The 16 cases of patient with Hodgkin's disease admitted to Department of Pediatrics. Yonsei Cancer Center, Collage of Medicine, Yonsei University during 15 years from January 1975 to December 1989 were reviewed on the basis of clinical charicteristics, treatment and survival rate. The results were summerized as follows. 1) The mean age of patients was 7.6 4.1(range 2~15 years of age). 2) The clinical symptoms and signs were fever (50%), cervical lymphoadenpathy (44%), weight loss(25%), night sweat sweat(19%), hepatomegaly (13%) in order. 3) The stage by Ann Arbor classification revealed Stage I (19%), Stage II (37%), Stage III (19%), stage IV (25%). 4) The histologic subtype of the 14 cases confirmed by Rye Classification revealed that mixed cellularity type (57%) was the most common and lymphocyte predominant type (28%), nodular 5) The seven patients were treated by combind modality therapy, and the six patients by chemotherapy only and the three patients by radiotherapy only. 6) Overall 5 year survival rate was 69% in all patients, and 100% in Stage I, II, 67% in Stage III, but the patients of Stage IV were all died within 7 months.
Classification ; Drug Therapy ; Fever ; Hepatomegaly ; Hodgkin Disease* ; Humans ; Lymphocytes ; Pediatrics ; Radiotherapy ; Secale ; Survival Rate ; Sweat

To find the severity and the type of the cervicobrachial syndrome, through physical examinations and laboratory tests were made toward 137 patients complaining the cervicobrachial syndrome (CBS) through the health interview among 313 workers occupied in a microwave-oven assembling factory from December 1993 to February 1994. Results were as follows. 1. The prevalence of spontaneous pain was 94.9%, while 78.1% suffered from muscle tenderness, 63.5% suffered from muscle induration and 62.0% showed kinesalgia. 54.7% of patients showed positive cervical X-ray findings and 28.5% showed positive Morley test. 2. The muscle induration was associated with the total duration of the job among female workers. 3. The severity of neck tenderness was negatively correlated with the strength of the grip at both hands, positively correlated with the duration of overtime in male and the severity of the wrist tenderness was negatively correlated with the height in female. 4. X-ray findings, muscle induration, Morley test results, muscle tenderness on the neck and muscle tenderness on the shoulder were associated with subjective symptoms of the workers.5. The muscle tenderness was associated with the number of the complaints at upper extremities among the sufferings in daily life significantly and the electromyogram (EMG) finding was associated with; the number of the complaints: about neuropsychological system among the sufferings in daily life significantly. In conclusion, the results of the physical examination were related with the subjective symptoms of the cervicobrachial syndrome. The muscle induration, the muscle tenderness, cervical X-ray findings and the Morley test results were more useful for the diagnosis of CBS. More efforts to objectify the subjective symptoms were asked.
Diagnosis ; Female ; Hand ; Hand Strength ; Humans ; Male ; Myalgia ; Neck ; Physical Examination ; Prevalence ; Shoulder ; Upper Extremity ; Wrist

Type II membranoproliferative glomerulonephritis (MPGN) is characterized by thickening of the glomerular basement membrane owing to electron-dense deposits on electron microscopy. We experienced a case of type II MPGN in a child presenting with proteinuria, hematuria on school urinary screening tests. He had been treated with losartan and enalapril. This is the first case report of type II MPGN detected by school urinary screening tests in Korea. Thus we report a case of 10-years-old male with type II MPGN with a review of brief literature.
Child ; Enalapril ; Glomerular Basement Membrane ; Glomerulonephritis, Membranoproliferative ; Hematuria ; Humans ; Korea ; Losartan ; Male ; Mass Screening ; Microscopy, Electron ; Proteinuria

Poststreptococcal glomerulonephritis (PSGN) is one of the most well-known and important infectious renal diseases resulting from a prior infection with group A beta-hemolytic streptococcus. The typical clinical characteristics of the disease reflect acute onset with gross hematuria, edema, hypertension and moderate proteinuria after the antecedent streptococcal infection. In children, usually PSGN is healed spontaneously but if it combines with fast progressing glomerulonephritis, it would be developed to chronic renal failure. Therefore, it is important to make a fast diagnosis and treatment by simple tools to predict the course and the prognosis of disease. Sonography is a simple tool for diagnosis but there is no typical renal sonographic finding in PSGN, so it is difficult to predict the course and the prognosis of disease by sonographic findings. In comparison between two cases of renal sonographic findings in PSGN, a patient who showed more increased echogenicity in more extended area of renal sonography had the severe results of renal pathology, prolonged treatment period and low serum C3 level. Here, we report the different findings of renal sonography and pathology depending on the degree of severity between two patients. Thus, it is necessary to gather more information from further studies to make a consensus about the relationship between the renal sonography and the prognosis of disease in PSGN.
Child ; Consensus ; Diagnosis ; Edema ; Glomerulonephritis* ; Hematuria ; Humans ; Hypertension ; Kidney Failure, Chronic ; Pathology ; Prognosis ; Proteinuria ; Streptococcal Infections ; Streptococcus ; Ultrasonography

PURPOSE: The purpose of this study was to determine the accuracy of ultrasound guided vacuum-assisted Mammotome biopsy (UVAMB) for breast lesions. METHODS: Percutaneous biopsies of 564 breast lesions, in 489 patients, using UVAMB were performed between October 2000 and May 2002. The pathological findings of the UVAMB were compared with excisional biopsies, sonographic follow-ups and clinical follow-up findings. We evaluated the complication on immediate post-biopsy and 1 week later using ultrasound. RESULTS: Of the 564 lesions, 108 (19.1%) were diagnosed as malignant by UVAMB, and of 456 benign lesions, 63 were excised. On excision two of the benign lesions were found to be carcinomas. The false negative rate of the UVAMB was 2.7%, and 99 (17.5%) of the 564 biopsies were revealed as hematomas by ultrasound 1 week later. However, almost all of complications were well controlled by conservative management. CONCLUSION: Ultrasound guided vacuum-assisted Mammotome biopsies reduced the possibility of false-negatives and underestimated the disease. The complications of UVAMB were not serious, was proved to be a good biopsy method for small, non-palpable breast lesions.
Biopsy* ; Breast* ; Follow-Up Studies ; Hematoma ; Humans ; Ultrasonography*

We experienced anaphylaxis during general anesthesia twice in the same patient. After the first incidence of anaphylaxis at the induction of anesthesia, we speculated that the allergen was rocuronium. Thus, we administered sugammadex as well as a vasopressor to treat the anaphylaxis and the vital signs gradually recovered to nearly normal. Thereafter, we could not avoid the administration of another muscle relaxant, cisatracurium, since the patient moved uncontrollably after the surgery was restarted. A second anaphylactic event then occurred. We speculated that the second allergen was cisatracurium and stopped using it. The results of the investigation after the surgery showed that the allergens were indeed rocuronium and cisatracurium. When we encounter anaphylaxis during general anesthesia, it is necessary to suspect all administered medicines as the cause, with the potential of two or more causes, especially with muscle relaxants.
Allergens ; Anaphylaxis* ; Anesthesia ; Anesthesia, General* ; Humans ; Incidence ; Intradermal Tests ; Vital Signs

BACKGROUND: We aimed to evaluate the efficacy and safety of chloral hydrate-based pediatric sedation conducted by non-anesthesiologists. METHODS: The design and setting of this study was a single-center retrospective study performed at a tertiary university hospital between July 2012 and May 2013. A total of 519 children were enrolled in this study. We investigated the sedation medication, age of patients and type of diagnostic tests or procedures and evaluated the success rate of sedation, sedation/recovery profiles and adverse events. RESULTS: Most patients underwent moderate sedation for diagnostic tests. The most commonly used sedative drug was chloral hydrate, which was solely used for 482 patients. A combination of chloral hydrate/midazolam was used for 24 patients and midazolam only was used for 13 patients. Use of chloral hydrate resulted in a sedation success rate of 65.5% after the initial dose and a success rate of 95.2% with additional doses. The sedation failure rate in children > 6 years was significantly higher than that in children under 6 years. In all patients, the overall onset time and recovery time were too slow and long, respectively, and there was no critical complication. CONCLUSIONS: This study demonstrated that chloral hydrate-based pediatric sedation conducted by non-anesthesiologists was mostly moderate, with a high success rate and a low complication rate. However, the overall onset time and recovery time were too slow and long, respectively. Especially, alternative sedation regimens are required in children > 6 years considering the slower onset time and higher failure rate of sedation.
Child ; Chloral Hydrate ; Conscious Sedation ; Diagnostic Tests, Routine ; Humans ; Midazolam ; Retrospective Studies

OBJECTIVE: To investigate the characteristics of foot deformities in patients with Charcot-Marie-Tooth (CMT) disease compared with normal persons according to severity of disease. METHOD: Sixty-two patients with CMT disease were recruited for this study. The normal control group was composed of 28 healthy people without any foot deformity. Patients were classified into a mild group and a moderate group according to the CMT neuropathy score. Ten typical radiological angles representing foot deformities such as pes equinus and pes varus were measured. The CMT group angles were compared with those of the normal control group, and those of the mild group were also compared with those of the moderate group. RESULTS: The lateral (Lat.) talo-first metatarsal angle, anteroposterior talo-first metatarsal angle, Lat. calcaneal-first metatarsal angle, Lat. naviocuboid overlap, Lat. calcaneal pitch, Lat. tibiocalcaneal angle, and Lat. talocalcaneal angle in the CMT group showed a significant difference compared to the normal control group (p<0.05). These findings revealed CMT patients have pes cavus, forefoot adduction, midfoot supination and pes varus deformity. Compared to the mild group, the moderate group significantly showed an increased Lat. calcaneal pitch and decreased Lat. calcaneal-first metatarsal angle, Lat. tibiocalcaneal angle, Lat. talocalcaneal angle, and Lat. talo-first metatarsal angle (p<0.05). These findings revealed that the pes cavus deformity of CMT patients tend to be worse with disease severity. CONCLUSION: The characteristic equinovarus foot deformity patterns in CMT patients were revealed and these deformities tended to be worse with disease severity. Radiographic measures may be useful for the investigation of foot deformities in CMT patients.
Charcot-Marie-Tooth Disease ; Clubfoot ; Congenital Abnormalities ; Foot ; Foot Deformities ; Humans ; Metatarsal Bones ; Supination

Histopathologic evidence of "full-house" immune complex deposits is a pathognomonic feature of lupus nephritis. This report presents the case of a 12-year-old boy with persistent microscopic hematuria and proteinuria. He was diagnosed with "full-house" nephropathy based on a renal biopsy. However, there was no other clinical or biological evidence of systemic lupus erythematosus (SLE). Although the potential for isolated "full-house" nephropathy preceding SLE is unclear, such patients should be followed for clinical signs and autoantibodies of SLE. In most cases, microscopic hematuria has a good prognosis, and follow-up usually requires only regular urinalysis. However, we should be aware of isolated "full-house" nephropathy that remains asymptomatic for a long time, as few patients with no clinical signs and negative serology ultimately develop SLE.
Antigen-Antibody Complex ; Autoantibodies ; Biopsy ; Child ; Fluorescent Antibody Technique ; Follow-Up Studies ; Hematuria ; Humans ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Male ; Prognosis ; Proteinuria ; Urinalysis

OBJECTIVE: Habitual abortion(HA) is postulated to be due to several factors including immunogenetic mechanisms. Many studies have been conducted on the effect of the major histocompatibility(MHC) region in the reproductive phenomena suggesting an immunological or genetic involvement in HA. HLA-G is a nonclassical class I MHC molecule, with evidence of protecting cells against natural killer cell lysis and not stimulating an allogeneic response by peripheral blood T cells. These features suggest that expression of HLA-G could be a crucial factor for fetal survival in the face of a potentially hostile maternal immune system. The goal of this study was to investigate the immunogenetic role of HLA-G gene in the early pregnancy loss. This is the first report in Korea about the HLA-G gene in the patients of habitual abortion. METHODS: Twenty-one chorionic villi (study group) in the women with habitual abortion (at least 3 spontaneous abortion) and 10 normal chorionic villi (control group) in the women with therapeutic abortion were included in this study. The expression of HLA-G gene in placental extravillous cytotrophoblasts were made by reverse transcription-polymerase chain reaction(RT-PCR) and chromosomal analysis was done by ordinary GTG-banding method. Chi-square and Fisher's exact tests were used for the statistical analysis. RESULT: As a result, HLA-G mRNA was expressed in 52.4%(11/21) of study group, in 70%(7/10) of control group and there was no statistical significance. In study group, positive rate of HLA-G mRNA was 57.1%(4/7) in the patients with normal chromosome, and 50.0%(7/14) in the patients with abnormal chromosome and there was no statistical significance. CONCLUSION: Thus, these results suggest that HLA-G gene might not be a immunogentic marker of early pregnancy loss. But further large scale of study would be needed to reveal the role of HLA-G in habitual abortion.
Abortion, Habitual ; Abortion, Therapeutic ; Chorion* ; Chorionic Villi* ; Female ; HLA-G Antigens ; Humans* ; Immune System ; Immunogenetics ; Killer Cells, Natural ; Korea ; Leukocytes* ; Pregnancy* ; RNA, Messenger ; T-Lymphocytes ; Trophoblasts