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

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

No abstract available.
Intracranial Arteriovenous Malformations* ; 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

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*

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

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

The major purpose for the use of autotransfusion is to prevent the transmission of blood borne infectious agents, such as human immunodeficiency virus and non-A & non-B hepatitis virus. To evaluate the efficacy and quality of autolgous shed blood for autotransfusion, eighty patients who had total knee arthroplasty from Dec. 1992 to Mar. 1994, were included in one of two groups: Group I, who received the autotransfusion, or Group II, who did not. Each group included 20 patients of unilateral TKR and 20 patients of bilateral TKR. The Orth-evac system(Deknatel, USA) was used to salvage drained blood in the first six hours after the operation. All of the patients were evaluated for the postoperative blood loss, transfusion requirements, hemoglobin, hematocrit, platelet count, blood pressure and body temperatures. l. In bilateral TKR, the reinfusion of shed blood reduced the requirements for homologous blood by 41.4%(1.2 pints in group I versus 2.9 pints in group II). In unilateral TKR, it was decreased to 36.4%(0.4 pint in group I vs 1.1 pint in group II). 2. In bilateral TKR, the requirements for homologous transfusion was decreased from 95% of patients in control group to 55% in group I .In unilateral TKR, it was decreased from 60% to 20%. 3. There were four patients who had high fever above 39℃ after autotransfusion. 4. At the immediate postoperative period there were two patients who had hypovolemic shock in group I patients who had bilateral TKR. 5. There was no clotting abnormality, no transfusion reaction and no thromboembolic disease in group I patients. In conclusion, the reinfusion of autologous shed blood after TKR is an acceptable alternative to the homologous transfusion without untoward effect.
Arthroplasty, Replacement, Knee ; Blood Transfusion, Autologous ; Body Temperature ; Fever ; Hematocrit ; Hepatitis Viruses ; HIV ; Humans ; Knee ; Platelet Count ; Postoperative Hemorrhage ; Postoperative Period ; Shock ; Transfusion Reaction

Colles' fracture is a common injury encountered in emergency departments. Despite the frequent experience of every orthopedic surgeon with Colles' fracture, considerable variation remains in the treatment of fracture of the distal radius. Everyone nearly agress that reduction of the fracture is not difficult, but maintenance of reduction is the problem. Eighty patients with Colles' fracture were treated with closed reduction and percutaneous pinning under the C-arm fields and followed up more than 1 year, from January 1990 to May 1993 at the Department of Orthopedic Surgery, Dae Han Hospital. The results of this study were as follows: 1. The fractures were classified according to the system of Gartland and Werley. Of the 80 cases, 12(5%) were type 1; 25(31%) type 2; and 43(54%) type 3. 2. Complications were such as; temporary neuropathy of median nerve 2 cases, redisplacement 2 cases, radiocarpal arthritis 1 cases, stiff hand 1 case and shoulder hand syndrome 1 case. 3. The overall assessment showed exellent in 29 patients(36.2%), good in 44 patients(55,0%) and poor in 7 patients(8.8%) under the subjective and objective criteria of Gartland and Werley and the objective criteia of Scheck. 4. The results were mainly correlated with maintenance of an anatomical reduction. 5. The percutaneous pinning was suitable for anatomical restoration and maintence, had less com plication and more advantage such as the early range of joint and simple technique. Conclusively, it was considered to be one of ideal method for the treatment of Colles' fracture in selected cases.
Arthritis ; Colles' Fracture ; Emergency Service, Hospital ; Hand ; Humans ; Joints ; Median Nerve ; Methods ; Orthopedics ; Osteotomy ; Radius ; Reflex Sympathetic Dystrophy