Clofazimine (Lamprene or B668) is a phenazine congener that is used in leprosy, and the patients treated with the drug may develop red discoloration, dark brown pigmentation and ichthyotic skin. The authors observed 181 leprosy patients who had developecl discoloration, pigmentation and ichthyotic skin during clofazimine therapy, as well as disappearance of the pigmentation after stop of it. The results are summarized as follows: 1) Reddish discoloration was most frequently observed 2 weeks after beginning treatment in 66 patients (50. 4%), which showed earlier in the higher dosage grow up, 2) Dark brown pigmentation was iviost frequently observed 4 weeks after beginning treatment in 64 patients (48. 9%), which showed earlier in the higher dosage group. R) For histopathological evaluation of pigmentation, various ataining rnethods were used. On unstained frozen sections, yellow brown crystals were scattered in the dermis of both discolored and pigmented skin, and in H R E stain pigments, melanin were niarkedly increased in the epidermal basal layer and a, faint yellow brown. ghost was seen in dermis of pigmented skin. With fat stains using oil-red-0 and Sudan III, reddish amorphous materials were scattered in and around the cytoplasm of the macrophages c>f the pigmented skin. 4) Ichthyotic skin was observed in 97 patients, and most frequently 2 and R months after beginning treatment in 26 patients (26. 8%), but it was never observec1 in 34 of all patients in spite of a continuous intake of the drug for more than a. year. -countinue-
Clofazimine* ; Coloring Agents ; Cytoplasm ; Dermis ; Frozen Sections ; Humans ; Leprosy* ; Macrophages ; Melanins ; Pigmentation ; Skin ; Sudan

PURPOSE: We studied CT findings of bronchioloalveolar carcinoma that manifestated varied clinical and radiologic characteristics. MATERIALS & METHODS: We studied presenting radiographic patterns and their characteristics and secondary findings of histologically proven 30 cases of bronchioloalveolar carcinomas on chest CT scan. RESULTS: Bronchioloalveolar carcinoma appeared radiologically as a solitary nodule(19 cases), consolidation (7 cases), and multinodules(4 cases). A solitary nodular type shows irregular or spiculated borders, peripheral or subpleural location, heterogenous density, pleural tags, pseudocavitation, and sometimes rim-enhancement of mass. A consolidation type shows air-brochogram, pseudocavitation and CT anglogram within homogenous low attenuated consolidated lung. Hilar and mediastinal lymphadenopathy as secondary findings of bronchioloalveolar carcioma appeared frequently(43.3%). Even in a solitary nodular form, hilar & mediastinal lymphadenopathy was noted in 36.8% and follow-up study in 6 cases showed lung-to-lung metastasis with 14.7 months in mean metastasis duration. CONCLUSION: It is difficulty in diagnosis of bronchioloalveolar carcioma with clinical or plain radiographic features alone because of theis variability. We found that CT scan can help the diagnosis of this tumor. We also found out that a solitary form of bronchioloalveolar carcioma as well as diffuse form does not have a good prognosis.
Adenocarcinoma, Bronchiolo-Alveolar* ; Diagnosis ; Follow-Up Studies ; Lung ; Lymphatic Diseases ; Neoplasm Metastasis ; Prognosis ; Tomography, X-Ray Computed

Idiopathic calcinosis of the scrotum consists of multiple asymptomatic nodules of the scrotum without any underlying disease. We presented a case of idiopathic calcinosis of the scrotum and compared it with other reported cases in Korea, A 47-year-old farmer had slowly growing, asymptomatic, hard scrotal nodules which were 1cm in diameter and 6 in number for about twenty years. KUB X-ray film showed two radiopaque densities on the scrotal area. Histopathological finding revealed amorphous, basaphilic masses with acicular clefts which were confirmed as calcification in Von Kossa stain and surrounding foreign body granulomatous inflammatory reaction.
Calcinosis* ; Foreign Bodies ; Humans ; Korea ; Middle Aged ; Scrotum* ; X-Ray Film

The authors performed microsurgical reconstruction by free cutaneous or myocutaneous flaps transfer in 104 cases, who were sustained of extensive soft tissue injuries on their extremities by accident. These 104 cases were operated in 6 years from 1980 to 1986 and were consisted of 47 cases of latissimus dorsimyocutaneous free flaps, 36 cases of scapular free flaps, 18 cases of dorsalis pedis sensible free flaps, and 3 cases of groin flaps. Most of them were males(80 cases) and were in third decade(28 cases). The youngest case was 2-year-old baby and the oldest one was 76-year-old woman. The traffic accident was the most frequent cause of injuries(55 cases), and the others were burn, industrial injuries, and cultivator accidents. Most of the microsurgical reconstruction were performed in lower extremity injuries(81 cases), especially below the ankle joints(65 cases). The average dimension(width and length) of free flaps were 7.3×14.3cm in latissimus dorsi free flaps, 5.6×8.2cm in scapular free flaps, and 4.5×5.9cm in dorsalis pedis free flaps. The dorsalis pedis free flaps were successful in 100%, the scapular free flaps were in 83.3%, the latissimus dorsi myocutaneous free flaps were in 89.4%, and the groin free flaps were in 33.3%, And the overall viability of 104 free flaps was 87.5%.
Accidents, Traffic ; Aged ; Ankle ; Burns ; Child, Preschool ; Extremities ; Female ; Free Tissue Flaps ; Groin ; Humans ; Lower Extremity ; Myocutaneous Flap ; Soft Tissue Injuries ; Superficial Back Muscles

BACKGROUND: Recently elderly people have increased in Korea and increased demands of medical service. This study was carried out to identify diseases and health service utilization patterns of geriatric inpatients to provide better understanding and basis planning to meet the needs of expanding geriatric population. METHOD: We use data of `Patient Survey in Korea` in 1999 and analyzed characteristics of disease structure and utilization patterns of health care service of 54,013 cases of discharged patients aged 65 years or more. RESULT: The proportion of the elderly in total discharged patients is 14.7%. Male to female ratio is 1:1.3 and most common age group was between 65 and 69 years old. 84.2% of elderly patients were admitted at secondary or tertiary health care facilities. The most common disease in geriatric inpatients is malig- nancy in male and vascular disease in female. The average duration of hospitalization is 14.2 days. They stay longer than the nation wide average hospital length and stay longest when they are admitted by mental and behavioral disorders. CONCLUSION: Geriatric patients are admitted mostly with chronic degenerative diseases such as neoplasm and vascular disease. Elders prefer to be admitted to tertiary hospitals and oriental hospitals. They stay more in hospital.
Aged ; Delivery of Health Care ; Female ; Health Services* ; Hospitalization ; Humans ; Inpatients* ; Korea ; Male ; Tertiary Care Centers ; Vascular Diseases

Acardic twining is a rare congenital anomaly, usually in monozygotic twins. This condition is characterized by the absence or rudimentary development of fetal hear, and associated with various anomaly(especially with anecephalus). The acardiac malformations are uniformly fatal in the affected twin, and mortality in the co-twin is as high as 55%. We recently experienced a case of acardius acephalus associated with a normal term male infant, so present with a brief review of the literature.
Humans ; Infant ; Male ; Mortality ; Twins* ; Twins, Monozygotic

A case of multiple myeloma associated with adenocarcinoma of the stomach was review. A 59-year, old Korean man had been abmitted to St. Mary's Hospital in January 1984, with chief complaint of posterior neck pain, and intermittent headache for one year prior to amission. Osteo lytic punched-out lesions were noted on skull and other skeletal x-ray films. Bone marrow aspirates revealed diffuse infiltration of mature and immature plasma cells. Laboratory findings revealed anemia and Bence-Jones proteinuria. Immunoelectrophoresis revealed findings consistent with IgA-lamda type multiple myloma. Alkylating agents and steroids were tried with some clinical improvements. In August 1985, the patient revisited outpatient clinic with chief complaints of epigastric pain and neck mass. Endoscopic biopsy and excision biopsy of the cervical lymph node were performed. By microscopic examination, adenocarcinoma of the stomach and metastasis of multiple myeoma to the supraclavicular lymph nodes were confirmed. Subtotal gastrectomy was performed. By gross and microscopic revealed metastasis to the regional lymph nodes.
Male ; Humans ; Adenocarcinoma ; Biopsy ; Neoplasm Metastasis

Giant cell tumor of tendon sheath(GCTTS) is a benign mesenchymal lesion composed of cytologically bland mononuclear cells admixed with multinucleated giant cells. Our report describes the clinical and pathologic features of a 36-year-old female's tumor with a two years history over the lateral side of the left little finger, Especially, we could observe the characteristic thre types of cells in an electromicroscopic study, histiocyte-like cells, fibroblast-like cells and multinucleated giant cells. In lmmunohistochemical studies, we demonstrated that the tumor cells of GCTTS exhibit a phenotype consistent with histiocyte differentiated to Langerhan's cell.
Adult ; Fingers ; Giant Cell Tumors* ; Giant Cells* ; Histiocytes ; Humans ; Phenotype ; Tendons*

The skin defects or sensory impairment of the fingers, especially at the critical area for prehension(tips of thumb, index and middle fingers) should be reconstructed for the better function of hand. In our department, we performed neurovascular island pedicle flap transfer for the purpose of reconstruction of sensibility and skin defect simultaneousely to the critical area. 1. Since 1978, we had performed neurovascular island pedicle flap transfer in 14cases, among which 9 cases were followed for more than one year. 2. The operation was performed for the reconstruction of thumb in 8 cases, and index in 4 cases. The most common cause of injury was crushing by machine(8 cases). 3. The island flap was transferred from middle finger(9 cases) and from ring finger(4 cases). 4. Recovery of the protective sensation at the recipient sites was good or fair after one year, but reorientation and two point discrimination were poor. 5. Cold intolerance was developed in 3 cases and callosity was formed in 2 cases. 6. In all cases, the transferred flaps were good in circulation status and durability. 7. It is considered that the neurovascular island pedicle flap is an accepted method of restoring skin coverage as well as sensation to a localized tactile area in the hand.
Callosities ; Discrimination (Psychology) ; Fingers ; Hand ; Methods ; Sensation ; Skin ; Thumb

The development of the microvascular surgery revolutionalized the reconstructive surgery of the lower ext tremity. Especially, the defects of the heel and sole, the weight bearing area, were quite difficult and complicate to reconstruct by conventional methods. Many papers reported successful resurfacing the heel pad by free cutaneous or myocutaneous flaps. However, only few reports were conceming the late results of the reconstructed free flaps. The authors studied the histological and histochemical changes of the free flaps under the weight bearing stress in 10 cases. 1. The authors reconstructed 10 cases of the heel pad defects by dorsalis pedis free Aaps (5 cases) and latissimus dorsi myocutaneous flaps(5 cases). 2. Before transfer, the homy layer was very thin(about 0.16–0.2 mm) and had an arrangement of basket-weave pattem in both flaps. Until one year after transfer, this layer was wom out (0.02–0.08mm) However, after one year, this layer became thick (0.05–0.7 mm) and the arrangement was compact in both free flaps. 3. The granular and prickle cell layers were also increased in thickness after one year. 4. In the suprabasilar area, friction blisters were observed before one year, especially in latissimus dorsi myocutaneous flap. However, they slowly disappeared after one year and then the epidermis was stabilized. 5. In the dermis, the contents of the amyloid and acid mucopolysaccharides were increased up to the level of those of the normal heel pad in both flaps. 6. As a conclusion, the transferred free flaps were in distress before one year. But after one year, they began to adapt well histologically and histochemically to the weight bearing stress.
Amyloid ; Blister ; Dermis ; Epidermis ; Follow-Up Studies ; Free Tissue Flaps ; Friction ; Glycosaminoglycans ; Heel ; Myocutaneous Flap ; Superficial Back Muscles ; Weight-Bearing