To our knowledge, rectal cancer arising at the anastomotic site after surgery for Hirschsprung's disease has not been reported. We report a case of mucinous adenocarcinoma arising at the anastomotic site after Soave operation 26 years ago.
Adenocarcinoma, Mucinous* ; Hirschsprung Disease* ; Mucins* ; Rectal Neoplasms

Tarsal tunnel syndrom is characterized by pain, paresthesias in the foot in either the entire distribution of the tibial nerve or the distribution of one or two of its major branches and caused by compression of the posterior tibial nerve as it passes posterior and inferior to the medial malleolus. This syndrome is not recognized as readily as its counterpart in the upper extremity, the carpal tunnel syndrome. Anatomically unlike the transv erse carpal ligament the laciniate ligament(flexor retinaculum) has several deep fibrous septa which blend with the periosteum covering the medial side of the calcaneus. The neurovascular bundle in the tarsal tunnel is often attached to some of these septa, rendering itself more liable to minor degrees of traction on movements of the foot. A case of tarsal tunnel syndrome, the patient 24 years old policeman, treated succesfully with surgical release of laciniate ligament is reported.
Calcaneus ; Carpal Tunnel Syndrome ; Foot ; Humans ; Ligaments ; Paresthesia ; Periosteum ; Tarsal Tunnel Syndrome ; Tibial Nerve ; Traction ; Upper Extremity

Reiters syndrome is an unusual disease characterized a triad of nongonococcal urethritis, conjunctivitis, and arthritis in association with the mircoutaneous lesions of keratoderma blenorrhagica and balarintis circinata. We present herein a case of Reiters syndome combined yiti lung cancer. A 39-year-old man has experienced naigrating polyarthralgia and high fever ilitermittently for about 20 years, Hyperkeratotic erythemnous patches and plaques, which dyeliped about 1 year ago, have aggravated and expanded to the whole body. Histopathologic sections from the plaque on the right forc ari showed characteristic findings including thickened parakeratotic horny layer and spongiform micropustules of Kogoji He was associated with HLA-B27. On the chest X-ray, a thumbtip size mass was incidently found. Chest CT and bone scan findings supported lung cancer and multiele metastases.
Adult ; Arthralgia ; Arthritis ; Conjunctivitis ; Fever ; HLA-B27 Antigen ; Humans ; Lung Neoplasms* ; Lung* ; Neoplasm Metastasis ; Thorax ; Tomography, X-Ray Computed ; Urethritis

No abstract available.
Antibodies, Neutralizing* ; Feces* ; Rotavirus*

PURPOSE: The purpose of this study was to determine the role of CT and MR imagings in the diagnosis aortic dissection and differentiation between the true and false lumen. MATERIALS AND METHODS: We retrospectively studied forty patients with aortic dissection(AD) diagnosed imagings or surgery. Of the forty patients, 19 were examined with only CT, 14 with CT and MR, and 7 with MI~: Our points of view were(1) the classification of AD according to configuration of intimal flap by cross-sectional imaging, (2) differentiation between the true and false lumens, (3) the course of the false lumen, and (4)! detectability of the origin of major branch vessels of the abdominal aorta. RESULTS: The classification by corss-sectional imaging were crescentic(65%), circumferential(15%), flat(12%), and irregular(8%) type, in which false negative diagnosis was made in 1 case of crescentic and circumferential type, respectively. In 2 case of flat type and 1 case of irregular type, the differentiation between the true and false lumen was impossible with CT. The course of the false lumen in descending thoracic aorta revealed countrclock wise rotation(66%), clockwise rotation(5%) or fixed(29%) apperance. MR imaging was superior to CT in the detection of the origin of major branch vessels of the abdominal aorta. The determination of the origin of major branches of abdominal aorta arising from the true and false lumen were impossible in 2 cases in which only CT was done. CONCLUSION: Diagnosis of crescentic and circumferential types of AD with narrow and thrombosed false lumen was problematic in both CT and MR with no difference of diagnostic accuracy between the two modalities. The differentiation between the true and false lumen was difficult in flat and irregular types with only CT. Therefore, when surgical treatment is considered as in type B aortic dissection, MR imaging is recommended in order to determine the origin of major branch vessels.
Aorta, Abdominal ; Aorta, Thoracic ; Classification ; Diagnosis* ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies

PURPOSE: To assess the value of gray-scale stimulated acoustic emission in differential diagnosis between hepatocellular carcinoma and metastatic adenocarcinoma. MATERIALS AND METHODS: Twenty-four cases of epatocellular carcinoma (HCC) in 23 patients and 26 cases of metastatic adenocarcinoma in 14 patients were prospectively examined using the pulse-inversion harmonic technique after intravenous SH U 508A administration. Gray-scale stimulated acoustic emission (SAE) was measured 5 mins after bolus injection of a contrast agent (4g, 400 mg/ml). The presence or absence of SAE signals at internal and marginal areas of the tumor and the appearance (smooth or irregular) of its border were compared. In addition, the SAE index [SAE (parenchyma) - SAE (tumor)/ SAE (parenchyma)] was histographically determined using a computerized program (PiView TM ; Mediface, Seoul, Korea). The statistics were analysed using student'st test. RESULT: Of the 24 HCC cases, 20 (83%) showed internal SAE signals, while 23 (96%) marginal signals were emitted. Of the 26 cases of metastatic adenocarcinoma, one (4%) showed internal SAE signals, while in five (19%), these signals were marginal. The tumoral border was irregular in 19 HCC lesions (79%) and smooth in 23 metastatic lesions (88%). For HCC and metastatic tumors, the mean SAE index was 0.38 +/-0.15 and 0.60 +/- 0.08, respectively (p < 0.001). CONCLUSION: Gray-scale stimulated acoustic emission can be a useful tool in differential diagnosis between heatocellular carcinoma and metastatic adenocarcinoma.
Acoustics* ; Adenocarcinoma* ; Carcinoma, Hepatocellular* ; Diagnosis, Differential* ; Humans ; Liver Neoplasms ; Microbubbles ; Prospective Studies ; Seoul

In cross sectional fashion we recoreded the cone response in 98 adult diabetics and 20 normal controls according to the recommendation by the International Society for Clinical Electrophysiology of Vision. The photopic oscillatory potentials were extracted from the cone response by highpass filtering. The clear media and attached retina were criteria for inclusion in this study. The data were statistically analyzed expecting that this procedure may provide a feature that could have some clinical significance. The analysis of variance demonstrated that the summed amplitude of the oscillatory potentials, and second oscillatory potential amplitude were the most sensitive parameters to the diabetic retina. A timing delay in the first oscillatory potential wavelet, and a reduction in the second oscillatory potential amplitude and the summed amplitude of oscillatory potentials were the commonest abnormalities. Hence, the second oscillatory potential amplitude and the summed amplitude of oscillatory potentials may be the most valuable indicator among the photopic electroretinogram parameters representing a quantitative measure of overall retinal dysfunction.
Adult* ; Electrophysiology ; Humans ; Retina ; Retinaldehyde

PURPOSE: To elucidate the incidence of Gd-DTPA enhancement of the optic nerve/sheath complex (ONC) in patients with various ophthalmopathies using fat-suppression MRI. MATERIALS AND METHODS: Orbit MRI with fat-suppression technique (ChemSat) was performed in 58 patients with normal and various orbital lesions. The fat-suppression MR was done with and without Gd-DTPA injection in all cases. MR findings were reviewed retrospectively in a blind fashion with respect to presence or absence of contrast enhancement of the O NC. RESULTS: Contrast enhancement of the ONC was seen in 86% (6/7) of cavernous sinus lesions, 80% (8/10) of intraconal lesions excluding the ONC, 57% (16/28) of ONC lesions, 38% (3/8) of ocular lesions, and 2% (1/55) of normal orbits. The ONC enhancement was the most common in optic nerve/sheath tumors (10/10), and pseudotumors (6/6), cavernous sinus dural arteriovenous malformations (3/3) and cavernous sinus thrombosis (2/2), and less frequently seen in optic neuritis (3/14). CONCLUSION: Enhancement of the ONC may be seen in lesions of the cavernous sinusand orbit other than optic nerve/sheath lesion.
Arteriovenous Malformations ; Cavernous Sinus ; Cavernous Sinus Thrombosis ; Gadolinium DTPA ; Humans ; Incidence* ; Magnetic Resonance Imaging* ; Optic Neuritis ; Orbit* ; Retrospective Studies

Early MRI and arthroscopic findings were compared to evaluate the efficacy of the former for patients, who upon physical examination, were diagnosed with possihle acute ACL tears. MRI, taken between 1-21 days after injury, had to reveal complete ACL tears and arthroscopic surgery should have taken place 3-12 weeks after the injury for patients of this prospective study. Fifty such cases were initially catagorized according to five MRI patterns. Types I to V were separated by the following ACL tear characteristics: Enlarged and diffusely increased in signal, horizontally oriented, non-visualized, discontinuous and vertically oriented. The cases were then divided into two groups of arthroscopic findings; Group A included cases of complete ACL tearing and group B included those with intact or minimally torn ACLs. Of MRI types I through V, there were 31, 9, 5, 4, and I cases of each respectively. 37 cases resulted in complete ACL tears (21 type I, 6 type II, 5 type III, 4 type IV and 1 type V) and 13 cases were catagorized into group B, 10 of which had pattern type I and 3 of which had pattern type II. As result, types III, IV and V had a 100% Positive Predictive Value (PPV) whereas types I and II together had a 67% PPV vaiue. Division of the cases into the five pattern types in early MRI proved valuble for possible cases of acute ACL tears. MRI pattern types III, IV and V were correlated with definite complete ACL tears. However, caution must be taken for types I and II, the majority of the cases, for which there exists a significant possibility for misdiagnosis and consequently unnecessary arthroscopic surgery.
Arthroscopy ; Diagnostic Errors ; Humans ; Knee ; Magnetic Resonance Imaging* ; Physical Examination ; Prospective Studies

Forearm has a unique function of supination and pronation and for the performance of such movements, normal relationship between radius and ulna is indispensable. In ulnar shaft fracture, injuries are resulted mostly from .the external forces such as direct blows or indirect forces in some cases. There are many procedures for treatment of isolated ulnar fracture, but there are still controversies concerning the best management of these fractures. The authors treated fifteen cases surgically of ulnar shaft fracture from January 1982 to December 1986 in the Deparment of Orthopedic Surgery, National-Police Hospital. The results were as follows: 1. The most common age group was twenties with twelve cases(80.0%). 2. The most common cause of injuries were direct blow(80.0%). 3, Location of fracture were middle one third with nine cases(60.6%), while proximal one third accounts for four cases (26.7%) and distal ond third for two cases(13.3%). 4. Transverse fracture were the most common type (53.3%). 5. Displacement of fractures, out of fifteen cases, were witnessed in twelve cases (80.0%) and angulation were in eleven cases(73.3%). 6. In all cases we used operative method and had good functional results.
Forearm ; Humans ; Methods ; Orthopedics ; Pronation ; Radius ; Supination ; Ulna