We herein report a 28-year-old woman with typical marginal keratoderma of the palms of 4 years duration. She denied any chronic pressure or trauma. Histological findings disclosed marked hyperkeratosis, parakeratosis, acanthosis, elongation of rete ridges, edema and capillary dilatations of papillary dermis, and infiltration of chronic inflammatory cells. There was no changes in collagenous and elastic fibers. Treatment with oral 13-cis retinoid and topical application of 0.02% flumethasone ointment containing 3%, salicylate resulted in only transit effect.
Adult ; Capillaries ; Collagen ; Dermis ; Dilatation ; Edema ; Elastic Tissue ; Female ; Flumethasone ; Humans ; Parakeratosis

We analysed forty-six cases of femoral neck fracture treated with internal fixation and followed for more than one year at Korea University Hospital from January 1979 to June 1986 and the following results were obtained. 1. Sex distribution was 23 cases(50%) male and 23 cases(50%) female, and average age was sixty years old (range from 21 to 91 years). 2. The most common cause of injury was slip down(76%). 3. The most common type of fracture was Garden's type III(46%) and Pauwels' type III (67%). 4. In cases of internal fixation, the most commonly used method was closed reduction and multiple pinning under the local aneshtesia(83%). 5. Bony union was established within 5.9 months in average. 6. Among forty six cases, 7 cases(15%) of avascular necrosis, 4 cases(9%) of malunion, and 2 cases(4%) of nonunion was occurred. 7. The clinical results were excellent in twenty cases(43%), good in sixteen cases(35%), fair in seven cases(15%), and poor in three cases(7%) according to Lunceford's assessment.
Clinical Study ; Female ; Femoral Neck Fractures ; Femur Neck ; Humans ; Korea ; Male ; Methods ; Necrosis ; Sex Distribution

BACKGROUND: The photsensitizing effect of quinolones has been recognized since their introdulation as an antibacterial agents. Recently several new second eneration antibacterial agents of this pharmacological class have become available for therapy, and are gaining increasing impotance. OBJECTIVE: To reveal the phototoxic potentials of some new quinolones by photohemolysis test, estimation of fluorescenc spectra, and Candida albicans test. METHODS: Nalidixic acid and four second-generation quinolones(ciprofloxacin, enoxacini, norfloxacin, and ofloxacitid were examined by fluorescence spertra which measured t.he phototoxc potentials by photochemial instability, photohemolsis test for the phototoxic properties against cell membranes and Candida tlbicans test for phototoxic properties against DNA. RESULTS: All drugs showed a fluorescence spectra within 360 nm to 450 nm, and in the photohemolysis test, all studied drug except ofloxacin got above 5% hemolytic value, and all drugs showed clear zone. in Candida albicans test after 48hours. CONCLUSION: These results suggested that all tested drugs were photochemically unstable. According to the mechanisris of cellular phototoxicity, ciprofloxacin, enoxacin, and norfloxacin was phtototoxic to nucleus and cell membrane, whereas ofloxacin was phototoxic to nucleus only.
Anti-Bacterial Agents* ; Candida ; Candida albicans ; Cell Membrane ; Ciprofloxacin ; Dermatitis, Phototoxic ; DNA ; Enoxacin ; Fluorescence ; Nalidixic Acid ; Norfloxacin ; Ofloxacin ; Quinolones

Colon has the highest bacterial concentration in the gastrointestinal tract. When the colon is perforated, the operator has to decide whether to perform primary closure, resection with anastomosis, proximal colostomy, and exteriorizatoion. In this retrospective study, from October, 1993, through July 1998, 56 patient with panperitonitis due to colon perforation were operated at Ewha womans University medical center. The rectal perforation was limited the intraperitoneal portion. Our cases were divided into two groups. Group I included 34 patients who treated with one step operations of primaryrepair or resection anastomosis. Group II included 22 patients who treated with two step operations of proximal colostomy or exteriorization. The one step operations were performed in 34 patients, proximal colostomy in 21 patients, and exteriorization in 1 patient. There was 13.7% in the incidence of motality and 33.3% in the incidence of morbidity. The Chi-square test was used to evaluate the significance of differences between two groups. Independent risk factors for adverse outcomes were compared and used to analyse the probability for adverse outcomes with respect to the mode of treatmen. The mode of treatment was not dependent on the risk factors. These results suggest that one could select positively primary closure or resection with anastomosis for the treatment of patients with panperitonitis due to colon perforation.
Academic Medical Centers ; Colon* ; Colostomy ; Female ; Gastrointestinal Tract ; Humans ; Incidence ; Retrospective Studies ; Risk Factors

No abstract available.
Adenocarcinoma* ; Estrogens*

PURPOSE: Displaced medial humeral epicondyle fractures with or without elbow dislocation have been treated with open reduction and fixation using K-wires or screws. The purpose of this study is to evaluate the clinical and radiological outcomes of surgical treatments of medial humeral epicondyle fracture without elbow dislocation according to the fixation methods. MATERIALS AND METHODS: Thirty-one patients who had undergone open reduction and fixation of the displaced medial humeral epicondyle fracture without elbow dislocation were included. Group I consisted of 21 patients who underwent fixation with K-wires, and Group II comprised 10 patients who underwent fixation with cannulated screws. Immediate postoperative, final follow-up and normal anteroposterior radiographs were compared and the clinical outcome was assessed using the final Japanese Orthopaedic Association (JOA) elbow assessment score. RESULTS: On the immediate postoperative radiographs, the distal humeral width in Group II was larger than that in Group I. On the final follow-up radiographs, the epicondylar position in Group I was lower than that in Group II. There was no significant difference in the distal humeral width, epicondylar position and joint space tilt between the immediate postoperative, final follow-up radiographs and the normal side within each group. There was no significant difference in the final JOA score between groups. CONCLUSION: Open reduction followed by K-wire fixation or screw fixation of the displaced medial humeral epicondyle fracture without elbow dislocation in older children and adolescents resulted in improved radiologic outcome and good elbow function in spite of diverse radiologic deformities.
Adolescent ; Bone Screws ; Bone Wires ; Child ; Dislocations/*prevention & control ; Elbow Joint/*pathology ; Female ; Humans ; Humeral Fractures/*surgery ; Male

A retrospective clinical observation was done in 90 cases of acute myocadial infarction admitted to Hanyang University Hospital from July 1972 to Dec. 1980. The following results were obtained. 1) The ratio of male to female was 2.3:1. Most patients(63.2%) were in the age groups between the 6th and 7th decades. 2) The main symptoms of acute myocardial infarction were chest pain(76.6%), dyspnea (64.4%), radiating pain(27.7%), epigastric pain(18.8%) and palpitation(15.5%). The painless infarction accounted for 11.1% of all cases. 3) The most common preceding disease was hypertension(38.5%) and other associated diseases were diabetes mellitus(13.2%), C.V.A.(8.8%), angina pectoris(8.8%), previous myocardial infarction(6.6%) and drug intoxication(3.3%). No preceding diseases were found in 12.0% of cases. 4) The anterior wall infarction was 45.5% of 90 cases, inferior wall infarction 22.2%, antero-inferior wall infarction 11.2%, subendocardial infarction 7.7%, posterolateral infarction 2% on ECG. 5) The mortality rate of patients according to the Killip class was 4.2% in class I, 14.3% in class II, 50% in class III and 76.9% in class IV. Group of high Killip class was associated with high mortality. 6) In long term prognosis according to Norris' coronary prognostic index, the highest value was 11.72 with average value of 7.02+/-2.65 in survival group, whereas in death group, the lowest value was 5.08, the highest 16.88 and average value was 10.4+/-3.86. 7) High risk subgroup who complicated within the first 4 admission days, occupied 21.1% and low risk subgroup without complication occupied 46.7%. After the 5th admission days, 2.2% of high risk subgroup was expired, whereas there was no death cases in low risk subgroup. 8) Average duration of hospitalization was 22.4+/-9.5 days in high risk subgroup and 17.3+/-6.8 days in low risk subgroup. In low risk subgroup, 10 cases were discharged within the 7th day of admission and 30 cases after the 8th day of admission. 9) 89.5% of total death occured within the 4th hospitalized day, and 66.7% of cases under systolic BP of 84mmHg were expired. Definite cardiomegaly on chest X-ray and past history of myocardial infarction were associated with high mortality. Half of cases with pulmonary edema were died.
Cardiomegaly ; Dyspnea ; Electrocardiography ; Female ; Hospitalization ; Humans ; Infarction ; Male ; Mortality ; Myocardial Infarction* ; Prognosis ; Pulmonary Edema ; Retrospective Studies ; Thorax

We observed a case of sebaceous epithelioma associated with a nevus sebaceus in a 25-year-old male. The tumor was bean-sized, dome-shaped nodule on the slightly yellowish plaque of nevus sebaceus. Histopathological finding shows undifferentiated cells which are arranged in a palisade fashion at the periphery of a cell mass and a fairly large number of transitional cells and groups of mature sebaeeous cells.
Adult ; Carcinoma* ; Humans ; Male ; Nevus* ; Nevus, Sebaceous of Jadassohn*

A prospective study had been performed in infants with hydronephrosis due to ureteropelvic junction stenosis to determine adequate management plan. Forty infants (47 renal units) were selected for the study during the period from January 1995 to July 1997 in the Department of Pediatrics, Asan Medical Center. They were diagnosed prenatally or early postnatally (<3 months of age) on the basis of renal ultrasonography and techotium-99m-mercap- toacetyltriglycerine (MAG3) scan. The antero-poste- rior pelvic diameter (APPD) was measured from serial renal ultrasonography and relative renal function and clearance half time (T1/2) were calculated from serial MAG3 scan. Those who had accompanying other urogenital anomalies or vesicoureteral reflux were excluded in this study. Follow-up tests (ultrasonography and MAG3 scan) and surgical corrections, if necessary, were performed according to the predetermined algorithrn. The male to female ratio was 3: 1. Hydronephrosis was involved the left side in 24 renal units, the right side in 9 renal units, and the bilateral sides in 14 renal units. All the hydronephrotic renal units were divided into 2 groups; Group A (19 renal units) those had taken surgical correction, and group B (28 renal units) those revealed spontaneous improvement without surgical correction. The mean follow-up duration was 7.2+/-6.3 months in group A and 14.1+/-12.6 months in group B. The mean APPD in the first postnatal renal ultrasonography was 19.4+6.8 mm in group A and 10.0+/-3.0mm in group B and this was statistically significant (P<0.01). The rela- tive renal function of group A in the first MAG3 scan was under 35% in 7 renal units and over 35M in 12 renal units. In group B, the relative renal function was over 35% in the all 28 renal units. Tl/2 in the first MAG3 scan was longer than 20 minutes in the all 19 renal units in group A. In group B, Tl/2 was shorter than 10 minutes in 15 renal units, between 10 minutes and 20 minutes in 6 renal units, and longer than 20 rninutes in 7 renal units. The mean APPD of the 7 renal units in group B of which Tl/2 was longer than 20 minutes was 12.62.6mm and that of group A was 19.4+/-6.8mrn and this was statistically significant (P<0.01). In conclusion, the renal ultrasonography and MAG3 scan can be used effectively to determine the degree of the stenosis of the ureteropelvic junction in hydronephosis during infancy. When the babies are diagnosed with hydronephrosis due to ureteropelvic junction stenosis in the early infantile period, serial renal ultrasonography and MAG3 scan play an important role in the decision of the management.
Chungcheongnam-do ; Constriction, Pathologic ; Female ; Follow-Up Studies ; Humans ; Hydronephrosis* ; Infant ; Male ; Pediatrics ; Ultrasonography* ; Vesico-Ureteral Reflux

Subepidermal calcified nodule, a form of calcinosis cutis, usually occurs as a solitary lesion and develops in early childhood. We report a 20-month-old boy with an unusual form of subepidermal calcified nodules on both palms and soles which were multiple and present at birth. Interestingly, his uncle had similar lesions during infancy which had shown spontaneous remission.
Calcinosis ; Humans ; Infant ; Male ; Parturition ; Remission, Spontaneous