The intestinal nematode Enterobius vermicularis is the most common metazoan endoparasite in humans, with humans being the only host. But complicated perianal granulomas due to Enterobius are unusual. The literature reports only 13 previous cases of enterobiasis presenting as perianal mass or abscess. We describe an additional case of a perianal mass caused by granulomatous inflammation containing Enterobius vermicularis eggs and dead bodies in a 7-year-old boy. The lesion was located in the anus and measured 2 1 cm. Clinical impression was lipoma and excisional biopsy was done. Microscopic examination revealed necrotizing granuloma which contained several 50~60 20~30 micrometer sized eggs which were identified as those of Enterobius vermicularis. The adult worm could not be identified with clarity due to necrosis.
Abscess ; Adult ; Anal Canal ; Biopsy ; Child ; Eggs ; Enterobiasis ; Enterobius* ; Female* ; Granuloma* ; Humans ; Inflammation ; Lipoma ; Male ; Necrosis ; Ovum

BACKGROUND: Alopecia areata is replete with data from studies using variuos therapeutic approaches, none of which is clearly superior to another. OBJECTIVE: This study was designed to evaluate the therapeutic effect of cryotherapy in alopecia areata. METHODS: Thirty three patents with AA(M:13, F:20) well conduted in this study, precluding 3 patients with the moderate and extensive lesions. Cryotherapy using a cotton swab dipped with liquid nitrogen was applied to the involved areas, repeated with 2 times of freeze thaw cycle of two seconds. In 13 cases of AA multiplex, the lesions were divided into two groups, each of which was undertaken cryotherapy and intralesional injection of triamcinolone(3mg/ml) for evaluation of their respeetive effects. The treatment was done weekly method of 1 to 11 times, Th therapeutic response was determined as the regrowth of terminal hairs on the treated area(s) at 12 Weeks. RESULTS: Of the 33 patients with AA, the overall responders were 22(66.7%). There seemed good response rates of 70.0 % in females, 71.4 % in AA multiplex and 72.2 % in third decade as well as 72.4 % in those with lower than 1 year of duration. The remarkable resionse had 3-4 times in treatment numbers. There were no untoward side effects in patients except mild erythema. In the 13 patients treated with both modalities, cryotherapy had a slightly higher esaonse than triamcinolone therapy (69.2% vs 61.5%, p>0.05 by x-test). CONCLUSION: The effect of cryotherapy therapy in AA patients is not less than the intralesional therapy of triamcinolone. In addition, cryotherapy may be recommendec as the new, safe therapeutic modality.
Alopecia Areata* ; Alopecia* ; Cryotherapy* ; Erythema ; Female ; Hair ; Humans ; Injections, Intralesional ; Nitrogen* ; Triamcinolone

To find any specific radiologic findings of skeletal metastases from hepatocellular carcinoma, we analyzed plain radiographs(n=25), CT(n=16) and MRI(n=5)of 25 patients with metastatic bony lesions from hepatocellular carcinoma. Vertebrae(17/25) and rids(16/25)were most frequently involved and 16 cases showed multiple metastases. The size of the lesions was larger than 5cm in 17 cases. Plain radiographs showed osteolytic destruction(2/25). CT(n=16) showed osteolytic destruction with an isodense expansile mass in all cases. Focal low attenuations suggesting necrosis were found in 2 cases. Calcification within the mass was not detected. MRI(n=5) showed a slight hyperintense area on T1WI and a defimte hyperintense mass on T2WI. After gadopentetate dimeglumine enhancement. The mass showed irregular enhancement. We concluded that skeletal metastatic lesions from hepatocellular carcinoma showed relatively large osteolytic destruction accompanying soft tissue mass and minimum central necrosis.
Carcinoma, Hepatocellular* ; Gadolinium DTPA ; Humans ; Necrosis ; Neoplasm Metastasis*

Crohn's disease is a chronic, nonspecific inflammatory process which most commonly involves the terminal ileum, but which can affect any region of the gastrointestinal tract from the mouth to the anus. When Crohn's disease does involve the upper gastrointestinal tract, there is nearly always concomitant disease in the small bowel or colon. However isolated gastric Crohn's disease is a rare entity, and gastroduodenal involvement in Crohn's disease has been considered unusual, having an incidence of 1.5 to 7.0%. Gastric Crohn's disease usually localizes to antrum of the stomach and or the pyloroduodenal junction. No single feature is pathognomonic of Crohn' disease, and the diagnosis is based on supportive clinical, radiographic, endoscopic, and pathologic findings. Crohn's disease is invariably a diagnosis of exclusion, so infectious, neoplastic, ischemic, infiltrative, and other inflammatory processes must be ruled out. Usually a patient with isolated Crohn's disease of the stomach will have the clinical symptoms of nausea, vomiting, and epigastric pain, and there will be radiographic evidence of a small contracted stomach (or occasionally, a huge dilated stomach). The treatment of stomach Crohn's disease is palliative and symptomatic. In this paper, we describe a patient with Crohn's disease who had diffuse involvement of the entire stomach without any evidence of involvement elsewhere in the gastrointestinal tract.
Anal Canal ; Colon ; Crohn Disease* ; Diagnosis ; Gastrointestinal Tract ; Humans ; Ileum ; Incidence ; Mouth ; Nausea ; Stomach* ; Upper Gastrointestinal Tract ; Vomiting

The ankle joint plays important biomechanical role in erect position or ambulation. The ankle injury includes bony structures with articular surface, ligaments and soft tissue injury. So the goal of treatment is anatomical reduction of ankle mortise. Fifty two patients of ankle fractures which were admitted and treated in Seoul Adventist Hospital from January, 1980 to December, 1984, were analysed in the clinical and radiological aspect. The results obtained from this study were as follows; l. Of the 52 cases, male was 39 cases(75.0%) and female was 13 cases(25.0%). The average age of the patients was 33 years with range from 18 years to 75 years. 2. The most common cause of injury was traffic accidident. Nexts were fall down, sports injury, slip down and industrial injury in orders. 3. The most common type of the ankle fractures, according to the classification of Lauge-Hansen, was supination-external rotation type(40.4%). 4. 36 cases(69.2%) were treated with open reduction and internal fixation and 16 cases(30.8%) were treated with closed reduction. Poor outcome seemed closely related to the severity of the injury and degree of fracture displacement. 5. Accurate reduction and rigid internal fixation of the lateral malleolus without shortening was important factor. Classification of Lauge-Hansen was useful in the diagnosis and treatment of the ankle fractures.
Ankle Fractures ; Ankle Injuries ; Ankle Joint ; Ankle ; Athletic Injuries ; Classification ; Clinical Study ; Diagnosis ; Female ; Humans ; Ligaments ; Male ; Seoul ; Soft Tissue Injuries ; Walking

A 18-year-old male patient presented with the skin colored, dome-shaped, soft, movable mass in his left retroauriculr region. The mass has slowly increased in size since birth. Histopathologic exarnination revealed sebaceous gland, eccrine gland and crosssectioned hair in the surrounding tissue, hair shaft projected into the lumen, and laminated horny material in the cyst. Transitional zone between stratified squarnous epithelium and the wall lined by histiocytes showed homogenous degenerative change. After surgical removal of the lesion, no recurrence was observed during 15 months of follow-up.
Adolescent ; Dermoid Cyst* ; Eccrine Glands ; Epithelium ; Follow-Up Studies ; Hair ; Histiocytes ; Humans ; Male ; Parturition ; Recurrence ; Sebaceous Glands ; Skin

Primary cutaneous meningiomas are extremely rare tumors found in the cutis or subcutis, and generally have a benign course. The tend to be located on the scalp, face, neck. or paravertebral area. The primary cutaneous meningioma bears similarities to developmental defects and probably originates from arachnoid cell rests in the skin, although diverse groups of cutaneous meningiomas seem to arise from several different sources. A case of primary cutaneous meningioma occuring in the scalp of left parietal area of a 27-year-old female is presented. Clinically the lesion appeared as indolent, slow growing cutaneous mass and has no connection with underlying brain tissue, as determined by examination of the roentgenographs. The definite diagnosis was made after pathological examination. Microscopically the tumor is composed of sheets and nests of meningothelial cells. Immunohistochemical and electron microscopic studies reveal the typical findings of meningioma.
Female ; Humans ; Meningioma

M-mode, pulsed Doppler and Doppler color flow mapping, in addition to two-dimensional echocardiography, have greatly improved imaging of the fetal heart through identification of abnormal cardiac anatomy and rhythm in utero. The early detection of cardiac disturbance in utero permits alteration in obstetric management such as delivery in a high-risk center for optimal neonatal care and/or decision in optimal delivery time. We report two cases of the neonatal arrhy-thmia which were observed by fetal echocardiography. In the first case, female baby showed neonatal arrhythmias including tachycardia and brady-cardia until 3 days after birth, and then turned to bradyarrhythmia due to non-conducted atrial bigeminy. These events lead us to review the fetal echocardiographs of the patient carefully. Premature atrial contractions were observed in her fetal echocardiography. At 2 months after birth, the patient's electrocardiogram showed normal sinus rhythm. Severe neonatal bradycardia of the second case was due to congenital complete heart block, identified clearly by electrocardiogram after birth. This case also showed complete heart block in her fetal echocardiography. After insertion of the temporary pacemaker, cardiomegaly was improved. Both the neonate and the mother had positive anti-SSA/Ro autoantibody. But any other symptoms and signs of neonatal lupus did not appear in the neonate. Patient's mother also did not show any symptoms and signs of systemic lupus erythematosus. Since the prognosis depends upon the cause of bradyarrhythmia in fetus and neonates, differential diagnosis is important in obstetric management and optimal neonatal treatment.
Arrhythmias, Cardiac* ; Atrial Premature Complexes ; Bradycardia ; Cardiomegaly ; Diagnosis, Differential ; Echocardiography* ; Electrocardiography ; Female ; Fetal Heart ; Fetus ; Heart Block ; Humans ; Infant, Newborn ; Lupus Erythematosus, Systemic ; Mothers ; Parturition ; Prognosis ; Tachycardia

PURPOSE: To evaluate clinical and radiological results and to analyse the parapatellar complications after endoscopic anterior cruciate ligament reconstruction using central one-third bone-patellar tendon-bone autografts. MATERIALS AND METHODS: 66 cases among 158 consecutive cases from Feb 1990 to May 1996 were reviewed and evaluated with regard to patellofemoral pain, crepitus, quadriceps atrophy, graft donor site complication, Lysholm knee scoring system and radiological assessment. The average period of follow up was 23 months (range, 12-57 months) and the average age at operation was 31 years old (range, 18-58 years). RESULTS: The average Lysholmn knee score improved from 57.5 points preoperatively to 91.3 points at follow up. The instrumented anterior laxity test showed that excellent anterior stability was regained in most patients. There were many cases of parapatellar complications, 7 cases (10.6%) of anterior knee pain, 21 cases (32.8%) of crepitus, 43 cases (65.1%) of quadriceps weakness, 29 cases (45.3%) of graft donor site paresthesia and 15 cases (23.4%) of pain on kneeling. CONCLUSIONS: Although endoscopic ACL reconstruction using central one-third bone-patellar tendon-bone autografts had good clinical results, many parapatellar complications were noted. In order to prevent these complications, different reconstruction techniques and graft materials should be considered
Adult ; Anterior Cruciate Ligament Reconstruction ; Atrophy ; Autografts* ; Follow-Up Studies ; Humans ; Knee ; Paresthesia ; Tissue Donors ; Transplants

This presentation is a case of osteomalacia, the cause of which was a nutritional deficiency. The patient was a 42-year-old female who had pseudofractures of ribs, ulnae, pelvic raml, the right second metacarpai bone and both femoral necks. Following treatment by medication combined with internal fixation of the femoral necks, the result was good.
Adult ; Female ; Femur Neck ; Humans ; Malnutrition ; Osteomalacia ; Ribs ; Ulna