The following case report concerns a rare bone metastasis of malignant melanoma occurring in the 4th and 5th lumbar spines and adjacent iliac crests and sacrum. A 42-year-old woman was admitted with a 6 months history of severe lumbago ar right flank pain radiating to right lower extremity. Preoperative X-ray studies revealed stag horn stone in the right renal pelvis as spondylolisthesis of the 5th lumbar spine with bilateral isthmic defects. On physical examinations, dark brown colored nevus was noted at lower lumbar regio which was removed and subjected for biopsy. Surgical exploration demonstrated a melanoma metastasis to have invaded the spine process, lamina and transverse processes of the 5th lumbar spine, adjacent L4 and sacru and iliac crests. Surrounding soft tissues, however, were apparently normal. Postoperatively course of the patient seemed to follow a rapidly terminal clinical cours.
Adult ; Animals ; Biopsy ; Female ; Flank Pain ; Horns ; Humans ; Kidney Pelvis ; Low Back Pain ; Lower Extremity ; Melanoma ; Neoplasm Metastasis ; Nevus ; Physical Examination ; Sacrum ; Spine ; Spondylolisthesis

Penicillin is still the first choice of drug in the treatment of gonorrhea. The ever lowering sensitivity of Neisseria gonorrhoeae to penicillin and the emergence of PPNG (Penicillinase Producing Neisseria Gonorrhoeae) in the Far East and other parts of the world neceessitate reapprisal of treatrnent schedules with penicillin for gonococcal infections. In Korea, no authentical study in this regard has been done recently. The presence of intracellular gram r.egative diplococci in urethral smear as weIl as the presence of oxidase positive typical, round, convex, smooth, glistening, tratmslucent, greyish colonies of 0.5 to 2mm in diameter a 24 hours composed of grarn negative diplococci are used for presump'ive evidence of gonococccal infection 224 male patients with acnte uncomplicated gonococal infections were treated one of following regimens. Regimen A: 4.8mega unit combicillin (3.6mega unit procaine penicillin+l.2 mega unit sodium penicillin) i.m.. preceded by 1gm probenecid p.o., Regirnen B: 4.8 mega unit procaine penicillin i.m. preceded by 1gm probenecid P.O. Regimen A showed 14 failures(11.3% arnong 124. Regimen B showed 19 failures (19%) among 100 It is suggested that in Korea sesnsitivity to penicillin of Yeisseria gonorrhoeae is quite low.
Appointments and Schedules ; Far East ; Gonorrhea ; Humans ; Korea ; Male ; Neisseria ; Neisseria gonorrhoeae ; Oxidoreductases ; Penicillin G Procaine ; Penicillins* ; Probenecid ; Procaine ; Sodium

No abstract available.
Esophageal and Gastric Varices* ; Hypertension, Portal*

BACKGROUND: Experience of awareness and recall during general anesthesia would be most distressing for patients. Especially for the cesarean section, medical team must consider both maternal awareness and fetal safety. Authors tried to know the possibility of propofol use as induction and maintenance agent of anesthesia for the cesarean section in respect of maternal awareness, recall and fetal safety. METHODS: Forty patients (ASA physical status 1, 2) were allocated randomly to either propofol (n=20) (P) or thiopental-enflurane (n=20) (T-E) group. We checked B.P, pulse rate, and the incidence of maternal awareness using the isolated forearm technique (IFT). The postoperative interview was conducted between 12~24h after operation. RESULTS: The incidence of maternal awareness signaled by flexing fingers in response to voice commands were significantly lower in the T-E group (20% after induction, no response during other times) than the P group (45% after induction, then 35%, 30%, after 5, 10 min delivery respectively). Seven patients had postoperative recall of introspective awareness in the P group but no patients in the T-E group. The 1 min Apgar score of the newborn were significantly lower in the P group than the T-E group but both groups were within normal range. CONCLUSIONS: Our date indicated that, in comparison with thiopental-enflurane, propofol infusion (6 mg/kg/h) were associated with a greater incidence of awareness during surgery and recall.
Anesthesia* ; Anesthesia, General ; Apgar Score ; Cesarean Section* ; Female ; Fingers ; Forearm ; Heart Rate ; Humans ; Incidence ; Infant, Newborn ; Pregnancy ; Propofol ; Reference Values ; Voice

PURPOSE: This is to evaluate the clinical results and radiologic changes of the mandibular condyle fractures following the open reduction and fixation using the Lag-screws introduced by Eckelt and Martin Co. MATERIALS & METHODS: Ten patients who had been treated by the Lag-screw fixation for the unilateral fracture of the mandibular condyle at the high level and followed up for over 6 months(ranged from 24 weeks to 33 weeks). The incisal opening by time elapsed, displacement of the fragments, bone resorption around the Lag-screws, operating time consumed, and untoward complications were evaluated. The data were tested by repeated measure ANOVA and paired t-test. RESULTS: The maximum mouth opening was increased by time as follows ; 20.2+/-2.8mm soon after reduction. 26.3+/-3.9 at the 2nd week, 37.7+/-4.2mm at the 4th week, 44.4+/-4.3mm in PO 2 months(P<0.05). The bone resorption at anterior to lag-screw nut was measured to 1.9+/-1.0mm, while the posterior resorption was 2.6+/-1.9mm on average(P<0.05). Reduction and fixation of the fragments by Lag-screw were done within 80 minutes including the skin closure. The clicking sound of the TMJ(40%), weakness of the marginal branch(60%) were complicated but transient for 4-8weeks. There were no signs of bony displacement, but loosening of screws were observed at the time of removal. CONCLUSION: Open reduction and fixation with condylar Lag-screw(Martin co., Germany) thru the ramus can be a good option to reduce the high level(Kruger's Level III & IV) fracture of the mandibular condyle with anterior or medial displacement. However, this procedure requires 2nd surgery to remove the devices and it may complicate improper reduction for delayed fractures and in case of 's' curved mandibular ramus.
Bone Resorption ; Humans ; Mandibular Condyle* ; Mouth ; Nuts ; Prognosis* ; Skin

The gate control theory was proposed by Melzack & Wall in 1965. This theory implies that selective stimulation of cutaneous afferent fibers of large diameter inhibits pain. Transcutaneous electrical stimulation(TNS) is a practical employment of this concept. TNS was used on 14 herpes zoster patients to relieve associated pain. Good effeet was obtained in 13 patients. They experienced relief of their pain for 1-4 hours after 20 minutes of application. TNS has many advantages over analgesic drugs in the control of pain in herpes zoster.
Analgesics ; Employment ; Herpes Zoster* ; Humans

No abstract available.
Bacteria, Anaerobic*

We report a case of pityriasis rotunda occurring in a patient with pancreatic adenocarcinoma. The patient was a 64-year old female who had a pancreatic adenocarcinoma. The skin lesions were asymptomatic, multiple, various sized (1 to 15cm in diameter), isolated or confluent and finely scaly light brownish to grayish colored patches on the lower abdomen, back and thigh. Histopathologic findings shawed mild hyperkeratosis, atrophy, loss of granular layer, increased melanin pigments in basal layer of the epidermis and mild perivascular monocytic infiltration in the upper dermis.
Abdomen ; Adenocarcinoma* ; Atrophy ; Dermis ; Epidermis ; Female ; Humans ; Melanins ; Middle Aged ; Pancreas* ; Pityriasis* ; Skin ; Thigh

No abstract available.

BACKGROUND: Calcinosis cutis may occur when connective tissue is abnormal (dystrophic), or where calcium or phosphate levels in the blood are high(metastatic); alternatively, there may be no obvious underlying cause(idiopathic). The exact incidence of calcinosis cutis in dermatologic patients is not well-kniown and the pathomechanism of it remains to be elucidated. OBJECTIVE: This study was performed to analyze the incidence, clinical and histopathological features of calcinosis cutis. METHODS: We studied 72 patients with calcinosis cutis who visited our department between January 1985 and December 1996. The patients were classified into 3 types (dystrophic, metastatic, and idiopathic) and were analyzed clinically and histopathologically. Results : The results were summerized as follows; 1. There were 60 cases(83.3%) and 12 cases(16.7%) of the dystrophic and idiopathic types, respectively but the metastatic type was not observed. The frequency of dystrophic calcification in individual disorders was 88.2% in pseudoxanthoma elasticum, 66.7% in trichilemmal cyst and dermatomyositis, and 64.6% in pilomatrichoma. 2. In the idiopathic type, it was common in females aged over 50 years and the mean duration of lesions was 2.8+/-2.0 years. The predilection site was the flank(5 cases) and most of the lesions(7 cases) showed skin-colored nodules 3. Histopathologically, calcified material of the idiopathic type was located predominently in the dermis(10 cases) and was present as large masses surrounded by a foreign body reaction. 4. In the dystrophic type, calcified deposits were noted predominently within the shadow cells of pilomatricoma, in the degenerated elastic fibers of pseudoxanthoma elasticum, and in the keratinized area of basal cell carcinoma, squamous cell carcinoma, trichilemmal cyst, and epidermal cyst. Foreign body reactions with giant cells and mononuclear cell infiltrations were often found around large deposits of calcium. Conclusion : The incidence of calcinosis cutis in dermatologic patients is relatively low, but a variety of disorders can be associated with cutaneous calcification. Therefore, dermatologists should be familiar with the different forms of cutaneous calcification and the dermatoses that manifest them.
Calcinosis* ; Calcium ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Connective Tissue ; Dermatomyositis ; Elastic Tissue ; Epidermal Cyst ; Female ; Foreign Bodies ; Foreign-Body Reaction ; Giant Cells ; Humans ; Incidence ; Pilomatrixoma ; Pseudoxanthoma Elasticum ; Skin Diseases