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

BACKGROUND: A regional wall motion nonuniformity and a phase difference between LV posterior wall motion and transmitral flow are present during normal rapid filling period and are thought to be an evidence for involvement of ventricular restoring forces. To assess the role of nonuniformity on diastolic funtional impairment of asymmetric septal hypertrophy(ASH), the time relations between left ventricular regional wall motions and filling velocity were studied. METHOD: We measured the time intervals from A2 to peak rate of LV posterior wall(short axis) thinning(A2-(-)dpw/dt), peak rate of medial mitral annulus (long axis dimension) lengthening(A2-dL/dt) and peak mitral flow(A2-E) by M-mode and Doppler echocardiography. Result: In ASH patients, A2-(-)dpw/dt(106+/-6msec, mean SE) and the regional wall motion nonuniformity((-)dpw/dt-dL/dt, 89+/-11msec, mean SE) were increased significantly when compared with normal control values(88+/-4, 28+/-5msec, mean SE, p<0.01,respectively).In normal controls, peak mitral flow velocity lagged peak rate of regional wall motion, so the phase differences were present((-)dpw/dt-E :71+/-8msec, dL/dt-E:44+/-6msec). In ASH patients, (-)dpw/dt-E was present(90+/-16msec) but dL/dt-E was not present or reversed(-21+/-18 msec). So these chacteristic phase differences were disturbed. CONCLUSION: These data suggested that the relaxation nonuniformity of regional wall motion in ASH may act as an energy dissipating factor of restoring forces during rapid filling period.
Axis, Cervical Vertebra ; Cardiomyopathy, Hypertrophic* ; Echocardiography* ; Echocardiography, Doppler ; Humans ; Relaxation

Nefazodone, a newer antidepressant is a phenylpiperazine derivative that inhibits the reuptake of both norepinephrine and serotonin, and antagonizes 5-HT2A and alpha1 adrenergic receptors. Compared with SSRIs nefazodone caused the fewer activating symptoms, adverse gastrointestinal effects(nausea, diarrhea, anorexia) and adverse effects of sexual function, but is associated with the more dizziness, dry mouth, constipation, visual disturbances and confusion. We report on 4 cases of visual disturbances and hallucinations in patients taking nefazodone. 1) Nefazodone, as a 5-HT2A antagonist, might induce visual disturbances. 2) mCPP, metabolite of nefazodone might contribute to the hallucination through action on 5-HT receptor. 3) Dopaminergic enhancing activity of nefazodone might cause hallucination. The case report raises the possibility that dose-related perceptual disturbances may exist with nefazodone. The fact emphasizes the need to pay close attention to all possible drug interactions, particularly in patients treated with multiple psychoactive agents, older patients, and patients with decreased hepatic function.
Constipation ; Diarrhea ; Dizziness ; Drug Interactions ; Hallucinations ; Humans ; Mouth ; Norepinephrine ; Psychotropic Drugs ; Receptors, Adrenergic ; Serotonin ; Serotonin 5-HT2 Receptor Antagonists

No abstract available.
Meningitis* ; Salmonella*

No abstract available.
Birth Certificates* ; Parturition*

Several observation suggest that the antimelanocyte autoantibodies could play a role in melanocyte destruction. Some experiments indicate that melanocyte antibodies from patients with vitiligo can kill melanocyte in vitro. In these experiments, we demonstrated that vitiligo patient's sera containing antimelanocyte antibodies can lyse cultured human melanocytes by complement activation. Melanocyte cytotoxicity was measured using the ethidium bromide/ acridine orange viability assay. Significant melanocyte cytotoxicity was seen in sera from patients with both active and inactive vitiligo(p<0.01). Melanocyte cytotoxicity measured with complement-mediated cytotoxicity decreased after systemic steroid treatment(p<0.05) ; however melanocyte cytotoxicity showed no significant change with systemic PUVA therapy.
Acridine Orange ; Antibodies ; Autoantibodies* ; Complement Activation ; Ethidium ; Humans ; Melanocytes ; PUVA Therapy ; Vitiligo*

OBJECTIVE: Multiple birth implicates the important health and social problems such as preterm birth, low birth weight, high perinatal mortality, and increased medical cost. This study was performed to investigate the multiple birth rate in Korea using the birth certificate data. METHODS: Retrospective review and analysis of data from Korean birth certificate in 1996. RESULTS: Multiple birth rate was 1.4% of total births(683,043 cases). Mean birth weight was 3.29+/-0.47kg for singleton birth and 2.57+/-0.58kg for multiple birth. Mean gestational age was 39.56+/-1.32 weeks for singleton birth and 37.47+/-2.41 weeks for multiple birth. Rate of low birth weight (< 2.5kg) was 14 times higher for multiple birth compared with that of singleton birth, and rate of preterm birth(< 37 weeks) was 10 times higher. Multiple logistic regression analysis was performed to examine the relationship between multiple birth and selected variables including maternal age, job and birth order. As the odds ratio(OR) was 2.47(95% CI: 2.34 - 2.59, p<0.001) for the second birth, and 5.31(95% CI: 4.99 - 5.65, p<0.001) for the third and over birth compared with the first birth, there was a significant correlation between multiple birth and birth order. CONCLUSIONS: Based on the birth certificate data in 1996, the incidence of twin and higher order multiple birth was 1.7%, and a significant correlation between multiple birth and birth order was revealed. Further studies are necessary to elucidate the etiology and prognosis of multiple birth and the developmental problems from birth to adolescence.
Adolescent ; Birth Certificates* ; Birth Order ; Birth Weight ; Gestational Age ; Humans ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Logistic Models ; Maternal Age ; Multiple Birth Offspring* ; Parturition* ; Perinatal Mortality ; Pregnancy ; Premature Birth ; Prognosis ; Retrospective Studies ; Social Problems ; Twins

No abstract available.

PURPOSE: Many articles have proposed that osteonecrosis of the femoral head (ONFH) is caused by fat embolism or intravascular coagulation linked to hyperlipidemia. To determine whether hyperlipidemia is an associated factor for ONFH, serum lipid levels were measured. MATERIALS AND METHODS: Nighty-eight patients presenting with ONFH and 110 controls were investigated. We compared the average value of serum lipid levels and the incidence of hyperlipidemia of the two groups. RESULTS: ONFH group showed generalized increase in lipid level and statistically significant difference in the average value of total cholesterol (P=0.0001), HDL-cholesterol (P=0.0261) and phospholipid (P=0.0465) compared with the control. The incidence of hyperlipidemia of the two groups showed statistically significant difference in HDL-cholesterol (P=0.019) and triglyceride (P=0.024). CONCLUSION: Hyperlipidemia seems to be associated with pathogenesis of ONFH. We speculated that hyperlipidemia might be a contributing factor of ONFH. Hyperlipidemia may play a role as a triggering factor in the pathogenetic process that results in osteonecrosis. However, it can not be ruled out that secondary hyperlipidemia might be a finding following ONFH.
Cholesterol ; Embolism, Fat ; Head* ; Humans ; Hyperlipidemias ; Incidence ; Osteonecrosis* ; Triglycerides

No abstract available.
Acetabulum* ; Arthroplasty, Replacement, Hip* ; Transplants*