No abstract available.
Korea*

No abstract available.
Humans

Trichotillomania is the cllinical syndrome of alopecia resulting from the repetative pulling, plueking and breaking of ones own hair. We report four cases of trichotillomania in 10 year old children. The lesions were limited to the scalp. All of them had psychiatric problems in the school or home according to a psychiatric consultation. The histopathologic examinatiorii revealed a normal number of hair follices, empty hair follicles and no inflammatory reaction. The treatment led to hair growth in three cases but one case did not respond to the treatment.
Alopecia ; Child ; Hair ; Hair Follicle ; Humans ; Scalp ; Trichotillomania*

A doctor has to establish his or her own philosophy of medical practice for the management of congenitally disabled patients. To help the senior medical students to put their ideas on the management of such patients in shape, a question which asked them to describe their views on the medical, social, ethical aspects of the management was included in the examination for the 225 senior students of Seoul National University College of Medicine in 1992. The responses were summarized. The dismal prognosis of some malformations, considerable cases of abandonment by the misconception of parents and doctors, the conflict among the family members caused by the economic burden and social handicaps, the relative lack of support and the psychological and vacational discrimination by the society were among the prevalent problem. Of the 225 students, 131(58%) insisted that 'all' the congenitally disabled patients be provided with the best quality of treatment while 26(12%) argued against the idea. Fifteen students(7%) recommended to have a certain period of 'natural selection' and 14(6%) denied and warned against the doctor's role as a decision maker. Eleven students(5%) stated that the aggressive treatment should be confined to the patients who were selected by the medical criteria which supports the abandonment of poorly disabled patients. Three(1%) emphasized the 'prevention' as the ultimate goal. Twenty five(11%) showed reponses which lacked their own ideas or were inappropriate. Representative or unique statements are quoted. Though the ideas of students were not so contradictory to one another, the views were diverse as much as the variety of problem in the management of congenitally disabled patients. The authors believe it is worthwhile to ask medical students to think about the medically and ethically difficult situations before he or she becomes a doctor.
Discrimination (Psychology) ; Humans ; Parents ; Philosophy ; Prognosis ; Seoul ; Students, Medical*

To figure out the occurrence pattern of pediatric brain tumors in the aspects of age, sex, location and histopathological diagnosis, 365 cases of pediatric(age less than 16 year) brain tumor which were operated upon at the Department of Neurosurgery, Seoul National University Hospital from January 1959 to June 1993, were reviewed. Only the tumors, of which the pathological specimens were taken, were included. Tumors of bone origin or purely extradural mass, non-tumorous cystic lesions and vascular malformations were excluded. The mean age of 365 cases was 8.1 years and the sex ratio(M : F) was 1.3 : 1. Supratentorial tumors(56.2%) were more prevalent than infratentorial tumors(43.4%). Neuroepithelial tumors comprised of 64.4% of the 365 brain tumors. Forth three percent of the neuroepithelial tumors were embryonal origin such as medulloblastoma(MBL), primitive neuroectodermal tumor(PNET) and ependymoblastoma. Pathological common tumors were astrocytic tumor(22.7%), MBL(20.0%), craniopharyngioma(13.4%), germ cell tumor(GCT, 8.8%), PNET(6.6%), and ependymal tumor(6.3%) in the order of decreasing frequency. PNET and ependymal tumors were frequent in early childhood while pituitary adenoma and non-teratomatous GCT were common in older children. GCT, PNET and ependymoma were prevalent in male. The relative incidences of GCT, PNET, brain stem glioma, oligodendroglial tumor, pituitary adenoma and neuronal tumor increased in MRI era. In contrast, those of astrocytic tumor, MBL and ependymal tumor decreased.
Adenoma ; Brain Neoplasms* ; Brain Stem ; Brain* ; Child ; Diagnosis* ; Ependymoma ; Germ Cells ; Glioma ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Neoplasms, Neuroepithelial ; Neural Plate ; Neuroectodermal Tumors, Primitive ; Neurons ; Neurosurgery ; Pituitary Neoplasms ; Seoul ; Vascular Malformations

No abstract available.

No abstract available.

OBJECTIVE: Moyamoya disease (MMD) is an uncommon cerebrovascular disorder, characterized by progressive occlusion at the terminal portion of the internal carotid artery. Incidence of the disease is high in East Asia and familial MMD accounts for about 15% of the disease. Although the pathogenesis is unknown, association of HLA class I or II alleles with MMD has been reported with conflicting results. We investigated whether there is a difference in HLA class II association between familial and non-familial forms of the disease. METHODS: A total of 70 Korean children with MMD, including 16 familial cases (10 probands), and 207 healthy controls were studied. Among familial cases, only 10 probands were used for the HLA frequency analysis. High resolution HLA-DRB1 and DQB1 genotyping was performed using polymerase chain reaction (PCR)-sequence specific oligonucleotide hybridization and PCR-single strand conformation polymorphism methods. RESULTS: The phenotype frequencies of HLA-DRB1*1302 (70.0%) and DQB1*0609 (40.0%) were significantly increased in familial MMD compared to both controls [vs. 15.5%, corrected p (pc) = 0.008, odds ratio (OR) = 12.76; vs. 4.3%, pc = 0.02, OR = 14.67] and non-familial MMD patients (vs. 14.8%, pc = 0.02, OR = 13.42; vs. 1.9%, pc = 0.02, OR = 35.33). The frequencies of DRB1 and DQB1 alleles in non-familial MMD patients were not significantly different from those in controls. CONCLUSION: Our findings suggest that the genetic polymorphism of HLA class II genes or other closely linked disease relevant gene(s) could be a genetic predisposing factor for familial MMD.
Alleles ; Carotid Artery, Internal ; Cerebrovascular Disorders ; Child ; Chimera ; Far East ; Genes, MHC Class II ; HLA-DQ Antigens ; HLA-DR Antigens ; HLA-DRB1 Chains ; Humans ; Incidence ; Moyamoya Disease ; Odds Ratio ; Phenotype ; Polymerase Chain Reaction ; Polymorphism, Genetic

No abstract available.
Spine*

Although rare, agranulocytosis is the most serious, potentially fatal side effect of antithyroid drug. We experienced a 13-year-old girl who developed methimazole-induced agranulocytosis at 1 month after the initiation of treatment. Her granulocyte count recovered after discontinuation of methimazole and treatment with broad spectrum-antibiotics, G-CSF, and methylprednisolone. After recovery from agranulocytosis she was treated with radioiodine ablation therapy. Early detection and proper management of antithyroid drug-induced agranulocytosis is very important.
Adolescent ; Agranulocytosis* ; Female ; Granulocyte Colony-Stimulating Factor* ; Granulocytes* ; Humans ; Methimazole ; Methylprednisolone*