Porokeratosis is an uncommon autosomally dominant inher ted disorder. Clinically, it is characterized by nonhealing plaques that develop most comnorly on the limbs. We report a case of disseminated superficial porokeratosis in immunosuppre sed kidney transplant recipient. An abrupt and extensive eruption of porokeratosis was observed in a 46-year-old man 7 months after renal transplantation, while being treated with cyclosporin A and prednisone. The histological features were essentially the same as the typical cornoid lamella. Immunosuppression may exacerbate or initiate the developm nt of porokeratosis in patients predisposed to alterations of cutaneous growth dynamics.
Cyclosporine ; Extremities ; Humans ; Immunosuppression ; Kidney Transplantation ; Kidney* ; Middle Aged ; Porokeratosis* ; Prednisone ; Transplantation*

The term pseudolymphoma is not specific, and a variety of infl; m atory reactions may simulate clinically and histopat,hologically a cutaneous malignant lymphomas udolymphoma induced by drug therapies, especially anticonvulsants, have been reportecl. These pseidayrnphornas most commonly appear as single lesions. Characteristically, few localized lesions disappear after discontinuing therapy with the offending drug. Multiple and generalized tumors are very rate. We report a case of generalized cutaneous pseudolymphoma assocated with phenytoin therapy in a 52-year old male patient.
Anticonvulsants ; Drug Therapy ; Humans ; Lymphoma ; Male ; Middle Aged ; Phenytoin* ; Pseudolymphoma*

OBJECTIVE: The study was performed to evaluate whether thallium reinjection (RI) distinguishes viable from nonviable myocardium among myocardial segments which showed persistent perfusion defect (PD) in patients with acute myocardial infarction (AMI). MATERIALS AND METHODS: We studied 22 patients underwent PTCA after AMI. SPECT was performed in all patients using dipyridamole stress- 4 hour redistribution (RD) followed by 24 hour RI protocols. Dysfunctional segs were classified into 5 groups: 1) normal, 2) reversible, 3) mild to moderate PD, 4) severe PD and 5) reverse redistribution (RR). All patients underwent follow up echocardiography after 4 months to assess regional wall motion (WM) improvement such as a criteria of viable myocardium. RESULTS: A total of 127 segs with abnormal WM was analyzed. Of 74 segs with PD, 17 (23%) showed enhanced uptake after 24 hour RI. Five of 17 segs (29%) with PD that responded to RI with enhanced thallium uptake showed WM improvement. WM improvement were seen in the 24 of 57 segs (42%) not responding to RI. All four segs (100%) with RR that responded to RI showed improvement. WM improvement were not seen in the 5 of 8 segs (71%) with RR not responding to thallium RI. Eleven (73%) of 15 segs with mild-moderate PD after RI showed improvement, but 33% of segs with severe PD after RI did not showed improvement. Segs with mild-moderate PD after RI and fill in after RI showed improvement in comparison to segs with severe PD after RI(p<0.05). CONCLUSIONS: These data indicate that because only small proportion of PD showed further perfusion improvement after RI and predictive value by the uptake after RI was low, there was limited role of RI after myocardial infarction. Usefulness of RI could be found in segs showing RR responding to RI in AMI reflects viable myocardium.
Dipyridamole ; Echocardiography ; Follow-Up Studies ; Humans ; Myocardial Infarction* ; Myocardium ; Perfusion ; Thallium ; Tomography, Emission-Computed, Single-Photon

No abstract available.

No abstract available.
Animals ; Biogenic Amines* ; Brain* ; Electroshock* ; Rats*

STUDY OBJECTIVES: To identify the value of symptoms in head trauma patients with alert mental status requiring a head CT scan. METHODS: A retrospective study was performed at an emergency center over 8 months period. Patients(age > or = 7) were enrolled if they presented with a Glasgow Coma Scale score of 15 and underwent head CT after head trauma. The symptoms and signs were recorded in the entry forms prior to head CT The symptoms found in the patients with normal CT were compared with those in abnormal CT showing intracranial injuries. RESULTS: Among the 168 patients, traumatic intracranial abnormality was identified in 34(20.2%) by CT. Skull fracture was idendified in 8(4.8%) in normal CT, 17(10.1%) in abnormal CT group by simple X-ray and CT. In the normal CT group without skull fracture, 65(52.0%) had headache, 61(48.8%) had loss of consciousness( LOC), 43(34.4%) had vomiting, 24(19.2%) had nausea, 7(5.6%) had dizziness. In the abnormal CT group without skull fracture, 14(77.8%) had heacache, 9(50.0%) had LOC, 9(50.0%) had vomiting, 2(11.1%) had nausea, 2(11.1%) had dizziness. The patients with headache were significantly more common in the abnormal CT group. CONCLUSION: A head CT is required in alert head trauma patients with any symptoms and signs of intracranial injuries, especially with headache.
Craniocerebral Trauma* ; Dizziness ; Emergencies ; Glasgow Coma Scale ; Head* ; Headache ; Humans ; Nausea ; Retrospective Studies ; Skull Fractures ; Tomography, X-Ray Computed ; Vomiting

[Objective] To determine the long term survivorship and establish the idea I correction angle in proximal tibial osteotomy for primary osteoarthritis. [Method] Seventy-nine patients suffering from primary osteoarthritis (111 knees) were performed with proximal tibial valgus osteotomy from 1985 to 1997, among which 74 women (106 knees) and 5 men (5 knees). The age ranged from 37 to 70 years (mean, 55 years). Postoperatively, hospital for Special Surgery knee score (HSS) was used for clinical assessment. The femorotibial angle (FTA) was measured to classifiy patients to group Ⅰ of 61 knees with less than 7 of valgus; group Ⅱ of 23 knees with 7～9 of valgus; group Ⅲ of 27 knees with over 10 of valgus. Closed wedge osteotomy was performed in all cases. HSS was assessed pre-and post-operatively. [Result] The average follow-up period was 9 years and 6 months (2 years and 4 months to 14 years and 1 month). The HSS knee score averaged 60 points preoperatively, 94 after 1 year and 87 at the last follow-up. Falure I was the need for conversion of a proximal tibial osteotomy to a total knee arthrop lasty, and Failure Ⅱ was the need for conversion of HSS knee score of less than 60 points. The 4 and 14 years survival rates were 99% and 85% using the first definition of failure, and 96. 4% and 75.1% using the second. [Conclusion] Proximal tibial osteotomy is reliable for treating unicompartmental osteoarthritis, providing that the postoperative femorotibial angle is corrected to more than 7° of valgus and falls in the range of 10°～15°.

Neutrophilic eccrine hidradenitis(NEH) was originally described in 1982 by Harrist et al. in a patient with myelogenous leukemia receiving chemotherapy. Clinically NEH represents various cutaneous manifestations with or without tenderness and pruritus. Histologic examination demonstrates a neutrophilic infiltrate within and around the eccrine gland and degeneration of the eccrine gland structures. Although the pathogenesis and possible cause of NEH remain unknown, it is probably an unusual cutaneous reaction to chemotherapeutic agents. A few cases of infection associated eccrine hidradenitis are found in the literature. We report three cases of neutrophilic eccrine hidradenitis. Two cases were associated with hematologic malignancy. The third case was associated with an infection of Vibrio vulnificus.
Drug Therapy ; Eccrine Glands ; Hematologic Neoplasms ; Hidradenitis* ; Humans ; Leukemia, Myeloid ; Neutrophils* ; Pruritus ; Vibrio vulnificus

PURPOSE: To compare the measurements using a navigation system and radiographic measurement in an open wedge high tibial osteotomy under navigation control. MATERIALS AND METHODS: From July, 2005 to January, 2007, 32 open wedge high tibial osteotomies were performed using a navigation system for osteoarthritis of the knee. The postoperative mechanical axis % (MA%), which is planned on the navigation system, were 62%. The mechanical axis (MA) and MA% were measured on the navigation system. The preoperative and postoperative MA and MA% were measured on the radiographs. The angles measured with the navigation system and radiographs were compared. RESULTS: On the navigation system, the mean MA before osteotomy was varus 8.8degrees. The mean MA and MA% after fixation were valgus 2.9degrees and 57.7%. On the radiographs, the mean MA was varus 9.7degrees preoperatively and valgus 4.0degrees postoperatively. The mean MA% was 10.2% preoperatively and valgus 64.4% postoperatively. There were positive correlations between the values measured with the navigation system and the radiographs (r>0.5, p<0.001). CONCLUSION: There were significant correlations between the values measured with the navigation system and radiographs in an open wedge high tibial osteotomy using a navigation system. The correction angle from the navigation system is reliable, predictable and controllable during surgery.
Axis, Cervical Vertebra ; Knee ; Osteoarthritis ; Osteotomy ; Surgery, Computer-Assisted

PURPOSE: To analyze the pre- and postoperative posterior tibial slope angle (PSA) of performing cruciate-retaining total knee arthroplasty (TKA) and to identify the ideal value of the PSA in relation to the clinical results. MATERIALS AND METHODS: From June 1999 to May 2005, 202 TKA with a NexGen(R) cruciate-retaining knee were performed in 160 patients. The mean follow-up period was 39.8 months. The pre- and postoperative PSA referenced by the proximal tibial medullary canal (PSA-A) and the proximal tibial anterior cortex (PSA-B) were measured by two independent observers. The knee and function scoring system of the American Knee Society and the range of motion of the knee at the last follow-up were evaluated as the clinical results. RESULTS: The mean PSA-A was 11.4+/-4.8degrees preoperatively and 6.0+/-2.8degrees postoperatively, and the mean PSA-B was 13.6+/-4.9degrees preoperatively and 8.1+/-2.9degrees postoperatively. The difference between the pre- and postoperative PSA increased as the preoperative PSA-A changed from 6.0degrees and the PSA-B changed from 8.1degrees; these findings showed statistical significance based on a simple linear regression (PSA-A: r= 0.837, p=0.000; PSA-B: r=0.834, p=0.000). The knee and function score of American Knee Society improved respectively from 62.9 and 55.8, preoperatively, to 97.4 and 89.7 respectively, at the last follow-up. The range of motion of the knee joint was 128.0degrees preoperatively and 129.7degrees at the last follow-up. CONCLUSION: In cruciate retaining total knee arthroplasty, PSA-A is mostly distributed within 3.2-8.8degrees, and a reasonable range of PSA-A is 6.0+/-2.8degrees.
Arthroplasty ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Linear Models ; Range of Motion, Articular