We experienced a case of a primary aortoduodenal fistula, which was successfully diagnosed and repaired. This diagnosis must be considered in cases of gastrointestinal bleeding with an abdominal aortic aneurysm. If the correct diagnosis can be made promptly, surgical repair of the fistula is possible.
Aortic Aneurysm, Abdominal ; Diagnosis ; Fistula* ; Hemorrhage

BACKGROUND: We performed this study to evaluate the lower limit of the normal endothelial function, which can differentiate normal values from abnormal ones and to evaluate the changes of the endothelial function according to ages. MATERIALS AND METHODS: Study populations were consisted of four groups: patients (group A) with coronary artery disease (CAD) (n=2, mean age: 55 yrs), patients (group B) with one or more risk factors of atherosclerosis (n=3, mean age: 54 yrs), age- and sex-matched healthy subjects (group C, n=5, mean age: 54 yrs), and healthy young subjects (group D, n=3, mean age: 26 yrs). We measured the flow-mediated endothelium-dependent dilation (FMD) of brachial artery using a high-resolution ultrasound in all subjects. We analyzed the receiver operating characteristic (ROC) curve. RESULTS: The FMD of the A and B group were significantly lowered (8.6+/-3.7% vs 9.9+/-4/5% than C (14.3+/-3.3%, p<0.001) or D group (18.0+/-3.5%, p<0.001). The FMD level of 11.5% had 76.3% of sensitivity and 76% of specificity to differentiate normal endothelial function from abnormal one. The spearman correlation coefficient between ages and FMD in groups C and D was -0.543 (p<0.001). CONCLUSIONS: The endothelial function was decreased in patients with CAD or risk factors of atherosclerosis. We observed the age-related declining tendency of endothelial function in healthy subjects. 11.5% FMD) may be used to identify the person at risk of atherosclerosis.
Atherosclerosis* ; Brachial Artery ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Reference Values ; Risk Factors* ; ROC Curve ; Sensitivity and Specificity ; Ultrasonography

No abstract available.
Empyema* ; Muscle, Skeletal*

No abstract available.
Appendicitis* ; Humans

The single enzyme P-450c17 hydroxylase catalyzes the 17a-hydroxylation of both pregnenolone and progesterone and the side-chain cleavage of 17a-hydroxypregnenolone and 17a-hydroxypro- gesterone to dehydroepiandrosterone and androstenedione. This enzyme is located in the endoplasmic reticulum and consists of a P-450c17 and a specific flavoprotein NADPH-cytochrome P-450 reductase. The clinical picture and hormonal pattern in 17a-hydroxylase deficiency have been consistent in both genotypic sexes with hypergonadotropic hypogonadism in whom the virtual absence of gonadal steroids results in a female phenotype with primary amenorrhea and pseudohermaphro- ditism in the male and underdeveloped secondary sex characteristics and hypermineralocorticoidism with hypertension, hypokalemia, suppressed renin-angiotensin system and extremely reduced aldo-sterone production. A 17-year-old girl visited endocrine clinic because of amenorrhea, absence of pubic and axillary hair, and hypertension. she had elevated levels of serum corticosterone, deoxycorticosterone(DOC), 18-hydroxycorticosterone(18-OHB). Stumulation with ACTH effected minimal increase in the elevated steroids and the ACTH-stimulated 18-OHB to aldosterone ratio was more than 280. These hormonal patterns appear to be homozygote in 17a-hydroxylase deficiency.
Adolescent ; Adrenocorticotropic Hormone ; Aldosterone ; Amenorrhea ; Androstenedione ; Corticosterone ; Dehydroepiandrosterone ; Endoplasmic Reticulum ; Female ; Flavoproteins ; Gonads ; Hair ; Homozygote ; Humans ; Hypertension ; Hypogonadism ; Hypokalemia ; Male ; Oxidoreductases ; Phenotype ; Pregnenolone ; Progesterone ; Renin-Angiotensin System ; Sex Characteristics ; Steroids

A case of circular eczematous dermatitis around seborrheic keratosis was presented. A 54-year-old man presented with two weeks history of a round pruritic eruption around a preexisting lesion of seborrheic keratosis. Microscopic findings showed central tumor nest composed mainly of basaloid cells with occasional spongtosis and exocytosis. A diffuse, dense, mononuclear cell infiltrate with increased contents of melanophages was seen beneath the tumor. The surrounding lesion of halo dermatitis showed mild dilatation of the capillaries and perivascular infiltration of mononuclear cells in the upper and mid-dermis. The lesion of halo dermatitis disappeared gradually over a three week period following excision of the central lesion. This peculiar phenomenon seemed to be different from that of Suttons halo nevus, and might be a manifestation of an eczematous condition which might have a dermatitis provoking factor.
Capillaries ; Dermatitis* ; Dilatation ; Eczema ; Exocytosis ; Humans ; Keratosis, Seborrheic* ; Middle Aged ; Nevus, Halo

A 50-year-old female, who had been suffered from diabetes rielitus, showed typical cutaneous findinhs of dermatomyositis with only transient and mild proximal muscle weakness at sometime during the course of disease. She had Gottrons papules, Gottrons sign, heliotrope rash, macular violsceous erythema involving neck, anterior chest, back, extensor site of forearms and arms and dorsa of hands. However, he serum CPK, LDH and sGOP levels were within normal limits. Her fasting and 2 hours potprandial blood glucose levels were elevated. There were no histological abnormality in muscle biopsy. Histopathologic findigs of the skin lesion on her back were that of poikiloderma atrophicans vasculare. We diagnosed our patient as Rebeccas type 2 amyopathic dematomyositis which is chracterized by skin disease with subjective myalgias and musle weakness, but without laboratory evidence of muscle disease.
Arm ; Biopsy ; Blood Glucose ; Dermatomyositis* ; Erythema ; Exanthema ; Fasting ; Female ; Forearm ; Hand ; Humans ; Middle Aged ; Muscle Weakness ; Myalgia ; Neck ; Skin ; Skin Diseases ; Thorax

No abstract available.
Child* ; Humans

To evaluate intraindividual, interocular differences in blood flow of the optic nerve head in normal-tension glaucoma(NTG)patients with interocular asymmetric visual field loss, thirty-eight eyes of 19 NTG patients(mean age+/-SD, 56.1+/-15.0 years)with interocular asymmetric visual field loss of >3dB in the mean deviation or corrected pattern standard deviation were measured for the blood flow parameters(Volume, Velocity, Flow)at the temporal rim of the optic nerve head using scanning laser Doppler flowmetry(Heidelberg Retina Flowmeter or HRF). Measurements for peripapillary atrophy(area of zone beta)were performed using scanning laser tomography (Heidelberg Retina Tomograph). Visual field defects were evaluated by automated static threshold perimetry. The mean+/-standard deviation of the mean defect of the visual field indices was -1.38+/-3.02dB for the less affected eyes, and -6.23+/-3.84dB for the more affected eyes. All blood flow parameters were significantly smaller in the less affected eyes(0.004 Atrophy ; Flowmeters ; Glaucoma* ; Head* ; Humans ; Optic Disk ; Retina ; Visual Field Tests ; Visual Fields*

Twenty-nail dystrophy is a rare entity in which all 20 nail are uniformly and simultaneously affected with excess longitudinal ridging and loss of luster. This condition is thought to be idiopathic but, many cases are associated with alopecia areata, lichen planus, psoriasis, and ichthyosis. In such cases, it has been hypothesized that immunplogical disorders could play a role in pathogenesis. A 29-year-old male patient presented with dystrophic nail chatge on his all finger and toe nails for 3 years. On phisical examination, all nails were uniformly affected with longitudinal ridging and loss of luster and all body hairs were lost. Thyroid scan showed a finding of chronic thyroiditis. Herein we report a case of twenty-nail dystrophy associated with chronic thyroiditis and alopecia areata.
Adult ; Alopecia Areata ; Fingers ; Hair ; Humans ; Ichthyosis ; Lichen Planus ; Male ; Psoriasis ; Thyroid Gland* ; Thyroiditis* ; Toes