Toxic epidermal necrolysis(T.E.N.) is a toxic erythema of the skin that undergoes epidermal necrolysis and peding so that it appears to have been scalded. There seem to be two basic form of T.E.N. In children, the deavage of the epidermis that results from an acantholytic-dyskeratotic cytolytic process is in the malpighian or granular layer and is usually induced by a staphylococci toxin. In adult, it is characterized by a full-thicknees cytolytic cleavage of skin above the basal layer and is usually precipitated by a drug. The authors observed a 17 year-old male with T.E.N. He began to notify the erythematous skin lesion with burning sensation on the whole body surface at 12 hours after oral administration of some drugs for common cold and developed the characteristic flaccid bullous and denuded lesions with tenderness within next 20 hours.
Administration, Oral ; Adolescent ; Adult ; Burns ; Child ; Common Cold ; Epidermis ; Erythema ; Humans ; Male ; Sensation ; Skin

PURPOSE: To analyze the imaging features of brain abscess. MATERIALS AND METHODS: MR studies of nine patients with surgically verified brain abscess were retrospectively reviewed. RESULTS: The shape of abscesses were round(n=6), multilobulated(n=2) or triangular(n=1). All lesions were located in corticomedullary junction and extended into white matter. On gadolinium-DTPA enhanced images, smooth rim-like(n=6) or irregular thick enhancement(n=3) of abscess wall was noted. Budlike projection from the abscess capsule was found in 4 cases. The signal intensity of abscess capsule was either hyperintense (n=5) or isointense(n=4) relative to white matter on Tl-weighted images, and hypointense(n=6), isointense (n=2) or mixed hypo and isointense(n=l) on T2-weighted images. Satellite nodules were found in 2 cases. PNS inflammation(n=2), meningitis(n=1), ventriculitis(=2) and subdural empyema(n=1) were associated CONCLUSION: The MR features of brain abscess included characteristic intensity of abscess capsule, budlike projection from the abscess wall, moderate amount of peripheral edema, satellite nodules, and associated meningitis, ventriculitis or PNS infection. The morphology of abscess wall was not specific for the diagnosis of brain abscess.
Abscess ; Brain Abscess* ; Brain* ; Diagnosis ; Edema ; Humans ; Meningitis ; Retrospective Studies

The purpose of this study was to investigate the effects of combined exercise on visceral fat, cardiac function, adipocytokine, and NT-pro BNP concentration according to angiotensin-converting enzyme(ACE) genotype in obese middle aged men. Fifty three obese men (II type: 18, ID type: 20, DD type: 15), ratio of visceral and subcutaneous were over 0.4, were enrolled in the study. The combined exercise program included stretching, resistance training, aerobic exercise, and yoga. The exercise was conducted for 60 minutes, 4 times a week for 12 week period. ACE genotype was determined using a polymerase chain reaction (PCR), and the genetic subtype was classified in three patterns e.g. II, ID, DD. As a results, body weight, BMI, and WHR significantly decreased after 12 weeks of combined exercise in ID type and DD type. Body fat(%), visceral fat and V/S significantly decreased after 12 weeks in DD type. HDL-C and LDL-C significantly improved in II, ID and DD type. Cardiac structure decreased in all genotype and cardiac function increased in DD type. IL-6 and NT-pro BNP, the risk factors of cardiovascular disease, were significantly decreased in DD type, after 12 weeks. Therefore, exercises have shown to be most effective in type DD which is also considered as the risk of cardiovascular diseases. Among all the ACE genotype, DD type requires the most exercise.

Defect of the radius should be managed with either fusion of radius and ulna forming “one-bone forearm”, or restoration of its continuity by bone graft. Reported hereia are two cases in which the radius developed defect following sequestrectomy and treatment of open infected fructure respectively. Reconstruction of the radius was tried with bone graft; utilizing the ulnar end resected from the same side in one case and fibula in other. Both Sowed sound bony union of the graft about four months postoperatively.
Fibula ; Radius ; Transplants ; Ulna

Glanzmann's thrombasthenia is a rare autosomal recessive hemorrhagic disorder characterized by prolonged bleeding time, ad deficient or absent clot retraction in the presence of normal platelet count. The major underlying abnormality in this disease is grossly defective first-phase aggregation of platelet, which are unresponsive to ADP or other platelet agonists such as epinephrine, collagen, thrombin in any concentration. This disability is caused by a decrease or absence of the platelet membrans glycoprotein IIb-IIIa complex, a member of the integrin family of adhesive receptors involved in cell-cell and cell-matrix fibronectin, and vitronectin On the development of surface labeling technique, a variety of biochemical techniques such as radioimmunoassay, crossed immunoelectrophoresis and SDS-PAGE have been used to study the structure and the function of platelet membrane glycoproteins, and to detect the platelet functional defect. But all of these techniques demand a relatively large amount of homogeneous paletelet population that requires manipulation through isolation and washing procedures before analysis. In order to eliminaste such an intricate procedure, we have applied method for analyzing platelet surface components in whole blood using monoclonal antibody and flow cytometry to recognize the absence of severe reduction of platelet membrane glycoprotien llb-llla complex. Platelet analysis by flow cytometry is a successful alternative rapid diagnostic technique for Glanzmann's thrombasthenia patients as well as well as for carriers of this disease. Fow cytometry technique provides a sensitive tool for investigating platelet functional defects caused by altered expression or deficiency of platelet surface proteins.
Adenosine Diphosphate ; Adhesives ; Bleeding Time ; Blood Platelets* ; Clot Retraction ; Collagen ; Electrophoresis, Polyacrylamide Gel ; Epinephrine ; Fibronectins ; Flow Cytometry* ; Glycoproteins ; Hemorrhagic Disorders ; Humans ; Immunoelectrophoresis, Two-Dimensional ; Membrane Glycoproteins* ; Membrane Proteins ; Membranes* ; Platelet Count ; Platelet Membrane Glycoproteins ; Radioimmunoassay ; Thrombasthenia* ; Thrombin ; Vitronectin

OBJECTIVE: The clinical value of preoperative serum squamous cell carcinoma antigen(SCC) in relation to clinical stage, tumor volume, disease extent and prognosis has already reported in many papers. The aim of this study is to analyse the relationship between preoperative SCC level and pelvic lymph node metastasis. Matrials and METHODS: From March 1995 to December 1998, 157 patients who examined pretreatment SCC levels before undergoing radical hysterectomy for squamous cell carcinoma of uterine cervix were included. The effect of pelvic lymph node status on the SCC level was examined by comparing 125 cases with cancer limited uterus or upper vagina and 32 cases with cancer confined to the uterus (including upper vagina) and pelvic lymph node using multivariate analysis. RESULTS: 90% of patients without pelvic lymph node metastasis showed SCC levels of 2.9ng/ml or below. 60.7% of patients with serum SCC level more than 2.9ng/ml exhibited pelvic lymph node metastasis. The marker values exceeding 2.9ng/ml increased risk of nodal metastasis 5 times compared with serum level 2.9ng/ml or below. Multivariate analysis confirmed that the pelvic lymph node metastasis had a large impact on the marker level than did tumor size or depth of stromal infilteration. CONCLUSION: SCC levels greater than 2.9ng/ml can be considered a high risk zone for nodal metastasis
Carcinoma, Squamous Cell* ; Cervix Uteri ; Female ; Humans ; Hysterectomy ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis* ; Prognosis ; Tumor Burden ; Uterine Cervical Neoplasms* ; Uterus ; Vagina

BACKGROUND: Almost all STD(sexually tranamitted diseases) have been increasing worldwide since the 1960s. In Korea, the occurrence of STD from recent trends of sexual openness and development in the pleasure-seeking industry is becoming a social issue. However, epidemiological studies and reports concerning the incidence of STD are lacking in Korea, especially in the sexually aetive young age group. OBJECTIVE: We evaluated the incidence of YTD and sexual behavior of recruits in a Korean arrny training center to contribute to the management of STD in Korea. METHODS: We studied 1304 recruits in a Korean army training center by questionnaire, physical examination and laboratory data. The subjects were divided into 3 groups: group 1(1072 persons), those who visited the hospital for evaluation of STD; group 2(641 persons), a control group for coitus rate; and group 3(1304 persons; group 1 plus 232 persons out of group 2), those who had coital experiences. RESULTS: 1. The incidence of STD in group 1 was 65.7%(704/1072) and that of the total number of recruits was 0.43%(704/164,134). 2. Among the 704 cases of STD, the most frequently observed STD was non-gonococcal urethritis, 292 cases(41.5%) and the second was gonorrhea, 236 cases(33.5%). The others were, 68 cases(9.7%) of pediculosis pubis, 41 cases(5.8%) of condyloma acuminatum, 29 cases(4.1%) of syphilis, 20 cases(2.8%) of combined STD, 14 cases(2%) of herpes progenitalis, 2 cases(0.28%) of molluscum cohtagiosum and 2 cases(0.28%) of chancroid. 3. The coitus rate in group 2 was 36.2%(232/641). 4. The incidence of previous STD in group 3 was 20.9%(273/1304). 5. The mn;t common form of STD which the patients experienced previously was urethritis(82.8%) and the others were pediculosis pubis(7.3%), syphilis(3.3%), condylcena acuminahun and herpes progenitalis. 6. The group with more sexual partners tended to have a lower educational level. 7. The experience rate of drug abuse was higher in the group with more sexual partners. 8. The experience rate of oral and anal sex was higher in the group with experiences of clrug abuse than in the ather one. CONCLUSION: In this study, urethritis was the most common form of STD(75% of all STD) and non-gonococcal urethritis showed a greater incidence than gonorrhea. The incidence of STD is thought to be closely related to the factors associated with social or behavioral science, such as the number of sexual partners, grade of education, drug abuse, experience of oral and anal sex. To accomplish more effective management of STD, therefore, the improvement of current social problems involving sexual openness, the pleasure-seeking industry and drug abuse should be achieved.
Behavioral Sciences ; Chancroid ; Coitus ; Education ; Epidemiologic Studies ; Gonorrhea ; Humans ; Incidence ; Korea ; Lice Infestations ; Physical Examination ; Sexual Behavior* ; Sexual Partners ; Sexually Transmitted Diseases* ; Social Problems ; Substance-Related Disorders ; Syphilis ; Urethritis ; Surveys and Questionnaires

PURPOSE: To analyze the characteristies of traumatic brainstem injury by CT and MR MATERIALS AND METHODS: CT and MR studies of 10 patients with traumatic brainstem lesion in MR were retrospectively reviewed, particularly attended to location, signal intensity and associated lesions. RESULTS: CT failed to depict 8 of 10 brainstem lesions. All lesions were detected in MR images with T2-weighted images showing higher detection rate (n=10) (100%) than Tl-weighted images (n=3) (30%) or CT (n=2) (20%). The brainstem lesions located in the dorsolateral aspects of the rostral brainstem(mid brain and upper pons)in 7 (70%) cases, in ventral aspects of rostral brain in 2 (20%) cases and in median portion of pons in 1 (10%) case. Corpus callosal (n=5), Iobar white matter(n=5) diffuse axonal injury, and 2 hemorrhagic lesions in basal ganglia were the associated findings. CONCLUSION: MR imaging is more helpful than CT in the detection of brainstem injury, especially T2 weighted images. Primary brainstem lesions were typically located in the dorsolateral aspect of rostral brainstem(midbrain and upper pons). Corpus callosum and white matter lesions were frequently associated.
Basal Ganglia ; Brain ; Brain Stem* ; Corpus Callosum ; Diffuse Axonal Injury ; Humans ; Magnetic Resonance Imaging ; Pons ; Retrospective Studies

Obstruction of the inferior vena cava(IVC) is an uncommon condition, and the collateral pathway variesaccording to the level, extent, duration and the cause of obstruction. Membranous obstruction of IVC in itshepatic portion might be one of the principal cause among Korean, though not reported till now. Analytical studywas perfomred in 26 cases of IVC obstruction with various cause. 1. The level of the obstruction showed relativelyeven distribution as follows, upper caval in 11 cases, middle caval in 6 cases and infrarenal in 9 cases. 2. Themain cause of upper caval obstruction was membranous obstruction . 3. As a whole, the main collateral pathway wasthe central route(22 case:85%). 4. Characteristic collateral pathway unique to upper caval obstruction wastranshepatic vanous collateral, developed between the obstructed segment and unobstructed segment of IVC. 5.Scalloping of left cardiac border produced by pericardiophrenic venous collateral was characteristic simple chestX-ray finding in IVC obstruction.
Collateral Circulation ; Vena Cava, Inferior

We report a case of Kyrles disease occuring in a 19-year-old man with chronic renal failure. The patient had multiple hyperkeratotic papules with central plug on the upper extremities, lower extremities and buttocks. Histopathological findings showed epidermal invagination filled with parakeratotic column and basophilic debris. Many dyskeratotic and vacuolated cells were present below the keratotic plug, and penetration of the parakeratotic column into the dermis was seen.
Basophils ; Buttocks ; Dermis ; Humans ; Kidney Failure, Chronic ; Lower Extremity ; Upper Extremity ; Young Adult