Colorectoanal intussusception is a rare and distinct entity that differs from the more common rectal prolapse. Typically the intussusception occurrs with tumor at the apex of the intussuscepted segment acting as lead point. Here we present a case and review the literature of colorectoanal intussusception. The case presented here is that of an elderly woman with a proximal sigmoid colon cancer at its apex. Anterior resection was electively performed after reduction of the intussusception. It is important to differentiate a colorectoanal intussusception from the more common rectal prolapse because treatment may differ. The anorectum remains in its normal anatomic position in colorectoanal intussusception, whereas the anal canal is effaced with the prolapsed segment of bowel in rectal prolapse. Identification of a tumor at the apex of the intussuscepted bowel should also arouse suspicion that the condition is not a rectal prolapse.
Aged ; Anal Canal ; Colonic Neoplasms ; Female ; Humans ; Intussusception* ; Rectal Prolapse ; Sigmoid Neoplasms

We have experienced a case of pericardial tuberculoma, a very rare disease, with massive pericardial effusion in a 63-year-old veteran. He wdimensional echocardiography. Computed tomographic scans confirmed the presence of a pericardial mass and clinically unsuspected "lung mass". The presence of the lung mass led us a diagnostic and therapeutic dilemma. Surgery confirmed the pericardial mass which revealed tuberculosis by patholohy and loculated pleural effusion at the major fissure, so-called "phantom tumor", not a lung mass.
Echocardiography ; Humans ; Lung ; Middle Aged ; Pericardial Effusion ; Pleural Effusion ; Rare Diseases ; Tuberculoma* ; Tuberculosis ; Veterans

The purpose of the present study lied in examining the incidence, treatment and failure causes of peri-implantitis by analyzing medical charts of those patients who underwent implant placement for the past 2 years. The subjects included those patients who underwent implant placement at the present hospital from January 2001 to December 2002. 3i implants were used for the analysis for the comparison of significance. A total of 301 patients were examined, among whom 102 were females and 199, males. Implants were placed in a total of 578 cases. The number of peri-implantitis was present in a total of 29 cases (21 males and 8 females), giving the incidence at 9.6%. The evidence of peri-implantitis was seen in 60 cases, which was in 10.4% of the patients. Among those cases with peri-implantitis, 28 cases (47%) underwent bone graft and 22 cases (43%) underwent maxillary sinus lift. Furthermore, 4 of these patients had systemic diseases such as diabetes or hypertension. Regular management is important for the preven ion of peri-implantitis. In other words, early prevention through regular follow-ups to check the status of surrounding soft tissue would be needed to maintain implants.
Female ; Humans ; Hypertension ; Incidence ; Male ; Maxillary Sinus ; Peri-Implantitis* ; Retrospective Studies* ; Transplants

BACKGROUND: Inguinal hernia is one of the most common surgical diseases in pediatric patients. We reviewed pediatric inguinal hernia cases retrospectively to analyze the clinical characteristics. METHODS: We reviewed 200 herniorrhaphies in 194 patients who were under the age of 15 and who were operated on at Chungbuk National University Hospital from January 1992 to July 1997. RESULTS: 1) All of the cases were indirect inguinal hernias. Sliding hernias were noticed in 6 cases. High ligations were performed in all cases except 2 cases of Bassini operations. 2) Boys were affected 3.4 times more often than girls. 56.2% of the hernias occurred on the right side, 35.0% on the left side, and 8.8% bilaterally. Bilateral inguinal hernias occurred more often in girls (13.6%) than in boys (7.3%). 3) Hernias were noticed under the age of 1 year (47.9% of the cases). In most of those cases, operations were delayed. Especially, the operations were delayed more than 3 months for 82.1% of patients with hernias and under the age of 6 months. 4) On admission, most patients complained of inguinal or scrotal swelling and inguinal pain or discomfort. 5) Hospitalization occurred in 20.6% of the cases, 3 of which needed emergency operations. Hospitalization occurred in 47.5% of the cases under the age of 1 year; in those cases, hernias were noticed within the first 6 months, and in most of those cases, operations were delayed more than 3 months. 6) Postoperative complications occurred in 9 cases, i.e., 8 cases of scrotal swelling and 1 case of scrotal hematoma. There were no recurrent cases after operation (average follow-up of 33 months). 7) After unilateral inguinal hernia repairs, contralateral hernias developed in 10 patients including 4 patients who had had received their first hernia operations at other hospitals. The sex ratio was 9:1. Laterality of the first hernias were right in 5 cases and left in 5 cases. Contralateral hernias developed within an average of 4.8 months after the first operation; however, 6 cases developed within 6 months after the first operation. CONCLUSIONS: Education for early operation to prevent complications of hernias and careful evaluation of contralateral inguinal hernias in unilateral hernias are needed in the treatment of pediatric inguinal hernias.
Chungcheongbuk-do ; Education ; Emergencies ; Female ; Follow-Up Studies ; Hematoma ; Hernia ; Hernia, Inguinal* ; Herniorrhaphy ; Hospitalization ; Humans ; Ligation ; Postoperative Complications ; Retrospective Studies ; Sex Ratio

PURPOSE: Neonatal hyperbilirubinemia has benign courses in most cases, but the possibility of toxicity of hyperbilirubinemia required courses examination of every newborn infant to identify the severity of hyperbilirubinemia progress. This study aims to see how the body surface area of newborns influences the decline rate of serum bilirubin level in conventional phototherapy. METHODS: Based on the charts of the Pediatrics Department, Dae-Dong Hospital from January 2003 to December 2006, we analyzed 168 neonates diagnosed as neonatal hyperbilirubinemia (serum bilirubin > or =15 mg/dL) in retrospective way. We excluded newborn infants under 37 weeks of gestation and under 2,500 g birth weight and classified neonates into four groups by the calculation results of body surface area:males above 75 percentile (group A), males below 25 (group B), females above 75 (group C), and females below 25 (group D). RESULTS: Out of 168 samples, the number of group A, B, C, D was 30, 20, 20, 15 respectively. In conventional phototherapy, the mean decline rates of serum bilirubin of group B and D recording 2.09 mg/dL/day and 1.77 mg/dL/day, were significantly faster than those of group A and C recording 1.63 mg/dL/day and 1.41 mg/dL/day (P<0.01). No significant differences were found in different duration of phototherapy between groups below 25 percentile and those above 75 in both genders. CONCLUSION: In conclusion, body surface area influences of infants the decline rate of serum bilirubin level in conventional phototherapy.
Bilirubin* ; Birth Weight ; Body Surface Area* ; Female ; Humans ; Hyperbilirubinemia ; Hyperbilirubinemia, Neonatal ; Infant ; Infant, Newborn ; Male ; Pediatrics ; Phototherapy* ; Pregnancy ; Retrospective Studies

The patient was a 52-year-old female with swelling in both lower legs and peripheral blood eosinophilia. Biopsy specimen revealed the heavy infiltration of eosinophils with sparse small lymphocytes showing mild atypia. The diagnosis was Kimura disease. The symptoms including eosinophilia were relieved by steroid treatment. At 17 months from initial biopsy, the patient developed swelling of the buttock. At 25 months, fever and dyspnea with multiple lung nodules developed. Wedge resection revealed multiple aggregates of CD3(+), CD56(+), Epstein-Barr virus(+) large atypical lymphocytes with necrosis. The patient was finally diagnosed with extranodal NK/T cell lymphoma (NKTL). Epstein-Barr virus in situ hybridization retrospectively performed on the previous biopsies demonstrated Epstein-Barr virus infection in small CD3(+) lymphocytes. The patient expired after 26 months despite chemotherapy. Blood eosinophilia correlated well with disease activity during the clinical course. This case shows not only unusual histologic features, which hampered the correct diagnosis, but also a unique clinical manifestation of NKTL.
Angiolymphoid Hyperplasia with Eosinophilia ; Biopsy ; Buttocks ; Dyspnea ; Eosinophilia ; Eosinophils ; Epstein-Barr Virus Infections ; Female ; Fever ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Leg ; Lung ; Lymphocytes ; Lymphoma ; Middle Aged ; Morphinans ; Muscle, Skeletal ; Necrosis ; Retrospective Studies

The patient was a 52-year-old female with swelling in both lower legs and peripheral blood eosinophilia. Biopsy specimen revealed the heavy infiltration of eosinophils with sparse small lymphocytes showing mild atypia. The diagnosis was Kimura disease. The symptoms including eosinophilia were relieved by steroid treatment. At 17 months from initial biopsy, the patient developed swelling of the buttock. At 25 months, fever and dyspnea with multiple lung nodules developed. Wedge resection revealed multiple aggregates of CD3(+), CD56(+), Epstein-Barr virus(+) large atypical lymphocytes with necrosis. The patient was finally diagnosed with extranodal NK/T cell lymphoma (NKTL). Epstein-Barr virus in situ hybridization retrospectively performed on the previous biopsies demonstrated Epstein-Barr virus infection in small CD3(+) lymphocytes. The patient expired after 26 months despite chemotherapy. Blood eosinophilia correlated well with disease activity during the clinical course. This case shows not only unusual histologic features, which hampered the correct diagnosis, but also a unique clinical manifestation of NKTL.
Angiolymphoid Hyperplasia with Eosinophilia ; Biopsy ; Buttocks ; Dyspnea ; Eosinophilia ; Eosinophils ; Epstein-Barr Virus Infections ; Female ; Fever ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Leg ; Lung ; Lymphocytes ; Lymphoma ; Middle Aged ; Morphinans ; Muscle, Skeletal ; Necrosis ; Retrospective Studies

We performed anorectal physiologic studies to evaluate the pelvic floor musculature and its innervation in 73 pregnant women(35 primiparous, 38 multiparous) who had been recruited into a study of pudendal nerve damage and its recovery in vaginal delivery as part of a prospective investigation. These women had all delivered by vaginal route with pros terolateral episiotomy. Pudendal nerve terminal motor latency was significantly increased 2~3 days after delivery but substantial recovery occurred in the first 2 months after delivery nearly to the pre-delivery value. Maximum average resting pressure was not affected by delivery. In contrast, maximum average squeeze pressure was decreased significantly 2~3 days after delivery and some recovery occurred in the first 6 months after delivery, which still remained significantly low relative to pre-delivery value. Perineal descent was significantly increased 2~3 days after delivery but substantial recovery occurred in the first 2 months after delivery, which still remained significantly low relative to pre-delivery value and thereafter no significant recovery was found. These results suggest pudendal nerve damage occurrs during vaginal delivery which recovers in the first 2 months after delivery but functional disturbance in pelvic floor sphincter muscuature persists thereafter, and we support avoidance of further vaginal delivery after previous damage to the innervation of pelvic floor sphincter musculature.
Episiotomy ; Female ; Humans ; Pelvic Floor ; Prospective Studies ; Pudendal Nerve*

Plummer-Vinson syndrome is a clinical entity characterized by dysphagia, iron deficiency anemia, cheilosis, glossitis, and cervical esophageal web, especially in middle aged women. Recently, the authors experienced a case of Plummer-Vinson syndrome. A 53-year-old female was admitted due to intermittent solid food dysphagia for 18 months. She had a 2 years history of iron deficiency anemia. On admission glossitis, fissures at the angle of the mouth, spoon nails, and iron deficiency anemia were noted. Esophagogram and esophagoscopic examination revealed thin walled concentric web at upper esophagus. Esophageal web was succefully teared by endoscopic balloon dilatation with subseguant improvement of dysphagia. Skin manifestations as well as anemia were markedly improved after oral iron replacement therapy.
Anemia ; Anemia, Iron-Deficiency ; Deglutition Disorders ; Dilatation ; Esophagus ; Female ; Glossitis ; Humans ; Iron ; Middle Aged ; Mouth ; Plummer-Vinson Syndrome* ; Skin Manifestations ; Tears

Appendicitis is one of the most common condition causing an acute abdomen in young adult population. Two-hundreds and fifty-nine cases of acute appendicitis provened by surgery and pathology during recent 2 years in Han-ll Hospital were studied and analyzed by preoperative plain abdominal X-ray. One case of barium enema was also done. The results were as follows; 1. Male fo female sex ration was 1:1. 2. In age distribution, the most commonage group was from two to four decade. (75.3%) 3. The most common clinical symptom was classical abdominal pain as86.5%. 4. The positive radiographic findings were obtained 75.7% of all cases. 5. Common radiographic findings as follows; 1) Reflex ileus on RLQ (73.7%) 2) Obliteration of Rt. psoas line (41.3%) 3) Scoliosis of lumbar spine(21.2%) 6. The most common site of appendix was retrocecal in position. (84.2%) 7. One case of appendicolith and one case of appendiceal diverticulum were demonstrated.
Abdomen, Acute ; Abdominal Pain ; Age Distribution ; Appendicitis ; Appendix ; Barium ; Diverticulum ; Enema ; Female ; Humans ; Ileus ; Male ; Pathology ; Reflex ; Scoliosis ; Young Adult