The ability of photochemotherapy(PUVA) or UVA phototherapy to stimulate melangenesis is well known. It is now recognized that the PUVA lentigines, irregular in outline and often more darkly and unevenly pigmented than solar lentigines, are related to the additional pigmentary effects of the PUVA therapy. We present herein four cases of unusual pigmentation after one month of UVB irradiation. Raticulated dark brown pigmentation appeared on the lower extremities of the patients. Histopathologicially, an increase in melanin in the basal layer was found, but no dysplasia or malignant change. We suggest UVB as the cause of this unusual hyperpigmentation.
Humans ; Hyperpigmentation ; Lentigo ; Lower Extremity ; Melanins ; Phototherapy* ; Pigmentation* ; Psoriasis* ; PUVA Therapy

To our knowledge, rectal cancer arising at the anastomotic site after surgery for Hirschsprung's disease has not been reported. We report a case of mucinous adenocarcinoma arising at the anastomotic site after Soave operation 26 years ago.
Adenocarcinoma, Mucinous* ; Hirschsprung Disease* ; Mucins* ; Rectal Neoplasms

Morphological characteristics of human embryos of Carnegie stage 17 were described. The crown rump length of these embryos were 11.7-13.6mm. These embryos were characterized externally by ventrally directed nasal pits, 6 distinct auricular hillocks, finger rays in the hand plate, digital plate at the lower limb bud, herniation of a part of midgut through umbilical cord, and internally by the partial fusion of ventral and dorsal pancreas, prominent nasal sac which is not open to primitive oral cavity, formation of segmental and some subsegmental bronchial buds, branching of metanephrotic pelvis, crescent-shaped lens cavity, and imminent semicircular ducts.
Crown-Rump Length ; Embryonic Structures* ; Fingers ; Hand ; Humans* ; Lower Extremity ; Mouth ; Pancreas ; Pelvis ; Semicircular Ducts ; Umbilical Cord

Anterior interosseous nerve paralysis observed in a 13-year-old boy with supracondylar fracture of the left humerus was reported. During the conservative management at a bone setter of the fracture, the gradual loss of pinch action of the thumb and index finger became conspicuous, and with operative reduction of the fracture and release of the fibrous compression and adhesion to the nerve at the ulnar head of the pronator teres, the paralysis could be relieved.
Adolescent ; Child ; Fingers ; Head ; Humans ; Humerus ; Male ; Paralysis ; Thumb

A case of disseminated bone tuberculosis was reported, observed in a 23 year old male who visited with chronic ulcer on the midportion of the left upper arm and painful, tender swelling at the proximal part of the left tibia. Brief review was done regarding its pathogenesis and controversy of its nomenclature.
Arm ; Humans ; Male ; Tibia ; Tuberculosis, Osteoarticular ; Ulcer

We report a case of a 25-year-old woman with systematized epidermal nevi associated with alopecia universalis and onychodystrophy. The histopathologic examinations by light and electron microscopies of the epidermis of the trunk and scalp lesions showed epidermal nevus with characteristic features of epidermolytic hyperkeratosis. This is a rare case of systematized epidermal nevi associated with congenital alopecia universalis and onychodystrophy. Though there is no apparent gross skin lesion on the hair bearing area, the development of epidermal nevi can affect the hair and nail units which are derived from the common epidermal germinative cells.
Adult ; Alopecia* ; Epidermis ; Female ; Hair ; Humans ; Hyperkeratosis, Epidermolytic ; Microscopy ; Nevus* ; Scalp ; Skin

Results from two in vitro assays, Pharmacia CAP system(CAP) and fluoroallergosorbent test(FAST), for detecting serum specific IgE to three allergens, mugwort, Derraatophagoides pteronyssinus, and eat epithelium, were compared with skin prick test(SPT) results in 53 atopie dermatitis patients with positive SPT and 25 non-atopic controls. Using SPT results as the reference standards, CAP achieved higher sensitivity than FAST in determination of three allergens. CAP for measuring total IgE and eosinophil cationic protein(ECP) was also compared with FAST and ECP radioimmunoassay(RIA), respectively. In comparison of two assays for total serum IgE, the values obtained with CAP were significantly higher than those with FAST. In comparison of CAP and RIA for measuring ECP, the values obrained with CAP were significantly higher than those with RIA and the differences between ECP values of two assays were significant in high ECP group(>8.3 micro gram/1). These results suggest that CAP is the preferred test and seems to be more appropriate method for detection of specific IgE and ECP in patients with allergic digeases.
Allergens ; Artemisia ; Dermatitis ; Eosinophil Cationic Protein* ; Eosinophils* ; Epithelium ; Humans ; Immunoglobulin E ; Radioimmunoassay* ; Skin

BACKGROUND: Stratum corneum lipids serve as a water retainer as well as permeability barrier by forming a multi-lamellae structure in the stratum corneum. The major constituent of these lipids, ceramides, have been shown to be predominantly associated with both functions. OBJECTIVE: Exposure of human epidermis to ultraviolet(UV) irradiation leads to changes in the physiologic and biochemical features of the skin. In order to investigate the effect of UVB irradiation on the skin barrier function in hairless mice, transepidermal water loss (TEWL) and lipid composition of stratum corneum were evaluated in hairless mice. METHODS: Hairless mice were irradiated 3 times weekly for 3 weeks with suberythemal dose (0.6MED, Group I) and minimal erythemal dose(MED), Group II) of UB. The mice of Group III received high dose of UVB(3MED) on the back in a single exposure. The control was Group IV. TEWL measured by evaporimeter and lipid composition of stratum corneum appraised by high performance thin layer chromatography(HPTLC) were evaluated weekly for 3 weeks. RESULTS: 1. Each time it was measured, the values of TEWL in group I were lower than group IV, but the difference was not significant. The peak value of TEWL in group II was 8.2+/-1.56 g/cm/h on the 7th day. The increase in TEWL was markedly significant at this point(P<0.001). Although the values of TEWL on the 14th and 21th day in group E increased compared with those of the control group, the significance of the values decreased (P<0.05). 2. The peak value of TEWL in group III was 9.88+/-1.13 g/cm/h on the 2nd day, showed a markedly significant increase compared with that of the control group(P<0.001). The values of TEWL decreased to the level of the control group on the 14th day. 3. The lipid(cholesterol sulfate, ceramide and neutral lipid) and total lipid mass in group 1 were insignificantly larger than that of the group IV measured each time. On the 7th and 14th day, the amount of each three lipid and total lipid mass significantly increased (P<0.05). On the 21th day, the amount of ceramide and neutral lipid showed a significant increase(P<0.05), furthermore the total lipid mass increased pronouncedly(P<0.01) in group II. 4. The amount of the 3 kinds of lipid and total lipid mass in group III significantly increased compared with those of the control group on the 2nd day(P<0.05). After the 7th day, no significant difference of the lipid mass except neutral lipid compared with that of the control group was seen. Comparing the 2nd and 14th day, there was a significant decrease in the amount of ceramide and total lipid mass(P<0.05) CONCLUSION: These results results suggest that considerable amount of UVB irradiation given in single or repeated exposure causes the disruption of skin barrier function, but a compensatory increase of skin lipid, especially ceramide, protests it from further damage and also improves skin barrier function.
Animals ; Ceramides ; Epidermis ; Humans ; Mice ; Mice, Hairless* ; Permeability ; Skin*

STUDY DESIGN: The authors is to report the clinical and radiological results of proximal half corpectomy with one motion segment fusion in Denis type B burst fracture. OBJECTIVES: To evaluate the efficacy of proximal half corpectomy in Denis type B burst fracture of thethoracolumbar and lumbar spine. SUMMARY OF LITERATURE REVIEW: For the operative management of burst fracture, various mothods including posterior ligamentotaxis, posterolateral decompression, anterior decompression or combined were reported. Among the methods, anterior decompression by the corpectomy of fractured vertebral body and fusion with or without instrumentation is the one of the widely accepted method of treatment. However, anterior decompression by excision of whole vertebral body has the disadvantage of high complication rate due to the instability from the large defect and long length of bone graft. Moreover, two motion segments have to be sacrified, which is very important especially in thoracolumbar and lumbar area. Material and METHODS: 43 cases operated from 1989 to 1996 and the minimum follow up period was two years and compared with that of 48 cases who were treated by total corpectomy and two motion segment fashion from 1986 to 1989. RESULTS: Solid bony union was obtained in 43 cases within 6 months and no back pain was complained in 39 cases (93%) at last follow up. There was no significant difference between two groups in correction of anterior vertebral height and kyphotic angle. Length of bone graft was 3.0cm in half corpectomy group and was 6.3cm in total corpectomy group. Hardward breakage or graft collapse was not observed in proximal half corpectomy, while there were 5 cases in total corpectomy. CONCLUSION: Proximal half corpectomy and fusion of one motion segment in Denis type B burst fracture is believed to be a successful method which can minimize the fused level, increase the stability, preserve motion segment and reduce the complication.
Back Pain ; Decompression ; Follow-Up Studies ; Spine* ; Transplants

STUDY DESIGN: Sixteen patients with congenital kyphoscoliosis were evaluated the clinical and radiological results according to the treatment method. OBJECTIVES: To provide a guideline for surgical treatment of congenital kyphoscoliosis SUMMARY OF LITERATURE REVIEW: Congenital kyphoscoliosis is an abnormal coronal and sagittal curvature of spine that is caused by the presence of vertebral anomalies, which causes a significant deformity and disability. Correction of the deformity is challenging and accompanied by high risk of complications. Many methods of operative treatment were recommended with various results. MATERIALS & METHODS: We reviewed 16 patients of congenital kyphoscoliosis who were operated from 1984 to 1997, and follow-up periods were over 12 months in all. The average age of surgery was 12 years (ranged from 4 to 20 years). Nine cases were operated by excision of quadrant hemivertebra through combined anterior & posterior approach and 6 cases were treated only by posterior instrumentation and one underwent posterior on bloc spondylectomy. RESULTS: The type of curves were thoracic in 5, thoracolumbar in 9, lumbar area in 2 patients. Average angle of kyphosis was 55 degree preoperatively, 25 degree postoperatively, and 39 degree at the follow up study. Average angle of scoliosis was 48 degree, 22 degree, and 27 degree, respectively. In 9 cases corrected by excision of quadrant hemivertebra; kyphotic angle was changed from 62degrees preoperatively, to 22degrees postoperatively and to 36 degree at the end of follow up study, while scoliotic angle was changed from 47degrees, to 12degrees and to 21degrees, respectively. In 6 cases corrected by posterior instrumentation kyphotic angle was changed from 52degrees preoperatively, to 33degrees postoperatively and to 48degrees degree at the follow up study, while scoliotic angle was changed from 53degrees, to 33degrees and to 37degrees, respectively. CONCLUSION: Excision of quadrant hemivertebra through combined anterior and posterior approach or posterior instrumentation were resulted in significant loss of correction during the remaining growth period due to the secondary change of adjacent vertebrae. So, to obtain better correction and to reduce the recurrence of deformity, more aggressive approach including the concept of three dimentional osteotomy involving the upper and lower adjacent curve may be considered.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Kyphosis ; Osteotomy ; Recurrence ; Scoliosis ; Spine