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Femur

This report describes the pathologic features of 17 cases of Castleman's disease, examined at the Department of Pathology, Seoul National University Hospital during a period from 1973 to 1989. The lesions in 12 cases were hyaline-vascular type and the remainders plasma cell type. The pathologic features favoring the plasma cell type over the hyaline vascular type included a sufficient number to large-sized follicles. However, a histologic overlapping between two types was present. In the hyaline vascular type the age of the patients ranged from 7 to 76 years and they appeared to be no particular sex predominence. The majority of the lesions occurred in the neck and within the chest. Almost all cases presented with a solitary mass except three cases. Neither conventional symptoms nor systemic manifestations were associated. The plasma cell type was characterized by presentation of constitutional symptoms, involvement of intra abdominal and inguinal lymphnodes, in association with unusual clinicopathologic features including IgA nephropathy, diabetes mellitus, systemic progressive sclerosis, peripheral neuropathy, and anemia. Immunohistochemical study was performed in three cases of the plasma cell type. Two cases revealed poly-clonal plasma cell infiltration. In a patient with IgA nephropathy, however, serum IgA was increase and a strong immunoreactivity to IgA heavy chain was found. Another case, associated with systemic progressive sclerosis and neuropathy, revealed monoclonal plasma cell infiltration (IgG and lambda light chain). The above results support a possibility that in some of the plasma cell type an altered immune mechanism is involved in its pathogenesis.

Thermography is a sensitive and reliable method for diagnosis of radiculopathy. Skin temperature alterations of the involved dermatome named thermatone are diagnostic for sensory root involvement in radiculopathy which can be demonstrated by thermography. Digital infrared thermographic imaging system using computer is development and could measure thermal difference more exactly without hazards or discomforts to patient. Authors present 186 cases of thermographic evaluation in herniated lumbar disc disease by digital infrared thermographic imging system and the results are evaluated with literature review.
Diagnosis ; Humans ; Radiculopathy ; Skin Temperature ; Thermography

Immunohistochemical staining was performed in 20 skin granulomas of 16 patients with leprosy using antisera against lysozyme and S-100 protein. In lepromatous leprosy, lysozyme positive cells and S-100 protein positive cells were rarely found in the dermis. However, the histoid leprosy specimen had large numbers of lysozyrne positive cells and S-100 protein positive cells in granuloma. In borderline group, lysozyme positive cells and S-l00 protein positive cells were found in the dermis. S-100 protein positive cells were diffusely distributed throughuut the granuloma in borderline lepromatous leprosy, while they were often found in lymphocytic mantle in borderline tuberculoid leprosy. In tuberculoid leprosy, lysozymal staining was encouritered in epitheloid cells and giant cells, but S-100 protein positive cells were predominantly found encircling granuloma. In the epidermis, great numbers of S-l00 protein positive cells were found in tuberculoid leprosy than in lepromatous leprosy.
Dermis ; Epidermis ; Giant Cells ; Granuloma ; Humans ; Immune Sera ; Leprosy* ; Leprosy, Lepromatous ; Leprosy, Multibacillary ; Leprosy, Paucibacillary ; Leprosy, Tuberculoid ; Muramidase* ; S100 Proteins ; Skin

One of the commonest and most serious problems of the injured hand is flexion contractures of the fingers. Such deformities not only functionally impair the digit, but also reduce or restrict the functional capability of the entire hand. We reviewed 150 digits of 73 patients with flexion contractures of the fingers which had been treated at National Medical Center from Jan. 1976 to Dec. 1985. The results were as follows: 1. The duration of flexion contractures which were scattered from 4 months to 17 years and average duration of contracture was 20.6 months. 2. The methods of treatment were Z-plasty, adhesiolysis, capsulotomy, excision of both collateral ligaments, stripping of extensor mechanism and volar plate and release of flexor tendon sheath according to injury mechanism and duration of contracture. 3. The postoperative results showed up 32 (21.3%) excellent, 78 (52%) good, 24 (16%) fair and 16 (10.7%) poor. 4. The postoperative results of burned injury which showed up-8 excellent, 11 good out of 20 cases they are supposed to have satisfactory results. 5. Crushing injury which had intraarticular fracture or comminution show up unsatisfactory results. 6. It seems obvious that the early active motion of interphalangeal joint is important to improve joint function. 7. The arc of motion was retained in a more functional position postoperatively than preoperatively.
Burns ; Clinical Study ; Collateral Ligaments ; Congenital Abnormalities ; Contracture ; Fingers ; Hand ; Humans ; Intra-Articular Fractures ; Joints ; Tendons

Anthrax toxin consists of three separate proteins, protective antigen (PA), edema factor (EF), and lethal factor (LF). PA binds to the receptor on mammalian cells and facilitates translocation of EF or LF into its cytosol. PA is the primary component of anthrax vaccines. In this study we purified PA from culture filtrates of Bacillus anthracis. The purification involved sequential chromatography through hydroxylapatite, DEAE-Sepharose CL-4B, followed by Mono-Q. The purified PA was judged to be homogeneous on SDS-PAGE, and consisted of a single polypeptide chain with a relative molecular weight of 85,000.
Anthrax ; Anthrax Vaccines ; Bacillus anthracis* ; Bacillus* ; Chromatography ; Cytosol ; Durapatite ; Edema ; Electrophoresis, Polyacrylamide Gel ; Molecular Weight

In the diagnosis of acute spinal trauma, meticulous physical examination and history taking is the most important tool and auxilliary support support can be given by plain X-ray, CT or myelography, etc. But these cannot show the state of cord injury directly. On the contrary, MRI shows the cord directly as well as the soft and bony tissues. We analysed retrospectively 39 patients who suffered from acute spinal trauma at the level of cervical and thoracic spine and had their spine MRI taken. We verified the meaningful correlation between the signal change in the spinal cord on MRI and the degree of neurologic deficit and prognosis, using Frankel classification and trauma motor index at the time of admission and the final follow-up.
Classification ; Diagnosis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Myelography ; Neurologic Manifestations ; Physical Examination ; Prognosis ; Retrospective Studies ; Spinal Cord ; Spine

Since 1957, multiple possible mechanisms have been suggested to explain the production of the osteonecrosis of the femoral head and it is now accepted that steroid medication is one of the etiologic factors producing osteonecrosis of the femoral head. Among the surgical procedures in ischemic osteonercrosis of the femoral head are bone grafting, core decom-pression, rotational osteotomy, angulation osteotomy, hemiarthroplasty and total hip replacement. The choice of surgical procedures in the management of idiopathic osteonecrosis of the femoral head is dependent on several factors. Most important are the etiology and stage of the lesion. Other considerations are the patients age, lifestyle, and demands on his hip, and the surgeons preference and expertise. We reviewed 32 total hip replacements in 22 patients, which had been performed to treat steroid-induced osteonecrosis of the femoral head at Department of Orthopaedic Surgery, National Medical Center from Jan. 1975 to Dec. 1981. The longest follow-up was 7 years and 6 months and the shortest, 1 year, the average being 2 years and 6 months. The results were as follows: 1. There were 13 males and 9 females and more than half were in 5th decade. 2. Principal causes to use oral corticosteroids were rheumatoid arthritis, arthralgia, and low back pain in the order of frequency. 3. Duration of corticosteroid medication was between 2 months and 12 years and 18 patients took more than 12 months. 4. Of 18 patients who had the bilateral involvement, the two also had osteonecrosis of the humeral head. 5. Roentgenographically, 30 hips were in stage IV and 2, in stage III according to the classification of Arlet and Ficat. 6. Types of the implants used were Charnely (28 cases), MQller (2 cases) and Trapezoidal-28 (3 cases). 7. The function of the each hip was evaluated preoperatively and postoperatively by the method of Wilson and Salvati and all improved from average poor to average good.
Adrenal Cortex Hormones ; Arthralgia ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Hip ; Bone Transplantation ; Classification ; Female ; Follow-Up Studies ; Head ; Hemiarthroplasty ; Hip ; Humans ; Humeral Head ; Life Style ; Low Back Pain ; Male ; Methods ; Osteonecrosis ; Osteotomy ; Surgeons

We present a case of perforating granuloma annulare which appeared as multiple small papular lesions with central umbilication on the dorsum of both foot and sides of foot, The patient was a 12 year-old female child who had slightly tender lesions of one month's duration. Histologic study showed perforation of the epiderrnis and release of the abnormal necrobiotic material transepiderrnally. The epidermal perforation communicated with area of granuloma annulare in the dermis that consist of necrobiotic collagen surrounded by palisading mononucler phagocytes in the dermis. All the lesions resolved spontaneously with a slight hyperpigmentation in 4 months. She also had erythematous tender nodules, which diagnosed as erythema nodosum, on both shins. The lesions responded to potassium iodide 1.0g for 2 weeks.
Child ; Collagen ; Dermis ; Erythema Nodosum ; Female ; Foot ; Granuloma Annulare* ; Granuloma* ; Humans ; Hyperpigmentation ; Phagocytes ; Potassium Iodide

Large-cell acanthoma is a generally hyperkeratotic, sharply demarcated patch on sun-exposed skin with the outstanding pathologic feature being composed of large, relatively uniform keratinocytes. We describe a case of large-cell acanthoma that involved the skin of the nasal bridge. Patient was a 56-year-old women with a tannish brown patch, 2 cm in size and of 5 years' duration. Controversial issues about nosologic entity of large cell acanthoma are discussed.
Female ; Humans