We report herein a case of polymorphic pemphigoid in a 65-year-old woman, who had one-year history of generlized polymorphic eruption with intensely pruritic excoriated vesicobiullous lesions and residual pigmentation. Face and oral mucosa were spared. The skin biopsy specimen showed a subepidermal blister containing many eosinophils. Linear deposition of 1gG and C3 along the basement membrane was noticed on direct irnmunofluorescerice. Polyclonal garnmopathy with a tendency of beta-gamma bridging and increased IgG, IgA and kappachain, was frund on serum protein electrophoresis and immunoelectrophoresis. Skin lesions were well coritrolled by a combined therapy of prednisolone(20 mg/d), dapsone(100 mg/d) and cyclophosphamide(100 mg/d) for 4 months. Direct immunofluorescence performed 11 rnonths after the cnmpletion of the therapy was negative.
Aged ; Basement Membrane ; Biopsy ; Blister ; Electrophoresis ; Eosinophils ; Female ; Fluorescent Antibody Technique, Direct ; Humans ; Immunoelectrophoresis ; Immunoglobulin A ; Immunoglobulin G ; Mouth Mucosa ; Pemphigoid, Bullous* ; Pigmentation ; Skin

PURPOSE: We performed this study to assess the value of CT in the differential diagnosis of palpable neck masses in children. MATERIALS AND METHODS: We retrospectively reviewed the CT scans of the palpable neck masses in 30 children. The masses were proved histopathologically and classified into cystic, solid, and inflammatory mass and their CT findings were analyzed. RESULTS: Twelve cases were cystic masses, 4 were solid masses, and 14 were inflammatory lesions. Cystic masses included cystic lymphangiomas (n=6), branchial cleft cysts (n=3), thyroglossal duct cysts (n=2), and ranula (n=l). Cystic lymphangiomas showed insinuating appearances into adjacent structures and 4 cases occurred in the posterior cervical space. All branchial cleft cysts were round cystic masses with smooth wall and displaced the submandibular gland anteriorly and the sternocleidomastoid muscle posteriorly. Two thyroglossal duct cysts occurred centrally adjacent to the hyoid bone and 1 ranula in the submental area. Solid masses were juvenile hemangioma, pleomorphic adenoma in submandibular gland, neurilemmoma, and fibromatosis colli. Juvenile hemangioma showed well-enhancing mass with indistinct margin and the other solid masses had well-defined margin with their characteristic location. Inflammatory lesions were abscess (n=4), deep neck infections with lymphadenopathy (n=4), submandibular gland inflammation (n=3), and tuberculous lymphadenitis (n=3) and they showed strand-like enhancement in adjacent subcutaneous tissues. Tuberculous lymphadenitis had multiple lymph node enlargement with internal low attenuation areas and showed less surrounding strand-like enhancement than suppurative lymphadenopathies. CONCLUSION: Most neck masses in infants and children were of congenital or inflammatory origin. CT is useful for the evaluation of the child presenting with a neck mass, because it can differentiate various forms of neck masses and is able to reveal the relationship of the masses to the adjacent structures with their characteristic location.
Abscess ; Adenoma, Pleomorphic ; Branchioma ; Child* ; Diagnosis, Differential ; Fibroma ; Hemangioma ; Humans ; Hyoid Bone ; Infant ; Inflammation ; Lymph Nodes ; Lymphangioma, Cystic ; Lymphatic Diseases ; Neck* ; Neurilemmoma ; Ranula ; Retrospective Studies ; Subcutaneous Tissue ; Submandibular Gland ; Thyroglossal Cyst ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node

Contemporary cementing techniques improved the longevity of the cemented total hip replacement. The mechanical strength of acrylic bone cement can be changed by different handling techniques with reduction of the porosity of acrylic bone cement. The greatest improvement of the mechanical properties with reducing the porosity is that of the fatigue strength. We investigated the mechanical properties of the specimens of high viscosity, Palacos R(Merk, Darmstadt, FRG) bone cement with two mixing methods, hand and vacuum mixing. Vacuum mixing improved the ultimate tensile strength by 22.4% compared to hand mixing in previous study. For the uniaxial tension fatigue test, the specimens were cyclically loaded at a maximum stress of 25 MPa at a frequency of 2.5 Hz and to investigate the porosity, scanning electromicroscopic examination was taken in each hand mixed and vacuum mixed specimens. Scanning electromicrogram showed the vacuum mixed specimens to be the more uniform and free of small voids compared with the hand mixed specimens. The results of the fatigue test were analized using Weibull distribution of survival probability, the average number of cycles to failure was 1459±924 cycles in hand mixed specimens, in vacuum mixed specimens, 21491±14956 cycles. The average fatigue life of the vacuum mixed specimens was 15 times loanger than that of the hand mixed specimens by Weibull mean, this differene exists stastically within 95% confidence interval. We could suggest vacuum mixing technique as a method eliminating porosity in a chilled acrylic bone cement and thereby markedly improving the mechanical properties. In cemented joint replacement surgery, a vacuum mixing technique are recommended as a method of preparation of acrylic bone cement
Arthroplasty, Replacement, Hip ; Clothing ; Fatigue ; Hand ; Joints ; Longevity ; Methods ; Polymethyl Methacrylate ; Porosity ; Tensile Strength ; Vacuum ; Viscosity

We report a case of mixed connective tissue disease. A patient, 25-year-old woman, presented Raynaud phenomenon, proximal muscle weakness, sclerodactyly, fever, and diffuse alopeeia. In the serologic examination, antinuclear antibody and anti-RNP antibody were positiv but anti-native DNA antibody was negative. In direct immunofluorescent study of biopsy specimen of the skin, speckled epidermal nuclear staining of IgG and granular deposits of IgM at the dermoepidermal junction were seen: Electromyographic finding of the right deltoid and right gastrocinemius muscle was consistent with myopathy.
Adult ; Antibodies, Antinuclear ; Biopsy ; DNA ; Female ; Fever ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Mixed Connective Tissue Disease* ; Muscle Weakness ; Muscular Diseases ; Raynaud Disease ; Skin

No abstract available.

No abstract available.
Child* ; Humans ; Tachycardia, Supraventricular*

PURPOSE: To determine the value of thin-section CT in the diagnosis of nasal bone fractures. MATERIALS AND METHODS: We evaluated the thin-section CT scans of 40 patients with nasal bone fracture. CT scans were obtained with both axial and coronal planes, 1.5mm collimation with 2mm interval, and 9.6cm field-of-view. The axial scan plane was kept parallel to the orbitomeatal line from the nasion to the lower limit of the nose and the coronal plane was kept perpendicular to the axial plane. The data were reconstructed with bone algorithm. Nasal bone fracture was classified into 1 of 3 types on thin section CT:(I) simple fracture;(ll) simple fracture with displacement;(III) comminuted fracture. Associated facial bone injuries were also evaluated Simple radiographs of nasal bone were reviewed for comparison. RESULTS: Six patients had simple fracture, 10 patients had simple fracture with displacement, and 24 patients had comminuted fracture. Twenty-six patients had associated facial bone injuries which included fracture of nasal septum (n=15), fracture of frontal process of maxilla (n=9), fracture of ethmoid (n=6), widening of nasofrontal suture (n=5), and fracture of nasolacrimal duct (n=2). In 15 of 40 patients, CT could identify nasal bone fractures not detected on simple radiographs. CONCLUSION: Thin-section CT is a valuable aid in the evaluation of nasal bone fracture for accurate identification, nature, and combined facial injury.
Diagnosis ; Facial Bones ; Facial Injuries ; Fractures, Comminuted ; Humans ; Maxilla ; Nasal Bone* ; Nasal Septum ; Nasolacrimal Duct ; Nose ; Sutures ; Tomography, X-Ray Computed

The anatomical variations of 112 hypophysis and diaphragma sellae in Korean adult cadavers and coronal CT were studied. 1) The hypophysis was classified 4 types based on superior view. 2) The superior surface of the hypophysis was concave(65.9%) in cadavers and flat(55.3%) in CT. 3) The neural lobe was placed on the center of the posterior surface of the anterior lobe(72.3%). 4) The hypophysis was compressed by the internal carotid artery in 9.6%. 5) The mean A-P length, width and height of the hypophysis were 10.4mm, 14.2mm and 4.8mm in cadavers, respectively. The mean width and height in CT were 13.2mm and 5.0mm, respectively. 6) The width of the hypophysis was significantly different between man and woman. 7) The diaphragma sellae was concave or flat. 8) The diaphragmatic line was average 13.9mm in man and 14.6mm in woman. 9) The diaphragmatic foraman was circular or oval and the A-P diameter was greater than transverse one. 10) Type IIb that diaphragma sellae and hypophysis were concave according to Busch(1951) was 40.4%. 11) The empty sella was found in 14.4%.
Adult* ; Cadaver* ; Carotid Artery, Internal ; Female ; Humans ; Pituitary Gland* ; Pituitary Gland, Posterior

A patient (Hellman dental age IIIA) who had anterior cross bite due to functional factor was treated with activator. Following results were obtained: 1) Anterior cross bite was crorrected 3 months after the initial application of the appliance. 2) Comparing pretreatment records with posttreatment, the main effects were labioversion of upper incisors, increase of upper arch length and downward-backward rotation of the mandible. 3) There was no damage on teeth and periodontal tissues and the patient had normal occlusion 1 year after the treatment.
Humans ; Incisor ; Malocclusion ; Mandible ; Prognathism* ; Tooth

PURPOSE: To described the MR findings in the periodic changes of the size and signal intensity ofreconstructed anterior cruciate ligament (ACL) of the knee and the efficacy of oblique axial imaging in patientswho underwent arthroscopic ACL reconstruction using autogenous patellar tendon. MATERIALS AND METHODS: Twenty-onepatients who had undergone ACL reconstruction were evaluated by follow-up MRI at postoperative 1 week, 1, 2, 3 and6 months, and 1 year, Conventional Fast-Spin-Echo (FSE) sagittal and coronal images and oblique axial images(proton density and T2-WI; VEMP TR/TE, 2000/20/70) were obtained perpendicular to the ligament, and using an ROIcurve in the intra-articular area, periodic changes in the cross-sectional area were evaluated by proton densityimaging and signal intensity by T2WI imaging. Cross-sectional morphology was categorized as either smooth, andround or notch-shaped and periodic changes in configuration were observed. In three cases, we evaluated the retearof reconstructed ACL by comparing the oblique axizl image obtained by conventional sagittal and coronal imaging. RESULTS: The cross-sectional area and signal intensity of grafted ACL increased significantly (p<0.05) after 3months and at 1 year, respectively. Cross-sectional morphology was smooth and round in 86% of cases, and notchedin 14%, and during follow-up MR studies, no periodic changes were seen. Notch-shaped ACL and decreased perigraftsignal intensity, as seen on sagittal images, could lead to a misdiagnosis of partial tear ; on oblique axialimages, ACL and perigraft signal intensity were found to be normal. CONCLUSION: During the natural evolution ofgrafted ACL, cross-sectional area and signal intensity increased significantly after 3 months and at 1 year,respectively ; on follow-up MR studies, cross-sectional morphology did not change, however. Oblique axial imagingprovides important information for evaluating whether the reconstructed ACL is torn or not.
Anterior Cruciate Ligament* ; Cross-Sectional Studies ; Diagnostic Errors ; Follow-Up Studies* ; Knee* ; Ligaments ; Magnetic Resonance Imaging ; Patellar Ligament ; Prospective Studies* ; Protons ; Transplants*