Eosinophilic gastroenteritis is an uncommon disease of unknown etiology that is characterized by massive tissue infiltration of eosinophils in the tissue layers of various areas of the gastrointestinal tract. An accurate diagnosis is difficult as clinical presentations, symptoms, endoscopic and radiologic findings are nonspecific. A 51-year-old man visited our hospital presenting with abdominal pain. Esophagogastroduodenoscopy revealed diffuse hyperemic mucosal lesions at the stomach, duodenum. Symptoms and endoscopic findings deteriorated rapidly after three days. Small amounts of eosinophilic infiltration without malignant cells was confirmed from biopsy. However, we could not exclude malignancy and performed a subtotal gastrectomy. Stomach specimen showed eosinophilic infiltrations, and the patient was finally diagnosed as eosinophilic gastroenteritis. We report a case of atypical eosinophilic gastritis with rapid deterioration mimicking Borrmann type 4 advanced gastric cancer.
Abdominal Pain ; Biopsy ; Diagnosis ; Duodenum ; Endoscopy, Digestive System ; Eosinophils* ; Gastrectomy ; Gastritis ; Gastroenteritis* ; Gastrointestinal Tract ; Humans ; Middle Aged ; Stomach ; Stomach Neoplasms*

Avascular necrosis of the first metatarsal head is uncommon. It is most often seen following a distal metatarsal osteotomy for hallux valgus. Although many cases may be subclinical, it is a powerful cause of failure of bunion surgery. Avascular necrosis of the first metatarsal head results in a series of events that begins with phases of avascularity; revascularization, with or without collapse; and reossification. Collapse may result in degenerative change of the metatarsophalangeal joint. We have recently experienced a case of avascular necrosis of the first metatarsal head.
Hallux Valgus* ; Hallux* ; Head* ; Metatarsal Bones* ; Metatarsophalangeal Joint ; Necrosis* ; Osteotomy*

PURPOSE: We try to retrospectively analyze the clinical results of the modified Chrisman-Snook procedure for chronic ankle instability. MATERIALS AND METHODS: From November 1997 to April 2006, thirty-one patients who underwent modified Chrisman- Snook procedure for chronic ankle instability were analyzed. All patients were male and the mean age was 31 years. The follow-up period averaged 48 months. We evaluated the clinical results measured by Hasegawa method. RESULTS: Among them, there were soldiers in 11, socker players in 6, patients who weigh more 80 kg in 5. And there were 9 patients who previously underwent modified Brostrom procedure for chronic ankle instability. The clinical results were rated as excellent in 29, fair in 2 who did not cooperate with postoperative rehabilitation program. There were complications of 2 cases of irritation of the sural nerve and recurrence respectively, 1 case of wound problem. CONCLUSION: Our results show that the modified Chrisman-Snook procedure is effective treatment method for patients with high-performance athlete/soldier or failed modified Brostrom procedure.
Ankle* ; Follow-Up Studies ; Humans ; Male ; Military Personnel ; Recurrence ; Rehabilitation ; Retrospective Studies ; Sural Nerve ; Wounds and Injuries

Pseudomyxoma peritonei is a very rare condition, and even rarer in patients with history of cancer. A 70-year old woman with a history of breast cancer was admitted with abdominal pain and distention. Abdominal computed tomography revealed ascites collection, diffuse engorgement and infiltration of the mesenteric vessel, suggesting peritonitis or peritoneal carcinomatosis. Diagnostic paracentesis was attempted several times, but a sufficient specimen could not be collected due to the thick and gelatinous nature of the ascites. Therefore, the patient underwent diagnostic laparoscopy for tissue biopsy of the peritoneum, which indicated pseudomyxoma peritonei. However, the origin of the pseudomyxoma peritonei could not be identified intraoperatively due to adhesions and large amount of mucoceles. Systemic chemotherapy was performed using Fluorouracil, producing some symptomatic relief. After discharge, abdominal pain and distention gradually worsened, so at 18 months after initial diagnosis the patient received palliative surgery based on massive mucinous ascites and palpable mass at the omentum. The patient expired after surgery due to massive bleeding.
Abdomen/diagnostic imaging ; Aged ; Antimetabolites, Antineoplastic/therapeutic use ; Ascites ; Breast Neoplasms/pathology ; Colonoscopy ; Female ; Fluorouracil/therapeutic use ; Humans ; Laparoscopy ; Peritoneal Neoplasms/*diagnosis/drug therapy/pathology ; Peritoneum/pathology ; Pseudomyxoma Peritonei/*diagnosis/drug therapy/pathology ; Tomography, X-Ray Computed

48-year-old woman was admitted to emergency room due to left flank pain. It was diagnosed with left ureteral stone and underwent extracorporeal shock wave lithotripsy (ESWL). However, 12 hours later, the patient complained acute upper abdominal pain with pulmonary edema and low blood pressure. A diagnosis of moderate acute pancreatitis with local complication was considered and we decided conservative therapy including fluid resuscitation, inotropics and antibiotics. It was suggested that ESWL was responsible for the acute pancreatitis. The patient gradually recovered and was discharged on 13th day of admission. ESWL is considered the standard treatment for urolithiasis. Although, it has proved to be safe and effective, serious complications have been reported in 1% of patients, including acute pancreatitis, perirenal hematoma, urosepsis, venous thrombosis, biliary obstruction, bowel perforation, lung injury, and cardiac arrhythmia. Although the possibility of post-ESWL acute pancreatitis is extremely low, physicians should take care of this complication.
Abdominal Pain ; Anti-Bacterial Agents ; Arrhythmias, Cardiac ; Diagnosis ; Emergency Service, Hospital ; Female ; Flank Pain ; Hematoma ; Humans ; Hypotension ; Lithotripsy* ; Lung Injury ; Middle Aged ; Pancreatitis* ; Pulmonary Edema ; Resuscitation ; Shock* ; Ureter ; Urolithiasis* ; Venous Thrombosis

OBJECTIVES: In order to investigate the effect of cultural and ethnic differences on the development of self-image, we conducted a cross-cultural study on Korean, Korean-Chinese and Chinese adolescents. METHODS: A total of 1576 Korean middle and high school students in Seoul/Choongju, 665 Korean-Chinese students and 634 Chinese students living in Yunbyun, China participated in this study. The Korean version of the Offer Self-Image Questionnaire was administered to Korean students, and the Chinese version of the questionnaire was administered to Korean-Chinese and Chinese students. The data obtained from all subjects were analyzed according to ethnicity and age variable through ANOVA. RESULTS: A significant difference across ethnicity was found in the 12 subscales and the total self-image score of OSIQ-R. Korean adolescents obtained significantly higher scores in all of the 11 subscales except the sexuality subscale than Korean-Chinese and Chinese adolescents. Korean-Chinese adolescents obtained significantly higher scores on the ethical value, idealism, family functioning, social functioning, impulse control, self-confidence and total self-image scores than Chinese adolescents, whereas Chinese adolescents obtained significantly higher scores in the subscales of emotional tone, sexuality, vocational attitudes, and self-reliance than Korean-Chinese adolescents. CONCLUSION: The results suggest the possibility that the difference in ethnicity(Korean versus Chinese), the tradition associated with each ethnic group, and the cultural-political factor(democracy versus socialism) significantly affects the development of self-image in adolescents. Although Korean-Chinese adolescents seemed to show cultural pluralism between Korean and Chinese cultures, they were similar to Korean adolescents in their tendency to respond in socially desirable ways, which suggests that although raised under the different cultural systems, traditional Korean ethical values were learned and internalized within the family.
Adolescent* ; Asian Continental Ancestry Group* ; China ; Cultural Diversity ; Ethnic Groups ; Humans ; Surveys and Questionnaires ; Sexuality

A posterior shoulder dislocation with a fracture is rare. Most fractures are impression fractures of the humeral head or lesser tuberosity fractures. However, there are no reports of a complete rupture of the rotator cuff with a combined posterior glenohumeral dislocation. We report a unique case of a posterior shoulder dislocation with an avulsion fracture of the greater tuberosity and a complete rupture of infraspinatus, teres minor and subscapularis tendons, which were treated surgically.
Humeral Head ; Rotator Cuff* ; Rupture* ; Shoulder Dislocation* ; Shoulder* ; Tendons

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease characterized by various clinical manifestations. Hypothermia is rarely associated with SLE and only five cases were reported. It may be due to corticosteroid, which is administered in severe SLE. We report a case of 21-year-old woman with SLE and hypothermia. After using prednisolone, she became hypothermic for 3 days without any neurologic manifestation.
Autoimmune Diseases ; Female ; Humans ; Hypothermia* ; Lupus Erythematosus, Systemic* ; Neurologic Manifestations ; Prednisolone ; Young Adult

BACKGROUND: Several factors contribute to differences in Streptococcus pneumoniae serotype distribution. We investigated the serotype distribution and antimicrobial resistance of S. pneumoniae isolated between 2014 and 2016 in Korea. METHODS: We collected a total of 1,855 S. pneumoniae isolates from 44 hospitals between May 2014 and May 2016, and analyzed the serotypes by sequential multiplex PCR. We investigated the distribution of each serotype by patient age, source of the clinical specimen, and antimicrobial resistance pattern. RESULTS: The most common serotypes were 11A (10.1%), followed by 19A (8.8%), 3 (8.5%), 34 (8.1%), 23A (7.3%), and 35B (6.2%). The major invasive serotypes were 3 (12.6%), 19A (7.8%), 34 (7.8%), 10A (6.8%), and 11A (6.8%). Serotypes 10A, 15B, 19A, and 12F were more common in patients ≤5 years old, while serotype 3 was more common in patients ≥65 years old compared with the other age groups. The coverage rates of pneumococcal conjugate vaccine (PCV)7, PCV10, PCV13, and pneumococcal polysaccharide vaccine 23 were 11.8%, 12.12%, 33.3%, and 53.6%, respectively. Of the 1,855 isolates, 857 (46.2%) were multi-drug resistant (MDR), with serotypes 11A and 19A predominant among the MDR strains. The resistance rates against penicillin, cefotaxime, and levofloxacin were 22.8%, 12.5%, and 9.4%, respectively. CONCLUSIONS: There were significant changes in the major S. pneumoniae serotypes in the community. Non-PCV13 serotypes increased in patients ≤5 years old following the introduction of national immunization programs with the 10- and 13-polyvalent vaccines.
Cefotaxime ; Humans ; Immunization Programs ; Korea ; Levofloxacin ; Multiplex Polymerase Chain Reaction ; Penicillins ; Pneumococcal Vaccines ; Pneumonia ; Serogroup ; Streptococcus pneumoniae ; Streptococcus ; Vaccines