We report a case of sarcoidosis which developed in the skin, lung and eyes in a 50-year-old woman. The skin lesions showed two types of cutaneous manifestations which were subcutaneous nodules on her back and erytrematous papules on the face for several months. Our patient's seurm angiotensin converting enzyme (ACE) level was elevated at 33.5 IU/L(reference range, 8.3-21.4 IU/L) and the purified protein derivative(PPD) skin test had a negative result. On her roentgenographic examinations, we could find multiple nodular densities with hazziness on both her lungs and radionuclides(Gallium 67) uptakes in right lower lung field. The ratio of helper to suppressor T cells was 9 in bronchial lavage. Diagnosis of sarcoidosis was made on the basis of histologic findings of non-caseating granulomas from skin and lung tissue. Treatment was initiated with oral alternate-day prednisone 40mg. The cutaneous lesions and dyspnea improved in 2 and 4 weeks respectively, and serum ACE level returned to normal in 2 months.
Bronchoalveolar Lavage ; Diagnosis ; Dyspnea ; Female ; Granuloma ; Humans ; Lung ; Middle Aged ; Peptidyl-Dipeptidase A ; Prednisone ; Sarcoidosis* ; Skin ; Skin Tests ; T-Lymphocytes

No abstract available.

No abstract available.
Knee Joint* ; Knee* ; Torque*

1. A study on chest radiographic findings of 54 cases with pneumonia like symptoms was performed. Of 54 cases,8 cases were confirmed to be leptospirosis and 7 cases were leptospirosis combined with Korean hemorrhagic fever.2. Of 8 cases of leptospirosis, 4 cases showed abnormal chest radiographic findings: acinar nodular type 2,massive cofluent consolidation type 2. Of 7 cases of leptospirosis combined with Korean hemorrhagic fever: acinarnodular type 3, massive confluent consolidation type1, and increased interstitial markings type 1 respectively. 3.It was considered to be difficult to diagnose the leptospirosis on chest radiographic findings alone, especiallythe case combined with Korean hemorrhagic fever.
Hemorrhagic Fever with Renal Syndrome ; Leptospirosis ; Pneumonia ; Radiography, Thoracic ; Thorax

No abstract available.
Hearing* ; Humans ; Tinnitus*

The purpose of this study is to evaluate the stress distribution in the bone around dental implants supporting mandibular overdenture according to the number of implant and the type of attachment. Two or four implants were placed in an edentulous mandibular model and three dimensional photoelastic stress analysis was carried out to measure the fringe order around the implant supporting structure and also to calculate principle stress components at cervical area of each implant. The attachments tested were rigid and resilient type of Dolder bar, Round bar, Hader bar and Dal-Ro attachment. The results were as follows; 1. In 2-implant supported overdenture using Round bar, Hader bar, and Dal-Ro attachment, compressive stress pattern was observed on the supporting structure of implant on loaded side, while tensile stress pattern in unloaded side. 2. In 2-implant supported overdenture using Dolder bar, the rigid Dolder bar shared the occlusal loads between 2 implants in a more favorable manner than was exhibited by the resilient type, while the resilient type placed a more stress on the distocervical area of the implant on the loaded side. But compressive stress pattern was observed in both the loaded and unloaded sides in either case. 3. In 2-implant supported overdenture, rigid and resilient type of Dolder bar exhibited more cross arch involvement than the Round bar, Hader bar, or Dal-Ro attachment. 4. In 4-implant supported overdenture using resilient Dolder bar and Hader bar, stress turned out to be distributed evenly among the implants between loaded and unloaded side, but ther was no reduction in the magnitude of the stress in the surrounding structure of implant contratry to 2-implant supported overdenture.. 5. The stress pattern at cervical area of implant was different with the number of implant or the type of attachment but the overload, harmful to surrounding structure of implant, was not observed.
Dental Implants ; Denture, Overlay*

PURPOSE: To determine the incidence and predisposing factors of a visual acuity of 0.5 or better after vitrectomy for proliferative diabetic retinpopathy. METHODS: The factors that could affect visual acuity in 267 eyes of 215 diabetic patients who had undergone vitrectomy for proliferative diabetic retinopathy were calculated retrospectively. The factors were compared between 2 patient groups: postoperative visual acuity of 0.5 or better and of less than 0.5. The statistical significance of differences in factors between the 2 groups was calculated. RESULTS: In 62 (23.2%) of the eyes, postoperative visual acuity was 0.5 or better. Univariate analysis revealed that the patients in the group with better visual acuity were younger, and had no macular detachment, no intraocular tamponade, low level of HbA1c preoperatively, and no cataract surgery (P<0.05). Multivariate analysis revealed that postoperative visual acuity of 0.5 or better was associated with no macular detachment, younger age, and a preoperative visual acuity of 0.1 or better. CONCLUSIONS: The patients who undergo vitrectomy for proliferative diabetic retinopathy complications are more likely to achieve visual acuity of 0.5 or better if they have not had macular detachment, are younger, and have a preoperative visual acuity of 0.1 or better.
Cataract ; Causality ; Diabetic Retinopathy* ; Humans ; Incidence ; Multivariate Analysis ; Retrospective Studies ; Visual Acuity* ; Vitrectomy*

Accurate diagnosis of pancreatic solid lesions is often difficult using conventional imaging modalities. With the recent introduction of contrast-enhanced harmonic endoscopic ultrasound (CEH-EUS), it is now possible to evaluate the microvascular environment and dynamic enhancement of a variety of pancreatic lesions. With CEH-EUS, three patterns of pancreatic lesion enhancement compared with the normal pancreatic tissue (fast, simultaneous, or slow), two washout patterns (fast or slow) and two distribution patterns (homogeneous, inhomogeneous) can be described. By evaluating the microvasculature, enhancement speed, and washout pattern, CEH-EUS may help to differentiate pancreatic adenocarcinoma from other masses and differentiate between pancreatic neuroendocrine tumor (pNET) and inflammatory masses. The finding of a hyperenhancing lesion on CEH–EUS, both with homogeneous and inhomogeneous patterns, was a strong predictor of histology different from adenocarcinoma (94% positive predictive value). pNET was the most common hyperenhancing lesions overall. Although CEH-EUS is useful for ruling out pancreatic ductal adenocarcinoma, making the differential diagnosis between pNETs and pseudotumoral pancreatic masses is difficult because both may share an isovascular or hypervascular appearance. Currently the interpretation of CEH-EUS findings is examiner-dependent. In the future, digital image analysis by image-processing techniques should allow more objective interpretation.
Adenocarcinoma ; Diagnosis ; Diagnosis, Differential ; Microvessels ; Neuroectodermal Tumors, Primitive ; Neuroendocrine Tumors ; Pancreatic Ducts ; Ultrasonography*

Primary or isolated chylopericardium of unknown etiology is considered a rare cause of pericardial effusion. Its etiology is obscure but certain communication between the lymphatic system and pericardial sac was suggested. Up to 1991, there was only one case report that successfully showed the direct communication by a lymphangiogram. We report a case of chylopericardium occurring in a nearly asymptomatic 22-year-old man with no apparent history of trauma, infection or mediastinal neoplasm, in which we succeeded in visualizing the communication between the thoracic duct and pericardial sac by lymphangiography and computed tomography of the chest. A review of the previous cases is described also.
Adult ; Case Report ; Chyle/*metabolism ; Human ; Lymphography ; Male ; Pericardial Effusion/*metabolism/radiography ; Radiography, Thoracic ; Tomography, X-Ray Computed

The Marfan syndrome is a generalized connective tissue disease involving eye, musculoskeletal system, cardiovascular system, and inherited autosomal dominant with various expression type. The cardiovascular complications such as aortic aneurysm, aortic dissection, aortic regurgitation, mitral regurgitation and aortic dissection which usually occurs in previously normal sized aorta are poor prognostic factors. However, the aortic dissection which developed in patient with Marfan syndrome and aortic aneurysm was rare. We experienced one case of dissecting aneurysm in patient diagnosed as previous aortic aneurysm, aortic regurgitation, and Marfan syndrome, receiving successful operation.
Aneurysm, Dissecting ; Aorta ; Aortic Aneurysm* ; Aortic Valve Insufficiency ; Cardiovascular System ; Connective Tissue Diseases ; Humans ; Marfan Syndrome* ; Mitral Valve Insufficiency ; Musculoskeletal System