Crohn's disease (CD) is a chronic, idiopathic, inflammatory disorder of the gastrointestinal tract. In rare cases, CD has been associated with Hirschsprung's disease (HD); however, the underlying pathophysiology of this and other comorbidities is not yet fully understood. In this report, we describe the case of a 17-year-old patient who was diagnosed with both CD and ankylosing spondylitis (AS), having undergone a long ileo-colonic anastomosis to treat HD at 12 months of age. To our knowledge, this is the first documented case of CD combined with AS in a patient with HD.
Adolescent* ; Comorbidity ; Crohn Disease* ; Gastrointestinal Tract ; Hirschsprung Disease* ; Humans ; Infant* ; Inflammatory Bowel Diseases ; Spondylitis, Ankylosing*

There are two major types of vascular birthmarks, hemangiomas, those demonstrating endothelial hyperplasia, and malformation, those with normal endothelial turnover. Venous malformations have previously been treated by surgical excision, where possible. Although not a panacea for all such tumors, the use of sclerosing agents is decidedly preferable in some cases to extirpation with a scapel. The method involves the direct injection of absolute alcohol into the lesion on the fluoroscopic guide. The effect of treatment is satisfactory and there appears tobe no long term complication. We report 2 cases of surgically irresectable and deep-seated venous malformation which were treated sclerotherapy using ethanol.
Ethanol ; Hemangioma ; Hyperplasia ; Sclerosing Solutions ; Sclerotherapy*

No abstract available.
Rickets, Hypophosphatemic*

The visual acuity and intraocular pressure were measured and analyzed in 1641 healthy adults visiting AMC health care center. The visual acuity was measured irrespective of wearing glasses and contact lenses with autoacuitometer and we defined this visual acuity as everyday vision. The average everyday vision of better eye was 1.10 in males and 0.96 in females[converted with Han chart:0.95, 0.85; converted with Jin chart: 0.89, 0.78] between 20 and 69 years old. The average everyday vision in males was better than that of females[p<0.01]. The everyday vision was decreased in older subjects. The everyday vision of the subjects under 44 years of age was better than that of over 45 years of age[p<0.01]. The linear equation of the everyday vision according to age was Y=-0.0049X 1.30 in males[R=-0.77], Y=-0.0112X 1.43 in females[R=-0.88][X:age, Y:visual acuity, R:correlation coefficient]. In classification according to occupation, the visual acuity of housewives was low 0.89, but when matched to age &sex it was statistically insignificant. The average intraocular pressure was 13.25+/-2.57 mmHg in males, 12.85+/-2.45 mmHg in females. The IOP of the subjects under 44 years of age was not different from those over 45 years of age[male p=0.31, female p=0.20]. The number of subjects higher than 21 mmHg in intraocular pressure was 21[0.64%].
Adult* ; Aged ; Classification ; Contact Lenses ; Delivery of Health Care* ; Eyeglasses ; Female ; Glass ; Humans ; Intraocular Pressure* ; Male ; Occupations ; Seoul* ; Visual Acuity*

PURPOSE: Carcinoembryonic antigen (CEA) is the most widely used tumor marker for detecting colorectal cancer. This study was designed to evaluate the level of serum CEA that is associated with recurrence after potentially curative surgery for colorectal cancer. METHODS: We retrospectively investigated the pre- and post-operative levels of serum CEA in 246 patients with colorectal cancer and they had undergone potentially curative surgery from 1996 through 2005. RESULTS: The pre-operative CEA level was significantly associated with the number of metastatic lymph nodes, the tumor size and the recurrence rate. The feature that was associated with recurrent disease on multivariate analysis was the pre-operative level of serum CEA. CONCLUSION: In order to detect the recurrence of colorectal cancer, we should closely follow up with frequent checks of the CEA level after surgery for those patients who had a high preoperative CEA level.
Carcinoembryonic Antigen ; Colorectal Neoplasms ; Follow-Up Studies ; Humans ; Lymph Nodes ; Multivariate Analysis ; Recurrence ; Retrospective Studies

OBJECTIVE: To quantitatively evaluate the asymmetry of the multifidus and psoas muscles in unilateral sciatica caused by lumbar disc herniation using magnetic resonance imaging (MRI). METHODS: Seventy-six patients who underwent open microdiscectomy for unilateral L5 radiculopathy caused by disc herniation at the L4-5 level were enrolled, of which 39 patients (51.3%) had a symptom duration of 1 month or less (group A), and 37 (48.7%) had a symptom duration of 3 months or more (group B). The cross-sectional areas (CSAs) of the multifidus and psoas muscles were measured at the mid-portion of the L4-5 disc level on axial MRI, and compared between the diseased and normal sides in each group. RESULTS: The mean symptom duration was 0.6+/-0.4 months and 5.4+/-2.7 months for groups A and B, respectively (p<0.001). There were no differences in the demographics between the 2 groups. There was a significant difference in the CSA of the multifidus muscle between the diseased and normal sides (p<0.01) in group B. In contrast, no significant multifidus muscle asymmetry was found in group A. The CSA of the psoas muscle was not affected by disc herniation in either group. CONCLUSION: The CSA of the multifidus muscle was reduced by lumbar disc herniation when symptom duration was 3 months or more.
Demography ; Humans ; Magnetic Resonance Imaging ; Paraspinal Muscles* ; Psoas Muscles ; Radiculopathy ; Sciatica*

We investigated the ability of the GDx-Nerve Fiber Analyzer (NFA) to discriminate between normal and early glaucomatous eyes among Korean individuals by reviewing the medical records of 217 consecutive subjects: 61 early glaucoma patients, 68 ocular hypertensive patients, and 88 normal subjects. GDx parameters were compared using ANOVA. The Receiver Operating Characteristics (ROC) curve for each GDx-NFA variable was used to diagnose each parameter, and Pearson correlation coefficients were calculated to assess the association between GDx-NFA parameters and visual field indices in early glaucoma. The best GDx parameters to discriminate between early glaucomatous and normal subjects were the number, maximum modulation, ellipse modulation and inferior ratio (i.e. area under the ROC curve > 0.8). A value for the Number of equal to or greater than 27 was optimal for detecting early glaucoma, with a sensitivity of 80.3% and specificity of 80.7%. In addition, symmetry was positively correlated with the corrected pattern standard deviation (CPSD) among visual field indices in early glaucoma.
*Diagnostic Techniques, Ophthalmological ; Female ; Glaucoma, Open-Angle/*diagnosis/ethnology ; Humans ; Intraocular Pressure ; Korea/epidemiology ; Male ; Middle Aged ; Nerve Fibers/*pathology ; Ocular Hypertension/diagnosis/ethnology ; Optic Nerve Diseases/*diagnosis/ethnology ; ROC Curve ; Retinal Ganglion Cells/*pathology ; Retrospective Studies ; Sensitivity and Specificity ; Visual Fields

No abstract available.
Drug Therapy*

Purpose: To compare efficacy of ultrasound (US)-guided single-injection nerve blocks (SINB) before bipolar hemiarthroplasty (BHA) of the hip in patients with femoral neck fractures. Materials and Methods: Clinical outcomes of 89 patients who underwent BHA between September 2016 and February 2018 were retrospectively compared. Eight patients were excluded according to exclusion criteria and the remaining patients were divided into two groups: patients who received SINB before surgery (Group I; n=40), and patients who did not (Group II; n=41). The femoral, obturator, and lateral femoral cutaneous nerves were each blocked separately under US guidance. Pain scores determined using the visual analogue scale (VAS) were recorded 6, 12, 24, and 48 hours postoperatively, and all use of analgesics were recorded separately for 72 hours after surgery. Duration of hospitalization, general complications, and local complications due to SINB were also compared among the groups. Results: Significant differences were observed between the two groups: I) VAS at 6 hours and at 12 hours after the operation, II) total amounts of analgesics used. VAS at 24 hours and at 48 hours were not significantly different between the two groups. General complications and duration of hospitalization were also not significantly different between the groups. Conclusion US-guided lower limb nerve blocks provide excellent immediate postoperative pain relief and can be used as a safe, and effective method of pain control after BHA.

Evaluation of intracranial CSF flow was accomplished by the use of cine MR technique. In the cine MR, there were two methods of evaluation in CSF flow pattern. Qualitative and quantitative methods were called magnitude reconstruction and phase contrast mapping method, respectively. The image of magnitude reconstruction method can demonstrate areas of decreased CSF flow and help explain the cause of hydrocephalus. The image of phase contrast mapping method is more sensitive to fluid motion and may increase utility in the future for analysis of fluid flow. Cine MR is capable of showing both normal and abnormal intracranial CSF flow. Such a study can be easily added as an extra pulse sequence at the end of a routinely acquired MR examination. We evaluated 2 cases of the normal pattern of pulsatile flow within subarachnoid space and 3 cases of abnormal patterns of CSF flow(communicating hydrocephalus: 2 cases, arachnoid cyst in posterior fossa: 1 case). These observations were compared with pre- and post-operative CSF flow state. In conditions which result in alterations of flow, cine MR shows either obstruction or excessively turbulent flow within the CSF pathways. In our studies, the most distinctive pathological finding was bulk flow in the aqueduct of Sylvius. The authors suggest that this technique can be applied in a wide range of conditions where CSF pathway is altered including hydrocephalus, evaluation of the function of the shunt system and communication between arachnoid cyst and subarachnoid space . Moreover correct diagnosis is possible in patients with hydrocephalus, in whom the exact level of CSF obstruction can be determined. We believe that surgical decisions can be aided by careful analysis of these CSF cine MR studies. We discuss the normal and abnormal CSF flow findings and indications of cine MR CSF flow technique with literature review.
Arachnoid ; Cerebral Aqueduct ; Diagnosis ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging ; Pulsatile Flow ; Subarachnoid Space