No abstract available.
Arthroplasty* ; Joints*

Sporotrichosis is a chronic infection that follows accidental implantation of the fungus Sporothrix schenckii into the skin. The infection begins with skin trauma under conditions when conidia may be present. A 48-year-old woman presented with a 5-year history of an 8X 12 cm sized, centrally depressed, erythematous plaque on the left wrist. She had been treated with antifungal agents at an other hospital for about 6 months but there was no improvement. The histopathological findings showed an infiltration of mononuclear cells and tuberculoid structures on the whole dermis and subcutis. According to the histopathological findings and clinical manifestations, she was diagnosed as having lupus vulgaris. There was much improvement of the lesion after antituberculous therapy. However, 2 months later she developed asymptomatic multiple erythematous papules around the lesion of lupus vulgaris and along the lymphatic drainage of the left arm. The histopathological findings of the newly developed lesion showed a granulomatous reaction and an infiltrate of acute and chronic inflammatory cells. Moist and creamy colonies were changed into brown-to-black ones with a leathery appearance with age. This appearance and clinical manifestations confirmed the diagnosis of lymphocutaneous sporotrichosis. This clinical appearance reflects that the sporotrichosis developed on the ulcerative lesion or biopsy site of lupus vulgaris.
Antifungal Agents ; Arm ; Biopsy ; Dermis ; Diagnosis ; Drainage ; Female ; Fungi ; Humans ; Lupus Vulgaris* ; Middle Aged ; Skin ; Spores, Fungal ; Sporothrix ; Sporotrichosis* ; Ulcer ; Wrist

PURPOSE: To report a case of corneal perforation caused by non-infectious corneal ulcer in a patient with toxic epidermal necrolysis (TEN). METHODS: A 29-year-old female visited the hospital with bullous lesions on the erythematous body surface. She also had severe conjunctivitis and keratitis in both eyes. She had been taken antibiotics and analgesics for nasopharyngitis. The patient was diagnosed with TEN. Although she was hospitalized and treated in the department of internal medicine, the left cornea was severely necrotized and became thinner. Slit-lamp examination showed focal descematocele in the central cornea. The result of corneal culture was negative and corneal infiltration that would suggest an infectious ulcer was not observed. RESULTS: The patient was in poor general health because of pneumonia. We performed tectonic amniotic membrane transplantation to prevent corneal perforation. Fibrovascular tissues were growing on the amniotic membrane from the surrounding conjunctiva. However, they did not cover the descemetocele area. Her general condition continued to worsen and she was transferred to the intensive care unit. The cornea was perforated and the patient died of septic shock. CONCLUSIONS: Corneal perforation may occur in a patient with TEN without secondary bacterial infection. Therefore, patients with TEN need to be informed of this serious complication and the possible need for more intensive treatment.
Adult ; Amnion ; Analgesics ; Anti-Bacterial Agents ; Bacterial Infections ; Blister ; Conjunctiva ; Conjunctivitis ; Cornea ; Corneal Perforation* ; Corneal Ulcer* ; Female ; Humans ; Intensive Care Units ; Internal Medicine ; Keratitis ; Nasopharyngitis ; Pneumonia ; Shock, Septic ; Stevens-Johnson Syndrome* ; Ulcer

No abstract available.
Pregnancy* ; Purpura*

No abstract available.

Serum immunoglobulins from Israeli carp (I. carp) were purified using affinity chromatography. Fish were immunized with purified mouse IgG, and the specific fish antibodies purified from the immune serum on a mouse IgG-immobilized agarose gel. Rabbit anti-carp Ig (Raclg) antibodies were produced following hyperimmunization with mlgG specific I. Carp Ab. SDS-PAGE analysis under reducing condition showed that I. carp Ig (clg) were composed of two u-like heavy chains with about 82 and 50 kD, respectively and one light chain with about 25 kD. On immunoblotting analysis, however, Raclg failed to react with light chain. When both protein A and protein G purified normal clg were compared with mlgG specific clg, no significant structural differences among them were observed. To investigate if there is any homology between other fish Ig molecules, cross-reactivity of Raclg against Ig molecules from 6 different fish sera and mouse control serum was checked on immunoblotting analysis. As a result, Raclg responded to only carp and tilapia Ig molecules, indicating that both tilapia and carp are very closely associated, especially, in the genetic basis of immunoglobulin structure. In flow cytometry study, Raclg appeared to recognize 45.8% of carp Ig+, 14.5% of catfish Ig+ and <5% of tilapia Ig+ cells. The result suggest the heterogeniety between receptor immunoglobulins on B-like lymphocytes and soluble immunoglobulins in serum. It is crucial to obtain pure fish immunoglobulins to produce reagent antibodies as tools for the study of their specific immune response.
Animals ; Antibodies ; Carps* ; Catfishes ; Chromatography, Affinity ; Electrophoresis, Polyacrylamide Gel ; Flow Cytometry ; Immunoblotting ; Immunoglobulin G ; Immunoglobulins* ; Lymphocytes ; Mice ; Sepharose ; Staphylococcal Protein A ; Tilapia

PURPOSE: This study was designed to verify intermediate-term functional and radiological results of limb salvage operation using endoprosthetic replacement system (MUTARS(R)) used in patients with a malignant bone tumor. MATERIALS AND METHODS: Thirty one cases which used MUTARS(R) tumor prosthesis were reviewed. The mean age of the patients was 49.2 years and the mean follow up was 39.8 months. We retrospectively reviewed complications, and evaluated functionally and radiologically by Enneking functional score, ISOLS radiological implants evaluation system at last follow-up. RESULTS: 3 patients had died of disease, distant metastasis was seen in 4 patients and local recurrence was seen in 1 patients. Complications were developed in 12 patients. (infection 6, leg length discrepancy 2, aseptic loosening 2, periprosthetic femoral fracture 1, screw loosening 1) Mean value of total functional scores were 81.2% in proximal femur, 77.4% in distal femur, 78.1% in proximal tibia, and 80.2% in proximal humerus. The overall radiological result was relatively satisfactory. CONCLUSION: Our results suggest limb salvage with the MUTARS(R) endoprosthesis is successful with good functional and radiological results. But we should be careful with complications such as infection.
Extremities ; Femoral Fractures ; Femur ; Follow-Up Studies ; Humans ; Humerus ; Leg ; Limb Salvage ; Neoplasm Metastasis ; Prostheses and Implants ; Recurrence ; Retrospective Studies ; Tibia

PURPOSE: To compare the ability of scanning laser polarimetry with variable corneal compensation (GDx-VCC) and Stratus optical coherence tomography (OCT) to detect photographic retinal nerve fiber layer (RNFL) defects. METHODS: This retrospective cross-sectional study included 45 eyes of 45 consecutive glaucoma patients with RNFL defects in red-free fundus photographs. The superior and inferior temporal quadrants in each eye were included for data analysis separately. The location and presence of RNFL defects seen in red-free fundus photographs were compared with those seen in GDx-VCC deviation maps and OCT RNFL analysis maps for each quadrant. RESULTS: Of the 90 quadrants (45 eyes), 31 (34%) had no apparent RNFL defects, 29 (32%) had focal RNFL defects, and 30 (33%) had diffuse RNFL defects in red-free fundus photographs. The highest agreement between GDx-VCC and red-free photography was 73% when we defined GDx-VCC RNFL defects as a cluster of three or more color-coded squares (p<5%) along the traveling line of the retinal nerve fiber in the GDx-VCC deviation map (kappa value, 0.388; 95% confidence interval (CI), 0.195 to 0.582). The highest agreement between OCT and red-free photography was 85% (kappa value, 0.666; 95% CI, 0.506 to 0.825) when a value of 5% outside the normal limit for the OCT analysis map was used as a cut-off value for OCT RNFL defects. CONCLUSIONS: According to the kappa values, the agreement between GDx-VCC deviation maps and red-free photography was poor, whereas the agreement between OCT analysis maps and red-free photography was good.
Adult ; Aged ; Cross-Sectional Studies ; Diagnostic Techniques, Ophthalmological ; Female ; Fundus Oculi ; Humans ; Male ; Middle Aged ; Nerve Fibers/*pathology ; Retina/*pathology ; Retrospective Studies ; *Scanning Laser Polarimetry ; *Tomography, Optical Coherence ; Young Adult

The displaced femoral neck fracture continues to be a difficult problems such as high percentage of avascular necrosis and non-union. Compression hip screw was designed to aliow firm impaction at the time of operation and secondarily, for continued impaction if resorption occurs at the fracture line during healing. 22 cases of femoral neck fracture treated by compression hip screw in the department of orthopaedic surgery at National Medical Center were analyzed, and results were as follow. 1. The average of patient was fifty-three years, and man was predominant. 2. Average 8.9 days was elapsed from initial injury to hospital, and good results were observed in the cases of operation within 3 days. 3. The end results were good when the fragment was reduced within 165°–180° of Garden's angle in A-P film and 20° of anterior and posterior angulation in lateral film. 4. The good results were observed in the position of the screw center and low in A-P film, and center and posterior in lateral film. 5. The positive findings of the intraosseous-venogram was observed in 6 weeks from operation and apparent in all cases done after 6 months. 6. Bony union was obtained within 5.9 months, and avascular necrosis was established in 29 months. 7. Developed 3 avascular necrosis, 1 non-union, and 2 degenerative arthritis of 22 cases.
Femoral Neck Fractures ; Femur ; Hip ; Humans ; Neck ; Necrosis ; Osteoarthritis

Over twenty per cent of adult knees have a synovial plica which always has possibility of changes into pathologic synovial plica symptomes and signs resembling those of other common internal derangement of the knee joint. Especially the young active patient who has a history of trauma to the knee should once be suspected incarcerated synovial plica not only the possibility of internal derangement. Four cases of symptomatic synovial plica experienced by authors are reported with available references.
Adult ; Humans ; Knee ; Knee Joint ; Patella