BACKGROUND: Fibrostenosis of large airway due to tuberculosis is one of the most perplexing clinical problems not only because it can lead to respiratory failure but also because of difficulty in the management. No one technique, such as balloon dilatation or insertion of self expandable metallic steno, has proved totally satisfactory in the management of fibrostenosis. We evaluated the effect of laser therapy in patient with severe fibrostenosis due to tuberculosis. METHOD: We classified the fibrostenosis to three types by bronchoscopic finding - the diaphragm type: stenosed by fibrous diaphragm, sparing the tracheobronchial wall, the collapse type: stenosed by collapse of the wall due. to destruction of the cartilage, and the combined type: stenosed by nonspecific inflammatory scar tissue within internal lumen with collapse of the wall. We have treated 10 patients complaining dyspnea due to with severe fibrostenosis of the diaphargm or the combined type using a neodymiumyttrium aluminum garnet(Nd-YAG) laser through a flexible bronchoscopy. RESULTS: Eight of the 10 cases improved after laser therapy and maintained during a follow up period of average 31.9 months. All of the cases undergoing laser therapy showed no serious complication to need the therapy. CONCLUSION: The results of our present study indicate that the Nd-YAG laser therapy is an effective and safe method for the management of selective tuberculous fibrostenosis.
Aluminum ; Bronchoscopy ; Cartilage ; Cicatrix ; Diaphragm ; Dilatation ; Dyspnea ; Follow-Up Studies ; Humans ; Laser Therapy ; Lasers, Solid-State* ; Respiratory Insufficiency ; Tuberculosis

Bacteriological study, including antibiotic sensitivity tests, of 81 patients with pyodermas such as impetigo, folliculitis, furuncle, carbuncle, cellulitis and acuete infectious eczematoid dermatitis, was carried out during 4 months period from June, 1980 to September, 1980 at the department of dermatology, Han Il Hospital. The results were as follows: 1) The causative agents of impetigo in 42 patients, were coagulase positive Staphylacoccus aureus in 33, p-hemolytic Streptococcus in 6 and both organisms in R (S. aureus and 3-hemolytic Streptococcus). Coagulase negative Stgaphylococcus was not found. 2) The causative agents of superficial and deep follicultis in 23 cases, were coagulase positive S. aureus in 12, coaulase negative Staphylococcus in 5, p-hemolytic Streptococcus in 4 and S. aureus and p-hemolytic Streptococcus in 3. 3) The causative agents of cellulitis in 2 cases, were coagulase positive S. aureus in 1, and coagulase negative Staphylococcus in 1. 4) The causative agents of acute infectious eczematoid dermatitis in l4 cases, were coagulase positive S. aureus in 6, coagulase negative Staphylococcua in 1, p-hemolytic Streptococcus in 2, and two organisms in 5 (4 cases were mixed).
Carbuncle ; Cellulitis ; Coagulase ; Dermatitis ; Dermatology ; Folliculitis ; Furunculosis ; Humans ; Impetigo ; Pyoderma* ; Staphylococcus ; Streptococcus

The palatal fracture results in deformity of the midface, as well as change in occlusion. However, no report was found on the incidence, treatment and results of palatal fracture in Korea. A retrospective review was done over 6 years and 11 patients(6.5%) with palatal fracture were determind out of 168 patients who had midfacial bone fractures without nasal bone fracture. According to the Hendrickson's classification, the number of patients with specific types of palatal fracture was described as follows; sagittal (2 cases), parasagittal (2 cases), para-alveolar (3 cases), transverse(3 cases) and complex(1 case). Le Fort I (6 cases), Le Fort II (7 cases) and mandible (6 cases) fractures were also associated. Open reduction and internal fixation was applied to all patients. Internal fixation consisted of pyriform or alveolar ridge stabilization and maxillary buttress stabilization. The rigid palatal vault stabilization was applied in one patient with midline split of the palate. The duration of intermaxillary fixation was shortened to less than 3 weeks from 4 to 6 weeks with rigid fixation. The palatal splint was used temporarily before internal fixation. All the patients showed good bony union and satisfactoryocclusion postoperatively. Open reduction and internal fixation showed satisfactory results from the aspects of stability, occlusion, patient convenience and final aesthetics. The following treatment model for palatal fracture according to the fracture type is proposed; 1) Alveolar type - close reduction or open reduction and selective alveolar ridge fixation and selective application of palatal splint, 2) Sagittal type - open reduction and internal fixation of the alveolar ridge, maxillary buttress and palatal vault. 3) Parasagittal type - open reduction and internal fixation of the pyriform aperture and maxillary buttress, as well as selective fixation of the palatal vault. 4) Para-alveolar type - open reduction and internal fixation of the alveolar ridge and maxillary buttress. 5) Complex type - open reduction and internal fixation of the alveolar ridge, maxillary buttress, pyriform aperture and continuous use of a palatal splint to bony union. 6) Transverse type - open reduction and internal fixation of the alveolar ridge and maxillary buttress.
Alveolar Process ; Classification ; Congenital Abnormalities ; Esthetics ; Fractures, Bone ; Humans ; Incidence ; Korea ; Mandible ; Nasal Bone ; Palate ; Retrospective Studies ; Splints

No abstract available.
Bronchiectasis*

The hypereosinophilic syndrome consists of peripheral blood eosinophilia of 1500/ mm3 or more without a known cause, plus signs and symptoms of organ eosinophilia. We report a case of hypereosnophilic syndrome with cutaneous manifestation. A 31 year-old female had intermittent fever, sbdominal pain, anemia, systolic murmur, hepatosplenomegaly, cheat discomfort, dry cough without rales, and skin-colored wheal on the trunk. Diagnoais of hypereosinophilic syndrome wss established by clinical findings, marked blood eosinophilia without a known cause, bone marrow aspiration and biopsy, liver scan, and histopsthologic findings of the skin.
Adult ; Anemia ; Biopsy ; Bone Marrow ; Cough ; Eosinophilia ; Female ; Fever ; Humans ; Hypereosinophilic Syndrome* ; Liver ; Respiratory Sounds ; Skin ; Systolic Murmurs

Reiters syndrome is classically described as the triad of urethritis, coijuctivitis, and arthritis along with the skin manifestation. of keratodermia blenorrhagica, circinate b lanitis and oral ulcetation. Since arthritis is now recognized as the only consistent component, iricr nplete forms consisting of characteristic arthritis associeited with one or more of these features and of dysentery are common, We reported a 48-year-old male who presented with a 3 years histor of significant arthralgia and psoriasiforrn skin involvemeni. He had neither an episode of dysentery not, history of sexual exposure before the onset of symptomes. Showed a correlation with the HLAB 7 tialotype. C-reactive protein levels were significantly elevated. He was treared with corticosteroid, pcycline, methotrexate and indomethacin for about 3 months resulting favorable improvement.
Arthralgia ; Arthritis ; C-Reactive Protein ; Dysentery ; HLA-B27 Antigen ; Humans ; Indomethacin ; Male ; Methotrexate ; Middle Aged ; Skin ; Skin Manifestations ; Urethritis

Lymphangiectasis(=acquirecl lymphangioma) ate dilated lymph caillaris and may be due to the obstruction of the lymphatic circulation from surgery, irradiation, chronic recurrent infection or trauma. The patient was a 5 years old girl who developed a straw-colcre, asymptomatic grouped vesicular mass resembling frog spawn measuring 9 cm in diameter the left axilla and arm, 2 months after the total excision of a previous lymphangiectatic mass. She had a history of previous open heart surgery at 2 years of age. Histopathologic findings showed large, irregularly shaped cysticalation lined by a single layer of endothelium in the superficial dermis. Immunohistochemical stainig showed vimentin positive and negative results in Factor VIII and HLA-DR antigen which was compatible with a lymphatic vessel.
Arm ; Axilla ; Child, Preschool ; Dermis ; Endothelium ; Factor VIII ; Female ; Heart* ; HLA-DR Antigens ; Humans ; Lymphangioma* ; Lymphatic Vessels ; Thoracic Surgery* ; Vimentin

Infantile acute hemorrhagic edema of the skin(IAHE) is a benign disease which affects infants between 4 months and 2 years of age and is characterized by palpable ecchymotic purpura and edema on the limb and face. We report a typical case of IAHE, which was presenting a cockade, annular, reticulated, and iris-like purpura and edema on the face and extremities in a 19-month-old male infant. We consider it to be a new disease category because its characteristics different markedly from HenochSchoenlein purpura in several clinical and histopathologic findings.
Edema* ; Extremities ; Humans ; Infant ; Male ; Purpura ; Skin*

Eosinophilic pustular folliculitis(EPF) is characterized by recurrent crops of pruritic follicular papules and pustules that occur mainly on the face, trunk, and extremities. Histologically, the major distinguishing feature is abundant eosinophils that invade sebaceous glands and outer root sheaths of hair follicles. We herein report a typical case of eosinophilic pustular folliculitis for promoting research of this rare disease.
Eosinophils* ; Extremities ; Folliculitis* ; Hair Follicle ; Rare Diseases ; Sebaceous Glands

The objective of this study is to examine the correlation between the tolylene concentration in the work environment of organic solvents and the concentration of hippuric acid in urine of workers exposed toluene, and to acquire the fundamental materials of workers' health care and to assist the assessment of the biological permissible exposure limit. The control groups are 72 workers who had never been exposed to toluene and the case groups are 101 workers who had been exposed to toluene. This study was conducted to examine the correlation between the concentration of toluene in work environment and workers' hippuric acid concentration, to investigate the complaint difference of subjective symptoms by means of questionnaire, between the case groups and control groups. The results and conclusions are as follows: 1) The highest mean concentration of toluene in the air is 544.13+/-7.75 ppm in the Printing Department of mixing organic solvents. The concentrations of the others are 463.27+/-5.24 ppm in Department of mixture for organic solvents, and 393.56+/-45.69 ppm in the Printing Department(1), and 248.38+/-45.16 ppm in the Printing Department(2), and 159.38+/-18.51 ppm in the Printing Department(3). 2) The highest mean concentration of hippuric acid in urine is 6034.84+/-1298.35 mg/l in the Printing Department with mixing organic solvents. The concentrations of the others are 4798.44+/-784.53 mg/l in Department of mixture of organic solvents, and 2883.06+/-701.90 mg/l in the Printing Department(1), and 1449.98+/-905.19 mg/l in the Printing Department(2), and 598.52+/-299.43 mg/l in the Printing Department(3). 3) As the toluene concentration in the work environment becomes higher, the concentration of hippuric acid in urine also becomes higher. It is found that the coefficient of correlation between toluene concentration and the concentration of hippuric acid are positive (r=0.868, Y=7.18X+349.57). 4) It is found that the case groups complain of much more subjective symptoms than the control groups.
Delivery of Health Care ; Surveys and Questionnaires ; Solvents ; Toluene*