Among the complications of Clostridium difficile (C. difficile) infection, rectal prolapse has been very rarely reported in children. We report a 29-month-old girl who presented with rectal prolapse complicated with C. difficile-associated pseudomembranous colitis following 3-week course of oral amoxicillin/clavulanic acid for treatment of acute otitis media. The patient complained of fever, abdominal pain and mucoid bloody diarrhea. She also showed a protruded and everted rectal mucosa with discrete white-yellowish exudative plaques. Abdominal CT scan revealed a diffuse wall thickening with mucosal enhancement of the rectosigmoid colon. Both stool culture and toxin assay for C. difficile were positive. Her symptoms were completely improved with oral metronidazole treatment. C. diffile-associated pseudomembranous colitis should be considered as a rare but possible cause of rectal prolapse in children who have recently received antibiotic therapy.
Abdominal Pain ; Child* ; Child, Preschool ; Clostridium difficile ; Colon ; Diarrhea ; Enterocolitis, Pseudomembranous* ; Female ; Fever ; Humans ; Metronidazole ; Mucous Membrane ; Otitis Media ; Rectal Prolapse* ; Tomography, X-Ray Computed

The syndrome of postural headache associated with low CSF pressure usually occurs after a dural puncture, myelography, or spinal anesthesia. However, it can also develop spontaneously or after minor trauma. Although the clinical and MRI findings of this syndrome are well described, radionuclide cisterno-graphic findings have not yet been clearly characterized. We report four patients presenting with postural headache associated with very low or unmeasurable CSF pressure. Three patients developed after minor trauma, while one developed spontaneously. Brain MRI revealed symmetric pachymeningeal enhancement in all four patients. Radionuclide cisternography demonstrated delayed migration of tracer to the cerebral convexity at 6 and 24 hours in three patients, and early soft tissue uptake suggestive of CSF leakage in one. We suggest that these radionuclide cisternographic findings are supportive evidences for the presence of intracranial hypotension and may provide useful information for appropriate treatment.
Anesthesia, Spinal ; Brain ; Headache ; Humans ; Intracranial Hypotension* ; Magnetic Resonance Imaging ; Myelography ; Punctures

This study's purpose was to compare the treatment efficacy and the effects on the patients' quality of life of the pelvic floor muscle (PFM) exercise and the functional electrical stimulation (FES)-biofeedback method. Ninety female incontinence patients were randomly selected and evenly divided into three groups: control, intensive PFM exercise, and FES-biofeedback groups. They were treated for 6 weeks. The subjective changes in the severity of incontinence and discomfort in daily and social life were measured using a translated version of Jackson's Bristol female urinary symptom questionnaire. Objective changes of pelvic muscle contraction force were measured by perineometer. Pre and post-treatment maximal pelvic floor muscle contractile pressure (PMC pressure) among the three groups showed statistically significant differences (p < 0.001). Especially the FES-biofeedback group showed significantly increased maximal PMC pressure compared with other groups (p < 0.001). From the questionnaire, pre and post-treatment changes in the severity of urinary incontinence and discomfort due to incontinence showed significant differences among the three groups (p < 0.001). The level of discomfort in daily life, social activity, physical activity, personal relations and discomfort due to urinary symptoms had largely changed and the FES-biofeedback group, in particular, showed a significant decrease after treatment. In conclusion, when PFM exercise and FES-biofeedback were compared in terms of their effects on the patients' quality of life, FES-biofeedback proved to be more effective than verbal explanation or simple PFM exercise.
Adolescence ; Adult ; Aged ; Electric Stimulation ; Exercise* ; Female ; Human ; Middle Age ; Pelvis/physiology* ; Prospective Studies ; Quality of Life* ; Urinary Incontinence, Stress/prevention & control*

We undertook this work to compare the treatment efficacies and the changes of quality of life after pelvic floor muscle (PFM) exercise and the functional electrical stimulation (FES)-biofeedback treatment, both of which are being widely used as conservative treatment methods for female urinary incontinence. We randomly selected 60 female incontinence patients who visited our department and divided them evenly into two groups. They were treated for a period of 6 weeks. The subjective changes in the severity of incontinence and discomfort in daily and social life were measured using a translated version of the questionnaire by Jackson. Objective changes of pelvic muscle contraction force were measured using a perineometer. Pre- and post-treatment maximal pelvic floor muscle contractile (PMC) pressure and changes in the severity of urinary incontinence and discomfort of the two groups showed statistically significant differences (p>0.001). In particular the FES-biofeedback group showed significantly increased maximal PMC pressure and a decreased severity of urinary incontinence and discomfort compared to the intensive PFM exercise group (p>0.001). In conclusion, FES-biofeedback proved more effective than simple PFM exercise.
Activities of Daily Living ; Biofeedback (Psychology)* ; Exercise Therapy*/methods ; Female ; Human ; Muscle Contraction ; Muscles ; Pelvic Floor ; Treatment Outcome ; Urinary Incontinence, Stress/therapy* ; Urinary Incontinence, Stress/psychology ; Urinary Incontinence, Stress/prevention & control ; Urinary Incontinence, Stress/physiopathology

We undertook this work to compare the treatment efficacies and the changes of quality of life after pelvic floor muscle (PFM) exercise and the functional electrical stimulation (FES)-biofeedback treatment, both of which are being widely used as conservative treatment methods for female urinary incontinence. We randomly selected 60 female incontinence patients who visited our department and divided them evenly into two groups. They were treated for a period of 6 weeks. The subjective changes in the severity of incontinence and discomfort in daily and social life were measured using a translated version of the questionnaire by Jackson. Objective changes of pelvic muscle contraction force were measured using a perineometer. Pre- and post-treatment maximal pelvic floor muscle contractile (PMC) pressure and changes in the severity of urinary incontinence and discomfort of the two groups showed statistically significant differences (p>0.001). In particular the FES-biofeedback group showed significantly increased maximal PMC pressure and a decreased severity of urinary incontinence and discomfort compared to the intensive PFM exercise group (p>0.001). In conclusion, FES-biofeedback proved more effective than simple PFM exercise.
Activities of Daily Living ; Biofeedback (Psychology)* ; Exercise Therapy*/methods ; Female ; Human ; Muscle Contraction ; Muscles ; Pelvic Floor ; Treatment Outcome ; Urinary Incontinence, Stress/therapy* ; Urinary Incontinence, Stress/psychology ; Urinary Incontinence, Stress/prevention & control ; Urinary Incontinence, Stress/physiopathology

Chylous ascites in neonates is an unusual and etiologically poor understood entity. We report a male newborn who suffered from abdominal distension and respiratory distress after birth. Paracentesis was performed and ascitic fluid was obstained. Analysis of the fluid revealed cell count (RBC 10,000/mm3, WBC 800/mm3: segmented form-72%, lymphocyte form- 28%), protein 4,100 mg/dl, glucose 57 mg/dl, cholesterol 53 mg/dl, triglyceride 28 mg/dl. Culture of ascitic fluid grew no bacteria. A plain film of abdomen and abdominal sonogram showed massive ascites. On the 4th hospital day, gastrografin enema showed microcolon and ileal atresia. On the 6th hospital day, ileocolostomy has been performed and operative findings sho- wed blind pouch in terminal ileum, massive inflammation and extensive adhesion on peritoneum. After operation, he gained weight by continuous gavage feeding. He discharged on the 36th hospital day.
Abdomen ; Ascites ; Ascitic Fluid ; Bacteria ; Cell Count ; Cholesterol ; Chylous Ascites* ; Diatrizoate Meglumine ; Enema ; Glucose ; Humans ; Ileum ; Infant, Newborn ; Inflammation ; Lymphocytes ; Male ; Paracentesis ; Parturition ; Peritoneum ; Triglycerides

No abstract available.
Carcinoma, Squamous Cell*

Primary cervical neuroblastoma is very rare disease in neonates and should be distinguished with other diseases, which cause stridor in neonate, including laryngomalacia, vocal cord paralysis, laryngeal web, laryngotracheal esophageal cleft, laryngotracheal stenosis, etc. It is characterized by cough, stridor, dysphagia, neck mass, Horner syndrome and heterochromia iridis. Survival rate is high even in the advanced cases, in which the residual mass is remained after partial resection, without further therapy. A 1-day-old girl showed severe dyspnea with inspiratory stridor after birth. At first, she was misdiagnosed as a case of laryngomalacia, but later proved to have stage I primary neuroblastoma by plain X-ray film of lateral view of the neck, flexible nasolaryngoscopy, and computerized tomography. She has been well without relapse after total resection for 1 (1/2) year. We report this case as the first case in Korea.
Constriction, Pathologic ; Cough ; Deglutition Disorders ; Dyspnea ; Female ; Horner Syndrome ; Humans ; Infant, Newborn ; Korea ; Laryngomalacia ; Neck ; Neuroblastoma* ; Parturition ; Rare Diseases ; Recurrence ; Respiratory Sounds* ; Survival Rate ; Vocal Cord Paralysis ; X-Ray Film

We analyzed 320 clinical samples of parasitic infections submitted to the Department of Environmental Biology and Medical Parasitology, Hanyang University from January 2004 to June 2011. They consisted of 211 nematode infections, 64 trematode or cestode infections, 32 protozoan infections, and 13 infections with arthropods. The nematode infections included 67 cases of trichuriasis, 62 of anisakiasis (Anisakis sp. and Pseudoterranova decipiens), 40 of enterobiasis, and 24 of ascariasis, as well as other infections including strongyloidiasis, thelaziasis, loiasis, and hookworm infecions. Among the cestode or trematode infections, we observed 27 cases of diphyllobothriasis, 14 of sparganosis, 9 of clonorchiasis, and 5 of paragonimiasis together with a few cases of taeniasis saginata, cysticercosis cellulosae, hymenolepiasis, and echinostomiasis. The protozoan infections included 14 cases of malaria, 4 of cryptosporidiosis, and 3 of trichomoniasis, in addition to infections with Entamoeba histolytica, Entamoeba dispar, Entamoeba coli, Endolimax nana, Giardia lamblia, and Toxoplasma gondii. Among the arthropods, we detected 6 cases of Ixodes sp., 5 of Phthirus pubis, 1 of Sarcoptes scabiei, and 1 of fly larva. The results revealed that trichuriasis, anisakiasis, enterobiasis, and diphyllobothriasis were the most frequently found parasitosis among the clinical samples.
Animals ; Arthropods/*pathogenicity ; Cestode Infections/*epidemiology ; Humans ; Intestinal Diseases, Parasitic/epidemiology ; Malaria/epidemiology ; Nematode Infections/*epidemiology ; Protozoan Infections/*epidemiology ; Republic of Korea/epidemiology ; Trematode Infections/*epidemiology

BACKGROUND: The pathological features in asthmatic airway remodeling are diverse. The aim of this study was to examine the degree of airway vascularity in relation to the other remodeling parameters in asthmatics. METHODS: Bronchial biopsies were done in 34 asthmatic patients, and 6 control subjects. The basement membrane thickness and the subepithelial thickness were measured in the hematoxylin-eosin stained tissue, and the degree of vascularity was measured using type IV collagen immunostaining. RESULTS: 1) Compared to the control subjects, the asthmatics showed a significant increase in the basement membrane thickness (6.92+/-2.01micrometer vs 9.67+/-2.84micrometer, p<0.05) and the subepithelial thickness (44.49 +/- 31.92micrometer vs 121.22+/-72.79micrometer, p<0.05). 2) Compared to the control subjects, the asthmatics showed a significant increase in the vascular area per unit submucosal area (4.51+/-2.13% vs 10.32+/-6.08%, p<0.05). In addition, the number of vessels per unit submucosal area showed an increased tendency without statistical significance. 3) In the asthmatics, the number of vessels and the vascular area per unit submucosal area showed no correlation with the basement membrane thickness, the subepithelial thickness, the severity, the forced expiratory volume in 1 second(FEV1), and the methacholine provocative concentration 20(PC20). CONCLUSION: This study showed that vascularity was an important parameter in asthmatic airway remodeling but it was not related to the other remodeling parameters such as the basement membrane thickness and the subepithelial thickness. Each of these asthmatic remodeling parameters may have a different clinical significance. Therefore, further studies will be needed.
Airway Remodeling ; Asthma ; Basement Membrane ; Biopsy ; Collagen Type IV ; Forced Expiratory Volume ; Humans ; Methacholine Chloride