STUDY DESIGN: A case report is presented of destructive lesion involuting intervertebral disc space and adjoing vertebral bodies in association with ankylosing spondylitis. OBJECTIVE: To report unusual clinical and radiological presentation of spondylodiscitis and its treatment wi th anterior interbody fusion. SUMMARY OF BACKGROUND DATA: Althought there is some mention in the literature of pathogenesis, diagnosis and treatment of spondylodiscitis in ankylosing spondylitis, we think that its occurrence is frequent enough to warrant this condition and we should differentiate it from other infectious or tumorous condition. RESULTS: Anterior debridement and anterior interbody fusion with structural bone graft were performed. The microscopic study showed nonspecific chronic inflammation and extensive necrosis. CONCLUSION: It was suggested that primary spondylodiscitis or pseudoarthrosis resulted from mechanical trauma be related to this condition rather than infectious spondylitis.
Debridement ; Diagnosis ; Discitis ; Inflammation ; Intervertebral Disc ; Necrosis ; Pseudarthrosis ; Spondylitis ; Spondylitis, Ankylosing* ; Transplants

No abstract available.
Nevus, Pigmented*

BACKGROUND: Dermatophytosis is sometimes difficult to diagnose deinitively if it has atypical clinical characteristics and mycological tests are negative. Histopathologic findings may be different depending upon the location and causative dermatophytes. OBJECTIVE: The purpose of the present study was to evaluate histopathologic characteristics nf dermatophytosis depending upon the areas of involvement. METHODS: We evaluated the clinical and histopathologic features of 32 cases of dermatophytosis which were diagnosed by skin biopsies at the Dermatology Department of branch hospitals of Catholic University Medical College from March 1985 to August, 1994. Histopathologic features were observed in three dilferent groups divided by location, area of terminal hair, areas of vellus hair and hairless areas. RESULTS: Epidermal changes including hyperkeratosis, parakeratos, acanthosis, spongiosis and neutrophilic exocytosis were frecuently observed in the three groups of Iermatophytosis. In 7 cases of tinea capitis and linea barbae, follicular and inflamma or changes of the deep dermis were important. Hyphae and spores were observed in 71%(5 cases) and 57%(4 cases) respectively, in the follicles. In 19 cases of tinea faciale, tiriea corporis and tinea cruris, change epidermis and superficial dermis as well as findings of follicular infundibulum were important. Herphae were observed in 84%(16 cases) and 53%(10 cases) in the stratum corneum and vellus hir follicle respectively, and in 3 cases the hyphae were observed only in the vellus hair follicle. Sandwich sign, known to be important clue of dermaliophytosis, was observed in only 5%(1 cacse, In 6 cases of tinea manus and linea pedis, hyphae and spores were rebserved in 100% (6 cases) and 33%(2 cases) respectively, in the stratum corneum. CONCLUSION: We consider tha histopathologic observations may of great help to diagnose some difficult cases of dermatophytosis and the presence of hyphae n .he vellus hair follicle may be a more frequent and important finding than the sandwich sign the dermatophytosis of the vellus hairy regions.
Arthrodermataceae ; Biopsy ; Dermatology ; Dermis ; Epidermis ; Exocytosis ; Hair ; Hair Follicle ; Hospitals, Satellite ; Hyphae ; Neutrophils ; Skin ; Spores ; Tinea Capitis ; Tinea*

No abstract available.
Humans ; Male*

Thirty one free vascularized fibula bone grafts were performed for treatment of osteonecrosis of the femoral head in 26 patients, 24 men and 2 women aged from 16 to 48(mean:32 years). Twenty one patients had unilateral disease. Five patients had bilateral disease underwent staged bilateral free vascularized fibula grafts three months apart. Associated etiological factors included alcohol(9 patients), steroid(7 patients), and trauma(one patient). The condition was considered idiopathic in the remaining 9 patients. Radiologic staging by Ficat included stage 1 in one hip, stage II in 15 hips, stage III in 14 hips, and stage IV in one hip. A skin island flap was used for monitoring purpose for the grafted fibula. One monitoring, flap was necrotized due to vascular occlusion but the fibula bone graft was left in place to use as a nonvascularized bone graft. Average follow-up period was 21 months in 31 hips. Pain was relieved in 28 hips(93.3 percent) and aggravated in 2 hips(6.7 per cent). On radiographic evaluation, 26 hips(86.7 per cent) demonstrated excellent preservation of the femoral head contour. Progressive collapse of the femoral head (greater than 1-2 mm) occurred in 2 hips, i mm depression in one hip with stage III and 2 mm collapse in one hip with stage IV. In conclusion, the free vascularized fibula bone graft is an excellent treatment modality for preserving the femoral head and relieving symptoms in cases of the osteonecrosis of the femoral head.
Depression ; Female ; Fibula* ; Follow-Up Studies ; Head* ; Hip ; Humans ; Male ; Osteonecrosis* ; Skin ; Transplants

The number of cancers in the head and neck areas has been increasing due to the increasing life span of the patients and a free flap is a common procedure to reconstruct defect in the head and neck area. From March 1990 to February 1998, 105 patients underwent 110 free flap operations after head and neck cancer ablation and they were reviewed retrospectively. Among 110 free flaps, 93 are forearm flaps, 6 jejunal flaps, 5 vascularized fibular osteocutaneous flaps, 2 lateral arm flaps, 2 rectus abdominis myocutaneous flaps and 1 latissimus dorsi muscle flap and 1 latissimus dorsi myocutaneous flap. Sixty-five radial forearm flaps and 4 ulnar forearm flaps were utilized in patched type and 24 radial forearm flaps in tubed type mainly for the reconstruction of intraoral and hypopharyngeal defects. Sis jejunal flaps were utilized for the esophageal reconstruction and 5 vascularized fibular osteocutaneous flaps for the mandibular reconstruction. The remaining flaps were for the reconstruction of other areas of head and neck.Overall survival rate of the flap was 95.5%. Immediate complications were fistula formation(3 cases), total flap loss (4 cases) or partial flap loss(3 cases) and donor site problems(10 cases). Superior thyrodial artery was the most commonly used recipient artery(89 cases) which was followed by facial artery, lingual artery and transverse cervical artery. Size discrepancy was not remarkable between the donor and recipient arteries. However, there was usually a marked size discrepancy between donor and recipient veins. More than two venous anastomoses were performed to increase the success rate of the flap surgery. An average follow-up period was 38 months ranging from 3 months to 6 years. There was no patient who died during or right after the operations, but 23 patients died due to recurrence of tumors or underlying heart disease during the follow-up period. Remaining patients lived well excluding 6 late postoperative complications such as 4 cases of esophageal stenosis and 2 cases of osteoradionecrosis. We conclude that free flap reconstruction after head and neck cancer ablation improves the quality of life and minimizes the loss of function.
Arm ; Arteries ; Esophageal Stenosis ; Fistula ; Follow-Up Studies ; Forearm ; Free Tissue Flaps* ; Head and Neck Neoplasms* ; Head* ; Heart Diseases ; Humans ; Mandibular Reconstruction ; Myocutaneous Flap ; Neck ; Osteoradionecrosis ; Postoperative Complications ; Quality of Life ; Rectus Abdominis ; Recurrence ; Retrospective Studies ; Superficial Back Muscles ; Survival Rate ; Tissue Donors ; Veins

Lichen nitidus, characterized by its typical clinical and histopathologic findings, is an uncomrnon chronic dermatosis of unknowned etiology. The distribution of this disease is most often localized, but in some cases it may becorne generalized. Some authors suggested that lichen nitidus is a variant of lichen planus in terms of its coincidence, ultrastructural and immunophenot,ypic studies. We report herein a case of lichen nitidus which presents dark brown linear, grouped, or confluent papules on the face, cheat, and upper extremities, accompanying with the histopathologic findings of pigmentary incontirence in the portion of claw clutching a ball appearance. This report suggests that lichen nitidus shows hyperpigmentation clinically and could be one of the dermatoses which exhibit pigmentavy incontinence in a histopathologic study.
Animals ; Hoof and Claw ; Hyperpigmentation ; Lichen Nitidus ; Lichen Planus ; Skin Diseases ; Upper Extremity

Eccrine spiradenoma is a txnign, painful tumor of the skin, which probably originates in the coil of the eccrine sweat glands and presents a characteristic clinical and pa.hological picture. However recently, the weakness and inconsistency of the enzymes histochemican, actions and electron microscopic findings, and the presence of numerous undifferentiated and indetirn, inate cells suggest a rather low degree of differentiation. We present herein four cases of eccrine spiradenoma which show livrse histopat.hologic characteristics including typical rosette-like structure, ductal structure, vacuar structure and mixed type, respectively. This report may support the premise that eccrine spiridinoma is defived not only from the eccrine duct but also from pluripotential stem cells.
Skin ; Stem Cells ; Sweat Glands

No abstract available.
Lichens*

Acute mobile thrombus of the abdominal aorta after chemotherapy is a very unusual finding, which can be a potential source of arterial embolism. We report here on a case of an acute mobile aortic thrombus with renal infarction. We successfully treated the patient with hybrid operation-open surgical and endovascular approach. Our case shows that hybrid treatment using wire-directed balloon catheter thrombectomy is a feasible, minimally-invasive treatment for a mobile aortic thrombus.
Angioplasty ; Aorta ; Aorta, Abdominal ; Catheters ; Chimera ; Embolism ; Humans ; Infarction ; Thrombectomy ; Thrombosis