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

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

No abstract available.

No abstract available.
Animals ; Lordosis* ; Spine*

Sclerema neonatorum is a lesion of degeneration, necrosis or crystallization of adipose tissue of new born, and is classified into two types; the generalized type in which death occurs usually within one week without treatment, and the nodular type which is localized and heals spontaneously. In this report, nodular type was presented. Nut to palm sized indurated plaques on deltoid region, upper back and hip were noted 3 weeks after birth. Histopathologic findings of necrosis of subcutaneous tissue with early granulomatous reaction were showed in biopsy specimen. Literature was briefly reviewed for the discussion of clinical and microscopic findings of this disease.
Adipose Tissue ; Biopsy ; Crystallization ; Hip ; Necrosis ; Nuts ; Parturition ; Sclerema Neonatorum ; Subcutaneous Tissue

Five cases of incontinentia pigmenti (Bloch-Sulzberge type) were presented and literature were reviewed. They were all girls. 3cases of them were associated with defects of ectodermal or mesodermal development. As the manifestation of those, malformed teeth in 2 cases, delayed dentition in 3 cases, eye problem in 2 cases, and alopecia in 3 cases were noticed. One of 3 cases had eruptions of lichen striatus on her upper extremities. Especially, family history of involvement of maternal relative in one case was noticed. Diagnosis of them were confirmed by characteristic clinical appearance and histopathologic findings.
Alopecia ; Dentition ; Diagnosis ; Ectoderm ; Female ; Humans ; Incontinentia Pigmenti ; Lichens ; Mesoderm ; Tooth ; Upper Extremity

Pemphigus foliaceus is a chronic vesiculobullous dermatosis which seems to be an autoimmune etiology, and favorable results are usually able to obtain with massive doses of corticosteroids administration and Imuran or other anticancer drugs. Two cases of typical pemphigus foliaceus, who showed cutaneous candidiasis, one with clinical improvements, and the other one who had lung abscesses of aspergilli as a complication of the long-term corticosteroid treatment, have been presented. The diagnosis of pemphigus foliaceus was confirmed by histopathologically subcorneal bullae containing acantholytic cells, also Tzank test and Nikolsky's sign. First case, 37 year old man who has the history of corticostcroid therapy for 3 years tor rheumatoid arthritis, was treated with high dosage of prednisolone and antibiotics with nystatin for cutaneous candidiasis, but lung abscesses of aspergilli developed while we couldn't even notice its progress and he died suddenly because of it although skin lesions showed marked improvement. Second case, 36 year old house wife who has the history of recurrent aphthous stomatitis like eruptions was recovered from pemphigus foliceus after steroid treatment and cutaneous candidiasis after using antibiotics and nystatin. As the complication of corticosteroid therapy, cushingoid feature, blurred vision, and cutaneous candidiasis were occurred in both patients, especially in the first case, hyperglycemia and metabolic alkaloses were developed. And so, as mention of Saunders, we checked the patient's complete history, body weight everyday, and CBC and occult blood every week, but urine sugar or blood sugar and chest X-ray not periodically. We used anabolic agent for osteoporosis, antibiotics, mycostatm, diuretics, and antacid regimen, but failed to deveIopment of aspergillosis.
Adrenal Cortex Hormones ; Adult ; Alkalosis ; Anti-Bacterial Agents ; Arthritis, Rheumatoid ; Aspergillosis ; Azathioprine ; Blood Glucose ; Body Weight ; Candidiasis, Cutaneous ; Diagnosis ; Diuretics ; Humans ; Hyperglycemia ; Lung Abscess ; Nystatin ; Occult Blood ; Osteoporosis ; Pemphigus* ; Prednisolone ; Skin ; Skin Diseases ; Spouses ; Stomatitis, Aphthous ; Thorax

These are the first reported cases of granuloma faciale in two Koreans. Unilateral, slightly elevated violaceous plaque with illdefined margin on cheeck since 20 years ago was observed in 36 year old house-wife, and 40 year old male has had bilateral plaques on both cheek areas since 10 years ago, These plaques were showed the typical histological appearance of granuloma faciale respectively on both of two patients. Literature was briefly reviewed for the discussion of clinical and microseopic findings of this disease. Both patients were treated by intralesional injections and ointment of steroid with relative clinical improvements.
Adult ; Cheek ; Granuloma* ; Humans ; Injections, Intralesional ; Male

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.
Aloe*