Reiters syndrome is a clinical triad of arthritis, urethritis and conjunctivitis, but the characteristic mucocutaneous lesions occur frequently enough to be included in this syndrome. This applies to the initial stage of the disease, in which the arthritis usually, but by no means invariably, comes triad, i.e. after the urethritis and conjunctivitis have made their apperance. In most instances the arthritisis is of subacute onset, reaching its full intensity within a few weeks. Some 50% of the patients suffer from recurrences of the arthritis. The chronic progressive polyarthritis occuring in Reiters syndrome has severe functional and anatomical repercussions. Here we report a case of Reiters syndrome in a 14 year old middle school boy. He had classical characteristic triad of arthritis, nonspecific urethritis and conjunctivitis. He had pyuria in first fewdays after onset and the arthritis of acute onset, reaching its full intensity within two weeks and then followed by conjunctivits. A review of literature was included.
Arthritis ; Conjunctivitis ; Humans ; Male ; Pyuria ; Recurrence ; Urethritis

Macrodactyly is a rare congenital malformation characterized by an increase in the size of all the elements or structures of a digit or digits. The phalanges, tendons, vessels, subcutaneous fat, finger nails, and skin are all enlarged, but the metacarpals are not affected. The condition is most frequently found in the index and long fingers, and its etiology remains unexplained. Macrodactylism associated with neurofibroma of the median nerve in the left middle finger, in a 13 year old girl, is presented with a review of the literature, and diagnosis was confirmed by pathological examination. Chief complaints were enlargement of the left middle finger and a soft tissue mass in the left palm since birth. There was no change in motor and sensory function of the hand. X-ray showed enlargement of phalanges and a diffusely enlarged soft tissue shadow in the middle finger. We performed epiphysiodesis of the proximal, middle and distal phalanges of the left middle finger with exploration of the left median nerve to the wrist joint. An enlarged fibromatous median nerve, left side, was found with very large abundant fat lobules around it.
Diagnosis ; Female ; Fingers ; Hand ; Humans ; Median Nerve ; Metacarpal Bones ; Neurofibroma ; Parturition ; Sensation ; Skin ; Subcutaneous Fat ; Tendons ; Wrist Joint

The increase of health care expenditures is an important problem in the almost countries. Also, suppression of the health care expenditures is an important problem in the health field of Korea since the national health insurance for total people in 1989. Thus, it is very important to grasp the change of the health care expenditures of family and proportions of the health care expenditures to total expenditures of family, because they are the basis of national health care expenditures in Korea. While the health care expenditures of urban family were increased during 1980-1993 by 12.8% annually, the total expenditures of urban family were increased by 14.8% annually. consequently, the proportions of health care expenditures to total expenditures were decreased from 5.98% to 4.76%. The proportions of health care expenditure for 3 years to come were predicted to 4.75% in 1994, 4.67% in 1995, and 4.63% in 1996 by the time-series ana]ysis. That is, it was predicted that they would be decreasing slowly. The product elasticity of health care expenditure was less than 1 in the multiple regression analysis, so the health care is normal good rather than superior good. Therefore, it seems that the household economy is able to bear the expense pursuing the improvement of quality of health care by actualizing the medical insurance fee.
Delivery of Health Care* ; Elasticity ; Family Characteristics ; Fees and Charges ; Hand Strength ; Health Expenditures* ; Humans ; Insurance ; Korea ; National Health Programs ; Quality of Health Care

BACKGROUND: Early detection and treatment of cytomegalovirus (CMV) infection is very important because CMN infection is a major cause of morbidity and mortality after organ transplantation. CMV antigenemia assay has been reported to be very sensitive and specific for detection of CMV infection among many laboratory methods. However, there is no single method correlated well with the infection state up to now. We compared the results of SHARP Signal System Assay (Digene, USA) using PCR and hybridization with those of CMV antigenemia assay (Clonab CMV-kit; Biotest AG, Germany) to evaluate their clinical usefulness. METHODS: We performed SHARP Signal Assay on whole blood samples of 125 from 56 transplanted patients submitted for CMV antigenemia at Samsung Medical Center. We compared the results with those of CMV antigenemia and evaluated the correlation with CMV disease state. RESULTS: Fifty six patients were classified as three groups; 43 patients with no evidence of CMV infection, four patients with CMV infection and 9 patients with CMV disease. Twenty four cases (19.2%) showed discrepant results between the two methods. Of the 22 cases showing positive only by SHARP Signal Assay, two cases were proved to be CMV disease, 12 cases were on antiviral treatment and remaining cases had no evidence of infection. Two cases showing positive only by CMV antigenemia were confirmed to be CMV disease. For CMV disease, the sensitivity of SHARP Signal Assay and CMV antigenemia were 85.7% and 90.5%, respectively and the specificity of them were 73.1% and 93.3%, respectively. CONCLUSIONS: CMV antigenemia is thought to be useful for early diagnosis and follow-up of antiviral treatment as a quantitative and highly specific method, and SHARP Signal Assay can be used as a complementary method because it correlates well with disease state.
Cytomegalovirus Infections* ; Cytomegalovirus* ; Diagnosis* ; Early Diagnosis ; Follow-Up Studies ; Humans ; Mortality ; Organ Transplantation ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Transplants

Pathological laughing and crying(PLC) is a condition that is characterized by episodic, brief, contextually inappropriate, uncontrollable outbursts of laughing and/or crying. It can be observed in patients with various neurological disorders. PLC often causes distress in interpersonal functioning and activities for patients and their families. PLC can be recognized easily with proper understanding of the condition and its nature. Also it generally shows good response to various pharmacological treatments. This review aims to encourage the diagnosis and treatment of PLC by providing definition and clinical presentation of PLC, analysis of its pathophysiology and various current treatment options.
Crying* ; Diagnosis ; Humans ; Nervous System Diseases

No abstract available.
Replantation*

Pachydermoperiostosis (idiopathic hypertrophic osteoarthropathy) ia an unusual syndrome of familial nature and characterized by clubbing of the digits, periosteal new bone formation especially over the distal ends of the long bones, and coarsening of the facial features with thickening and furrowing of the skin of the face and forehead. The case of a 46 year old male exhibiting the above characteristics is reported, The same tendencies were exhibited by his father before him. A review of literature is included.
Fathers ; Forehead ; Humans ; Male ; Osteoarthropathy, Primary Hypertrophic ; Osteogenesis ; Skin

Ossification of the ligamentum flavum (OLF) has been recognised as a definite clinical entity as an ossification of the posterior longitudinal ligament. It has been known that the incidence of OLF is high in Japan and OLF usually occurs in the thoracic and lumbar region. Recently OLF has received considerable attention as a cause of myelopathy. OLF is quite distinct from “hypertrophy” of the ligamentum flvum. We experienced 2 cases of OLF with neurological symptom, which were treated by decompressive laminectomy and removal of the ossified ligamentum flavum. So remarkable symptomatic improvement was obtained.
Incidence ; Japan ; Laminectomy ; Ligamentum Flavum ; Longitudinal Ligaments ; Lumbosacral Region ; Spinal Cord Diseases ; Spine

Eighty primary Harris-Galante Porus (HGP) total hip replacements were performed at Severance Hospital from January 1986 to January 1989. A minimum of 18 months follow-up was available for 80 hips in 72 patients, whose mean age was fifty two years. The most common presenting diagnosis was avascular necrosis (47.5%) followed by fused hips (10%), tuberculosis (10%), rheumatoid arthritis (7.5%). Complications included three calcar cracks and two immediate dislocations and 6 cases of mild myositis ossificans. There were no infections and no revisions. The mean Harris hip score was 93 points (range, 74–100 points) at two years. The thigh pain was in nine patients (11 per cent) at one year and in three patients (3 per cent) at two years postoperatively. Radiographic analysis revealed that, a progressive radiodense femoral line developed in 21 hips (26 per cent); a progressive acetabular line in 3 hips (4 per cent); and decreased proximal femoral density in 28 hips (35 per cent). There were no position change of the acetabula and femoral compent. We conclude that the early overall clinical results of HGP total hip replacements are encouraging, at average 30 months. The prognostic significance of the radiographic changes such ar radiodense lines, the changes of the proximal femur and cortical thickening, have to be determined with longer follow-up. Long term follow-up of uncemented HGP total hip replacement is necessary to evaluate the efficacy of such implants.
Acetabulum ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Hip ; Diagnosis ; Dislocations ; Femur ; Follow-Up Studies ; Hip ; Humans ; Myositis Ossificans ; Necrosis ; Thigh ; Tuberculosis