Intussusception is the most common cause of acquired intestinal obstructions during infancy and early childhood. Barium reduction and pneumoreduction have been sued widely as nonsugical method of treatment in radiologic department. In the past, attempts at barium reduction of intussusception were contraindicated in the presence of frank intestinal obstruction, shock, fever, dehydration, bowel perforation, peritonitis and longstanding symptoms. At present, however, there is no agreement on the contraindications, except for shock, peritonitis and bowel perforation. Especially, there is no consensus regarding its application on patient presenting with sign of frank intestinal obstruction. The authors analyzed the effect of pneumoreduction in the intussusception with sign of frank intestinal obstruction. Pneumoreduction was attempted in 53 cases of intussusception with sign of frank intestinal obstruction. Reduction was successful in 43 cases(81%). The mean fluroscopic time was 15.1 minutes and mean maximal pressure was 121.8mmHg in successful reduction. As complications, two cases of bowel perforation were observed, but could be treated surgically without any significant problem. In conclusion, pneumoreduction is a useful substitute for barium reduction in the management of pediatric intussusception with sign of frank intestinal obstruction.
Barium ; Consensus ; Dehydration ; Fever ; Humans ; Intestinal Obstruction* ; Intussusception* ; Methods ; Peritonitis ; Shock

There have been several reports of more than one type of porokeratosis occurring in the same family or the same individual. We hope to support the view of different phenotypic expressions of a common genetic aberration by describing an additional case of porokeratosis of Mibelli on the perianal area and DSAP on the face, forearms occurring in a 45-year-old man.
Actins* ; Forearm ; Hope ; Humans ; Middle Aged ; Porokeratosis*

Scrub typhus (Tsutsugamushi disease)is an acute febrile systemic illness caused by Rickettsia tsutsugamushi that is transmitted to humans by the bite of larval-stage trombiculid mites (chiggers). The authors analyzed chest radiographic findings of scrub typhus in 160 patients in Ulsan area. One hundred and eight (67.5%) of160 patients showed abnormal findings which included lung lesions in 108 patients (67.5%), cardiomegaly in 37 patients (23.1%), lymphadenopathy in 25 patients (15.6%) and pleural effusion in 11 patients (6.9%). Among the lung lesions, interstitial patterns were seen in 107 patients (66.9%), mostly fine or medium reticulonodular, and air-space patterns in 14 patients(8.8%) and combined interstitial and air-space patterns in 13 patients (8.1%). Sixty-four patients(40%) had combined chest radiographic findings. The typical chest radiographic findings of scrub typhus would be helpful in evaluation of the causes of acute febrile illness that occur during late fall in the endemic area.
Cardiomegaly ; Humans ; Lung ; Lymphatic Diseases ; Orientia tsutsugamushi ; Pleural Effusion ; Radiography, Thoracic* ; Scrub Typhus* ; Thorax* ; Trombiculidae ; Ulsan*

PURPOSE: To clarify the chracteristic sonographic features of benign soft tissue tumors and to evaluate the usefulness of sonographic imaging. MATERIALS AND METHODS: We retrospectively reviewed ultrasonographic images of 70 cases in 68 patients with histologically proved benign soft tissue tumors. RESULTS: The tumors included 33 lipomas, 11 hemangiomas. 11 lymphangiomas, 7 neurilemmomas, 4 epidermold cysts, 2 fibromas, 1 mesenchymoma, and 1 myxoma. The SOhographic appearances of the lesions were mainly solid in 53 cases(33 lipomas, 8 hemangiomas, 2 lymphangiomas, 7 neurilemmomas, 2 fibromas and 1 mesenchymoma), mainly cystic in 14 cases(1 hemangioma, 8 lymphangiomas, 4 epidermoid cysts, and 1 myxoma), and mixed in 3 cases(2 hemangiomas and 1 lymphangioma). Although an accurate histologic prediction could not be made in most cases, certain patterns appeared to be characteristic of specific tumor types. 26 cases(78%) of lipoma were seen as lentiform, iso- or hyperechoic, solid mass. Hemangioma had variable appearance and chacteristic calcifications were seen in 3 cases. Unicameral or multiseptated cystic mass with variable thickness of echogenic septa and solid portion was the characteristic finding of lymphangioma. Neurilemmoma showed Iobulated, oval to round, relatively hypoechoic mass with or without internal cystic portion. CONCLUSION: Sonographic evaluation of benign soft tissue tumros is useful in demonstrating the location, size, extent, and internal characteristics of the mass. A relatively confident diagnosis can be made when the characteristic features of the benign soft tissue tumor are present on sonographic imaging.
Diagnosis ; Epidermal Cyst ; Fibroma ; Hemangioma ; Humans ; Lipoma ; Lymphangioma ; Mesenchymoma ; Myxoma ; Neurilemmoma ; Retrospective Studies ; Ultrasonography

Inflammatory pseudotumors are tumor-like, benign lesions of uncertain pathogenesis and have most commonly been reported in the lungs. They occur rarely in the gastrointestinal tract and may cause small bowel obstruction due to intussusception or, less commonly, as an incidental finding on radiologic examination or screening endoscopy. We present a case of surgically proven jejunal intussusception caused by inflammatory pseudotumor.
Endoscopy ; Gastrointestinal Tract ; Granuloma, Plasma Cell* ; Incidental Findings ; Intussusception* ; Jejunum* ; Lung ; Mass Screening

Neutrophilic eccrine hidradenitis(NEH) is a self-limited inflammatory dermatosis primarily induced by chemotherapeutic agents. The pathogenesis and possible cause of NEH remain unknown. NEH may represent as a reaction pattern to chemotherapeutic agents or bacterial infection. Also it is developed on palmoplantar areas in healthy children or young adults. In some cases it is developed as a paraneoplastic phenomenon. We report a case of neutrophilic eccrine hidradenitis that developed in a patient suffering from aplastic anemia after or during treatment with cyclosporine, oxymetholone and folic acid.
Anemia, Aplastic ; Bacterial Infections ; Child ; Cyclosporine ; Folic Acid ; Hidradenitis* ; Humans ; Neutrophils* ; Oxymetholone ; Skin Diseases ; Young Adult

PURPOSE: We aimed to evaluate effect on maximum knee flexion by patellofemoral overstuffing after total knee arth- roplasty MATERIALS AND METHODS: As a prospective inspection we have measured anterior hump height of distal femur in the preoperative true lateral radiographic view in those who had taken total knee arthroplasty with Genesis II which is external rotation laden prosthesis allowing to be inserted parallel to femoral anterior cortex. We compared the thickness of anterior hump height resected during operation and thickness of anterior flange of femoral prosthesis and then considered post operative thickness of patella to estimate the effect of patellofemoral overstuffing in 55 cases comparing maximum knee flexion. RESULTS: The average thickness of resected femoral anterior hump was 7.14+/-1.91mm. Average in hump overstuffing was 1.32+/-1.09mm and postoperative maximum flexion angle was average of 125.6+/-15.5 degree with average decrease of 1.8 degree. In 29 cases, Average of 1.35mm of overstuffing occurred in patella overstuffing and postoperative maximum flexion angle was average of 131.0+/-16.4 degree with average increase of 2.1 degree. Considering change of anterior femoral hump height and thickness of patella, preoperative and postoperative average maximum flexion angle was 128.9+/-14.9, 128.0+/-14.5 degree, repectively in patellofemoral overstuffing with average decrease of 0.9 degree. CONCLUSION: We concluded that the patellofemoral overstuffing does affect the decrease of the angle of maximum flexion in total knee arthroplasty and the effect of hump overstuffing is superior than patellar overstuffing effect.
Arthroplasty* ; Femur ; Knee* ; Patella ; Prospective Studies ; Prostheses and Implants

Bullous pemphigoid (BP) is a chronic, autoimmune blistering disease that has concerning morbidity and mortality rates. Recently, several studies have focused on eosinophils due to their significant role in the pathogenesis of BP, considering that they are ubiquitous in the serum, tissue, and blister fluids of patients with BP. With this context, precision therapy that targets mediators of eosinophil activity could be a possible novel therapeutic strategy.Interleukin (IL)-5 is crucial for B-cell maturation, which consequently results in immunoglobulin production, and promotes eosinophil differentiation, proliferation, and activation. To our best knowledge, reslizumab has not yet been reported to treat BP. Herein, we report a case of steroid- and omalizumab-resistant BP treated successfully using reslizumab. Our data suggest that IL-5 could be a novel specific biologic target within the entire immunopathogenesis of BP, and reslizumab would be a novel therapeutic modality.

Migraine is a disabling headache that can occur with or without aura. We present here a case of migraine that was effectively managed by a series of cervical epidural blocks. A 41-year-old woman who had suffered from severe headache on her left temporal area for 12 years visited our pain clinic. Her 11-point numeric pain rating scale was 10 out of 10 at the first visit and the symptoms were associated with homonymous visual disturbances, paresthesia on the left face, shoulder and arm, and general weakness. For the first 5 years after the headaches began, her headache was relatively well controlled by acetaminophen; after then, the acetaminophen wasn't effective. After wandering from this hospital to the next one in search of relief, she managed to visit our pain clinic. We tried several blocks including cervical epidural block, and she was continuously medicated with sumatriptan. Her headache was gradually relieved. Now, her 11-point numeric rating scale is 1-2 out of 10 at the most during her headache attacks.
Acetaminophen ; Adult ; Arm ; Epilepsy ; Female ; Headache ; Humans ; Migraine Disorders* ; Pain Clinics ; Paresthesia ; Shoulder ; Sumatriptan

Purpose: The purpose of this study was to compare the concurrent validity and test-retest reliability of ‘KPIMT Torticollis Protractor’, a smart phone and I-pad application for convenient range of motion measurement, and ‘Image J’, an analysis software with high reliability and validity, according to head tilt and active cervical rotation angle. This was done to determine the clinical utility of ‘KPIMT Torticollis Protractor’. Methods: Head tilt and active cervical spine rotation angles of 40 children with congenital muscular torticollis were measured using Image J and KPIMT Torticollis Protractor, respectively. The level of concurrent validity and inter-rater and intra-rater reliability between the two measurement methods were analyzed. Results: For forty participants, the concurrent validity between Image J and KPIMT Torticollis Protractor showed very high validity with ICC of ICC 0.977 (0.995-0.999), 0.994 (0.994-0.998), CVME% 0.71-0.72%, SEM% 0.31-0.34%, MDC% 0.86-0.94%. The test-retest intra-rater reliability showed very high reliability ICC 0.911 (0.911-0.966), CVME% 0.71%, SEM% 0.34-0.36%, MDC% 0.81-0.94%. The test-retest inter-rater showed very high reliability ICC 0.936 (0.933-0.957), CVME% 0.70%, SEM% 0.34-0.35%, MDC% 0.81-0.83%. Conclusion The KPIMT Torticollis Protractor, a smart phone and IPD application, is a highly reliable and valid device for angle measurement in children with congenital myotonia and can be easily used in clinical practice.