On a total 233 sera from the VDRL reactive patients without a history of syphilitic symptoms or treatment for syphilis, TPHA and 19S(IgM)-FTA tests were performed, Also the reactivities of the 19 S (IgM)-FTA test in relation to the VDRL and the TPHA titers were observed. The results are summarized as follows: 1. Among 233 sera, 103 sera(44%) showed negative results in the 19S(IgM)- FTA test. 2. Reactivities of the 19 S(IgM)-FTA test were significantly increased in relation to the VDRL, titers arnong 233 sera reactive in the VDRL test: 47% in the VDRL titer 1: 1, 61% in 1: 2, 71% in 1: 4, 62% in 1: 8, 96% 1: 16 or more. 3. There was no relationship statistically (IgM)-FTA test and the TPHA titers. It can be derived from the above results that when a person with no history of treatment for syphilis and clear of any signs of syphilis shows a positive reaction in the VDRL test, he is less likey to be a syphilis patient when the VDRL titer is low.
Humans ; Immunoglobulin M* ; Syphilis

No abstract available.
Antibodies, Monoclonal* ; Treponema pallidum* ; Treponema*

Reconstruction of extensive soft tissue defects of the lower extremity, especially when complicated by open fracture and bone loss, is usually a difficult problem for the plastic surgeon. Many methods have been devised to treat these conditions Musculocutaneous flaps add a valuable surgical alternative that bring vascularized cover to the defects, and the free microvascular transfer of these flaps gives the surgeon an added dimension of versatility. The latissimus dorsi is an extremly reliable musculocutaneous flap with a long, large-caliber vascular pedicle, so that dissection of the muscle can be performed with relative ease. The size of the latissimus dorsi muscle lends itself to coverage of large defects. While these characteristics appear to make the free latissimus dorsi musculocutaneous transfer ideal in many circumstances, it has some disadvantages. At the recipient site, the flap is ofter too bulky, and donor-site closure requires skin grafts if the flap is wider than 10cm. These skin grafts on the posterior thorax seriously detract from the final appearance of the donor site. The authors have experienced 12 cases of reconstruction of extensive lower extremity soft tissue defect in which the latissimus dorsi muscle alone was transferred and covered with a split-thickness skin graft. This method improves the recipient-site contour by decreasing the bulk of the flap and it also improves the donor-site appearance. We described technical considerations in each case and the advantages of free latissimus dorsi muscle flap and skin graft for the reconstruction of extensive soft tissue defect in the lower extremity.
Fractures, Open ; Humans ; Lower Extremity ; Myocutaneous Flap ; Skin ; Superficial Back Muscles* ; Thorax ; Tissue Donors ; Transplants

No abstract available.
Alcoholism* ; Mass Screening*

Dubin-Johnson Syndrome is a form of benign, familial idiopathic jaundice presenting with chronic intermittentconjugated hyperbilirubinnmia and a melamin-like pigment has been found in the parenchymal liver cells. This disorder is rarely diagnosed in the neonatal period. We report a case of Dubin-Johnson syndrome presenting with neonatal cholestasis.
Cholestasis ; Jaundice ; Jaundice, Chronic Idiopathic* ; Liver

Dubin-Johnson Syndrome is a form of benign, familial idiopathic jaundice presenting with chronic intermittentconjugated hyperbilirubinnmia and a melamin-like pigment has been found in the parenchymal liver cells. This disorder is rarely diagnosed in the neonatal period. We report a case of Dubin-Johnson syndrome presenting with neonatal cholestasis.
Cholestasis ; Jaundice ; Jaundice, Chronic Idiopathic* ; Liver

No Abstract Available.
Churg-Strauss Syndrome*

Excess hair growth in unwanted areas may result from heredity, endocrine disease, or drug therapy. Conventional methods of hair removal include shaving, wax epilation and chemical depilatories that frequently cause side effects such as contact dermatitis and that also have temporary effects. Electrolysis is a well-established medical method for permanent destruction of terminal hair follicles. However, this method is tedious and efficacy has been reported to range from 15-to-50% permanent hair loss. The evolution of the laser use for hair removal continues a year after Food and Drug Administration (FDA) approval of the first laser for these applications. The authors have experienced hair removal utilizing a long-pulsed alexandrite laser. This laser system employs the principle of thermokinetic selectivity, a revolutionary concept. The principle of thermokinetic selectivity involves the use of lasers with pulse durations below the thermal relaxation on a the large target such as the hair folllicle (40-100 msec), and significantly longer than the thermal relaxation time of smaller structures of the same chromophore (melanin) in epidermis (3-10 msec). The study was based on 76 patients treated with 20 msec pulse duration laser set to energy densities of 17-21 J/cm2. Treated areas included arms, legs, beard-chin, upper lips and bikini lines. Gross observation showed leaching of hair color, decresed size of the skin pores, easily broken hair shafts, and elimination of hair. Therefore, it can be assumed that the majority of hair follicles were destroyed by this procedure, Side effects included intermediary risk of hyperpigmentation and blister. Over 80% of treated patients were satisfied with the results. As the process of research and clinical application continues, we need the long-term results of this laser system to ensure its efficacy.
Arm ; Blister ; Dermatitis, Contact ; Drug Therapy ; Electrolysis ; Endocrine System Diseases ; Epidermis ; Hair Color ; Hair Follicle ; Hair Removal ; Hair* ; Heredity ; Humans ; Hyperpigmentation ; Lasers, Solid-State* ; Leg ; Lip ; Relaxation ; Skin ; United States Food and Drug Administration

Hereditary angioedema is a rare genetic disease transmitted with a autosomal dominant trait result of a quantitative or functional defect of Cl inhibitor. We report three cases of heriditary angioedema from the same famly respectively the 35-year-old sister, the younger bn)ther of 32, and the younger sister of 20 The older sister died due to her airway being obstructel by acute laryngeal edema, and her you igirbrother and sister experienced recurrent episodes oswelling on the hand and forearm. The ore we examined the two patients serum complement levils to confirm diagnosis. In both, the r;ults showed decreased levels of Cl inhibitor and C4 which are the evidence of hereditary a giedema. The younger sister has been administered danazol (600mg/day) to prevent angioedem or 8 weeks, and we have not yet found a recurrenc of he symptoms. However, well cont ol the dosage of danazol because amenorchea has developec.
Adult ; Angioedema ; Angioedemas, Hereditary* ; Complement System Proteins ; Danazol ; Diagnosis ; Forearm ; Hand ; Humans ; Laryngeal Edema ; Siblings

Cutaneous focal mucinosis is a rare disease which usually manifests itself as a single asymptomatic papule or nodule, but vesicular presentati:on has only rarely been reported. This condition is one of many mucinoses, including localized lichen myxedematosus, acral persistent papular mucinosis, alopecia mucinosa, follieular mucinosis, and myxoid cysts which present with localized cutaneous lesions. We report a rare vesicular form of cutaneous focal mucinosis in a 42-year-old caucasian male who showed a slowly growing, 0.5 cm-sized, asymptomatic vesicle of one-week duration on his right knee. A histopathological examination revealed a localized accumulation of amorphous basophilic material which was positive on colloidal iron staining at pH 2.5. However, it was negative at pH 0.4 in an alcian blue stain, and negative on colloidal iron staining after treatment with hyaluronidase. The amorphous material was judged to be hyaluronic acid from the results of the above special stains. Proliferation of fibroblasts was also observed. Electron microscopy showed well-develuped endoplasmic reticulum and secretory vesicles in the fibroblasts. The lesion could not be completely removed even after two succesive wide excisions.
Adult ; Alcian Blue ; Basophils ; Colloids ; Coloring Agents ; Endoplasmic Reticulum ; Fibroblasts ; Ganglion Cysts ; Humans ; Hyaluronic Acid ; Hyaluronoglucosaminidase ; Hydrogen-Ion Concentration ; Iron ; Knee ; Male ; Microscopy, Electron ; Mucinoses* ; Mucinosis, Follicular ; Rare Diseases ; Scleromyxedema ; Secretory Vesicles