The Melkersson-Rosenthal syndrome consists of the associated of indings of facial nerve paralysis, facial swelling and scrotal tongue. We report a case of MRS where a 20 year old female had diffuse swelling on her face and lips for 10 years. This was also accompaiined with difficulty of facial expression and fissured tongue. The improved with intralesional injection: of triamcinolon acetonide 40mg for 3 consecutive weeks and 2 every other week.
Facial Expression ; Facial Nerve ; Facial Paralysis ; Female ; Humans ; Injections, Intralesional ; Lip ; Melkersson-Rosenthal Syndrome ; Tongue, Fissured ; Young Adult

Syphilis is a communicahble disease caused by the motile microaerophilic spirochete Treponema pallidum, which is only a netural pathogen for human. Prevalence of syphilis and other sexually transmitted diseases has traditioially fluctuated with changes in sccia, conditions and sexual behavior. Although sexual contact is the main route of transmission, T. pallidum may also be infected through direct contact with syphilitic lesions, blood transfusion, ingestion of menstrual blood or vaginal secretions, or trsnsplacental transemission. Fomites as the means of transfer is only hypothetical and account for very few, if any, infection. Prosectors, blood handlers and laboratory technicians are at risk for accidental inoculation with infected materials. In extremely unusual circumstances, infection by means of contact with a skin lesion and human bite have been reported. We report two cases of eyphilis following the abnormal imposition of hands, which caused unnecessary erosive trauma with fingernails,
Bites, Human ; Blood Transfusion ; Eating ; Fomites ; Hand* ; Humans ; Laboratory Personnel ; Nails ; Prevalence ; Sexual Behavior ; Sexually Transmitted Diseases ; Skin ; Spirochaetales ; Syphilis* ; Treponema pallidum

PURPOSE: We investigated whether myocardial SPECT had additional usefulness to clinical, functional or surgical indices for the preoperative evaluation of cardiac risks in noncardiac surgery. MATERIALS AND METHODS: 118 patients (M: F=66:52, 62.7+/-10.5 years) were studied retrospectively. Eighteen underwent vascular surgeries and 100 nonvascular surgeries. Rest T1-201/stress Tc-99m-MIBI SPECT was performed before operation and cardiac events (hard event: cardiac death and myocardial infarction; soft event: ischemic ECG change, congestive heart failure and unstable angina) were surveyed through perioperative periods (14.6+/-5.6 days). Clinical risk indices, functional capacity, surgery procedures and SPECT findings were tested for their predictive values of perioperative cardiac events. RESULTS: Peri-operative cardiac events occurred in 25 patients (3 hard events and 22 soft events). Clinical risk indices, surgical procedure risks and SPECT findings but functional capacity were predictive of cardiac events. Reversible perfusion decrease was a better predictor than persistent decrease. Multivariate analysis sorted` out surgical procedure risk (p=0.0018) and SPECT findings (p=0.0001) as significant risk factors. SPECT could re-stratify perioperative cardiac risks in patients ranked with surgical procedures. CONCLUSION:: We conclude that myocardial SPECT provides additional predictive value to surgical type risks as well as clinical indexes or functional capacity for the prediction of preoperative cardiac events in noncardiac surgery.
Death ; Electrocardiography ; Heart Failure ; Humans ; Multivariate Analysis ; Myocardial Infarction ; Myocardial Ischemia ; Perfusion ; Perioperative Period ; Retrospective Studies ; Risk Factors ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: Recent ad vances and innovation in laser technology encourages us to learn and use it experimentally and clinically. The pulsed dye laser(Candela SPTL-1) is a flashlamp excited dye laser, using the princ ples of selective photothermolysis that targets the abnormal microvascu lature of cutaneous lesions while sparing adjacent structures including the epidermis. The laseemits a 585nm wavelength, and has a pulse duration of 450 usec. It is now being widely used in the treatment of vascular diseases in the dermatology field. OBJECTIVE & METHOD : Buring the period of about 3 years from August 1994 to March 1992, at the out patient clinin of Department of Dermatology of Yonsei University. 252 patients who were treated with SPTL was analyzed to evaluate the clinical effects of the pulsed dye laser. Patient di@st.ributition f the cutaneous vascular lesions included 1fil pat.ients with nevui flammeus, 68 with telangcetasia, 15 with spider angima, 5 with strawberry hemangiona and 2 with cavernous hemangior ia. RESULTS: The results and summarized as follows : 1. Nevus flammeus 4b.7% of early childhood, 41.5% of late childhood and 47.3% of adults showed excellent or good results. 2. Telangiectasia 78.1% of patients she wed excellent or good results. 3. Spider angioma 66.7% of patients she wed excellent or good results. 4. Strawberry hemangioma and cavernous hemangioma Most, of the patients,howed fair or poor results. 5. Complications included hyperpigmentation(26.5%), hypopigmentation(1.6%) and atrophic scar(4.5% ). CONCLUSION: Our experince with pulsed dye laser during the last 3 years revealed that it was superior in treating vascular disease than other existing lasers.
Adult ; Dermatology ; Epidermis ; Fragaria ; Hemangioma ; Hemangioma, Cavernous ; Humans ; Lasers, Dye* ; Port-Wine Stain ; Spiders ; Telangiectasis ; Vascular Diseases

T-cell lymphomas primarily involving subcutaneous tissue and minicking panniculitis have rarely been described. In addition, some cases may have been orviously reported as malignant histiocytosis. Some of the affected patients have developed a hemohagocytic syndrome. A 44-year-old wornan showed multiple, recurrent, ill-defined, sarble sized, erythematous, tender subcutnaeous nodules on the trunk and extremities. Histopathological findings levealed the infiltration of hyperchrorriatiatypical large lymphocytes and nurnerous beanbag-like cells in the subcutaneous fat. The infitrted cells were positively stained with Leucocyte common antigen, UCHL-1 antigen, Lysozyme, that ot with CD20. Bone marrow biopsy showed mild erythreid hyperplasia and erythorophagocytic. hitiocytes. These histopathological features were consistent with cutnaeous T cell lymphoma involvnig the subcutaneous tissue.
Adult ; Biopsy ; Bone Marrow ; Extremities ; Histiocytic Sarcoma ; Humans ; Hyperplasia ; Lymphocytes ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Cutaneous* ; Muramidase ; Panniculitis ; Subcutaneous Fat ; Subcutaneous Tissue*

Reconstructjon of old anterior cruciate ligament injury was divided into extraarticular and intraarticular group. The intraarticular ligament reconstruction was a reliable method to correct the rotational axis of knee joint instability. Authors studied 10 cases in 10 patients who were treated by reconstruction of anterior cruciate ligament using patellar tendon under arthroscopy from January, 1988 to June, 1989. The follow up period was over 10 months. 7 cases were negative in Lachman test and 2 cases had mild instability of knee joint. The postoperative result was excellent in 3 cases, good in 4 cases, fair in 1 case, and failure in 1 case according to Clancy's evaluation. We concluded that the reconstruction of anterior cruciate ligament injury using patellar tendon under arthroscopy was an effective method in the treatment of old anterior knee instability.
Anterior Cruciate Ligament ; Arthroscopy ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Ligaments ; Methods ; Patellar Ligament

No abstract available.
Dermatitis*

No abstract available.
HIV* ; Syphilis*

Ecthyma Gangrenosum is a rapidly progressing skin infection charact,erized by edema, hemorragic bullae and necrosis. Ecthyma Gangrenosum occurs almost exclusively in severely imrnunocompromised patients during the course of pseudomanas aeruginosa septisemia. A 5 month-old boy was transferred to our department because of multiple well defined central necrotic black-colored large erythematous bullae. In the bacterial cultures of skin, stool and liver aspiration fluid, Pseudomonas aeruginosa was grown. In the abdominal ultrasonogram and computed tomogram, the multiple liver abscess, hepatomegaly and ascites were shown on both hepatic lobes. Herein we report a case of ecthyma gangrenosum associated with liver abscess.
Ascites ; Ecthyma* ; Edema ; Hepatomegaly ; Humans ; Infant ; Liver Abscess* ; Liver* ; Male ; Necrosis ; Pseudomonas aeruginosa ; Skin ; Ultrasonography

Lactococcus garvieae is a Gram-positive cocci that has been known to be a fish pathogen, and considered as a low virulence organism rarely associated with human infection. We report a case of acute cholangitis with common bile duct (CBD) stone and bacteremia by L. garvieae bacteremia in a 70-year-old male. The patient presented with epigastric pain and was diagnosed with two CBD stones. Blood culture obtained prior to empiric antimicrobial therapy with ceftizoxime sodium showed growth with Escherichia coli and L. garvieae. The bacteria were confirmed by matrix-assisted desorption/ionization time-of-flight mass spectrometry. Initial attempt at endoscopic biliary drainage failed, and the patient underwent percutaneous transhepatic biliary drainage and subsequent stone removal. He occasionally ingested raw fish and had a history of gastric ulcer with acid suppression therapy, which could be possible risk factors for L. garvieae infection. This is the first case of L. garvieae bacteremia in acute cholangitis.