Eccrine nevus is a rare benign cutaneous lesion, frequently present at birth or at an early age. Herein we report on a 1-year-old girl with erythematous papules in a zosteriform arrangement associated with hyperhidrosis on the left side of her trunk.
Female ; Humans ; Hyperhidrosis ; Nevus* ; Parturition

Acute necrotizing encephalopathy (ANE) is a rare immune-mediated complication of a viral infection commonly involving the bilateral thalamus and has been reported mainly in children. Here, we describe the MRI findings of coronavirus disease 2019 (COVID-19)-associated ANE in two pediatric patients, including a 7-year-old girl with fever and mental change, and a 6-year-old girl with fever and generalized seizures. Brain MRI revealed symmetrical T2 fluid attenuated inversion recovery high-signal intensity lesions in the bilateral thalamus with central hemorrhage. In one patient, the thalamic lesions showed a trilaminar pattern on the apparent diffusion coefficient map. This report emphasizes the importance of creating awareness regarding these findings in patients with COVID-19, particularly in children with severe neurological symptoms. Furthermore, it provides a literature review of several documented cases of COVID-19 presenting with bilateral thalamic hemorrhagic necrosis, suggesting a diagnosis of ANE.

Acute necrotizing encephalopathy (ANE) is a rare immune-mediated complication of a viral infection commonly involving the bilateral thalamus and has been reported mainly in children. Here, we describe the MRI findings of coronavirus disease 2019 (COVID-19)-associated ANE in two pediatric patients, including a 7-year-old girl with fever and mental change, and a 6-year-old girl with fever and generalized seizures. Brain MRI revealed symmetrical T2 fluid attenuated inversion recovery high-signal intensity lesions in the bilateral thalamus with central hemorrhage. In one patient, the thalamic lesions showed a trilaminar pattern on the apparent diffusion coefficient map. This report emphasizes the importance of creating awareness regarding these findings in patients with COVID-19, particularly in children with severe neurological symptoms. Furthermore, it provides a literature review of several documented cases of COVID-19 presenting with bilateral thalamic hemorrhagic necrosis, suggesting a diagnosis of ANE.

Acute necrotizing encephalopathy (ANE) is a rare immune-mediated complication of a viral infection commonly involving the bilateral thalamus and has been reported mainly in children. Here, we describe the MRI findings of coronavirus disease 2019 (COVID-19)-associated ANE in two pediatric patients, including a 7-year-old girl with fever and mental change, and a 6-year-old girl with fever and generalized seizures. Brain MRI revealed symmetrical T2 fluid attenuated inversion recovery high-signal intensity lesions in the bilateral thalamus with central hemorrhage. In one patient, the thalamic lesions showed a trilaminar pattern on the apparent diffusion coefficient map. This report emphasizes the importance of creating awareness regarding these findings in patients with COVID-19, particularly in children with severe neurological symptoms. Furthermore, it provides a literature review of several documented cases of COVID-19 presenting with bilateral thalamic hemorrhagic necrosis, suggesting a diagnosis of ANE.

PURPOSE: The purpose of this study was to compare the validity of Onen's alternative grading system (AGS) with that of the APDRP and SFU grading systems in patients with isolated and complicated congenital hydronephrosis. METHODS: We retrospectively reviewed the medical records of 153 patients (204 renal units) diagnosed with congenital hydronephrosis between January 2002 and December 2011. We classified patients into 2 groups; isolated or complicated hydronephrosis. All renal units were graded according to anterior-posterior diameter of renal pelvis (APDRP), Society for Fetus Urology (SFU) and Onen's grading systems. We analyzed the prognosis of hydronephrosis, according to each grading system, at 2 years of age. RESULTS: There were 152 renal units with isolated hydronephrosis and 52 renal units with complicated hydronephrosis. The isolated hydronephrosis group had a lower grade according to Onen's AGS, and showed more frequent spontaneous remission by 2 years of age. There was more frequent obstruction (P=0.000) and surgical treatment (P=0.000) of units with high-grade hydronephrosis according to Onen's AGS. In the complicated hydronephrosis group the frequencies of spontaneous remission (P=0.015) and renal dysfunction (P=0.013) were significantly higher than those in high-grade hydronephrosis, as indicated by Onen's AGS. There were no significant differences in clinical outcomes among the highest grade groups, according to the 3 systems, in either isolated or complicated hydronephrosis. CONCLUSION: Onen's AGS reflects the prognosis of hydronephrosis as well as other grading systems in those with isolated hydronephrosis. It was better predictor of renal dysfunction in those with complicated hydronephrosis. However, Onen's AGS was not superior to the other grading systems in terms of predicting prognosis, especially in high-grade hydronephrosis.
Fetus ; Humans ; Hydronephrosis* ; Kidney Pelvis ; Medical Records ; Prognosis ; Remission, Spontaneous ; Retrospective Studies ; Ultrasonography ; Urology

Purpose: To establish age/sex-specific reference intervals for serum uric acid and to examine the associations between serum uric acid level and metabolic syndrome (MetS) and its components in Korean children and adolescents. Methods: We analyzed data for 1,349 subjects aged 10 to 19 years from the Korea National Health and Nutrition Examination Survey 2016–2017. Results: The mean uric acid levels were 5.9±1.3 mg/dL (interquartile range, 5.0–6.8 mg/dL) in males and 4.6±0.9 mg/dL (interquartile range, 3.9–5.2 mg/dL) in females. The mean uric acid level increased significantly from 10–13 years of age in males, but not in females. The overall prevalence of MetS was 5.9% (7.3% in males and 4.3% in females; P=0.022). The prevalences of MetS in the lowest, second, third, and highest quartiles of uric acid level were 4.4%, 3.3%, 6.1%, and 15.2%, respectively, in males (P for trend <0.001) and 1.9%, 0.0%, 4.1%, and 10.9%, respectively, in females (P for trend <0.001). Compared with the lowest quartile of uric acid level, the odds ratio (with 95% confidence interval) for MetS in the highest quartile was 2.897 (1.140–7.361) in males and 5.173 (1.459–18.342) in females. Subjects in the highest quartile exhibited increased risk for abdominal obesity and low high-density lipoprotein cholesterol in both sexes. Conclusion Serum uric acid level is positively associated with MetS and its components abdominal obesity and low high-density lipoprotein cholesterol.

PURPOSE: To investigate the applicability of the new three-dimensional overlapped reconstruction MR angiography (3-D ORMRA) technique in patients with hemifacial spasm and to compare the new 3-D reconstruction images with conventional MRA source images. MATERIALS AND METHODS: The study group comprised 27 patients with surgically proven hemifacial spasm. In all patients, conventional MRA source images and 3-D fast imaging employing steady-state acquisition (FIESTA) images were obtained prospectively. After 3-D MR angiographic images were obtained, the 3-D MRA and FIESTA images were overlapped at the workstation by using GE A/W 4.2 add/sub software. We analyzed the relationship between the offending vessels and root exit zone of the facial nerve using both 3-D ORMRA images and conventional MRA source images. RESULTS: In 25 of 27 patients, the offending vessel at the REZ of the facial nerve could be correctly identified on conventional MRA source images. In all patients, the presumed offending vessels depicted by the overlapped 3-D reconstruction MRA image corresponded well with the intraoperative findings. The 3-D reconstruction image showed more clear visualization of the spatial relationship between the offending vessels and the root exit zone of the facial nerve. CONCLUSION: The overlapped 3-D reconstruction MR angiography technique is very useful and informative in patients with hemifacial spasm, as compared with conventional MRA angiography technique.
Angiography ; Facial Nerve ; Hemifacial Spasm* ; Humans ; Prospective Studies

BACKGROUND: Length of stay in ICU after thoracotomy is related to postoperative pulmonary function and complication which are affected by postoperative pain. For the post-thoracotomy pain control, epidural morphine is commonly used. Although total dose-requirement for analgesia of lumbar epidural morphine is more than the thoracic, lumbar epidural morphine could be substituted the thoracic. Our study compared the effect of patient controlled analgesia using thoracic epidural morphine (TEA group) and lumbar epidural analgesia with patient controlled intravenous analgesia using morphine (LEA+IV group). METHODS: Sixty patients were randomly assigned into one of the two groups. The epidural taps were done before the induction. In all the patients morphine 0.2 mg/ml was administered via the epidural catheter at the end of surgery. In TEA group, basal infusion rate was 0.1 mg/hr and bolus dose was 0.02 mg. In LEA+IV group, basal infusion rate of epidural morphine was 0.1 mg/hr, patient controlled intravenous analgesia with morphine started when patients arrived at ICU, and basal infusion rate of intravenous morphine was 1.0 mg/hr and bolus dose was 0.8 mg. Pain score, side effect, postoperative length of stay in ICU and hospital were observed. RESULTS: There were no significant differences between two groups in pain score, side effects, length of stay in ICU and hospital. CONCLUSIONS: Lumbar epidural analgesia with patient controlled intravenous analgesia using morphine showed similar postoperative analgesia and length of stay in ICU and hospital compared to thoracic epidural analgesia with morphine, so that can substitute the thoracic epidural analgesia.
Analgesia* ; Analgesia, Epidural ; Analgesia, Patient-Controlled ; Catheters ; Humans ; Length of Stay* ; Morphine* ; Pain, Postoperative ; Tea ; Thoracotomy

PURPOSE: To evaluate the usefulness and reproducibility of 1H MRS in different 1.5 T MR machines with different coils to compare the SNR, scan time and the spectral patterns in different brain regions in normal volunteers. MATERIALS AND METHODS: Localized 1H MR spectroscopy (1H MRS) was performed in a total of 10 normal volunteers (age; 20-45 years) with spectral parameters adjusted by the autoprescan routine (PROBE package). In all volunteers, MRS was performed in a three times using conventional MRS (Signa Horizon) with 1 channel coil and upgraded MRS (Echospeed plus with EXCITE) with both 1 channel and 8 channel coil. Using these three different machines and coils, SNRs of the spectra in both phantom and volunteers and (pre)scan time of MRS were compared. Two regions of the human brain (basal ganglia and deep white matter) were examined and relative metabolite ratios (NAA/Cr, Cho/Cr, and mI/Cr ratios) were measured in all volunteers. For all spectra, a STEAM localization sequence with three-pulse CHESS H2O suppression was used, with the following acquisition parameters: TR=3.0/2.0 sec, TE=30 msec, TM=13.7 msec, SW=2500 Hz, SI=2048 pts, AVG=64/128, and NEX=2/8 (Signa/Echospeed). RESULTS: The SNR was about over 30% higher in Echospeed machine and time for prescan and scan was almost same in different machines and coils. Reliable spectra were obtained on both MRS systems and there were no significant differences in spectral patterns and relative metabolite ratios in two brain regions (p>0.05). CONCLUSION: Both conventional and new MRI systems are highly reliable and reproducible for 1H MR spectroscopic examinations in human brains and there are no significant differences in applications for 1H MRS between two different MRI systems.
Brain* ; Ganglia ; Healthy Volunteers ; Humans* ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy* ; Spectrum Analysis ; Steam ; Volunteers

PURPOSE: To evaluate the US findings of epididymal adenomatoid tumor. MATERIALS AND METHODS: Were trospectively reviewed US findings of four patients with histopathologically proven epididymal adenomatoidtumors. Lesions were evaluated for their size, location, margin, shape and echogenicity. RESULTS: The size of thetumors ranged between 0.5cm and 2cm and all occurred on the left side of the epididymis. Of the four cases, three were located at the tail of the epididymis and one at its head. The tumors were well marginated and spherical andecho-texture was variable but homogenous. CONCLUSION: The possibility of and adenomatoid tumor should be considered when the epididymal mass is round and has a clear margin and the echo-texture of ultrasound ishomogenous.
Adenomatoid Tumor* ; Epididymis* ; Head ; Humans ; Male ; Ultrasonography