Fibroelastolytic papulosis of the neck(FEPN) was introduced by Balus et al in 1997. Before this term was used, white fibrous papulosis of the neck(WFPN) and pseudoxanthoma elasticumlike papillary dermal elastolysis(PDE) had differently been used. These two disease entities had clinical similarities such as asymptomatic, white to yellow discolored, papular eruptions on the neck in elderly persons. As names implicated, however, they showed variable histological findings, for examples, fibrosis in WFPN or elastolysis in PDE or both in FEPN. Taken into ac-count together, instead of using WFPN or PDE separately, FEPN might be preferred to describe these two kinds of skin diseases. We report a case of a 36-year-old male patient with papules compatible with FEPN, whose biopsy mainly showed elastolysis.
Adult ; Aged ; Biopsy ; Fibrosis ; Humans ; Male ; Neck* ; Skin Diseases

One of the most important factors leading to a successful healing of rotator cuff tear is good bone quality to secure the suture anchor in the bone for a stable fixation. However, rotator cuff tear are commonly found in elderly patients, and their proximal humerus often shows osteoporosis or cystic lesions. Especially when the transosseous repair prevails for a torn rotator cuff, a weak metaphyseal cancellous bone is often the case, which associated with difficulty in stable fixation of the lateral row suture anchor. In this situation, we were able to augment the lateral row fixation with polymethylmethacrylate bone cement. Although there is a concern of disturbance in the blood flow and healing potential, our case showed good clinical results with respect to healing. If we suspect a weak fixation of the lateral row suture anchor, bone cement seems to be a good option for augmentation.
Aged ; Bone Cements ; Humans ; Humerus ; Osteoporosis ; Polymethyl Methacrylate ; Rotator Cuff* ; Suture Anchors ; Tears

Since the olecranon fractures are caused by relatively low-energy injuries, such as a fall from standing height, they are usually found without comminution. Less commonly they can be developed by high-energy injuries and have severe concomitant comminution or injuries to surrounding structures of the elbow. Because the fracture by nature is intra-articular with the exception of some avulsion-type fracture, a majority of olecranon fractures are usually indicated for surgical treatment. Even if there is minimal displacement, surgical treatment is recommended because there is a possibility of further displacement by the traction force of triceps tendon. The most common type of olecranon fracture is displaced, simple non-comminuted fracture (that is, Mayo type IIA fractures). Although tension band wiring was the most widespread treatment method for these fractures previously, there is some trends toward fixation using locking plates. Primary goal of the surgery is to restore a congruent joint and extensor mechanisms by accurate reduction and stable fixation so that range of motion exercises can be performed. The literature has shown that good clinical outcomes are achieved irrespective of surgical fixation technique. However, since the soft tissue envelope around the elbow is poor and the implants are located at the subcutaneous layer, implant irritation is still the most common complication associated with surgical treatment.
Elbow ; Exercise ; Fracture Fixation ; Joints ; Methods ; Olecranon Process* ; Range of Motion, Articular ; Tendons ; Traction

Rud's syndrome (RS), basically composed of ichthyosis, mental deficiency and hypogonadism, is a rare hereditary disease. Some varying dermatologic, neurologic, endocrinologic, ophthalmologic and musculoskeletal abnormalities have coincided with RS. No case of RS has been documented from Asian countries except one from Japan. We describe a 16-year-old girl who presented with lamellar ichthyosis, mental retardation, hypogonadism, short stature, alopecia, sparse eyebrows, strabismus, cataracts, and congenital dislocation of the hip. To our knowledge, RS coexisting congenital dislocation of the hip herein is the first case in English literature.
Adolescent ; Alopecia ; Asian Continental Ancestry Group ; Cataract ; Dislocations ; Eyebrows ; Female ; Genetic Diseases, Inborn ; Hip ; Humans ; Hypogonadism ; Ichthyosis ; Ichthyosis, Lamellar ; Intellectual Disability ; Japan ; Musculoskeletal Abnormalities ; Strabismus

Mammary carcinoma was induced in rats by itravenous injection of N-methy-N-Nitrosourea. Microangiography was perfromed to evaluate the microvascular alterations in mammary carcinoma after irradiation. The tumors were givena single dose of 1.400 rads using Co-60 telethrapy unit with field size of 4 x 4 cm at 40 cm SSD. The dose ratewas 147.5 rads per minute. Microangiography was performed prior to irradiation and at one, two, and four weeksfollowing irradiation. The results are as follows: 1. Before irradiation, mammary carcinoma in rats tended to formlobules and the basic vasculature consisted of peripheral vascular pattern with central penetrating vessels. Theperipheral vascular pattern was always richer than that of the center. Irregular and tortuous vessles stretchedfrom the periphery into the center of lobule. 2. One week following irradiation, an increase in the number ofsmaller, tortuous vessels and decreased intervasular distance were obseved in the central portion of each lobule.This finding seems to be due to an improved filling of some previously existing but unfilled vessels. This maylead to improved metabolic changes and reoxygenation. 3. Later's changes of microvasculature after irradiation aretortuosity, irregularity, narrowing, abrupt tapering, fragmentation, and extravasation. These findings progressedafter a lapse of time. 4. The results can be considered as the microangiographic demonstration of the fact that reoxygenation after irradiation is mainly due to dilatation of the collapsed tumor vessels.
Animals ; Dilatation ; Microvessels ; Radiation Effects ; Rats ; Silver Sulfadiazine

No abstract available.
Adult ; Humans

One of the most important factors leading to a successful healing of rotator cuff tear is good bone quality to secure the suture anchor in the bone for a stable fixation. However, rotator cuff tear are commonly found in elderly patients, and their proximal humerus often shows osteoporosis or cystic lesions. Especially when the transosseous repair prevails for a torn rotator cuff, a weak metaphyseal cancellous bone is often the case, which associated with difficulty in stable fixation of the lateral row suture anchor. In this situation, we were able to augment the lateral row fixation with polymethylmethacrylate bone cement. Although there is a concern of disturbance in the blood flow and healing potential, our case showed good clinical results with respect to healing. If we suspect a weak fixation of the lateral row suture anchor, bone cement seems to be a good option for augmentation.
Aged ; Bone Cements ; Humans ; Humerus ; Osteoporosis ; Polymethyl Methacrylate ; Rotator Cuff ; Suture Anchors ; Tears

BACKGROUND: For Neer type IIB fracture of distal clavicle with coracoclavicular ligament injury, various surgical treatments have been used in literatures. However, there was no consensus on the optimal treatment. The aim of this study is to report the clinical and radiological results of open reduction and internal fixation of unstable distal clavicle fracture and suture augmentation of disrupted coracoclavicular ligament. METHODS: A prospective study was performed in 23 patients with Neer type IIB distal clavicle fracture in Seoul Medical Center, Eulji Hospital, and National Medical Center. Firstly, suture anchors are inserted in the base of coracoid process and preliminary reduction was achieved by tie-off of three suture limbs around the clavicle. Then, the final fixation was completed with anatomical locking plate. Bony union and the distance between coracoclavicular ligaments were evaluated. Clinical results and complications including stiffness and secondary procedures were evaluated. RESULTS: Bony union was achieved in all cases except one (22 of 23). At mean 14.9 months, no significant difference in the mean coracoclavicular distance was observed compared to uninjured shoulder (8.2 +/- 7.9 mm versus 7.3 +/- 3.4 mm, p=0.14). Pain visual analogue scale, American Shoulder and Elbow Surgeons score, Constant score, and Disabilities of the Arm, Shoulder and Hand score were 0.5, 83.4, 78.5, and 6.2, respectively. Revision surgery was performed in one case of nonunion. Four patients who complained of skin irritation underwent implant removal. CONCLUSIONS: In cases of an unstable distal clavicle fracture with coracoclavicular ligament disruption, satisfactory clinical results were obtained by locking plate fixation and coracoclavicular ligament suture augmentation concurrently.
Arm ; Clavicle* ; Consensus ; Elbow ; Extremities ; Hand ; Humans ; Ligaments* ; Prospective Studies ; Seoul ; Shoulder ; Shoulder Fractures ; Skin ; Suture Anchors ; Sutures*

To investigate the relationship between Radiosensitivity and postirradiation recovery in human cancer cells, a study was performed using human cancer cell lines-A549, CaSki, SNU-C5 and PCI-13. for the study of radiosensitivity, single doses of 2, 4, 6, 8, 10, 12, and 14 Gy were given and for postirradiation recovery, two fractions of 4 Gy were separated with a time interval of 0, 0.5, 1,1.5, 2, 2.5, 3, 4, 5, or 6 hours. Surviving fraction was estimated using colony forming ability. Surviving fractions at 2 Gy (SF2) were 0.496 (0.570-0.412) for A549, 0.496 (0.660-0.332) for CaSki, 0.386 (0.576-0.216) for SNU-C5, and 0.185(0.247-0.123) for PCI-13. By statistical analysis the SF2 of PCI-13 was lower significantly than those of others (p<0.05). this difference was also observed at 4,6 and 8 Gy dose levels. At 6 and 8 Gy the surviving fractions of SMU-C5 were also lower significantly than A549 and CaSki(p<0.05). By the analysis with linear quadratic model, the value of alpha for A549, CaSki, SNU-C5 and PCI-13 were 0.3016, 0.3212, 0.4327 and 0.8423, respectively, and those of betawere 0.024929, 0.02009, 0.03349 and 0.00059, respectively. So, the value of alpha showed increasing tendency with decreasing SF2.By the multitarget single hit model the values of Do for A549, CaSki, SUN-C5 and PCI-13 were 1.97, 1.97,1.46 and 0.81, respectively, and those of n were 1.53, 1.50, 1.56 and 2.28, respectively. So, the value of Do decreased with decreasing SF2. Post-irradiation recovery reached plateau at around 2 hours. Recovery ratio at plateau phase ranged from 1.2 to 4.2; the value were 1.2 for PCI-13, 3.2 for CaSki, 3.3 for SNU-C5, and 4.2 for A549. Recovery rate well correlated with SF2, and increased with increasing Do and decreasing alpha. According to above results, the intrinsic radiosensitivity was quite different among the tested cell ilnes; PCI-13 was the most sensitive and A549 and CaSki was similar. This difference of radiosensitivity is thought to be partly due to the difference in amount of postirradiation recovery. By linear quadratic model the difference of alpha values was very high, and by multitarget single hit model the difference of Do value was significantly high among four cell lines.
Cell Line* ; Humans* ; Radiation Tolerance*

A total of 47 patients with a diagnosis of nasopharyngeal carcinoma was treated in Department of Therapeutic Radiology, Seoul National University Hospital during last 4 years. Of the 47 patients, 23(49%) had undifferentiated carcinoma, 20(43%) had squamous cell carcinoma, while 4(8%) had lymphoepithelioma. Most of the patients(71%) has Stage IV disease, cervical lymph node metastases were found in 36(77%) and distant metastasis was found in 1 at the time of diagnosis. Complete response rate after radiotherapy for 47 patients of nasopharyngeal carcinoma was 85.1%. The overall actuarial 3 year survival rates was 0.718 and the disease free actuarial 3 year survival rates was 0.468. Nodal involvement and symptom duration were statistically significiant influencing factors for actuarial survival rate. Treatment failures were found in 20 patients (42.6%), local recurrence only in 6(30%), local and neck recurrence in 3(15%), local recurrence with metastasis in 4(20%) and distant metastasis only in 7(35%). Local failures were more frequent in the patients with cranial nerve symptoms (P=0.032). Distant metastases were more frequent with T4 lesions (P=0.047), and with nodal involvement (P<0.01). Retreatment after the tumor recurrence was chemotherapy and/or radiotherapy, two patients refreated for local recurrence were alive without evidence of disease for more than 19 and 44 months after retreatment.
Carcinoma ; Carcinoma, Squamous Cell ; Cranial Nerves ; Diagnosis ; Drug Therapy ; Humans ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Radiation Oncology ; Radiotherapy* ; Recurrence ; Retreatment ; Seoul ; Survival Rate ; Treatment Failure