No abstract available.

No abstract available.

The patients initially underwent epikeratoplasty for keratoconus but a penetrating kerato plasty was required due to the opacity in the cornea. By using of this specimen, which was obtained by trephination the healing process of the host-Ienticule cornea could be examined by electron microscopy and immunofluorescence method. Epithelial ingrowth over the lenticule was well formed by the regeneration of the basement membrane over the Bowman's membrane. However, the poor attachment of the lenticule over the host corneal stroma made the interface easily separated during the sectioning processes. Electron microscopic study revealed the keratocytes in the lenticule stroma vacuolized with large number of degenerated microorganelles. These results suggest that it may take a long time to complete the wound healing of the host-Ienticule interface despite the epithelial ingrowth onto the lenticule was well formed.
Basement Membrane ; Bowman Membrane ; Cornea ; Corneal Stroma ; Epikeratophakia* ; Extracellular Matrix ; Fluorescent Antibody Technique ; Humans ; Keratoconus ; Microscopy, Electron ; Regeneration ; Trephining ; Wound Healing

Neurenteric cyst(enterogenous cyst) is a rare congenital lesion, usually affecting the lower cervical or upper thoracic areas, and its occurrence in cranial vault is even rarer. We present a patient with intracranial neurenteric cyst anterior to the pons and medulla oblongata. A 40-year old man presented with two-month history of occipital headache and facial spasm. The cyst was decompressed via far lateral suboccipital approach, and the patient recovered without permanent neurological deficits. Features on imaging studies and histological findings are discussed with the review of the literatures.
Adult ; Cranial Fossa, Posterior* ; Headache ; Humans ; Medulla Oblongata ; Neural Tube Defects* ; Pons ; Spasm

Clinical chemotherapy refractoriness is characterized by resistance to multiple drugs. Multidrug resistance(MDR) is caused by over-reactivity of a unidirectional drug efflux pump, transmembrane glycoprotein(P-glycoprotein), which is encoded by the MDR1 gene. P-glycoprotein leads to increased drug efflux and decreased intracellular drug concentration. Clinical trials that attempt to reverse or modulate MDR have been done. Cyclosporin-A and verapamil are the most extensively studied agents and several trials of cyclosporin-A as a MDR modulator have been reported. We report a case of an 8-year-old girl with acute mixed type leukemia who failed to respond 3 times to remission-induction therapy. It led us to conclude she had multidrug resistance. We tried a fourth induction chemotherapy including cytarabine, idarubicin and 6-thioguanine to which cyclosporin-A was added. Then, she showed signs of severe bone marrow depression and fulminant perianal cellulitis. But she recovered and successfully achieved complete remission. The addition of cyclosporine could be useful in achieving complete remission for cases of acute leukemia that resist to usual chemotherapy. Futher observation including more cases will be needed to assess long-term survival and efficacy of adding cyclosporine.
Bone Marrow ; Cellulitis ; Child ; Cyclosporine ; Cytarabine ; Depression ; Drug Resistance ; Drug Resistance, Multiple ; Drug Therapy ; Female ; Humans ; Idarubicin ; Induction Chemotherapy ; Leukemia* ; P-Glycoprotein ; Thioguanine ; Verapamil

PURPOSE: Bacteremia is one of the major concerns in the treatment of pediatric cancer patients. This study was to determine the etiologic agents and the pattern of antibiotic susceptibilities in a single tertiary medical center. METHODS: We retrospectively reviewed the medical records of the cases of bacteremia in pediatric cancer patients from 1998 to 2005 in Keimyung University Dongsan Medical Center. RESULTS: There were 62 cases of bacteremia from 44 patients. Gram-positive organisms(48.3%) were more common than gram-negative organisms(38.7%) or fungi(13%). Among gram-positive organisms, Staphylococcus epidermidis was the most common etiologic agent(63.3%), followed by Staphylococcus aureus(16.7%), alpha-hemolytic Streptococcus(16.7%), and Streptococcus mitis(3.3%). Among gram-negative organisms, Alcaligenes xylosoxidans was the most common agent(41.7%) and the other organisms were Klebsiella pneumoniae(20.8%), Stenotrophomonas maltophilia(12.5%), Acinetobacter baumanii(8.2%), etc. In febrile neutropenic patients, however, K. pneumoniae was the most common cause of gram-negative bacteremia. All of the isolated K. pneumoniae in our center produced extended-spectrum beta-lactamase and were related with high mortality. S. aureus, S. epidermidis, and Streptococcus species were all susceptible to vancomycin and teicoplanin. Most staphylococci were resistant to penicillin and oxacillin. Most of the gram-negative organisms were susceptible to imipenem. CONCLUSION: Gram-positive organisms were more commonly isolated than gram-negative organisms in pediatric cancer patients like other studies. We could obtained valuable information on the choice of proper antibiotics in our institution. Further studies will be needed to explain the prevalence of A. xylosoxidans in our center.
Acinetobacter ; Alcaligenes ; Anti-Bacterial Agents ; Bacteremia* ; beta-Lactamases ; Child ; Humans ; Imipenem ; Klebsiella ; Medical Records ; Mortality ; Oxacillin ; Penicillins ; Pneumonia ; Prevalence ; Retrospective Studies ; Staphylococcus ; Staphylococcus epidermidis ; Stenotrophomonas ; Streptococcus ; Teicoplanin ; Vancomycin

Russell-Silver syndrome is characterized by low birth weight, growth retardation, delayed bone age, asymmetry, abnormal sexual development, cranio-facial disproportion, short little finger and clinodactyly. Short stature is the major concern, so there have been interests treating Russell-Silver syndrome with human growth hormone. However, there are no large-scale controlled studies to confirm the effectiveness of growth hormone therapy until now because of the rarity of this disorder. In Korea, we cannot find reports dealing with growth hormone treatment in Russell-Silver syndrome. We present three children with Russell-Silver syndrome who showed accelerated growth with growth hormone treatment.
Child ; Fingers ; Growth Hormone* ; Human Growth Hormone ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Sexual Development ; Silver-Russell Syndrome*

PURPOSE: Intravenous immunoglobulin (IVIG) is effective for the treatment of idiopathic thrombocytopenic purpura (ITP) in children. Recently, several reports have been published that show its impact on the absolute neutrophil count. The present study was performed to confirm these findings. METHODS: Data on 26 ITP patients were analyzed. Patients with febrile illness or increased C-reactive protein levels at presentation, which would influence the neutrophil counts, were excluded to determine the sole impact of IVIG. In addition, patients who received steroid treatment were also excluded. RESULTS: Sixteen boys and ten girls were analyzed. For patients who received an IVIG dose of 0.4 g/kg/day (n=17), the absolute neutrophil count (ANC) measured next day was significantly decreased. For patients who received an IVIG dose of 1 g/kg/day (n=9), the ANC measured the next day was also significantly decreased. However, the decrease was more profound in the high-dose group compared to the low-dose group. Among six cases with profoundly decreased ANC greater than 1,000/ mm3, four patients (67%) received IVIG at a dose of 1 g/kg/day. All four cases with increased ANC were treated with IVIG dose of 0.4 g/kg/day, and three cases (75%) among them had a febrile reaction during IVIG administration. None of the cases with decreased ANC had a febrile reaction. No cases had infectious complications reported. CONCLUSION: IVIG treatment for ITP patients appears to suppress the ANC. This decrease of ANC was more pronounced when a higher dose of IVIG was used. Some cases with increased ANC counts after IVIG use were found only in low-dose IVIG group, and was associated with febrile reactions during IVIG use.
C-Reactive Protein ; Child* ; Female ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Neutrophils* ; Purpura, Thrombocytopenic, Idiopathic*

Cutaneous leiomyoma is a rare benign tumor that originates from the smooth muscles derived from arrector pili muscles, the media of dermal blood vessels and the dartos muscle of the scrotum, vulva or nipples. Piloleiomyomas usually occur in the second to third decades of life with an equal incidence in men and women. They can be solitary, but multiple lesions are seen in 80% of these patients. Although multiple leiomyomas are often grouped, unilateral zosteriform pilar leiomyoma is rare. We report here on a rare case of grouped piloleiomyomas that presented as a zosteriform pattern on the right trunk of a 59-year-old woman.
Blood Vessels ; Female ; Humans ; Incidence ; Leiomyoma ; Male ; Middle Aged ; Muscle, Smooth ; Muscles ; Nipples ; Scrotum ; Vulva

BACKGROUND: Fractional photothermolysis makes thousands of minute areas called microthermal treatment zones on the skin surface and transmits thermal injury to facilitate heat shock protein formation around the dermis. Potential side effects include acneiform eruption, herpes simplex virus outbreak, erythema, and post-inflammatory hyperpigmentation. OBJECTIVE: To investigate and compare the changes in the skin of Asian patients after two different fractional photothermolysis systems (FPS) on a split face. METHODS: A half-split face study was performed with 10,600 nm carbon dioxide FPS on the left and 1,550 nm erbium-doped FPS on the right side of the face. Only one session of laser irradiation and several biophysical measurements were done. RESULTS: Although both FPS proved to be effective in treating acne scar and wrinkle patients, a slightly higher satisfaction rating was seen with the 10,600 nm FPS treatment. Both types of FPS showed a significant increase in transepidermal water loss which decreased gradually after treatment and returned to pre-treatment level after 1 week. A decreased reviscometer score was sustained for a longer period in wrinkle areas treated with 10,600 nm FPS. CONCLUSION: Even though the changes in skin varied according to different FPS wave-length, adverse outcomes, such as increased erythema and TEWL were entirely subdued within 3 months of treatment.
Acne Vulgaris ; Acneiform Eruptions ; Asian Continental Ancestry Group ; Carbon Dioxide ; Cicatrix ; Dermis ; Erythema ; Heat-Shock Proteins ; Humans ; Methylmethacrylates ; Polystyrenes ; Simplexvirus ; Skin ; Water Loss, Insensible