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

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

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

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

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

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

No abstract available.
Esophageal Atresia*

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*

AIMS OF STUDY: Present study designed to observe inhibitory effects of propiverine HC1 and tiropramide against the smooth muscle contraction of female rat bladder. Propiverine has both direct smooth muscle relaxation and anticholinergic effect and has relatively fewer side effect than conventionally used drugs such as oxybutinin. Tiropramide has been known as modulatory agents of gastrointestinal motility but also has inhibitory effects against the bladder contraction. METHODS: 30 adult female Sprague-Dawley rats were used. Bladder body above ureteral orifice was resected under pentobarbital anesthesia. 1 x 0.5 cm sized smooth muscle strip was made, and incubated in Tyrode`s solution aerated with 95% oxygen. After reaching equilibrium state, each strip was stimulated by field stimulation (FS, 1-32 Hz) and bethanechol administration (0.0000001-0.0001M). From each strip, degree of muscle contraction was recorded by physiograph (Gilson IC-MP). After the control stimulations, each strip was treated by atropine, tiropramide, oxybutinin and propiverine HC1. After 30 minutes, same stimulation were repeated and degree of muscle contraction was compared to pre incubation data. RESULTS: Frequency and dose dependent muscle contractions were noted for both FS and bethanechol stimulation. Greater degree of contractions were noted for FS than for bethanechol stimulation. Inhibitory effects of tiropramide, propiverine HC1 and oxybutinin were greater than those of atropine at FS (1-32 Hz). At high concentration (0.0001M), all of the drugs but atropine inhibited field stimulated smooth muscle contraction more than 90%. At lower concentration (0. 0000001-0.000001M), inhibitory actions of oxybutinin and propiverine HC1 were greater than that of tiropramide (p>0.05). Propiverine HC1 and oxybutinin had similar inhibitory effect for all con-centration. At higher concentration (0.0001M), inhibitory effects of tiro-pramide were more than 98% whereas those of oxybutinin and propiverine HC1 were 88%. At low concentration (0.0000001-0.000001M), oxybutinin exhibited greater inhibition against the bethanechol induced contraction than did tiropramide and propiverine HC1. With these results, it was suggested that in low concentration, oxybutinin and propiverine HCI had greater inhibitory effect than did tiropramide against smooth muscle contraction of the bladder. In high concentration though, tiropramide had superior inhibitory effect than did oxybutinin and propiverine HC1. Since, no difference was noted between oxybutinin and propiverine HC1 for the inhibitory action of bladder contraction, propiverine HC1 seems reasonable substitute for the treatment of detrusor hyperreflexia with less side effects. Also these results indicate that tiropramide can be used for the management of unstable bladder.
Adult ; Anesthesia ; Animals ; Atropine ; Bethanechol ; Female ; Gastrointestinal Motility ; Humans ; Muscle Contraction ; Muscle, Smooth* ; Oxygen ; Pentobarbital ; Rats* ; Rats, Sprague-Dawley ; Reflex, Abnormal ; Relaxation ; Ureter ; Urinary Bladder*