Kasabach- Merritt syndrame consists of thrombocytopenia, microangiopathic hemolytic anemia, and an acute or chronic censumptive coagulopathy in associati an with a rapidly enlarging hemangioma. Most vascular turrnrs causing Kasabach-Merritt syndon e are benign but the associated coagulopathy may be lifethreatening. Our patient, a 30-day-old female infant, was admitted after an increase in the size of a hemangioma present since birth on the right leg with extension to the lower abdomen and left inguinal area. Her herrnglobin count fell to 7.1g/dl, platelet count was 26,000/ul, prothrombin time was 26 seconds, and hypofibrinogenemia developed. The patient was treated with transfusions of platelets, fresh frozen plasma and red cells and prednisolone. for 2 weeks without improvement. We started interferon alfa-2a therapy. Over the past 6 months, he hemangioma progressively diminished in size withcut any serious complication.
Abdomen ; Anemia, Hemolytic ; Female ; Hemangioma ; Humans ; Infant* ; Interferon-alpha* ; Interferons* ; Kasabach-Merritt Syndrome ; Leg ; Parturition ; Plasma ; Platelet Count ; Prednisolone ; Prothrombin Time ; Thrombocytopenia

Among the 413 patients of the lumbar herniated nucleus pulposus(HNP) who were admitted and treated at Dong-A University Hospital from March 1990 to May 1994, we analyzed 387 patients who checked magnetic resonance imaging(MRI). MRI study followed by open disectomy was carried out on 127 patients of the lumbar HNP, and we analyzed the clinical and operative findings of the lumbar HNP and compared these with MRI findings. The following results were obtained. 1. MRI findings of 387 patients consisted of bulging discs in 107 cases(27.6%), protruded discs in 165 cases(42.6%), extruded subligamentous discs in 73 cases(18.9%), extruded transligamentous discs in 34 cases(8.8%) and sequestered discs in 8 cases(2.1%). 2. MRI findings of 127 patients who had been treated with open discectomy consisted of protruded discs in 53 cases(41.7%), extruded subligamentous discs in 47 cases(37.0%), extruded transligamentous discs in 19 cases(15.0%) and sequestered discs in 8 cases(6.3%). 3. Operative findings revealed the protruded discs: 49 cases(38.6%), extruded subligamentous discs: 52 cases(40.9%), extruded transligamentous discs: 18 cases(14.2%) and sequestered discs: 8 cases(6.3%). 4. In sequestered disc, we could get the highest sensitivity, specificity and accuracy with MRI in distinguishing from another type of lumbar HNP. MRI can be available for accurate assessment of type and location of the lumbar HNP and it can show the high specificity, sensitivity and accuracy in preoperative diagnostic method.
Diskectomy ; Humans ; Magnetic Resonance Imaging ; Methods ; Sensitivity and Specificity

Generalized sterile pustular eruptions occur in various dermatoses including pustular psoriasis, erythema multiforme, Sneddon-Wilkinsan disease and others. Recentlr, acute eruptions of disseminated sterile pustules have been reported. The etiology is not related to a gepetic predisposition to psoriasis but to drug ingestion or viral infections, thus termed toxic pustuloderm; (T. P.). In this report, we present a typical case of T. P. observed iu our department. Our patient, an 18-year-old male, with no personal or family history of psoriasis, was given drug medication including amoxicillin for fever and chilling sensation. Pustilar eruptions first, appeared on his face about two days aft.er the medication and gradually spread to the trunk and limbs. The skin examination revealed numerous small pustules on an erythematous base. Laboratory examination revealed neutrophilic leukocytosis and an elevated sedimentation rate skin biopsy showed subeorneal and spongiform neutrophilic pustules Upon interruption of the amoxicillin, the pustules cleared rapidly in 3 days and there has been ri.o recui rence of any rash over a 7-month follow-up period.
Adolescent ; Amoxicillin ; Biopsy ; Eating ; Erythema Multiforme ; Exanthema ; Extremities ; Fever ; Follow-Up Studies ; Giant Cell Tumors ; Humans ; Leukocytosis ; Male ; Neutrophils ; Psoriasis ; Sensation ; Skin ; Skin Diseases

OBJECTIVE: This study was to investigate the prevalence of tardive dyskinesia (TD) in Korean inpatients using antipsychotics and the relationship between TD and sociodemographic, clinical variables. METHODS: This study was done from January to Feburary, 2003, at the Seoul National Mental Hospital. A cross-sectional assessment of randomly selected inpatients (n=324;mean age=39.73+/-9.63years) with DSM-IV schizophrenia, schizoaffective, bipolar disorder was performed with standard rating instrument for TD and extrapyramidal symptoms. The relations between the prevalence of TD and sex, age, length of medication and dosage of antipsychotics, clozapine, and other psychotropic medication, EPS were analyzed with Chi-square test or t-test. RESULTS: Using Schooler and Kane's criteria, 20 subjects (6.17%) had TD. TD was significantly less prevalent in patients receiving clozapine. There was no other significant difference between the TD and without TD groups with respect to type of antipsychotics, other psychotropic drug, antiparkinsonian drug, mood stabilizer augmentation. CONCLUSION: The result of this study have confirmed the lower prevalence of TD among inpatients using antipsychotics compared to previous investigations. The study has also replicated the association of TD with older age. Clozapine use was associated with lower prevalence rate of TD.
Antipsychotic Agents* ; Bipolar Disorder ; Clozapine ; Diagnostic and Statistical Manual of Mental Disorders ; Hospitals, Psychiatric ; Humans ; Inpatients* ; Movement Disorders* ; Prevalence* ; Schizophrenia ; Seoul

No abstract available.
Acetabulum*

No abstract available.
Ankle Fractures* ; Ankle*

No abstract available.
Adult* ; Decompression* ; Head* ; Humans ; Osteonecrosis*

The incidence of herniated lumbar disc under the age of 19 years is increasing due to increased sports activity of teenager and development of diagnostic methods. 33 cases of herniated lumbar disc of the teenager was analyzed at Department of Orthopaedic Surgery, Dong-A College of Medicine from March 1990 to May 1994. The results were obtained as follows: 1) Among 413 patients, 33 patients(7.9%) were teenagers and the sex ratio was 2.3:1 in male to female. 2) Average intervals between the onset of clinical symptoms and the admission were 13.2 months. 3) 20 cases(60.6%) had a definite trauma history, and among these cases, 14 cases(70.0%) were associated with sports activity. 4) The most common level of herniation was L4-5 in 29 cases(64.4%), straight leg raising test was positive in 32 cases(97.0%), sensory change in 13 cases(39.4%), motor weakness in 10 cases(30.3%). 5) Among positive MRI findings(32 cases), 17 cases(53.1%) were the protruded type. 6) Among 23 operative cases, 21 cases had excellent or good results.
Adolescent ; Female ; Humans ; Incidence ; Intervertebral Disc ; Leg ; Magnetic Resonance Imaging ; Male ; Sex Ratio ; Spine ; Sports

Radiation induced pemphigus, as an example of induced pemphigus, is a rare disease which occurs in patients receiving radiotherapy. A 56-year-old male patient with nasopharyngeal cancer received 3 cycles of chemotherapy and radiotherapy on the neck and anterior chest areas. One month after completion of radio-therapy, eroded and crusted areas developed within the irradiation site. In spite of systemic antibiotic treatment, the skin lesions persisted and spread further to the trunk and upper extremities with new crops of bullae. He was treated with a high dose of prednisolone and the skin lesions cleared. We discuss the suggestive pathogenesis of radiation-induced pemphigus with the comparative results of immunoblotting in various variants of pemphigus.
Cytochrome P-450 CYP1A1 ; Drug Therapy ; Humans ; Immunoblotting ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; Neck ; Pemphigus* ; Prednisolone ; Radiotherapy ; Rare Diseases ; Skin ; Thorax ; Upper Extremity

BACKGROUND: Extensive study of the p53 gene has established its role as a tumor-suppressor gene, and the mutant p53 gene is expressed in a wide spectrum of human malignancy. The conversion of sulfhydryl groups to disulfide bonds in epidermis is carried out by skin sulfhydryl oxidase(SSO) at the junction of the granular layer and horny layers. So it is of interest to investigate the localization and properties of SSO in epidermal keratinocytic neoplasms. OBJECTIVE: Our purpose is to investigate the expression pattern of the p53 protein and SSO and to gain a better understanding of biologic behavior in epidermal keratinocytic neoplasms. METHODS: We investigated the expression pattern of p53 protein and SSO by immunohistochemical method on formalin-fixed, paraffin-embedded tissue specimens in 8 cases of squamous cell carcinomas, several cases of recancerosis(1 Bowen's disease, 1 actinic keratosis, 1 arsenic keratosis) and benign keratinizing disorders(1 verruca vulgaris, 1 condyloma accuminatum and 2 cases of lichen planus). RESULTS: 1. Seven out of 8 cases of squamous cell carcinama(88%) and 1 case of 1 Bowen's disease showed p53 protein expression 2. SSO was weakly present in squamous cell carcinoma and precancerosis compared to the normal skin. In the well differentiated squamous cell carcinoma and Bowen's disease, the presence of SSO was rather diffuse than poorly differentiated squamous cell carcinoma and concentrated in dyskeratotic cells and horn pearls. 3. p53-stained cells or areas were seldom stained with SSO antibody, especially in invading borders of squamous cell carcinomas. CONCLUSION: Our results suggest that p53 mutation is a common genetic change in epidermal tumorigenesis and it can be useful marker of tumor invasion in the squamous cell carcinoma and precacerosis of skin.
Animals ; Arsenic ; Bowen's Disease ; Carcinogenesis ; Carcinoma, Squamous Cell* ; Epidermis ; Genes, p53 ; Horns ; Humans ; Keratosis, Actinic ; Lichens ; Oxidoreductases* ; Skin* ; Warts