Annular pancreas is a rare congenital malformation consisting of pancreatic tissue surrounding the descending portion of the duodenum and induces intestinal obstruction. This is caused by incomplete rotation of the ventral pancreatic bud. In children, the annular pancreas is also associated with trisomy 21 and other congenital diseases such as Meckel’s diverticulum, intestinal, or cardiac malformations. Here we presented a rare case of the annular pancreas with Meckel’s diverticulum identified by the abdominal exploration of an 8-day-old girl who suffered from projectile bilious vomiting. A plain abdominal radiograph showed a ‘double-bubble sign’ with air in the stomach and duodenum, and the upper gastrointestinal series showed a dilated proximal duodenum, with partial obstruction of the descending duodenum. The exploration revealed an annular pancreas, Meckel’s diverticulum, and Ladd’s band without large bowel malrotation. Subsequently, she ate well and was discharged on the 27th hospital day.

Annular pancreas is a rare congenital malformation consisting of pancreatic tissue surrounding the descending portion of the duodenum and induces intestinal obstruction. This is caused by incomplete rotation of the ventral pancreatic bud. In children, the annular pancreas is also associated with trisomy 21 and other congenital diseases such as Meckel’s diverticulum, intestinal, or cardiac malformations. Here we presented a rare case of the annular pancreas with Meckel’s diverticulum identified by the abdominal exploration of an 8-day-old girl who suffered from projectile bilious vomiting. A plain abdominal radiograph showed a ‘double-bubble sign’ with air in the stomach and duodenum, and the upper gastrointestinal series showed a dilated proximal duodenum, with partial obstruction of the descending duodenum. The exploration revealed an annular pancreas, Meckel’s diverticulum, and Ladd’s band without large bowel malrotation. Subsequently, she ate well and was discharged on the 27th hospital day.

Fractures of the lateral process of the talus (LPT) are considered rare, accounting for less than 1% of all ankle injuries in the general population. These fractures are nearly 15 times more likely to occur in snowboarders. Recently, the number of population who started enjoying cable-wakeboard is increasing and this sport may cause fracture of the LPT by axial loading occur on the LPT while boarding or trick. We report on a case of involving LPT fracture during cable-wakeboard trick with successful screw osteosynthesis.
Ankle Injuries ; Skiing ; Sports ; Talus

BACKGROUND: Loss of heterozygosity (LOH) and mutation of the p16 tumor suppressor gene have been detected in non-Hodgkin's lymphomas (NHLs). Recently, hypermethylation of the p16 gene has been reported. The role of p16 gene alterations in the genesis of NHLs and their high-grade transformations require explanation. METHODS: LOH of D9S171 and IFNA microsatellite markers, DNA hypermethylation, and mutation of exon 1 and 2A were assessed in 43 cases of NHLs. The genetic abnormalities were compared with the protein expression by immunohistochemistry, and they were evaluated according to the histologic subtypes, grades and immunophenotypes. RESULTS: DNA hypermethylation was the most common p16 gene abnormality and was found in 30 of 39 cases (76.9%). Eight cases (18.6%) showed LOH in one or both microsatellite markers, and five cases (11.6%) showed mutations in exon 1 or 2A. Loss of protein expression was seen in 17 cases (39.5%) and was associated with mutation and LOH. Loss of protein was more frequent in high-grade lymphomas than in low-grade lymphomas. CONCLUSION: These results suggest that the functional loss of the p16 gene contributes to the development of NHLs, especially to the development of high-grade lymphomas.
DNA ; Exons ; Genes, p16* ; Genes, Tumor Suppressor ; Immunohistochemistry ; Loss of Heterozygosity ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Microsatellite Repeats

Isolated stress fracture of the first rib is quite rare cause of uncertain shoulder pain in athletes. These fractures are stress induced and precipitated by repeated traction of muscles acting on the first rib. A prompt diagnosis can shorten the time required for healing and decrease the risk of associated complication as nonunion or pseudoarthrosis. The diagnosis can be made by taking a thorough history and performing chest X-ray, computed tomography, or bone scan. Early recognition and proper management generally lead to successful outcomes and return to normal activities. Typically, they heal with conservative treatment with rest and mild analgesia. This report describes stress fractures of bilateral first rib in a weightlifter, one of which developed into a pseudoarthrosis as a result of persistent overhead activities due to missed diagnosis.
Analgesia ; Athletes ; Diagnosis ; Fractures, Stress* ; Humans ; Muscles ; Pseudarthrosis* ; Ribs* ; Shoulder Pain* ; Shoulder* ; Thorax ; Traction

No abstract available.
Korea ; Thyroid Gland

Noonan syndrome is characterized by short stature, typical facial dysmorphology, and congenital heart defects. The main facial features of Noonan syndrome are hypertelorism with down-slanting palpebral fissures, ptosis, and low-set posteriorly-rotated ears with a thickened helix. The cardiovascular defects most commonly associated with this condition are pulmonary stenosis and hypertrophic cardiomyopathy. Other associated features are webbed neck, chest deformity, mild intellectual deficit, cryptorchidism, poor feeding in infancy, bleeding tendency, and lymphatic dysplasias. The patient is a 10-year-old boy. He had experienced repeated febrile convulsions. He had typical facial features, a short stature, chest deformity, cryptorchidism, vesicoureteral reflux, and mental retardation. His language and motor development were delayed. When he went to school, it was difficult for him to pay attention, follow directions, and organize tasks. He also displayed behavior such as squirming, leaving his seat in class, and running around inappropriately. Clinical observation is important for the diagnosis, so we report a patient who was diagnosed with Noonan syndrome, mental retardation, and attention-deficit hyperactivity disorder.
Cardiomyopathy, Hypertrophic ; Child ; Congenital Abnormalities ; Cryptorchidism ; Ear ; Heart Defects, Congenital ; Hemorrhage ; Humans ; Hypertelorism ; Intellectual Disability ; Male ; Neck ; Noonan Syndrome ; Pulmonary Valve Stenosis ; Running ; Seizures, Febrile ; Thorax ; Vesico-Ureteral Reflux

Epidermal inclusion cysts are benign cutaneous or subcutaneous lesions, which are filled with lamellated keratin and lined with stratified squamous epithelium. They are commonly found in the face, neck, trunk, and rare in the breast. Although most epidermal inclusion cysts are harmless, ruptured cysts can lead to infection or abscess and which often require surgical removal. Only few cases of ruptured epidermal cyst in breast have been reported, and furthermore, occurrence of ruptured epidermal cyst in the breast parenchyma is very rare. We now report a rare case of a ruptured epidermal inclusion cyst arising in the breast parenchyma.
Abscess* ; Breast* ; Epidermal Cyst ; Epithelium ; Neck

PURPOSE: To find clinical factors related to the long-term outcome of binocularity in accommodative esotropia. METHODS: Forty-nine patients with accommodative esotropia who were followed over 5 years after successful optical alignment within 8 prism diopters of orthophoria at near and distance with glasses including bifocals were included. The patients who had stereo acuity better than 50 seconds/arc and central fusion without suppression scotoma at the final visit were divided into the bifoveal fusion group and the others were divided into the peripheral fusion group. Clinical factors were analyzed between the two groups (Chi-square test, student t-test). RESULTS: Of the 49 patients, 15 patients were included in the bifoveal fusion group and 34 patients were included in peripheral fusion group. Mean follow-up was 88.9 +/- 25.4 months. Clinical factors that were significantly related to the bifoveal fusion group were older age of onset, shorter duration of misalignment, intermittent esotropia at the initial visit and after initial optical correction, smaller residual deviations at distance after initial optical correction and at the final visit, and lesser amblyopia. CONCLUSIONS: To obtain better levels of long-term binocularity, optical correction should be done as early as possible, before the presence of constant eye misalignment or amblyopia, and the residual esodeviations after optical correction should be kept as small as possible.
Age of Onset ; Amblyopia ; Esotropia* ; Eyeglasses ; Follow-Up Studies ; Glass ; Humans ; Scotoma ; Telescopes*

Amniotic fluid is an indicator of normal placental function and is essential for normal fetal lung maturation. Amniotic fluid index (AFI) is the most preferred method of amniotic fluid measurement in pregnancy although single deepest pocket (SDP) is also used. To measure AFI, the examiner divides the uterus into four equal quadrants. AFI is the sum of deepest pocket from each quadrant. The normal AFI ranges between 5~24 cm while any value above 24 cm is considered as hydramnios and that below 5 cm is indicated as oligohydramnios. An adequate volume of amniotic fluid is critical to allow normal fetal movement and growth, while also cushioning the fetus and umbilical cord. Regardless of the etiology, oligohydramnios may inhibit these processes and may lead to fetal deformation, umbilical cord compression, and death in some instances. Oligohydramnios can be due to underproduction, loss, or sometimes, isolated. Isolated oligohydramnios has been found to be responsive maternal hydration and is neither a malformation of the urinary system in the fetus, nor a rupture of amnion and due to genetic cause. The author would like to introduce a way to increase amniotic fluid volume in isolated oligohydramnios which is expect to improve the perinatal outcomes.
Amnion ; Amniotic Fluid ; Female ; Fetal Movement ; Fetus ; Lung ; Methods ; Oligohydramnios ; Polyhydramnios ; Pregnancy ; Rupture ; Umbilical Cord ; Uterus