No abstract available.
Follow-Up Studies*

Eosinophilic fasciitis is a syndrome which is characterized by scleroderma-like skin involvement, eosinophilia and hypergammaglobulinemia without significant systemic changes. The primary pathological alterations are thickening and inflammation of the deep fascia. The majority of the cases that have been reportecd respond to systemic corticosteroids. We describe a 19-year-old male patient with eosinophilic fasciitis. On physical examination, he showed tender, edematous, indurated and tight skin in the back and both lower legs, and the laboratory findings showed eosinophilia and mild hypergammaglobulinemia. He also had Raynaud phenomenon, mild dyspnea, abdominal pain, pulmonary function abnormalities and roentgenographic evidence of pulmonary fibrosis. Result of a biopsy showed sclerosis of dermia and intense infiltrations of eosinophils, lymphocytes and histiocytes and fibroais of panniculus and fascia. Treatment with systemic corticosteroids showed complete resolution of the skin lesions, but after withdrawal new scleroderma-like skin lesions developed in the dorsum of feet.
Abdominal Pain ; Adrenal Cortex Hormones ; Biopsy ; Dyspnea ; Eosinophilia ; Eosinophils ; Fascia ; Fasciitis* ; Foot ; Histiocytes ; Humans ; Hypergammaglobulinemia ; Inflammation ; Leg ; Lymphocytes ; Male ; Physical Examination ; Pulmonary Fibrosis ; Raynaud Disease ; Sclerosis ; Skin ; Young Adult

We report a case of inflammatory linear verrucous epidermal nevus which was treated with an aromatic analog of vitamin A acid, Ro 10-9359, with significant effect, The patient is a 17-year-old woman who has had linear verrucous patches involving the entire length of the extensor surface of the right arm, right scapular area and anterior upper part of the right chest with persistent itching sensation of 10 years' duration. The patient was treated with oral Ro 10-9359 75mg daily, and showed marked improvement of the skin lesions after seven days of treatment, but the patient was lost to follow up.
Adolescent ; Arm ; Etretinate ; Female ; Humans ; Lost to Follow-Up ; Nevus, Sebaceous of Jadassohn* ; Pruritus ; Sensation ; Skin ; Thorax ; Tretinoin

OBJECTIVE: In a variety of thoracolumbar diseases, corpectomy followed by interbody bone graft and anterior instrumentation has allowed direct neural decompression and reconstruction of the weight-bearing column by short segments fusion. In this study, we compared spinal stability of the two different anterior thoracolumbar instruments : Z-plate and Kaneda device representing plate and two-rods type, respectively. METHODS: A retrospective review was performed for all the patients with thoracolumbar diseases or traumas treated with anterior corpectomy, autologous iliac bone graft, and fixation with instruments from 1996 to 2000. For the anterior instrumentation, Z-plate or Kaneda device was used for 24 (M:F=5:9, average age=37) and 12 (M:F=9:3, average age=41) patients, respectively. The plain AP and lateral flexion-extension films were taken immediately after surgery and at each follow-up. The sagittal and coronal Cobb's angles at the operation segments were used to observe the change of initial fixation status. The surgical time length and bleeding amount of the two groups were compared. Intra-operative and post-operative instrumentassociated complications were evaluated. Student t-test was used for statistical analysis and p-value less than 0.05 was considered to be significant. RESULTS: Mean follow-up durations for Z-plate and Kaneda device were 24 and 21 months, respectively. The fusion rate was 91% for Z-plate and 100% for Kaneda device. Two cases of Z-plate group showed instrumentation failure during the followup period, in which additional surgery was necessary. The mean differences of sagittal Cobb's angles among the AP images immediate after surgery and at follow-up were 7 and 2 degrees for Z-plate and Kaneda device, respectively (p<0.05). The mean differences of coronal Cobb's angles were 5 and 2 degrees for Z-plate and Kaneda device, respectively (p<0.05). No intra-operative complication has occurred in both groups. There was no difference in surgery time and bleeding amount between two groups. CONCLUSION: We think that Kaneda device (rod type) is stronger than Z-plate (plate type) to keep the spinal stability after anterior thoracolumbar surgery.
Decompression ; Follow-Up Studies* ; Hemorrhage ; Humans ; Operative Time ; Retrospective Studies ; Transplants ; Weight-Bearing

Multicentric pigmented Bowen's diseas. (MPBD) is a bowenoid atypia in the genitalia of young adults which was first described by Lloyd in 1970. Clinically the lesions appear to be benign warts, but histologically they show bowenoid atypia., Although the pathogenesis and cours of MPBD is as yet unknown, many authors have suggested viral etiology. We recentiy encountered two cases of MPBD, one a 25 year-old male and the other a 38 year-old female, confirmed clinicallr and histopathologically. Case 1 showed spontaneous regression without any treatment, but case 2 showed recurrence of the lesions inspite of three times of surgical excision. The recurrent MPBD which has proven to be resistant to surgical therapy is unusual according to the previous reported cases.
Adult ; Bowen's Disease* ; Female ; Genitalia ; Humans ; Male ; Recurrence ; Warts ; Young Adult

Posterior cervical fusion is still the procedure of choice in the cases of spinal instability caused by flexion injuries. Halifax interlaminar clamp system can be used whenever posterior cervical fusion is to be performed. Thirty-one consecutive patients were treated with Halifax interlaminar clamp for cervical instability from Jan. 1991 to Jan. 1995. We followed up all of the cases for more than one year. All of the twenty-six mid-and low-cervical fixations showed immediate and long-term stability and there were no neurological complications. Two cases among the five C1-2 fixations were failed due to loosening of clamps. Fifteen cases of mid-and low-cervical fixations showed facet sclerosis and interbody fusion on the plain X-ray films after more than one year.
Humans ; Sclerosis ; X-Ray Film

Autogenous bone graft used for the contouring and reconstruction of craniofacial bone defect has many advantages over the alloplastic material implantations. However, there are several problems associated to the autogenous bone grafting: obtaining the donor site is the most problematic; transplanted bone may be absorbed at the recipient site; and the molding to fit to the recipient site is difficult. Therefore, research in alloplastic materials is inevitable. The current research is focused on two types of hydroxyapatite, calcium phosphate and calcium carbonate. The calcium phosphate is known to show a limited osteogenesis. However, Coral(Biocoral, Inoteb B.P., Saint Gonnery, France) composed of calcium carbonate is known to be more effective in osteogenesis. Fibrin sealant(Duplojet system, Immuno AG. Vienna, Austria), a tissue glue, is known to increase tissue affinity, proliferation of fibroblast and vessel ingrowth. It is also known to have osteoinductive effect. We believe that fibrin sealant improves the effect of coral by increasing bone graft substitution, enhancement of plasticity and stability of the granular material. Therefore, we have undertaken an experimental investigation as following; Using high speed burr, three 10 mm in diameter skull defects were made on 24 New Zealand white rabbits. The defects were treated with implantations, which are divided into three samples: A) Control in which on coral or fibrin sealant, B) Coral 50 mg with fibrin sealant 0.3 cc, C) Coral 50 mg with saline 0.3 cc. The specimens of its skull were collected at 3, 7, 14, 28, 42 and 56 days postoperatively. The operative sites were carefully examined grossly, microscopially and radiologically. The experimental results are as followings: At 56 days post operation date, control group showed a thin layer of only fibrous connective tissue and minimal immature bone filling the defect. Coral with saline given group showed a thick layer of connective tissue and granule of coral, accompanied by partial new bone formation, mostly composed of woven bone, in the middle of the defect. In the group that were given coral with fibrin sealant, a thick layer of fibrous connective tissue and granules of coral, accompanied by more increased new bone formation in the middle of the defect were observed. Another difference from the Group B is a formed new bone replaced by lamellar bone.We concluded that by using coral and fibrin sealant together, contouring and reconstruction of bone defected areas were enhanced. It was difficult to prove directly that fibrin has osteoinductive effect. However, the plasticity and stability, the fibrin sealant gives to coral enhances the osteogenesis. Our study provides evidence that coral used with fibrin sealant will significantly improve the result of the craniofacial bone surgery.
Adhesives ; Anthozoa* ; Bone Transplantation ; Calcium ; Calcium Carbonate ; Connective Tissue ; Durapatite ; Fibrin Tissue Adhesive* ; Fibrin* ; Fibroblasts ; Fungi ; Humans ; Osteogenesis* ; Plastics ; Rabbits ; Saints ; Skull ; Tissue Donors ; Transplants

This study was undertaken to determine whether verapamil protects renal function in rabbits with ischemic acute renal failure. Renal ischemia was induced by clamping bilateral renal arteries for 60 min. One group received intravenously an infusion of verapamil (lmg/kg) for 30 min prior to initiation of renal artery clamping and the other group received equal volume of saline. Renal blood flow was measured with flowmeter before (basal) and 24 hr after ischemia. Serum creatinine level increased 24 hr after ischemia and remained high to 72 hr. When verapamil was pretreated, the level 48 and 72 hr after ischemia was significantly decreased compared with saline insusion. Urine flow was markedly decreased 24 hr after ischemia and remained depressed to 72 hr, but it was significantly increased 72 hr after ischemia in verapa- mil-pretreatment animals as compared with the saline-infusion animals. GFR were markedly reduced 24 hr after ischemia and remained depressed to 72 hr, which was significantly prevented by verapamil pretreatment. Ischemia caused a significant increase in FEVa and a reduction in Uosm, and TcH2O, indicating impairment in urine concentrating ability of tubules, and the impairment was significantly attenuated by verapamil. The uptake of p-aminohippurate in cortical slices was depressed by ischemia, which was significantly prevented by verapamil pretreatment. In salineinfusion animals, renal blood flow was not significantly different between the basal value and that after 24 hr of reflow. Renal blood flow was not significantly altered by verapamil pretreatment. Anoxia/reoxygenation injury in the control renal slices was not significantly prevented by Ca channel blockers. These results suggest that verapamil exerts a protective effect in ichemic acute renal failure, and the beneficial effects may be attributed to effects other than vasodilation. These data also indicate that a reduction in GFR following ischemia does not result from change in renal blood flow.
Acute Kidney Injury* ; Animals ; Constriction ; Creatinine ; Flowmeters ; Ischemia ; Kidney Concentrating Ability ; p-Aminohippuric Acid ; Rabbits* ; Renal Artery ; Renal Circulation ; Vasodilation ; Verapamil*

OBJECTIVE: Anterior cervical locking plates are the devices for achieving anterior cervical spinal fusion. This study was conducted to evaluate the locking plate system regarding its long-term advantages and disadvantages in the view of interbody fusion rate, hardware-related failures, vertebral change close to the fusion segment and postoperative complications. METHOD:Eight-six patients, operated from Jan., 1996 to Jun. 1998, were followed-up for more than two years. All of the cases were fused with iliac bone graft and ORION locking plate(Sofamor Danek USA, Inc., Memphis, TN) fixation. The patients were discharged or transferred to rehabilitation department 2-7 days after operation. A comprehensive evaluation of the interbody fusion state, instrument failure, vertebral change and postoperative complications were made by direct interview and cervical flexion-extension lateral plain films. RESULTS: There were 55 male and 31 female with a mean age of 45 years(18-75 years). The mean follow-up period was 29 months(24-43 months). Various disorders that were operated were 40 cervical discs, 6 cervical stenosis including OPLL, 2 infections, and 38 traumas. Fusion level was single in 59 cases, two levels of each disc space in 15 cases, and two levels after one corpectomy in 12 cases. There was no instrument failure. Pseudoarthrosis was observed in two cases(2%) without radiological instability. The other patients(98%) showed complete cervical fusion with stable instrument. Mild settling of interbody graft with upward migration of screws was found in 12 cases(14%). Anterior bony growth at the upper segment was found in 5 cases(6%). Postoperative foreign body sensation or dysphagia was observed in 12 cases(4%), and disappeared within one month in 7 cases and within six months in 4 cases. One patient complained for more than six months and required reoperation to remove paraesophageal granulation tissue. CONCLUSION: The results show that Orion cervical locking plate has some disadvantages of upward migration of screws, anterior bony growth at the upper segment, or possibility of esophageal compression even though it has advantages of high interbody fusion rate or low instrument failure. Author believe that anterior cervical locking plate in the future should be thinner, and should have short end from the screw hole, and movable screw with adequate stability.
Constriction, Pathologic ; Deglutition Disorders ; Female ; Follow-Up Studies ; Foreign Bodies ; Granulation Tissue ; Humans ; Male ; Postoperative Complications ; Pseudarthrosis ; Rehabilitation ; Reoperation ; Sensation ; Spinal Fusion ; Spine* ; Transplants

BACKGROUND: Malignant thyroid tumors may mimic the clinical symptoms and signs of a non-malignant tumor in the early course of the disease. The choice of the treatment modality for a thyroid tumor can be based on exact interpretation of FNAC (fine needle aspiration cytology) and frozen section. METHODS: We have experienced 237 cases of thyroid tumors during the past ten years at St. Columban hospital. From September 1988 to August 1998, subjects were selected and a retrospective study was done. RESULTS: (1) Of the 237 cases in this study, 194 had non-malignant lesions and 43 had malignant lesions, a ratio of 4.5:1. (2) The female to male ratio was 9.2:1 with non-malignant lesions (female: 195/male: 19) and 9.8:1 with malignant lesions (female: 39/male: 4). (3) The age distribution was the 4th to the 6th decades, regardless of the nature of the lesions. (4) The duration of disease was within 3 months with 42.2% of subjects, and 71.8% of subjects came within first year of disease, regardless of the nature of lesions. (5) Thyroid function tests showed no abnormality with most of the patients, regardless of the nature of lesions. (6) Fine needle aspiration cytology biopsy showed a sensitivity of 32.7%, a specificity of 100%, and an accuracy of 90.8%, and revealed preoperative diagnostic validity. (7) Ultrasonography of the neck, showed a sensitivity of 32.7%, a specificity of 88.1%, and an accuracy of 77.4%, and had no diagnostic value. (8) With benign lesions, adenomatous goiters were most common (96 cases), and with malignant lesions papillary carcinomas were predominant (36 cases). CONCLUSIONS: FNAC and frozen section are valuable preoperative and intraoperative diagnostic tool for thyroid tumors.
Age Distribution ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Female ; Frozen Sections ; Goiter ; Humans ; Male ; Neck ; Needles ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Function Tests ; Thyroid Gland* ; Ultrasonography