BACKGROUND: In patients with systemic lupus erythematosus(SLE), LE-specific cutaneous lesions include malar rashes, widespread/morbilliform erythema, oral ulcer and bullous lesions. OBJECTIVE: Clinical observations were carried out to define cutaneous features of morbilliform erythema and to see possible relevancy of this erythema to disease activity of SLE. METHODS: Examinations were performed on 7 SLE patients with morbilliform erythema regarding the distribution and course of the cutaneous lesions; some SLE-activity related hematologic/immunologic data taken during/around the time of this skin disease were also assessed in each patient. RESULTS: In most of those patients with morbilliform erythema, which covered the trunk and extremities, the skin lesions lasted for about 2 weeks until their disappearance. At or around the time of suffering from this skin disease of acute eutaneous LE, activities of systemic disease were recognized as "in a state of flare-up or aggravation" with hypocomplementemia and high titers of anti-nDNA autoantibodies. CONCLUSION: As with malar rashes, morbilliform erythema of acute cutaneous LE seems to develop more frequently at the time of severe systemic involvement of immunopathological processes of SLE.
Autoantibodies ; Blister ; Erythema* ; Exanthema ; Extremities ; Humans ; Lupus Erythematosus, Systemic* ; Oral Ulcer ; Skin ; Skin Diseases

The fracture of femoral neck, the unsolved fracture, is a msjor periphersl fracture of our skeleton, and for more than century its treatment and the results hsve been a matter of controversy and inquiry among surgeons, and although the results obtained today show improvement, they are not at all comparsble to those of other fractures. This study was performed to find the characteristics of femoral neck fractures in Korea and to give the direction of further treatment. Through the review of 30 articles reported on Journal of K.O.A., we suggest the followings are essential for further study. l. Epidemiologic study of femorsl neck fractures based on statistical data needs to be performed. 2. The study should be directed not only the frscture itself but also the prevention of the fracture via the study of osteoporosis. 3. The relationship of severity of fracture, time frorn trauma to treatment, and the result of treatment established by our own data is to be established.
Epidemiologic Studies ; Femoral Neck Fractures ; Femur Neck ; Korea ; Neck ; Osteoporosis ; Skeleton ; Statistics as Topic ; Surgeons

In recent years there has been an increase in the number of outpatient surgical procedures performed using local anesthesia with intravenous sedation. However, many patients are reluctant to undergo surgery because of their concerns about pain and pain-awareness during the operation. We performed a study to evaluate the effectiveness and safety of midazolam during outpatient surgical procedures. Between March 1997 and December 1998, 50 patients were anesthetized with bolus intravenous injection of 0.1mg/kg of midazolam, followed by local anesthesia. The blood pressure, pulse and oximeter values were monitored. There was no significant change of arterial oxygen saturation. Midazolam induced antegrade amnesia in most cases. All patients except three (94%) said they would willingly choose this anesthetic technique again. Major complications were not noted. We concluded that midazolam is a good sedative agent in providing favorable antegrade amnesia, as well as reduced anxiety and fear of pain during surgical procedures. This suggests that midazolam may be used routinely in outpatient surgical procedures. Monitoring of oxygen saturation, however is essential in preventing severe hypoxia during procedures.
Amnesia ; Anesthesia, Local* ; Anoxia ; Anxiety ; Blood Pressure ; Humans ; Injections, Intravenous ; Methods ; Midazolam* ; Outpatients ; Oxygen

PURPOSE: To cmpare the clinical results of complex tibial plateau fractures treated by hybrid external fixation and dual plate fixation. MATERIALS AND METHODS: We studied forty patients with Schatzker type V and VI fractures respectively and selected twenty seven patients who were followed at least one year between January 2000 and December 2005. We evaluated the clinical results in which fourteen fractures with hybrid external fixation were compared with thirteen fractures with dual plate fixation. The clinical results were evaluated according to Knee Society Clinical Rating System and the statistical analysis was performed by Student t-test. RESULTS: There were no significant differences in terms of bone union time (average union time: dual plate fixation 13.8 weeks, hybrid external fixation 14.2 weeks). The quality of osseous reduction was superior in the fractures with dual plate fixation than those with hybrid external fixation. There were significant differences in functional score (average functional score: dual plate fixation 73, hybrid external fixation 62), but not in average knee score. CONCLUSION: The hybrid external fixation can be a useful modality for treatment of complex proximal tibial plateau fractures. But the good quality of the fracture reduction by dual plate fixation may be a indicator for favorable prognosis for satisfactory knee function.
Chimera ; External Fixators ; Humans ; Knee ; Prognosis

A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.
Aged ; Bays ; Decompression, Surgical ; Deglutition ; Esophagus ; Gastrostomy ; Humans ; Hyperostosis ; Hypoxia, Brain ; Intensive Care Units ; Neck Pain ; Osteophyte* ; Pneumonia ; Pneumonia, Aspiration* ; Shock, Septic ; Spine ; Vomiting

Torsion of a mucocele of the vermiform appendix is an extremely rare condition and also a rare cause of an acute abdomen with a clinical presentation that is indistinguishable from acute appendicitis, and thus, the condition is diagnosed during operation. Here, the authors describe the case of a 78-year-old female, who presented with intermittent abdominal pain. The appendix had a pelvic position and the torsion was counterclockwise. In addition, the torsion was associated with mucocele of the appendix, which was considered a secondary factor of torsion. Appendectomy and drainage were performed.
Abdomen, Acute ; Abdominal Pain ; Aged ; Appendectomy ; Appendicitis ; Appendix ; Drainage ; Female ; Humans ; Mucocele ; Torsion Abnormality

No abstract available.
Acute Kidney Injury ; Mannitol* ; Renal Insufficiency*

Chronic complication of diving and working in compressed air is dysbaric osteonecrosis. Dysbaric osteonecrosis could be diagnosed by simple bone x-ray, in the case of exposure history to dysbaric atmosphere. The case is 44 years old man who worked as a shell fish diver for 20 years. He was exposed dysbaric atmosphere during diving. He had bone necrosis in both femur head, both distal femur and proximal tibia. He had multiple attacks of decompression sickness. Other causes of bone necrosis are ruled out. We conclude that diver's bone necrosis is dysbaric osteonecrosis.
Adult ; Atmosphere ; Compressed Air ; Decompression Sickness ; Diving ; Femur ; Femur Head ; Humans ; Necrosis ; Osteonecrosis* ; Tibia

STUDY DESIGN: The authors is to report the clinical and radiological results of proximal half corpectomy with one motion segment fusion in Denis type B burst fracture. OBJECTIVES: To evaluate the efficacy of proximal half corpectomy in Denis type B burst fracture of thethoracolumbar and lumbar spine. SUMMARY OF LITERATURE REVIEW: For the operative management of burst fracture, various mothods including posterior ligamentotaxis, posterolateral decompression, anterior decompression or combined were reported. Among the methods, anterior decompression by the corpectomy of fractured vertebral body and fusion with or without instrumentation is the one of the widely accepted method of treatment. However, anterior decompression by excision of whole vertebral body has the disadvantage of high complication rate due to the instability from the large defect and long length of bone graft. Moreover, two motion segments have to be sacrified, which is very important especially in thoracolumbar and lumbar area. Material and METHODS: 43 cases operated from 1989 to 1996 and the minimum follow up period was two years and compared with that of 48 cases who were treated by total corpectomy and two motion segment fashion from 1986 to 1989. RESULTS: Solid bony union was obtained in 43 cases within 6 months and no back pain was complained in 39 cases (93%) at last follow up. There was no significant difference between two groups in correction of anterior vertebral height and kyphotic angle. Length of bone graft was 3.0cm in half corpectomy group and was 6.3cm in total corpectomy group. Hardward breakage or graft collapse was not observed in proximal half corpectomy, while there were 5 cases in total corpectomy. CONCLUSION: Proximal half corpectomy and fusion of one motion segment in Denis type B burst fracture is believed to be a successful method which can minimize the fused level, increase the stability, preserve motion segment and reduce the complication.
Back Pain ; Decompression ; Follow-Up Studies ; Spine* ; Transplants

The authors studied the plasma cholesterol levels in 39 rats (Sprague-Dawley) after 4 weeks administration of etretinate and/or fish oil. The study groups were as follows.'13 rats recieved etretinate only;13, fish oil only;13, both ertetinate and fish oil. Cholesterol levels were determined by standard enzymatic methodology. The results were as follows. Tot,al-cholesterol levels in rats following administration of ertetinate only were increased(p<0.05), but the levels in rats receiving fish oil only and both etretinate and fish oil were markedly decreased(p<0.01). HDL-cholesterol levels in rats following administration of fish oil and both etretinate and fish oil were decreased(p<0.01). The ratio of HDL-cholesterol to total-cholesterol in rats receiving fish oil only and both etretinate and fish oil were increased(p<0.05) because of markedly decreased total-cholesterol levels.
Acitretin* ; Animals ; Cholesterol* ; Etretinate* ; Plasma* ; Rats*