No abstract available.
Ear* ; Humans ; Tissue Donors* ; Transplants*

BACKGROUND: Livedo vasculitis shows variable clinical and histopathologic features according to its courses. There are also some discrepancies in histopathologic findings between the authors. OBJECTIVE: Our purpose is to clarify the clinical and istopathologic feat tures of livedo vasculitis. METHODS: We reviewed the clinical and histopathologic features in cluding direct immunofluorescence study and response to treigtment in eight patients with livedo vasalitis. RESULTS: The ratio of males to females was 1:3 with female predusm nance. Age of onset was predominant, in young to middle-age, ranging from 19 to 64 years old. In seven patients skin lesions were aggravated during the summe, and in one patient during the winer. All patients had purpuric or telangiectatic lesions on the lower extremities. Painful ulcers developed in seven patients and some of the ulcers healed with whitish atrophic scars. Five patients had preceeding livedo reticularis. One patient had Raynauds phenomenoin and the other patients did not show alinormal findings related to the systemic diseases. Histopathologically, in two patients fibrinoid materi.il was deposited in the vessel walls mildly, and in six patients obviously with partial to complete obst,r iction of blood vessels. Extravasation of RBCs and thrombus formation were found clearly in seven patients, but in one patient these findings were observed in a mild degree. Endothelial swellings were obserrved in all patients. Perivascular infiltrations of mononuclear cells were also observed in all patients in various degrees. But only two patients with secondary bacterial infection showed neutrophil infilt ations or nuclear dusts. So, histopathologic findings are corripatible with lymphocytic vasculitis. The locations of predominantly affected vessels were variable. Direct immunofluorescence studies were done in six patients. Four of these patients showed positive findings. At least 4 months were needed for the complete healing of the skin lesions. CONCLUSION: Livedo vasculitis is chronic vasculit is aggravated in mostly summer. Most of the initial purpuric lesions progress to ulcers which is healed with whitish atrophic scars. Histopathoiogic findings suggest livedo vasculitis is a sort of lymphocytic vasculitis.
Age of Onset ; Bacterial Infections ; Blood Vessels ; Cicatrix ; Dust ; Female ; Fluorescent Antibody Technique, Direct ; Humans ; Livedo Reticularis ; Lower Extremity ; Male ; Middle Aged ; Neutrophils ; Skin ; Thrombosis ; Ulcer ; Vasculitis*

No abstract available.
Breast ; Paget's Disease, Mammary*

Ae opposed to most other drug eruptions, drug-induced pemphigus may not develop for at least several months following the initiation of therapy with the offending agent. Unlike sporadically occuring pemphigus, the clinical and hietopathologic patterns of drug-induced pemphigus are most often those of pemphigus foliaceus. We report a case of diphenylhydantoin-induced pemphigus occuring in 30-year-old male with epilepsy. A few coinsized erythematous scaly patches developed on his fae, chest, snd left wrist, and two flaccid bullae on erythemstous base developed on his abdomen after three years snd nine months of therapy with diphenylhydantcin. Histopathologicslly, a biopsy specimin taken from a bullous lesion revealed that bulla is formed just beneath the granular layer and aeaitholytic cells are seen within the bulla. Direct and indirect irnmunofluorescence studies showed regitive findings. Administration of diphenylhydantoin was discontinued and he was treated with systemi and topical corticoeteroid. After 4 weeks, the skin lesions were healed with postinflammatory hysroigmentation and no new lesions were developed thereafter.
Abdomen ; Adult ; Biopsy ; Blister ; Drug Eruptions ; Epilepsy ; Humans ; Male ; Pemphigus* ; Phenytoin* ; Skin ; Thorax ; Wrist

This case was an acquired aplastic anemia patient who required a major operation for excision of a mediastinal mass. The authors previewed that the coagulation abnormalities would be developed due to major operation. Thus we decided to monitoring the coagulation function using the thromboelastography during the perioperative period and checked the complete blood count, concommitantly. The total blood volume lost during operation was 1800 ml, so we gave him a transfusion of 10 U's of platelet concentrate, 10 U's of pheretic platelet rich plasma and 5 U's of whole blood. The thromboelastography was a good guide that helped us to avoid excessive treatment of the coagulation abnormalities. We concluded that the thromboelastograhy was a reliable and effective monitoring system at the intraoperative coagulation management.
Anemia, Aplastic* ; Anesthesia, General ; Blood Cell Count ; Blood Platelets ; Blood Volume ; Humans ; Perioperative Period ; Platelet-Rich Plasma ; Thrombelastography

No Abstract Available.

The chin plays a decisive role in the contour of the lower face. And harmonious jaw will correspond to good facial profile and positive image. Osseous genioplasty is a widely used method to correct the 3-dimensional(sagittal, vertical, tranverse) deformity of the chin with minimal complications. During an 8 year period from 1988, the authors at the In-Je University Seoul Paik Hospital experienced 198 patients of osseous genioplasty. Results of clinical analysis are as follows : 1) Male to female ratio was 1 : 3 with female being predoniment. The average age was 24.9 years. 2) Horizontal advancement genioplasty in 169 cases was the most common procedure with 7.0mm of average advancement. There was 4 cases of horizontal retrusion with average retrusion of 4.3mm. 52 cases had vertical augmentation with average of 7.5mm increase. 9 cases had vertical reduction with average redution of 4.9mm. 3) Although malocclusion is not necessarilly contraindication to genioplasty alone, genioplasty following surgical with or without orthodontical correction of malocclusion is the way to get better result with patient satisfaction. 4) 77% of the patients had adjunctive procedures simultaneously to acheive a better contour and profile 5) Complications such as hematoma, infection, fracture, nerve damage were minimal.
Chin ; Congenital Abnormalities ; Female ; Genioplasty* ; Hematoma ; Humans ; Jaw ; Male ; Malocclusion ; Patient Satisfaction ; Seoul

Familial adenomatous polyposis (FAP) is an hereditary autosomal dominant disease characterized by development of hundreds to thousands of adenomatous polyps in the colon and rectum. The common symptoms are bloody stool, diarrhea, and abdominal pain. The average age at onset of symptoms is 33 years. Because of inevitable progression to malignancy, it is necessary to remove the entire colonic and rectal mucosa. Current surgical options are total proctocolectomy with permanent ileostomy, trans-abdominal colectomy with ileorectal anastomosis (IRA), and restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). Recently IPAA can give optimum control of colorectal polyposis in FAP patients with an acceptable incidence of postoperative complications and satisfactory functional results. We experienced one case of FAP who had malignacy in the remained rectum after subtotal colectomy. IPAA was done and the result was satisfactory.
Abdominal Pain ; Adenomatous Polyposis Coli* ; Adenomatous Polyps ; Colectomy* ; Colon ; Diarrhea ; Humans ; Ileostomy ; Incidence ; Mucous Membrane ; Postoperative Complications ; Proctocolectomy, Restorative ; Rectum*

No abstract available.
Humans ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn

The authors recently reported that over the years, the outcome of aneurysm surgery improved, and that surgical complications importantly affected this change. The present study was conducted to determine whether the incidence of symptomatic vasospasm in fact changed during the period under review, and the factors contributing to any changes. Between 1990 and 1995, 219 Hunt-Hess grade I to III patients with ruptured intracranial aneurysm underwent surgery within 3 days of subarachnoid hemorrhage ; all operations were performed by the same surgeon. Age, Hunt-Hess grade on admission, Fisher grade, hypertension, and hydrocephalus were analyzed to determine which factors were significant for syptomatic vasospasm, and for the periods 1990 to 1993, and 1994 to 1995, the distribution of each significant factor was then examined. Syptomatic vasospasm decreased significantly (p<0.05), but was seen in 28 of 124 patients(22.6%) treated beween 1990 and 1993 and 11 of 95(11.6%) treated between 1994 and 1995 ; no significant reduction of syptomatic vasospasm as a cause of mortality and morbidity (irreversible vasospasm) was seen, however, Fisher grade(p<0.05) and Hunt-Hess grade(p<0.05) significantly contributed to the development of symptomatic vasospasm, though the distribution of these two biologically significant factors was not statistically different. The question of whether or not surgery aggravates symptomatic vasospasm is controversial, and symptomatic vasospasm is, in addition, still an ill-defined disease entity. Except for the occurrence of fewer surgical complication and the fact that the incidence of reversible symptomatic vasospasm was less during the second period of treatment, no differences were found in the distribution of factors which significantly influenced symptomatic vasospasm, and this suggests that surgery affects the development of reversible symptomatic vasospasm. On the basis of increased risk of cerebral ischemia associated with surgery in vulnerable ischemic brain resulting from subarachnoid hemorrhage, the use of the term 'delayed ischemic neurologic deficit' after such hemorrhage appears to be more suitable than 'symptomatic vasospasm'.
Aneurysm* ; Brain ; Brain Ischemia ; Hemorrhage ; Humans ; Hydrocephalus ; Hypertension ; Incidence ; Intracranial Aneurysm ; Mortality ; Neurologic Manifestations* ; Subarachnoid Hemorrhage