A 26-year-old man presented with a 7-month history of hyperkeratotic skin lesions on both elbows and heels. He also had marked subungal hyperkeratosis and splinter hemorrhage on the finger and toe nails. A biopsy specimen from the elbow revealed lichenoid re-actions with areas of epidermal atrophy with alternating acanthosis and foci of parakeratosis. We made a diagnosis of keratosis lichenoides chronica based on the characteristic clinicopathologic findings. We have treated the patient with etretinate, but only the skin lesions on the elbows and heels responded to treatment.
Acitretin ; Adult ; Atrophy ; Biopsy ; Diagnosis ; Elbow ; Etretinate ; Fingers ; Heel ; Hemorrhage ; Humans ; Keratosis* ; Nails, Malformed* ; Parakeratosis ; Skin ; Toes

Developmental venous anomalies are congenital anomalies of the intracranial venous drainage and clinically asymptomatic. Cavernous hemangiomas are vascular malformations composed of dilated vascular channels lined with a single layer of endothelial cells without any intervening normal neural tissue. Although, cavernous hemangioma may be clinically silent, but frequently cause variable neurologic manifestations; intracranial hemorrhage, seizures, and focal neurologic deficits. Frequent association of these two diseases has already been reported and it has been suggested that cavernous hemangiomas not the developmental venous anomalies that cause the acute clinical symptoms. A 4 year old girl with sudden onset of headache, vomiting, gait disturbance and signs of unilateral cerebellar dysfunction 2 days before admission showed a 2.5x2.5cm sized hematoma with heterogenous signal intensity both in CT and MRI in the left cerebellar hemisphere. Four-vessel cerebral angiography revealed characteristic findings of developmental venous anomalies. Pathologic findings of the surgically removed hematoma disclosed typical feature of cavernous hemangioma. Based on the findings in this case and review of the literatures, we concluded that the possibility of other diseases such as cavernous hemangiomas must be considered in patients who has intracranial hemorrhage due to the developmental venous anomalies.
Cerebellar Diseases ; Cerebral Angiography ; Child, Preschool ; Drainage ; Endothelial Cells ; Female ; Gait ; Headache ; Hemangioma, Cavernous* ; Hematoma ; Hemorrhage* ; Humans ; Intracranial Hemorrhages ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Seizures ; Vascular Malformations ; Vomiting

We have experienced a case of neurofibromatosis with unusual giant pigmentation, which presents itself as a 28 cm x 40 cm sized, serrated bordered light brownish patch speckled with small dark hyperpigmented macules on his back. Histopathologic examinations of light brown patch and speckles showed only an increase in basal melanin pigmentation.
Melanins ; Neurofibromatoses* ; Pigmentation*

No abstract available.
Gastrointestinal Stromal Tumors* ; Hemorrhage*

A lg year-old female patient with pityriasis lichenoides et varioliforrnis acuta (PLEVA) was been treated with PUVA, At first, she was treated with tetracycline for 8 weeks with improvement somewhat. But 2 months later, her skin lesions aggravated slowly. So, we tried to treated her with PUVA and then she was cleared completely. The initial dose of UVA was 5 J/cm The UVA dosage increased by 10g of the previous exposure and increased to the maximum dose, 15 J/cm The patient exposed to UVA R times per week. 12 times after the PUVA therapy, the skin lesions begin to improve and completely improved at 21 times of Pl.JVA therapy. She was followed up every week and there was no side effect except hyperpigrnentation till 24 months. The total dose during treatment is 210 J/cm.
Female ; Humans ; Photochemotherapy* ; Pityriasis Lichenoides* ; Pityriasis* ; PUVA Therapy ; Skin ; Tetracycline

Long term follow-up study was done on 38 cases of anterior fusion for spinal tuberculosis especially about effect of buttress graft. The average follow-up period was 16 months. 14 cases of effective buttress group were appeared' to achieve more rapid bony union and prevent further kyphosis or lateral wedging of the involved vertebral body than inadequate buttress group of 7 cases.
Follow-Up Studies ; Kyphosis ; Spine ; Transplants ; Tuberculosis ; Tuberculosis, Spinal

Paralytic hand is the ultimate result of permsnent damage of the central nervous system, failure of the functional repair of peripheral nerve injuries and extensive muscular or tendinous defect resulting in the impairment of hand function. There are a lot of controversies in the side of treatment methods in the paralytic hand, and it is very difficult to formulate the most adequate surgical reconstruction for a given pstient. At Depsrtment of Orthopedic Surgery, Seoul National University Hospital, 66 cases oi paralytic hands in 62 patients have been treated surgically with tendon transfers for 7 years from Jan, 1980 to Dec, 1986. 49 case in 46 patients were followed up for more than one year, and surgical method and its results were anslysed. They consist of CNS lesion (17), peripheral nerve lesion(23) and musulotenidinous defect(9). The methods of surgical reconstruction were opponenesplasty(12), standard set extensor reconstruction(9), Green and Bsnks FCU transfer(11), intrinsic reconstruction(7), pronator rerouting(7), adductorplasty (5) and so on. The mean follow-up was 2.2 years, and in 38 cases good or excellent results were obtained.
Central Nervous System ; Follow-Up Studies ; Hand ; Humans ; Methods ; Orthopedics ; Peripheral Nerve Injuries ; Peripheral Nerves ; Seoul ; Tendon Transfer

Bullous pemphigoid(BP) and herpes gestationis(HG) are subepidermal bullous diseases which show clinical and immunological similarities. Both diseases show immune deposits along the basement membrane zone and their autoantibodies bind a common antigenic site within the non-collagenous stretch of the 180 kDa BPAG2 ectodomain. Besides its association with pregnancy, HG has some characteristic features that distinguish it from BP. The serum of patients with HG often contains an IgG that avidly fixes complement, and showes IgG1 subclass predominance. We report here two cases of non-pregnant young women presenting clinical and histological features of bullous pemphigoid or herpes gestationis. The immunopathology, IgG subtyping and immunoblotting studies showed that the autoantibodies in the patients were the characteristic ones of herpes gestationis. The patients might be a subtype of BP that have characteristics of autoantibodies of HG patients.
Autoantibodies* ; Basement Membrane ; Complement System Proteins ; Female ; Humans ; Immunoblotting ; Immunoglobulin G ; Pemphigoid Gestationis* ; Pemphigoid, Bullous* ; Pregnancy

Since the introduction of percutaneous mitral valvotomy(PMV) in 1984, PMV was an effecive alternative to surgical commissurotomy in selected patients with severe mitral stenosis. Also PMV was an excellent palliative strategy in such patients who were high risk for operative management or longterm anticoagulation was not feasible. We performed PMV in a patient with very tight mitral stenosis and severe pulmonary hypertension under the general anesthesia because the patient was anticipated to be uncooperative due to mental problem, who was diagnosed as schizophrenia 16 years ago. Robinol was used for premedication and i.v fentanyl was used for maintenance of anesthesia. Inoue balloon was introduced into the LV and gradual ballooning was performed with favorable results. Total anesthesia time and interval from internal jugular vein puncture to the completion of valvuloplasty were 1 hour 45 min and 40 minutes respectively. Hemodynamic variables were improved immediately after intervention and mitral valve area was increased from 0.5cm2 to 1.3cm2.
Anesthesia ; Anesthesia, General* ; Fentanyl ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Jugular Veins ; Mitral Valve ; Mitral Valve Stenosis* ; Premedication ; Punctures ; Schizophrenia*

A 18 year-old boy developed a rheumatoid atlantoaxial subluxation with mild weakness of all extremities which developed relatively suddenly 4 months after the innitial symptom of neck pain. Skeletal traction followed by posterior C1-2 fusion with wiring and halovest were done successfully.
Adolescent ; Arthritis, Rheumatoid ; Extremities ; Humans ; Male ; Neck Pain ; Traction