We are reporting a case of multiple dermatofibromas which occuired during the treatment of systemic lupus erythematous with prednisolone for 3 years in a 30-yenr-old woman, All of the 26 lesions were 0.5-2cm sized. and had the same appearanes ad usual dermatofibromas coccurring singly. Histopathologic examination showed typical findings of dermatofibroma which were characterized hy proliferation of fibroblasts intermingled with collagen in irregular arrangement and proliferation of small vessels and endothelial cells.
Collagen ; Endothelial Cells ; Female ; Fibroblasts ; Histiocytoma, Benign Fibrous* ; Humans ; Lupus Erythematosus, Systemic* ; Prednisolone

The authors reviewed 85 knees in 59 patients(9 males, 50 females) who had preoperative flexion contracture(FC) greater than 20° and taken total knee arthroplasty(TKA) at the Seoul National University Hospital from Jan.1987 to Dec.1992. We reviewed the surgical methods according to preoperative FC, changes of postoperative FC and range of motion, and clinical and radiologic findings. In our series, 48 knees were degenerative arthritis(average FC: 26°), 34 knees, rheumatoid arthritis(average FC: 40°)and 3 knees, others(average FC:28°). The average follow-up period was 2 years(range, 1 to 4(+8) years). Seventy three knees with FC less than 45 (Group I)had been treated with TKA accompanied with adequete soft tissue release, removal of osteophyte and appropriate bone resection. Eleven knees with FC greater than 50° (Group II) had been treated with skin traction followed by TKA. One knee with 65° of FC(Group III)was treated with posterolateral and posteromedial release including tendon lengthening at first, and then TKA in second stage. Preoperative FC was significantly greater in RA group than in DA group. Flexion contracture improved until postoperative 3 years in DA group and improved until postoperative 2 years and slightly deteriorated after then in RA group, but statistically insignificant(p>0.05). There was no difference of FC at postoperative 2 weeks and final follow-up between Group I and II. Range of motion improved until postoperative 2 years in DA group significantly(p < 0.05). In RA group, range of motion improved until postoperative 2 years(p>0.05) and deteriorated after then(p < 0.05). With TKA, range of motion increased significantly in both Group I and II and there was no difference of range of motion between Group I and II at final follow-up. Postoperative HSS score and pain score improved in DA and RA groups significantly, and final HSS score with greater in DA group than RA group(p < 0.05). Preoperative HSS score and pain score of Group I were significantly higher than those of Group II, but final follow-up, there was no difference between two groups. There was no correlation between final FC and HSS score. There was no difference in score of radiolucency between two groups in which final FC was greater and lesser than 10°. We thought that in knees with fixed flexion contracture, successful correction of moderate to severe flexion contracture and satisfactory result of total knee arthroplasty can be achieved by adequate soft tissue release, appropriate bone resection, and/or preoperative management.
Arthroplasty, Replacement, Knee ; Contracture ; Follow-Up Studies ; Humans ; Knee ; Male ; Osteophyte ; Range of Motion, Articular ; Seoul ; Skin ; Tenotomy ; Traction

There are several factors to be considered while performing reduction mammoplasty in patients having giant breast with severe breast ptosis. These are degrees of breast ptosis, location of newly created nipple areolar complex, preservation of sensation, symmetry of both breasts, amount of breast tissues to be resected, and finally the postoperative scar. Among the above factors, postoperative scar seems to be the major problem that patients complain about. So several methods have been investigated in time to minimize the scar. Authors have performed 3cases of reduction mammoplasty in patients with severe ptotic large breast by applying the method of umbilicus creation in abdominoplasty, so that only periareolar and submammary scars remained without a vertical scar. The age were between 33 and 43 years old. Mean follow up period was about 6.5 months. Amount of the resected mammary tissues was about 750-1350g. Periareolar deepithelialization was made about 8cm diameter for better cirulation to the nipple areolar complex and wider contact area thus enhancing the stabilization and survival of the nipple areolar complex. Only 1 case with partial deepithelialization of the areola occurred but completely healed within 1 month. Patients were pleased with natural shape and size of the breast and the sensation of the nipple areolar complex was restored completely in all cases after surgery. Authors have performed reduction mammoplasty without leaving the vertical scar which considered to be the major problems of the classical methods. Other problems such as insufficient reduction, flattening of the breast and severe wrinkles around the nipple were also solved. This method not only improve the aesthetic importance but also minimize the functional complications such as sensory loss and difficulty in lactation.
Abdominoplasty ; Adult ; Breast ; Cicatrix* ; Female ; Follow-Up Studies ; Humans ; Lactation ; Mammaplasty* ; Nipples ; Sensation ; Umbilicus

No abstract available.
Heart ; Shock

Five patients with “definite” or “classical” rheumatoid arthritis who had failed to respond to salicylates, non-steroid anti-inflmmatory agents, steroids, and gold, were treated with D-Penicillamine. In a follow-up ranging from 3 weeks to 4 months, two patients had complete remission and one had major improvement. In one patient penicillamine had to be discontinued because of side effects and in another the time interval is too short at this reporting to assess the results.
Arthritis, Rheumatoid ; Follow-Up Studies ; Humans ; Penicillamine ; Salicylates ; Steroids

BACKGROUND: It is well-known that dyspeptic symptoms in functional dyspepsia are related to psychological factors such as stress and mood disorder. But it is still controversial whether H. pylori infection is a important factor for functional dyspepsia. We conducted this study to investigate whether H. pylori infection or stress are related to dyspeptic symptom severity in functional dyspepsia. METHODS: From Mar. 1 1999 to Apr. 30 1999, attendees to a Health Screening Center and a Family Practice Center were eligible study subjects. The subjects were responded to questionnaire including dyspeptic symptom severity items and BEPSI-K(stress scale). And among eligible subjects, one hundred and thirty two diagnosed with functional dyspepsia by gastrofibroscopy were final study subjects. H. pylori infection was confirmed by antral biopsies & smear (Giemsa stain). RESULTS: In functional dyspepsia, high BEPSI-K score group(upper tertile) complained more severe dyspeptic symptom severity than low BEPSI-K score group(lower tertile) after adjusted for other variables(adjusted OR=8.389, 95% C.I.=2.232-31.231). But the dyspeptic symptom severity was not associated with H. pylori infection status (adjusted OR=1.514, 95% C.I.=0.567-4.046). CONCLUSIONS: The dyspeptic symptom severity in functional dyspepsia was associated with stress but not with H. pylori infection status.
Biopsy ; Dyspepsia* ; Family Practice ; Helicobacter pylori* ; Helicobacter* ; Mass Screening ; Mood Disorders ; Psychology ; Surveys and Questionnaires

As one of many cell-many cell-based cartilage repairing methods, transplantation of chondrocyte-embedded-collagen gels in cartilage defect was performed for more satisfactory regeneration of cartilage. The authors performed this study to investigate whether the TGF-beta1 treatment of chondrocytes can do some additional synergistic effect on the transplantation of chondrocyte-embedded-collagen gels for crtilage repair. Chondrocytes were isolated from the articular cartilage of newborn Sprague-Dawley rats. Chondrocytes cultured for 10 days in monolayer were embedded in the 0.45% type I collagen gel. Full-thickness cartilage defect was made in the patellar groove of adult Sprague-Dawley rats. Chondrocytes culdefect was made in the patellar groove of adult Sprague-Dawley rats. The cartilage defects were treated with the following methods in a total of 200 animals, which were assigned to 5 different groups of 40 rats. In the control group, the deffect was left without any treatment, in group I, the defect was filled with collagen gel only, in group II, with collagen gel coontaining 10 ng/ml concentration of TGF-beta1, in group III, with collagen gel containing chondrocytes, and in group IV, with collagen gel containing chondrocytes and TGF-beta1. At 1, 2, 4, 8, 12 weeks after the operation, eight rats of each group were sacrificed, and their distal femurs were harvested for the histologic and biomechanical tests. The section s were stained with hematoxilin and eosin. Alcian-blue, and Safranin-O. Regenerated cartilage was analyzed by the semiquantitative histological grading system. Point indentation test was performed as a biomechanical evaluation, and the stiffness was calculated. The results of the histological grading system revealed that the scores gradually increased with time in all groups, and the scores of group III and IV were higher than those of control, group I and II. The biomechanical study showed that the stiffness gradually increased to reach a plateau level in each group. In control, group I and II, the stiffness increased up to the eighth week and remained around the increased level at the twelfth week, and did not show any statistically significant difference between the groups. In group III and IV, the stiffness was higher than in control group, and increased markedly at the fourth week and the increased level was maintained onwards. The results of this study showed that the transplantation of chondrocyte-embedded-collagen gels enhanced the healing process, and the treatment of TGF-beta1 demonstrated at least partially significant improvement.
Adult ; Animals ; Cartilage ; Cartilage, Articular* ; Chondrocytes ; Collagen ; Collagen Type I ; Eosine Yellowish-(YS) ; Femur ; Gels ; Humans ; Infant, Newborn ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Transforming Growth Factor beta1

Endometrial papillary serous carcinoma (EPSC) is a distinct variant of endometrial adenocarcinoma that histologically resembles ovarian serous papillary adenocarcinoma and has an aggressive clinical course. Usually, the tumor is diagnosed at the advanced stage. The tumor has well confused with metastatic ovarian tumor of identical histology. Dignosis of EPSC should be considered when the cervico-vaginal smear reveals numerous papillary clusters of tumor cells with macronucleoli and psammoma bodies. Recently, we have experienced two cases of EPSC diagnosed on cervico-vaginal smears, which revealed characteristic cytologic features including numerous papillary clusters of tumor cells with macronucleoli. The cytologic diagnoses were confirmed on histologic sections.
Adenocarcinoma ; Adenocarcinoma, Papillary ; Diagnosis ; Polycystic Kidney, Autosomal Recessive*

PURPOSE: To evaluate the clinical efficacy of balloon catheter dilatation in the treatment of esophageal achalasia. MATERIALS AND METHODS: Seven patients(three males and four females) with esopha-geal achalasia were treated with balloon catheter dilatation. Balloon catheters of variable sizes were used depending on patient's conditions. The patients were followed up over a period of 12-39months. RESULTS: Balloon catheter dilatation in esophageal achalasia was successful in all patients without esophageal perforation. All patients were relieved from dysphagia. Recurrence was not found in 5 patients on long term follow-up study, but was seen in 2 patients after 18 and 21 months, respectively. CONCLUSION: Balloon catheter dilatation was a safe and effective method in the treatment of esophageal achalasia with low recurrence rate of 29% on follow-up study.
Catheters* ; Deglutition Disorders ; Dilatation* ; Esophageal Achalasia* ; Esophageal Perforation ; Follow-Up Studies* ; Humans ; Male ; Recurrence

No abstract available.