Since the classical description of pyoderma gangrenosum by O'Leary, Brunsting and Goecgerman in 1930, a considerable nurnber of reports of this clinical entity has appeared. Pyoderma gangrenosum is a painful, ulcerative disease of the skin. The ulcers are highly characteristic in clinical feature as necrotic pus covered lesions having purple colored and elevated border with red halo. Frequently, the ulcers heal with a cribriform type of scar. Its pathogenesis is not understood clearly. We present a case of pyoderma gangrenosum deveIoped on the leg in a 11-year old boy occurring with rectal poIyp, the association of whicb is very rare in world wide. And this case has the evidence of cell mediated immunity impairment characterized by no response to mumps antigen and purified protein derivatives, and not to be activively sensitized by DNCB.
Child ; Cicatrix ; Dinitrochlorobenzene ; Humans ; Immunity, Cellular ; Leg ; Male ; Mumps ; Polyps* ; Pyoderma Gangrenosum* ; Pyoderma* ; Skin ; Suppuration ; Ulcer

Chymopapain and collagenase are well known chemonucleolytic agents for lumbar disc herniation. However, these enzymes have serious problems occasionally, such as severe neurotoxicity or anaphylaxis even fatal to patients. Chondroitinase ABC, a metabolic product of Proteus vulgaris, has a specific action on the proteoglycans of the nucleus pulposus, but rarely no effect on the intrathecal nerve tissues of vessels. Seventy eight rabbit lumbar discs were evaluated radiographically and histologically after injection of chondroitinase ABC 40U/ml per disc and compared with buffer injected group and nonigected control group. There was considerable disc space narrowing of the chondroitinase ABC injected group which was verified radiographically and histologically(p < 0.01). A zone of Safranin 0 depletion was present in the ventral anulus fibrosus adjacent to the nucleus pulposus in all treated discs, indicating proteoglycan loss. On electron microscopic findings there were collapse of chondrocytes and notochordal cells. All of these findings are corresponding to the evidence that chondroitinase ABC may be another chemonucleolytic agent by decreasing disc volume and thereby decompressing spinal cord or nerve roots. All histologic effects of chondroitinase ABC were confined to intervertebral disc tissues. Chondroitinase ABC deserves to be a study object for the alternative of chemonucleolysis.
Anaphylaxis ; Chondrocytes ; Chondroitin ABC Lyase ; Chymopapain ; Collagenases ; Humans ; Intervertebral Disc ; Intervertebral Disc Chemolysis ; Nerve Tissue ; Notochord ; Proteoglycans ; Proteus vulgaris ; Spinal Cord

The coexistence of the variants of porokeratosis is very rare. We report a case of coexistence of linear porokeratosis with disseminated superficial actinic porokeratosis (DSAP). A 43-year-old wornan first noticed a brownish papule on the left side of groin in early infancy. She developed multiple discrete or confluent keratotic plaques in linear fashion on the left lower extrernity and trunk in childhood. These leaions became pruritic in summer. Two years ago, she developed multiple scattered small annular lesions on the face and forearms. Her family history showed no abnormalities. Biopsy specimene from the groin and trunk showed eornoid lamella.
Adult ; Biopsy ; Forearm ; Groin ; Humans ; Porokeratosis*

BACKGROUND: McKeown first described two autopsy cases of esophageal small cell carcinoma (SMC) in 1952; about 230 cases have since been reported in the literature. Small cell carcinoma has been reported to account for 0.4% to 7.6% of all esophageal malignancies. SMC of the esophagus as regarded as having a poor prognosis with frequent systemic dissemination. Choice of treatment remains controversial. MATERIAL AND METHOD: From August 1987 to December 1998, a review of the records and histologic sections of 8 patients with primary small cell carcinoma of the esophagus seen in 11 years was undertaken. RESULT: Small cell carcinoma of the esophagus constituted 1.5% of all esophageal cancers. The median age was 61.5 years (range from 42 to 71 years). Seven patients were male, tumor was mainly located in the middle and lower thirds (6 cases) of the esophagus. Pure SMC is 5 cases, and mixed SMC is 3 cases. Operative procedure were as follow: transthoracic esophagectomy with thoracic or cervical reconstructon in 7 patients, transhiated esophagectomy with cervical reconstruction in one. The operative death was none. Adjuvant chemotherapy was performed in 7 patients except one who had poor general condition. Recurrence was observed in 4 patients (mediastinal LN, abdominal LN, SCN, bone). The overall median survival was 15.9 months. Only one patient survived for more than 5 years. CONCLUSION: We considered that esophageal SMC should be regarded as a systemic disease, and multimodality treatment including chemotherapy should be used. Surgery may be offered in selected patients to manage local disease as part of a chemotherapy based treatment program.
Autopsy ; Carcinoma, Small Cell* ; Chemotherapy, Adjuvant ; Drug Therapy ; Esophageal Neoplasms ; Esophagectomy ; Esophagus* ; Humans ; Male ; Prognosis ; Recurrence ; Surgical Procedures, Operative

No abstract available.
Bronchopulmonary Sequestration*

Purpose: To analyze the causes and to prevent dislocations of the hip joint that occur in patients who underwent revisions of total hip arthroplasties by changing only the polyethylene liners and femoral heads, subsequent to primary total hip arthroplasties. Materials and Methods: We evaluated 28 patients who underwent acetabular component revisions of total hip arthroplasties subsequent to primary total hip arthroplasties. The average age of the patients was 55 years old and all 28 patients had operations through the posterolateral approach. In 17 of the cases, the acetabular cups, polyethylene liners, and femoral heads were changed; in 10 cases, just the polyethylene liners and femoral heads were changed; and in 1 case, only the polyethylene liner was changed. Results: We observed 7 cases of hip dislocations that occurred among a total of 28 cases after revisions of total hip arthroplasties. In all 7 cases, the polyethylene liners and femoral heads were changed, but not the acetabular cups. In additional, in all 7 cases of dislocation, the patients were non-compliant and started weight-bearing prematurely after revisions of the total hip arthroplasties Conclusion: We observed new dislocations in the 7 cases in which the polyethylene liners and femoral heads were changed. The main reasons were inadequate soft tissue tension and hip joint laxity. Therefore, it is necessary to increase the neck length, use elevated rim polyethylene liners, readjust the acetabular cups to their optimal positions, and apply hip abduction braces to patients early after revision of total hip arthroplasties in order to lessen the danger of dislocations.
Acetabulum* ; Arthroplasty ; Braces ; Dislocations* ; Head ; Hip ; Hip Dislocation ; Hip Joint ; Humans ; Neck ; Polyethylene ; Risk Factors* ; Weight-Bearing

The application of the arthroscope to the shoulder joint has evolved in recent years for the purpose of diagnosis and treatment. This paper presented 11 cases with various shoulder diseases treated by arthroscopy during the period from January, 1984 to September, 1985 in the Department of Orthopedic Surgery, College of Medicine, Soon Chun Hyang University. The advantages of the arthroscopy were as follows: 1. The arthroscopy made it easier to diagnose the unsolved cases by direct biopsy on the pathologic lesions in the joint. 2. The damage on the inside and outside of the shoulder joint was minimal and the post-operative incision scar was acceptable cosmetically. 3. The limitation of the joint motion did not remain due to early exercise post-operatively. 4. The complications such as infection, neurovascular injury, scuffing of joint cartilage, etc. could be avoided.
Arthroscopes ; Arthroscopy ; Biopsy ; Cartilage ; Cicatrix ; Diagnosis ; Joints ; Orthopedics ; Shoulder Joint ; Shoulder

No abstract available.

No abstract available.
Azoospermia* ; Sarcoidosis*

The effects of naloxone on circulation and respiration were observed in 20 surgical patients during general anesthesia. Respiratory and circulatory changes were measured up to 15 minutes after naloxone injection at 5 minute intervals. Blood pressure and heart rate were slightly increased after naloxone injection during l5 minutes, but were not significantly increased. Arterial carbon dioxide partial pressure and pH were considerably decreased after naloxone injection during 15 minutes. Respiratory rate, tidal volume, and minute volume were markedly increased after naloxne injection during l5 minutes. In conclusion naloxone doses of 0.01 mg/kg seemed not to significantly change circulation and respiration during general anesthesia and naloxone slightly increased circulatory and respiratory function.
Anesthesia, General* ; Blood Pressure ; Carbon Dioxide ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Naloxone* ; Partial Pressure ; Respiration* ; Respiratory Rate ; Tidal Volume