Three cases of congenital coxa vara were treated by subtroch-anterie abduction osteotomy with percutaneous pin fixation of both fragments. The indications of the corrective subtrochanteric osteotomy for coxa vara deformity were the neck-shaft angle of 100 degress or less, the presence of marked gluteus medius limp and the vertical neck defect with progression of the varus deformity. Through a lateral approach, the lateral aspect of the proximal end to the femoral shaft was exposed and 2 Steinmann pins were inserted through the upper and lower levels to the proposed osteotomy. The distal pin was inserted perpendicular to the long axis of the femur and the proximal pin at an algle of desired correction to the distal pin and a subtrochanteric transverse osteotomy was completed. Two Steinmann pins were paralell to each other by adducting the proximal fragment and abducting the distal fragment. and the lateral cortex of the proximal fragment was impacted into the marrow cavity of the distal fragment. The Steinmann pins were then incorporated in the hip spica cast. The object of the operation was to correct the coxa vara, to change the stress on the vertical fissure in the neck from shear to compression and to overcome shortening of leg. With this technically simple method, the authors achieved adequate correction of the deformity. The ostetomies healed rapidly and the medullary canal was re-established in all cases, The gait of each patient was markedly improved and the Trendelenburg test become negative in all of them. One of these patients showed a mild recurrence of varus deformity and limp 2 years following surgery.
Bone Marrow ; Congenital Abnormalities ; Coxa Vara ; Femur ; Gait ; Hip ; Humans ; Leg ; Methods ; Neck ; Osteotomy ; Recurrence

Because of increasing resistance of circulating N. gonorrhoeae and frequent failures in the treatment of gonorrhoea, intensive work on gonorrhoea has become of paramount importance. During January 1980-April 1984, at the Choong-Ku VD Clinic in Seoul, 3,340 male patients with uncomplicated gonococcal urethritis were treated with various treatment regimens. Diagnosis of gonorrhoea and declaration of a treatment failure were made on the basis of positive urethral culture. In 1984, the prevalence of Penicillinase Producing N. gonorrhoeae (PPNG) was about 30%, The pretreatment minimun inhibitory concentration of various antibiotics were quite high. Even for non-PPNG urethritis standard penicillin regimens gave unsatisfactory results. For PPNG urethritis, only spectinomycin, cefoperazone and cefotaxim-probenecid regimens gave satisfactory results. No spectmomycin resistant strain of N. gonorrhoeae has been found since 1982 at the Choong-Ku VD Clinic. As an agent of single drug therapy, spectinomycin seems to be one of the most cost effective drugs in the treatment of uncomplicated gonorrhoea in men.
Anti-Bacterial Agents ; Cefoperazone ; Diagnosis ; Drug Therapy ; Humans ; Male ; Penicillinase ; Penicillins ; Prevalence ; Seoul ; Spectinomycin ; Treatment Failure ; Urethritis

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*

Infantile myofibromatosis is an uncornmon, benign, self-limiting, localized or generalized process, probably of hamartomatous origin, which consists to a large degree of cells having the characteristics of myofibroblasts and sometimes of pericytes. Both solitary and multicentric forms occur. Most lesions are present at birth or in early infancy, and some are familial in origin. A female newborn presented with a firm, round, red colored, 3 x 3 cm sized tumor with central necrosis on the left chest. Histological examination revealed well-circumscribed nodules consisting of short bundles of plump, spindle shaped cells displaying staining characteristics intermediate between fibroblasts and smooth muscle cells. The tumor was immunoreactive for actin but did not stain for desmin. A Follow-up examination at the age of 3 months revealed a moderate degree of spontaneous regressior of the lesion.
Actins ; Desmin ; Female ; Fibroblasts ; Follow-Up Studies ; Humans ; Infant, Newborn ; Myocytes, Smooth Muscle ; Myofibroblasts ; Myofibromatosis* ; Necrosis ; Parturition ; Pericytes ; Thorax

BACKGROUND: Generally, there are few problems in the diagnosis of Paget's disease(PD) using the H&E stain. However, the differentiation of PD from the clonal type of Bowens disease and superficial spreading melanoma in situ that shows pagetoid spreading of tumor cells, may present diagnostic difficulties. In addition, the specia1 stains used for demonstrating the presenee of Pagets cells, such as PAS and mucicarmim, are non-specific and not always sensitive. So, inenunohistochemical stains with monoclonal antibodies against various antigens may be helpful for differentiating PD from ather morphologically similar skin lesions. OBJECTIVE: The purpose of this study was to investigate the diagnostic accuracy of immunohisto- chemical staining for diagnostic use in PD. METHODS: Immunohistochemical stains used in the biotin streptavidin amplificxl technique with monoclonal antibodies to several low rnolecular weight cytokeratin(CK)s, EMA and CEA, were performed on formalin-fixed, paraffin-embedded tissue. Twelve cases of PD(10 cases of extranmmmary PD and 2 cases of mammary PD), five cases of superficial spreading melanoma in situ and five cases of Bowens disease were investigated. RESULTS: The results were as follows. 1. Positive reactions with variable intensity using CK7, CKS, CK19 were seen in all cases(100%) of PD and the. staining intensity tor CK7 or CK19 was stronger than that of CKS. 2. Of the 12 cases of PD, both CK18 and CAM5.2 staining showed positivity in 11 cases(92%). 3. EMA and CEA staining showed positivity in 10(83%) and 9(75%) of 12 cases, respectively. 4. Some Pagets cells were negative for CK8, CK18 and EMA, although other positive cells were observed in the same sections. 5. All antigens were consistently negative in all cases of Bowens disease and superficial spreading melanoma in situ. CONCLUSION: The results show that moaoclonal antibodies to low molecular weight CKs are more sensitive than EMA or CEA in the demonstration of Pagets cells. Moreover, among the low molecular weight CK series, CK7 and CK19 are most useful for their high sensitivity and intensity.
Antibodies ; Antibodies, Monoclonal ; Biotin ; Bowen's Disease ; Coloring Agents ; Diagnosis ; Melanoma ; Molecular Weight ; Skin ; Streptavidin

BACKGROUND: The high level of susceptibility of patients with liver cirrhosis (LC) to septicemic infection is thought to be due to decreased reticuloendothelial function and irnpairment of several components of cell mediated and humoral immunity. It is well known that LC may cause many characteristic skin changes including jaundice, spider angioma, palmar erythema, xanthelasrna and nail changes such as clubbing and white nails. OBJECTIVE AND METHODS: During a 7 month period frorn April to October 1995, 100 patients who had been diagnosed as having LC were evaluated for the duration of their LC, the associated diseases they had apart from LC and various skin manifestations. Also, we performed the tuberculin test in 20 patients with LC and evaluated the correlation of the tuberculin test with severity of LC divided into 3 groups according to the Childs classification. RESULTS: The results are summarized as follows ; 1. The most frequent duration of LC was under 5 years (74%). 2. The most common associated disease of patients with LC was upper GI bleeding including esophageal varix (24 cases). Also, diabetes mellitus (13 cases) and hepatic coma (11 cases) were observed. 3. Jaundice (82 cases) was the most frequent skin rnanifestation of patients with LC. In addition, vascular changes (81 cases) and various nail changes (69 cases) were observed. Onychomychosis was the most common nail change of patients with LC. 4. 60% of the patients who were given the tuberculin test showed anergy, and the frequency of anergy increased in proport on to the severity of LC. However, it was not significant statistically (p> 0.05 ). CONCLUSIONS: Some of the skin manifestations help in the diagnosis of LC. Also, increased frequency of tuberculin test anergy in proportion to the severity of LC is thought to be related to decreased cell mediated immunity, although statistically it is not significant.
Child ; Classification ; Diabetes Mellitus ; Diagnosis ; Erythema ; Esophageal and Gastric Varices ; Hemangioma ; Hemorrhage ; Hepatic Encephalopathy ; Humans ; Immunity, Cellular ; Immunity, Humoral ; Jaundice ; Liver Cirrhosis* ; Liver* ; Skin Manifestations* ; Skin* ; Spiders ; Tuberculin Test

No abstract available.
Anesthesia* ; Humans

During the past three years, 110 consecutive cases of intravenous lidocaine anesthesia under tourniquet for surgery in the upper extremities were observed. The cases were simple injuries or diseases which needed simple surgery or closed reduction requiring only a short period of time. A tourniquet with double cuff was utilized. After tourniquet inflation, 0.5% or 0.75% lidocaine was injected intravenously in the amount of 1.5 mg per Kg body weight. Satisfactory anesthesia was performed in all except 18 cases who had some discomfort of tourniquet origin and analgesics were necessary. No significant complication was noticed. The technic was very simple, safe and effective for simple procedures on hands or forearms.
Analgesics ; Anesthesia ; Anesthesia, Conduction ; Body Weight ; Forearm ; Hand ; Inflation, Economic ; Lidocaine ; Tourniquets ; Upper Extremity

Fibrofolliculoma is a benign follicular neoplasm which usually occurs in multiple and rarely solitarily. We have found only seven cases of previous reports of solitary fibrofolliculomas worldwide and only two in Korean literature. Herein we report on a 40-year-old female patient with a solitary flesh-colored bean sized mass on the scalp which histopathologically proved to be a fibrofolliculoma.
Adult ; Female ; Humans ; Scalp

BACKGROUND: Stellate ganglion block (SGB) is known to increase blood flow to the innervations area of the stellate ganglion. Near infrared spectroscopy reflects an increased blood volume and allows continuous, non-invasive, and bedside monitoring of regional cerebral oxygen saturation (rSO2). We investigated the influence of SGB on bilateral cerebral oxygenation using a near infrared spectroscopy. METHODS: SGB was performed on 30 patients with 1% lidocaine 10 ml using a paratracheal technique at the C6 level and confirmed by the presence of Horner's syndrome. The blood pressure (BP), heart rate (HR) and rSO2 were measured before SGB and 5, 10, 15 and 20 minutes after SGB. Tympanic temperature of each ear was measured prior to SGB and 20 minutes after SGB. RESULTS: The increments of the rSO2 on the block side from the baseline were statistically significant at 5, 10, 15 and 20 minutes. The rSO2 on the non-block side compared with the baseline, however, decreased at 15 and 20 minutes. The difference between the block and the non-block sides was significant at 15 and 20 minutes. The BP at 10, 15 and 20 minutes was increased and the HR was increased at 10 and 15 minutes. CONCLUSIONS: We observed an increment of the rSO2 on the block side from the baseline; however, the rSO2 on the non-block side decreased.
Blood Pressure ; Blood Volume ; Ear ; Heart Rate ; Horner Syndrome ; Humans ; Lidocaine ; Oxygen ; Spectrum Analysis ; Stellate Ganglion