Toxic epidermal necrolysis(T.E.N.) is a toxic erythema of the skin that undergoes epidermal necrolysis and peding so that it appears to have been scalded. There seem to be two basic form of T.E.N. In children, the deavage of the epidermis that results from an acantholytic-dyskeratotic cytolytic process is in the malpighian or granular layer and is usually induced by a staphylococci toxin. In adult, it is characterized by a full-thicknees cytolytic cleavage of skin above the basal layer and is usually precipitated by a drug. The authors observed a 17 year-old male with T.E.N. He began to notify the erythematous skin lesion with burning sensation on the whole body surface at 12 hours after oral administration of some drugs for common cold and developed the characteristic flaccid bullous and denuded lesions with tenderness within next 20 hours.
Administration, Oral ; Adolescent ; Adult ; Burns ; Child ; Common Cold ; Epidermis ; Erythema ; Humans ; Male ; Sensation ; Skin

Between sept. 1982 and June 1985, the authors have performed arthroscopic debridement on 32 knees of 30 patients with primary osteoarthritis of the knee. Operative procedures including lavage, partial meniscectomy, excision of shelf, partial or total synovectomy of the anterior compartment, debridement of the articular cartilage, removal of loose bodies and multiple drilling of the articular cartilage were variously combined case by case. The follow-up period was between 18 and 52 months, with on average of 30.6 months. Clinical results were evaluated with the modified method of Sprague, III and were classified “Excellent”. “Good”, “Fair” and “Poor”. The data were analyzed by Fishers exact test to clarify the relationship between clinical results and various preoperative factors. The results were as follows: l. Of the total 32 knees, results were “excellent” in 17(53.1%), “good” in 9(28.1%), “fair” in 3 (9.4%) and “poor” in 3(9.4%) knees respectively. Satisfactory results, including “excellent” and good, were achieved in more than 3/4 cases(81.2%) . 2. Of the 3 “poor” cases, 2 cases seemed to be affected by major depression and the other one case had no specific cause to be considered. 3. The unsatisfactory cases, including “fair” and “poor” cases, commonly had degenerative changes of patellofemoral joint arthroscopically although the correlation between it and the results were not significantly proved statistically(P>0.05). 4. The correlation between amount of effusion, degree of degeneration of articular cartilage and amount of fibrinoid debris were not significantly proved statistically(P>0.05). 5. The correlation between clinical results and amout of effusion. degreq or site of degeneration of articular cartilage, degree of flexion contracture, meniscal tear, synovectomy, debridement of articular cartilage and number of operative procedures could not be significanly proved statistically. In conclusion, arthroscopic treatment of the primary osteoarthritis of the knee shows relatively satisfactory results in most cases with fewcomplications and a short rehabilitation period, and the procedure could be recommended as a process inbetween conservative treatment and definitive treatment such as total knee replacement. But any specific relationship between clinical results and various preoperative factors could not be proved statistically. The clinical results seemed to be attected by individual unknown factors and further precise analysis and long term follow-up will be necessary to clarify them.
Arthroplasty, Replacement, Knee ; Arthroscopy ; Cartilage, Articular ; Contracture ; Debridement ; Depression ; Follow-Up Studies ; Humans ; Knee ; Methods ; Osteoarthritis ; Patellofemoral Joint ; Rehabilitation ; Surgical Procedures, Operative ; Tears ; Therapeutic Irrigation

Nevus Iipomatosus cutaneous superficialis (NLCS) is a very rare skin disease which usually is present at birth. The lesion consists of grouped papules and nodules which on histological examination show the presence of ectopic fatty tissue in the corium. The authors observed a 17year old female with NLCS. She noticed soft papules and nodules on the coccygeal area since 8 years old. We confirmed this case by clinically and histopathological findings which showed the strands or islands of mature fatty tissue within papillay, mid and lower dermis.
Adipose Tissue ; Child ; Dermis ; Female ; Humans ; Islands ; Nevus* ; Parturition ; Skin Diseases

OBJECTIVE: The purpose of this study was to evaluate the therapeutic efficacy and toxicity of high dose cisplatin-cyclophosphamide combination chemotherapy on patients with primary epithelial ovarian cancer. METHODS: A review of 63 patients previously diagnosed as primary epithelial ovarian cancer after initial operation and histology at Pusan National University Hospital from Jul. 1993 to Jun, 1997 was performed. Patients were received the combination chemotherapy including cisplatin 100mg/m2/day and cyclophosphamide 750mg/m2/day, repeated 6 cycles every 4 weeks. The mean age was 48 years old, and previous surgical procedures were total abdominal hysterectomy and bilateral salpingo-oophorectomy with omentectomy. The patients were classified into FIGO stage and pathologic results. RESULTS: The clinical response rate was 100% in the FIGO stage Ic patients with PC combination chemotherapy, 100% in stage II, 53.5% in stage III, and 25% in stage IV. The overall response rate was 69.8%. The 3-year survival rate according to the treatment groups was 93.3% in stage Ic group, 60% in stage II, 50% in stage III and 0% in stage IV. The mean survival duration was 34.6 months. Hematologic toxicities in cisplatin-cyclophosphamide chemotherapy were neutropenia and anemia. Nausea and vomiting were the most common side effects and occurred in 96.8%. Most of the toxicities were grade 1 and 2. CONCLUSION: The combination chemotherapy with cisplatin-cyclophosphamide is relatively safe and effective method in the treatment of primary epithelial ovarian cancer.
Anemia ; Busan ; Cisplatin* ; Cyclophosphamide* ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Hysterectomy ; Middle Aged ; Nausea ; Neutropenia ; Ovarian Neoplasms* ; Survival Rate ; Vomiting

A modern development of ambulatory ECG monitoring gave great advances in the diagnosis and evaluation of various cardiac conditions. Fifteen cases of ischemic heart disease, 11 cases of nonischemic heart disease, 5 cases of noncardiac disease and 9 cases of normal healthy subjects were studied from January 1980 to July 1981 in national Medical Center, with the following results: 1) The heart rate was decreased during night time, with less decreasing tendency in patients with ischemic heart disease. 2) Among 30 cases, including 12 patients with ischemic heart disease, who didn't show arrhythmia on routine 12 lead ECG, 12 cases, including 6 patients with ischemic heart disease, showed arrhythmia on Holter monitoring. 3) Among 5 cases with ischemic heart disease who showed premature ventricular contraction on day time monitoring, 2 cases didn't show premature ventricular contraction on nigh time monitoring. 4) The S-T segment and T wave were changed during night time in 2 cases with ischemic heart disease and in 2 normal subjects. From these results, we could assert that Holter monioring or ambulatory ECG tracing would be a good method for diagnosis and evaluation of ischemic heart disease, and other cardiac conditions. Several another studies with this equipment have to be performed and would give more distinctive outcomes.
Arrhythmias, Cardiac ; Diagnosis ; Electrocardiography ; Electrocardiography, Ambulatory* ; Heart Diseases ; Heart Rate ; Humans ; Myocardial Ischemia ; Ventricular Premature Complexes

Cnical analysis of pyogenic hip in children was made on 18 patients, who had been admitted in the dept. of orthopedic surgery, Seoul Red Cross Hospital from Jan. 1972 to Dec. 1976. The following results were obtained: 1. The incidence of the pyogenic hip was slightly higher in male than female as 11 versus 7 and it was higher in the age group of 5~7 years and 11~13 years. 2. The most of the etiological microorganism was coagulase positive stap hylococcus aureus. 3. Penicillin was resistant to staphylococcus aureus in about 75% of cases, and orbenin and Lincocin were most sensitive in 58.2% of cases. 4. All cases treated with arthrotomy and irigation or drainage, but prognosis was different by method of surgical approach and method of treatment. 5 In reference with progoosis early hospitalization, early diagnosis and early treatment were counted to be imperative as known.
Child ; Coagulase ; Drainage ; Early Diagnosis ; Female ; Hip ; Hospitalization ; Humans ; Incidence ; Lincomycin ; Male ; Methods ; Orthopedics ; Penicillins ; Prognosis ; Red Cross ; Seoul ; Staphylococcus aureus

BACKGROUND: The present study was carried out in association with neutrophilic respiratory burst in the lung in order to clarify the pathogenesis of acute respiratory distress syndrome(ARDS) following acute severe hemorrhage. Because oxidative stress has been suggested as one of the principal factors causing tissue injury, the role of free radicals from neutrophils was assessed in acute hemorrhage-induced lung injury. METHOD: In Sprague-Dawley rats, hemorrhagic shock was induced by withdrawing blood(20 ml/kg of B.W) for 5 min and the hypotensive state was sustained for 60 min. To determine the mechanism and role of oxidative stress associated with phospholipase A2(PLA2) by neutrophils, the level of lung leakage, pulmonary myeloperoxidase(MPO), and the pulmonary PLA2 were measured. In addition, the production of free radicals was assessed in isolated neutrophils by cytochemical electron microscopy in the lung. RESULTS: In hypotensive shock-induced acute lung injury, the pulmonary MPO, the level of lung leakage and the production of free radicals were higher. The inhibition of PLA2 with mepacrine decreased the pulmonary MPO, level of lung leakage and the production of free radicals from neutrophils. CONCLUSION: A. neutrophilic respiratory burst is responsible for the oxidative stress causing acute lung injury followed by acute, severe hemorrhage. PLA2 activation is the principal cause of this oxidative stress.
Acute Lung Injury* ; Free Radicals ; Hemorrhage ; Lung ; Lung Injury ; Microscopy, Electron ; Neutrophils* ; Oxidative Stress ; Phospholipases A2* ; Phospholipases* ; Quinacrine ; Rats, Sprague-Dawley ; Respiratory Burst* ; Shock, Hemorrhagic

No abstract available.
Cholesteatoma*

In order to obtain more accurate pathological diagosis of the angiographically occult vascular malformations(AOVM) of the brain in the future and to examine the clinical, and radiological characteristics and management outcome of the AOVM, the authors retrospectively reviewed the 30 cases of AOVM in which patients were treated at our instituition during the past 11-year period. The pathological specimens were reexamined, and the lesions were reclassified according to the strict histopathological criteria. The clinical characteristics, radiological features, the difference between the clinical and pathological diagnosis and the management results were studied. There were 15 males and 15 females. The mean age at the time of diagnosis was 31 years, ranging from 3 months to 74 years. The clinical diagnosis were arteriovenous malformation(AVM) in 18 cases, cavernous angioma in 11 and mixed lesion in 1. The pathologic diagnosis was AVM in 14 cases, cavernous angioma in 2, and unclassified lesion in 12. The common presenting symptoms were hemorrhage(53.3%), seizure(20.0%) and mass lesions(20.0%). Twenty four lesions were located at the supratentorial region, 4 at cerebellum and 2 at pons. Most of the lesions were revealed as high density masses with minimal or no contrast enhancement on CT and a core of mixed signal intensity with a peripheral low signal intensity rim on T2-weight MRI. Preoperative clinically significant recurrent hemorrhages were noted in 8 cases and one of them showed marked deterioration of the neurological functions a result of recurrent hemorrhage. Twenty-eight patients underwent surgery and all except one improved neurologically. Six patients initially presented with seizure showed improvement in seizure frequency after operation. One patient who had the lesion at the pons was managed by a radiosurgery and one patient who refused surgery was managed by a conservative method. The conservatively managed patient and another patient who was not found AVM at the hematoma cavity during initial operation rebled about 2 years later following diagnosis and surgery. Thse findings suggest that the complete microsurgical excision, which prevents rebleeding and suppresses seizure activity, represents the treatment of choice for patients with clinically symptomatic AOVM. Avoiding the injury of the vascular mass, obtaining sufficient biopsy specimen during surgery, together with careful histopathological observation of operative specimens through complete clinical-radiological-pathological context are necessary to obtain more accurate pathological diagnosis.
Arteriovenous Malformations ; Biopsy ; Brain ; Cerebellum ; Diagnosis ; Female ; Hemangioma, Cavernous ; Hematoma ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Male ; Pathology ; Pons ; Radiosurgery ; Retrospective Studies ; Seizures ; Vascular Malformations*

No abstract available.
Aneurysm ; Arteriovenous Malformations* ; Brain* ; Intracranial Aneurysm*