The nodular vasculitis described by Montgomery on 1945 and is characterized by relatively chronic, persistent, or recurrent nodular lesions of nontuberculous origin chiefly on the legs. In the differential diagnosis the following must also be considered; erythema induratum, eythema nodosum, Weber-Christian disease, erythema nodosum migrans, recurrent thrombophrebitis and periarteritis nodosa. The authors observed one case of nodular vasculitis caused by sulfa drug. This patient was diagnosed to papulonecrotic tuberculid at first and treated by prednisolone 20 mg, INH 300 mg and streptomycin l.0 gm BIW. By the treatment, the patient, was cured completly within 3 months but visited again because of recurrence after 6 months. Therefore, same medication was given, but did not show improvment and added sulfa drug, Lederkyne. But, unfortunately the skin lesions was aggrevated after sulfa medication. It was suggestive that the cause of aggrevation was sulfa drug and discontinued the sulfa drug. The skin lesions were completely cured after the drug was discontinued.
Diagnosis, Differential ; Erythema Induratum ; Erythema Nodosum ; Humans ; Leg ; Panniculitis, Nodular Nonsuppurative ; Polyarteritis Nodosa ; Prednisolone ; Recurrence ; Skin ; Streptomycin ; Tuberculosis, Cutaneous* ; Vasculitis*

This study was performed in order to explore the immunologic relationship between the skin lesions induced by the human serum and the lymphatic organs. For these purposes, the authors induced the dermatitis in the rabbits by the injections of pooled human serum with Freunds complete adjuvant into the skin, and administered prednisolone and azathioprine as immunosuppressive drugs to the rabbits. Immunologic asmy was performed by the measurement of the plasma ceIls and immunogobulin-bearing B lymphocytes in lymph node and spleen. The results were as follows: 1. By the injections of human serum pyroninophilic cells and immunoglobulining B lymphocytes in lymph node and spleen were increased. 2. By the administrations of prednisolone and azathioprine, pyroninophilic cells and immunoglobulin-bearing B lymphocytes in lymph node and spleen were all decre RSCd.
Azathioprine ; B-Lymphocytes ; Dermatitis* ; Humans ; Immunoglobulins ; Lymph Nodes ; Plasma ; Prednisolone ; Rabbits* ; Skin ; Spleen

Heat disorders are not uncommon in the military society due to supposedly hard training to overcome the environmental conditions. Twenty-two soldiers with heat disorders were admitted to Chin Hae Naval Hospital June 1969 through July 1970. Hoping that our clinical studies on them contribute to a renewed understanding, the results are reported in summary as follows: 1) Heat disorders occurred with an overall incidence of 3.1 per cent during running in early summer. 2) Of the twenty-two patients, eight (37 per cent) had heat cramps, six (27 per cent) heat exhaustion, five(23 per cent) heat stroke, and three(13 per cent) had undetermined disorder. 3) Ten patients(45 per cent) were comatous, and this occurred most frequently(80 per cent) among those with heat stroke. 4) All patients were grouped into four according to their physical status on admission. Those with heat exhaustion mostly belonged to group I (good) or group II (fair). Those with heat stroke and heat cramps eomprised most of group III (poor) and group IV (grave). 5) Group I and II patients recovered within 12 hours; group III, within 12~24 hours; and group IV, required more than 24 hours of care. 6) One patient with heat stroke, graded V, expired with sudden hypothermia 15 hours following admission. Overall mortality of heat disorders was 4.5 per cent, and that of heat stroke 20 per cent. 7) The rest recovered uneventfully within 19 hours of average.
Chin ; Emergencies* ; Heat Exhaustion ; Heat Stress Disorders ; Heat Stroke ; Hope ; Hot Temperature* ; Humans ; Hypothermia ; Incidence ; Military Personnel ; Mortality ; Running

Temporal and spatial expression of bmp-2 and bmp-4 was investigated in distraction osteogenesis and fracture healing models in order to delineate their roles in these new hone formation processes. Distraction osteogenesis was performed on the left tihia diaphyses of Sprague-Dawley rats, and was confirmed by serial radiographs and histologicaJ examination. Total RNA was isolated from the distraction gaps and fracture sites sequentially until the postoperative eighth week, and mRNA expression was quantitated hy competitive reverse transcription-polymerase chain reaction(RT-PCR) using specific primers for bmp-2 and bmp-4. In-situ hybridization was performed on the undemineralized tissue section of distraction osteogenesis group. Both bum-2 and bmp-4 mRNA expression increased during distraction osteogenesis and fracture healing. Increase in bmp-2 mRNA expression was more marked and prolonged in distraction osteogenesis compared with fracture healing, whereas bmp-4 mRNA expression was persistently increased in both groups. In-situ hybridization study revealed that hoth bmp-2 and bmp-4 were expressed at eariy osteohlasts producing osteoid, trabeculae-lining osteoblasts and osteocytes of regenerate bone. Enhanced new bone formation in distraction osteogenesis is associated with prolonged and increased expression of BMPs, especially BMP-2. lnspite of their structural similarity, BMP-2 and BMP-4 appear to have their distinct roles in new hone formation.
Bone Morphogenetic Proteins* ; Diaphyses ; Fracture Healing* ; Osteoblasts ; Osteocytes ; Osteogenesis ; Osteogenesis, Distraction* ; Rats, Sprague-Dawley ; RNA ; RNA, Messenger*

Wegener's granulomatosis is a disease of unknown etiology that is characterized by the clinicopathologic complex of necrotixing granulomatous vasculitis of the upper and lower respiratory tract, glomerulonephritis, and variable degrees of small vessel vasculitis. Recently Antineutrophil Cytoplasmic Antibody (ANCA) has been reported to be a highly specific test for the diagnosis of Wegener's granulomatosis. We have experienced a patient of Wegener's granulomatosis in a 11 year old girl who was admitted with complaints f arthralgia, hematuria, convulsion and associated with otitis media and sinusitis. Serologic test of C-ANCA was positive and histologic findings of the kidney showed crescentic glomerulonephritis with sclerosis and surrounding infiltration of multinucleated giant cells. Patient was treated with pulse methylprednisolone without improvement. The clinical course progressed rapidly and expired due to the renal failure, gastrointestinal bleeding and status epilepticus. A brief review of literatures was made.
Antibodies, Antineutrophil Cytoplasmic* ; Arthralgia ; Child ; Diagnosis ; Female ; Giant Cells ; Glomerulonephritis ; Hematuria ; Hemorrhage ; Humans ; Kidney ; Methylprednisolone ; Otitis Media ; Renal Insufficiency ; Respiratory System ; Sclerosis ; Seizures ; Serologic Tests ; Sinusitis ; Status Epilepticus ; Vasculitis ; Wegener Granulomatosis*

Erythromelalgia(Erythermalgia) is a syndrome of red, warm, congested, and burning painful extremities. Presently, there are three distinct clinicopathological entities: erythromelalgia, primary erythermalgia, and secondary erythermalgia. Secondary erythermalgia usually arises at an adult age either in association with a detectable underlying disorder or with the use of vasoactive drugs. Typically, it responds to proper treatment of the underlying disorder or discontinuation of the causative drugs. A seven-year-old boy presented with persisting burning pain, erythema, and warmth on both of his feet and lower legs, along with hypertension. He had had this condition for 20 months. Laboratory studies of the patient revealed increased urinary catecholamines and plasma renin activity. Various treatment modalities including aspirin, captopril, sodium nitroprusside, labetalol, epidural block, and stellate ganglion block yielded unfavorable results. Herein, we report an intractable case of secondary erythermalgia associated with hypertension in a child.
Adult ; Aspirin ; Burns ; Captopril ; Catecholamines ; Child ; Erythema ; Erythromelalgia* ; Estrogens, Conjugated (USP) ; Extremities ; Foot ; Humans ; Hypertension* ; Labetalol ; Leg ; Male ; Nitroprusside ; Plasma ; Renin ; Stellate Ganglion

No abstract available.
Nasal Polyps*

Sixteen patients who underwent 18 modified Colonna capsular arthroplasty for old unreduced DDH1 between 1984 and 1992 were recalled and critically reviewed. The average age at operation was 11.5 years (range, 8.1 to 14.5 years). The average follow-up period was 7 years and 1 month (range, 5 to 13 years). All of the patients had pain or discomfort of the hip and limp. Femoral shortening was combined in all patients, and 13 hips required concurrent pelvic osteotomy (Chiari osteotomy in 5 hips Salter innominate osteotomy in 1 hips and Steel s osteotomy in 2 hips) or slotted shelf augmentation (5 hips) due to small and shallow acetabulum relative to the femoral head. In the remaining 5 hips which had thick medial acetabular wall acetabular reaming alone was performed. At the latest followup, 9 hips showed excellent 5, good; and 4, fair results according to the modified Harris hip score and IOWA hip score. In addition, all patients except one were satisfied with the outcome in terms of regaining hip stability and decrease in pain or discomfort and limp. Radiological evaluation revealed progressive, significant increase in size of the femoral head and sphericity improvement in 12 hips. The sphericity of the femoral head did not improve in other 2 hips. In the remaining 4 hips, in which preoperative femoral head shape was relatively aspherical, the sphericity worsened after affection of ischemic necrosis or osteoarthrosis. Complications included undisplaced femoral neck fracture during physiotherapy in 2, ischemic necrosis in 2, heterotropic ossification in 2, acetabular protrusio due to too much reaming in 3 hips, and residual subluxation requiring additional pelvic surgery in 2 hips, In conclusion, we believe that modified Colonna capsular arthroplasty with femoral shortening is valid, if properly done, in the reconsruction of painful hip with old unreduced DDH in late childhood and adolesence.
Acetabulum ; Adolescent* ; Arthroplasty* ; Femoral Neck Fractures ; Follow-Up Studies* ; Head ; Hip ; Humans ; Iowa ; Necrosis ; Osteoarthritis ; Osteotomy ; Steel

No abstract available.

The purpose of this study is to investigate the effect of lengthening in long bones on the articular carilage by observing the changes in articular cartilage, Fifty-seven rabbits of growing period were divided into four lengthening groups; 5%, 10%, 20%, and 30%. Lengthening by callotasis that was done on the left tibiae and right tibiae were used as control. After lengthening histopathological, histochemical and autoradiographic studies were done on the proximal and distal tibial articular cartilages. That following observations were made. 1. As compared with controls, statistically significant degenerative changes were noted in proximal and distal articular cartilages when the tibiae were lengthened 10% or more. 2. In the proximal joints, the changes were significant between 10% and 20% lenghtening groups, but not between the 20% and 30% lengthening groups. 3. In the distal joints, the changes were significant. Not only were there between 10% and 20% lengtening groups but also there were between 20% and 30% lengtening groups. 4.Degenerative changes were frequently found in the intermediate zone between the periphery and the center, where most of the weight is borne.5. Decrease in matrix content of degenerated articular cartilage was noted by histochemical studies using safranin-0 and Alcian-blue.6. Autoradiography with S04 was done to quantitate matrix content of articular cartilage, and the mean uptake ratio of the articular cartilage was slightly higher than others in the 30% lengthening group. This esuggest decreased matrix synthesis, but no statistical significance was found. Following conclusion were drawn from above observations. 1. In rabbits, tibial lengthening tended to cause microscopic degenerative changes, and the changes begun to appear when the tibiae were lengthened 10% or more. 2. When lengthened over 20%, the changes became more pronounced in the distal joint than in the proximal joint.
Autoradiography ; Bone Lengthening ; Cartilage, Articular ; Joints ; Leg ; Osteogenesis, Distraction ; Rabbits ; Tibia