Eczema herpeticum occurred in a patient with pemphigus foliaceus and esophageal cancer. The patient's initial skin lesions composed of large flaccid bullaes showed subcorneal bullae with typical acantholytic cells. Subsequent grouped small vesicles appeared widely on the erythematous base were diagnosed herpes simplex virus infection by Tzanck smear and histopathological findings. The patient died one week after the development of the widespread herpes virus infection.
Eczema* ; Esophageal Neoplasms ; Humans ; Kaposi Varicelliform Eruption* ; Pemphigus* ; Simplexvirus ; Skin

Thirty-seven patient who had forearm bone fracture were treated by four different methods at the Department of Orthopedic Surgery, Soonchunhyang University Hospital from Jan. 1979 to March 1982. The obtained results are as follow; 1. Nineteen cases out of 37 cases of the forearm bone fracture were both forearm bones, 10 cases were ulna and 8 were radius fracture. 2. Twenty-three cases out of 37 were closed and 13 cases were open fracture, respectably. 3. The applied treatment were manual reduction with cast immobilization, intramedullary naliing, plate and screw fixation and combined. 4. Mean duration of primary bone union of the forerm bone fracture which were treated by plate and screw was 12. 4 weeks, combined fixation was 12.8 weeks, intramedullary nailing was 15.3 weeks and that of manual reduction and cast was 16 weeks in order. 5. Functional result was classified according to the rating system of Smith and Sage. The best method was plate and screw and the worst was manual reduction and cast immobilization. 6. D.C.P. fixation seems to be one of the best method in this series. Combined method, in a way of D.C.P. for radius and I–M nailing for ulna, is a method when shortening of operation time is inevitable.
Adult ; Forearm ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Fractures, Open ; Humans ; Immobilization ; Methods ; Orthopedics ; Radius ; Radius Fractures ; Ulna

To evaluate the radiographic characteristics of osteochondritis dissecans (OCD) and useful parameter for predicting mechanical stability, we retrospectively analysed 26 plain radiographic examinations and seven MR imagings in 28 cases of OCD in 24 patients. Typical radiologic findings were osteochondral defect with sclerotic rim of variable thickeness and osteochondral fragment. Sites of osteochondral defect were medial (35.9%) or lateral (32%) femoral chondyle and medial (7.1%) or lateral (25%) side of talar dome. Sclerotic rim was seen in 24 cases (85%) and osteochondral fragments including nine loose bodies were seen in 21 cases (75%). The size of osteochondral defect with unstable fragment (average 2.05cm) and loose body (2.04cm) in the knee joint were similar to, but statistically larger than that with stable fragment (1.35cm). All osteochondral defects were well visualized on MR images. Abnormalities of articular cartilage and effusion in the interface between the parent bone and fragment were seem in five cases of which there were confirmed three unstable cases arthroscopically. We conclude that size of defect may be a good parameter for predicting mechanical stability and MRI may be useful in the diagnosis of OCD and determining the methods of treatment.
Cartilage, Articular ; Diagnosis ; Humans ; Knee Joint ; Magnetic Resonance Imaging ; Osteochondritis Dissecans* ; Osteochondritis* ; Parents ; Retrospective Studies

The authors evaluated the clinical significance of the bilirubin values as screening test means for predicting the occurrence of neonatal jaundice earlier after birth, by using the transcutaneous bilirubinometry which is known to measure the bilirubin values in a noninvasive, accurate and simple way. The results obtained were as follows: 1. In comparison between the test group(showing the symptom of a jaundice within 72 hours after birth) and the control group, there were found no statistically significant differences in terms of sex, delivery type, birth weight, gestational age and mother's age, while being found statistically significant differences in terms of transcutaneous bilirubin at birth(TcBbirth), transcutaneous bilirubin at 24 hours after birth(TcB24hr), increase in transcutaneous bilirubin per hour during the first 24 hours after birth(TcBin/hr) and transcutaneous bilirubin at 72 hours after birth(TcB72hr)(p<0,05). 2. The correlation test using the Pearson's coefficient produced statistically significant correlationship between each transcutaneous bilirubin index (TcBbirth, TcB24hr, TcBin/hr and TcB72hr) and serum bilirubin concentration at 72 hours after birth(B72hr)(p<0.05), while the result of the correlation test using the Spearman's roh showed statistically significant correlationship only between TcB24hr or TcB72hr and B72hr(p<0.05). As it was, the correlationship between TcB72hr and B72hr was highest in both Pearsons coefficient and Spearman's roh tests, followed by that between TcB24hr and B72hr. 3. In view of the ROC graph, the most effective means of predicting the occurrence of the neonatal jaundice was TcB72hr followed by TcB24hr, TcBbirth and TcBin/hr in their order. In particular, TcB24hr was conceived to be useful as screening test for determining an early discharge from the nursery within 48 hours. On the other hand, since the negative predictive value of TcBbirth, and TcB24hr is higher, the possibility that those infants showing a lower value of these indices may well be free later from a serious neonatal jaundice even if they should be discharged earlier from the nursery. In conclusion, those four indices predicting the neonatal jaundice in a simple, quick and noninvasive manner using the transcutaneous bilirubinometry were considered to be effective screening test means whereby any serious neonatal jaundice developed earlier after delivery can be successfully predicted.
Bilirubin ; Birth Weight ; Gestational Age ; Hand ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Jaundice, Neonatal* ; Mass Screening* ; Nurseries ; Parturition

Plain chest films are the most useful modality in diagnosis of primary lung cancer, but it is difficult tointerpret the radiologic findings by histological types. Authors reviewed chest films of 324 cases ofhistologically confirmed primary lung cancer from Jan. 1974 to April 1982 at Seoul National University. The resulsare as follows; 1. Incidence was most common in the 6th decade as 34.4%. Male to female sex ratio was 3.8:1 andthere was no sex difference in Adenocarcinoma. 2. Distrubution of histologic types of primary lung cancer asfollows; Squamous cell Carcinoma 50.6%, Small Cell Carcinoma 22.5% lange Cell Carcinoma 9.3% Bronchegenic adenocaranoma 10.5% Bronchioloalveolar Cell Carcinoma 1.9%. Adenosquamos Carcinoma 0,6%, Carcinoid Tumor 0.3%, AdenoidCystic Carcinoma 0.3%. 3. Radiologic findings by histologic types as follows; a) Squamous cell carcinoma commonlypresent as collapse(51.8%) peripheral mass (40.8%), pneumonitis(37.2%), hilar involvement(34.8%), and in singleabnormality, peripheral mass (44.4%). b) Small cell carcinoma commonly present as hilar involvement(78.1%),mediastinal wideing or mass (53.4%) and in single abnormality, hilar involvement(58.3%). c) Large cell carciomacommonly present as hilar involvement(50%) pneumonia(46.7%), collapse (40%), peripheral mass(36.7%) and in singleabnormality, large peripheral mass (33.3%). d) Bronchogenic Adenocarcinoma commonly present as peripheralmass(44.1%), collapse (41.2%), pleural effusion (35.2%) and in single abnormality, peripheral mass(50%). e)Solitary peripheral mass commonly present as lobulation(48%) and spiculated margin (51%), but no specific findingsby histologic types. Cavitary formation was most common in Squamous cell carcinoma.
Adenocarcinoma ; Carcinoid Tumor ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Female ; Humans ; Incidence ; Lung Neoplasms ; Lung ; Male ; Pleural Effusion ; Seoul ; Sex Characteristics ; Sex Ratio ; Thorax

Percutaneous nephrostomy for relief of obstruction and functional preservation of the kidney was effectivelyperformed 19 times in 14 patients for recent 1 year since July 1982 at Departement of Radiology in Seoul NationalUniversity Hospital. The etiologies of the total 14 obstructive uropathies were metastatic cervix cancer in 6-cases, metastatic rectal cancer in 2 cases, and metastatic bladder cancer, malignant mixed mesodermal tumor operimetrium, pyonephrosis, bilateral staghorn stone, UVJ obstruction of undertermined cause, congenital UPJobstruction in 1 case respectively. Percutaneous nephrostomy was done bilaterally in 1 case of congenital UPJobstruction and unilaterally in 13 cases. We used ultrasound as puncture guide in 13 cases and CT in 1 case. Majorcomplication was absent, but minor complications occured in 4 patients; gross hematuria persisting 24 hours (1case), catheter dislodgment after several seeks (2 cases ) and luminal narrowing after 3 months(1 case).Satisfactory outcomes were made in 13 patients except 1 patient who succumbed one day after the procedure due topreexisting severe sepsis. The procedure proved to be safe and effective alternative to operative nephrostomy insome patients with urinary obstruction.
Catheters ; Hematuria ; Humans ; Kidney ; Mesoderm ; Nephrostomy, Percutaneous ; Phenobarbital ; Punctures ; Pyonephrosis ; Rectal Neoplasms ; Seoul ; Sepsis ; Ultrasonography ; Urinary Bladder Neoplasms ; Uterine Cervical Neoplasms

The aim of percutaneous transhepatic biliary drainage(PTBD) is to decrease serum bilirubin level and promoteliver function in patient with biliary tract disease, especially obstruction by malignant disese. But somepatients showed persistent high serum bilirubin level or higher than pre-PTBD level. Percutaneous transhepaticbiliary drainage was performed in 341 patients of obstructive jaundice for 5 years from July, 1981 to July, 1986at departement of radiology, Seoul Natinal University Hospital. Follow up check of the serum bilibrubin level waspossible in 188 patients. Among them the authors analysed 32 patients who showed persistent high serum bilirubinlevel after PTBD. The results were as follows: 1. The male to female ratio was 3.4:1 and the age ranged from 33 to 75. 2. The causes of obstructive jaundice included 30 malignant diseases and 2 benign diseases. Malignant diseasewere 16 cases of bile duct carcinoma, 7 cases of pancreatic cancer and 7 cases of matastasis from stomach, colonand uterine cervix. Benign disease were 1 cases of common hepatic duct stone and 1 case of intrahepatic ductstones. 3. The msot common level of obstruction was trifurcation in 17 cases. 4. The most common indication ofPTBD was palliative drainage of obstruciton secondary to malignant tumor in 28 cases. 5. Change of serujmbilirubin level ratio(post-PTBD level) was 1.28, 1.22, 1.38, 1.51 in serial period of 1–3 days, 4–6 days, 1–2 week 2–3 week after PTBD. 6. Causes of persistent high serum bilirubin level after PTBD were 12 cases of partialdrainage of intrahepatic bile, 13 cases of hepatic dysfunction including 9 cases of metastatic nodule, 2 cases ofbiliary cirrhosis, 2 cases of multiple liver abscess, and 7 cases of poor function of cather including 4 cases ofhemobilia, 1 case of multiple intrahepatic stones, pyobilia and intraheptic Clonorchis sinensis.
Bile ; Bile Ducts ; Biliary Tract Diseases ; Bilirubin ; Cervix Uteri ; Clonorchis sinensis ; Drainage ; Female ; Fibrosis ; Follow-Up Studies ; Hepatic Duct, Common ; Humans ; Jaundice, Obstructive ; Liver Abscess ; Male ; Pancreatic Neoplasms ; Seoul ; Stomach

In spite of numerous clinical and patho-anatomical studies made in the past, there are still different opinions concerning the machanism of low back pain. We have focused attention on the posterior structures as an alternative source of low back pain with leg radiation, so we have studied and analyzed the effect of the injection of mixture methylprednisolone acetate suspension (20-40 mg) and local anesthetic (1% procaine, 1cc) into the posterior facet joint. In this paper, the records of 41 in-patients who have chiefly compalned of low back pain wlth leg radiation and have been treated at the Departmnt of Orthopedics, Han Yang University Hospital from May, 1979 to April, 1980 were studied. The following results are recognized by observing and analyzing their chief complalnts, physical examination, x-ray findings, the effect of facet block and the follow-up studies after facet block. 1. Low back pain with sciatica was 1.9 times more common in female than male, and frequently occured In 4th to 6th decades (75.7%). 2. The abnormal findings of plain x-rays were osteophyte (35.6%), marginal sclerosis (27.1%), narrowing of disc spce (18.6%), lumbarization (11.9%), spina bifida (3.4%), and tropism (3.4%). 3. The most frequent site of abnormal posterior facet joints was at the level between 4th and 5th lumbar vertebra (42.9%), and all were on lower lumber region. 4. The range of lumbar motion was decreased in the cases of abnormal posterior facet jolnt or degenerative changes, and it was especially more decreased in the combined cases. 5. The effect of facet block was as follows; In initial assessment, 29 of 41 cases (70.7%) showed complete rellef and one month later, 16 of 29 cases (55.2%) showed continuous rolief, 4 of 18 cases (22.2%) which were followed for 3 more months showed complete relief. 6. The effect of facet block according to pain character was as follows: 20 of 26 cases (76.9%) of numbness, 5 of 6 cases (83.3%) of dull pain and 4 of 8 cases (50.0%) of radlating pain were completely relleved and a case of burning pain was partially relleved.
Burns ; Female ; Follow-Up Studies ; Humans ; Hypesthesia ; Leg ; Low Back Pain ; Male ; Methylprednisolone ; Orthopedics ; Osteophyte ; Physical Examination ; Procaine ; Sciatica ; Sclerosis ; Spinal Dysraphism ; Spine ; Tropism ; Zygapophyseal Joint

OBJECTIVES: This study was conducted to investigate that the chronic noise exposure is associated with decreased serum magnesium concentrations and evaluate whether decreased serum magnesium is associated with noise induced hearing loss. METHODS: One hundred seventy-eight male workers exposed to noise were selected and classified three groups by the degree of hearing loss. Hearing threshold levels were less than 30 dB at 1,000 Hz or less than 40 dB at 4,000 Hz in group I, more than 30 dB at 1,000 Hz or more than 40 dB at 4,000 Hz and 15 dB and less of pure tone average(PTA: (500 Hz+1,000 Hz+2,000 Hz)/3) in group II, more than 30 dB at 1,000 Hz or more than 40 dB at 4, 000 Hz and over 15 dB of PTA in group III. RESULTS: Serum magnesium concentrations were 2. 42+/-0. 26 nc/dt in group I, 2. 35+/-0.23 mg(dl in group II, 2.26+/-0.24 ne/dl in group III, respectively and significantly different between group I and group III (p<0. 01). It was negatively correlated with duration of the noise exposure as correlation coefficient(r) of -0.194 (p<0.05). Analysis of the multiple regression on hearing threshold levels showed that serum magnesium, diastolic blood pressure, duration of the noise exposure were statistically significant at 4,000 Hz(p<0.05). While only age was statistically significant at 1,000 Hz(p<0.05). CONCLUSIONS: These results suggest that chronic noise exposure may induces decrease in serum magnesium concentrations and that its decreased concentration is related with noise induced hearing loss.
Blood Pressure ; Hearing Loss* ; Hearing* ; Humans ; Magnesium* ; Male* ; Noise*

BACKGROUND AND OBJECTIVES: Altered environmental gravity, including both hypo- and hypergravity, may result in space adaptation syndrome. To explore the characteristics of this adaptive plasticity, the expression of immediate early gene c-fos mRNA in the vestibular system following an exposure to hypergravity stimulus was determined in rats. MATERIALS AND METHOD: The animals were subjected to 2 G force (two-fold earth's gravity) stimulus for 3 hours, and were examined at post-stimulus hours 0, 2, 6, 12, and 24. Real time reverse transcription-polymerase chain reaction (RT-PCR) was adopted to analyze temporal changes in the expression of c-fos mRNA. RESULTS: The hypergravity stimulation produced the expression of c-fos mRNA in the vestibular ganglion, medial vestibular nucleus, inferior vestibular nucleus, hippocampus, vestibulocerebellum, and vestibular cortex. The peak expression occurred at hour 6 in the animals hypergravity-stimulated for 3 hours. Bilateral labyrinthectomy significantly attenuated the degree of up-regulation in c-fos mRNA expression. MK-801, an NMDA receptor antagonist, also significantly attenuated the degree of up-regulation in c-fos mRNA expression. CONCLUSION: These results indicate that the adaptive neuroplasticity in response to an altered gravity occurs in the vestibular-related organs in the central nervous system, in which peripheral vestibular receptors and NMDA receptors play an important role.
Animals ; Central Nervous System ; Dizocilpine Maleate ; Ganglion Cysts ; Genes, fos ; Gravitation ; Hippocampus ; Hypergravity* ; N-Methylaspartate ; Neuronal Plasticity* ; Plastics ; Rats ; Receptors, N-Methyl-D-Aspartate ; RNA, Messenger ; Space Motion Sickness ; Up-Regulation ; Vestibular Nuclei