Reiters syndrome is classically described as the triad of urethritis, coijuctivitis, and arthritis along with the skin manifestation. of keratodermia blenorrhagica, circinate b lanitis and oral ulcetation. Since arthritis is now recognized as the only consistent component, iricr nplete forms consisting of characteristic arthritis associeited with one or more of these features and of dysentery are common, We reported a 48-year-old male who presented with a 3 years histor of significant arthralgia and psoriasiforrn skin involvemeni. He had neither an episode of dysentery not, history of sexual exposure before the onset of symptomes. Showed a correlation with the HLAB 7 tialotype. C-reactive protein levels were significantly elevated. He was treared with corticosteroid, pcycline, methotrexate and indomethacin for about 3 months resulting favorable improvement.
Arthralgia ; Arthritis ; C-Reactive Protein ; Dysentery ; HLA-B27 Antigen ; Humans ; Indomethacin ; Male ; Methotrexate ; Middle Aged ; Skin ; Skin Manifestations ; Urethritis

Bartter's syndrome is a rare tubular disorder characterized by hypokalemic, hypochloremic metabolic alkalosis, hyperreninemic, hyperaldosteronism, hyporesponsiveness to pressor agents and juxtaglomerular apparatus heperplasia. We report a case of Bartter's syndrome of a 5 month-old male infant with subdural hematoma who was confirmed by characteristic clinical, laboratory findings and kidney biopsy.
Alkalosis ; Bartter Syndrome* ; Biopsy ; Epilepsy* ; Hematoma, Subdural* ; Humans ; Hyperaldosteronism ; Infant ; Juxtaglomerular Apparatus ; Kidney ; Male ; Seizures*

PURPOSE: Three-dimensional(3D) magnetic resonance(MR) projection imaging was evaluated as a noninvasive alternative to direct cholangiography for the assessment of its reliability in patients with obsructive jaundice. METHODS AND MATERIALS: A heavily T2-weighted gradient-echo sequence(PSIF) was used for 3D MR projecion imaging of the biliary system in five healthy volunteers and 25 patients with obstructive jaundice. The 3D images of the bile ducts were formed by stacking consecutive coronal MR images obtained with a fast imaging method to a maximum-intensity projection algorithm. RESULTS: In the volunteers, MR cholangiography could demonstrate the anatomy of the biliary tract in only two subjects. The extrahepatic and intraheparic bile ducts were well visualized in 23 patients with obstructive jaundice. The leve of obstruction and the grade of dilatation were dipicted with MR cholangiography in all cases. And the cause of obstruction could be determined with MR cholangiography in 18 cases, MR cholangiography was successful in two patients in whom ERCP failed. The gallbladder or dilated pancreatic duct not demonstrated by means of direct cholangiography was demonstrated with MR cholangiography in six cases.
Bile Ducts ; Biliary Tract ; Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Dilatation ; Gallbladder ; Healthy Volunteers ; Humans ; Jaundice ; Jaundice, Obstructive* ; Pancreatic Ducts ; Volunteers

Necrotizing colitis associated with carcinoma of the colon, Known also as obstructive colitis, is a disordercharacterized by anulceration and inflammation of the colon proximal to an obstructive lesion, especiallycarcinoma of the rectosigmoid colon, and in rare instances, leads to actual gangrene of the colon. The authorsanalysed radiologic findings in four cases of necrotizing colitis associated with carcinoma of the colon. Bariumenema disclosed mucosal edema, nodular filling defects, irregularity of the colonic controur and typicalthumbprinting appearance of involved colon proximal to an obstructing carcinoma of the colon. The mechanism ofnecrotizing colitis was briefly reviewed.
Colitis ; Colon ; Edema ; Gangrene ; Inflammation

Condyloma acuminatum, a benign disease caused by a filtrable virus, occurs predominantly in the perianal andgenital areas. The lesions are noninvasive but are subject to recurrence. In rare instances, a more aggresive formof this disease, known as "giant condlyloma acuminatum" or "Buschke-Lownestein tumor", occures. In this form,infiltration of the lesion into surrounding structures takes place. This tumor has been reported to occurprincipally in the genitourinary tract. The authors experienced a cases of giant condyloma acuminatum originatingfrom rectum in 67 years old male patient which recurred 3 months after electrofulguration.
Buschke-Lowenstein Tumor ; Humans ; Male ; Rectum ; Recurrence

Although the ultrasonography has been regarded as a important procedure in the diagnosis of intraabdominalabscess, there were relatively few papers concerning the ultrasonographic findings of periappendiceal abscess.Nineteen cases of surgically proven periappendiceal abscess caused by perforated appendicitis were studied byultrasonography at the Kyung Hee University Hospital during last 34 months. The results were as follows; 1.Diagnostic accuracy of the real-time ultrasonography was 94.7%(18/19). There were only one false positive and onefalse negative. 2. The location of abscesses were ; periappendiceal 68.4%(13/19), pelvic 21.0%(4/19), subhepatic5.3%(1/19) and subphrenic 5.3%(1/19) in order of frequency. 3. Variable echo-patterns of abscesses wereencountered. But irregular, thick walled, posteriorly reinforcing, echo-free or mixed echo-patterns were mostcommon.
Abscess ; Appendicitis ; Diagnosis ; Ultrasonography

Stomach carcinoma is more common disease in korea than western contries. The reported ultrasonographicfindings of gastric carcinoma were thickening of gastric wall and “pseudokidney” sign. The auther analizedultrasonographic findings of 101 cases with gastric carcinoma who were performed ultrasonography and gastroscopyat Kyung Hee Universtiy Hospital from Oct. 1982 to Oct. 1985. The results were as followings; 1. Types of gastriccarcinoma were consisted with infiltrative type 68 cases, infiltrative type with ulceration 16 cases, polypoidtype with ulceration 1 cases, infiltrative and polypoid type 4 cases, linities plastica type 3 cases, lcerativetype 1 case and polypoid type 1 case. 2. Extent of the lesions were in body and antrum 45 cases, entire stomach 18cases, antrum 18 cases, body 12 cases, body and fundus 6 cases. 3. Ultrasonography was useful in demonstrating theextent of the tumor and the presence of materials elsewhere in abdoment.
Korea ; Stomach ; Ulcer ; Ultrasonography

Tibialis anterior muscle hernia is the most common hernia among lower extremity muscles. This condition can be diagnosed by physical examination and radiologic findings, especially by dynamic ultrasonography. There are surgical methods of treatment for muscle hernia, including direct repair, fasciotomy, fascial patch grafting using autologous fascia lata or synthetic mesh. We report a case of tibialis anterior muscle hernia treated with local periosteal rotational flap. Because there are several advantages to the local periosteal rotational flap, such as lack of donor site morbidity, lack of skin irritation, low cost, simplicity, and an easy approach, this technique could be an option for tibialis anterior muscle hernia.
Fascia Lata ; Hernia ; Humans ; Lower Extremity ; Muscle, Skeletal ; Muscles ; Physical Examination ; Skin ; Tissue Donors ; Transplants

PURPOSE: This study was conducted to evaluate success and perforation rates of pneumatic reduction and to find the predictors of reduction failure. METHODS AND MATERIALS: We reviewed 224 cases of pediatric intussusception diagnosed by air-enema between July, 1989 and June, 1992. The mean age was 9.8 months(range, 1 month to 3 years). Logistic regression analysis was used to find predictors of reduction failure. RESULTS: Successful reduction was achieved in 197 cases(87.9% of success rate). Bowel perforation occurred in two cases(0.9% of perforation rate). There were two statistically significant predictors of failure;(1) ileoileocolic intussusception(p<.001), (2) long duration of symptom(p<.001). Surgery was performed in 26 cases (11.6%), of which seven required bowel resection. CONCLUSION: Pneumatic reduction is a useful means in the management of pediatric intussusception with a high success rate and no mortality.
Child* ; Humans ; Insufflation* ; Intussusception* ; Logistic Models ; Mortality

PURPOSE: The purpose of this study is to assess the usefulness of dynamic MR imaging after contrast enhancement with Gd-DTPA in the differential diagnosis of hepatic focal lesions. MATERIALS AND METHODS: The population consists of 22 cases of hepatocellular carcinoma, 44 cases of hemangioma, and five cases of metastasis. Diagnosis of hepatocellular carcinoma was made by surgery, fine needle biopsy, ultrasonography, CT and conventional angiography. Hemangioma was diagnosed on the basis of ultrasonography, CT, conventional spin-echo MRI and clinical data. Diagnosis of metastasis was done by fine needle aspiration biopsy. Dynamic and delayed images were obtained using 1.5T superconductive magnetom after Gd-DTPA(0.1mmol/kg) intravenous injection. Quantitative and qualitative evaluation was done for each lesion. RESULTS: Early contrast enhancement with rapid or gradual washout was noted in 15 lesions of hepatocellular carcinoma(68.2%) ;on the delayed images, no contrast enhancement was noted in 18 lesions(81. 8%). Peripheral contrast enhancement pattern was predominantly(86.4%) observed in hemangiomas during dynamic phase. On the delayed images, homogeneous and persistent contrast enhancement of masses were noted in all hemangiomas. Characteristic centripetal fill-in pattern was observed in 32 lesions of hemangioma (72.7%). Contrast inversion of masses during contrast enhancement study was noted in all hemangiomas, while continuous negative contrast was noted in hepatocellular carcinomas and metastases. CONCLUSION: Dynamic MR imaging after contrast enhancement with Gd-DTPA is an useful method in the differential diagnosis of hepatic focal lesions.
Angiography ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Hepatocellular ; Diagnosis ; Diagnosis, Differential* ; Evaluation Studies as Topic ; Gadolinium DTPA ; Hemangioma* ; Injections, Intravenous ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Ultrasonography