Spinal dysraphism, first described by Lichtenstein in 1940, is a congenital anom- aly due to incomplete fusion or malformation of the midline dorsal embryonic structures including the ectoderm, mesoderm, and neuroectoderm. Spina bifida occulta is a spinal dystraphism and a manifestation of a midline defect of osseous spine and related structures without cyst formation. Spinal dysraphism may be associated with hypertrichosis, lipoma, dimpling, pigmentation, hemangioma, congenital scar, sinus, cyst, or skin defect in the midline dorsal area. We observed a 23-year-old female patient with spina bifida occulta who had a blue scar surrounded by circumscribed hair growth of the lumbosacral area since 1-montb-old age. Histopathologic finding of the blue scar revealed common blue nevus showing intradermal melanocytes and melanophages. Spine X-ray showed hemivertebra of L5 and spina bifida occulta of Sl. There were no abnormal neurologic signs.
Cicatrix ; Ectoderm ; Embryonic Structures ; Female ; Hair ; Hemangioma ; Humans ; Hypertrichosis* ; Lipoma ; Melanocytes ; Mesoderm ; Neural Plate ; Neurologic Manifestations ; Nevus, Blue* ; Pigmentation ; Skin ; Spina Bifida Occulta* ; Spinal Dysraphism* ; Spine ; Young Adult

Systemic lupus erythematosus is an autoimmune disease characterized by multisystem involvement and various laboratory findings. A retrospective study was made of the medical records of 59 patients with SLE at Severance hospital, Yonsei University College of Medicine, for the analysis of clinical and laboratory findings during the years 1970 through 198I. The results were compared with those of previous serial studies in Korea and western countries. The results obtained are as follows: l. In 59 patients with SLE, 7 patients were men and 52 patients were women (M: F=l: 7.4). Their age at onset of the dsiease ranged mainly in the 3rd and 4th decades. 2. The major clinical manifestations were skin eruptions (81%), fever(73%), renal involvements(66%), pulrnonary(66%) and cardiac(61%) abnomalities. 3. The variety of skin and mucus membrane manifestations seen included butterfly rash of face(53%), maculopapular eruption (34%), purpura(22%), and mucosal ulcer (19%) in that order. 4. Mucosal ulcers and alopecia were correlated closely with exacerbations of disease activity. Patients with Raynauds phenomenon were not likely to have severe organ involvement. 5. Compared with Western series, renal manifestation, anemia and thrombocytopenia were more frequent, and lymphadenopathy, Raynauds phenomenon and alopecia were less frequent. 6. The ANA test showed a, high sensitivity(96%) and a high titer. Compared with the patients showing a speckled pattern(30%), those showing a homogenous pattern(60%) had more severe organ involvement and poorer prognosis. 7. The anti-nDNA antibody test had a high sensitivity(81%), and indicated. severe renal involvement and poorer prognosis. Also, the titer correlated well with disease activity. 8. The disease was associated with autoimmune hemolytic anemia, Buergers disease, thyroid diseases, myelofibrcsis and chilblain. 9. A bimodal rnortality pattern was seen with infection being the major cause of early death, and renal failure and cardiopulmonary abnormalities in late death.
Alopecia ; Anemia ; Anemia, Hemolytic, Autoimmune ; Autoimmune Diseases ; Butterflies ; Chilblains ; Exanthema ; Female ; Humans ; Korea ; Lupus Erythematosus, Systemic* ; Lymphatic Diseases ; Male ; Medical Records ; Membranes ; Mucus ; Prognosis ; Renal Insufficiency ; Retrospective Studies ; Skin ; Thromboangiitis Obliterans ; Thrombocytopenia ; Thyroid Diseases ; Ulcer

No abstract available.
Bronchiolitis* ; Respiratory Sounds*

A case of congenital orbital teratoma with marked unilateral proptosis was noted at birth, Patients with congenital orbital teratoma had a uniform clinical picture and were very similar in their morphological pattern, often polycystic and with varied amounts of solid tissue. Six months after birth, the orbital tissues were totally extirpated. Histological examination revealed components from all three germinal layers and no sign of malignancy. Within the first year, the condition of the patient has been satisfactory.
Humans ; Infant ; Orbital Neoplasms/*congenital/pathology ; Teratoma/*congenital ; Tomography, X-Ray Computed

PURPOSE: To evaluate postcontrast CT findings of acute pyelonephritis and correlate these with clinical findings and severities. MATERIALS AND METHODS: We retrospectively reviewed the medical records and CT scans of 50 patients with abnormal CT findings among 52 patients of acute pyelonephritis whose postcontrast CT scans had been examined. Fifty cases of acute pyelonephritis were classified into three subgroups on the basis of postcontrast CT findings : Group I (n=20, 40%) wedge-shaped lesions; Group II (n=13, 26%) mass-like lesions; Group III (n=17, 34%) renal abscess formation. In each group, clinical findings and severity were analyzed and correlated with CT findings. The results were statistically analyzed. RESULTS: Although mean values of clinical parameters of group I were lower than those of group II and III with regard to all clinical parameters (including maximal temperature and duration of fever, flank pain, leukocytosis, and admission period), there was no statistically significant correlation among the three groups (p>0.05). All cases were successfully treated with antibiotics only, despite the high rate of abscess formation (34%). CONCLUSION: Acute pyelonephritis spans a continuum of CT findings of varying severity from wedge-shaped or mass-like lesions to multifocal abscesses ; postenhanced CT scan shows high sensitivity (96%) in the detection of acute pyelonephritis. Although the clinical course of groups of mass-like lesions and abscess formation was longer and more severe than that of wedge-shaped lesions, there was no statistically significant clinicoradiologic correlation among the three groups.
Abscess ; Anti-Bacterial Agents ; Fever ; Flank Pain ; Humans ; Leukocytosis ; Medical Records ; Nephritis ; Pyelonephritis* ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUND: Knowledge about the degree of risk and location of multiple primary cancers can facilitate the targeting of screening and surveillance practices on follow-up after treatment of cervical cancer. PURPOSE: The retrospective study was performed to evaluate the characteristics of multiple primary malignancies in patients treated for cervical carcinoma. METHOD: From data base file of gynecologic cancer patients between 1976 and 1995, total 20 patients were found to have cervical cancer and another primary malignancy. Their medical records and pathologic slides were reviewed. Follow-up information was obtained from medical records or by telephone. RESULT: There were 8 synchronous and 12 metachronous multiple primary cancers (MPC) among 20 patients. Their mean age was 51 years (range 23 ~ 68 years). The distribution of FIGO stage of the patients with cervical cancer was classified into stage I, 6 patients; stage II, 9 ; and stage III, 5. All patients showed squamous cell type histology of cervical cancer. Eight(40 %) of 20 patients developed second cancer in uterus : 6 malignant mixed Mllerian tumors(MMMT), one endometrial stromal sarcoma, and one endometrial adenocarcinoma. Seven of 8 synchronous type MPC patients are alive (median follow-up, 27 months). In contrast, only one out of 12 metachronous type MPC patients is alive(median follow-up, 114 months). The occurrence of eight malignancies including 6 MMMT, one bladder cancer, and one rectal cancer might be related with previous radiation therapy for cervical cancer. CONCLUSION: These results suggest that routine screening and surveillance work-up might not be necessary in most of patients with cervical cancer. However, the patients with cervical cancer undergoing radiation treatment have to be followed carefully with the consideration of possibility for developing second cancer in the field of irradiation.
Adenocarcinoma ; Follow-Up Studies ; Humans ; Mass Screening ; Medical Records ; Neoplasms, Second Primary ; Rectal Neoplasms ; Retrospective Studies ; Sarcoma, Endometrial Stromal ; Telephone ; Urinary Bladder Neoplasms ; Uterine Cervical Neoplasms ; Uterus

Anisakiasis is a disease of the alimentary tract caused by nematode larva belonging to the subfamily Anisakinae. It is possible for Anisakis larva to be transmitted to man through eating raw sea fish that is preferred by Korean people. The clinical symptoms are characterized by severe cramping abdominal pain, nausea, vomiting, diarrhea, tarry stool, and epigastric fullness. The endoscopic examination has played a important role in the diagnosis of anisakiasis. However, gastric anisakiasis is undetected due to unspecific symptom and delayed endoscopy. Endoscopic ultrasonography is probably the choice of investigative tool for the evaluation of submucosal mass. However distinctive feature of parasitic infectation presenting an submucosal tumor has not been reported. Recently, we experienced two cases of gastric anisakiasis. We found gastric submucosal tumors by endoscopy, differentiated them by endoscopic ultrasonography and treated by endoscopic submucosal resection.
Abdominal Pain ; Anisakiasis ; Anisakis ; Diagnosis ; Diarrhea ; Eating ; Endoscopy ; Endosonography ; Eosinophilic Granuloma* ; Eosinophils* ; Larva ; Muscle Cramp ; Nausea ; Stomach* ; Vomiting

We report the case of a 44-year-old woman underwent cholecystectomy with two common bile duct stones (2.6 x 1,9 cm and 1.6 X 1.0 cm) which failed to be captured by endoscopic mechanical lithotriptor. However, those were successfully dia-integrated with extracorporeal shock wave lithotripsy (ESWL), permitting subsequent endosaopic extraction using the Dormia basket of the fragments without complication; In our experience, ESWL is considered to be a new and safe method to treat patients with common bile duct stone which cannot be removed by endoscopic mechanical lithotripsy.
Adult ; Cholecystectomy ; Common Bile Duct* ; Female ; Humans ; Lithotripsy* ; Shock*

Fibrinolytic properties have been detected in animal and human gallbladder (GB) bile. Plasminogen activator inhibitor-1 (PAI-1) has been reported in greater concentration in GB stone bile and may be a nucleating factor in the pathogenesis of GB stone formation. It is unknown whether or not human choledochal bile has similar properties, which could have a role in choledocholithiasis. The aims of this study were to determine the presence of fibrinolytic properties of human choledochal bile and to compare those properties among normal, acalculous, and calculous-infected choledochal bile. Tissue plasminogen activator (t-PA) and PAI-1 of choledochal bile were measured by enzyme linked immunosorbent assay in patients with cholangitis due to acalculous bile duct obstructions (n = 9), choledocholithiasis with cholangitis (n = 20), and normal bile (n = 7). The t-PA concentration of choledochal bile was no different among the three groups (acalculous-infected bile, median 4.61 ng/ml, and calculous-infected bile, 4.61 ng/ml, versus normal bile, 7.33 ng/ml). PAI-1 was detected in choledochal bile in significantly greater concentrations in patients with acalculous cholangitis due to bile duct obstructions and choledocholithiasis with cholangitis (acalculous-infected bile, median 0.36 ng/ml, and calculous-infected bile, 0.1 ng/ml, versus normal bile, 0.02 ng/ml, p < 0.05), but the bile concentration of PAI-1 was no different between the acalculous and calculous-infected choledochal bile. Human choledochal bile possesses t-PA and PAI-1. PAI-1 was present in greater concentrations in both acalculous and calculous-infected choledochal bile. Increased levels of PAI-1 may be an epiphenomenon of cholangitis rather than a factor in the pathogenesis of choledocholithiasis.
Aged ; Bile/microbiology ; Bile/chemistry* ; Cholangitis/microbiology ; Cholangitis/metabolism ; Cholangitis/etiology ; Cholangitis/chemically induced ; Cholestasis/metabolism ; Cholestasis/complications ; Common Bile Duct/metabolism* ; Common Bile Duct Calculi/metabolism ; Common Bile Duct Calculi/complications ; Female ; Human ; Male ; Middle Age ; Plasminogen Activator Inhibitor 1/analysis* ; Tissue Plasminogen Activator/analysis*