Ichthyosis hystrix is characterized by extensive bilateral systemic involvement of thick hyperkeratotic verrucous papules forming confluent plaques or linear arrangement and is currently classified into a systematized epidermal nevi, which was once conaidered as an extreme variant of congenital ichthyosiform erythroderma. Here is presented a case with typical clinical features and characteristic histopathologic findings of epidermolytic hyperkeratosis. Our patient exhibited no skeletal or CNS abnormalities reported to be associated with this condition. Marked improvement was obtained with oral administration of etretinate.
Acitretin* ; Administration, Oral ; Eating ; Etretinate* ; Flushing ; Humans ; Hyperkeratosis, Epidermolytic ; Hypertrophy ; Ichthyosiform Erythroderma, Congenital ; Ichthyosis* ; Mandible ; Nevus ; Porcupines* ; Sclerosis ; Sweat ; Sweating ; Sweating, Gustatory* ; Young Adult

No abstract available.
Meniere Disease*

PURPOSE: We wanted to investigate the efficacy of percutaneous radiofrequency (RF) neurotomy of the medial branch for the management of chronic low back pain due to lumbar zygapophysial joint dysfunction. MATERIALS AND METHODS: Thirteen patients who had unremitting chronic low back pain for more than 6 months and whose VAS scores were over 7 were selected on the basis of double comparative nerve blocks. The patients consist of three males and 10 females, and their nean age was 67 years. Sensory stimulation was performed to detect the "pathologic branches" that were responsible for pain generation. RF neurotomy was performed using a lesion generator at 80 C for 90 seconds. The postoperative outcome was classified, depending on the degree of pain reduction, as excellent (> or = 75%), good (50-75%), and poor (<50%). Follow-up evaluation was performed at 6 weeks, 3 months and 6 months after surgery. RESULTS: The mean number of medial branches was 6.2. Eleven patients had bilateral disease and two had unilateral disease. Sensory stimulation was positive in all patients with a mean amplitude of 4.5V (range: 0.15-6 V). The L5 dorsal ramus was the most frequently involved segment, and this was followed by L4, L3 and L2. The number of lesionings for each medial branch was 3.7. The surgical outcome was graded as excellent (53%), good (23%), and poor (24%) after 6 months of follow-up. Transient backaches were noticed in two patients; however, complications were not observed. Recurrences were not demonstrated during the follow-up period CONCLUSION: We conclude that RF neurotomy of the medial branches is an efficient method to substantially alleviate the chronic low back pain caused by zygapophysial joint dysfunction.
Arthralgia* ; Back Pain ; Female ; Follow-Up Studies ; Humans ; Joints* ; Low Back Pain ; Male ; Nerve Block ; Recurrence ; Spine

So many modalities have been suggested for the treatment of servere pain and ankylosis of the elbow with destruction of the articular surfaces. Among them, two major methods which have been widely used are resection arthroplasty and prosthetic replacement arthroplasty. However prosthetic replacement arthroplasty has some problems. Its indications are limited in the elderly inactive subjects. And there have been many kinds of complications including loosening and infection. Also, resection arthroplasty in now rarely indicated due to severe instability. From July 1980 to July 1987, we tried distraction arthroplasty in 8 cases of elbow with severe destruction of its articular surfaces, mainly in the young active persons. The average follow-up period was 45 months. The effect of distraction arthroplasty on relief of pain was not remarkable. The average increase in ROM, including that of one reankylosed elbow, was 51 ±22 degrees in flexion-extension and 48 ±23 degrees in pronstion-supinstion. No deep wound infection and instability which was main complication of resection arthroplasty were observed with our method of distraction arthroplasty. On the basis of functional results, the the results were excellent in 4, good in 1, fair in 2 and poor in 1 cases. In conclusion, distraction arthroplasty of the elbow can be one of the of effective methods reconstruction for the young active patients with the destruction of the elbow, if they are intelligent and motivated.
Aged ; Ankylosis ; Arthroplasty ; Arthroplasty, Replacement ; Elbow ; Follow-Up Studies ; Humans ; Methods ; Wound Infection

From March 1988 to August 1989, 51 knees with clinically suspected meniscus injuries were examined by both MRI and arthroscopy and compared their findings prospectively on the basis of arthroscopic findings to determine the accuracy of MRI in detecting meniscus injury of the knee. We used 2.0 tesla superconducting magnet imager(Spectro-20000, GoldStar, Korea) to obtain MR imaging. Our protocol for imaging was producing Tl sagittal images by spinecho technique and T2 coronal images by gradient echo technique, interleaved at 4mm continuously while the patient's knee was in 8–10 degrees of external rotation and surface coil was placed posteriorly to the knee in supine position. We grouped and correlated the findings of MRI with the arthroscopic findings. With this noninvasive MRI, we could obtain multiplanar, high quality images without compliations. Compared with the arthroscopic findings, MRI resulted in a high diagnostic accuracy of 96 and 86 percent for the medial and lateral meniscus, respectively. And it aided in optimal surgical planning for the clinically suspected meniscus injuries.
Arthroscopy ; Knee ; Magnetic Resonance Imaging ; Menisci, Tibial ; Prospective Studies ; Supine Position

No abstract available.
Dermatitis, Atopic* ; Killer Cells, Natural*

T cell activation is a critical event for initiation and regulation of immune responses and inhibitors of such signaling pathways are clinically useful for the treatment of patients received allogratt and autoimmune disease. In the course of screening soil microorganisms from the forest of Cheju island in Korea for new immunosuppressive agent, one of Streptomyces species (CK-95441) was found to produce a new immunosuppressant, tautomycetin which also had antifungal activity. Tautomycetin showed the inhibition of T cell proliferation in murine mixed lymphocyte reaction (MLR) and T cell activation induced by concanavalin A. Tautomycetin also blocked the induction of IL-2 gene expression which was examined in Jurkat TAg cell line in which multiple NFAT-binding sites and minimal IL-2 promoter drive the production of B-galactosidase. Also, the level of inhibition in activation-induced IL-2 receptor expression by tautomycetin was greater than those by cyclosporin A measured by flow cytometry. But, Fas ligand-induced apoptosis in Jurkat cells was unaffected by tautomycetin which was measured by DNA fragmentation assay. These results suggested that tautomycetin will be able to be used as a potent immunosuppressive drug following organ transplantation.

No abstract available.

The injured tendon is thought to be healed by, extrinsic healing from tendon sheath and adjacent connective tissue, and intrinsic healing from epitenon and endotenon. About the factors influencing the healing of injured tendon, many authors reported the effects of mobilization, electricity, ultrasound and various druge. Especially, active or passive mobilization had been known to promote the healing process and to reduce adhesion. To investigate the influences of active limited mobilization, intrinsic and extrinsic healing process, right Achilles tendons of 30 New Zealand white rabbits were grouped according to the types of treatments (Group I; tenotomy of Achilles tendon only, Group II; Tenotomy and long leg cast, Group III; surgical repair after tenotomy and long leg cast). The tendon sheath was repaired in all the groups, and the left Achilles tendons were used as control. At six weeks after operation, the tendons were removed and analysed biomechanically using Instron 1000, and histologically. The following results were obtained: 1. There were significant decreased of break strength, in order of Group III, Group I and Group II(p < 0.05). But, no difference was found between control group and Group III. 2. Extension length to the rupture, was decreased significantly in the experimental groups than control group. But there was no difference among the experimental groups. 3. Histologically, dense proliferation of fibroblasts and hypertrophy of tendon was observed in Group I; and matured fibricytic tendon tissues in Group II and III. In Group II, the amount of matured tendon tissues and degree of maturity were less than in Group III. In summary, suture and active limited motion were considered as promoting factors on the tendon healing.
Achilles Tendon ; Connective Tissue ; Electricity ; Fibroblasts ; Hypertrophy ; Leg ; Rabbits ; Rupture ; Sutures ; Tendons ; Tenotomy ; Ultrasonography

The authors analysed the CT findings in 75 cases diagnosed as gastric carcinoma by U.G. I.S. or endoscopy in a 3)1, year period. The comparative analysis betw~en CT findings and surgical pathologic findings was done in 55 cases who underwent surgery. 20 cases could not be operated upon because of distant metastasis. The gastric carcinoma was devided into 4′ stages according to the staging system of the American joint Committee on Cancer. The CT findings were then compared and the following results noted : 1. The relationship with gastric wall thickening and penetratioil degree of tumori no thickening (Iesser than 1.0 cm) of 3 cases showed all of T1, 11 of localized thickening (1. 0.1 .5cm) showed 7 of T2, 38 of localized thickening (more than 1.5 cm) showed 37 of T3 and 3 of diffuse thickening showed all of T4a. 2. The accuracy of Iymph node detection by CT scan, 1) Regionaf tymph node showed 86% in operative f in ding and 73% in pathologic. 2) Extragastric Iymph node showed 87% in operative finding and 89% in pathologic. 3) Retro-peritoneallymph node showed 96% in operative finding and 95% in pathologic. ic. 3. In operated cases, there was one case of false positive distant metastasis and three false negative cases. 20 cases of non-operated cases showed distant metastasis such as liver, lung or kidney. 4. 55 cases were classified as stage 1 in 4 cases, 11 in 18, 111 in 23 and IV in 10 by pathologic findings, and 1 in 3, 11 in 24, 111 in 19 and IV in 9 by CT. The overall accuracy by CT stagi ng is 75%. 5. Among a total of 75 cases, there were 46 operable cases by CT finding an d 43 operabl e cases by pathologic staging. There we re 29 inoperable cases by CT finding and 27 cases by pathologic staging. Therefore, there was a 93% overall accuracy by CT stagi ng in terms of determination of operability. 6. The accuracy of adhesion into adjacent structure by CT finding was 69%. compared with operable finding.
Endoscopy ; Joints ; Kidney ; Liver ; Lung ; Neoplasm Metastasis ; Tomography, X-Ray Computed