Cutis marmorata telangiectatica congenita is a very rare congenital vascular anomaly, characterized by vascular mottling of the skin, telangiectasia, hemangioma and skin atropy at birth. The mottling may be generalized or localized in distribution and tends to fade spontaneously with age. A case of CMCT occuring in a 5 months old girl shows localized, reticuhted mottling of the skin and telangiectasia from the left buttock to the leg and s!in atrophy on the left knee. There was no other anomaly except the finger-tip sized capillary hemangioma on the letf scapular area and no change in the course for 8 months.
Atrophy ; Buttocks ; Female ; Hemangioma ; Hemangioma, Capillary ; Humans ; Infant ; Knee ; Leg ; Parturition ; Skin ; Telangiectasis

A case of a clinical syndrome of selective hereditary complete IgA deficiency with partial T-lymphocyte inactivation is reported. A 14 year old boy was admitted with chjef complaint of persistent wide shallow ulcerated non-vesicular patches on the skin folds of whole body, chronic upper respiatory infections and gastointestinal upsets. General appearance showed us as if the undemourished or malabsorption status had been accompanied. The duration of illness was about 10 years under the incorrect or mistaken diagnosis and skin lesions have incompletely responded to the treatment. Peripheral T-lymphocyte determination was carried out by the method of Wybran to be tumed out active T-cell 14%, total T-cell 48%. Tuberculin test showed negative with 5 TU. Immunoglobulin values were respectively as follows: IgG 325 mg%, IgM 60 mg%, and IgA trace. And we diagnosed this case as selective IgA defiency with partial T-lymphocyte inactivation. We started the immunochemotherapy with tuberculo-protein complex, Tubercin-3 and antibictics for 2 months. After 2 months with above regimen. the skin lesions were markedly improved. T-cell count also retumed to the normal limit(active 35%, total 59%) and levels of TgG and IgM raised(IgG 617.5 mg%, IgM 75mg%), but IgA still showed trace amount, Tuberculin test tumed out positive.
Adolescent ; Dermatitis* ; Diagnosis ; Humans ; IgA Deficiency* ; Immunoglobulin A* ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Lymphocytes* ; Male ; Skin ; T-Lymphocytes ; Tuberculin Test ; Ulcer

Adhesion around tendons of the hand and wrist and subsequent limitation of motion, is one of the major complications after tendon surgery. In addition to the tendon surgery such as tendon repair or graft, infection, open reduction of fracutres, and burn scar contracture could be the casuses of tendon adhesion. Tenolysis and adequate postoperative rehabilitation program, has been proved to be effective in preventing of adhesion, whatever the cause may be, if its continuity is maintained. In order to evaluate the efficiency and problems of tenolysis, we reviewed 37 fingers of 31 patients who had been treated by tenolysis at Seoul National University Hospital from 1981 to 1991. There were 20 men and 11 women, and the average age was 28.2 years(9-45 years). The causes of adhesion were various; 24 fingers(64%) after tendon repair or tendon graft, 3 fingers(8%) after infection, 4 fingers(10%) after treatment of fracture, 4 fingers(10%) after burn scar contracture, and the other 2 fingers(5%) after curettage of enchondroma. Involved tendon were flexor tendon in 28 fingers and extensor in 9. The average duration of follow-up was 17 months(13 months to 4 years). Active motion of involved finger was started within 2 days after operation. The Total Active Motion(TAM) after operation was average 213°(100°-260°), compared to 123°(40°-180°) before operation. According to Strickland formula which was modified by us, the postoperative results were excellent in 17 fingers, good in 9 fingers, fair in 6 fingers and poor in 5 fingers. In 24 cases who had tenolysis after repair or graft, 19 case(79%) were rated as excellent or good. But in 7 cases whose causes of adhesion were infection or burn scar contracture, only 3 cases(42%) were rated as excellent or good. Compairing the results between younger(less than 30 years of age) and older(more than 30 years of age) group, the younger group showed excellent and good in 8496 and the older group in 41%, The complications were tendon rupture in 3 fingers and minor infection in 2 fingers, respectively. In summary, tenolysis was considered as a useful procedure to improve function of tendon bound down in scar tissue. And the results were better in younger age group(p < 0.05) and in previous tendon repair or graft(p < 0.05) group.
Burns ; Chondroma ; Cicatrix ; Contracture ; Curettage ; Female ; Fingers ; Follow-Up Studies ; Hand ; Humans ; Male ; Rehabilitation ; Rupture ; Seoul ; Tendons ; Transplants ; Wrist

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second*

BACKGROUND: Generalized immune activation occurs early in the course of many infectious disease. Laboratory investigations have shown that immune activation can be quantified by the measurement of soluble immune activation products in serum. Soluble CD25, CD8, and CD4 are major immune activation products. Soluble CD8 and CD4 are indices of CD8+ T cell and CD4+T cell activity, respectively. OBJECTIVE: We estimated the concentrations of these molecules in patients with leprosy. METHODS: The study population consisted of 31 patients with tuberculoid leprosy and 71 patients with lepromatous leprosy(32 cases of M. leprae negative patients and 39 cases of M. leprae positive patients). Serum samples and clinical and laboratory data were collected form each patient and control. The levels of serum soluble CD25, CD8, and CD4 were measured by sandwich enzyme immunoassay. RESULTS: The levels of serum soluble CD25 were significantly raised in leprosy patients as compared to control and did not vary signficantly between tuberculoid and lepromatous leprosy. The soluble CD8 levels in the serum of patients with leprosy did not differ from the levels of the control. The levels of serum soluble CD4 were significantly decreased in the patients with lepromatous leprosy, but not in the patients with tuberculoid leprosy. However, there was no significant correlation between CD25, CD8, and cD4 and bacterial indices in patients with lepromatous leprosy. CONCLUSIONs: There data suggest that non-specific immune activation occurs the spectrum in leprosy, while CD4+ T cell activity is significantly decreased in patients with lepromatous leprosy.
Communicable Diseases ; Humans ; Immunoenzyme Techniques ; Leprosy* ; Leprosy, Lepromatous ; Leprosy, Tuberculoid

In carpal injury, a good functional end result seems to correlate with final anatomic alignment of carpus after treatment. Some cases are often misdiagnosed and result in inadequate treatment. Forty six cases of carpal injuries were analysed which were treated for 9 years from 1975 to 1984 at the Department of Orthopedic Surgery, Seoul National University Hospital. The observations can be summarized as follows. 1. The male to female ratio was 3.5: 1 and 82% of total cases were in the third and fourth decades. 2. The most frequent cause of injury was fall from height with outstretched hand. 3. Trans-scaphoid perilunar dislocation and its variant were the most common diagnosis in this analysis. 4. All of the scapho-lunate dissociation showed volar flexion intercalated segmental instability with scapho-lunate gap more than 2 mm in our series. 5. In 11 cases of trans-scaphoid perilunar dislocation and its variant, carpal collapse was found in 10 cases. In 5 cases dorsiflexion intercalated segmental instability pattern and in one case volar flexion intercalated segmental instability pattern were found to be present. 6, There was an increase in scapho-lunate angle in all cases of dorsiflexion intercalated segmental instability, but a decrease in scapho-lunate angle is not a consistent finding in volar flexion intercalated segmental instability. 7. In 24 cases more than 6 months follow-up, excellent and good results were obtained in 20 cases. 8. As a result of above findings, authors conclude that scapho-lunate gap more than 2mm has diagnostic value in scapho-lunate dissociation but that dorsiflexion intercalated segmental instability or volar flexion intercalated segmental instability only means the changes in the relationship between carpal bones and does not have definite or specific diagnostic value for a specific carpal injury.
Carpal Bones ; Diagnosis ; Dislocations ; Female ; Follow-Up Studies ; Hand ; Humans ; Male ; Orthopedics ; Seoul ; Wrist

Over 26 kinds of tablets and capsules, such as Tetracycline, Quinidine and Potassium preparations were reported to cause esopbageal ulcerations, eharacterized in various size, shape and number, ind sually in mid-esophagus, Recently authors experienced 10 cases of drug-induced esophageal ulcerations due to antibiotics and antiinflammatory agents such as Tetracycline, Aspirin, etc. Four cases were men and six were women. Four cases were in third dades, three in fourth cleeades, two in fifth decades and one in sixth decades. Presenting symptoras were odynophagia(4/10), dysphagia(3/10), substernal pain(7/10) and epigastric pain(3/10). Endoscopic examination of the esophgus showed single or multiple, small and shallow ulcers on the mid-esophgeal mucosa at the level of 30cm from the ineisor in eight cases, one Iarge and deep ulcer at the level of 40cm from incisor in one patient and one amall, shallow and one large, deep ulcers at the same time. in one patient The shape of alcers were various from a round to a large horseshoe shaped one. The clinical course was mild without complications. It was suggested that drug-induced esophsgeal ulcers with antibiotics and antiinflammatory agents could be found frequently and they had benign and mild clinicalc ourse,
Anti-Bacterial Agents ; Anti-Inflammatory Agents ; Aspirin ; Capsules ; Female ; Humans ; Incisor ; Male ; Mucous Membrane ; Potassium ; Quinidine ; Tablets ; Tetracycline ; Ulcer*

Mirizzi syndrome is an uncommon cause of obstructive jaundice. It consists of the following elements: (1) an anatomic arrangement of the cystic duct such that it lies almost parallel to the common hepatic duct, (2) impaction of a gallstone in the cystic duct or neck of the gall bladder, (3) partial mechanical obstruction of the common hepatic duct by the stone itself or the resulting inflammatory reaction, and (4) recurrent cholangitis or ultimately cholangitic cirrhosis due to the partial obstruction. (continue...)
Cholangitis ; Cystic Duct ; Fibrosis ; Gallstones ; Hepatic Duct, Common ; Jaundice, Obstructive ; Mirizzi Syndrome* ; Neck ; Urinary Bladder

1) In out of a total of 41 cases, the measurement of the corneal curvatures were performed at a preoperative state and postoperative state after 1 month and again after 2 months. 2) The results show that the changes which cccured in the initial stage of the operation tend to become the preoperative state in the healing processes. 3) During the postoperative changes, the changes in the vertical curvatures were shown to be greater than the changes in the horizontal curvatures.
Cataract*

The reconstruction of soft tissue defects with open fracture around the knee joint is limited by its unique location. Free tissue transfer is hindered by the selection of the recipient vessel and problems of microsurgery. The arc of rotation, defect size, and location must be taken into consideration in the use of regional muscle transfer such as gastrocnemius. According to Mathes et al, the flap survival can be enhanced by selective division of the dominant segmental pedicles, only a part of which can normally be transposed safely on its minor segmental pedicle. Neovascularization, vascular proliferation, and dilatation have also been produced by the delay procedure using silicone sheets. The authors have used the delay procedures with wrapping of the gracilis or sartorius muscle which enabled distally-based transposition of these muscles. The method showed satisfactory outcome in resurfacing the wound around the knee joint. The indictions for this procedure were defects of moderate size and those difficult to reach with conventional muscle flaps. The flap could reach the upper one-third of the lower leg. Other merits are relative simplicity and reliability without significant extension of hospital stay. The drawbacks are the two operative procedures necessary and the risk of infection due to silicone sheets.
Dilatation ; Fractures, Open ; Knee Joint* ; Knee* ; Leg ; Length of Stay ; Microsurgery ; Muscles ; Silicones ; Surgical Procedures, Operative ; Wounds and Injuries*