We presented a case of Reiters syndrome consisting of conjunctivitis, arthritis, and skin lesions, occurring in 20-year-o1d male. He had neither an episode of dysentery nor a history of sexual exposure before onset of syndrome. The skin lesions had begun with erythernatous scaly patches on the inguinal region and scalp, and later followed by generalized pustular, psoriasiform and/or hyperkeratotic crusted lesions on the erythematous base. Yellowish discoloration and onycholysis of nails and shallow ulcer of glans penis were observed. Arthritis of the knee and shoulder joints were developed, accompanied by pain, swelling, limited motion, wasting and weakness of both lower extremities. In laboratory investigation, urinalysis, stool examination for parasites and occult blood, renal function test, blood VDRL, and X-ray of chest, both knee. joints, shoulder joint and thoracolumbar spine were within normal limit or negative except for leukocytosis(24, 500/mm), increased ESR(90 mm/hr) and hypoalbuminemia(2.6 g/dl), and he was associated with HLA-A3, A 9, B5, and Rw 49 Histopathologically skin biopsy specimen showed extensive hyperkeratosis, paralceratosis, elongated rete ridges, spongiform macropustule of Kogoj. He was treated effectively with antibiotics, corticosteroid, and methotrexate for two months without recurrence till now.
Anti-Bacterial Agents ; Arthritis ; Biopsy ; Conjunctivitis ; Dysentery ; Hematologic Tests ; HLA-A3 Antigen ; Humans ; Joints ; Knee ; Lower Extremity ; Male ; Methotrexate ; Occult Blood ; Onycholysis ; Parasites ; Penis ; Recurrence ; Scalp ; Shoulder Joint ; Skin ; Spine ; Thorax ; Ulcer ; Urinalysis

This study was performed with 31 cases of cutaneous tuberculosis among 18,846 cases of out-patients in Dermatologic Department of Busan National Universicy Hospital from 1967 to 1976. These 31 cases were consistent with skin tuberculosis in histological and clinical findings. The results were as follows. 1. The incidence of skin tuberculosis is 0.16%, among 18,846 cases of outpatients, 2. The localized tuberculosis of the skin, i.e. lupes vulgaris, tuberculosis verrucosa cutia and scrofuloderma was more common than disseminated type of tuberculosis of the skin. Among the disseminated types, papulonecrotic tuberculid is rather common than other types. 3. The ratio between male and female was l. 2: 1. 4. The age of onset varied according to types, but 70% of all cases occurred in the age group between 10-30 years. 5. Lung tuberculosis was associated in abaut 20 of skin tuberculosis. 6. Tubercle and tuberculoid structure were noticed in all biopsy specimens ancl in 55% the caseation necrosis was noticed.
Age of Onset ; Biopsy ; Busan ; Female ; Humans ; Incidence ; Lung ; Male ; Necrosis ; Outpatients ; Skin* ; Tuberculosis ; Tuberculosis, Cutaneous*

A patient with keratoma hereditaria mutians, 20 years old Korean girl, presented the following classic features of this rare disease, palmar and plantar hyperkeratosis beginning early in life, starfishlike keratosis of the dorsa of the hands, hyperkeratotic patches of dorsa of the feet with thickening of the toe nails, keloid-like keratoma of the elbows and knees, and constriction of the all fingers begining in early life and spontaneous amputation of theleft 5th finger. No family history was demonstrated in this patient.
Amputation ; Constriction ; Elbow ; Female ; Fingers ; Foot ; Hand ; Humans ; Keratosis* ; Knee ; Rare Diseases ; Toes ; Young Adult

We reported a case of follicular mucinosis which occurred in a 51 year old m;', . He had a firm grouped folliculopapular plaque above left eyebrow with ill-defined border, without any loss of eyebrow. But histopathologic findings showed charac- teristic changes in hair follicles and sebaceous glands with mucinous degeneration and no evidence of suggesting mycosis fungoides. Relatively rapid response to systemic corticosteroid suggested that this therapy had an actual effect.
Eyebrows ; Hair Follicle ; Humans ; Middle Aged ; Mucinosis, Follicular ; Mucins ; Mycosis Fungoides ; Sebaceous Glands

The author carried out an experimentation to clarify a possible pathogenesis of renal papillary necrosis induced by an univisceral Shwartzman reaction. The experimental animals were healthy white rabbits in weighing between 1.7 kg and 3.0 kg. Under the condition of ureterostomy, animals were pretreated with 0.5 cc of 50% ethyl alcohol and followed by administration of 0.2 ~ 1.5 mg endotoxin (E. coli 026 : B6, bacto lipopolysaccharide B. Difco, U.S.A.) as preparation in the renal pelvis. And then sacrificed at 10 minutes, 30 minutes, 1 hour, 2 hours, 6 hours and 24 hours after intravenous injection of 0.2 mg or 0.6 mg endotoxin through the ear veins, subjection to examine light and electron microscopically. The obtained results were summarized as follows: Papillary necrosis was developed in 88% among 18 cases excluding 6 cases died before sacrification. There were two types of necrosis, namely papillary and medullary type, but the former and combined forms of both types were the most common findings. Initial main target site of injury in renal papilla induced by endotoxiin was the endothelium of vasa recta and then followed by the Henle's loop, interstitial cell and collecting tubule respectively. Vascular injuries such as swelling and detachment of endothelium were observed since 10 minutes after endotoxin injection. Henle's loop showed stratification of basement membrane without consistent features with time lapses and initially observed fatty vaculoes at 1 hour after endotoxin injection were more eminent in 24 hours group. Main changes of interstitial cells were decrease of lipid droplets while increase of fatty vacuoles; the latter were initially observed in 1 hour group and more eminent in 24 hours group. Collecting tubule showed many fatty vacuoles especially in 24 hours group. It is thought that emergence of fatty vacuoles seems to be a kind of immature lipid droplets to compensate the increased demand of PC release due to continuous ischemic condition. In conclusion, it is thought that ischemic injury due to the vascular changes is pathogenic mechanism producing renal papillary necrosis. Endotoxin induced univisceral Shwartzman reaction in the kidney may be a good experimental model in studying renal papillary necrosis.
Rabbits ; Animals

No abstract available.
Stomach Neoplasms*

It has been well known that infertile women experience not only emotional disturbance but also stress. But there is no concern about male infertility patients. So phychiat.ic symptoms were studied with SCL-90 (Symptom Check List-90) in 30 infertile men who was operated testicular sperm extraction (TESE) in Samsung Cheil Hospital and in age matched 31 fertile men from Jan. 1998 to Aug. 1998. In 5 symptom dimensions (Obcessive-Compulsive, Interpersonal Sensitivity, Depression, Phobic anxiety, Psychoticisim) scores. The Infertile group scored significantly higher than the control group. The result revealed that infertile men also experienced substantially more psychiatric symptoms than fertile men. Considering this results, psychiatric evaluation and tender care by infertility specialist are necessary for infertile men during and after evaluation and treatment.
Affective Symptoms ; Anxiety ; Depression ; Female ; Humans ; Infertility ; Infertility, Male* ; Male ; Male* ; Specialization ; Spermatozoa

OBJECTIVE: Although cor pulmonale due to chronic lung disease was not uncommon, there was uncertainty in its diagnosis due to the difficulty in measuring functional and anatomical changes of right heart and pulmonary vascular system. Among various non-invasive diagnostic methods presented so far, no ideal standard diagnostic criterion has been established. The authors attempted to know positive diagnostic ratio of cor pulmonale and to study the presence of the relationship between these diagnostic criteria when electrocardiographic and echocardiographic diagnostic criteria for cor pulmonale were applied to the patients with chronic lung disease. And we investigated the usefulness of echocardiogaphic diagnostic criteria for the diagnosis. METHODS: One electrocardiographic and two echocardiographic diagnostic criteria were applied to 38 patients with chronic lung disease(21 pulmonary emphysema and 17 chronic advanced pulmonary tuberculosis) for the diagnosis of cor pulmonale. Comparison was also made in their relationship. Then pulmonary artery diameter, measurement of pulmonary function test and echocardiographic examination and radio-nuclear right ventricular ejection faction were compared between the groups to ensure each criterion was satisfied. RESULTS: 1) When the three diagnostic criteria for confirming the cor pulmonale, electrocardiographic rriterion(right ventricular hypertrophy), right ventricular dimension criterion(right ventricular end-diastolic dimension>25mm, RVDd>25mm), and right ventricular wall thickness criterion (right ventricular wall thickness>6mm, RVWT>6mm) were applied to the patients, the positive rate were 32%(12/37), 30%(10/33) and 17%(6/36) respectively. A statistically significant correlation between electrocardiographic criterion and right ventricular wall thickness criterion was found to exist. 2) Various parameters of pulmonary function test and echocardiographic examination were compared in the patient groups with and without cor pulmonale when each non-invasive diagnostic criterion was applied to all patients. Followings are the results. (1) In the positive group on electrocardiographic criteria, vital capacity, forced vital capacity, and arterial oxygen tension were significantly smaller than in the negative group on electrocardiographic criterion(p<0.05), and the echocardiographic parameters of right ventricle, ie. end-diastolic area, end-systolic area, end-diastolic dimension, end-systolic dimension, mid-ventricular short axis and maximal short axis in positive group were significantly larger than in the negative group. (2) In the positive group on right ventricular diastolic dimension criterion(RVDd>25mm), percentage forced expiratory volume in 1 second and forced expiratory flow 25-75% were significantly smaller than in the negative group on right ventricular diastolic dimension criterion. (3) In the positive group on right ventricular wall thickness criterion(RVWT>6mm), vital capacity, forced vital capacity, forced expiratory volume in 1 second, forced expiratory flow 25-75% and arterial oxygen tension were significantly smaller than in the negative group on right ventricular wall thickness criterion. CONCLUSION: When several non-invasive diagnostic criteria for cor pulmonale were applied to the patients with chronic lung disease, there were some differences in its positive diagnostic ratio depending on the applied diagnostic criteria. There was also a statistically significant correlation between electrocardiographic criterion and right ventricular wall thickness criterion. When each diagnostic criterion was applied to the patients, significant differences were found in several parameters resulted from pulmonary function test and echocardiographic examination based on presence or nonpresence of cor pulmonale. But no difference in the ejection fraction measured by radio-nuclear method was shown between cor pulmonale group and non cor pulmonale group. Consequently it was suggested that applying echocardiographic criteria in addition to electrocardiographic criterion for the diagnosis of cor pulmonale in the patients with chronic lung disease is clinically useful.
Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Electrocardiography ; Forced Expiratory Volume ; Heart ; Heart Ventricles ; Humans ; Lung ; Lung Diseases ; Oxygen ; Pulmonary Artery ; Pulmonary Emphysema ; Pulmonary Heart Disease* ; Respiratory Function Tests ; Uncertainty ; Vital Capacity

No abstract available.
Diagnosis* ; Fluorescent Antibody Technique, Indirect* ; Herpes Simplex* ; Simplexvirus*

A 25 years old sergeant of Dicrocoeliidae infection was studied. This patient was not a spurious infection case and diagnosis was based on rocovery of the characteristic eggs consistently in the feces for 2 month. This case had no history of ingestion of ingestion of ants, land snail of grasshopper. In this case with complaints of flatulence, nausea, loss of appetite and dizziness, physical examination reveald no pathological findings except pale cornea. Liver function tests were observed to be normal and there was slight eosinophilia.
parasitology-helminth-trematoda- Dicrocoeliidae ; case report