Clinical and Anatomical Outcomes of Arthroscopic Repair of Large Rotator Cuff Tears with Allograft Patch Augmentation: A Prospective, Single-Blinded, Randomized Controlled Trial with a Long-term Follow-up

Background@#Arthroscopic rotator cuff repair using human dermal matrix allograft augmentation has been widely used. We assessed the effect of acellular human dermal matrix augmentation after arthroscopic repair of large rotator cuff tears through a prospective, single-blinded, randomized controlled trial with a long-term follow-up. @*Methods@#Sixty patients with large-sized rotator cuff tears were randomly assigned to two groups. Patients in the control group underwent arthroscopic rotator cuff repair. Allograft patch augmentation was additionally performed in the allograft group. All patients were subdivided into a complete coverage (CC) group or an incomplete coverage (IC) group according to footprint coverage after cuff repair. Constant and American Shoulder and Elbow Surgeons (ASES) scores were assessed preoperatively and at final follow-up. Magnetic resonance imaging was also performed at the same time to evaluate the anatomical results. @*Results@#Forty-three patients were followed up for an average of 5.7 years. Clinical scores (Constant and ASES) increased significantly at the last follow-up in both groups. The increase in ASES score in the allograft group was statistically significantly greater than that in the control group. The degree of Constant score improvement did not differ significantly between the two groups. The retear rate was 9.1% in the allograft group, which was significantly lower than that in the control group (38.1%). In the control group, the CC subgroup had a statistically significantly lower retear rate (16.7%) than did the IC subgroup. There were no retear cases in the CC subgroup of the allograft group. @*Conclusions@#Long-term follow-up of arthroscopic repair of large rotator cuff tears with allograft patch augmentation showed better clinical and anatomical results. Footprint coverage after rotator cuff repair was an important factor affecting the retear rate. If the footprint was not completely covered after rotator cuff repair, allograft patch augmentation may reduce the retear rate.

Chromoblastomycosis Treated with Occlusive Dressing of Amphotericin B Cream / 대한의진균학회지

We report a case of chromoblastomycosis in a 65 year-old woman. She had a 3x4 cm sized, annular, erythematous, plaque with crusts and ulcers on the right lower arm. The lesion had grown slowly for 2 years. In fungal and histopathologic examinations, several muriform cells were found in dermis as well as in scales and crusts on the lesional skin surface. Isolated fungus was identified as Fonsecaea pedrosoi. We treated the patient occlusive dressing of amphotericin B (3%) ointment for 8 weeks and achieved a good response without any evidence of recurrence. We propose that the occlusive dressing therapy of amphotericin B cream is a good modality among the various treatments of small localized chromoblastomycosis.

Relapse in Two Couples Among Longterm Smear Negative Leprosy Patients / 나학회지

All registered inactive leprosy patients were treated with multidrug regimen since 1985. We experienced two couples of relapsed leprosy patients among them. Three were relapsed as multibacillary type and one paucibacillary type. They were given the regimen regularly but taken irregularly. The spouse cases were relapsed 6months and 4years after index cases relapsed. Three patients were elevated PGL1 ELISA titer after relapse

Infantile Acute Hemorrhagic Edema

We report a case of infantile acute hemorrhagic edema in a 15-month-old boy. The patient showed multiple, bean to walnut-sized, red to purple-colored, indurated purpura with a cockade pattern on the face, earlobes, and extremities. Edema of the hands, feet, and earlobes was also observed. Laboratory examinations showed thrombocytosis, decreased serum CH50, and ketone in the urine. A skin biopsy taken from indurated purpura on the lower leg exhibited findings of acute leukocytoclastic vasculitis. Direct immunofluorescence examination showed deposition of IgM along the dermo-epidermal junction and C3 in the dermal vessel walls. With-out specific management except for fluid therapy to correct dehydration, the skin lesions cleared completely in 2 weeks, and recurrence has not observed.

A Case of Blue Rubber Bleb Nevus / 대한피부과학회지

Blue rubber bleb nevus syndrome is a rare disease of cutaneous hemangioma of a variant of the carvenous type which is clinically characterized by multiple, protuberant, dark blue, generally soft, rubbery, and compressible cutaneous masses usually associated with similar lesions of the gastrointestinal tract. Most cases are sporadic, although autosomal dominant inheritance has been described. We report herein a cases of blue rubber bleb nevus syndrome in a 49-year-old, who had multiple, dark blue, slightly tender, easily compressible vascular tumors on the face, right postauricular area, tongue, neck, and right had and foot, measuring from 0.5 to 1.0 cm in diameter. Endoscopic examination also revealed several similar lesions on the upper third of the esophagus. Biopsy specimen from the lesion of the neck showed irregularly dilated vessels containing red blood cells and fibrinous material. The vascular space was lined by a single layer of flattened endothelial cells.

Lipids Analysis of Epidermis and Stratum corneum Using Circumcised Prepuce / 대한피부과학회지

BACKGROUND: The changes in lipid composition during epidermal differentiation has been reported in human and animal models. Because of the difficulties in getting adeguate specimens from human subjects, the authors used easily obtainable circumcised prepuce for lipid analysis. OBJECTIVE: To investigate the changes in lipid composition duriig cornification of the epidermis, the lipid compositions of whole epidermis and stratum corneum were analyzed by thin layer chromatography(TLC). METHODS: From circumcied prepuce whole epidermis and stratum orneum were separated by 10mM EDTA(ethylene diamine tatraacetate) in PBS(phosphate-buffered saline) or heat(60C), and 0.5% trypsin in PBS respectively. Lipids were extracted with methanolctloroform-HO mixture(4:2:1.6, v/ v, Bligh-Dyer solvent), TLC was performed and lipid composition was quantitated by photodensitometer. RESULTS: In the composition of stratum corneum lipids, sphingoliids were the highest(33.3+2.9%) followed by cholesterol, free fatty acids and cholesterol esters in cleceasing order, there were small percentages of triglycerides, cholesterol sulfate and squalene. CONCLUSION: In this study the lipid composition of epidermis was similar to that of stratum corneum rather than those of previous reports on epidermal lipids, which may indicate the regional characteristics of epidermal/stratum orneum lipids in hyperkeratotic prepuie.

A case of Weber-christian disease in a child / 대한피부과학회지

Weber-Christian disease is an inflammatory disease of subcutneious fat tissue which is clinically characterized by relapsing, febrile, nodular, nonsuppurative pannicutilitiy. The cause is unknown, but the disease has been attributed to an autoimmune reaction, infectioris, halogen compounds, sarcoidosis, SLE and a-antitrypsin deficiency. We report here in a case of Weber-Christian disease in a 8-year-old girl, who had indurated erythemataus subcutaneous nodules on the extremities, buttock and trunk accompanied by various general symptoms such as fever, malaise, arthralgia and edema of the abclorren and legs. This case was successfully treated with dapsone,