Neuroarthropathy has infrequently been associated with diabetic patients. The initial presenting symptoms are in most cases the peripheral neuropathy involving chiefly the sensory components of peripheral nerves, leading to numbness, hyper-or paresthesia, and coldness of the extremity affected. The diabetic arthropathy, once occurred, is apt to show progressive deterioration of the function with destruction of both skeletal and supporting soft tissues Two cases of such arthropathy were presented here, the one was observed in a 29-year-old man with involvement of the left fourth and fifth tarsometatarsal joints and a large ulcer on the dorsal skin of the lesion, and the other in a 35-year-old man with destruction of the right ankle joint. Both of them showed remarkable remission of the symptoms with conservative measures such as arch support, cast immobilization and skin graft.
Adult ; Ankle Joint ; Extremities ; Humans ; Hypesthesia ; Immobilization ; Joints ; Paresthesia ; Peripheral Nerves ; Peripheral Nervous System Diseases ; Skin ; Transplants ; Ulcer

No Abstract Available.
Pterygium*

A clinical evaluation was done on Il patients with postrenal acute renal failure who were admitted to the Busan National University Hospital during the period of 6 years and 8 months from Jan. 1976 to Aug. 1982. The results were as follow. 1. The patients were mean ages of 44.3 years, being thought somewhat older than other cause of renal failure. And the male was more frequently affected than the female. 2. The 2 most common causes of postrenal acute renal failure in 11 patients were malignant neoplasms (5 patients; 1 bladder Ca. 3 cervical Ca. and 1 retroperitoneal metastatic Ca.) and ureteral calculi (5 patients; 2 bilateral and 3 unilateral in solitary renal unit). 3. Ureteral obstructions were bilateral in 7 patients (14 ureters) and unilateral in 4 patients (4 ureters) in the solitary kidney. The involved site of ureteral obstructions were bilateral lower ureters in 5 patients (10 ureters), bilateral upper ureters in 1 patient (2 ureters), unilateral right upper ureter and left lower ureter in 1 patient 12 ureteral, and unilateral lower ureter in 4 patients (4 ureter). 4. Seven patients were treated with urinary diversion, 3 with ureteral catheterization and 1 with ureterolithotomy. Among 7 patients of urinary diversion, nephrotomy was done in 6 patients and double-barreled ureterocutaneostomy in 1 patient. 5. The prognosis was excellent in 10 patients and 1 patient was expired due to uremia and generalized marasmus following malignant neoplasm.
Acute Kidney Injury* ; Busan ; Female ; Humans ; Kidney ; Male ; Prognosis ; Protein-Energy Malnutrition ; Renal Insufficiency ; Uremia ; Ureter ; Ureteral Calculi ; Ureteral Obstruction ; Urinary Bladder ; Urinary Catheterization ; Urinary Catheters ; Urinary Diversion

In general the appearance of cerebrospinal fluid (CSF) is the most important sign of adequate dura puncture. We experienced an unusual case of spinal failure due to the blockage of a spinal needle hole by a foreign body. After the needle tip penetrated the dura, the stylet was removed, but we could not see a free flow of CSF. We found that a small rubber fragment of the local anesthetic bottle plug was on the spinal needle tip. The reason for this was the aspiration of the local anesthetic with an 18 gauge introductory needle.
Cerebrospinal Fluid ; Foreign Bodies* ; Needles* ; Punctures ; Rubber

BACKGROUND: Pilomatricoma(Benign calcifying epithelioma of Malherbe) is a uncommon benign tumor with differentiation toward hair cortex cells. It commonly manifests itself as a firm, deep seated nodule with normal Overlying skin, However, anetodermic cutaneous changes have also been described in the literature since 1943. Although the authors hypothesized this phenomenon as a chronic mechanical irritation or a step of transepidermal elimination of the tumoral mass, distinctive elucidation of pathomechanism of it remained. OBJECTIVE: The purpose of this study was to characterize the clinical and histopathologic features of 25 cases with pilomatricoma and to elucidate pathomechanism of the anetodermic cutaneous changes through the comparison of the anetodermic pattern of overlying skin with the changes of the tumoral mass or collagen and elastic fibers in the dermis. METHODS: Twenty-five cases with pilomatricoa have been collected at Chunganam National University Hospital and Kongju Medical Center during 15 years and 5 years, respectively, And we studied the clinical and histopathological characteristics of patients and tried to reveal the relationship between the cutaneous manifestations and the histologic changes through the test for independence. RESULTS: 1. In the age distribution, the patients lesser than 30 years old was 23 cases(92%). The mean age was 18.9 years old. The ratio of males to females was 1 : 2.6. 2. The duration of lesions was from 2 months to 7 years, with the mean duration of 11 months. The predilection sites were arm(40%), face(28%), neck(12%), shoulder(8%), scalp(4%) and back(4%) in order. All lesions were hard in consistency, and were from bean to walnut sized. Clinically, 10 cases (40%) showed reddish discoloration and/or anetodermic cutaneous changes. 3. Histopathologically, the typical patterns of pilomatricoma were commonly located at the dermis (23 cases) and consisted of the shadow cells predominantly(21 cases). Calcium deposits(21 cases, 84%) were noted within the shadow cells. Eight cases(32%) had the tumoral maese demarcated with fibrous capsules, and the foreign body reaction with giant cells and chronic mononuclear cell infiltrations around the shadow cells ruptured the fibrous capsules in 17 cases(68%). 4. When we compared the relationship between the inflammatory cell infiltrations around the tumoral mass and the changes of dermal collagen and elastic fibers, we observed that the changes of dermal fibers and foreign body reaction and mononuolear cell infiltrations were statistically co-related. When compared the cutaneous changes with the inflammatory cell infiltrations of the tumoral masses, we could also reveal that the anetodermic cutaneous changes of the overlying skin might be influenced by the foreign body reactions with chronic mononulcer cell. Based on the status of foreing body reaction, the average of onset was inversely proportional to the average of age. CONCLUSION: Pilomatricomas are slowly growing, firm, deep seated benign tumor which occurs commonly on the arm, face and neck. However, they often showed the anetodermic changes on the overlying skin. Anetodermic cutaneous changes or discoloration may be correlated with the degree of foreign body reactions without the evidences of transepidermal elimination histopathologically.
Adult ; Age Distribution ; Arm ; Calcium ; Capsules ; Carcinoma ; Chungcheongnam-do ; Collagen ; Dermis ; Elastic Tissue ; Female ; Foreign Bodies ; Foreign-Body Reaction ; Giant Cells ; Hair ; Humans ; Juglans ; Male ; Neck ; Pilomatrixoma* ; Skin

Adenomyotic cyst is very rare disease, their sizes are mostly lesser 5mm. The intrauterine adenomyotic cyst may arise from progressive expansion of cyst due to progressive menstrual bleeding. Authors experienced a case of large adenomyotic cyst within myometrium occuring in a l9-year-old woman, and who was accompanied with endometriosis. The cyst was about 3 x 3em sized, and had chocolate colored thick viscous contents, We experienced one case of adenomyotic cyst which was thought to be degenerated uterine myoma, so we report the case with a brief review of the concerned literatures.
Animals ; Cacao ; Endometriosis* ; Female ; Hemorrhage ; Humans ; Leiomyoma ; Mice ; Myometrium* ; Rare Diseases

A clinical observation was made on 5 cases of congenital posterior urethral valves admitted recently to the Department of Urology, Busan National University Hospital. The results were following: 1. Age distribution showed; 1 case (20%) under 6 months, 2 cases (40%) between 6 and 12 months, 2 cases (40%) over 6 years old. 2. The symptoms of urinary dribbling, weak stream, frequency and difficult urination were observed in all 5 cases. Abdominal mass, abdominal pain, fever, vomiting and failure to thrive were observed in 4 cases (80%) . Enuresis was observed in 2 cases (40%) . Hypertension and gross hematuria were observed in 1 case (20%) . 3. IVP revealed bilateral hydronephrosis and hydroureter in all cases. Vesicoureteral reflux was observed in 3 cases (60%) , in which 2 cases were unilateral and the other 1 case was bilateral and bladder diverticulum appeared in 3 cases (60%). Voiding cystourethrogram was performed on 4 cases, and in all of these 4 cases (100%) dilatation of posterior urethra and cut-off at the membranous level and a thin stream in the bulb and 2 cases (50%) bladder neck contracture due to congenital posterior urethral valves had developed. 4. Endoscopic examination was performed on 5 cases, in which 3 cases (60%) were young's type I, and remaining 2 cases 140%) were Young's type III. 5. All 5 cases were treated by transurethral electrofulguration of the valves and one case of them was performed bilateral ureteroneocystostomy 3 years after valve ablation but in the case with marked bilateral hydronephrosis and vesicoureteral reflux a cystostomy was also performed. 6. The follow up study was performed in 4 cases with the follow-up period from five months to 36 months and mean duration of 2 years. All 4 cases had excellent results with much improved urinary stream and Renal condition after operation, but in 2 cases intermittent incontinence occurred for 3 years and 1 year respectively. In all 4 cases much diminished hydronephrosis and urethral dilation on IVP were observed. The posterior urethral dilatation became nearly normalized and abnormal findings of bladder improved on voiding cystourethrogram, but in 2 cases with bladder diverticulum 1 showed nonspecific interval changes during 3 years and the other 5 months. In 2 cases with vesicoureteral reflux, 1 showed loss of vesicoureteral reflux spontaneously 1 month after the operation and the other showed persistent vesicoureteral reflux for 1 year, which was observed to be improving.
Abdominal Pain ; Age Distribution ; Busan ; Child ; Contracture ; Cystostomy ; Dilatation ; Diverticulum ; Enuresis ; Failure to Thrive ; Fever ; Follow-Up Studies ; Hematuria ; Humans ; Hydronephrosis ; Hypertension ; Neck ; Rivers ; Urethra ; Urinary Bladder ; Urination ; Urology ; Vesico-Ureteral Reflux ; Vomiting

A clinical observation was made on 5 cases of congenital posterior urethral valves admitted recently to the Department of Urology, Busan National University Hospital. The results were following: 1. Age distribution showed; 1 case (20%) under 6 months, 2 cases (40%) between 6 and 12 months, 2 cases (40%) over 6 years old. 2. The symptoms of urinary dribbling, weak stream, frequency and difficult urination were observed in all 5 cases. Abdominal mass, abdominal pain, fever, vomiting and failure to thrive were observed in 4 cases (80%) . Enuresis was observed in 2 cases (40%) . Hypertension and gross hematuria were observed in 1 case (20%) . 3. IVP revealed bilateral hydronephrosis and hydroureter in all cases. Vesicoureteral reflux was observed in 3 cases (60%) , in which 2 cases were unilateral and the other 1 case was bilateral and bladder diverticulum appeared in 3 cases (60%). Voiding cystourethrogram was performed on 4 cases, and in all of these 4 cases (100%) dilatation of posterior urethra and cut-off at the membranous level and a thin stream in the bulb and 2 cases (50%) bladder neck contracture due to congenital posterior urethral valves had developed. 4. Endoscopic examination was performed on 5 cases, in which 3 cases (60%) were young's type I, and remaining 2 cases 140%) were Young's type III. 5. All 5 cases were treated by transurethral electrofulguration of the valves and one case of them was performed bilateral ureteroneocystostomy 3 years after valve ablation but in the case with marked bilateral hydronephrosis and vesicoureteral reflux a cystostomy was also performed. 6. The follow up study was performed in 4 cases with the follow-up period from five months to 36 months and mean duration of 2 years. All 4 cases had excellent results with much improved urinary stream and Renal condition after operation, but in 2 cases intermittent incontinence occurred for 3 years and 1 year respectively. In all 4 cases much diminished hydronephrosis and urethral dilation on IVP were observed. The posterior urethral dilatation became nearly normalized and abnormal findings of bladder improved on voiding cystourethrogram, but in 2 cases with bladder diverticulum 1 showed nonspecific interval changes during 3 years and the other 5 months. In 2 cases with vesicoureteral reflux, 1 showed loss of vesicoureteral reflux spontaneously 1 month after the operation and the other showed persistent vesicoureteral reflux for 1 year, which was observed to be improving.
Abdominal Pain ; Age Distribution ; Busan ; Child ; Contracture ; Cystostomy ; Dilatation ; Diverticulum ; Enuresis ; Failure to Thrive ; Fever ; Follow-Up Studies ; Hematuria ; Humans ; Hydronephrosis ; Hypertension ; Neck ; Rivers ; Urethra ; Urinary Bladder ; Urination ; Urology ; Vesico-Ureteral Reflux ; Vomiting

PURPOSE: Long-term follow-up results of concurrent bilateral or unilateral cementless hip arthroplasty were compared. MATERIALS AND METHODS: Forty eight and 49 patients with concurrent bilateral and unilateral hip artrhoplasties who had more than a 17-year follow-up time were selected. At final follow-up, mean ages were 69.1 and 66.7 years old in the bilateral and unilateral groups, respectively. Mean follow-up times were 21.5 and 22.4 years in the bilateral and unilateral groups, respectively. Clinical results were attained using Harris hip score and standardized anteroposterior and lateral view X-rays. RESULTS: The bilateral group had mean Harris scores of 44.3(standard deviation 3.78) preoperatively, and 81.2 (10.75) at final follow-up. For the unilateral group, the mean scores were 46.5(3.27) preoperatively, and 80.1 (12.05) at final follow-up. At final follow-up, an acetabular cup was securely located in 78.9% and 82.8% of the bilateral and unilateral groups, respectively, and all cases showed firm fixation of the femoral stem in both groups. Osteolysis around the cup and stem were found in 26.3% and 31.4% of the bilateral group and 16.6% and 17.1% of the unilateral group, respectively. Polyethylene wear rate was 0.17 mm/yr and 0.16 mm/yr in the unilateral and bilateral groups, respectively. Using the Kaplan-Meier method, 17-year survival rates for cup and stem were 78% and 89% in the bilateral group, respectively, and 78% and 86% in the unilateral group, respectively. CONCLUSION: In 17-year long-term follow-up, concurrent bilateral hip arthroplasty was insignificantly different clinically and radiologically from the result of unilateral hip arthroplasty.
Arthroplasty ; Follow-Up Studies ; Hip ; Humans ; Osteolysis ; Polyethylene ; Survival Rate

BACKGROUND: Cardiogenic embolic infarction is the most preventable type of ischemic stroke. This study was under-taken to compare the infarct size, prognosis, and risk factors between cardiogenic embolic infarction (CE) and large artery atherosclerotic infarction (LAA). METHODS:We reviewed the medical records and brain computed tomography/magnetic resonance image (CT/MRI) scans of patients with CE or LAA during the period between January 1996 and May 1998. Patients with lacunar and posterior circulation infarctions were excluded. A slice of brain CT/MRI scan showing the largest lesion was selected in each patient and the area of infarction was then measured. Prognosis was determined by the Modified Rankin Disability Scale (MRDS) and was grouped as either good (MDRS 0, 1, 2) or poor (MDRS 3, 4, 5). RESULTS: The study included 103 patients : 50 with CE (NVAF in 23, VHD with or without AF in 13, prosthetic valve in 6, and others in 8) and 53 with LAA (large artery thrombosis in 29, and artery to artery embolism in 24). The infarct size of CE (23.2+/-14.7 cm2) was significantly larger than that of LAA (11.4+/-10.5 cm2) (p<0.001). The infarct size of NVAF (29.0+/-19.1 cm2) was significantly larger than that of VHD with or without AF (19.2+/-11.5 cm2) (p<0.05). Patients with CE had a worse prognosis (poor in 46%) than those with LAA (poor in 23%) (p<0.05). CONCLUSIONS Our results showed that CE led to larger lesions and worse outcomes. Therefore, we emphasize the importance of primary and secondary preventions of stroke in patients with cardiogenic embolic sources.
Arteries* ; Brain ; Embolism ; Heart Valve Diseases ; Humans ; Infarction* ; Medical Records ; Prognosis* ; Risk Factors ; Secondary Prevention ; Stroke ; Thrombosis