Eosinophilic colitis is a chronic inflammatory bowel condition of unknown etiology and a rare subtype of eosinophilic gastrointestinal diseases. It is characterized by gastrointestinal symptoms and increased eosinophil numbers in the intestinal mucosa and absence of other potential causes of gastrointestinal eosinophilia. The clinical presentation is varied and depends on the involved layer of the large intestine. There are no confirmatory laboratory tests, and the morphologic evaluation of biopsies or surgical specimens is required to confirm the diagnosis. A 65-year-old man presented with an 8 day duration of bloody diarrhea and lower abdominal pain. The patient was diagnosed with eosinophilic colitis by histopathological evaluation of biopsies and was further categorized as a nonatopic variant associated with non-IgE-mediated reaction. The patient was successfully treated with systemic corticosteroid for 2 weeks. On follow-up after 9 months, the patient remained well without relapse or new lesions.
Abdominal Pain ; Aged ; Biopsy ; Colitis ; Diarrhea ; Eosinophilia ; Eosinophils ; Follow-Up Studies ; Gastrointestinal Diseases ; Humans ; Intestinal Mucosa ; Intestine, Large ; Recurrence

OBJECTIVE: To evaluate the influences of age and height on pulmonary function in cervical spinal cord injury patients and to suggest the reference value of Pulmonary Function Test (PFT) with respect to each level of injury. METHOD: One hundred eighteen subjects with complete cervical spinal cord injury underwent PFT. Forced Vital Capacity (FVC) and Forced Expiratory Volume in 1 second (FEV1) were measured and percentages of normal predictive values were also calculated. RESULTS: Age, height and injury level were determinants of FVC and FEV1. But only injury level affected the percen-tages of FVC and FEV1 predictive values. The mean FVC of C4, C5, C6, C7, C8 tetraplegic subjects were 1.78 L, 2.00 L, 2.20 L, 2.74 L, 2.94 L respectively. The mean FEV1 of C4, C5, C6, C7, C8 tetraplegic subjects were 1.64 L, 1.83 L, 2.08 L, 2.59 L, 2.74 L respectively. CONCLUSION: Age and height should be considered when interpreting PFT of tetraplegic patients. The reference values suggested would help to evaluate the severity of pulmonary function loss in complete cervical spinal cord injury patients.
Forced Expiratory Volume ; Humans ; Male ; Quadriplegia ; Reference Values ; Respiratory Function Tests ; Spinal Cord Injuries ; Spinal Cord* ; Vital Capacity

Targetoid hemosiderotic nevus (THN) is a rare variant of melanocytic nevus, characterized by a sudden development of a targetoid ecchymotic halo around a pre-existing nevus. THN clinically raises concern for malignant transformation due to its abrupt change in color and size. THN should be distinguished from other diseases showing a peripheral halo, including targetoid hemosiderotic hemangioma, halo nevus, and Meyerson nevus. Dermoscopy can help clinicians to differentiate THN from these diseases. The typical dermoscopic features of THN are known to be divided into two distinctive areas: the central melanocytic area and the peripheral ecchymotic area. In our case, dermoscopy revealed a novel bull’s eye pattern composed of a central area with characteristic features of benign melanocytic nevus, an intermediated white circular ring, and a peripheral milky red area. When a sudden change occurs in a pre-existing nodule showing targetoid features, dermoscopy should be considered before conducting a biopsy or surgical intervention.

BACKGROUND/AIMS: This study evaluated the efficacy of endoscopic treatment in a bile leak that occurred through various causes. METHODS: The medical records of 35 patients (mean age 55.4 years; male/female 25/10), who were diagnosed with a bile leak by endoscopic retrograde cholangiopancreatography in Yeungnam University Hospital from January 1998 to January 2006, were reviewed. RESULTS: The most common cause of the bile leak was an open cholecystectomy (n=13, 37.1%) followed by a laparoscopic cholecystectomy (n=10, 28.6%), trauma (n=2, 5.7%), transarterial chemoembolization (n=3, 8.6%), spontaneous (n=3, 8.6%), and a hepatic resection (n=4, 11.4%). Thirty-four patients were treated endoscopically by the insertion of a plastic stent with/without a sphincterotomy (70.6%, 24/34), a nasobiliary drainage (11.8%, 4/34), or a sphincterotomy alone (17.6%, 6/34). Of these 34 patients, 30 were cured by the endoscopic treatment, 2 patients died from liver failure despite the use of nasobiliary drainage and 2 patients did not improve after endoscopic treatment. One patient underwent surgery without endoscopic treatment because of a transsection of the common bile duct. With the exception of the two who died from liver failure, the overall cure rate of endoscopic treatment was 90.9% (30/33). There were no complications associated with the endoscopic treatment. CONCLUSIONS: Endoscopic treatment for a bile leak is safe and effective regardless of the cause.
Bile* ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Common Bile Duct ; Drainage ; Humans ; Liver Failure ; Medical Records ; Plastics ; Stents

PURPOSE: Determination of medical intractability is primarily essential for planning a surgical treatment of epolepsy. Questions regarding intractability include the optimum duration of adequate antiepileptic drug (AED) treatment and the tolerable seizure frequency. Unfortunately, thereis no established guideline for determination of medical intractability in terms of the duration or the tolerability of AED resistance. In temporal lobe epilepsy (TLE) with mesial temporal sclerosis (MTS), a Well-Known surgically remediable epileptic syndrome, the inverstigation of relationship between short-term and long-term AED response may help us finding a way to solve the above questions. METHODS: From 2 epilepsy centers, 86 patients with TLE demonstrating MTS on MRI were evaluated. All of them were on AED treatment for at least 2 years. We investigated seizure free rate for 1st 1 year, for next 1 year and that for two years. We compared seizure number of 1st 1 year with that of 2nd 1 year and analyzed corrdlation coefficiency between seizure numbers of the two periods. Paired-t-test and Pearson correlation test were performed for statistical analysis. RESULTS: Two year terminal remission rate was 3.5%. Remission rate for the 1st 1 year was 4.7% Whereas in the 2nd 1 year it rose to 16.3%. Mean seizure number of 1st one year was 34.9 and that of next one year was 27.0. Mean paired differences between seizure numbers of the two periods was 7.95(95% dcnfidence interval:1.82-14.09) Which was statistically significant(p=0.012). Pearson correlation coefficiendy was 0.815 between seizure numbers fo the two periods. CONCLUSION: In TLE with MTS, seizure free outcome was very poor. However, seizurw-free rate rose and seizure number declined as AED treatment duration was prolonged for 2 years. Weizure munber of 1st year may predict that of 2nd year. To establish an appropriate index time for considering medical intractability, further studies on longer-term outcone by AED treatment duration was porlonged for 2 years. Seizure munber of 1st year further studies on longer-term outcome by AED treatment should be recommended in addition to studies on adequate tolerability of AED resistance.
Epilepsy ; Epilepsy, Temporal Lobe* ; Humans ; Magnetic Resonance Imaging ; Sclerosis* ; Seizures* ; Temporal Lobe*

The authors conducted a clinical observation of 55 cases of solitary pulmonary nodules at Yeungnam University Hospital from June 1986 to October 1990, and the following results were obtained: 1. The age distribution was ranged from 18 to 77 years, and the male-to female ratio was 1.8:1. 2. Among 55 cases of nodules, 28 cases were benign and 27 cases were malignant nodules, and of malignant nodules, the primary lung cancer was 23 cases and of benign nodules, 18 cases were tuberculoma. 3. 23 cases (41.8%) was asymptomatic and the other 32 cases were symptomatic; chest pain 12 cases, hemoptysis; 8 cases, cough; 8 cases and dyspnea; 4 cases. 4. The non-smoker-to-smoker ratio was 1:1.04, but among 23 smoker over 20 pack years, 14 cases were malignant nodules. 5. According to nodular size, there is no striking differences between benign and malignant nodules except 3-4 cm sized nodules. 6. The lobar distribution of nodules, 35 cases were in the right lung (upper lobe; 14 cases, middle lobe; 11 cases, and lower lobe; 10 cases) and 23 cases were in the left lung (upper lobe; 9 cases, lower lobe; 11 cases), and the malignant nodules were most commonly observed in the right upper lung.
Age Distribution ; Chest Pain ; Cough ; Dyspnea ; Female ; Hemoptysis ; Humans ; Lung ; Lung Neoplasms ; Solitary Pulmonary Nodule* ; Strikes, Employee ; Tuberculoma

PURPOSE: To evaluate the application of MRI to the ILAE classification of epilepsies and epileptic syndromes in the setting of epilepsy clinic. METHODS: We reviewed epilepsy registry forms, EEG, and MRI of 300 patients who were consecutively registered to the Yonsei Epilepsy Clinic. The algorhithm of syndromic classification consisted of 3 steps ; 1) clinical diagnosis based on the clinical informations described in the registry form, 2) clinical-EEG correlations, and 3) clinical-EEG-MRI correlations. The interictal epileptiform discharges (IEDs) in EEG were divided into focal, multilobar/multifocal, and generalized. MRI-lesions were divided into focal and non-focal (multilobar/multifocal, and diffuse) lesions. The clinical-EEG, EEG-MRI, and MRI-clinical correlations were categorized as concordant, not discordant, and discordant. RESULTS: Among 300 patients evaluated, 249 patients were found to have epilepsies and both EEG and MRI. By clinical analysis, 190 of 249 patients were diagnosed as localization-related epilepsies (LRE), 24 patients were generalized epilepsies (GE), 34 patients were undetermined epilepsies (UDE), and one patient had alcohol related epilepsy. EEG revealed IEDs in 124 patients and altered the clinical diagnosis in 79 patients. MRI lesions were found in 106 patients with focal lesions in 65 patients and non-focal lesions in 41 patients. MRI lesions were found in 47 of 125 patients with negative EEG. Concordance rates of clinical-EEG, EEG-MRI, and MRI-clinical correlations in 54 patients with lobar epilepsies, who had positive EEG and MRI, were 39%, 54%, and 52%, respectively, and discordant rates were 17%, 11% and 7%, respectively. The complete concordance of all 3 correlations was found in only 33% of them. In 20 patients diagnosed as GE by clinical-EEG correlations, MRI lesions were found in only 3 patients and none of them changed the diagnostic categories due to MRI lesions. CONCLUSION: In lobar epilepsies, the sensitivity of MRI was quite comparable with EEG and the clinical-MRI correlation was superior to the clinical-EEG correlations. MRI provided additional and complimentary informations and should be incorporated to the ILAE-classification system as the category of 'lesional epilepsy'.
Classification ; Diagnosis* ; Electroencephalography ; Epilepsies, Partial ; Epilepsy* ; Epilepsy, Generalized ; Humans ; Magnetic Resonance Imaging*

OBJECTIVES: The aim of this study was to evaluate the risk of recidivism in sex offenders according to the sociodemographic factors, IQ, diagnosis by using Static-99 and KSORAS. METHODS: A total of 48 sex offenders were enrolled. Among them, 44 offenders were rated by Static-99, 41 offenders were evaluated by KSORAS. All the information was collected by reviewing medical records and written records of prosecutors or police retrospectively. RESULTS: In Static-99 and KSORAS, young adults tend to commit more recidivism than late adults. Single offenders have high rates of recidivism than married offenders in Static-99. In KSORAS, mental retardation patients have a tendency to commit more recidivism than schizophrenia patients. CONCLUSION: We should not overlook that specific condition of sex offenders (young adults, single, mental retardation) can have more possibility of recidivism.
Adult ; Criminals ; Humans ; Intellectual Disability ; Medical Records ; Police ; Schizophrenia ; Young Adult

Neurilemmoma, also refired to as Schwannoma, neurinoma and perineural fibroblastoma, is well capsulated solitary tumor of Schwann cell origin. The most common sites for benign solitary neurilemmoma are the extremities or the head and neck region. In the retroperitoneum, they are commonly seen in the presacral region. It is incidentally detected and confirmed by pathologic findings. We report a case of retroperitoneal neurilemmoma arising from adjacent to kidney, in 49 years old man.
Extremities ; Head ; Humans ; Kidney* ; Middle Aged ; Neck ; Neurilemmoma*

This study was carried out to observe and evaluate the middle ear pressure(MEP) change by nitrous oxide(N2O) and end tidal PCO2 during general anesthesia with halothane or enflurane. MEP was measured during general anesthesia by impedance audiometer(GSI 28 Auto tymp model) in 50 patients who were relatively healthy without upper respiratory tract infection and otologic problems from August 1987 at Chonbuk National University Hospital. The results were as follows: 1) During general anesthesia with 100% O2 and halothane or enflurane, MEP was decreased progressively under the preinduction level with time. 2) The decrease in MEP during general anesthesia with 100% O2 and halothane or enflurane was reversed by relative hypoventilation, but MEP showed negative values in all patients. 3) End tidal PCO2 was increased progressively by relative hypoventilation and returned gradually to pre-hypoventilation level by normoventilation. 4) MEP was increased during general anesthesia using N2O, which is propotional to the concentration of N2O by 20 minutes. Thereafter, MEP remained increased until termination of N2O administration. From the above results, it is concluded that MEP is increased during anesthesia using N2O. MEP can also be affected by end tidal PCO2 even though physiologic range. Therefore, it is prudent to avoid N2O especially when hyperventilation is not adequately permitted during general anesthesia for middle ear surgery and patient with middle ear disease.
Anesthesia ; Anesthesia, General* ; Ear, Middle* ; Electric Impedance ; Enflurane ; Halothane ; Humans ; Hyperventilation ; Hypoventilation ; Jeollabuk-do ; Nitrous Oxide ; Respiratory Tract Infections