Tethered cord syndrome is one of the spinal dysraphism with low-lying conus medullaris frequently associated with spinal lipoma, diastematomyelia and thick filum. The clinical manifestation is variable from no overt symptoms for a long time to back pain, scoliosis, progressive neurological deficit of legs and incontinence. Therefore the diagnosis requires a strong clinical suspicion and aggressive investigation. We experienced a case of 1 day-old male infant who was presented with small soft mass on sacral area. Spinal ultrasonography and spine MRI revealed tethered cord associated with intradural lipoma. We reported a case of tethered cord syndrome with brief review of literatures.
Back Pain ; Conus Snail ; Diagnosis ; Humans ; Infant ; Leg ; Lipoma ; Magnetic Resonance Imaging ; Male ; Neural Tube Defects* ; Scoliosis ; Spinal Dysraphism ; Spine ; Ultrasonography

No abstract available.
Microsporum ; Tinea Capitis

The management of severe recalcitrant atopic dermatitis (AD) is a challenging issue for clinicians and patients. We hypothesized that repeated intramuscular injections of autologous immunoglobulin (autologous immunoglobulin therapy: AIGT) might induce clinical improvements in patients with AD by stimulation of the active immune response to antigen-binding-site of pathogenic antibodies. We tried AIGT in 3 adult patients with severe recalcitrant AD whose clinical conditions could not be effectively controlled by medical treatments (including oral cyclosporine) for more than 2 years. Autologous immunoglobulin was purified from the autologous plasma by affinity chromatography using Protein A. The patients were treated by an intramuscular injection of 50 mg of autologous immunoglobulin twice a week for 4 weeks. A clinical severity score of AD (SCORAD value) showed a decrease greater than 30% at 8 weeks after the initiation of AIGT compared with the baseline before the initiation of AIGT in all 3 patients with severe recalcitrant AD. No significant side effects from treatment were observed. Further studies with larger numbers of patients are required to evaluate the clinical usefulness of AIGT for AD.
Adult ; Antibodies ; Chromatography, Affinity ; Dermatitis ; Dermatitis, Atopic* ; Humans ; Immunity, Active ; Immunization, Passive* ; Immunoglobulins* ; Injections, Intramuscular ; Plasma ; Staphylococcal Protein A

PURPOSE: There are compelling evidences that house dust mites are important in the pathogenesis of atopic dermatitis. Recently, detection of house dust mite allergens from clothing, skin, and dust from human hair has been reported. To evaluate the importance of house dust mite exposure in the clinical severity of atopic dermatitis. METHODS: We measured house dust mite allergens (Der f1 from Dermatophagoides farinae and Der p1 from D. pteronyssinus) in scalp dander from 27 children with atopic dermatitis and 41 children with asthma only by enzyme-linked immunosorbent assay and examined correlation between house dust mite allergen concentrations in scalp dander and clinical severity of atopic dermatitis in children. RESULTS: Der f1 was detectable in scalp dander samples of 32 patients (47%) from overall 68 patient and Der p1 was detectable in 33 patients (49%). House dust mite allergens (Der f1 or Der p1) were detectable in scalp dander samples of 46 patients (70%) from overall 68 patient. There was no significant differences in house dust mite allergen levels between atopic dermatitis patients and patients with asthma only. There was a tendency of inverse correlation between frequency of scalp washing and concentration of Der f1 in scalp dander extract (r=-0.24, P=0.052). There was a significant correlation between severity grade of atopic dermatitis and concentration of Der f1 in scalp dander (r=0.39, P<0.05) in 27 children with atopic dermatitis. However, there was no significant correlation between severity grade of atopic dermatitis and concentration of Der p1 in scalp dander (r=-0.05, P>0.05). CONCLUSION: There was a significant correlation between house dust mite allergen concentrations in scalp dander and clinical severity in children with atopic dermatitis. And these results suggest that exposure to house dust mite allergen is important in the pathogenesis of atopic dermatitis.
Allergens ; Asthma ; Child* ; Clothing ; Dander* ; Dermatitis, Atopic* ; Dermatophagoides farinae ; Dust* ; Enzyme-Linked Immunosorbent Assay ; Hair ; Humans ; Pyroglyphidae* ; Scalp* ; Skin

No abstract available.
Adult* ; Fistula* ; Humans

Human toxocariasis is a zoonotic parasitic disease caused by Toxocara canis or Toxocara cati larvae. Human infection is usually an outcome of accidental ingestion of the embryonated eggs, and the involvement of central nervous system is rare. We report a case of cerebral infarction which was caused by toxocariasis in adult, who had headache, abdominal pain and right side weakness. He had only a history of ingestion of raw liver of deer.
Abdominal Pain ; Adult ; Central Nervous System ; Cerebral Infarction* ; Deer ; Eating ; Eggs ; Headache ; Humans ; Larva ; Liver ; Ovum ; Parasitic Diseases ; Toxocara ; Toxocara canis ; Toxocariasis*

Cesarean scar pregnancy is one of the rarest forms of ectopic pregnancy. Little is known about its incidence and natural history. With increasing incidence of caesarean section worldwide, more and more cases are diagnosed and reported. Transvaginal ultrasound and colour flow Doppler provides a high diagnostic accuracy with very few false positives. A delay in diagnosis and/or treatment can lead to uterine rupture, major haemorrhage, hysterectomy and serious maternal morbidity. Surgical management can be safe and effective and medical treatment can be selected as appropriate selection criteria. Patients with history of a pregnancy in a cesarean delivery scar should be advised of the risk for future uterine rupture and placenta accreta. We experienced a case of ectopic pregnancy with treatment of surgical excision and report with a brief review of literatures.
Cesarean Section ; Cicatrix* ; Diagnosis ; Female ; Humans ; Hysterectomy ; Incidence ; Natural History ; Patient Selection ; Placenta Accreta ; Pregnancy ; Pregnancy, Ectopic* ; Ultrasonography ; Uterine Rupture

PURPOSE: This study was to evaluate the effect of the solution temperature on the mechanical properties of dualcure resin cements. MATERIALS AND METHODS: For the study, five dual-cure resin cements were chosen and light cured. To evaluate the effect of temperature on the specimens, the light-cured specimens were immersed in deionized water at three different temperatures (4, 37 and 60degrees C) for 7 days. The control specimens were aged in a 37degrees C dry and dark chamber for 24 hours. The mechanical properties of the light-cured specimens were evaluated using the Vickers hardness test, three-point bending test, and compression test, respectively. Both flexural and compressive properties were evaluated using a universal testing machine. The data were analyzed using a two way ANOVA with Tukey test to perform multiple comparisons (alpha=0.05). RESULTS: After immersion, the specimens showed significantly different microhardness, flexural, and compressive properties compared to the control case regardless of solution temperatures. Depending on the resin brand, the microhardness difference between the top and bottom surfaces ranged approximately 3.3-12.2%. Among the specimens, BisCem and Calibra showed the highest and lowest decrease of flexural strength, respectively. Also, Calibra and Multilink Automix showed the highest and lowest decrease of compressive strength, respectively compared to the control case. CONCLUSION: The examined dual-cure resin cements had compatible flexural and compressive properties with most methacrylate-based composite resins and the underlying dentin regardless of solution temperature. However, the effect of the solution temperature on the mechanical properties was not consistent and depended more on the resin brand.
Aged ; Androsterone ; Collodion ; Composite Resins ; Compressive Strength ; Dentin ; Hardness Tests ; Humans ; Immersion ; Light ; Resin Cements ; Water

Purpose: Trocar-site burns occurring during laparoscopic surgery have been reported in various cases, and several efforts to reduce them are underway. This study aimed to analyze the effect of capacitive coupling on trocar site by observing electrical and histological changes for electrical skin burn injury. Methods: To measure the electrical changes relating to capacitive coupling, the temperature, current, voltage, and impedance around the trocar were measured when an open circuit and a closed circuit were formed using insulation intact instruments and repeated after insulation failure. After the experiment, the tissue around the trocar was collected, and microscopic examination was performed. Results: When open circuits were formed with the intact insulation, the impedance was significantly reduced compared to the cases of closed circuits (142.0 Ω vs. 109.3 Ω, p = 0.040). When the power was 30 W and there was insulation failure, no significant difference was measured between the open circuit and the closed circuit (147.7 Ω vs. 130.7 Ω, p = 0.103). Collagen hyalinization, nuclear fragmentation, and coagulation necrosis suggesting burns were observed in the skin biopsy at the trocar insertion site. Conclusion This study demonstrated that even with a plastic trocar and electrosurgical instruments that have intact insulation, if an open circuit is formed, capacitive coupling increases, and trocar-site burn can occur. When using electrocautery, careful manipulation must be taken to avoid creating an open circuit to prevent capacitive coupling related to electrical skin burn.

Mantle cell lymphoma is relatively rare and generally difficult to differentiate from other types of lymphoma. The clinical course is very aggressive. We recently experienced a very rare patient with pleural mantle cell lymphoma associated with pleural tuberculosis. A 60-year-old female patient was admitted because of dyspnea. Chest films revealed pleural effusion. Analysis of pleural effusion was not diagnostic, but we started therapeutic trial for tuberculosis. After 2 months of anti-tuberculosis medication, the pleural effusion was not improved. We repeated pleural biopsy. Histologic finding was chronic inflammation but AFB culture was positive. After another 3 months of medications for tuberculosis, there was no improvement. We repeated pleural biopsy and thoracentesis. Repeated biopsy and the result of flow cytometry of pleural effusion were consistent with mantle cell lymphoma. We started chemotherapy for lymphoma. After three cycles of chemotherapy, pleural effusion was decreased, but she worsened and died of hepatic failure probably due to viral hepatitis.
Biopsy ; Drug Therapy ; Dyspnea ; Female ; Flow Cytometry ; Hepatitis ; Humans ; Inflammation ; Liver Failure ; Lymphoma ; Lymphoma, Mantle-Cell* ; Middle Aged ; Pleural Effusion ; Pleurisy ; Thorax ; Tuberculosis ; Tuberculosis, Pleural*