Eosinophilic gastroenteritis is a rare disorder of unknown etiology characterized by protein losing enteropathy, peripheral eosinophilia and iron deficiency anemia secondary to gastrointestinal blood loss. It is often accompanied by signs of systemic allergy. This case of a 26-month-old male patient who developed scrotal edema and diarrhea for a month had peripheral eosinophilia ranged from 24 to 32% of total leukocyte, iron deficiency anemia and hypoalbuminemia with slightly increased level of serum lgE. Biopsies of the stomach and duodenum demonstrated marked eosinophilic infiltration of the mucosa and lymphatic dilatation, which was consistent with eosinophilic gastroenteritis. We report a case of eosinophilic gastroenteritis with a brief review who was treated with corticosteroid alone and had marked symptomatic improvement.
Anemia, Iron-Deficiency ; Biopsy ; Child, Preschool ; Diarrhea ; Dilatation ; Duodenum ; Edema ; Eosinophilia ; Eosinophils* ; Gastroenteritis* ; Humans ; Hypersensitivity ; Hypoalbuminemia ; Leukocytes ; Male ; Mucous Membrane ; Protein-Losing Enteropathies ; Stomach

No abstract available.

No abstract available.

Anal duct carcinoma is a rare tumor, and accounts for less than 5 percent of all anal cancers, which typically present a long-standing perianal fistulas. Some authors suggest that the fistulous tracts are congenital duplications of the lower end of the hind gut lined by rectal mucosa which is prone to malignant change to mucinous adenocarcinoma. It is usually a well differentiated mucinous (colloid) adenocarcinoma. The prognosis after wide excision of the rectum is relatively good. Since 1985, we have had three cases of anal duct carcinoma with well differentiated mucinous adenocarcinoma involving the posterior wall of the anus. Two patients had a long history of perianal fistula with mucinous discharge. There was no spread to the regional lymph node except one patient who had regional lymph node metastasis, and post-operative chemotherapy and radiation therapy were then given. All patients have no evidence of any recurrent problem at 16 months to 3 years following the surgical treatment. Because of their rarity and the failure of recognition at an early stage, we are presenting three cases to emphasize the characteristic features of this insidious, slow-growing carcinoma.
Adenocarcinoma

PURPOSE: To evaluate the findings and the role of contrast enhanced magnetic resonance imaging in avascular necrosis of femoral head. MATERIALS AND METHODS: Sixteen patients with avascular necrosis of femoral head were examined with MRI. Tl-weighted and T2-weighted images and contrast-enhanced Tl-weighted images were obtained. Enhancing characteristics of the necrotic area and synovium were determined. Also a change of the disease extent after enhancement was assessed. RESULTS: Twenty seven avascular necrosis of the femoral head including 11 cases of bilateral lesion were detected. Fifteen cases revealed collapse of the femoral head. The portions of the lesion with low signal intensity on Tl-weighted images and high signal intensity on T2-weighted images showed contrast enhancement in 15 cases. However, the portions with low signal intensities both on T1 and T2-weighted images showed enhancement in one case. There was no significant change of the disease extent after enhancement. Synovium showed enhancement in 18 cases, and joint effusion was detected in 23 cases. CONCLUSION: Contrast enhanced MR images may be helpful in predicting histopathologic findings of avascular necrosis of the femoral head, but not useful for evaluating the extent of disease.
Head* ; Humans ; Joints ; Magnetic Resonance Imaging* ; Necrosis* ; Synovial Membrane

No abstract available.
Intracranial Arteriovenous Malformations* ; Risk Factors*

Titanium alloy has been widely used as material for total knee arthroplasty(TKA). However, titanium alloy has frequently been reported as causing black staining of the periprosthetic tissues as a result of debries from metallic wear and tissue reaction. We report six cases of failed TKA in five patients, in which the tibial tray and/or metal backed patellar components were composed of titanium alloy. Wear, breakage or separation of the ultra-high molecular weight polyethylene of tibial insert and/or patellar component, which allowed metal-on-metal friction and aggravated the production of metal wear debries, were observed in all cases. The average time from primary operation to revision was 5 year and 3 months (range, 9 months to 8 year and 8 months). In all cases, patients showed painful swelling of knee jont and radiopaque periarticular deposits on radiogrphs. Most of radiographs showed abnormal position of the metallic components and metal line sign. Histology of synovium showed abundant titanium particles lying free and within histiocytes, and polyethylene and cement particles with foreign-body type giant cell reaction. The synovial lining showed a preliferative reaction and abundant fibrosis was noted. On polarizing briefringent. Elemental analysis of metal particles on histologic section, using energy dispersive X-ray spectrophotometer (EDS ; EDAX PV9900) unit attached to a transmission electron microscope, detected the titanium peak. Radiopaque metallic densitien in the painful knee after TKA are highly suggestive findings of titanium reaction. Tissue reaction in response to the metal wear debries from titanium prosthesis may have contributed to the early failure of these implants.
Alloys ; Arthroplasty, Replacement, Knee ; Deception ; Fibrosis ; Friction ; Giant Cells ; Histiocytes ; Humans ; Knee ; Molecular Weight ; Polyethylene ; Prostheses and Implants ; Synovial Membrane ; Titanium

Discoid meniscus is a congenital morphological variable anomaly of meniscus which is often asymptomatic. Arthroscopic surgeries on 91 symptomatic lateral discoid menisci of 84 patients were performed at the Department of Orthopedic Surgery, Seoul National University Hospital during the period of Jan. 1987 to Jan. 1994, which equals 19.2% of arthroscopic meniscectomies performed. Follow up was done from minimum of 1 year to maximum of 8 years, with an average period of 3 years and 10 months. Retrospective study was done with the review of clinical records, roentgenograms, MRI, and arthroscopic findings on recorded videotapes to evaluate the clinical and radiological features, results of arthroscopic treatment and possible prognostic factors. The followings are the results: 1. The lateral discoid meniscus encompassed 19.2% of arthroscopic meniscectomies performed at the same period, which was relatively high incidence. Arthroscopic partial and subtotal menis- cectomy resulted in satisfactory results. 2. Since 8 (11%) knees were not diagnosed preoperatively as discoid meniscus due to type being incomplete or torn meniscus displacement, these points should be considered with clinical findings at diagnosis of discoid meniscus. 3. 34.9% of 83 menisci with tear had previous trauma history which showed high vulnerability to tear. Discoid menisci without tears but with grade II intrasubstance increased signal and symptoms were treated with arthroscopic meniscectomy and showed good results. Therefore discoid menisci without tears should be considered of arthroscopic meniscectomy in the presence of clinical symptoms and MRI findings. 4. Lysholm total and pain scores were significantly improved at postop. 1 year and at the final follow up with p<0.05. Factors such as degenerative changes, sex, age, duration of preoperative symptoms, presence of tears and types of meniscectomy gave no significant influence on the results and the prognosis.
Arthroscopy ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Knee* ; Magnetic Resonance Imaging ; Orthopedics ; Prognosis ; Retrospective Studies ; Seoul ; Videotape Recording

No abstract available.
Rhizotomy* ; Scoliosis*

No abstract available.
Knee*