Spinal stenosis is defined as any type of narrowing of the main spinal canal, nerve canal or foramina caused by bony or sourrounding soft tissues. Its pressure symptoms are characterized by ill localized back pain, and usually bilateral chronic sciatica. During the past 80 years, the knowledge subjected to the spinal stenosis has been inproved but still many problems are remaining to be solved. Recently, the diagnosis and treatment of spinal stenosis have been facilitated due to introduction of computerized tomographic scanning apparatus. During the period of 3 years, from May 1979 to March 1982, we experienced 40 cases of spinal stenosis at Han Gang Sacred Heart Hospital and Gang Nam Sacred Heart Hospital. In study of this 40 cases clinical and radiological evaluation were made and obtained following result (25 cases of which were operated on). 1. The most common type was degenerative one (50%) 2. There were 16 males and 24 females (4:5) 3. The age distribution showed a peak incidence is the third decade (25%) 4. The most common chief complaint on admission was ill localized chronic sciatica (50%) 5. Decompressive surgery was carried on 25 cases such as; Laminectomy only (8%), Posterolateral fusion (20%), Both Laniinectomy and posterolateral fusion (72%) 6. The longest follow-up was 3 years and the shortest one was 4 months and the average was one year and four months. The outcome of follow-up were; excellent (52%), good (40%), fair (8%), poor (0%).
Age Distribution ; Back Pain ; Diagnosis ; Female ; Follow-Up Studies ; Heart ; Humans ; Incidence ; Laminectomy ; Male ; Sciatica ; Spinal Canal ; Spinal Stenosis

Traditionally, many kinds of mechanical bonding techniques were used for bonding resins to the surface of the metal alloys. If there is a seperation between resin and metal junction by stress accumulation and temperature change of oral cavity, the cracks or crazing may occur, accompanied by failure of resin bonding to metal. This study was designed to compare the shear bond strength of the type IV gold alloy and Cr-Co alloy surfaces treted with various methods and thermocyling. Universal Instron (Model 1000) and scanning electron Microscope (JEOL, Japan) was used to record the shear bond strength of 5 groups. Forty specimens were made for each group ; group 1 was treated with sandblasting only, group 2 was coated with V-primer after sandblasting, group 3 was coated with Metal primer, group 4 wase coated with MR Bond and group 5 was coated with silane. After treated with various methods, thermocycling was done for half of the each group. The surfaces of failed pattern were observed with SEM. The results were as follows: 1. Shear bond strength of the group 1 was lower than that of another groups in type IV gold alloys and bond strength of the group 1, 2 were lower than that of group 3, 4, 5 in Cr-Co alloys. 2. Shear bond strength of the gold alloy with resin was higher than that of Cr-Co alloy when specimens were coated with V-primer. 3. Shear bond strength of the Co-Cr alloys with resin was higher than that of gold alloys when specimens were coated with Metal primer. 4. The bond strength of all specimens did not decreased significantly after thermocycling. 5. Adhesive failures were found in group 1 and Cr-Co alloy in group 2, but adhesive and cohesive failures ere found in another groups.
Adhesives ; Alloys ; Gold Alloys ; Mouth ; Polymethyl Methacrylate*

No abstract available.
Korea* ; Scrub Typhus*

Basal cell carcinoma (BCC) in the skin is the most common malignancy worldwide. Surgery is still the golden standard treatment for BCCs, but it may be intensive and sometimes excessively destructive. Imiquimod is a member of novel class of immune response modifiers which stimulate or enhance both the innate immune system and cell-mediated immune response and approved by FDA for treating anogenital wart. A 73-year-old male patient was presented with 8x10cm sized erythematous scaly, peripheral ridging patch with central black colored crust on the back. Histopathological finding showed masses of various shapes and sizes composed of basalioma cells. He refused surgery treatment, so we tried 5% imiquimod cream (AldaraTM, 3M) topically three times weekly for the duration of 7 months. Although lesions had incompletely resolved, clinically and histopathologically improvement was observed. Herein we report a case of basal cell carcinoma which responded to imiquimod.
Aged ; Carcinoma, Basal Cell* ; Humans ; Immune System ; Male ; Skin ; Warts

Allopurinol (4-hydroxypyrazolo[3, 4-d]pyrimidine) is a xanthine oxidase inhibitor and is widely used in the treatment of hyperuricemia. Allopurinol hypersensitivity syndrome (AHS) includes a prolonged illness initially manifested by fever, a prominent cutaneous reaction, eosinophilia, hepatic abnormalities, and decreased renal function. Two patients in our study had a decreased renal function; one due to bilateral polycystic kidneys and the other due to bilateral ureteral stones. Both had received allopurinol for asymptomatic hyperuricemia. Whilst taking this medication, they showed a generalized erythematous, maculopapular eruption with fever, leukocytosis, eosinophilia, a further decrease of renal function and prolonged severe hepatic abnormalities. One patient showed an improvement after they stopped taking allopurinol and were treated with steroids, however, died, due to combined giant cell pneumonia. However, the other patient did improve when they stopped taking allopurinol.
Allopurinol* ; Eosinophilia ; Fever ; Giant Cells ; Humans ; Hypersensitivity* ; Hyperuricemia* ; Leukocytosis ; Pneumonia ; Polycystic Kidney Diseases ; Steroids ; Ureter ; Xanthine Oxidase

Merkel cell carcinoma is a rare, aggressive skin cancer that occurs most frequently in the elderly on sun-exposed areas. However, any possible cutaneous or mucosal sites may also be involved. It usually presents as a rapidly- growing, painless, single red or purple colored cutaneous papule, nodule or indurated plaque that may elude diagnosis until histopathologic examination. We report a case of an 83-year old female patient who presented with a 3 x 3.5 cm sized, skin-colored, painful nodule on the left mandibular angle area. A new red nodule had combined on the original lesion after 6 months, and showed unusual clinical manifestation. Microscopically, the tumor cells were uniform with round to oval-shaped nuclei and scanty cytoplasm, and they showed a trabecular arrangement. In immunohistochemical studies, the patient was reactive to cytokeratin-20, and focally reactive to NSE and synaptophysin.
Aged ; Aged, 80 and over ; Carcinoma, Merkel Cell* ; Cytoplasm ; Diagnosis ; Female ; Humans ; Keratin-20 ; Skin Neoplasms ; Synaptophysin

BACKGROUND: Alopecia areata (AA) is an autoimmune condition of the hair follicle, resulting in bald patches. The details of the pathogenesis of AA still remain unclear. However, several recent studies have indicated that AA is an organ-specific autoimmune disease in which T cells (especially CD8+T cells), as well as certain cytokines (especially Th1 cytokines, IL-1, IFN-gamma, and TNF-alpha) may play an important role in its development. OBJECTIVE: The purpose of this study was to characterize the cytokine response in the peripheral blood of patients with AA, before and after treatment. METHODS: Twenty one active AA patients and 10 healthy people were evaluated in this study. The levels of 3 cytokines, including IFN-gamma, IL-10, and IL-16, in all subjects were measured at the first visit and 3 months after treatment. RESULTS: The levels of IFN-gamma, IL-10, and IL-16 in the AA group were significantly elevated (p<0.05) compared to the normal control group. The level of IFN-gamma showed an excellent response to treatment (hair regrowth>75%), and was decreased in comparision to the level before treatment (p=0.003). There was no difference in the cytokine levels after PUVA, DPCP, or a combination therapy of PUVA and DPCP (p>0.05). CONCLUSION: The results suggest the involvement of IFN-gamma in the AA process. Also, IFN-gamma could be a potential marker for treatment. Even though different treatments have different mechanisms, IFN-gamma is considered to be a common pathway for alopecia areata treatment.
Alopecia Areata* ; Alopecia* ; Autoimmune Diseases ; Cytokines ; Hair Follicle ; Humans ; Interleukin-1 ; Interleukin-10* ; Interleukin-16* ; T-Lymphocytes

Since Steeg, et al.(1988) identified NM23/NDP kinase as non -metastasis gene, other multiple functions of have reported. One of them, Postel, et al.(1993) suggested that transcription factor PuF, being encoded by NM23 -H2/NDP kinase gene, interacts with nuclease hypersensitive element located upstream of the c -myc gene. C -myc amplification and activation can be present in squamous cell carcinoma of the head and neck as well as in an increased metastatic propensity for individual tumor. To clarify the role of NM23/NDP kinase on c -myc expression, comparison of these two gene expressions in cell lines was done. No direct correlation of expression kinetics was found. A plasmid containing human c -myc fragment was cloned upstream of chloramphenicol acetyltransferase (CAT) gene. When murine melanoma cell line was cotransfected with a murine NM23 -M2 including expression vector and c -myc CAT, CAT activity was elevated, while no change of CAT activity was found in the cotransfectant of human NM23 -H2 and c -myc CAT. Data suggest that murine NM23 -M2 gene transactivates c -myc gene indirectly with a cellular factor in murine cell line which dose not work with human NM23 -H2 gene. Additionally, we found same kinetics of NM23 -H2/NDP kinase and c -myc expression change correlated with proliferation of PLC/PRF/5 which was induced by HGF.
Animals ; Carcinoma, Squamous Cell ; Cats ; Cell Line* ; Chloramphenicol O-Acetyltransferase ; Clone Cells ; Gene Expression ; Head ; Humans ; Kinetics ; Melanoma ; Neck ; Phosphotransferases* ; Plasmids ; Transcription Factors ; Transcriptional Activation

BACKGROUND: There are many therapeutic methods for treating vitiligo including PUVA, narrow-band UVB, topical corticosteroids, tacrolimus, calcipotriol, intralesional injection of steroids or oral corticosteroids, but there is no reliable treatment. Autologous epidermal grafting has been used by several authors, and is reported to be a surgical method which has minimal adverse effect, little risk of scarring, and is easily performed in the clinic. OBJECTIVE: The purpose of this study was to evaluate the effectiveness of autologous epidermal grafting in the treatment of vitiligo, and investigate both patient satisfaction, and any adverse effects. METHODS: The evaluation was conducted using 44 patients (48 cases) with intractable vitiligo who had been treated by autologous epidermal grafting using suction blistered epidermis. We investigated both patient satisfaction, and any problems or adverse effects during the procedure. The efficacy was rated as excellent (repigmentation >75%), good (repigmentation 75-50%), fair (repigmentation 50-25%), or poor (repigmentation <25%). Efficacies according to clinical type, recipient sites, the preparation method for recipient sites, the disease duration at operation and the duration after operation were also investigated. RESULTS: Eexcellent repigmentation was shown in 77.1% of the patients. The epidermal graft was more effective in treating segmental vitiligo, and when the disease duration was more than 36 months. Patient satisfaction was more than 75%. CONCLUSION: The autologous epidermal graft is an effective treatment modality. However, for more effective results and a high level of patient satisfaction we think doctors should only treat stable vitiligo. They should explain the operation procedure, side effects, and postoperative PUVA therapy in detail to the patient.
Adrenal Cortex Hormones ; Blister ; Cicatrix ; Epidermis ; Humans ; Injections, Intralesional ; Patient Satisfaction ; PUVA Therapy ; Steroids ; Suction ; Tacrolimus ; Transplants* ; Vitiligo*

Hemangiopericytoma of the bone is a rare malignant tumor, which usually originates in the femur and the pelvic bone of the adult. Heman-giopericytoma is often not a primary tumor but a secondary tumor associated with extraskeletal metastasis. We experienced a case of hemangiopericytoma, which originated from the retroperitoneum and had multiple metastasis to the scapula, proximal femur, cervical spine, and which converted from low grade to high grade.
Adult ; Femur ; Hemangiopericytoma* ; Humans ; Neoplasm Metastasis* ; Pelvic Bones ; Scapula ; Spine