removal of the drain. During the period of follow-up (from 6 months to 24 months), most of the patients were satisfied with their operative results. Though we experienced one case of capsular contracture, one case of malposition of the implant, and three cases of scar contracture on axillar incision site, as a whole, we could minimize the complications associated with augmentation mammoplasty. We present our postoperative results with the conclusion that our standardized method of augmentation mammoplasty can bring results of high satisfaction rate, minimal complication, predictability of postoperative results, shortening of operation time when applied consistently to the Korean patients whose physical characteristics are similar. We also hope that stanadardized method can be used to compare the influencing effect of many factors in the case of changing one factor within the standardized in the future follow up period.
Breast ; Cicatrix ; Contracture ; Endoscopes ; Female ; Follow-Up Studies ; Hemostasis ; Hope ; Humans ; Mammaplasty* ; Massage ; Suction

No abstract available.
Hypertension ; Leigh Disease*

No abstract available.
Brain Stem* ; Glioma*

Collagen is the major structural protein in the human body, especially in connective tissues. There are more than 13 types of collagen. Among them, type II collagen is a main component of articular cartilage structure. Altered immunological conditions against type II collagen may be closely related to the pathologic conditions of joint, especially arthritis. Since 1977, animal model for collageninduced arthritis(CIA) has been developed and used in the investigation of arthritis. In those animals, high titers of anti-type II collagen antibody were noticed. Pathologic findings were similar to rheumatoid arthritis of human, which suggested that rheumatoid arthritis might be one of the autoimmune diseases. There had been many reports about elevation of serum and synovial level of anti-type II collagen antibody in rheumatoid arthritis patients. But majority of them did not discriminate the antibody titers according to the type of immunoglobulin(i.e. IgG, IgM). And the question whether the elevated antibody titers are cause or effect of the arthritis is still in controversy. In this study, the serum levels of anti-type II collagen antibody were determined in 82 persons(35 degenerative arthritis patients, 24 rheumatoid arthritis patients and 22 normal controls without any joint problem) via ELISA method. In each person the serum IgG, IgM and IgG+M+A antibody levels against bovine type IIcollagen and chicken typeII collagen were determined individually. Statistical evaluation of these data among degenerative arthritis group, rheumatoid arthritis group and normal control group was performed. The results were as follows; 1. Degenerative arthritis group revealed significant elevation of anti-type II collagen antibody(IgG, IgG+M+A) compared to normal control(p < 0.05). 2. Rheumatoid arthritis group showed significant elvation of IgM and IgG+M+A compared to normal control. 3. Between degenerative arthritis and rheumatoid arthritis group, no sigificant difference was noticed. 4. Rheumatoid arthritis group showed significant increase of IgM antibody level compared to normal control. 5. Female rheumatoid arthritis group showed significant increase of IgM level compared to female degenerative arthritis group. These findings suggested that the elevation of anti-type II collagen antibody titer is not specific for rheumatoid arthritis and related with general pathologies destroying articular cartilage. And it is suggested that anti-type II collagen antibody associated with rheumatoid arthritis is mainly IgM proportion, especially in female patients. So further investigation of anti-type II collagen antibody associated with rheumatoid arthritis is needed to target IgM antibody.
Animals ; Arthritis ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Cartilage, Articular ; Chickens ; Collagen ; Collagen Type II ; Connective Tissue ; Enzyme-Linked Immunosorbent Assay ; Female ; Human Body ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Joints ; Methods ; Models, Animal ; Osteoarthritis ; Pathology

Mucormycosis is an opportunistic fungal infection caused by the mucorales, which consist of the Rhizophus, Absidia, Mortierella, and Mucor. The diverse clinical forms of mucormycosis can be categorized as rhinocerebral, pulmonary, disseminated, gastrointestinal, cutaneous and miscellaneous. Although it can cause disease in healthy people, it most commonly affects patients who are diabetic or immunosup-pressed. Rarely, mucormycosis develops confined to the subcutaneous tissue. We experienced a case of cutaneous mucormycosis developed in a well-controlled diabetic patient who had previously injected foreign material on her face for an aesthetic purpose at the behest of an unlicensed physician. The patient had tissue necrosis and purulent discharge on her left cheek. Following histologic examination, we diagnosed the condition as cutaneous mucormycosis and treated it by wide excision combined with amphotericin B therapy. The disease was cured without any significant sequelae within 6 months of follow up. Cutaneous mucormycosis is rarely reported but it can cause facial deformity due to tissue necrosis, so that early diagnosis and appropriate treatment are important. Currently, foreign material injection for aesthetic purposes is still performed by unlicensed physicians. We present a case report concluding that one should consider the possibility of fungal infection in skin lesion in diabetic or other immunosup-pressed patients. We also emphasize the seriousness of illegal injection of foreign material.
Absidia ; Amphotericin B ; Cheek ; Congenital Abnormalities ; Early Diagnosis ; Follow-Up Studies ; Humans ; Mortierella ; Mucor ; Mucorales ; Mucormycosis* ; Necrosis ; Paraffin* ; Skin ; Subcutaneous Tissue