Anti-myelin oligodendrocyte glycoprotein (anti-MOG) syndrome is an immunemediated inflammatory condition of the central nervous system, which usually involves spinal cord and optic nerves. Herein, we studied the case of a 57-yearold female patient who presented with acute/subacute symptoms of sphincter dysfunction, paraparesis, and ocular pain. The patient was diagnosed with anti-MOG syndrome with findings resembling snake-eye appearance (SEA), characterized by nearly symmetrical round high signal intensity lesions located at anterior horns (gray matter) on T2-weighted image.

Purpose: To evaluate the MRI findings and clinical factors that are characteristic of patients who ultimately undergo surgery for medial epicondylitis. Materials and Methods: Fifty-two consecutive patients who were diagnosed with medial epicondylitis and underwent an elbow MRI between March 2010 and December 2018 were included in this retrospective study. The patients’ demographic information, clinical data, and MRI findings were evaluated. All variables were compared between the conservative treatment and surgical treatment groups. Logistic regression analyses were conducted to identify which factors were associated with surgical treatment. Results: Common flexor tear (CFT) tear size showed a statistically significant difference in both the transverse and longitudinal planes (p < 0.001, p = 0.013). The CFT abnormality grade significantly differed in both the transverse and longitudinal planes (p = 0.022, p = 0.003). A significant difference was also found in the medial collateral ligament abnormality (p = 0.025). Logistic regression analyses showed that only the transverse diameter of the CFT tear size (odds ratio:1.864; 95% confidence interval: 1.264–2.750) was correlated with surgical treatment. Conclusion Of patients diagnosed with medial epicondylitis, patients with a larger transverse CFT tear size tend to undergo surgical treatment ultimately.

Purpose: To evaluate the MRI findings and clinical factors that are characteristic of patients who ultimately undergo surgery for medial epicondylitis. Materials and Methods: Fifty-two consecutive patients who were diagnosed with medial epicondylitis and underwent an elbow MRI between March 2010 and December 2018 were included in this retrospective study. The patients’ demographic information, clinical data, and MRI findings were evaluated. All variables were compared between the conservative treatment and surgical treatment groups. Logistic regression analyses were conducted to identify which factors were associated with surgical treatment. Results: Common flexor tear (CFT) tear size showed a statistically significant difference in both the transverse and longitudinal planes (p < 0.001, p = 0.013). The CFT abnormality grade significantly differed in both the transverse and longitudinal planes (p = 0.022, p = 0.003). A significant difference was also found in the medial collateral ligament abnormality (p = 0.025). Logistic regression analyses showed that only the transverse diameter of the CFT tear size (odds ratio:1.864; 95% confidence interval: 1.264–2.750) was correlated with surgical treatment. Conclusion Of patients diagnosed with medial epicondylitis, patients with a larger transverse CFT tear size tend to undergo surgical treatment ultimately.

Anti-myelin oligodendrocyte glycoprotein (anti-MOG) syndrome is an immunemediated inflammatory condition of the central nervous system, which usually involves spinal cord and optic nerves. Herein, we studied the case of a 57-yearold female patient who presented with acute/subacute symptoms of sphincter dysfunction, paraparesis, and ocular pain. The patient was diagnosed with anti-MOG syndrome with findings resembling snake-eye appearance (SEA), characterized by nearly symmetrical round high signal intensity lesions located at anterior horns (gray matter) on T2-weighted image.

Sclerosing peritonitis is a rare but fatal complication of peritoneal dialysis (PD). Management of sclerosing peritonitis includes cessation of PD, total parenteral nutrition, and surgery. Recently, a few reports have indicated immunosuppression might be beneficial in sclerosing peritonitis. In these reports, all of patients had the combination therapy of steroid and immunosuppressant. A 37-year old man develped sclerosing peritonitis 3 months after switching from PD to hemodialysis because of uncontrolled peritonitis. An abdominal computed tomography (CT) scan demonstrated massive ascites with multilocuated fluid collection and extensive enhancement of the peritoneum. A peritoneal biopsy showed proliferation of fibrous collagenous tissue with infiltration of lymphocytes. We started corticosteroid for one month. A follow-up CT scan showed complete resolution with absence of peritoneum thickness and fluid collection 16 months after corticosteroid therapy. The patient currently remains free of symptoms in an outpatient hemodialysis unit. To our knowledge, this is the first case of sclerosing peritonitis successfully treated with corticosteroid therapy alone in Korea.
Adult ; Ascites ; Biopsy ; Collagen ; Follow-Up Studies ; Humans ; Immunosuppression ; Korea ; Lymphocytes ; Outpatients ; Parenteral Nutrition, Total ; Peritoneal Dialysis ; Peritoneum ; Peritonitis* ; Renal Dialysis ; Tomography, X-Ray Computed

The resistance to recombinant human erythropoietin (r-HuEPO) in patients with chronic renal failure can develop in conditions such as iron deficiency, chronic bleeding, or chronic inflammatory disease. Recently, there have been several case reports of pure red cell aplasia due to antibody production to r-HuEPO in chronic hemodialysis patients. A 59-year old female undergoing chronic hemodialysis responded well to r-HuEPO for 6 years. But, a rapidly progressive anemia was then noted which was unresponsive to maximal doses of r-HuEPO and the patient became transfusion-dependent. Bone marrow examination showed absence of red cell precursors. A detailed search for the cause of this pure red cell aplasia was unrevealing. We conclude that although very rare, pure red cell aplasia should be considered in evaluating chronic hemodialysis patients with erythropoietin-resistant anemia.
Anemia* ; Antibody Formation ; Bone Marrow Examination ; Erythropoietin ; Female ; Hemorrhage ; Humans ; Iron ; Kidney Failure, Chronic ; Middle Aged ; Red-Cell Aplasia, Pure* ; Renal Dialysis*

In 17-30% of subjects, at least one kidney is supplied by more than one artery arising from the aorta. Subjects with multiple renal arteries have been reported to suffer more frequently from hypertension, But the precise association between hypertension and multiple renal arteries was not yet defined. A 20- year old woman presented clinical manifestations of renovascular hypertension. Basal renin activity was elevated, and time-activity curves showed delayed peak time at captopril renal scan. Angiography showed multiple renal arteries with 2 right and left 3 arteries. There was neither stenosis nor inflammation. We strated angiotensin-receptor blocker, calcium channel blocker, and beta-blocker. The patient currently remains normotensive in an outpatient unit. In general, accessory renal arteries are narrower and longer than main artery. As a results, the renal segments supplied by accessory vessels might have lower levels of blood pressure than the remainder of the parenchyma, thereby increasing the renin secretion. So hypertension associated with multiple renal arteries might be involved in renin-angiotensin-aldosterone system activation.
Angiography ; Aorta ; Arteries ; Blood Pressure ; Calcium Channels ; Captopril ; Constriction, Pathologic ; Female ; Humans ; Hypertension ; Hypertension, Renovascular* ; Inflammation ; Kidney ; Outpatients ; Renal Artery* ; Renin ; Renin-Angiotensin System

PURPOSE: To compare the diagnostic accuracies of renal ultrasonography (US) and voiding cystourethrography (VCUG) for vesicoureteral reflux (VUR). MATERIALS AND METHODS: This retrospective study included infants and children (× 24 months of age) with urinary tract infections who underwent renal US and VCUG. The incidences of decreased or increased renal size, increased renal parenchymal echogenicity, ureteral dilation, ureteral wall thickening, renal pelvic dilation, pelvic wall thickening, and accentuated pelvic dilation in the prone position were compared. Grade 3 or higher VUR was classified as “high-grade.” A total of 138 patients (109 males; mean age, 3 months) were included. Multivariate logistic regression analysis was performed, and diagnostic accuracy was calculated. RESULTS: Fifty-three (38.4%) and 43 (31.2%) patients exhibited all-grade and high-grade VUR. Decreased renal size was significantly related to all-grade [odds ratio (OR): 16.6; 95% confidence interval (CI): 3.4–81.3; p = 0.001) and high-grade VUR (OR: 29.7; 95% CI: 5.7–155.3; p < 0.001). Accentuated pelvic dilation in the prone position, increased renal parenchymal echogenicity, and ureteral dilation were related to all-grade and high-grade VUR. CONCLUSION Decreased renal size showed the highest diagnostic accuracy for US-based diagnosis of all-grade and high-grade VUR. Accentuated pelvic dilation in the prone position, increased renal parenchymal echogenicity, and ureteral dilation may aid in the diagnosis of high-grade VUR.

BACKGROUND AND OBJECTIVES: The presence of leukocytosis in patients with acute myocardial infarction (AMI) has been reported to be related to the extent of MI and with the prognosis. However, whether the leukocytosis itself is a cause or result of the myocardial injury has not been determined. The relationship between the leukocyte count and the extent of myocardial injury was investigated in patients with AMI that had undergone reperfusion therapy. SUBJECTS AND METHODS: Patients with AMI that had undergone thrombolysis (n=60) or primary PCI (n=36) were included. The initial leukocyte counts were analyzed with regard to the peak and initial CK-MB levels. The relationship between leukocytosis and the time elapsed from the onset of symptoms, infarct related coronary arteries and the proximity of the lesions were also investigated. RESULTS: In both groups, the initial leukocyte count did not show a significant relationship with the initial CK-MB level or the time elapsed from symptoms onset, which could be an indication of the extent of early myocardial injury. Furthermore, no significant relationship was shown with the infarct related coronary artery or proximity of the lesion. However, a relationship was shown with the maximum CK-MB level, which could be an indication of the extent of myocardial injury following reperfusion therapy in both groups (p<0.01). CONCLUSION: This study suggests that the initial leukocyte count in patients with AMI might is an important prognostic factor that determines the extent of myocardial injury following reperfusion therapy, rather than being a simple indicator of the extent of early myocardial injury.
Coronary Vessels ; Humans ; Leukocyte Count* ; Leukocytes* ; Leukocytosis ; Myocardial Infarction* ; Myocardial Reperfusion ; Prognosis ; Reperfusion*