Behcets disease is a chronic systemic disease of unknown etiology, which is characterized by the recurrent orogenital ulcers, eye involvement and skin manifestations. In addition to the major symptoms, it includes arthritis, vasculitis, neurologic manifestations and gastrointestinal lesions. We report a case of Behcets disease associated with intestinal ulcers. The patient, a 45-year-old female, who had been treated under the diagnosis of Behcets disease for 4 years, presented with swallowing difficulty, vaginal discharge and persistent right lower abdominal pain. Colonoscopic examination showed multiple ulcers on the ileocecal region which is reported as the most common site of gastrointestinal Behcets disease. Gastrointestinal evaluation can be useful in diagnosis of Behcets disease, especially in a patient with gastrointestinal symptoms.
Abdominal Pain ; Arthritis ; Deglutition ; Diagnosis ; Female ; Humans ; Middle Aged ; Neurologic Manifestations ; Skin Manifestations ; Ulcer* ; Vaginal Discharge ; Vasculitis

Congenital dislocations of the hip are all present at birth. Therefore if adequate examination of all newborn infants is done regularly, it should theoretically never be seen in adolescents or adults. Both the pathogenesis and management of congenital dislocation of the hip remain controversial topics. Closed reduction of simple congenital dislocations of the hip with retention in frog position was introduced by Lorenz. After this great efforts to receive these patients for treatment as early as possible were made by investigators. Also numerous surgical procedures and modifications have been used. Congenital dislocations of the hip were known to be uncommon in Korea. Nevertheless adolescents with untreated dislocations were not rarely met. The author studied congenital dislocation of the hip for sex incidence, X-ray findings, birth history, relation with combining anomaly and the results of treatment, In this study, 39 cases of congenital dislocation of the hip, treated at the Orthopedic Department of Severance Hospital during 7 years and 6 months from July, 1970 until December, 1977, were reviewed. The results of this study are as follows: 1. The annual number of the patients who were treated at Severance Hospital has not changed markedly. 2. The number of female patients was much greater than males. The ratio of female to male was 9 to 1. 3. The incidence of bilateral involvement was relatively low compared to the western coutries. 4. Congenital anomaly associated with congenital dislocation of hip occurred in about 7.8%. 5. The acetsbular index, C-E angle, Y-coordinate and height on affected hips are aggrevated according to the increment of age. 6. Closed reduction was satiafactory in 16 cases among 22 cases under the age of 3, but 4 cases were treated by operation. 7. Open reduction was performed in 8 cases, Salter's innominate osteotomy in 8 cases, Colonna's capsular arthroplasty in 2 cases, and supracondylar osteotomy in 2 cases.
Adolescent ; Adult ; Arthroplasty ; Clinical Study ; Dislocations ; Female ; Hip ; Humans ; Incidence ; Infant, Newborn ; Korea ; Male ; Orthopedics ; Osteotomy ; Parturition ; Reproductive History ; Research Personnel

Neonatal Hemangioendothelioma (HE) is the most common type of hepatic vascular tumor that presents in infancy. HE generally undergo spontaneous regression within a year, but it may become symptomatic and be associated with life-threatening complications including congestive heart failure, consumptive coagulopathy and hepatic rupture. We report five cases of neonatal hepatic HE with brief review of the literatures. The report include a case of HE associated with AV malformation complicated by congestive heart failure who was successfully treated by hepatic artery embolization, a case of HE associated with transposition of great artery (TGA), and three cases of asymptomatic HE with spontaneous involution.
Arteries ; Heart Failure ; Hemangioendothelioma* ; Hepatic Artery ; Rupture

OBJECTIVE: The patients with spinal cord injury (SCI) suffered by a lot of complications that influence the quality of life both physically and mentally. The purpose of this study was to evaluate the epidemiology of patients with spinal cord injury in incidence of the complication according to the injury level and period. METHOD: Retrospective study was done in 554 patients with SCI who discharged from Yonsei University Medical Center from January, 1987 to December, 1996. We investigated the incidence of each complication such as respiratory, cardiovascular, genitourinary, musculoskeletal, and dermatologic complications according to the neurologic level and each period (1987~1991, 1992~1996). RESULTS: Among the 554 cases, urologic complication (40.3%) was the most common complication followed by dermatologic (39.0%), musculoskeletal (33.6%), cardiovascular (27.1%) and so on. The most common complications of each system were autonomic dysreflexia (13.2%) in cardiovascular, pneumonia (9.6%) in respiratory, contracture (27.8%) in musculoskeletal, urinary tract infection (34.3%) in urologic, hemorrhoid in gastrointestinal, and central pain (24.0%) in neurogenic complications. The most common site of pressure sore was sacral area (58.9%). There was no significant difference in each complication according to the injury period. CONCLUSION: Urologic complication was the most prevalent in patients with SCI followed by dermatologic, musculoskeletal and so on. These basic results would be helpful for prevention and management of the complication of SCI.
Academic Medical Centers ; Autonomic Dysreflexia ; Contracture ; Epidemiologic Studies* ; Epidemiology ; Hemorrhoids ; Humans ; Incidence ; Pneumonia ; Pressure Ulcer ; Quality of Life ; Retrospective Studies ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Tract Infections

No abstract available.
Consensus ; Hyperthyroidism ; Thyroid Gland

Using KAIS 0.15 Telsla resistive magnetic imaging system, ECG gated magnetic resonance (MR) image of variouscardiovascular disease was obtained in 10 patients. The findings of MR image of the cardiovascular disesase wereanlaysed and the results were as follows: 1. In 6 cases of acquired and congenital cardiac disease, there were 2cases of myocardial infarction, 1 case of mitral stenosis and 3 cases of corrected transpossition of greatvessels. The others were 3 cases of aortic disease and 1 case of pericardial effusion with lymphoma. 2. Myocardialthinning left ventricular aneurysm were detected in MR images of myocardial infarction. The left atrium was welldelineated and enlarged in the case of mitral stenosis. And segmental analysis was possible in the cases ofcorrected transposition since all cardiac structures were well delineated anatomically. 3. In aortic disease, thefindings of MR image were enlarged lumen, compressed cardic chambers in ascending aortic aneurysm, intimal flap,enhanced false lumen in dissecting aneurysm and irregular narrowing of aorta with arterial obstruction inTakayasu's arteritis. 4. Pericardial effusion revealed a conspicuous contrast with neighboring meidastinal fat andcardiac wall due to it low signal encircling cardiac wall. 5. ECG gated MR image is an accurate non-invasive imaging modality for the diagnosis of cardiovascular disease and better results of its clinical application areexpected in the futher development in the imaging system and more clinical experiences.
Aneurysm ; Aneurysm, Dissecting ; Aorta ; Aortic Aneurysm ; Aortic Diseases ; Arteritis ; Cardiovascular Diseases ; Diagnosis ; Electrocardiography ; Heart Atria ; Heart Diseases ; Humans ; Lymphoma ; Magnetic Resonance Imaging ; Mitral Valve Stenosis ; Myocardial Infarction ; Pericardial Effusion

PURPOSE: To assess the diagnostic efficacy of macular and peripapillary retinal thickness measurements for the staging of diabetic retinopathy (DR) and the prediction of disease progression. METHODS: In this prospective study, 149 diabetic patients (149 eyes) and 50 non-diabetic control subjects were included. Baseline optical coherence tomography was employed to measure retinal thickness in the macula (horizontal, vertical, and central) and the peripapillary zone (superior, inferior, nasal, and concentric to the optic disc). Seven baseline parameters were correlated with the DR stages identified by fluorescein angiography. Baseline retinal thickness was compared between groups of patients requiring panretinal photocoagulation (PRP) within 6 months (PRP group) and patients not requiring PRP (No-PRP group). RESULTS: Macular and peripapillary retinal thicknesses in diabetic subjects were significantly greater than that in normal controls (p<0.05). All retinal thickness parameters, and particularly peripapillary circular scans, tended to increase with increasing DR severity (p<0.05). The baseline thicknesses of the peripapillary circular scans were greater in the PRP group than in the no-PRP group (p<0.05). CONCLUSIONS: Peripapillary retinal thickness may prove to be a useful criterion for DR severity and may also serve as an indicator of disease progression.
Aged ; Diabetic Retinopathy/*diagnosis/surgery ; Disease Progression ; Female ; Fluorescein Angiography ; Humans ; Light Coagulation ; Male ; Middle Aged ; Optic Disk ; Prospective Studies ; Retina/*pathology/surgery ; *Severity of Illness Index ; *Tomography, Optical Coherence

BACKGROUND: In the emergency department, the diagnosis of ischemic stroke is difficult because the diagnostic modalities are limited to non-contrast brain CT and neurologic examination. Serum S100B protein, a bio-marker for ischemic stroke, is needed as an additional diagnostic aid in acute ischemic stroke. METHODS: We retrospectively reviewed 50 patients diagnosed with ischemic stroke between August 2007 and December 2008 by brain MRI after brain CT and serum S100B measurement in the emergency department. The serum levels of S100B protein were analyzed and the diagnostic sensitivity of non-contrast brain CT combined with abnormal elevation of S100B protein was compared with that of non-contrast brain CT alone. RESULTS: The overall sensitivity of non-contrast brain CT in the diagnosis of ischemia was 54%. S100B protein in early ischemia had a sensitivity of 58%. However, combining non-contrast brain CT and S100B increased the sensitivity to 74%. CONCLUSIONS: A biomarker-based diagnostic test would not replace the necessity for CT or other early imaging studies, and before contemplating any reperfusion strategy, neuro-imaging must be performed to rule out intracranial hemorrhage. However, S100B protein, a serum bio-marker, is able to help emergency physicians evaluate patients with suspected ischemic stroke and decide on treatment.
Brain ; Diagnostic Tests, Routine ; Early Diagnosis ; Emergencies ; Humans ; Intracranial Hemorrhages ; Ischemia ; Nerve Growth Factors ; Neurologic Examination ; Reperfusion ; Retrospective Studies ; S100 Proteins ; Stroke

OBJECTIVES: To document the first known case of posterior migration of a herniated disc in a lumbar flexion-distraction injury.SUMMARY OF LITERATURE REVIEW: Lumbar disc herniation is sometimes confused with epidural hematoma, especially when the disc migrates posterior to the thecal sac. There has been no report of posterior migration of a herniated disc after a lumbar flexion-distraction injury. MATERIALS AND METHODS: A 47-year-old woman with no pertinent medical history was diagnosed with a flexion-distraction injury of the L2–L3 vertebrae after a motor vehicle accident. The patient had no neurological deficit initially. Magnetic resonance imaging (MRI) showed a space-occupying lesion with T2 hyperintensity and T1 isointensity on the dorsal side of the thecal sac at L2–L3. After posterior lumbar fixation and fusion, progressive leg weakness occurred 1 week postoperatively. RESULTS: A second operation revealed no evidence of epidural hematoma, but a sequestrated disc. Decompression and sequestrectomy were performed, and the patient's neurological status had recovered fully at 4 months postoperatively. CONCLUSIONS This case highlights the potential for posterior migration of a herniated disc with flexion-distraction injuries of the thoracolumbar spine. Discontinuity of the posterior annulus fibrosus on MRI may aid the distinction of posterior migration of a herniated disc from epidural hematoma. Because posterior migration of a herniated disc is associated with progressive neurological deficits, surgeons must consider decompression surgery when such herniation is suspected, even in the absence of neurological symptoms.

STUDY DESIGN: Case report. OBJECTIVES: To document the first known case of posterior migration of a herniated disc in a lumbar flexion-distraction injury. SUMMARY OF LITERATURE REVIEW: Lumbar disc herniation is sometimes confused with epidural hematoma, especially when the disc migrates posterior to the thecal sac. There has been no report of posterior migration of a herniated disc after a lumbar flexion-distraction injury. MATERIALS AND METHODS: A 47-year-old woman with no pertinent medical history was diagnosed with a flexion-distraction injury of the L2–L3 vertebrae after a motor vehicle accident. The patient had no neurological deficit initially. Magnetic resonance imaging (MRI) showed a space-occupying lesion with T2 hyperintensity and T1 isointensity on the dorsal side of the thecal sac at L2–L3. After posterior lumbar fixation and fusion, progressive leg weakness occurred 1 week postoperatively. RESULTS: A second operation revealed no evidence of epidural hematoma, but a sequestrated disc. Decompression and sequestrectomy were performed, and the patient's neurological status had recovered fully at 4 months postoperatively. CONCLUSIONS: This case highlights the potential for posterior migration of a herniated disc with flexion-distraction injuries of the thoracolumbar spine. Discontinuity of the posterior annulus fibrosus on MRI may aid the distinction of posterior migration of a herniated disc from epidural hematoma. Because posterior migration of a herniated disc is associated with progressive neurological deficits, surgeons must consider decompression surgery when such herniation is suspected, even in the absence of neurological symptoms.
Decompression ; Female ; Hematoma ; Humans ; Intervertebral Disc Displacement ; Leg ; Magnetic Resonance Imaging ; Middle Aged ; Motor Vehicles ; Spine ; Surgeons