Chromoblastomycosis, a chronic fungal infection of the skin and subcutaneous tissue, is known to be difficult to treat. Recently itraconazole has proved effective for treatment of this infection, but requires a prolonged treatment course. We experienced a case of chromoblastomycosis caused by Fonsecaea pedrosoi in a 68-year-old Korean man showing a complete resolution with a short course of oral itraconazole, 200 mg daily, for six weeks.
Aged ; Chromoblastomycosis* ; Humans ; Itraconazole* ; Skin ; Subcutaneous Tissue

BACKGROUND: Intralesional injection of corticosteroids has widely been used for the t,reatment of alopecia areata. The pair produced during the repeated multiple injection procedures is an actual therapeutic obstacle in both adult and child patients. Buffering of the local anesthetics is known to reduce the pain. OBJECTIVE: The purpos; of this study was to evaluate the degree of pain reduction and hair regrowing effect by the use of buffered lidocain-triamcinolone acetonide suspension(BLT) compared with nonbuffered lidocairi triamcinolone acetonide suspension(LT) in the intralesional injection of alopecia areata. METHODS: We evaluat d the degree of pain reduction by the use of BLT compared with LT in the intralesional injection in 40 cases of alopecia areata. The pain was ineasured by patients verbal pain score from zerc to ten and simultaneously observed if there were be any differences in hair regrowing bet,ween the two groups. RESULTS: 1. Remarkable reduction of the pain du~ring the inject,ion was noted by the buffering agent and the pain was further reduced by the vertical insertion of the needle. The pain score of BLT was 1.5 by vertically inserted injections and 2.4 by ~30 degree angle injections while the pain score of LT was 4.4 by the vertical and 5.6 by t.he 30 degree, Z. The mean time for appearance of regrowing hairs was 3.6 weeks in the BLT area and 4.0 weeks in the LT area. The use of BLT area showed a statistically faster response than the LT area. CONCLUSION: The use ot BLT is recommended not only by it,s remarkable effect on pain reduction but also by its sigriificantly accelerated hair regrowing effect in the trea~tment of alopecia areata.
Adrenal Cortex Hormones ; Adult ; Alopecia Areata* ; Alopecia* ; Anesthetics, Local ; Child ; Hair ; Humans ; Injections, Intralesional* ; Needles ; Triamcinolone Acetonide* ; Triamcinolone*

BACKGROUND: Intralesional injection of corticosteroids has widely been used for the t,reatment of alopecia areata. The pair produced during the repeated multiple injection procedures is an actual therapeutic obstacle in both adult and child patients. Buffering of the local anesthetics is known to reduce the pain. OBJECTIVE: The purpos; of this study was to evaluate the degree of pain reduction and hair regrowing effect by the use of buffered lidocain-triamcinolone acetonide suspension(BLT) compared with nonbuffered lidocairi triamcinolone acetonide suspension(LT) in the intralesional injection of alopecia areata. METHODS: We evaluat d the degree of pain reduction by the use of BLT compared with LT in the intralesional injection in 40 cases of alopecia areata. The pain was ineasured by patients verbal pain score from zerc to ten and simultaneously observed if there were be any differences in hair regrowing bet,ween the two groups. RESULTS: 1. Remarkable reduction of the pain du~ring the inject,ion was noted by the buffering agent and the pain was further reduced by the vertical insertion of the needle. The pain score of BLT was 1.5 by vertically inserted injections and 2.4 by ~30 degree angle injections while the pain score of LT was 4.4 by the vertical and 5.6 by t.he 30 degree, Z. The mean time for appearance of regrowing hairs was 3.6 weeks in the BLT area and 4.0 weeks in the LT area. The use of BLT area showed a statistically faster response than the LT area. CONCLUSION: The use ot BLT is recommended not only by it,s remarkable effect on pain reduction but also by its sigriificantly accelerated hair regrowing effect in the trea~tment of alopecia areata.
Adrenal Cortex Hormones ; Adult ; Alopecia Areata* ; Alopecia* ; Anesthetics, Local ; Child ; Hair ; Humans ; Injections, Intralesional* ; Needles ; Triamcinolone Acetonide* ; Triamcinolone*

The slipped capital femoral epiphysis is characterized by a growth disturbance of the capital physi. resulting in weakening of this structure and a subsequent displacement of the femoral head on the fe moral neck. It is a rare entity in Korea and only six cases have been reported so far1-5). One of ou cases was a bilateral mild acute slips in 13 yearold boy which were treated by Hagie pinning. Th other case, a 17 year-old boy, who suffered from a moderate acute on chronic slip in his left hip an showed a typical Pistol grip deformity. He was treated by gentle closed rcduction and Knowles pi fixation with good result.
Congenital Abnormalities ; Epiphyses ; Hand Strength ; Head ; Hip ; Humans ; Korea ; Male ; Neck ; Slipped Capital Femoral Epiphyses

When the multiple myelographic defects at lumbosacral region are noted, the prudential effort for decision of appropriate area of surgical decompression would be needed. Fifty four patients who had been treated surgically for the deseases, such as HNP and spinal stenosis, from March in 1982 to Feb. In 1987 at Department of Orthopecdic Surgery, Soonchunhyang University Hospital, were analyzed in order to define the etiology, the level of the defect, indication for the operation and to assess the results of each level which had been operated. The results of the study were as follows. 1. The number of patients, which the multiple indentations were noted in the myelogrsphy, was 54 cases, 29 spinal stenosis, 15 HNP and 10 mixed types. 2. The most common defect levels in myelography were L3-4 snd L4-5, which were 19 cases (35.2%), the next levels were L4-5 and L5S1, which were 16 cases(29.6%), then L3-4, L4-5 and L5S1 were 7 cases(13%) and the other levels were 12 cases(22.2%). 3. The decision for the sppropriste operation area had not be done following to the size of the myelographic defect, but the clinical symptoms and physicsl exsminations. 4. The results were classified ss excellent or good in 79.7%, which was 80% at two levels snd 79.5% at one level. 5. The operation levels could be decressed for the reducing the spinal instability, operation time and possibility of the dangerous conditions and promotion of early restoration and, ambulation, if the severe differences between the results of one and two operation levels were not seen.
Decompression, Surgical ; Humans ; Lumbosacral Region ; Myelography ; Spinal Stenosis ; Walking

Ureterosciatic hernia is extremely rare. In ureteral herniation, ureter prolapses occur through either the greater or lesser sciatic foramen. Atrophy of the piriformis muscle, hip joint diseases, and defects in the parietal pelvic fascia are predisposing factors for the development of ureterosciatic hernia. Most symptomatic patients have been treated surgically, with conservative treatment reserved only for asymptomatic patients. To the best of our knowledge, long-term follow-up outcomes after ureterosciatic hernia management are sparse. In this paper, we report the case of a 68-year-old woman who presented with colicky left abdominal pain. After computed tomography (CT) scan and anterograde pyelography, she was diagnosed ureterosciatic hernia with obstructive uropathy. We performed ureteral balloon dilatation and double-J ureteral stent placement. After this minimally invasive procedure, CT scan demonstrated that the left ureter had returned to its normal anatomical position without looping into the sciatic foramen. The patient remained asymptomatic with no adverse events 7 years after the minimally invasive procedures. This brief report describes ureterosciatic hernia successfully managed with minimally invasive procedures with long-term follow-up outcomes.

Background: To determine the benefit of pelvic floor muscle exercise with visual biofeedback on promoting patient recovery from incontinence, we investigated variables associated with the early restoration of continence for patients who underwent robot-assisted radical prostatectomy. Methods: Of the 83 patients enrolled, 41 consecutive patients completed pelvic floor muscle exercise (the exercise group), and the other 42 consecutive patients just before the pelvic floor muscle exercise program commenced (the control group). The primary outcome was whether pelvic floor muscle exercise engagement was associated with zero pad continence restoration within 3 months of surgery. Results: Continence restoration percentages (defined as zero pads used per day) at 1, 3, and 6 months after surgery were 49.4%, 77.1%, and 94.0%, respectively. The exercise group achieved significantly higher recovery rates at 1 month (p=0.037), 3 months (p<0.001), and 6 months (p=0.023). Cox regression analysis demonstrated that a lower Gleason score (<8; hazard ratio, 2.167), lower prostate specific antigen (<20 ng/dL; hazard ratio, 2.909), and engagement in pelvic floor muscle exercise (hazard ratio, 3.731) were independent predictors of early recovery from postprostatectomy incontinence. Stratification by age showed that those younger than 65 years did not benefit significantly from exercise (log-rank test, p=0.08), but that their elderly counterparts, aged 65–70 years (p=0.007) and >70 years old (p=0.002) benefited significantly. Conclusion This study suggests that postoperative engagement in pelvic floor muscle exercise with biofeedback speeds up the recovery of continence in elderly patients (≥65 years old) that undergo robot-assisted radical prostatectomy.

OBJECTIVE: Because of the limited penetration into the central nervous system after systemic administration of numerous therapeutic compounds, intratumoral chemotherapy for brain tumors has also been used. However, the efficacy of intratumoral drug administration is restricted by the poor diffusion of drug through tumor and brain interstitium. In order to enhance the diffusion of chemotherapeutic agent and increase the cytotoxicity with minimal dose, the authors report the results of convection-enhanced delivery(CED) of chemotherapeutic agent to the malignant brain tumor as a method of enhancing cerebral drug delivery. METHODS: Authors used "CADD-Micro(R) ambulatory infusion pump" from Deltec, which can be programmed for continuous infusion. Intratumoral injection of chemotherapeutic drug using the pump was applied to eight patients with glioma and one patient with lymphoma. Surgery was done and tumor was removed as much as possible. The tip of catheter was placed in the center of tumor cavity. Adriamycin (0.16~0.32mg) was put in the reservoir which was connected to the proximal catheter and fixed in the pump device. Twenty-four hours after surgery, Adriamycin was infused. RESULTS: There was no adverse reaction of CED technique. Compared with current delivery techniques, the improvement of survival rate has been observed(5 patients: alive, 3 patients: dead, 1 patient: lost(alive to 5 mo.)). CONCLUSION: CED can be useful method for distributing therapeutic molecules in the interstitial space of tumor and can be utilized for chemotherapeutic agents, immunotoxins, and gene etc..
Brain ; Brain Neoplasms ; Catheters ; Central Nervous System ; Diffusion ; Doxorubicin ; Drug Therapy ; Glioma ; Humans ; Immunotoxins ; Lymphoma ; Survival Rate

PURPOSE: To obtain basic data for development of a glioblastoma-specific immunotoxin, the expression of variable cell surface receptors on a human glioblastoma xenograft model was evaluated, using NOD/SCID mice. MATERIALS AND METHODS: We developed a xenograft model in NOD/SCID mice implanted with a human glioblastoma cell line (U-87MG). Immunohistochemical studies were performed on implanted tumor nodules (n=8) using antibodies against CD71, EGFR, IGF-IRalpha, CXCR4 and IL-4Ralpha. RESULTS: Expression of IL-4Ralpha, in implanted tumornodules, was the highest of the cell surface receptors evaluated in this study. However, the endothelial cells in, and around, the tumor nodules also revealed immunopositivity against IL-4Ralpha. The immunoreactivity of IL-4Ralpha, and other surface receptors such as CD71, IGF-IRalpha and EGFR, was prominent in tumor nodules associated with tumor necrosis. CONCLUSION: IL-4Ralpha would be a possible target for the development of glioblastoma-specific immunotoxin, although there are limitations due to its endothelial expression.
Animals ; Antibodies ; Cell Line ; Endothelial Cells ; Glioblastoma* ; Heterografts* ; Humans* ; Immunotoxins ; Mice* ; Mice, SCID ; Necrosis ; Receptors, Cell Surface*

Laurence-Moon-Biedl syndrome is a rare inherited disorder and its common findings include pigmentary retinal degeneration, obesity, hypogonadism, mental retardation and digital anomaly. Recently, the authors experienced two cases of Laurence-Moon-Biedl syndrome in a family of 15 year-old male and 17 year-old female. In our cases, the male patient showed syndactyly and polydactyly, chorioretinal degeneration, hypogonadism and female patient showed polydactyly, chorioretinal degeneration, hypogonadism, obesity and mental retardation.
Adolescent ; Female ; Humans ; Hypogonadism ; Intellectual Disability ; Laurence-Moon Syndrome* ; Male ; Obesity ; Polydactyly ; Retinal Degeneration ; Syndactyly