No abstract available.
Arthritis, Rheumatoid* ; Hand Deformities* ; Hand*

The hyperimmunoglobulin E syndrome is a primary immunodificiency disorder characterized by recurrent staphylococcal infections and markedly elevated serum IgE level. Clinical features are coarse face and severe infections of the skin-furunculosis or chronically pruritic dermatitis and sinopulmonary tract infection from infancy by coagulase positive Staphylococcus aureus, or Candida albicans etc. The patients's serum IgE level is elevated but the basic immunologic pathogenesis not fully understood. We have experienced a case of hyperimmunoglobulin E syndrome in a 26/12-year-old who had suffered from recurrent staphylococcal pneumonias and abscesses and chronically pruritic dermatitis from 1 month of age with elevated serum IgE level. A brief review of the related literature is presented.
Abscess ; Candida albicans ; Coagulase ; Dermatitis ; Immunoglobulin E ; Pneumonia, Staphylococcal ; Staphylococcal Infections ; Staphylococcus aureus

PURPOSE: Urinary tract infection (UTI) in children is the most common disease during the infantile period, therefore early diagnosis and treatment are important. Pyuria is a useful clinical parameter for the initial diagnosis of a UTI. In this study we aimed to compare the clinical, laboratory, and imaging findings in relation to the duration of pyuria in infants with UTIs. METHODS: Three hundred seventy-four infants <12 months of age who were admitted between January 1995 and December 2005 for the first episode of a febrile UTI were retrospectively reviewed. Patients were divided into two groups according to the duration of pyuria as follows: group 1, pyuria resolved <3 days after initial treatment; and group 2, pyuria lasted at least 3 days after initial treatment. RESULTS: There were no significant differences between the two groups in relation to gender, age, total duration of fever, and organisms in the urine. Group 2 had a significantly higher peripheral blood leukocyte count (14,360.86+/-5,526.16 cells/mm3 vs. 11,822.55+/-5,687.26 cells/mm3, P<0.001), erythrocyte sedimentation rate (32.81+/-19.34 mm/hr vs. 23.74+/-20.43 mm/hr, P<0.001), and C-reactive protein (6.84+/-5.68 mg/dL vs. 3.78+/-3.99 mg/dL, P<0.001) than group 1. There was a significantly higher incidence of hydronephrosis and a higher grade of vesicoureteral reflux (VUR) in group 2 compared to group 1. CONCLUSION: In infants with UTI, pyuria of longer duration is related to severe UTI and higher grade VUR, therefore aggressive radiologic studies may be necessary.
Blood Sedimentation ; C-Reactive Protein ; Child ; Early Diagnosis ; Fever ; Humans ; Hydronephrosis ; Incidence ; Infant ; Leukocyte Count ; Pyuria ; Retrospective Studies ; Urinary Tract ; Urinary Tract Infections ; Vesico-Ureteral Reflux

Trichilemmal horn(trichilemmal keratosis) is a rare keratinizing tumor that resembles a cutaneous horn. Histologically, it is characterized by an abrupt maturation of keratinocytes into lamellar keratin without the formation of a granular layer. We describe a case of a trichilemmal horn on the right cheek of a 78-year-old woman.
Aged ; Animals ; Cheek ; Female ; Horns* ; Humans ; Keratinocytes

No abstract available.
Thumb*

OBJECTIVES: Chronic pain is one of the most common experiences of humans and a typical psychophysiological disorder. The aim of this study was to measure the psychophysiological responses in chronic pain patients using a biofeedback system, and to compare them with the results from normal healthy subjects. METHODS: Forty two patients with chronic pain (17 males and 25 females, average age 44.67+/-11.10 years) and 42 normal healthy controls (17 males and 25 females, average age 45.17+/-10.46 years) participated in this study. Electromyography (EMG), skin conductance (SC), and skin temperature (ST) were recorded using biofeedback system during the 3 phases (baseline, stress, and recovery) of stress reactivity test, and average values of them were calculated. Difference of values between two groups in each corresponding phase was analyzed with independent t-test, and change of values across phases of stress reactivity test was analyzed with paired t-test (all two-tailed, p<0.05). RESULTS: Compared to normal controls, chronic pain patients had higher value of EMG (baseline : 8.10+/-5.97 micronV vs 4.72+/-1.52 micronV, t=-3.56, p<0.01 ; stress : 11.25+/-6.89 micronV vs 8.49+/-4.78 micronV, t=-2.13, p<0.05 ; recovery : 7.12+/-3.77 micronV vs 4.78+/-1.59 micronV, t= -3.70, p<0.01) and SC (baseline : 1.06+/-1.0 micronS vs 0.42+/-0.29 micronS, t=-4.0. p<0.01 ; stress : 1.87+/-2.05 micronS vs 1.03+/-0.86 micronS, t=-2.47, p<0.05 ; recovery : 1.74+/-1.77 micronS vs 0.64+/-0.59 micronS, t=-3.8, p<0.01) in all the 3 phases. But, skin temperature comparison did not reveal significant differences in all the 3 phases between two groups. CONCLUSION: Psychophysiological responses of chronic pain patients in stress reactivity test were different from those of normal healthy controls. These results suggest that sympathetic nervous system is more activated in chronic pain patients.
Biofeedback, Psychology ; Chronic Pain ; Electromyography ; Female ; Humans ; Male ; Psychophysiologic Disorders ; Psychophysiology ; Skin ; Skin Temperature ; Sympathetic Nervous System

BACKGROUND: Chronic immune thrombocytopenic purpura (chronic ITP) is the most common autoimmune disease for blood elements. Some patients recovered spontaneously during follow up of disease. We investigated the difference of related clinical parameters between spontaneous remission and no remission.METHODS: We reviewed retrospectively medical records from January 1994 to December 2010. We analyzed clinical parameters such as age, sex, initial platelet count, response to initial treatment, maintenance therapy, and platelet counts at post-diagnosis with regular period in children with or without spontaneous remission.RESULTS: This study was enrolled for 49 children with chronic ITP. Median age was 3.5 years (0.1-17.3). Male to female ratio was 1:1.9. Initial treatment with intravenous immunoglobulin was received in 36 children (73.3%). Spontaneous remission was shown in 23 children (46.9%) during study period with 4.4 year of median follow up. The relevant factors of remission were observed in younger age at diagnosis, maintenance therapy, and platelet counts at post-diagnosis 1 year, 2 years, 3 years (P<0.05). The most significant parameter for spontaneous remission was platelet count at post-diagnosis 6 months in Kaplan-Meier estimate (P=0.047, RR: 3.47, 95% CI: 1.03-24.04).CONCLUSION: Spontaneous remission was shown in about half of patients with chronic ITP. This remission was related with younger age, maintenance therapy, and platelet count at post-diagnosis 6 months. These results suggest that regular follow up with maintenance therapy may be required for management of chronic ITP in children.
Autoimmune Diseases ; Child ; Female ; Follow-Up Studies ; Humans ; Immunoglobulins ; Kaplan-Meier Estimate ; Male ; Medical Records ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; Remission, Spontaneous ; Retrospective Studies

A case of arterial priapism was treated by superselective transcatheteric autologous clot embolization of cavernosal artery 25 days after blunt periheal trauma. No immediate improvement was noted but the priapism subsided on 48th day after the procedure. Normal physiclogic erectlie function was achieved on 53rd day after the procedure, and the period of postprocedure impotence was shortened, as compared with previously reported cases. Autologous blood clot embolization may be an effective treatment method even in delayed priapism, and superselective technique is thought to be more effective to shorten the postprocedure erectlie dysfunction
Arteries ; Erectile Dysfunction ; Male ; Priapism*

PURPOSE: To analyze the risk factors of Korean patients with anterior ischemic optic neuropathy (AION). METHODS: Medical records of 48 Korean patients (24 men, 24 women) who were diagnosed as having AION were retrospectively reviewed and the risk factors of AION including age, sex, associated systemic disease, past medical history, social history, hematologic findings, 24-hour blood pressure monitoring, and optic disc of the clinically normal fellow eye, were analyzed. RESULTS: The mean age of the 48 patients was 59.4 years (range, 36~80 years). There were 6 patients (12.5%) less than 45 years of age, 18 patients (37.5%) of 45 to 65 years of age, and 24 patients (50.0%) more than 65 years of age. There were 29 patients (60.4%) with associated systemic diseases such as hypertension (65.5%), diabetes mellitus, cerebrovascular disease, migraine, and heart disease with a decreasing order. Nine patients (18.8%) with a mean age of 50.6 years were smoker. Four patients developed AION after a cataract operation. There were 17 (68.0%) out of 25 patients with an increased level of cholesterol. Four patients whose 24-hour blood pressure was monitored showed that their blood pressure in night was lower than that in the day time. A cup disc ratio less than 0.2 was observed in 28 contralateral eyes (68.3%) of 41 patients with unilateral AION. CONCLUSIONS: Hypertension, high cholesterol and decreased cup-to-disc ratio were observed in more than 60% of the Korean patients with AION, thereby composed the major risk factors.
Blood Pressure ; Blood Pressure Monitors ; Cataract ; Cholesterol ; Diabetes Mellitus ; Heart Diseases ; Humans ; Hypertension ; Male ; Medical Records ; Migraine Disorders ; Optic Neuropathy, Ischemic* ; Retrospective Studies ; Risk Factors*

BACKGROUND: To evaluate the clinical and functional outcomes of arthroscopic-assisted reduction and percutaneous screw fixation for glenoid fractures with scapular extension, and investigate the radiologic and clinical benefits from the results. METHODS: We evaluated patients treated with arthroscopic-assisted reduction and percutaneous screw fixation for glenoid fractures with scapular extension from November 2008 to September 2015. Fractures with displacement exceeding one-fourth of the anterior-articular surface or more than one-third of the posterior-articular surface in radiographic images were treated by surgery. Clinical assessment was conducted based on range of motion, Rowe score, and Constant score of injured arm and uninjured arm at last follow-up. RESULTS: Fifteen patients with Ideberg classification grade III, IV, and V glenoid fracture who underwent arthroscopic-assisted reduction using percutaneous screw fixation were retrospectively enrolled. There were no differences in clinical outcomes at final follow-up compared to uninjured arm. Bone union was seen in all cases within five months, and the average time to bone union was 15.2 weeks. Ankylosis in one case was observed as a postoperative complication, but the symptoms improved in response to physical therapy for six months. There was no failure of fixation and neurovascular complication. CONCLUSIONS: We identified acceptable results upon radiological and clinical assessment for the arthroscopic-assisted reduction and percutaneous fixation. For this reason, we believe the method is favorable for the treatment of Ideberg type III, IV, and V glenoid fractures. Restoration of the articular surface is considered to be more important than reduction of fractures reduction of the scapula body.
Ankylosis ; Arm ; Arthroscopy ; Classification ; Follow-Up Studies ; Fracture Fixation ; Glenoid Cavity ; Humans ; Methods ; Postoperative Complications ; Range of Motion, Articular ; Retrospective Studies ; Scapula