We observed a case of tuberculosis cutis orificialis, which occurred in 50 year-old man. He had been suffered from single markedly inflamed, erythematous painful ulcer, covered by dirty brown pseudomembranous material, around anus for 3 months. The laboratory findings (CBC, routine urinalysis, stool ova and parasite with occult blood) are within normal limits except elevated ESR (52mm/hr.). Staphyloeoccus aureus and proteus are observed on wound culture, and many AFB are seen on scrapings of wound but not on sputum for 3 times. Unfortunately culture was not done. Tuberculin skin test revealed strong reaction (36mm/hr.). Chest PA and small bowel series showed far advanced pulmonary tuberculosis and intestinal tuberculosis on ileocecal area. But the findings of upper gastro-intestinal series and barium enema are within normal limits. Histopathologic findings of skin lesion showed tuberculous and tuberculoid granuloma in the deep dermis and subcutaneous tissue. We observed a case of tuberculosis cutis orificialis, which occurred in 50 year-old man. He had been suffered from single markedly inflamed, erythematoas painful ulcer, covered by dirty brown pseudomembranous material, around anus for 3 months. The laboratory findings (CBC, routine urinalysis, stool ova and parasite with occult blood) are within normal limits except elevated ESR (52mm/hr.). Staphyloeoccus aureus and proteus are'observed on wound culture, and many AFB are seen on scrapings of wound but not on sputum for 3 times. Unfortunately culture was not done. Tuberculin skin test revealed strong reaction (36mm/hr.). Chest PA and small bowel series showed far advanced pulmonary tuberculosis and intestinal tuberculosis on ileocecal area. But the findings of upper gastro-intestinal series and barium enema are within normal limits. Histopathologic findings of skin lesion showed tuberculous and tuberculoid granuloma in the deep dermis and subcutaneous tissue. Treatment with INH, myambutol and rifampin resulted in some improvment on the chest and considerable improvement on the skin and intestine within 6 months.
Anal Canal ; Barium ; Dermis ; Enema ; Ethambutol ; Granuloma ; Humans ; Intestines ; Middle Aged ; Ovum ; Parasites ; Proteus ; Rifampin ; Skin ; Skin Tests ; Sputum ; Subcutaneous Tissue ; Thorax ; Tuberculin ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer ; Urinalysis ; Wounds and Injuries

Apolipoprotein E is a plasma protein that has an important role in transport and metabolism of lipids in serum as well as central nervous system. Among the 3 common alleles, the ε2 allele has the most stable structure followed by ε3 and ε4 in order. There is evidence for a deleterious role of ε4 allele by atherosclerosis and amyloid beta accumulation in brain and body. The presence and gene dose of ε4 allele are risk factors for late-onset Alzheimer's disease. Apolipoprotein E ε4 may have a role in the pathology of amyloid beta and tau and it has a strong relationship with the early onset of late-onset Alzheimer's disease. However, early-onset Alzheimer's disease has a weaker relationship with ε4 allele of apolipoprotein E.
Alleles ; Alzheimer Disease ; Amyloid ; Apolipoprotein E4* ; Apolipoproteins* ; Atherosclerosis ; Brain ; Central Nervous System ; Cognitive Aging* ; Metabolism ; Pathology ; Plasma ; Risk Factors*

A case of metastatic tumor of the skin is described with literature review. Cutaneous metastases of malignant tumor is rarely seen but lung cancer in male and breast cancer in female are not infrequently reported. This patient, 37 year old male, had lung cancer, had several chest tappings for pleural effusion and a pleural biopsy. 8 months later, skin manifestation of diffuse erythematous sclerotic patches and confluent nodules was noted on pleural biopsy site, right lateral chest wall. Histopathological finding was compatible with metastatic carcinoma. This metastatic skin tumor is considered to be arisen from the lung probably due to pleural biopsy.
Adult ; Biopsy* ; Breast Neoplasms ; Carcinoma, Bronchogenic* ; Female ; Humans ; Lung ; Lung Neoplasms ; Male ; Neoplasm Metastasis* ; Pleural Effusion ; Skin Manifestations ; Skin* ; Thoracic Wall ; Thorax

BACKGROUND: Congenital hypotrichosis is a non-specific, descriptive term for structural abnormalities of hairs showing variable clinical features. We recently have encountered a group of eleven patients exhibiting abnormal hairs showing similar patterns. OBJECTIVES: Our purpose was to clarify the entity of this structural hair disorder. METHODS: Dermatologic examination with routine histopathology, trichograms along with scanning electron-microscopic examination and laboratory studies were undertaken. RESULTS: All cases except one were female, and hair abnormalities had developed at birth or within a year. Diffuse distribution of thin, sparse, soft and hypopigmented hairs were noticed. On hair mounts, four patients showed tapering of roots. The majority of the patients exhibited cuticular changes, as well as pitting and longitudinal axial twisting by scanning electron-microscopic examination; one case demonstrated trichorrhexis nodosa, and another, trans-verse fracture. CONCLUSION: Although our cases bear some similar points with woolly hair, some differences were noted between this type of congenital hypotrichosis and other previously described syndromes.
Female ; Hair ; Humans ; Hypotrichosis* ; Parturition

No abstract available.
Intracranial Arteriovenous Malformations* ; Risk Factors*

Extrapyramidal symptoms are common in patients with advanced Alzheimer's disease and have various etiologies. We report a 65-year-old man with probable Alzheimer's disease (AD) who concomitantly developed Pisa syndrome, ataxic gait, postural instability and voiding difficulty. Pisa syndrome improved after the discontinuation of acetylcholinesterase inhibitor (AchEI) and antipsychotics. However his ataxic gait and voiding symptoms persisted. A ventriculo-peritoneal shunt operation eliminated the symptoms except for cognition. We report Pisa syndrome in a patient with Alzheimer's disease and concomitant normal pressure hydrocephalus.
Acetylcholinesterase ; Aged ; Alzheimer Disease ; Antipsychotic Agents ; Cognition ; Gait ; Humans ; Hydrocephalus, Normal Pressure ; Ventriculoperitoneal Shunt

A 14-year-old-girl developed sudden amnesia upon study for semester examination. She was using cellular phone texting when he realized amnesia and texted to her friend about the amnesia. On the captured texting messages, she showed grammatical errors and spelling errors. Diffusion-weighted brain MRI showed tiny lesions in left hippocampus consistent with transient global amnesia. EEG and other laboratory tests were normal. The amnesia recovered within 24 hours and did not recur during one and half year of follow up period.
Amnesia ; Amnesia, Transient Global* ; Brain ; Cellular Phone* ; Child ; Electroencephalography ; Female ; Follow-Up Studies ; Friends ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Text Messaging*

There are many reports about the snapping syndrome in the hip, shoulder, ankle, but the snapping knee has rarely been reported. In general, the symptom of this disease was relatively tolerable for that seldom requires operative treatment. We experienced one case of snapping knee, for which the pain, easy fatigability and feeling of instability on both knee joint were main complaints. During an exploratory operation, we confirmed the gracilis and semitendinosus tendon passing over the medial tibial condyle. The clinical, radiologic and operative findings were reviewed.
Ankle ; Hip ; Knee Joint ; Knee ; Shoulder ; Tendons

PURPOSE: To analyze the clinical and radiological results of bilateral TKA with and without patellar resurfacing in osteoarthritic patient. MATERIALS AND METHODS: We have prospectively studied 17 patients who had bilateral TKA and whose patella was resurfaced on one side and not on the other. Criteria of patient selection include no preoperative patellofemoral pain and bony eburnation of articular cartilage. The Ortholoc Modular. prosthesis was implanted on both sides by same surgeon using identical technique in all cases. The mean follow-up period was 10.6 years. Evaluation was performed annually using HSS (Hospital for Special Surgery) knee rating score and radiological parameters including tibiofemoral angle, width of patella, length of patella, thickness of patella, tilt of patella and shift of patella. RESULTS: On the basis of long term follow-up results, there was no significant difference between resurfaced and unresurfaced group in clinical and radiological study. According to radiological findings as time passed, tibiofemoral angle and patellar thickness decreased but patellar length and width increased in both groups. There was no relationship between HSS knee score and radiological result in both groups. CONCLUSION: This study showed that long term clinical and radiological results of TKA does not depend on patellar resurfacing. Author can propose that patellar resurfacing is not always required in patients with relatively good condition in articular surface of patella.
Arthroplasty* ; Cartilage, Articular ; Follow-Up Studies ; Humans ; Knee* ; Patella* ; Patient Selection ; Prospective Studies* ; Prostheses and Implants

The rationale for proximal tibial osteotomy is to correct the abnormal loading stresses on the knee that are caused by an abnormal tibiofemoral axis in the coronal plane. Aithough there are many methods of fixation including cast, staple and external fixation, Coventry staple has been used widely. But Coventry staple has some disadvantages such as inadequate fixation, long term cast immobilization and rehabilitation. The purpose of this study is to demonstrate the superior performance of Miniplate staple which was designed by authors(Johnson & Johnson Orthopaedics, New Milton, UK) over the conventional Coventry staple. We have analyzed the clinical results including postoperative rehabilitation course of 3I cases who had proximal tibial osteotomy fixed with Miniplate staple. Preoperative diagnosis was osteoarthritis(OA) in 24 cases(77.4%) and physiologic genu varum in 7 cases(22.6%). 1. Hospital for Special Surgery knee score was average 72.2 points preoperatively, 90.1 points postoperatively in osteoarthritis and average 94.1 points preoperatively, 99.7 points postoperativeiy in physiologic genu varum. 2. The average tibiofemoral angle was varus 5.8 degrees preoperatively and valgus 8.7 degrees postoperati vely. 3. The active ROM exercise started at 5.3 days, standing at 13.3 days, crutches ambulation at 20.2 days and ambulation without crutches at 46.3 days after operation. In conclusion, more rigid fixation and rapid mobilization was possible with newly designed Miniplate staple in proximal tibial osteotomy.
Axis, Cervical Vertebra ; Crutches ; Diagnosis ; Genu Varum ; Immobilization ; Knee ; Osteoarthritis ; Osteotomy* ; Rehabilitation ; Walking