One hundred eighty-eight patients with avascular necrosis of the femoral head in adults, who were admitted and treated in Department of Orthopedic Surgery, Seoul National University Hospital between January of 1965 and May of 1985 are investigated in terms of the history, clinical data and laboratory examinations. And, the following results were obtained. 1. The incidence was higher in the 5th decade and the sex ratio between male and female was 3.3:l. 2. 106 cases (56%) had the bilateral hip involvement. 3. The most frequent etiological factor was alcohol (72 cases, 38%), followed by trauma (35 cases, 19 %), and steroid (32 cases, 17%). 4. Underlying diseases in steroid-induced avascular necrosis of the femoral head were dermopathy (9 cases), nephropathy (4 cases), pain over other joints (5 cases), systemic lupus erythematosus (2 cases), etc. 5. The time intervals between etiological events and appearances of clinical symptoms were 2 years and 3 months in the steroid induced cases, 1 year and 1 month in trauma induced ones, 2 years and 1 month in femur neck fracture cases, 2 years and 2 months in Caissons disease, and 3 years in post-irradiation 6. Bone scan was valuable in the early diagnosis of avascular necrosis of the femoral head. 7. Selective femoral head angiography show narrowing of lateral femoral circumflex artery, narrowing or obstruction of medical femoral circumflex artery, and obstruction of superior retinacular artery. 8. It is suggested that minor trauma and osteoporosis could make micro-fracture, resulting avascular necrosis of the femoral head, and the vascular change is secondary to the avascular necrosis.
Adult ; Angiography ; Arteries ; Early Diagnosis ; Female ; Femoral Neck Fractures ; Femur ; Head ; Hip ; Humans ; Incidence ; Joints ; Lupus Erythematosus, Systemic ; Male ; Necrosis ; Orthopedics ; Osteoporosis ; Seoul ; Sex Ratio

No abstract available.
Child* ; Humans ; Tuberculosis*

Isolated acute monoarticular septic arthritis of the sternoclavicular joint is a extremely rare disorder, and is usually associated with predisposing factors such as contiguous foci of infection, heroin addiction, rheumatoid arthritis, diabetes mellitus and maintenance hemodialysis. This case occurred in healthy adult. The etiological agent was staphylococcus aureus. Good result wads achieved by applying appropriate antibiotic therapy combined with an adequate drainage.
Adult ; Arthritis, Infectious ; Arthritis, Rheumatoid ; Causality ; Diabetes Mellitus ; Drainage ; Heroin Dependence ; Humans ; Renal Dialysis ; Staphylococcal Infections ; Staphylococcus aureus ; Sternoclavicular Joint

BACKGROUND: Partial unilateral lentiginosis (PUL) is a rare pigmentary disorder characterized by grouped multiple lentigines on otherwise normal skin that histologically have the typical features of lentigo. This entity has been only rarely reported in the Korean population. OBJECTIVE: The purpose of this study was to evaluate clinical and histopathologic characteristics, association with other disorders, and differential diagnosis of PUL. METHODS: We reviewed our experiences of thirteen cases of PUL which had been collected in our dermatology clinic during the 6-year period between 1993 and 1998. RESULTS: Twelve patients were female and one was male. In 3 patients the lesions appeared after the age of 20 years. Ten patients had the lesions on the upper part of the body, the neck being the most common location. No bias was shown in terms of the side of the body affected. Cafe-au-lait macules (one to three) were found in six patients, axillary freckles were observed in two. Histopathologic examination of biopsy specimens commonly showed hyperpigmentation of the basal layer, elongation of rete ridges, and an increased number of melanocytes. There ,was no evidence of associated disorders or family history. CONCLUSION: Based on this data, we confirmed that PUL is a benign, idiopathic lentiginosis with no commonly associated abnormalities. Furthermore, we believed that PUL is not uncommon in Korean people.
Bias (Epidemiology) ; Biopsy ; Dermatology ; Diagnosis, Differential ; Female ; Humans ; Hyperpigmentation ; Lentigo ; Male ; Melanocytes ; Melanosis ; Neck ; Skin

We present herein a case of human infestation of canine scabies occuring in a 7l-year-old female patient. Severe pruritic, erythematous papular lesions and excoriation were found over the abdomen, submammary area, and thigh. The itching sensation was aggravated especially at night. Efforts to demonstrate mites from the lesiona of the patient were unsuccessful. Her pet, a small puppy, showed loss of hair and crusted or scaly erythematous patches on the auricles and trunk 1 month prior to her skin lesions. Sarcaptescabiei var. canis were collected from the puppy by brushing the hair snd crusted or scaly patches on its skin. The patient and puppy were treated successfully with application of 25% benzyl benzoate solution.
Abdomen ; Benzoates ; Female ; Hair ; Humans* ; Mites ; Pruritus ; Scabies* ; Sensation ; Skin ; Thigh

We present herein a case of pyodcrma gangrenosum, who showed good response to clofazimine therapy. The patient, 19-year-old male, had suffered from chronic diarrhea for 10 months before the rapidly spreading pustules and ulcers with undermined purple-to-red borders devkloped on his both lower and upper extremitics. Clofazimine was given orally in a dose of 100mg three times daily for 16 days, and tapered to 100 mg two times daily for the next 11 days. Clinical improvement was noted after 7 day's treatment and the almost all of the skin lesiors were replaced by granulation tissue with epithelizatiori or crust formation after 6 days treatment.
Clofazimine* ; Diarrhea ; Granulation Tissue ; Humans ; Male ; Pyoderma Gangrenosum* ; Pyoderma* ; Skin ; Ulcer ; Young Adult

Nucleolar organizer regions (NORs) are loops of DNA which occur in the nucleoli of cells which possess ribosomal RNA genes. The numbers and areas of NORs have been thought to be related to cellular activities. We aimed to investigate the direct relationship between the parameters of AgNORs and cellular proliferative activity using immunohistochemical method with the monoclonal antibody Ki-67, which demonstrates proliferating nuclei. The sequential technique for the simultaneous Ki-67 immunostaining and NOR staining was applied to the same slides of a series of non-Hodgkin's lymphomas (NHL) of the low, intermediate, and high grade type. The number of AgNOR per cell was counted and mean NOR percentage nuclear area (NPNA) was measured by morphometry in both the Ki-67 positive and Ki-67 negative nuclei. The increased immunoreactivity for Ki-67 was found in the high grade than in the low grade non-Hodgkin's lymphoma. This was reflected in the two areas of the palatine tonsils and lymph nodes, the positive cell counts being higher in the follicle center nuclei than in those in the interfollicular compartment. In general the numbers and NPNA of AgNORs were higher in the Ki-67 positive nuclei than in those lacking the antigen in malignant lymphomas as well as in control. The AgNORs numbers and NPNA in controls were the highest in the Ki-67 positive cells in the follicular area and the lowest in the Ki-67 negative cells in the perifollicular area. In malignant lymphomas the numbers and NPNA of AgNORs tended to increase in proportion to their grade in both the Ki-67 positive and negative cells. The numbers of AgNORs of the high grade and the NPNA of the intermediate and the high grade were significantly higher in Ki-67 positive cells than in Ki-67 negative ones. With this double staining method it was now possible to confirm that numbers and NPNA of AgNORs were directly related to the cellular proliferative activity. In maligant lymphoma, among the several parameters of the AgNORs, NPNA in Ki-67 positive cells is proposed to be the most useful marker in determining the prognosis of the patient.
Cell Count ; DNA ; Genes, rRNA ; Humans ; Lymph Nodes ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Nucleolus Organizer Region* ; Palatine Tonsil ; Prognosis

Angioma serpiginosum is a rare vascular naevoid disorder due to progressive ectatic dilatation of capillaries in the papillary dermis. We report two cases of angioma serpiginosum. A 24-year-old woman presented with asymptomatic multiple deeply red macules arranged in a serpiginous pattern on the left posterior thigh. In the other case, an 8-year-old girl had asymptomatic red nonpalpable puncta that were grouped closely together in a linear pattern from the left lower abdomen to thigh. On the histopathological examination, both cases commonly showed grouped, dilated, ectatic vessels in the upper dermis. These clinical and histopathological findings were typical of angioma serpiginosum.
Abdomen ; Capillaries ; Child ; Dermis ; Dilatation ; Female ; Hemangioma* ; Humans ; Thigh ; Young Adult

Tubular apocrine adenoma is a well-circumscribed intradermal benign tumor with tubular structures showing apocrine differentiation. Most of those cases occur on the scalp in middle aged women. Histologically, tubular structure with apparent apocrine decapitation secretion, cystic dilatation of tubule, and connection with epidermis are the characteristic features of tubular apocrine adenoma. We presented a case of tubular apocrine adenoma that had recurred after incomplete excision. It showed apocrine decapitation secretion histologically and both eccrine and apocrine differentiation on immunohistochemical study.
Adenoma* ; Decapitation ; Dilatation ; Epidermis ; Female ; Humans ; Middle Aged ; Scalp

Myofibrosarcoma of the breast is a rare malignant mesenchymal tumor that has been reported in only four well documented cases so far. We report a case of myofibrosarcoma of the breast in an 88-year-old man who complained of a palpable mass for 1 year. Microscopically, the tumor consisted mainly of spindled cells, arranged in irregular fascicles and embedded in broad bands of dense hyalinized collagen. It showed ill-defined border infiltrating the adjacent adipose tissue, moderate cellular pleomorphism, and high mitotic rate (8~9/10 HPF). Immunohistochemical study confirmed myofibroblastic differentiation of the tumor cells with diffuse strong reaction for vimentin, smooth muscle actin, and fibronectin.
Actins ; Adipose Tissue ; Aged, 80 and over ; Breast* ; Collagen ; Fibronectins ; Humans ; Hyalin ; Muscle, Smooth ; Myofibroblasts ; Vimentin