Dermatologic treatment was greatly advanced when topical corticasteroids were introduced for the management of many inflammatory and pruritic dermatoses. Their use reduced or diminished mnst of the undiserable side effects which accompanied the systemic administration of these compounds. The good effects of topical application of hydrocortisone had been demonstration in the treatment of variaus dermatoses eg., atopic dermatitis, seborrheic dermatitis, contact dermatitis etc. The halogenated derivatives followed and led to the trend to most of analogs now in use. Especially, fluocinolone acetonide cream greatly enhanced its therapeutic effectiveness in psoriasis, chronic discoid lupus erythematosus, pustular bacterid, granuloma and neurodermatitis circumscripta. But many side effects of topical corticosteroids such as steroid acne. Stria were developed and also fluorinated topical corticosteroids resulted in telangiectasia, purpura, atrophy in skin. Weber reported that strong topical corticosteroids eg.. Betamethasone valerate and fluocinolone acetonide were resulted in rosacealikc dermatitis and it was steadily increased. These adverse side effcts of topical corticosteroids, especially steroid acne, were indisputable argument in dermatologic field, for the view that this topical corticosterodis is used for cosmetics and treatment of acne vulgaris in our country. Since the strong corticosteroid tnpical preparation, the peculiar form acne, so called steroid acne, was steadily increased in our clinic. Behrman and goodman reported that acneform eruption induced by hormone was not associated with oiliness and there were but few comedone. Sullivan and Zeligman reported that the the acneform eruption due to adrenal corticaa 1 hormone was uniform in size, small papule and few pustule, usualIy erythematous base. There were also differential histologic feature. The most important difference is the normal apperance of sebaceous glands in acneform eruption due to corticosteroids contrast with hyperplasia in acne vulgaris. Abscess formation was more frequent and more extensive in acne vulgaris. Sutton Jr and Van Scott & MacCardle described that histologically, the major component in lesion of steroid acne was excessive keratinization of follicle. Castor and Baker demonstrated that topical application of corticosteroids resulted in decrease of sebaceous gIands, decrease of mitosis and increased cornification in epidermis. The present study investigated clinical case of the steroid acne, which are induced by topical application and systemic administration of corticosteroids and experimentally induced the steroid acne with the topical application of corticosteroid. And also clinical cases and experimentally induced steroid acne were compared with acne vulgaris. Material and method Subjects are 13 Patients of steroid acne induced by strong topical corticosteroid eg., fluocinolone acetonide, fluocortolone, dexamethaone, betamethasone valerate and 4 patients of steroid acne induced by systemic administration of corticosteroid eg., prednisolone and also 10 patients of acne vulgaris. Biopsy was performed from 13 patients of topical steroid acne, 3 patients of steroid acne induced by systemic administration of steroid and one patient of acne vulgaris. In order to induce steroid acne, experimentally, strong topical corticosteroid such as beta methasone valerate, fluocinolone acetonide and fluocortolone were applied on back. Comment and conclusion In Clinical feature, the steroid acne by topical application and systemic administration of corticosteroid and experimentally induced steroid acne had unique clinicall features, that showed absence of comedone and uniform sized follicular papule on deep seated erythematous scaly base. The topical steroid acne was distributed the region where were applied. But the eruption of the steroid acne induced by systemic administration of corticosteroids was distributed to face, neck, and scalp. Above findings are quite different form acne vulgaris. Histopathologically, the steroid acne induced by topical application and systemic administration of corticosterojds showed hypoplasia of sebaceous glands and excessive follicular keratinization. Occlusion of pilosebaceous opening by keratotic plug in severe case by long term application showed atrophy of epidermis and sparsity of sebaceous glands with hypokeratosis and parakeratosis. In experimentally induced steroid acne, it was definitely specific features which were absolutely identcall with above cinical steroid acne.
Abscess ; Acne Vulgaris* ; Adrenal Cortex Hormones ; Atrophy ; Betamethasone Valerate ; Biopsy ; Dermatitis ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Epidermis ; Fluocinolone Acetonide ; Fluocortolone ; Granuloma ; Humans ; Hydrocortisone ; Hyperplasia ; Lupus Erythematosus, Discoid ; Mitosis ; Neck ; Neurodermatitis ; Parakeratosis ; Prednisolone ; Psoriasis ; Purpura ; Scalp ; Sebaceous Glands ; Skin ; Skin Diseases ; Telangiectasis

Erythroplasia of Queyrat is a precancerous lesion, usually located to glans penis or prepuce. It is characterized by a slowly developing, circumscribed, usually velvety and shiny patch. The etiology was unknown, but it is extremely rare in those circumcised in early infancy. It had been suggested that phimosis had some etiologic importance. The typical case of Erythroplasia of Queyrat is presented. A 46 year old man had 4 months history of dark-brownish pea sized maculopapular rashes on sulcus of glans penis and prepuce associated with mild itching, which was increased in number day by day. He had a phimosis. On examination, there are sharply defined, slightly elevated, pea sized dark-brownish maculopapular rashes over erythematous infiltrated base on sulcus of glans penis and prepuce, which have moist and velvety appearance. A biopsy was performed from sulcus of glans penis. Histopathologically, there was acanthosis, with in epidermis many cells are vacuolated and showed individual cell keratiinization. Epithelial cell showed marked atypia, variation in nuclear size and there was intercellular, intracellular edema. The lesion was treaterd with topical application of 5% 5-fluorouracil twice daily 2 weeks and thereafter for 4 weeks. 2 months after treatment, no erythroplastic lesion was found and 3 months after treatment, rebiopsy was perforrned which showed marked improvement histopathologically.
Biopsy ; Edema ; Epidermis ; Epithelial Cells ; Erythroplasia* ; Exanthema ; Female ; Fluorouracil* ; Humans ; Male ; Middle Aged ; Peas ; Penis ; Phimosis ; Pruritus

This clinical study of nine patients presented Disseminated Superficial Actinic Porokeratosis (DSAP) as a distinctive and recognizable entity characterized by multiple uniformly small, irregular marginated, keratotic plug with atrophic center developing during second or third decade of life on sun exposed area of skin. Six of nine patients had DSAP, which was inherited as autosomal dominant trait. The patient's father, two brothers and two sisters were known to have same skin lesions. Of nine patients, five were female and four were male. Eight patients were developed DSAP lesions during second decade of life and other one was third dcade of life. Three patients had pruritus. In alI patients, lesions were developed bilaterally over sun exposed area but was not always symmetrical. The number of lesion was multiple in all patients. The greatest number of lesions were found on distal part of extremities, neck, face, upper portion of anterior chest and back.
Extremities ; Fathers ; Female ; Humans ; Male ; Neck ; Porokeratosis* ; Pruritus ; Siblings ; Skin ; Solar System ; Thorax

The case of a 30 year old man is described, in whom mycosis Fungoides was originating from nose and followed by tumor stage of Mycosis Fungoides on skin. In January 1970, the patient leveloped nasal tumor, when he was n at E.N.T. department of Severance Hospital. At that time a biopsy of nasal tumor demonstrated only a non-specific inflammatory cell infiltrated mass. He received radiation therapy (Co 60) with satisfadory suppression of mass and resulted in right nasal septal deviation. Jn December 1970, thumb sized painful non-tender, movable mass developed on right supraclaviular area. In August 1971, thumb sized painful, tender, movable mass appeared at right posterolateral aspect of neck, which was excied and removed at local clinic. But excised wound was not healed and the mass was enlarged. One month after above lesion, pea sized same mass developed. On physical examination, there were 4*5cm round, erythematous, painful, tender, granulomatous ulceration mass on right postero-lateral aspect of neck and also same mass on postero-inferior site of above lesion. Two times of biopsy was done and it interpreted as tumor stage of Mycosis Fungoids. Treatment included radiation therapy with Co 60 (200r/day, total 6,000r), prednisolone 40mg/day and antibiotics. There has been good response 1 month after radiation therapy and mass is diminished in size and would begin to heal.
Adult ; Anti-Bacterial Agents ; Biopsy ; Humans ; Mycosis Fungoides* ; Neck ; Nose* ; Peas ; Physical Examination ; Prednisolone ; Skin ; Thumb ; Ulcer ; Wounds and Injuries

No Abstract Available.
Head* ; Osteonecrosis* ; Rabbits*

BACKGROUND: Not rarely we can find young people with acute myocardial infarction(AMI), many studies revealed they have fewer risk factors and less severe coronary angiographic abnormalities than middle and old aged group. METHODS: We studied clinical characteristics and coronary angiographic findings of 5 young men with AMI treated at Masan Koryo General Hospital from June 1986 June 1992. RESULTS: The age ranged between 19 and 32 years(mean 25.4). They had no other risk factors except cigrarette smoking(4 out of 5). Their coronary angiograms revealed no significant lesion in each infarct related artery. After discharge, all patient remained asymptomatic. CONCLUSION: AMI in young man might be related with cigarette smoking, and coronary artery spasm and/or thrombosis may play a significant role in its pathogenesis.
Arteries ; Coronary Vessels ; Hospitals, General ; Humans ; Male ; Myocardial Infarction* ; Risk Factors ; Smoking ; Spasm ; Thrombosis

OBJECTIVES: Since vertebroplasty has been introduced, we performed short segment pedicle screw fixation with augmented intra-operative vertebroplasty in patients with unstable thoraco-lumbar fracture. Our intentions are to demonstrate the efficacy and indication of this new technique compare to conventional methods. MATERIAL AND METHODS: The surgery comprised of pedicle screw fixations on one level above and below the fracture site, and the fractured level itself, if pedicle is intact, and intra-operative vertebroplasty under the fluoroscopic guide with in-situ postero-lateral bone graft. Also, in cases of bone apposition, we removed those with small impactor through a transfascetal route. During the last 2 years, we performed in seven(7) unstable thoraco-lumbar fracture patients who consisted of two different characteristics, those four(4) with primary or secondary osteoporosis and three(3) of young and very healthy. All patients were followed clinically by A.S.I.A. score and radiography. RESULTS: Mean follow up period was 14 months. We observed well decompressed state via transfascetal route in cases of bone fragments apposition and no hardware pullout in osteoporotic cases, no poly-methyl-methacrylate (PMMA) leakage through the fracture sites into the spinal canal, and no kyphotic deformities in both cases during follow-up periods. All patients demonstrated solid bony fusion except one following osteoporotic compression fracture on other sites. CONCLUSIONS: In the management of unstable thoraco-lumbar fracture, we believe that this short segment pedicle screw fixation with augmented intra-operative vertebroplasty reduce the total length or levels of pedicle screw fixation without post-operative kyphotic deformity.
Congenital Abnormalities ; Follow-Up Studies ; Fractures, Compression ; Humans ; Intention ; Osteoporosis ; Radiography ; Spinal Canal ; Transplants ; Vertebroplasty*

To study the effect of hydrocephalus and skull defect on the pressure volume index(PVI), PVI values were measured in 4 groups, total 23 cats. Five normal cats(group I : control group), five kaolin induced hydrocephalic cats(group II), six kaolin induced hydrocephalic cats with delayed hemicranicetony(group III) and seven kaolin induced hydrocephalic-hemicraniectomy cats(group IV) were used. In 4 groups, the effects of laterality of ventricular bolus infusion site, hydrocephalus and skull defect on the PVI values were evaluated. The measuremnets were performed 4 weeks after kaolin inhection in hydrocephalic groups(group II, III and IV). The laterality of ineusion site did not have satistically significant influence on the PVI valu in all 4 groups. Compared to group I, the PVI values in group II and III showed increasing tendency without significance. But in group IV, the PVI values showed statistically significant increase, and this seemed to be due to the biomechanical changes of brain and the more progressive ventricular enlargement by the combination of kaolin induced hydrocephalus and skull defect. As with above results, PVI values showed increasing tendency according to the degree of ventricular enlargement and the defect of skull.
Animals ; Brain ; Cats ; Hydrocephalus* ; Kaolin ; Skull*

BACKGROUND: Phosphatidic acid (PA), an important second messenger, is involved in inflammation. Notably, cell-cell interactions via adhesion molecules play a central role in inflammation. This thesis show that PA induces expression of intercellular adhesion molecule-1 (ICAM-1) on macrophages and describe the signaling pathways. MATERIALS AND METHODS: Macrophages were cultured in the presence of 10% FBS and assayed cell to cell adhesion using HUVEC. For the gene and protein analysis, RT-PCR, Western blot and flow cytometry were performed. In addition, overexpressed cell lines for dominant negative PKC-delta mutant established and tested their effect on the promoter activity and expression of ICAM-1 protein by PA. RESULTS: PA-activated macrophages significantly increased adhering to human umbilical vein endothelial cell and this adhesion was mediated by ICAM-1. Pretreatment with rottlerin (PKC-delta inhibitor) or expression of a dominant negative PKC-delta mutant, but not Go6976 (classical PKC-alpha inhibitor) and myristoylated PKC-zeta inhibitor, attenuated PA-induced ICAM-1 expression. The p38 mitogen-activated protein kinase (MAPK) inhibitor blocked PA-induced ICAM-1 expression in contrast, ERK upstream inhibitor didn't block ICAM-1. CONCLUSION: These data suggest that PA-induced ICAM-1 expression and cell-cell adhesion in macrophages requires PKC-delta activation and that PKC-delta activation is triggers to sequential activation of p38 MAPK.
Blotting, Western ; Cell Adhesion ; Cell Line ; Endothelial Cells ; Flow Cytometry ; Humans ; Inflammation ; Intercellular Adhesion Molecule-1* ; Macrophages ; p38 Mitogen-Activated Protein Kinases ; Phosphatidic Acids ; Protein Kinase C ; Protein Kinases ; Second Messenger Systems ; Umbilical Veins

Chiari malformation is a condition characterized by herniation of the posterior fossa contents below the level of the foramen magnum : The main pathologic change is downward displacement of the cerebellar tonsils to occlude the subarachnoid space at the level of the foramen magnum. For this reason, the practice of posterior fossa decompression in the treatment of syringomyelia with Chiari malformation has been widely accepted. In order to evaluate the usefulness of the procedure in the treatment of this condition, clinical data and surgical outcome in 20 patients who underwent posterior fossa decompression during the last five years were analyzed. The average age at presentation was 35.9(range 17 to 61) years. Chiari I malformation was found in 14 patients, and Chiari II malformation in six : weakness and pain were the most common symptoms. The most useful preoperative imaging study was magnetic resonance imaging. In order to expose the outlet of the fourth ventricle, all patients underwent suboccipital craniectomy and C1 or C1-2 laminectomy with the supportive procedure consisting of adhesiolysis and tonsillar elevation. Postoperatively, 75% of patients showed improvement, and the condition of 15% stabilized. Postoperative MRI was performed in 12 patients, and revealed that in 11 of these, the syrinx cavity had become smaller. Transient headache and vomiting was the most frequent postoperative complication. Patients with pain and numbness had a better prognosis than those with weakness and sensory loss, and it appears that in cases of syringomyelia with Chiari malformation, posterior fossa decompression is beneficial.
Decompression* ; Foramen Magnum ; Fourth Ventricle ; Headache ; Humans ; Hypesthesia ; Laminectomy ; Magnetic Resonance Imaging ; Palatine Tonsil ; Postoperative Complications ; Prognosis ; Subarachnoid Space ; Syringomyelia* ; Vomiting