BACKGROUND: Periungual warts are a therapeutic challenge. Many studies have revealed that intralesional interferon α-2b therapy and pulsed dye laser therapy have numerous advantages over other modalities of theratment. OBJECTIVE: The purpose of this study was to determine if combination therapy with intralesional interferon α-2b and pulsed dye laser might offer an effective treatment for periungual warts. METHODS: Thirty-three patients were randomly assigned to one of three study groups. In group A, the patients received both intralesional interferon α-2b treatment and pulsed dye laser(PDL) therapy (n=13). Group B patients were treated wit intralesional interferon α-2b alone (n=10) and group C was done with PDL therapy only (n=10). RESULTS: The clearance rate was 92.3% for the patients treated with the combination therapy of intralesional interferon α-2b treatment and pulsed dye laser (PDL) therapy. It was 50% for the patients with the intralesional interferon α-2b treatment alone, and 0% for the group with the PDL therpy only. No significant side effects were observed. At 6 months after cessation of the therapy, total 2 cases (one from group A and the other from group B) were recurred. CONCLUSION: The combination therapy with intralesional interferon α-2b treatment and pulsed dye laser therapy was highly effective for the treatment of recalcitrant periungual warts.
Humans ; Interferons* ; Lasers, Dye* ; Warts*

Giant cell tumor is a predominantly benign condition but often the tumor is locally aggressive and tends to have high rate of recurrence and it can evolve into a malignant tumor. Thus the lesions have a practically difficult therapeutic problem for the orthopaedic surgeon and any method of treatment has not been satisfied. Between March 1984 and March 1993, clinical observation was carried out on 22 cases of giant cell tumor of bone to analyse the recurrence rate and functional evaluation of the joint according to the treatment methods, pathological grade and cortical destruction. The mean follow-up time was 75. 2 months. The recurrence rate of the intralesional excision group was 54.5% and that of the wide excision group was 9%, There was no relationship between the pathologic grade and recurrence rate. There was no recurrent case in the grade I cortical destruction but almost all of recurrence was occurred in the grade I or II cortical destruction. The functional result of the giant cell tumor occurred around the knee joint was that the mean ratings in the intralesional excision group were 79% and in the wide excision group were 51%. In conclusion, to achieve better joint function and less recurrence rate, intralesional or marginal excision with heat using bone cement or with chemical cauterization using phenol and alcohol can be used for cases of radiological grade I or II, and wide excision for grade III.
Cautery ; Follow-Up Studies ; Giant Cell Tumor of Bone ; Giant Cell Tumors ; Giant Cells ; Hot Temperature ; Joints ; Knee Joint ; Methods ; Phenol ; Recurrence

Cryptococcosis is a disease caused by the Cryptococcus neoformans, occcuring most frequently in immunocompromised hosts. Cutaneous involvement is seen in 10-15 % of disseminated cases and its manifestation is variable. A 52 year old man presented with a subcutaneous neck mass and severe headache which had lasted for 2 months and 1 month respectively. Initially cutaneous involvement was monomorphic and localized and a CSF study failed to reveal any organisms. After several weeks of herb medication, however, multiple skin lesions occurred with varied morphology and a CSF study confirmed cryptococcosis by culture. The Urine cortisol was markedly elevated, suggesting an exogenous intake of steroid.
Cryptococcosis* ; Cryptococcus neoformans ; Headache ; Humans ; Hydrocortisone ; Immunocompromised Host ; Middle Aged ; Neck ; Skin

Treatment of tumors on the lip often present special difficulties in selecting the appropriate modality of treatment that will provide the patient with the best cosmetic result. The complex functions and contours of the lip, the many small cosmetic subunits and the limited availability of adjacent skin make the preservation of function and appearance difficult. Five cases comprised of 4 cases of squamous cell carcinoma, 1 case of basal cell carcinoma on the lip, particulary involved in the vermilion border. Five cases of malignant tumors were removed by total excision, followed by reconstructive surgery, such as A-T advancement flap, and advancernent flap after fusiform excision with angles greater than 30o (i.e., 60o), W-plasty, bilateral opposing advancement flap. We can treat malignant tumors on the lip involved upto one half of the total length by simple excision followed by reconstructive surgery under local anesthesia without great hazards. In our experience, surgical treatment is one of the best treatments for malignant tumors.
Anesthesia, Local ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Humans ; Lip* ; Skin

BACKGROUND: Interleukin-4(IL-4) from the Th2 subset of lymphocytes has been known to have a key role in the pathogenesis of atopic dermatitis. Blood levels of IgE, often reflecting the severity of allergic diseases, are not always elevated in patients with atopic dermatitis due to its homocytotrophic characteristics. OBJECTIVE: We propose that IL-4 can substitute or at least complement the role of IgE as an index of disease severity of atopic dermatitis. METHODS: Eleven patients with atopic dermatitis and five normal controls were included in this study. Before treatment, we evaluated the clinical severity of atopic dermatitis by the method described elsewhere with some modification which employed extent, duration, and intensity of skin lesions. Based on this criteria, we divided patients into 'severe and mild groups. With blood samples drawn from patients and normal controls, we measured IL-4 and IgE values. After a treatment period of I to 2 months, when all of the patients became free of symptoms and signs of atopic dermatitis, patients in each group were re-evaluated for ehanges of IL-4 and IgE values. IL-4 values were determined with a Predicata human interleukin-4 kit from Genzyme diagnostics (Predicta IL-4 kit) and ELISA reader (CRES UV900, Biotek). IgE values were measured .with IMx total IgE assay system from Abott laboratories (model 8389-0). RESULTS: l. Of eleven patients, six were mild and five were severe in clinical severity. 2. IL-4 levels were decreased from the pre-treatment average value of 57.149+/- 40.079 pg/ml to a post-treatment average value of 32.072+/- 16.912 pg/ml (p<0.05) which was similar to average normal control value, 36.690+/- 24.451 pg/ml. 3. IgE levels were similarly decreased from an average value of 230.2 86.4 IU/ml before treatment to one of 171.S+/-79.4 IU/ml after treatment (p<0.05). 4. This tendency of post-treatment lowering of values became more apparent in severe groups (p<0.05) but less obvious in mild groups both in terms of IL-4 and IgE (p>0.1). CONCLUSION: We conclude that IL-4 is not only involved in the pathogenesis but can also be used as a main index of disease severity in atopic dermatitis especially when the clinical severity is more than mild.
Complement System Proteins ; Dermatitis, Atopic* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin E ; Interleukin-4* ; Lymphocytes ; Skin

We assessed about growth hormone binding proteins (GHBP) activity which was measured eluted biotin GH fraction with alkaline phosphatase-streptavidine in children with insulin dependent diabetes mellitus (IDDM), short stature due to growth hormone deficiency (GHD), chronic renal failure, short stature due to nutritional deficiency. hypothyroidism and normal control groups using high pressure liquid chromatography protein pak 300 sw column. The following results are observed: 1) There were 3 types of growth hormone (GH) in serum: first GH binded with type I (minor) GHBP suggesting 200K dalton of molecular weight, second GH binded with type II (major) GHBP suggesting 60~70K dalton of molecular weight, and third GH were free form GH suggesting 20~25K dalton of molecular weight. 2) Type II (major) GHBP showed considerable individual variation in all ages. Neonates had the lowest levels of GHBP activity, but by the puberty the levels had increased & remained stable from adolescent to adult periods. 3) GHBP activity of children with IDDM at diagnosis was low value as compared to the same agenormal control group (p<0.05), and difference of GHBP activity among children with IDDM was related with height velocity (r=+0.92). Follow up GHBP activity during insulin therapy was reverse correlation with HbAlc. 4) GHBP activity of children with GHD at diagnosis was a slightly low compared to aged matched control and follow-up GHBP activity after 1 dose GH therapy showed increasing tendency (r=-0.68). 5) Otherwise, children with chronic renal failure, short stature due to nutritional deficiency, and hypothyroidism were assessed lower value than normal control group. Above results, GHBP activity had the lowest levels at neonatal period and then increasing tendency until puberty period and remained steady level until adult period. Regulation of GHBP may be closely related with metabolic control state by insulin, GH, nutritional status, and thyroid hormone..
Adolescent ; Adult ; Biotin ; Carrier Proteins ; Child ; Chromatography, Liquid ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diagnosis ; Follow-Up Studies ; Growth Hormone ; Humans* ; Hypothyroidism ; Infant, Newborn ; Insulin ; Kidney Failure, Chronic ; Malnutrition ; Molecular Weight ; Nutritional Status ; Puberty ; Thyroid Gland

No abstract available.

The goals of treatment in the injuries of posterior cruciate ligament(PCL) are restoration of normal tibiofemoral stability and reduction of long term osteoarthrosis of the knee. The purpose of this study is to analyze the factors on posterior stability and functional result after PCL reconstruction. From March 1996 to April 1997, twenty operation on PCL reconstruction were carried out in our hospital. The functional results according to the criteria of the Lysholm knee score and stress radiograph for posterior stability were evaluated. The average functional results evaluated by Lysholm knee score was 87. There was no significant difference in functional result according to selected grafted material, combined knee injury, type of injury and arthrotomy, etc. Difference in posterior tibial translation on average were 2.8mm in acute and 7.7mm in chronic injury. In posterolateral combined injury, average posterior tibial translation in pos- terolateral repair was 3.2mm and in posterolateral reconstruction was 9.4mm. In PCL reconstruction using hamstring with repair of PCL remnant was 2mm. In conclusion, to obtain the good result on posterior sta- bility, early PCL reconstruction using hamstring with repair of PCL remnant, and appropriate treatment on combined posterolateral injury were recommended.
Knee ; Knee Injuries ; Osteoarthritis ; Posterior Cruciate Ligament* ; Transplants

STI571 (imatinib mesylate, Gleevec(TM)), a selective inhibitor of the bcr-abl, c-kit, platelet-derived growth factor receptor tyrosine kinases, is a new anticancer drug used for chronic myelogenous leukemia and gastrointestinal stromal tumors. Cutaneous adverse reactions of periorbital edema and exfoliative dermatitis related to STI571 are rare and there have been no previous reports in the Korean literature. We herein report a case of periorbital edema and exfoliative dermatitis due to STI571 and discuss the possible mechanism of periorbital edema related to STI571.
Dermatitis, Exfoliative* ; Drug Eruptions* ; Edema* ; Gastrointestinal Stromal Tumors ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Mesylates* ; Phosphotransferases ; Receptors, Platelet-Derived Growth Factor ; Tyrosine ; Imatinib Mesylate

We experienced a case of vitamin B12 unresponsive methlymalonic acidemia in a 4 day old female, who had poor feeding, dehydration with metabolic acidosis, and hyperammonernia and died at 7 days of age. Diagnosis was made by gas chromatography and mass spectrometry, and this case is probably a methylmalonyl CoA mutase apoenzyme deficiency type.
Acidosis ; Apoenzymes ; Chromatography, Gas ; Dehydration ; Diagnosis ; Female ; Humans ; Mass Spectrometry ; Methylmalonyl-CoA Mutase ; Vitamin B 12