We present a case of perforating granuloma annulare which appeared as multiple small papular lesions with central umbilication on the dorsum of both foot and sides of foot, The patient was a 12 year-old female child who had slightly tender lesions of one month's duration. Histologic study showed perforation of the epiderrnis and release of the abnormal necrobiotic material transepiderrnally. The epidermal perforation communicated with area of granuloma annulare in the dermis that consist of necrobiotic collagen surrounded by palisading mononucler phagocytes in the dermis. All the lesions resolved spontaneously with a slight hyperpigmentation in 4 months. She also had erythematous tender nodules, which diagnosed as erythema nodosum, on both shins. The lesions responded to potassium iodide 1.0g for 2 weeks.
Child ; Collagen ; Dermis ; Erythema Nodosum ; Female ; Foot ; Granuloma Annulare* ; Granuloma* ; Humans ; Hyperpigmentation ; Phagocytes ; Potassium Iodide

Ameloblasts ; Child ; Fibroma ; Humans ; Maxilla ; Molar ; Odontoma

Although Soft tissue contrast and direct multiplanar imaging capability of MRI are well recognized, myelo Been the imaging modality of choice in evaluationg cervical root injury. We assessed the role of M compared its diagnostic accuracy with myelography in the evaluation of cervical root injury. MR finding Root injury in ten patients (55 roots) were retrospectively reviewed. In 26 explored roots (6 patin Frndings were compared with myelography and surgical results. In 29 roots (8 patients), which were By myelography or exploration, the MR findings were focal extraudral CSF collections (pseudomem In 21/29(72.4%, 8 patients), thickening of extradural roots in 4/29 (13.6%, 5 patients), and thickern Darn in 12/29 (41.4%, 6 patients) roots. T2-weighted axial image was superior to Tl weighted and Density-weighted images for delineationg root avulsion. The sensitivity and specificity of MRI were 7 93.3% respectively, while those of myelography were 83% and 90%. Overall diagnostic accuracy of Myelography were comparable (84.6% vs 87.5%). In conclusion, myelography is still considered as the Of choice in the preoperative evaluation of the cervical root avulsion because of its higher sensi, however, may obviate the myelography with some technical refinements.
Humans ; Magnetic Resonance Imaging* ; Myelography ; Retrospective Studies ; Sensitivity and Specificity

Although Soft tissue contrast and direct multiplanar imaging capability of MRI are well recognized, myelo Been the imaging modality of choice in evaluationg cervical root injury. We assessed the role of M compared its diagnostic accuracy with myelography in the evaluation of cervical root injury. MR finding Root injury in ten patients (55 roots) were retrospectively reviewed. In 26 explored roots (6 patin Frndings were compared with myelography and surgical results. In 29 roots (8 patients), which were By myelography or exploration, the MR findings were focal extraudral CSF collections (pseudomem In 21/29(72.4%, 8 patients), thickening of extradural roots in 4/29 (13.6%, 5 patients), and thickern Darn in 12/29 (41.4%, 6 patients) roots. T2-weighted axial image was superior to Tl weighted and Density-weighted images for delineationg root avulsion. The sensitivity and specificity of MRI were 7 93.3% respectively, while those of myelography were 83% and 90%. Overall diagnostic accuracy of Myelography were comparable (84.6% vs 87.5%). In conclusion, myelography is still considered as the Of choice in the preoperative evaluation of the cervical root avulsion because of its higher sensi, however, may obviate the myelography with some technical refinements.
Humans ; Magnetic Resonance Imaging* ; Myelography ; Retrospective Studies ; Sensitivity and Specificity

BACKGROUND: Pleural effusion is a common disease in clinical practice but its effect on pulmonary function and altered pulmonary mechanics after removal of effusion are not still largely understood. Previous studies have shown that there is little or a relatively small improvement in pulmonary function and arterial blood oxygenation after therapeutic thoracentesis. The present study was designed to assess the effect on pulmonary function of pleural effusion and to test whether there was a significant improvement in pulmonary function and arterial oxygenation after thoracentesis and to observe long term effect after thoracentesis. METHOD: We examined flow-volume curve, body box and arterial blood gas analysis according to severity of effusion, present symptom, and symptom duration. Then, we measured changes of pulmonary function after thoracentesis and observed longterm effect after thoracentesis. RESULT: 1) Pleural effusion cause restrictive pulmonary insufficiency. Not only functional impairment of small airway but also large airway is provoked. 2) MMFR, FEV1, Raw, PO2 are earlier improved than FVC and TLC after thoracentesis and patients without complication have mild restrictive pulmonary insufficiency after longterm observation 3) FVC, FEV1, & TLC are similarly restricted as severity of pleural effusion and PO2 is relatively decreased. 4) Cases with symptom duration 1 week or less and cases with dyspnea have more severe pulmonary insufficiency than others. 5) The flow volume curves show a relatively greater improvement in flow rates at large lung volumes than small airway. 6) Significant relationship is shown between first thoracentesis amount and changes of FEV1, FVC, TLC. CONCUSION: Pleural effusion cause restrictive pulmonary insufficiency and not only functional impairment of small airway impairment but also large airway is provoked. Then, Pulmonary function is progressively improved after thoracentesis and remained mild restrictive pulmonary insufficiency after recovery
Blood Gas Analysis ; Dyspnea ; Humans ; Lung ; Maximal Midexpiratory Flow Rate ; Mechanics ; Oxygen ; Pleural Effusion* ; Tuberculosis, Pleural*

Spontaneous intraperitoneal extravasation of urine is rare. Perirenal urinoma may develop when obstruction to urinary flow creates sufficient back pressure to produce extravasation of urine. Urinary ascites most commonly indicate a disruption to the integrity of the urinary tract. We report a case of urinary ascites with urinoma resulting from an ureteropelvic junction obstruction in a neonate.
Ascites ; Humans ; Infant, Newborn ; Ureteral Obstruction ; Urinary Tract ; Urinoma

PURPOSE: It is important to diagnose paragonimiasis in early active stage because it can be dured by chemotherapy. However, it is difficult to make a correct diagnosis of cerebral paragonimiasis in the early active stage, and the radiographic findings of cerebral paragonimiasis have been rarely reported. Thus, this experimental study was designed to produce early active cerebral paragonimiasis and to demonstrate radiologic-pathologic correlations. MATERIALS AND METHODS: In 8 cats, 7-8 metacercariae of Paragonimus westerrnani were directly introduced into the brain parenchyma of each cat's after trephination of the skull. In anogher 16 cats, the juvenile worms and the adult worms that had developed for varying periods (2 weeks, 4 weeks, 6 weeks, 8 weeks and 12 weeks) in the lunges of another cats were introduced into the brain parenchyma of each cat's with the same procedures described above. Follw-up MR images and chest radiographs were obtained at 2 days, 1 weeks, 2 weeks, 4 weeks and 8 weeks after innoculation. The autopsies and histopathological examinations of the cat's brain were undertaken in 22 cats. In 9 cats that were suspected with pulmonary lesions on chest radiograph, the soft tissue radiographs of inflated-fixed lungs were obtained. RESULTS: In one cat with innoculation of adult worm, acute suppurative inflammation of the brain parenchyma was demonstrated. But the other cats with innoculction of adult worm or juvenile worm and the cats with innoulation of metacercaris did not reveal any evidence of acute cerebral paragonimiasis. More than half of the introduced metacercariae(5 out of 8 cats) were found in the lung parenchyma, while only 25%(4 out of 16 cats) of the adult worm innoculated cats were. CONCLUSION: Acute suppurative inflammation suggesting acute stage cerebral paragonimiasis was obtained in one case of adult worm innoculated cat. Most of the innoculated metacercariae and some of the juvenile worms or adult worms were migrated to the lungs.
Adult ; Animals ; Autopsy ; Brain ; Cats* ; Diagnosis ; Drug Therapy ; Humans ; Inflammation ; Lung ; Metacercariae ; Paragonimiasis* ; Paragonimus ; Radiography, Thoracic ; Skull ; Trephining

BACKGROUND: When Candida species and molds (non-dermatophytic filamentous fungi) are cultured from the onychomycotic nail samples, it is sometimes difficult to consider whether they are the causative fungi or not. Although repeated culture is the most effective method to solve the problem, it is time-consuming and not cost-effective. But KONCPA (KOH + Nail clipping + PAS stain) is an inexpensive, quick, sensitive and very useful supportive test for considering whether the cultured non-dermatophytic fungi are real causative fungi or not. OBJECTIVES: This study was aimed to know whether KONCPA test would increase the diagnostic sensitivity of onychomycosis and whether KONCPA findings would be of help to diagnose the accurate causative fungi in case where the Candida species and molds were cultured. METHODS: Nail saacmples were obtained from 213 patients with onychomycosis for fungus culture and KONCPA test. And the KONCPA findings were reviewd for the onychomycotic nail samples where the non-dermatophytic fugi such as Candida species and molds were cultured. RESULTS: The results of this study were summarized as follows: 1. From 93 onychomycotic nail samples, dermatophytes were cultured in 24 (11.3%), Candida spp. in 36 (16.9%), and molds in 33 samples (15.5%). 2. Of the 36 samples where the Candida spp. were cultured, 24 (66.7%) showed findings of dermatophytes, 2 (5.6%) of Candida spp. and remaining 10 (27.7%) samples were inadequate for diagnosis. 3. Of 33 samples where the molds were cultured, 30 (90.9%) showed findings of dermatophytes, 1 (3.0%) of molds and remaining 2 (6.1%) samples were inadequate for diagnosis. CONCLUSIONS: Among 93 onychomycotic nail samples where the non-dermatopytic fungi were cultured, only 3 samples were compatible with KONCPA findings. Therefore, in cases where Candida spp. and molds were cultured and the KONCPA findings were not compatible with the cultured fungi, the cultured fungi should not be considered as the definite causative fungi until other material evidence was obtained.
Arthrodermataceae ; Candida ; Fungi ; Humans ; Nails ; Onychomycosis

Limb-body wall complex, also known as the short umbilical cord syndrome or the body stalk anomaly, is a poorly defined, sporadic group of congenital anomaly characterized by a collection of protean fetal malformation, deformation and disruption. Accurate diagnosis is often difficult because of its variable presentation pattern and the absence of exactly same case. Ultrasonographic detection of abdominoschisis, scoliosis, abnormalities of the lower extremities, a single umbilical artery and a short umbilical cord is important for the prenatal diagnosis. This complex should be distinguished from other body wall defects including omphalocele and gastroschisis since the prognosis for limb-body wall complex is uniformly poor. We experienced a case of limb-body wall complex in a fetus of intrauterine pregnancy at 15 weeks who was terminated because of ultrasonographic demonstration of a large abdominal defect with eventration of abdominal organs, short umbilical cord and kyphoscoliosis. Thus, we report a case with brief review of the literatures.
Diagnosis ; Fetus ; Gastroschisis ; Hernia, Umbilical ; Lower Extremity ; Pregnancy ; Prenatal Diagnosis ; Prognosis ; Scoliosis ; Single Umbilical Artery ; Ultrasonography, Prenatal* ; Umbilical Cord

PURPOSE: The purpose of this study was to evaluate the clinical results of intraoperative periarticular injection for osteoarthritic patients who are treated with total knee arthroplasty (TKA). MATERIALS AND METHODS: Forty patients (2 males and 38 females) who underwent TKA under general anesthesia from January 2007 to May 2007 were enrolled in this study. We classified 20 cases to the injection group and 20 cases to the control group. For the injection group, we injected ropivacaine 40 mg, ketolocac tromethamine 2 mg, epinephrine 0.5 cc and morphine 0.8 cc to the periarticular soft tissue before inserting the prosthesis, and the same amount of saline was injected in the control group. We assessed the clinical results according to preoperative and postoperative range of motion (ROM), the visual analogue scale (VAS), and the dosage of the patient controlled anesthesia (PCA) in both groups. RESULTS: There was no significant difference in preoperative ROM and VAS between the groups (p>0.05). However, significant differences between the groups were reported for the postoperative ROM at 6 and 12 hour. In terms of the VAS, it showed significant differences between the groups at 6 and 12 hours and at the first and second days after operation. The dosage of PCA was significantly lower at postoperative 6 and 12 hours. CONCLUSION: For the patients treated with TKA, periarticular injection to the operation site is supposed to be an effective method at the early stage for recovery of the ROM, the postoperative pain control and to decrease of the PCA dosage.
Amides ; Anesthesia ; Anesthesia, General ; Arthroplasty ; Epinephrine ; Humans ; Knee ; Male ; Morphine ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Prostheses and Implants ; Range of Motion, Articular ; Tromethamine