We herein report a case of transient acrodermatitis enteropathica in a 3-month-old, breast-fed, full-term infant. The patient was presented with a 2-month history of diarrhea and crusted erythema- tous patches on the periorificial area. Similar lesions were seen in his siblings. His serum zinc level and the zinc level in his mother's breast milk were markedly reduced. Diarrhea and skin lesions disappeared promptly with oral zinc supplementation and did not recur when zinc was discontinued after three weeks. Our case indicates that even full-term infants, who feed excl-usively on mothers milk, run a risk of developing zinc deficiency, if the concentration of zinc in the breast milk is very low.
Acrodermatitis* ; Diarrhea ; Humans ; Infant* ; Milk ; Milk, Human ; Mothers ; Siblings ; Skin ; Zinc

The subepidermal calcified nodule, also known as a form of calcinosis cutis, is characterized by solitary circumscribed deposits of insoluble calcium within the subepidermis. The disease is not associated with any systemic or cutaneous diseases, or any biochemical abnormalities. The pathogenesis is still unknown. A 55-year-old female presented with a 4-month history of solitary skin-colored, hyperkeratotic papule on the left upper eyelid. The lesion was asymptomatic and had increased slowly in size. It is interesting that excisional biopsy showed typical histopathologic features of the subepidermal calcified nodule and the clear cell syringoma.
Biopsy ; Calcinosis ; Calcium ; Eyelids ; Female ; Humans ; Middle Aged ; Syringoma*

We report a 20-year-old female patient who developed clozapine-induced agranulocytosis on the 29th day of clozapine treatment. She recovered from the agranulocytosis on the 8th day of progression after treatment with G-CSE, GM-CSF, antibiotics and associated aseptic procedures. The cause of clozapine-induced agranulocytosis is still un known and it is proposed that the dominant gene of major histocompatibility complex region and the reactive metabolites which suppress the myeloid system may be responsible. We recommend that careful attentions such as the selection of patient, evaluation of the risk factors, and the thorough control of CPMS should be paid. If the agranulocytosis happens, it is helpful to consult to the department of medicine immediately.
Agranulocytosis* ; Anti-Bacterial Agents ; Attention ; Clozapine ; Female ; Genes, Dominant ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Major Histocompatibility Complex ; Risk Factors ; United Nations ; Young Adult

PURPOSE: The purpose of this study is to report on the short term follow-up of patients who underwent arthroscopic acetabular labral repair for femoroacetabular impingement and acetabular labral tear. MATERIALS AND METHODS: A total of 45 consecutive patients who underwent arthroscopic acetabular labral repair after diagnosis of femoroacetabular impingement and acetabular labral tear from January 2008 to December 2010 were included in this study. Modified Harris hip score (MHHS), VAS, Hip outcomes score (HOS), and patient satisfaction were used for evaluation of the clinical results. RESULTS: Patients included 22 males and 23 females, and the mean age of the patients was 33.0(range, 16-54) years old, and the mean follow up period was 26.7(range, 24-56) months. Of the clinical results, mean VAS score was 6.4 and 2.5 points before and after surgery, respectively, and mean MHHS score improved from 59.5 points before surgery to 85.4 points after surgery. Activities of daily living and sports-related activities of HOS were 58.3% and 51.2%, respectively, before surgery, and 83.0% and 79.8% after surgery. Revision arthroscopic surgery was performed on five cases(12.1%); labro-synovial adhesion, three cases, pull-out of suture anchor, one case, heterotropic ossification, one case. CONCLUSION: Arthroscopic acetabular labral repair is considered an effective treatment for femoroacetabular impingement and accompanying acetabular labral tear.
Activities of Daily Living ; Arthroscopy ; Female ; Femoracetabular Impingement ; Follow-Up Studies ; Hip ; Humans ; Male ; Patient Satisfaction ; Suture Anchors

We investigated the possible association between depression, anxiety, severity of recent stress in patients with myofascial paul, with chronic myofacial pain syndrome. On the initial visit, 30 subjects completed the following psychometiic battery Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory and Global Assessment of Recent Stress. As compared with the neurosis control group and the healthy control group, the results were as follows: 1) The myofascial paul group showed higher scores than the healthy controls but lower than the neurosis controls, in the Spielberger State-Trait Anxiety Inventory. 2) The myofascial pain group showed higher scores than the healthy controls but lower than the neurosis controls, in the total score of Beck Depression Inventory. 3) The myofascial pain group showed higher scores than the healthy controls but lower than the neurosis controls, in the score of Global Assessment of Recent Stress. 4) In the factor analysis of Beck Depression Inventory, the myofascial pain group showed significantly higher scores than the healthy controls but lower than the neurosis control in the somatic symptom subscale. However, there were no significant differences among the myofascial pain group and other control groups in the other subscales. These findings suggest that the myofacial pain group is more anxious and depressed and more preoccupied with their somatic symptoms due to their myofacial pain and more stressed in recent periods. The authors propose that the psychiatric management is helpful in intervening with the progression of myofacial pain.
Anxiety ; Depression ; Facial Neuralgia ; Facial Pain ; Humans ; Myofascial Pain Syndromes*

BACKGROUND AND OBJECTIVES: An understanding of the cross-sectional structures and histological features of experimental animals is necessary for conducting the research of rhinosinusitis in experimental animals. The aim of this study is to determine the most suitable cross-sectional level of rhinosinusitis in a rat model. MATERIALS AND METHODS: The study examined the histological features of the mucosal epithelium, gland, lymphoid tissue, and vomeronasal organs using 4 week-old male rats weighing 60-70 g as test subjects. Whole mounted sinus-nose complexes were divided into four levels of areas which were sectioned according to the coronal plane and each section was stained with hematoxylin-eosin and observed under light microscopy. RESULTS: Level I revealed the nasal turbinate, maxilloturbinale, and nasolacrimal duct. Level II revealed the nasal turbinate, maxilloturbinale, vomeronasal organ, and nasolacrimal duct. Level III revealed the ectoturbinale I, II, endoturbinale II, III, maxillary sinus, Steno's gland, maxillary sinus gland, and nasal associated lymphoid tissue (NALT). Level IV revealed the ectoturbinale II, endoturbinale III, IV, pharyx respiratorius, and NALT. The lining epithelia were squamous, respiratory and olfactory. However, the squamous epithelium was not observed in level III and IV. CONCLUSION: The Level III appears to be the most suitable for the rhinosinusitis animal rat model since we can observe the respiratory epithelium lined sinonasal airspace including the maxillary sinus and NALT.
Animals ; Epithelium ; Humans ; Lymphoid Tissue ; Male ; Maxillary Sinus ; Microscopy ; Models, Animal ; Nasal Cavity* ; Nasolacrimal Duct ; Nose ; Paranasal Sinuses* ; Rats* ; Respiratory Mucosa ; Turbinates ; Vomeronasal Organ

PURPOSE: The purpose of this study was to evaluate the overall rate and risk factors for the development of an incisional hernia and a parastomal hernia after colorectal surgery. METHODS: The study cohort consisted of 795 consecutive patients who underwent open colorectal surgery between 2005 and 2007 by a single surgeon. A retrospective analysis of prospectively collected data was performed. RESULTS: The overall incidence of incisional hernias was 2% (14/690). This study revealed that the cumulative incidences of incisional hernia were 1% at 12 months and 3% after 36 months. Eighty-six percent of all incisional hernias developed within 3 years after a colectomy. The overall rate of parastomal hernias in patients with a stoma was 6.7% (7/105). The incidence of parastomal hernias was significantly higher in the colostomy group than in the ileostomy group (11.9% vs. 0%; P = 0.007). Obesity, abdominal aortic aneurysm, American Society of Anesthesiologists score, serum albumin level, emergency surgery and postoperative ileus did not influence the incidence of incisional or parastomal hernias. However, the multivariate analysis revealed that female gender and wound infection were significant risk factors for the development of incisional hernias female: P = 0.009, wound infection: P = 0.041). There were no significant factors related to the development of parastomal hernias. CONCLUSION: Our results indicate that most incisional hernias develop within 3 years after a colectomy. Female gender and wound infection were risk factors for the development of an incisional hernia after colorectal surgery. In contrast, no significant factors were found to be associated with the development of a parastomal hernia.
Aortic Aneurysm ; Cohort Studies ; Colectomy ; Colorectal Surgery ; Colostomy ; Emergencies ; Female ; Hernia ; Hernia, Ventral ; Humans ; Ileostomy ; Ileus ; Incidence ; Multivariate Analysis ; Obesity, Abdominal ; Prospective Studies ; Retrospective Studies ; Risk Factors ; Serum Albumin ; Surgical Stomas ; Wound Infection

PURPOSE: To determine the frequency and distribution of parenchymal changes on mammography before and after hormone replacement therapy. MATERIALS AND METHODS: Mammograms of 100 postmenopausal women who underwent hormone replacement therapy without breast disease were evaluated. Mammograms obtained annually after hormone replacement were analysed and compared with that of pretreatment. In addition, mammograms of control group and treatment group were compared. RESULTS: An increase in density of breast parenchyma was seen on the mammogram of 20 women(20%) receiving therapy. The mammograms from the control group showed no change. Mammographic changes were detected at first year in 13 women, 2nd year in 4 women, 3rd year in 2 women, and 4th year in 1 woman (average,19 months). CONCLUSION: We conclude that increase in mammographic density following postmenopausal hormone replacement therapy is not uncommon(20%).
Breast Diseases ; Breast* ; Estrogen Replacement Therapy* ; Female ; Hormone Replacement Therapy ; Humans ; Mammography*

BACKGROUND: Paroxysmal atrial fibrillation (PAF) causes not only severe symptoms and hemodynamic changes, but may progress to chronic atrial fibrillation. Autonomic nervous system or atrial premature beat (APB) has been suggested to contribute to the spontaneous initiation of PAF, but the exact mechanism has been largely unknown. METHODS: One hundred and twenty nine episodes of PAF lasting longer than 5 sec were analyzed in 18 patients (M:F=11:?). Two minutes of normal sinus rhythm before the onset of PAF, and the initial one minute of PAF were printed and analyzed. RESULTS: Most of PAFs were initiated by APBs (38%) or rapid atrial tachycardias (AT, 59%). The frequency of APBs tended to increase immediately before PAF onset (p=0.08). The coupling intervals and coupling indices were not significantly different between PAF-producing APBs and benign APBs. More than half of PAF episodes were initiated by rapid ATs (rate, 357+/-50 bpm). After the onset, they accelerated over several seconds and then degenerated into AF. In some cases, transition from AF to atrial flutter and vice versa were observed. Heart rate, measured at 60-second intervals during 2 minutes before PAF onset, did not change significantly (p=0.44). CONCLUSION: Most of PAFs were initiated by APBs or rapid ATs. Heart rate did not change significantly but the frequency of APBs tended to increase immediately before PAF onset. Rapid ATs frequently accelerated and degenerated into AF. In this regard, Holter monitoring could be useful in identifying patients with PAF triggered by rapid ATs.
Atrial Fibrillation* ; Atrial Flutter ; Autonomic Nervous System ; Cardiac Complexes, Premature ; Electrocardiography, Ambulatory* ; Heart Rate ; Hemodynamics ; Humans ; Tachycardia

BACKGROUND: The restriction of wrist motion results in limited hand function, and the evaluation of the range of wrist motion is related to the evaluation of wrist function. To analyze and compare the wrist motion during four selected tasks, we developed a new desktop motion analysis system using the motion controller for a home video game console. METHODS: Eighteen healthy, right-handed subjects performed 15 trials of selective tasks (dart throwing, hammering, circumduction, and winding thread on a reel) with both wrists. The signals of light-emitting diode markers attached to the hand and forearm were detected by the optic receptor in the motion controller. We compared the results between both wrists and between motions with similar motion paths. RESULTS: The parameters (range of motion, offset, coupling, and orientations of the oblique plane) for wrist motion were not significantly different between both wrists, except for radioulnar deviation for hammering and the orientation for thread winding. In each wrist, the ranges for hammering were larger than those for dart throwing. The offsets and the orientations of the oblique plane were not significantly different between circumduction and thread winding. CONCLUSIONS: The results for the parameters of dart throwing, hammering, and circumduction of our motion analysis system using the motion controller were considerably similar to those of the previous studies with three-dimensional reconstruction with computed tomography, electrogoniometer, and motion capture system. Therefore, our system may be a cost-effective and simple method for wrist motion analysis.
Forearm ; Hand ; Methods ; Range of Motion, Articular ; Video Games* ; Wind ; Wrist*