ABSTRACT
Intestinal entrapment between two vertebral bodies is very rare. In all previous cases, it occurred by major trauma. However, the bowel entrapment between two vertebral bodies without trauma has never been reported, not to mention as the cause of lower extremity radicular pain. We describe the case of an 82-year-old female patient with right lower extremity radicular pain without recent trauma history. The patient was diagnosed sigmoid colon entrapment between the L5 and S1 vertebrae by lumbar spinal computerized tomography and magnetic resonance imaging, and showed improvement in radicular pain after manual reduction of interpositioned colon during surgery. Intestinal entrapment between two vertebrae without trauma is caused by degenerative and vacuum changes of the intervertebral disc combined with the anterior longitudinal ligament injury.
Subject(s)
Aged, 80 and over , Female , Humans , Colon , Colon, Sigmoid , Intervertebral Disc , Longitudinal Ligaments , Lower Extremity , Magnetic Resonance Imaging , Radiculopathy , Spine , VacuumABSTRACT
PURPOSE: This study was to evaluate the relationship of 25(OH)D3 levels with anticonvulsant use and other possible factors in epileptic children and adolescents. MATERIALS AND METHODS: We studied 143 patients with epilepsy (90 boys, 53 girls; 11.21+/-4.49 years), who had been treated with anticonvulsants for more than 1 year. Patients who had taken multiple vitamins before the blood test and those who have the limitation of physical activity (wheelchair-bound) were excluded from the study. We evaluated the difference in vitamin D status according to the type and number of anticonvulsants taken and other factors such as gender, age, intelligence and seizure variables. RESULTS: For patients with mental retardation or developmental delay, 25(OH)D3 levels were lower than the levels in patients with normal intelligence quotient levels (p=0.03). 25(OH)D3 levels were lower in patients who had taken anticonvulsants for more than 2 years as compared to those who had taken them for less than 2 years (p=0.03). Those taking oxcarbazepine had significantly lower vitamin D levels than patients taking valproic acid (p=0.01). However, no effects of number of anticonvulsants taken were detectable. More than two-thirds of the patients were diagnosed with osteopenia or osteoporosis in patients showing either vitamin D insufficiency or deficiency. CONCLUSION: The possibility of vitamin D deficiency can be considered in pediatric patients taking anticonvulsants if they have mental retardation or developmental delay or if they have been taking anticonvulsants for more than 2 years or taking hepatic enzyme inducing drugs.
Subject(s)
Adolescent , Child , Female , Humans , Anticonvulsants , Bone Diseases, Metabolic , Developmental Disabilities , Epilepsy , Hematologic Tests , Intellectual Disability , Intelligence , Methods , Motor Activity , Osteoporosis , Seizures , Valproic Acid , Vitamin D Deficiency , Vitamin D , VitaminsABSTRACT
Acrodermatitis enteropathica due to zinc deficiency is characterized by periorificial dermatitis, alopecia, and intractable diarrhea. Here we report a case of transient acrodermatitis enteropathica in a 2-month-old preterm infant, whose skin is erythematous, scaly, eczematous, with an eruption starting from the periorificial area. While her serum zinc level was normal at 118.2 ug/dL, the serum alkaline phosphatase level was low at 48 IU/L and the serum alkaline phosphatase level get increased concordant with clinical improvement after zinc supplementation. Hence, this case shows that the diagnosis of zinc deficiency can be aided with a low level of serum alkaline phoaphatase although serum zinc level is normal.