A case of znelanotic whitlow is presented which resembles clinically as chronic paronichia. Patient was 71 years old man and he has had a single brownish pigmented spot on left mid. finger since 3 years ago which was progressively grow and skin biopsy could be established the pathological diagnosis of superficial malignant melanoma.
Aged ; Biopsy ; Diagnosis ; Fingers ; Humans ; Melanoma ; Skin

No abstract available.
Muscle, Smooth* ; Renin* ; Renin-Angiotensin System*

Many investigators were interested in the pathogenesis and the relationship between microscopical features and clinical behavior of hydatidiform mole. Trophoblastic cells in the trophoblastic disease were intensively examined histologically, ultrastructurally, immunohistochemically, and with hormone assay method, etc. But ultrastructural study on the stroma of hydatidiform mole was scarcely reported. In this paper, hydatidiform mole was examined at light and electron microscopic levels, with emphasis on the stroma. The results were as follows: 1) Hydropic degeneration of H-mole is more severe in the center of stroma and is not related with the degree of trophoblastic proliferation. Hofbauer cell and vascular structure are extremely rarely observed in the periphery of stroma which has relatively preserved cellular components. 2) Basement membrane is sometimes separated from trophoblastic layer. Degenerated cells in the stroma contain vacuoles, autophagosomes, and lipid droplets. Collagen is abundant in the loose interstitium. Hofbauer cells have no lysosome or phagosome. Vascular lumen is patient and endothelial cells are degenerated. From the above results, H-mole may be produced due to abnormal changes of trophoblasts and stromal changes may be a secondary process, so called autolysis. Hofbauer cells are not engaged in the stromal degeneration and may be different from usual tissue macrophages.

In recent years, the rate of the thracolumbar and lumbar fractures rends to be increasing as the traffic accidents and industrial accidents frequently occurs. The purpose of this study is to review the results of conservative treatment for 73 patients with thoracolumbar and lumbar fractures and to review the failed 6 cases after conservative treatment, who were admitted and treated at National Medical Center during the period the period from January 1986 to June 1992. The following results were obtained: 1. Among the 65 cases of compression fracture, we performed hyperextension body cast in patient with height loss more than 30% and bed rest & brace in patient with height loss less than 30%, And in 63 cases, it showed good results. But two cases treated by bed & brace showed complaint such as radicular pain and persisdent back pain. 2. Among the 6 cases of burst fracture without neurological involvement, two cases treated by casting showed good result, but four cases treated by bed rest & brace showed complaint such as claudication and persistent back pain. 3. All cases of Chance fracture treated by casting showed good result. 4. There was no correlation between loss of correction of kyphotic angle and overall result. 5. Among the cases of poor result, we operated four cases which included two cases of instability & two cases of spinal stenosis and their results were good.
Accidents, Occupational ; Accidents, Traffic ; Back Pain ; Bed Rest ; Braces ; Fractures, Compression ; Humans ; Spinal Stenosis ; Spine

Although the incidence of leprosy is decreased considerably, the deformity and disability of it is serioues. In the hand, combined median and ulnar nerve affection is most common, and it leads to many problems including opposition dysfunction and claw hand deformity. And opposition dysfunction is most significant disability in the hand function, so its correction or reconstruction is mandatory We performed 20 cases of opponensplasty from Oct. 91 to Apr. 94 at National Medical Center, and analyzed its results according to new assessment criteria invented by authors, and evaluated the efficacy of the operative treatments. The results were as follows: 1. The patients were 9 males and 11 females, average age was 48 years old, and average duration of paralysis was 28 years. The mean follow-up period was 2.8 years. And most common type of nerve affection was combined low median and high ulnar nerves. 2. We performed 18 cases of Burkhalter opponensplasty using extensor indicis proprius and 2 cases of Riordan opponensplasty using ring finger sublimis at the leprosy hands. 3. According to authors assessment criteria for leprosy hand, the result of operative treatment was excellent in two, good in ten, fair in seven, and poor in two patients. So we obtained more than good results in 50% patients. 4. We could obtain good result with Burkhalter opponensplasty in leprosy hand, especially when combined with proper preoperative physical therapy and adjuvant operation for release of contracture and joint stiffness.
Animals ; Congenital Abnormalities ; Contracture ; Female ; Fingers ; Follow-Up Studies ; Hand ; Hand Deformities ; Hoof and Claw ; Humans ; Incidence ; Joints ; Leprosy ; Male ; Paralysis ; Tendon Transfer ; Ulnar Nerve

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare and recently recognized disease of unknown etiology, characterized by remission and exacerbation of multiple bone lesions which radiologically and pathologically have the appearance of hematogenous osteomyelitis. The natural history appears to be slow and spontaneous resolution of the osseous lesions without specific treatment. And antimicrobial agents seem to have no beneficial effect. In proper clinical setting, CRMO should be considered, because recognition of this entity would help us to avoid costly and potentially harmful diagnostic and therapeutic interventions. We report a case of a 48-year-old adult who had chronic recurrent multifocal osteomyelitis.
Adult ; Anti-Infective Agents ; Humans ; Middle Aged ; Natural History ; Osteomyelitis

A retrospective review was performed in 33 knees of 30 patients who had undergone arthroscopic debridement for degenerative osteoarthritis of the knee. The mean age of the patients at operation was 55 years and the mean follow-up after operation was 15 months. We divided the knec:s into 2 groups; meniscectomy group (23 knees) and non-meniscectomy group (10 knees). The preoperative radiographic findings were divided into 3 groups according to the classification systern by Lotke et al. The postoperative results were evaluated using the nine-point scale by Baumgaertner et al. Our study was conducted to: 1) assess the overall efficacy of arthroscopic debridement, 2) compare the results between the. Meniscectomy group and nonmeniscectomy group, and 3) identify the relationship between the preoperative radiographic findings and out- come at the final follow-up time. Overall excellent or good results were ac.hieved in 22 knees (67%) and the preoperative radiographic findings correlated with the outcome at the final follow-up time. But the results in the meniscectomy and non-meniscectomy poups showed no significant differences statistically. We believe that arthroscopic debridement is an effective option of treatments for mild I:o moderate degenerative arthritis of the knee after failure of conservative measures.
Classification ; Debridement* ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis* ; Retrospective Studies

In clinical setting, treatment-refractoriness, medication induced tardive dyskinesia and amenorrhea in chronic schizophrenia are frequently problematic. However, there are few guideline solving these problem available to clinicians. The goal of this study was collecting clinical data on clinical effeciveness and predictors of response of switching to olanzapine. We attempted to switch to olanzapine from risperidone and clozapine in chronic 31(risperidone 17, clozapine 14) schizophrenia and schizoaffective disorder patients suffering from sustained symptoms, weekly blood monitoring, medication induced tardive dyskinesia and amenorrhea. Previous antipsychotics dosage was gradually decreased for 2 or 3 weeks, at the same time olanzapine dosage was gradually increased. At baseline, after 1 week, after 2 weeks and after 4 weeks we checked Brief Psychiatric Rating Scale, Clinical Global Impression Scale, Sympson-Angus Rating Scale, Barnes Akathisia Rating Scale and Followed up after 12 months. Successful switch after 4 weeks was achieved in 25 patients(clozapine 9(64.2%), risperidone 16(94.1%). Overall, mean BPRS and CGI scores increased significantly. Successful maintenance after 12 months was achieved in 17 patients(clozapine 5(35.7%), risperidone 2(70.5%). Overall, mean BPRS and CGI scores increased significantly too. Switching to olanzapine from other atypical antipsychotics is recommendable in chronic schizophrenia with treatment refreactoriness and drug induced side effect.
Amenorrhea ; Antipsychotic Agents ; Brief Psychiatric Rating Scale ; Clozapine* ; Female ; Follow-Up Studies* ; Humans ; Movement Disorders ; Psychomotor Agitation ; Psychotic Disorders ; Risperidone* ; Schizophrenia

Cooper at al and Mills et al asserted that the essential pathologic finding of pyogenic granuloma (PG) is a unique lobular organization of capillaries. This pathologic pattern is present not only in conventional cutaneous PG, oral-nasal PG but also rarely in intradermal PG, subcutaneous PG and intravenous PG. A 32-year-old man presented with a two-day history of an asymptomatic, movable, pea-sized nodule on his left forearm. Excision biopsy revealed a pink, oval, cyst-like nodule within the vein of the subcutaneous tissue of the medio-lateral aspect of the forearm. Histopathologic finding of the nodule showed rnultiple lobules of capillaries and the lumens of the capillaries were lined by normal endothelial cells. The nodule was connected with the venous wall by a thin stalk. Each lobule was separated and surrounded by fibrous stroma. There was no evidence of thrombi.
Adult ; Biopsy ; Capillaries ; Endothelial Cells ; Forearm ; Granuloma, Pyogenic* ; Humans ; Subcutaneous Tissue ; Veins

No abstract available.
Alcoholics* ; Humans