We presented a case of Reiters syndrome consisting of conjunctivitis, arthritis and mucocutaneous lesions, occurring in 49 year-old Korean male. He had an pisode of dysentery 18 months before the onset of the syndrome and later followed by transient conjunctivitis but no history of venereal disease was revealed. He had the relatively well demarcated erythematous scaly patches on the scalp, face and back, and also the solitary or confluent thickened hyperkeratotic plaques on the dorsum of the feet and hands and lower extremities. Balanitis circinata as .a lesion of the mucous membrane, was seen but there were no lesions on the oral mucosa and palate. Arthritis of the knee and elbow joints were very scvere, accompanied by severe pain and limited motion, and severe wasting and weakness of the muscles of both lower extremities were noticed. He was treated with penicillin and corticosteroids systemically combined witb physiotherapy with some improvement of both skin lesions and joint pain but he died 3 months later probably of the far advanced pulmonary tuberculosis, gastrointestinal bleeding and cachexia.
Adrenal Cortex Hormones ; Arthralgia ; Arthritis ; Balanitis ; Cachexia ; Conjunctivitis ; Dysentery ; Elbow Joint ; Foot ; Hand ; Hemorrhage ; Humans ; Knee ; Lower Extremity ; Male ; Middle Aged ; Mouth Mucosa ; Mucous Membrane ; Muscles ; Palate ; Penicillins ; Scalp ; Sexually Transmitted Diseases ; Skin ; Tuberculosis, Pulmonary

A wide variety of cancers metastasize to the ovaries. In a majority of instances the primary site is the gastrointestinal tract, breast, or other gynecologic organs. The best known tumor of this type is signet-ring cell adenocarcinoma. The gallbladder and bile duct are rare sources of these metastases. The authors have had an experience of a case that was presented of Krukenberg tumor metastatic from the gallbladder and report the case with brief review of literature.
Adenocarcinoma ; Bile Ducts ; Breast ; Female ; Gallbladder* ; Gastrointestinal Tract ; Krukenberg Tumor* ; Neoplasm Metastasis* ; Ovary

DSA(Digital Subtractin Angiography) is a valuable diagnostic imaging method in many clinical fields, includingranal-related conditons. Sixty four renal DSA examinations were performed in 59 patients with renal-relateddiseases from Jan. 1984 to Dec. 1985. Summary of these were as follows: 1. Intraarterial (IA)-DSA is performed in6 cases, intravenous(IV)-DSA in 58 cases. In 58 Examinations of IV-DSA, diagnostic image quality is obtained in 51cases(88%). 2. In investigations of a possible renovascular etiology of hypertension, IV-DSA,is a safe, sensitiveand accurate method. On screening for evaluation of renovascular hypertension, RSP should be replaced with IV-DSA,because IV-DSA is moe sensitive and accurate and can detect not only anatomic change of renal arttery but alsofunctional hemodynamic change. 3. IV-DSA is valuable in diseases with morphologic changes of vessels. Incharacterization of a known renal mass, and evaluation of hematuria, suspected aneurym and renal trauma, IV-DSA isvery useful diagnostic imaging modality. 4. In evaluation of potential renal donors, IV-DSA is an accurate andsafe method with 82.4% of accuracy. IV-DSA also is useful in follow-up of allograft recipients. 5. Ininvestigation of diabetic nephropathy, glomerulonephritis, pyelonephritis, IV-DSA is little helpful. 6. Theadvantages of DSA are well known, particularly post-procedure process using computer programs is helpful forobtaining informations of hemodynamic change or time-sequence-curve of density etc. More technical improvementwith this modality is required for improvement of the image quality and resolution. And more accumulation ofclinical experience is required in order to increase the diagnostic accuracy.
Allografts ; Angiography, Digital Subtraction ; Diabetic Nephropathies ; Diagnostic Imaging ; Follow-Up Studies ; Glomerulonephritis ; Hematuria ; Hemodynamics ; Humans ; Hypertension ; Hypertension, Renovascular ; Mass Screening ; Methods ; Pyelonephritis ; Tissue Donors

PURPOSE: Horizontal visual field defects are generally caused by lesions before the optic chiasm, but we report a case with bilateral inferior altitudinal defects secondary to bilateral occipital lobe infarction. CASE SUMMARY: A 57-year-old male with a history of diabetes and hypertension presented with a month of blurring in the inferior visual field. His corrected visual acuity was 1.0 in the right eye and 0.63 in the left eye, and the intraocular pressure was normal in each eye. Pupillary response, ocular movement, and color vision tests were normal in both eyes. There was no specific finding of the optic disc and macula on fundus examination. Visual field examination revealed an inferior congruous homonymous hemianopia with horizontal meridian sparing and a left incongruous homonymous quadrantanopia. Optical coherence tomography for peripapillary retinal nerve fiber layer thickness revealed a mild decrease in the inferior disc of both eyes. Brain magnetic resonance imaging confirmed the presence of an acute infarction confined with upper medial calcarine fissures of bilateral occipital lobe and the right splenium of the corpus callosum, which were consistent with inferior altitudinal hemianopia and left superior incongruous quadrantanopia, respectively. Brain magnetic resonance angiography showed multiple stenosis of bilateral posterior cerebral arteries. CONCLUSIONS: The altitudinal visual field defects could be caused by the occipital lesion medial to the calcarine fissure, and unusual visual defects could be due to a combination of multiple lesions.
Brain ; Color Vision ; Constriction, Pathologic ; Corpus Callosum ; Hemianopsia ; Humans ; Hypertension ; Infarction ; Infarction, Posterior Cerebral Artery ; Intraocular Pressure ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nerve Fibers ; Occipital Lobe ; Optic Chiasm ; Posterior Cerebral Artery ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Acuity ; Visual Fields

The importance of tick-borne diseases is increasing because of climate change, with a lack of long-term studies on tick-borne pathogens in South Korea. To understand the epidemiological characteristics of tick-borne diseases, the monthly distribution of field ticks throughout the year was studied in South Korea between May 2014 and April 2018 in a cross sectional study.

Cyclopia is rare congenital craniofacial anomaly, in which the eyes are fused together and located in a single orbit. It is consistently associated with severe holoprosencephaly, which is the failure of cleavage of the prosencephalon with a deficit in the midline facial development. chromosomal study revealed 47, X( ), +13 (Patau syndrome).
Holoprosencephaly ; Orbit ; Prosencephalon ; Trisomy*

PURPOSE: To describe the clinical outcome of AMT (amniotic membrane transplantation) for corneal ulcers, persistent epithelial defects, corneal perforations, and neurotropic ulcers. METHODS: We performed AMT on 10 cases of corneal ulcer, 5 cases of persistent epithelial defect, 2 cases of corneal perforation, and 3 cases of neurotropic ulcer from Agust 1999 to May 2002. Amniotic membrane was obtained from the women undergoing elective Cesarean section or normal delivery. We had applied one or two layers of fresh amniotic membrane, that is used within 4hours after resection, over the ulcer bed and anchored by interrupted and running suture technique with 10-0 Nylon. After AMT, Topical eye drops was used three times a day. RESULTS: After AMT, Visual acuity was improved in 6 eyes of 10 corneal ulcer patients and maintained in 3 eyes. In all patients the persistent epithelial erosion was healed and pain was subsided between 6 and 12 days after surgery. There were no leakage in corneal perforation patients, and stable ocular surface were achieved after mean period 15.5 days. The ocular surface was restored by AMT in all neurotropic ulcer patients. CONCLUSIONS: The AMT is an effective method for managing corneal ulcer or ocular surface diseases, that are refractory to conventional treatment. The AMT shortened the usage of broad spectrum antibiotics , increased compliance, and decreased corneal opacity and neovascularization.
Amnion* ; Anti-Bacterial Agents ; Cesarean Section ; Compliance ; Corneal Opacity ; Corneal Perforation ; Corneal Ulcer* ; Female ; Humans ; Membranes ; Nylons ; Ophthalmic Solutions ; Pregnancy ; Running ; Suture Techniques ; Ulcer ; Visual Acuity

PURPOSE: We studied the result and cilincal significance of transscleral fixation of posterior chamber lens in complete vitrectomized eyes without capsular support. METHODS: We evaluated 30 aphakic eyes of 30 patients and according to the cause of pars plana vitrectomy, there were 9 eyes for intraocular foreign body, 8 eyes for lens dislocation, 8 eyes for retinal detachment, 3 eyes for vitreous hemorrhage, 2 eyes for endophthalmitis. RESULTS: The postoperative best-corrected visual acuity group was intraocular foreign body group and the group of lens dislocation, vitreous hemorrhage, retinal detachment, and endophthalmitis were in the descending order of visual acuity. The most common postoperative early complication was temporary hypotony and the others were hyphema, and temporary increased IOP. The most common postoperative late complication was exposed scleral fixation suture and the others were vitreous hemorrhage, cystoid macular edema, subluxation of intraocular lenses, retinal detachment. CONCLUSIONS: We experienced many postoperative temporary hypotony patients, but all cases were improved in short term period. The complication related to scleral fixation in vitrectomized eyes was imposed to smaller than the scleral fixation in vitreous support. But, in fact the development of retinal detachment or vitreous incarceration complication in the vitrectomized eye was not different from the eyes having vitreous support.
Endophthalmitis ; Foreign Bodies ; Humans ; Hyphema ; Lens Subluxation ; Lenses, Intraocular* ; Macular Edema ; Postoperative Complications ; Retinal Detachment ; Sutures ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

PURPOSE: To evaluate the early effect of orbital reconstruction with MacroPore(R) by assessment of orbital volume through orbital computed tomography (CT) in cases of orbital wall fracture METHODS: We performed orbital reconstruction with MacroPore(R) in patients with orbital wall fracture smaller than 3 cmx2 cm. Orbital CT was done preoperatively and 6 months postoperatively. We then evaluated the results by measuring the orbital volume through Rapidia 2.8 program. RESULTS: The study comprised 14 patients. The site of fracture was the medial wall in one patient, inferior in seven, and both medial and inferior in six patients. The site of insertion of MacroPore(R) was the medial wall in one patient, inferior in 12, and both medial and inferior walls in one. The mean volume of the affected orbit before operation was 20.23+/-2.78 cm3, that of the unaffected orbit was 18.27+/-2.24 cm3 (p-value=0.000), and the mean volume of the affected orbit after operation was 19.06+/-2.57 cm3, that of the unaffected orbit was 18.06+/-2.24 cm3 (p-value=0.000). The mean enophthalmos before operation was 1.00+/-0.62mm, and after operation was 0.64+/-0.46 mm. The mean difference of orbital volume between the affected and the unaffected orbits before operation was 1.96+/-0.33 cm3, and 1.00+/-0.87 cm3 after operation (p-value=0.000). The mean volume of the affected orbit before operation was 20.23+/-2.77 cm3, and 19.06+/-2.57 cm3 after operation (p-value=0.000). Each cubic centimeter decrement in volume caused a 0.67+/-0.68 mm mean decrease of enophthalmos. CONCLUSIONS: We concluded that MacroPore(R) was safe orbital implant and effective in decreasing the orbital volume at early orbital reconstruction in cases of orbital wall fracture smaller than 3 cmx2 cm through a comparison of orbital volume before and after operation.
Enophthalmos ; Humans ; Orbit ; Orbital Implants

BACKGROUND: The purpose of this study was to evaluate the historical anesthetic trends for last 35 years at Chonnam National University Hospital (CNUH). METHODS: The anesthetic records of total 101,637 anesthetic cases performed at CNUH from January 1961 to December 1996 were reviewed and analyzed according to age, sex, department, operation site, physical status, preoperative findings, anesthetic methods and agents, duration of operation, etc. RESULTS: Annual anesthetic cases was increased remarkably year by year; annual surgical patients increased 19 times for 35 years. The ratio of male to female was 1.18:1. The percent of geriatric anesthesia was increased year by year. In preoperative physical status from ASA definitions, 83.6 % of total patients was assigned class I and II. The average departmental distributions in descending order were surgery, orthopedic surgery, obstetrics and gynecology, neurosurgery, urology, ENT, thoracic surgery, ophthalmology, plastic surgery, oral and maxillofacial surgery, and others. The distributions of operation site in descending order were lower abdomen, neck, upper abdomen, lower extremities, head, chest, spine, upper extremities, and breast. Inhalational anesthesia was the most frequent used methods. Ether was abandoned from 1983, and major volatile anesthetics was halothane from 1981 to 1991. The use of enflurane has steadily increased and isoflurane has also been used with increasing frequency since 1992. CONCLUSIONS: Anesthetic cases are markedly increased year by year, and major volatile anesthetics and neuromuscular blocker were changed from halothane to enflurane and from pancuronium to vecuronium, respectively.
Abdomen ; Anesthesia ; Anesthetics ; Breast ; Enflurane ; Ether ; Female ; Gynecology ; Halothane ; Head ; Humans ; Isoflurane ; Jeollanam-do* ; Lower Extremity ; Male ; Neck ; Neuromuscular Blockade ; Neurosurgery ; Obstetrics ; Ophthalmology ; Orthopedics ; Pancuronium ; Retrospective Studies* ; Spine ; Surgery, Oral ; Surgery, Plastic ; Thoracic Surgery ; Thorax ; Upper Extremity ; Urology ; Vecuronium Bromide