It is generally recognized that several chemical mediators are involved in tbe pathogenesis of sunbum; however, the exact mechanism is still to he resolved. Recently, prostaglandin has been found to be one of the inflammatory mediators in sunbum, particularly in the delayed erythema response and several investigators have shown that the nonsteroidal antiinflammatory drugs inhibit the in vivo synthesis of prostaglandin. On the assumption that the nonsteroidal antiinflammatory drugs might exert a beneficial effect on the sunbum through the antiprostaglandin effect, several authors have reported the effect of indomethacin on sunbum. This study was undertaken to evaluate the effect of topical indomethacin on the delayed erythema response induced by artificial sunlamp and sunlight by clinical and histopathological examination. Indomethacin(2. 5% ointment, 2. 5% solution, 5% solution) was applied immediately after 3 MED irradiation of artificial sunlamp to the shaved back skin of 6 healthy albino guinea pigs weighing 550-850gm and 9 human volunteers and the delayed erythema response was observed at 2, 4, 6, 12, 24 and 48 hours after irradiation respectively. Punch biopsies of the skin were performed on 6 guinea pigs at 6, 12, 24 a.nd 48 hours after irradiation and the histologic changes were observed. Four human volunters were exposed t,o 3 MED of sunlight and indomethacin preparations were applied immediately after irradiation. The delayed erythema response was observed at 2, 4, 6, 12, 24 and 48 hours postirradiation and in one volunteer, the skin was biopsied at 24 hour for histologi.c evaluation. The results were as follows: 1. Topical indomethacin in ointment or solution forms delayed and decreased the appearance and degree of erythema induced by sunlight and artificial sunlamp in both human and animal subjects. 2. Histologically, the number of sunbum cells at 24 hour in the epidermis of one human volunteer was decreased on indomethacin applied sites. The dermis showe6 no difference in histologic changes between control and indomethacin sitea. In animal study, however, no detectable difference in epidermal or dermal changes was observed between control and indomethacin applied sites. The autors confirmed that topical indometha,cin was effective in delaying and blanching of the delayed erythema of sunbum in guinea pigs as well as in human volunteers, though there was no difference in histologic changes between indomethacin and control sites in guinea pigs. The mechanism involvel on this aspect is remained to be resolved.
Animals ; Biopsy ; Dermis ; Epidermis ; Erythema ; Guinea Pigs ; Healthy Volunteers ; Humans ; Indomethacin* ; Research Personnel ; Skin ; Sunburn* ; Sunlight ; Volunteers

We report a case of hepatoma with duodenal metastasis in a 53 year-old male patient. Hepatoma was confirmed by fine needle aspiration cytology technique, and duodenal metastasis by gastrofiberscopic biopsy. Duodenal metastasis of hepatoma is rare. We briefly review the role of fine needle aspiration cytology technique in diagnosis of hepatoma.
Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Hepatocellular ; Child* ; Diagnosis ; Endodermal Sinus Tumor ; Humans ; Male ; Mediastinum ; Middle Aged ; Neoplasm Metastasis ; Proteinuria* ; Specific Gravity*

Pressure sores are common complications in patients with spinal injuries or cerebrovascular accidents. The management of pressure sores requires prolonged hospitalization and repeated surgical interventions with a high recurrence rate. Particularly osteomyelitis following initial pressure sores persistently complicates wound healing and recovery. Furthermore, it may also ultimately result in serious sepsis; thus an early diagnosis of osteomyelitis in pressure sore patients is crucial along with appropriate surgical and antibiotic therapy. Although many diagnostic methods were reported, there is no single 'gold' standard for early diagnosis of pressure sore-associated osteomyelitis. Authors reviewed pre-operative CBC, plain X-ray, Tc-99m bone scan, and post-operative biopsy results in 37 patients who had received surgical treatment for pressure sores in a 5-year period from September 1991 to August 1996. Based on these reviews, authors compared and analyzed the sensitivity and specificity in diagnosing osteomyelitis.The results were as follows: 1. Of 37 patients studied, 25 cases were confirmed histologically as osteomyelitis. Ischial region revealed the highest incidence of pressure sore-related osteomyelitis(78%, 14 out of 18 cases) while the regional incidence was as following in descending order : ischial, sacral, and greater trochanteric area. 2. Tc-99m bone scan had superior sensitivity(100%) and specificity(83%) to other pre-operative studies in diagnosing osteomyelitis.In conclusion, authors suggest that Tc-99m bone scan is the best diagnostic method because of its high sensitivity and specificity if osteomyelitis is clinically suspected in pressure sore patients. And in case the test result is positive, agressive surgical bone resection and appropriate antibiotic therapy based on bacterial culture from deep bone specimen should be combined to prevent complications or recurrences.
Biopsy ; Early Diagnosis ; Femur ; Hospitalization ; Humans ; Incidence ; Osteomyelitis ; Pressure Ulcer* ; Recurrence ; Sensitivity and Specificity ; Sepsis ; Spinal Injuries ; Stroke ; Wound Healing

Complications after a median sternotomy incision, which is used currently in most open heart surgery, are serious, although it is infrequent. Reconstruction of the sternal defect resulting from dehiscence of median sternotomy is still big challenge to the most plastic surgeons. Since vascularized greater omentum was transposed to eliminate mediastinal wound problems, many vascularized regional muscle flaps became mainstay in reconstruction of median sternotomy wound. We treated 13 patients with median sternotomy dehiscence between October of 1993 and March of 1998. In two patients, the wound problems were so confined to superficial tissue that debrided and closed primarily. Eleven patients with deep wound infection were managed with vigorous debridement of all necrotic tissues and resultant defects were covered with regional muscle flaps: rectus myocutaneous flap(3) and bilateral pectoralis advancement flap(8). We used the pectoralis major advancement flaps without counter incision at humeral insertion site and the dissections were limited only medial to the anterior axillary line to preserve the axillary fold. In five patients with larger defects, we elevated muscle and cutaneous flaps separately to make these flaps more mobile. Large portion of two rectus abdominis flaps could not survive, whereas pectoralis advancement flaps had mo special wound problems. Only one patient developed fistula due to remained wire, regardless to flap surgery.
Debridement ; Fistula ; Humans ; Omentum ; Rectus Abdominis ; Sternotomy* ; Thoracic Surgery ; Wound Infection ; Wounds and Injuries

Miescher syndrome comprises congenital acanthosis nigricans, hypertrichosis, failure to thrive and short stature, dysmorphism especially of the jaws and oral cavity, insulin-resistant diabetes mellitus, and a characteristic general appearance. This report concerns a rare case of 12-year-old girl having insulin resistant diabetic mellitus with Miescher syndrome. The relevant literature was reviewed.
Acanthosis Nigricans ; Child ; Diabetes Mellitus* ; Failure to Thrive ; Female ; Humans ; Hypertrichosis ; Insulin ; Jaw ; Mouth

Benzoyl peroxide has been known to have bacteriostatic activity against Corynebacterium acnes and to have comedolytic action in patients with acne vulgaris. The present study was undertaken to evaluate the therapeutic effect of Renoxal, a 5% benzoyl peroxide lotion, in patients with acne vulgaris. A total of 35 patients entered this study at the Department of Dermatology, Seoul National University Hospital during the five months period from March to July, 1978. All patients were instructed to apply Benoxal on their affected sites once or twice daily; and the number of lesions on three fixed areas were counted before and every week for four weeks after the treatrnent. Two female patients stopped the application due to developrnent of contact dermatitis to Benoxal The results observed in the 33 patients were as follows: 1. The percentage decrease in total number of lesions in four weeks after treatment was 51.1% 2. Closed and open comedones were gradually eliminated; and their numbers were decreased in four weeks after treatment by 45. 8% and 55. 3% respectively. The papules were decreased. by 59. 1 @2 after the first week of treatment, but showed. a transient lag around tbe second week and then marked 61. 5% in four weeks after treatment. 3. Observed side effects included burning sensation,(3 cases), tightness (3 cases), itching sensation (2 cases) and scaling (1 case). All were tolerable without any specific measure or discontinuance of the application. The authors concluded througb this experiment that Benoxal (5% benzoyl peroxide lotion) is a very effective local therapeutic agent in the treatment of acne vulgaris patients.
Acne Vulgaris* ; Benzoyl Peroxide ; Burns ; Dermatitis, Contact ; Dermatology ; Female ; Humans ; Propionibacterium acnes ; Pruritus ; Sensation ; Seoul ; Thiram

No abstract available.
Alcoholism* ; Memory*

The antihypertensive efficacy and safety for once daily dosing of amlodipine, a new calcium channel blocker, was studied in a series of 36 patients with essential hypertension. The starting dose of amlodipine were 5mg/day, which were doubled after 4 weeks, if normalization of diastolic blood pressure was not reached. Amlodipine induced a clinically significant reduction in blood pressure(17.7mmHg in systolic blood pressure and 11.9mmHg in diastolic blood pressure) with similar heart rates after 12 weeks therapy. The efficacy of amlodipine therapy was noted an excellent in 18 patients(51.4%), good in 8 patients(22.9%), fair in 5 patients(14.3%), and failed in 4 patients(11.4%). There were few side reactions such as fatigue, headache, constipation and indigestion, but all studied patients completed for 12 weeks therapy except one patients who did not return. And also there was no abnormal results of laboratory tests before and after the amlodipine therapy. This results indicated that amlodipine is an effective and safe new long-acting calcium channel blocker in the treatment of hypertension.
Amlodipine* ; Blood Pressure ; Calcium Channels ; Constipation ; Dyspepsia ; Fatigue ; Headache ; Heart Rate ; Humans ; Hypertension*

Cloeortolone (9-a-chloro-6-a fluoro-11-B 21 digydroxy-16 methyl preganl,4-diene) is a newly synthesized corticonsteroid which has been found to have potent antinflammatory action and good tolerance through animal experiment. Several investigators reported its therapeutic affect in various dermatoses by topical application. The present was undertaken to evaluate the therapeutic effect of 0.1% clocortolone cream (Purantix-Sandoz) in patients with eczematous dermatoses and with psoriasis and to compare its effect with that of I% hydrocortisone. Eleven patients with contact dermatitis, 10 with psoriasis entered this study durtin the period of 6 months from January to june, 1977 at the Department of Dermatology, Seoul National University Hospital. All patients were instructed to apply 0.1% Clocortolone cream on one side of their lesion and 1%hydrocortisone cream on the opposite site for two weeks. After wo weeks' period of observation the status of the lesion was evaluated clinically and the tesults were as follows. 1. Ninety one percent of patiens with contact dermatitis, 70% of atopic dermatitis, 60% of nenrodermatitis, 67% of nummular eczema and 60% of psoriasis responded very effectively or moderately effectively. The therapeutic responses were generally similar to that of 1% hydrocortisone. 2. During the ovservation period, there was no systemic of local side effect of 0.1% Clocortolone cream.
Animal Experimentation ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatology ; Eczema ; Humans ; Hydrocortisone ; Psoriasis ; Research Personnel ; Seoul ; Skin Diseases*

The hyperlipoproteinemias are the disturbance of lipid transport resulted from accelerated synthesis or retarded degradation of lipoproteins that transport cholesterol and trigycerides through plasma. These diseases are classified as type I, type IIa, type IIb, type III, type IV, type V, and hyper- -lipoproteinemia by lipoprotein phenotype. Type V hyperlipoproteinemia is uncommon in childhood and characterized by elevation of triglyceride levels due to increases in both VLDL and chylomicrons and lipoprotein electrophoresis shows increased pre- , , and chylomicron bands. We experienced a case of hyperlipoproteinemia type V in a 12 year old male who presented no specific signs and symptoms. So, we report a case of hyperlipoproteinemia type V with brief review of the literatures.
Child ; Cholesterol ; Chylomicrons ; Electrophoresis ; Humans ; Hyperlipoproteinemia Type V* ; Hyperlipoproteinemias ; Lipoproteins ; Male ; Phenotype ; Plasma ; Triglycerides