No abstract available.
Lupus Erythematosus, Cutaneous* ; Scalp*

High dose intravenous gammaglobuline (IVLG) therapy is effective in some of the autoimmune diseases. Although the exact mechanism of action of IVIG is uncertain, the action as a neutralizing antibody against unknown etiologic agents, the action of blocking of Fc receptors of effector cells, or the action as a antiidiotypic antibody are suggested. We report a case of 12 year old girl with systemic juvenile rheumatoid arthritis who was treated with high dose IVIG and got a remission. In August 1990 she was admitted to our hospital. because of intermittent fever, transient rash and multiple arthralgia. Under the diagnosis of systemic juvenile rheumatoid arthritis, aspirin (4.0g/day) had been given with symptom improvement. She was readmitted in October 1990 because of aspirin intoxication and acute fulminant hepatitis. She was discharged after recovery and any medicine was not prescribed. In November 1990 she was admitted because of epigastric pain, vomiting, intermittent fever, multiple arthritis, and mild hepatomegaly. Total parenteral alimentation had been given under the diagnosis of superior mesenteric artery syndrome and gold sodium thiomalate (Myochrysine, 5 and 10 mg, two weekly IM injection) was given in conjunction with prednisolone (30 mg/day) and naproxen (375 mg/day). She was admitted again in February 1991 due to the fever, coughing, rash, and hepatosplenomegaly. Pneumonia and leukopenia (2100/mm(3)) were found and gold sodium thiomalate injection was discontinued. Gammaglobulin 1 g/kg/day was given intravenously for 2 consecutive days with dramatic symptom improvement. Five more monthly IV gammaglobulin had been given and the side reaction of injection were nausia, fever, and headache which were controlled by the decrease of infusion rate. Four months after the last IVIG injection she had no symtom of arthritis and the hepatosplenomegaly was decreased. Hemoglobin level was increase to 12.2 mg/dL form 6.2mg/dL and ESR was decrease to 15mm/h. The oral prednisolne and ibuprofen were stopped one year after th last IVIG injection. All the laboratory parameters of arthritis and physical examinations had been normal for more than two year after the stop of all the medications until March of 1994. We suggest that high dose intravenous gammaglobulin can be one of treatments for severe systemic juvenile rheumatoid arthritis.
Antibodies, Neutralizing ; Arthralgia ; Arthritis ; Arthritis, Juvenile ; Aspirin ; Autoimmune Diseases ; Child ; Cough ; Diagnosis ; Exanthema ; Female ; Fever ; Gold Sodium Thiomalate ; Headache ; Hepatitis ; Hepatomegaly ; Humans ; Ibuprofen ; Immunoglobulins, Intravenous ; Leukopenia ; Naproxen ; Physical Examination ; Pneumonia ; Prednisolone ; Receptors, Fc ; Superior Mesenteric Artery Syndrome ; Vomiting

STUDY DESIGN: Thirty-fiye thoracolumbar and lumbar burst fractures treated with pedicle screw instrumentation were assessed on loss reduction. OBJECTIVE: To compare the mechanical results of simple posterior fixation and posterior fixation with anterior augmentation by anterior interbody fusion, disc space fusion or longer construct. SUMMARY OF BACKGROUND DATA: Althrough the pedicle screw instrumentation provides good mechanical stability, two segment fixation without anterior column augmentation may not be adequate to withstand the repeated axial load. METHODS: Fifteen patients were treated with two segment fixation alone(Group 1), seven with anterior interbody fusion(Group 2), another seven with disc space fusion(Group 3) and remaining six with longer construct involving two segments abode the fracture(Croup 4). Change of anterior body height, upper disc height, lower disc height, kyphotic angle, inter-screw angle and gross screw bend- ing were measured using post-operative and follow-up lateral radiographs. RESULTS: Comparing the two groups(Croup 1 Ys. Group 2, 3, 4), the Group 1 showed definitely more loss of reduction than those groups which had anterior augmentation. But, loss of anterior body height was not significantly different. Comparing the four groups, loss at upper and lower disc height was significantly greater in the Group 1 than the Group 2. Change of kyphotic angle was significantly higher in the Group 1 than the Group 4 and change of inter-screw angle was also higher in the group 1 than every other group. Seyen patients in the Group 1 showed gross screw bending, but none in the Group 2, 3 and 4. All the seven patients with screw bending showed loss of inter-screw angle more than 5 . CONCLUSIONS: These results mean that anterior column augmentation is necessary for the treatment of thoraco-lumbar burst fracture. All the three methods(Group 2,3,4) are effective to prevent excessive loss of correction and screw bending. The best method should be selected considering the characters of each fracture.
Body Height ; Follow-Up Studies ; Humans

Gastric lesion in familial polyposis coli is commonly presented with fundic gland hyperplastic polyps, but duodenal and gastric adenomas together with their carcinomatous transformation have been rarely described in familial polyposis coli mostly by case reports. We present three cases of gastric adenomas in familial polyposis coli with one in synchronous development of gastric adenocarcinoma in Korea. All three cases had the family history related to familial polyosis coli and received proctocolectomy because of synchronous development of colonic adenocarcinoma. One patient developed gastric polyposis and adenocarcinoma 8 years after colectomy, and the remaining two presented with multiple polyps either in the stomach or duodenum synchronously at the time of the diagnosis of familial polyposis coli with colonic adenocarcinoma. None disclosed any evidence of Gardner's syndrome. We conclude that association of gastric adenomas in familial oplyposis coli is not uncommon and gastric adenoma-carcinoma sequence is an another important participating mechanism to understand the histogenesis of gastric carcinoma in Korea.
Adenocarcinoma ; Adenoma

Extramammary Paget's disease is a dermatosis which pathologically and clinically resembles Paget's disease of the breast. The disease occurs in regions with apocrine gIands; most often in the anogenital area, seldom in the axilla. umbilicus, mucous membrane of the mouth, nose, ear and Moll's gland of tne eyelid. In this work the effect of bleomycin for extramammary Paget's disease was studied on ultrastructural aspect. The material was a case of extramammary Paget's disease of 7 years standing occuring in the scrotum and the pubic area by serial sections after IV injection of 60mg, 120mg and 240mg of bleomycin, and examined under the electron microscope. The results obtained are summarized as follows: 1. The size of Paget's cell and its nucleus was gradually decreased. 2. The numbers of lysosome, dense body, autophagic vacuolization and tonofilament was decreased. From these fidings, it is suggested that bleomycin induces retrograde degenerative change of Pagct's cell, and cell necrosis finally.
Axilla ; Bleomycin* ; Ear ; Eyelids ; Intermediate Filaments ; Lysosomes ; Mouth ; Mucous Membrane ; Necrosis ; Nose ; Paget Disease, Extramammary ; Paget's Disease, Mammary ; Scrotum ; Skin Diseases ; Umbilicus

The purpose of this study was to the relationship between powerlessness, self-efficacy and quality of life in hemodialysis patients. The subjects were compromised of 198 hemodialysis patients from Pusan, Kyung-Sang Namdo and Kyung-Sang Bukdo 6 hemodialysis clinics. There were significant positive correlation between self-efficacy and quality of life(r= .512, p .00l). Data were collected by questionnaires from Sep. 19 to Oct. 27, 2001. The instrument used for study were the Powerlessness Behavioral Assessment Tool (Miller, 1983) and self-efficacy developed by Kim, Ju-Hyun(1995) and quality of life developed by Kim, Ok-Soo(1993). Collected data were analyzed by frequency, percentage, mean, standard deviation, t-test, ANOVA, Scheffe test, pearson correlation The results were as follows. 1. The mean score of powerlessness was 52.41+/-.93, mean mark 3.28+/-.43, and the mea score of self-efficacy was 45.44+/-.75, mean mark 2.87+/-.49, and the mea score of quality of life was 121.27+/-3.81. mean mark 2.96+/-.58. 2. There were significant differences in the level of powerlessness according to sex (1,=2.148, p= .033), occupation(t=3.682, p=.000), economic status(F=3.094, p=.048), experience of hospitalization (1,=-2.002. p= .047). 3. There were significant differences in the level of self-efficacy according to age(F=3.271. p=.013), economic status (F=5.759, p=.004), religion(F=2.667, p= .048), hemodialysis period(F=2.991. p =.032), hemodialysis frequency(t = 9.045, p = .003), experience of hospitalization (1,=4.40, p=.037). 4. There were significant differences in the level of quality of life according to occupation(t=3.796, p=.053), economic status(F=11.478, p=.000), hemodialysis frequency(t=7.573, p=.006). 5 There were significant negative correlation between powerlessness and self-efficacy (r=- .401. p .001), powerlessness and quality of .life(r=- .562, p .001),
Busan ; Hospitalization ; Humans ; Quality of Life* ; Surveys and Questionnaires ; Renal Dialysis*

There had been a continuous evolution of lymphoma classification and recently a Revised European-American Lymphoma Classification was proposed by the International Lymphoma Study Group. This new classification often requires information on immunophenotypic and molecular biologic markers in addition to the usual histologic findings. Recent advances in the production of commercially available monoclonal antibodies reactive on formalin-fixed paraffin-embedded tissues provide us a great help to classify the non-Hodgkin's lymphoma. We have analyzed 31 low grade B-cell lymphomas by the schemes proposed by the International Lymphoma Study Group using antibodies to CD3, CD5, CD20, CD23, CD43, cyclin D1, and bcl-2 protein, and have analyzed the immunophenotypic features. Among 31 low grade B-cell lymphomas, 8 small lymphocytic lymphomas, 5 mantle cell lymphomas, 7 follicle center lymphomas (2 grade I, 3 grade II, and 2 grade III), and 11 marginal zone B-cell lymphomas (all of which were extranodal) were identified. Among 8 small lymphocytic lymphomas, 5 cases were positive for CD5; 6 cases were positive for CD23; 7 cases were positive for CD43; all 8 cases were negative for cyclin D1; and 7 cases were positive for bcl-2. Among 5 mantle cell lymphomas, 4 cases were positive for CD5 and CD43; all five cases were negative for CD23; 4 cases were positive for cyclin D1 and bcl-2. All 7 follicle center lymphomas were negative for CD5, CD43 and cyclin D1 and 2 cases were positive for CD23; and 6 cases were positive for bcl-2. All marginal zone B-cell lymphomas were negative for CD5, CD23 and cyclin D1; 3 cases were positive for CD43 and 9 cases were positive for bcl-2. Diagnostic utility for CD5 antigen detection on paraffin embedded tissue has a limitation due to weak antigen expression in tumor cells of B-cell lymphomas; however, still be useful in differentiating small lymphocytic lymphoma and mantle cell lymphoma from other B-cell lymphomas when applied in conjunction with CD43. CD23, CD43, and cyclin D1 appear to be of great help in differentiating subgroups of low grade B-cell lymphomas. Bcl-2, as known, is found to be useful to rule out reactive follicular hyperplasia.
Antibodies ; Antibodies, Monoclonal ; Antigens, CD5 ; B-Lymphocytes* ; Biomarkers ; Classification ; Cyclin D1 ; Hyperplasia ; Immunohistochemistry* ; Leukemia, Lymphocytic, Chronic, B-Cell ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Mantle-Cell ; Lymphoma, Non-Hodgkin ; Paraffin*

Several investigators have attempted to clarify th well-known phenomenon of anergy in lepromatous leprosy during past two decades, utilizing various methods of immunologic assessrvent, including response to skin test antigens, active skin sensitization with strong allergens, skin homograft survival rate, imrnunopathology of lymphnodes, in vitro blastogenic response by antigens or mitogens of lymphocytes, lymphokine production in vitro and measurement of peripheral T and B cell ratio. Howcver, there is no general agreement as to the cellular irnmunologic status of leprosy patients b tween various investigators. The present study was undertaken to evaluate the ability to mount cutaneous hypersensitivity reactions to various skin test antigens and to investigate active sensitization with DViCB in patients with leprosy. Ten polar lepromatous (LL) and 12 polar tuberculoid (TT) p-tients who have been treated at Department of Dermatology, National Iviedical Center and Seoul Nationa,l University Hospital were the subjects. The subjects have rcceived regular antileprosy chemotherapy with DDS and the average duration of treatment in LL and TT groups was 6. 2 and 4. 7 years, respectively. The control group included 10 healthy physicians and nurs-s. Skin test antigens includ=d lepromin (1 x10' bacilli,ml'), PPD (Parke-Davis 5ppJ/0.1ml), SK-SD (Lederle, 40 u SK and 10 u SD/0.1 ml), Candidin (Hollister stier Lab 1: 1000 dilution) and DNCB aceton solution in the concentrations of 1000ug,/0.1ml for sensitization and 100ug/0.1ml for challenge, respcctively. Skin reactions were read 48 hours after intraderrnal injection of 0.1 rnl of each antigen anci th.' metho4 of DNCB sensitization was same as described elsewhere. The result showed that in polar lepromatous leprosy patients, the skin reactivity to various antigens were generally decroased, as cornpared to both th healthy control group and polar tuberculoicl patients, especially to lepromin, PPD and I')NCB sensitization (p<0.05, respectively). We concluded thxt lepromatous leprosy patients were especially unresponsive to mycobacterial antigcns(lepromin and PPD) and to newly administered antigen (DNCB) and tbe possible mechanism was discussed.
Allergens ; Allografts ; Antigens ; Dermatology ; Dinitrochlorobenzene ; Drug Therapy ; Humans ; Hypersensitivity* ; Lepromin ; Leprosy* ; Leprosy, Lepromatous ; Lymphocytes ; Mitogens ; Research Personnel ; Seoul ; Skin Tests* ; Skin* ; Survival Rate

As the percentage of the elderly in the population increases, research to identify the nutritional and health status of the elderly, to understand the factors influencing on them, and to delay aging have been done actively. It is necessary for these studies to be longitudinal. This study was carried out to assess the change of health-related habits such as dietary behaviors and smoking, alcohol drinking and exercising habit, and health status between previous study(1991/1994) and post study(1998) for middle-aged men and women living in Chonju. For the present study, the data of 63 pairs(23 men and 40 women) were analyzed. They were 11 men and 12 women followed up from 82 men and 100 women surveyed in 1994. Mean ages in the 1991/4 and 1998 studies were 53.6y(range 42-63y) and 59.0y(range 46-72y) respectively. The survey was conducted with interview using a questionnaire including dietary behaviors and health-related habits, and anthropometric measurement and blood test for analyzing biochemical indices in 1991/4 and 1998. To understand these changes over time, chi2-statistics, t-test and paired t-test were analyzed with an SAS package program. As people age, there were significantly decreases in the proportions to eat lightly salted foods and drink alcohol. Significant longitudinal increases in triceps skin fold thickness, gamma-GPT and HDL-cholesterol and significant decrease in hemoglobin value were noted over time in both men and women. In addition a significant decrease in blood glucose level was noted over time in women. Weight, blood glucose and total cholesterol increased significantly with age in those had had breakfast regularly or those had not used more slat at the table in the past. From this study, were found out the subjects of this study had relatively desirable health-related habits. But as improper health-related habits are likely to result in inappropriate health status(eg, increase in WHR, triglyceride, total cholesterol and LDL-cholesterol), it is recommended that nutrition education in necessary as soon as possible to meet the health elderly.
Aged ; Aging ; Alcohol Drinking ; Blood Glucose ; Breakfast ; Cholesterol ; Education ; Female ; Follow-Up Studies* ; Hematologic Tests ; Humans ; Jeollabuk-do* ; Male ; Skin ; Smoke ; Smoking ; Triglycerides ; Surveys and Questionnaires

Cirsoid aneurysm of the calp is a congenital arteriovenous malformation which is the result of abnormal connections betwe:.n the external carotid artery and scalp veins with a subsequent dilatation of vascular channels nd formation of aneurysm. We report a case of cirsoid aneurysm of the scalp on the left parieto-occipital area of 14-year-old female who had had 8 x 5 x 0.8 cm sized pulsating soft mass for 2 years. 4 vessel angiog raphy revealed a arteriovenous malformation that emerge mainly from a superficial temporal artery and occipital artery of the left external carotid artery and partially from the right superficial temporal artery and drined into the left scalp vein. The mass was removed by excision with ligation of the feeding arter es and followed up for 2 years without recurrence.
Adolescent ; Aneurysm* ; Arteries ; Arteriovenous Malformations ; Carotid Artery, External ; Dilatation ; Female ; Humans ; Ligation ; Recurrence ; Scalp* ; Temporal Arteries ; Veins