Disseminate and recurrent infundibulo-folliculitis is a rare,but distinctive dermatosis characterized by pruritic papular follicular eruption over the trunk and proximal extremities with histologic findings of lymphocytic infiltrations and spongiosis confined to the infundibulum. Little is known about the cause. Resistance to treatment is one of the characteristics of this disease. We herein report a case with typical clinical and histological findings in a 22 year old male.
Extremities ; Humans ; Male ; Skin Diseases ; Young Adult

The tibial plateau fracture is a fracture of the proximal end of the tibia, involving the articular surface and the supporting metaphysis of a major weight bearing joint. This fracture frequently accompanies soft tissue injury such as ligaments and menisci. So it often produces disability of the knee joint. Of the tibial plateau fractures which had been treated by open reductions at Keimyung University Hospital between May 1971 and December 1981, the 28 cases that were followed for 1 year to 3 years have been analysed according to its cause, classification, treatment and result. Open reduction is indicated in anyone with one or more of the following deformities as shown by roentgenograms: a compression greater than 6-8mm and a split greater than 5mm of the condyle. Anatomical considerations and a clinical end result study of the 28 fractures emphasize that the unacceptable results were from comminution of the fracture, associated soft tissue injury, osteoporosis, infection and other conditions that prevent early knee motion. Twenty-two cases (79 per cent) out of Twenty-eight revealed the rating of “ACCEPTABLE” according to Roberts criteria.
Classification ; Clinical Study ; Congenital Abnormalities ; Joints ; Knee ; Knee Joint ; Ligaments ; Osteoporosis ; Soft Tissue Injuries ; Tibia ; Weight-Bearing

Seven cases of traumatic fractured femoral heads with posterior dislocation of the hip were treated at the Keimyung University Hospital between November 1973 and December 1981. All cases were followed from 6 months to 8 years. Five cases were caused by traffic accidents. The other two cases were caused by a landslide. In six cases, at first a closed reduction was performed under general anesthesia and the femoral head was reduced in the acetabulum, but in 5 of the 6 cases head fragments were not reduced. So, after one or more days, open reductions were performed on the remaining 5 cases by internal fixation with iliac bone pegs (two-four). In the remaining one case of the 6, who had a head injury and an intestinal rupture, after the closed reduction, one head fragment was reduced but not anatomically. But because of his poor general condition, conservative treatment was taken. During conservative treatment redislocation and displacement of the head fragment occurred at the 4th week after the closed reduction was done. So this case was also treated by the above method. The 7th case, who has an ipsilateral femoral neck and intertrochanteric fracture, was reduced by primary open reduction. By the classification of the Pipkins, there were 4 cases of Type I and Type II, III and IV each had I case. The post operative X-ray and follow-up study showed that two were classified as excellent, four as good and the one who had the ipsilateral femoral neck and intertrochanteric fracture (Pipkin's Type III) was classified as poor.
Accidents, Traffic ; Acetabulum ; Anesthesia, General ; Classification ; Craniocerebral Trauma ; Dislocations ; Femur Head ; Femur Neck ; Follow-Up Studies ; Head ; Hip ; Landslides ; Methods ; Rupture

Primary Cutaneous Neuroendocrine Carcinoma(CNEC : or Merkel Cell Tumor) usually occurs as a solitary tumor in middle aged to elderly individuals. This tumor may occur on any layer of the skin but the most frequent location is in the dermis. Electron microscopic studies reveal that the tumor cell contains round, dense core granules similar to epidermal Merkel cell and other cells of the neural crest derived APUD system. We describe the clinical, histological, electron microscopic, immunohistochemical observation of a case of primary CNEC in a 66-year-old female and discuss the theories regarding the histogenesis of this unusual tumor.
Aged ; Carcinoma, Neuroendocrine* ; Dermis ; Female ; Humans ; Middle Aged ; Neural Crest ; Skin

PURPOSE: To evaluate CT findings of internal hernia. MATERIALS AND METHODS: Three patients with internal hernia had abdominal CT scans and two of them had small bowel follow through examinations. The CT features of two patients with retroanastomotic and one patient with left paraduodenal hernia were evaluated and correlated with small bowel follow through examinations, and surgical findings. Two patients with retroanastomotic hernia had a history of subtotal gastrectomy with antecolic gastrojejunostomy. The diagnosis of internal hernia was made on the basis of surgical find ings in two patients of retroanastomotic hernia, and characteristic barium study findings in one patient of left paraduodenal hernia. RESULTS: The small bowel follow through examination showed small bowel loops gathered in a circumscribed mass in the left mid abdomen, and delay in passage through these loops. In case of left paraduodenal hernia, abrupt narrowing of the distal duodenum could be identified. The characteristic CT findings of all three patients were whorling of the mesentery and mesenteric vessels in the left mid-abdomen. In the patient with left paraduodenal hernia, after resolution of the gastrointestinal symptoms, a follow-up CT scan showed spontaneous disappearance of whorling of the mesentery and mesenteric vessels suggesting spontaneous resolution of the hernia. In the other two cases, upon exploration of the abdomen, dilatation of afferent duodenum caused by adhesion between ligament of Treitz and adjacent bowel walls, and retro- anastomotic herniation of the efferent loops were found. CONCLUSION: The usual diagnosis of internal hernia is based on the appearance of the small bowel follow through examination. However, we consider that the whorling appearance(we call it whorling sign) of the mesentery and mesenteric vessels on CT scan is also suggestive of internal hernia in patients under clinical suspicion.
Abdomen ; Barium ; Diagnosis ; Dilatation ; Duodenum ; Follow-Up Studies ; Gastrectomy ; Gastric Bypass ; Hernia ; Humans ; Ligaments ; Mesentery* ; Tomography, X-Ray Computed

No abstract available.

A clinical study was conducted to compare effectiveness of IV Globulin with that of steriod in childhood acute ITP. We carried out an experiment to 36 patients of acute ITP who recovered over 50.000/mm(3) of platelet count and not to recur in 6 months. Study group consist of 10 children who were treated with steriod only (Group A), 13 children who were treated with IV Globulin (0.4g/kg/d, 5 days, Group B), and 13 children combined with steroid (Group C) Study period was from January 1988 to December 1992, folllowing results were obtained. 1) There were no significant difference in sex ratio. age distribution, pretreatment hemoglobin level, platelet count and prolonged bleeding time among study groups. 2) The days which platelet count reached to 50.000/mm(3), 100,000/mm(3) were 3.7 days (Group A), 2.1 days (Group B), and 2.3 days (Group C), respectively (p<0.05). 3) Complete response rates within 4 weeks did not show significant difference (90% in Group A, 84.6% in Group B, 92.3% in Group C), the complete response rate within 1 week were significantly different among three group (44.4% in Group A, 90.9% in Group B, 83.3% in Group C)(p<0.05). In conclusion, it is more desirable for early treatment of a childhood ITP because IV Globulin is easy to normalize platelet count in a short time.
Age Distribution ; Bleeding Time ; Child ; Humans ; Platelet Count ; Sex Ratio

Clinical study was carried out on the 64 hemodialysis patients(HD) with chronic renal failure who had been treated from December 1992 to July 1993 in Yeungnam University Hospital. The following results were obitained. In hematologic parameters, MCH was 28.8±2.0pg, and MCV was 92.4±4.7fl. Result revealed normochromic and normocytic anemia. Mean values of serum ferritin were 657.4±292.0ng/ml in men and 511.5±370g in women. Mean values of serum iron were 145.5±63.7µg/dl. Mean values of transferrin saturation was 61.6±28.4%. Serum frerritin, serum iron and transferrin saturation were higher in HD group than normal reference. In erythropoeitin treatment group, Hb and Hct were significantly higher than non-erythropoietin treatment group. Amount of transfusion was significantly higher in non-erythropoietin treatment group than erythropoeitin treatment group(p<0.05). Values of iron, transferrin saturation were significantly higher in abnormal liver function test(LFT0 hemodialysis group than normal LFT group(p<0.05). Transfusion amounts revealed positive correlation with ferritin(r=0.4675), transferrin satruation (r=0.3823) and iron(r=0.3386) (p<0.05).
Anemia* ; Clinical Study ; Erythropoietin* ; Female ; Ferritins ; Humans ; Iron ; Kidney Failure, Chronic ; Liver ; Male ; Renal Dialysis ; Transferrin

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*

BACKGROUND: Controversy exists as to whether or not inhalation anesthetics and intravenous anesthetics impair arterial oxygenation (PaO2) during one lung ventilation (OLV). Accordingly, we examined the effect of enflurane and propofol on PaO2 and pulmonary vascular resistance (PVR) during OLV. METHODS: Forty patients, who had prolonged periods of OLV anesthesia with minimal trauma to the nonventilated lung were studied in a cross over design. Patients were randomized to four groups; Group 1 received 1 MAC of enflurane and oxygen from induction until the first 20 min after complete lung collapse, then were switched to propofol 100 g/kg/min (P100). In group 2, the order of the anesthetics was reversed. Group 3, Group 4 received the same order of the anesthetics as Group 1, Group 2, respectively but received propofol 200 g/kg/min (P200). RESULTS: During OLV, the PaO2 values were lower than those with two lung ventilation (TLV), there were no significant differences among each groups and between propofol and enflurane in PaO2, but in the selected patients (n=10, PaO2<120 mmHg during OLV), PaO2 in propofol group was higher than that of enflurane group (p<0.05). Conversion from TLV to OLV caused a significant increase in PVR, but there were no difference in PVR between propofol and enflurane group. CONCLUSIONS: These results suggest that the usual clinical dose of propofol affords no advantage over 1 MAC of enflurane anesthesia except low PaO2 patients during OLV. Propofol might be of value in risk patients of hypoxemia during thoracic surgery when OLV is planned.
Anesthesia ; Anesthetics ; Anesthetics, Inhalation ; Anesthetics, Intravenous ; Anoxia ; Cross-Over Studies ; Enflurane* ; Humans ; Lung ; One-Lung Ventilation* ; Oxygen* ; Propofol* ; Pulmonary Atelectasis ; Thoracic Surgery ; Vascular Resistance ; Ventilation