We report a rare case of sporadic keratosis punctata palmaris et plantaris in a 49-year-old woman. Thirty years ago, firm semitranslucent papules developed on the middle portion of her palms without any subjective symptom. The lesions had flat-topped smooth surfaces. They were concentrated along the margins of the hands, especially on the lateral surfaces of both index fingers and finger tips/ Ten years ago, similar hyperkeratotic papules with or without central craters developed on the weight bearing portions of her soles. Her family and past histories were negative. The biopsy specimen revealed a dense hyperderatotic stratum corneum which fitted into a cup shaped depression in the stratum malpighii and a turning inward of the rete ridges at the margin. The Masson trichrome and elastic strains showed no peicific dermal changes.
Biopsy ; Depression ; Female ; Fingers ; Hand ; Humans ; Keratosis* ; Middle Aged ; Weight-Bearing

This study was designed to investigate the effect of local hyperthermia on contact hypersensitivity (CHS) and elucidate it's mechanism through assessment of number of epidermal LCs and transfer of spleen cells. Depilated dorsal skin of mouse was immersed into controlled water bath at 52 ℃ for 30 seconds in vivo. The number of epidermal LCs was counted by adenosine triphosphate staining, and CHS to 2,4-dinitro-l-fluorobenzene was assessed by ear swelling and transfer of spleen cells. The number of LCs was significantly reduced 1 to 3 days after the hyperthermia treatment and recovered to normal 5 days after the treatment. CHS was significantly suppressed in mice sensitized 5,7, or 10 days after hyperthermia treatment, but the suppression was meager in mice sensitized 1 or 3 days after the treatment. There is a discord between the number of LCs and degree of CHS. When mice received spleen cells from hyporesponsive donors, CHS was remarkably sup-pressed in the recipient mice compared with positive control. These findings suggest that tfeatment of local hyperthermia suppress CHS in mice, which may be associated with the induction of suppressor cells. The nature of the discord between the the number of LCs and degree of CHS in this investigation remains to be cleared by further studies.
Adenosine Triphosphate ; Animals ; Baths ; Dermatitis, Contact* ; Ear ; Fever* ; Humans ; Hyperthermia, Induced ; Langerhans Cells* ; Mice* ; Skin ; Spleen ; Tissue Donors ; Water

The authors studied 54 patients (55 cases) of femoral shaft fractures treated by compression plate fixation and IM nailing from August 1986 to December 1991. The purpose of this study is to analyse comparatively the radiological and clinical results between the compression plate fixation and IM nailing in femoral shaft fracture of adult. The obtained results were as follows: 1. Among the 54 patients, the ratio of male and female was 44: 10, and the highest in cidence of age was between 3rd and 4th decades. 2. The main cause of injury was traffic accident in 38 cases. 3. The most common fracture type was B1-② in ten cases by AO-ASIF classification. 4. The mean duration of union was 13 weeks in compression plate fixation by the Koostra's criteria and the average 23 weeks in IM nailing by the Bjorens criteria. 5. The clinical result according to Margerl et al, was good in 25 cases (80.6%) with compression plate fixation and good in 20 cases (83.3%) with intramedullary fixation. 6. Complications of compression plate fixation were metal failure in 2 cases and deep wound infection in 1 case, and 1 case of femur neck fracture during operation and 1 case of metal failure in intramedullary fixation.
Accidents, Traffic ; Adult ; Classification ; Female ; Femoral Neck Fractures ; Fracture Fixation, Intramedullary ; Humans ; Male ; Wound Infection

No abstract available.
Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Head* ; Hemiarthroplasty* ; Necrosis*

PURPOSE: This study was conducted to investigate the epidemic pyrogenic reactions that occurred hospital-widely in 51 patients on 30-31 Mar. 1995 at a tertiary, educational, and acute care hospital. METHODS: The remained intravenous (IV) drugs and IV fluids that were infused to patients (N=51) who developed pyrogenic reactions were cultured and tested pyrogenic matter. Pyrogenic test was done by Limulus Amebocyte Lysate (PyrotellRMA,USA). RESULTS: IV normal saline 50 cc bottles (AAXSAT and AAX5AV) those were collected being used from case patients, and new bottles stocked in the drug storage were positive to pyrogenic test. Used normal saline collected from case patients were cultured coagulase-negative Staphylococus. Moreover the company, manufacturer of these fluids reported the positive pyrogenic test on these IV fluids (AAXSAT and AAX5AV). CONCLUSION: This epidemic was a pyrogenic reaction for infused the intrinsic contaminated fluid with pyrogen. We could prevent not the additional pyrogenic reactions in study hospital but national wide epidemics to apply the rapid and well-designed epidemic investigation and infection control.
Bacteremia ; Cross Infection ; Drug Storage ; Horseshoe Crabs ; Humans ; Infection Control

No abstract available.
Fertilization in Vitro* ; Humans ; Twins* ; Umbilical Cord*

No abstract available.
Bronchiolitis*

PURPOSE: Refractory status epilepticus refers to patients who do not respond properly to adequate first-line drug treatment such as diazepam, phenytoin, phenobaribital, lorazepam and show longer than 60 minute seizure. This study was designed to determine the efficacy and safety of midazolam given as a continuous infusion in the treatment of status epilepticus in children. METHODS: Midazolam was infused to twelve children with seizures, for whom two time repeated doses of 0.3mg/kg of diazepam, 20mg/kg of phenobarbital, and 20mg/kg of phenytoin failed to bring the episode under control. All patients received a bolus of midazolam(0.15mg/kg) followed by a continuous infusion at 1microgram/kg/min. The dose was increased every 15 min until the episode of seizure was brought under control. Time required to control seizures, infusion rate, and side-effects were monitored. RESULTS: The mean age of the patient population was 6.06 yrs(range 2 months to 16 yrs; 6 females and 6 males). In 11 patients, seizures were controlled in a mean time of 60.1 min(range 15-180 min). The mean infusion rate was 8.5microgram/kg/min(range 1-20). The total treatment duration was 17.6 days(range 1-54 days). One patient who was confirmed to have cortical dysplasia failed to respond. Two of the patients showed respiratory depression and bradycardia. CONCLUSION: Midazolam is an effective and safe drug to control refractory seizures in children with status epilepticus.
Bradycardia ; Child* ; Diazepam ; Female ; Humans ; Lorazepam ; Malformations of Cortical Development ; Midazolam* ; Phenobarbital ; Phenytoin ; Respiratory Insufficiency ; Seizures ; Status Epilepticus*

Open carpal tunnel release has been the standard method of sumical treatment of carpal tunnel syndrome. Recently endoscopic carpal tunnel release has been introduced and is heing used by many authors. The advantages of this new technique are less postoperative pain, rapid restoration of power and rapid return-to-work. However many considerate authors, in spite of these advantages. insist that the inevitahle risk of neurovascular injury during the endoscopic procedure should not he underestimated. The purpose of our study is to compare the clinical results of endoscopic carpal tunnel release with those of open release. 20 open carpal tunnel releases in 16 patients and 15 endoscopic carpal tunnel reieases (single-portal technique) in 11 patients were performed hy the first author. Preoperative conditions of both groups are not different. Authors compared the clinical results between the two groups with some parameters. The overall clinical results were not different significantly hetween two groups. Rapid return-to-work(36 days in endoscopic group versus 60 days in open group) and less postoperative scar and pillar pain in endoscopic group were demonstrated. However, the major complication of one median nerve injury in endoscopic group seemed to overweigh these some benefits. We suggest that the standard operative technique for carpal tunnel syndrome should be open carpal tunnel release and more considerations should be takcn in choosing endoscopic method because of its inherent risk.
Carpal Tunnel Syndrome ; Cicatrix ; Humans ; Median Nerve ; Pain, Postoperative ; Return to Work

We investigate the serial change of the bone density of the lengthening sites in distraction osteogenesis in long bone lengthening of the lower extremity by measuring the pixel value of the PACS(Picture Archiving Communication System). The purpose of this study was to find the clinical implication of the pixel value in PACS in the distraction osteogenesis. The number of the distraction sites were 22 in tibia and 16 in femur. The average distraction length was 4.5cm ranged between 2.1cm and 7.0cm in femur, 4.1cm ranged hetween 1.9cm and 6.8cm in tibia. When the image were sent to the PACS workstations, they were directly interfaced to the workstation without any processing. The absolute and the relati ve pixel values of cortical bones of the original and the lengthening sites repr sented in workstation of PACS were obtained by average value measuring 3 times by 3 different persons. The average absoiute pixel value of the original cortical bone near distraction site was not significantly changed, maintaining 575+/-6 in femur, and 570+/-7 in tibia. The absolute pixel vaIues in AP and lateral view were not significantly changed until 6 week/cm, but rapidly increased after 7 week/cm hoth in the tibia and the femur. The relative pixel value of the lengthening sites were more than 95% in three of the four cortices at the time of the removal of the external fixators. in conclusion, the pixel value of the PACS can be a rapid, simple and easy method for detection of the change of the bone density in distraction osteogenesis.
Bone Density* ; Bone Lengthening* ; External Fixators ; Femur ; Humans ; Lower Extremity* ; Osteogenesis, Distraction* ; Tibia