After aseptic or septic meningitis, some neurologic complications such as convulsions, delirium, rigidity, cerebral infarctions and cerebral hemorrhage can be developed. The cerebral infarction after meningitis is caused by arterial or venous occlusions. Involvement of small perforating arteries leads to ganglionic infarcts while severe sapsm of major vessels may lead to massive infarctions in the distribution of middle and/or anterior cerebral arteries. Cortical venous and/or dural thrombosis (especially in the superior sagittal sinus) produces typical features, including multiple areas of white matter hemorrhagic infarction. These neurologic complications are common in bacterial meningitis and very rare in aseptic meningitis. We experienced a case of cerebral infarction in MCA/ACA territory and subdural hemorrhage in occipital lobe after aseptic meningitis in 10 month-old-boy. We report a case with a brief review of related literature.
Anterior Cerebral Artery ; Arteries ; Cerebral Hemorrhage ; Cerebral Infarction* ; Delirium ; Ganglion Cysts ; Hematoma, Subdural* ; Infarction ; Meningitis ; Meningitis, Aseptic* ; Meningitis, Bacterial ; Occipital Lobe ; Seizures ; Thrombosis

No abstract available.
Adrenocortical Carcinoma* ; Cushing Syndrome ; Humans ; Infant* ; Male* ; Puberty, Precocious

A notching deformity of the vermilion is one of the most common secondary lip deformities following unilateral cleft lip repair. It is due to inadequate approximation of the orbicularis marginalis muscle, vertical scar contracture, and inappropriate adjustment and suturing of the vermilion. During the primary repair, symmetric construction of vermilion is difficult. This is because the thickness and shape of the vermilion is different on both sides of the cleft. To prevent notching deformity of the vermilion, authors designed the incision line such as Tongue-in-Groove on the vermilion and has been utilizing this technique for the last several years and obtained quite satisfactory results. Hereby we present the technique and result.
Cicatrix ; Cleft Lip* ; Congenital Abnormalities ; Contracture ; Lip

BACKGROUND: The replacement of the narrowed long-segment trachea with various prosthetic materials or tissue grafts remains a difficult and unsolved surgical problem. Homologous cryopreserved tracheal transplantation has been considered to treat the irreversibly-damaged organs, such as in the lung or heart transplantation and also to overcome the limited supply of donor organs. We examined the morphological changes and the immunosuppressive effects of the cryopreserved trachea after the heterotopic transplantation in the rats. MATERIAL AND METHOD: Sixty tracheal segments harvested from 30 donor Wistar rats were heterotopically implanted into the peritoneal cavity of 20 recipient Wistar rats and 40 Sprague Dawley rats. The 60 recipient rats were divided into 6 groups(10 rats/ group). In groups I, II, and III, 30 tracheal segments were implanted immediately after the harvesting and in groups IV, V, and VI, the segments were implanted 28 days after the cryopreservation. Groups I and IV were Wistar syngeneic controls. Groups II and V were Sprague Dawley recipients receiving no immunosuppression and Groups III and VI, were Sprague Dawley recipients receiving immunosuppressive agents. At 28 days all rats were sacrificed and the tracheal segments were evaluated grossly and histologically. RESULT: Immunosuppression of the tracheal segments had a significant influence on the changes of the tracheal lumen and tracheal epithelial cells, irrespective of the cryopreservation of the trachea(p<0.001). In groups III and VI receiving immunosuppressive agents, the tracheal lumen was patent and the normal epithelial cells were observed, however in the other groups not receiving the immunosuppressive agents, there were almost luminal obliteration by the proliferation of the fibrous tissues and a loss of the epithelial cells, the findings were similar to those in the case of obliterative bronchiolitis after a lung and a heart-lung transplantation. CONCLUSION: With the appropriate immunosuppressive agents, the lumen and the respiratory epithelium of the transplanted tracheal segment were well preserved, even after the cryopreservation of the tracheal segment, which shows the possibility of the long-term preservation and homologous transplantation of the trachea. But fibroproliferative obliteration of the tracheal lumen and the loss of the normal respiratory epithelial cells, characteristic findings of obliterative bronchiolitis, were observed in the groups without the immunosuppression. This experiment using the rat trachea may be useful in studying the pathogenesis, treatment, and prevention of obliterative bronchiolitis after a lung and a heart-lung transplantation.
Allografts ; Animals* ; Bronchiolitis Obliterans ; Bronchiolitis* ; Cryopreservation ; Epithelial Cells ; Heart Transplantation ; Heart-Lung Transplantation ; Humans ; Immunosuppression* ; Immunosuppressive Agents ; Lung ; Models, Animal* ; Peritoneal Cavity ; Phenobarbital ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Respiratory Mucosa ; Tissue Donors ; Trachea* ; Transplantation, Heterotopic* ; Transplantation, Homologous ; Transplants

PURPOSE: We evaluated Kawasaki disease(KD) in children in order to evaluate the clinical characteristics and coronary complication of infantile Kawasaki disease. METHODS: A total of 226 medical records of children with KD admitted to The Catholic University of Korea, St. Mary's Hospital, from 1994 to 2003 were retrospectively analyzed. RESULTS: The incidence of lymphadenopathy was statistically lower in infantile Kawasaki disease than in Kawasaki disease of children older than one year. The incidence of atypical Kawasaki disease in infant(32%) was greater than that of total patients(24%), but there was no statistically significant difference in two groups. The incidence of coronary complication in atypical Kawasaki disease in children younger than one year was 50%(6/12), which was greater than that of coronary complication in typical KD of children older than one year. CONCLUSION: Diagnostic difficulties in infantile Kawasaki disease are due to high incidence of atypical characteristics of Kawasaki disease. Yet, early treatment with IVGV and aspirin is necessary because of its high incidence of coronary complication.
Aspirin ; Child ; Humans ; Incidence ; Korea ; Lymphatic Diseases ; Medical Records ; Mucocutaneous Lymph Node Syndrome* ; Retrospective Studies

Pachydermodactyly is a rare distinct form of fibromatosis characterized by acquired, asymptomatic dense fibrosis and fibroblastic proliferation around one or more proximal interphalangeal joints. Intralesional triamcinolone injection may be helpful in improving the clinical appearance. A 20-year-old unemployed female patient gave a four years history of progressive swelling of the fingers affecting predominantly the proximal interphalangeal joints of index fingers of left hand and index, middle fingers of right hand. There was no pain and tenderness. Physical examination, complete blood count, antinuclear antibody, rheumatoid factor were unremarkable and radiograph of both hands showed soft tissue swelling only without bony abnormality. We excised the redundant soft tissue from the both sides of proximal interphalangeal joint with longitudinal elliptical fashion. After operation, the fingers of the patient showed marked improvement cosmetically. There were no motor or sensory changes. Pachydermodactyly was first reported in 1996 in Korea. Histologic features include an increased dermal accumulation of collagen and occasionally an increased number of fibroblast. We report for one patient with pachydermodactyly treated with longitudinal elliptical excision and obtained an improvement of clinical appearance.
Antibodies, Antinuclear ; Blood Cell Count ; Collagen ; Female ; Fibroblasts ; Fibroma ; Fibrosis ; Fingers ; Hand ; Humans ; Joints ; Korea ; Physical Examination ; Rheumatoid Factor ; Triamcinolone ; Young Adult

PURPOSE: This study was performed to determine the relation between cord blood plasma cytokines responses and development of cerebral palsies in premature infants. METHODS: Interleukin-1beta(IL-1beta), Interleukin-6(IL-6), Tumor necrosis factor-alpha(TNF-alpha) were measured using ELISA kits in premature infants(n=60) who were admitted to St. Benedict Hospital from September 2001 to June 2003. Retrospective study was done by review of medical records. RESULTS: Cord blood levels of IL-1beta, IL-6 and TNF-alpha in the cerebral palsy group were higher, especially IL-6 but were not significant, compared with the control group. Cord blood levels of IL-6 in the cerebral palsy without asphyxia, sepsis, PROM, RDS and pneumonia were significantly different, compared with the control group. CONCLUSION: Cord blood levels of IL-1beta, IL-6 and TNF-alpha in the cerebral palsy group were increased, but concentrations of IL-6 increased significantly. Cord blood levels of IL-6 may be a useful value to predict the development of cerebral palsy, because they are related to IL-6 rather than to TNF-alpha & IL-1beta in this study.
Asphyxia ; Cerebral Palsy* ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Fetal Blood* ; Humans ; Infant, Newborn ; Infant, Premature* ; Interleukin-6 ; Medical Records ; Necrosis ; Paralysis ; Plasma ; Pneumonia ; Retrospective Studies ; Sepsis ; Tumor Necrosis Factor-alpha

In this report, we present an interesting description of an osteochondroma arising from the anterior arc of the left fifth rib mimicking an anterior mediastinal mass. Surgical excision confirmed the lesion to be a non-complicated osteochondroma of the rib abutting underlying the parent bone.
Humans ; Osteochondroma* ; Parents ; Ribs* ; Tomography, X-Ray Computed

PURPOSE: Immunosuppression is important for early success of renal transplantation. Mycofenolate mofetil (MMF) has been substituted for Azathioprine (AZA) and has been shown to have greater effect on T cell and also on B cell function than AZA. Although many side effects like infections have been investigated in patients who received AZA based therapy, they have not extensively been studied in MMF based protocol. The aim of this study is to evaluate the differences in incidence and frequency of infections during the first 6 months in the patients who received AZA or MMF based therapy. METHODS: Renal transplant recipients who received either AZA or MMF based therapy were reviewed. From January 1994 to December 2003, 112 patients were enrolled and analyzed the types and frequency of infection. RESULTS: 78 patients received AZA based therapy, and 34 patients received MMF based therapy. Infection developed in 37 (47.4%) and 12 (35.3%) patients respectively. AZA group showed higher incidence of infection than MMF group (P<0.05). In AZA group, UTI developed in 15 patients (19.2%), URI in 7 patients(9%), CMV infection in 7 patients (9%), tuberculosis in 2 patients (2.6%), and wound infection in 6 patients (7.7%). In MMF group, UTI developed in 6 patients (17.6%), URI in 2 patients (5.9%), CMV infection in 2 patients (5.9%), tuberculosis in 1 patient (2.9%), wound infection in 1 patient (2.9%). There were no significant differences in the type of various infectious episodes between two groups. CONCLUSION: AZA group showed higher incidence in total infection, but there were no differences in the type of various infectious episodes between two groups. MMF has more powerful immunosuppressive effect (18) but has similar infectious adverse effects compared with AZA.
Azathioprine ; Humans ; Immunosuppression* ; Incidence ; Kidney Transplantation ; Transplantation* ; Tuberculosis ; Wound Infection

Methotrexate (MTX) has been widely used in the treatment of psoriasis and rheumatoid arthritis. But prolonged use of MTX can induce hepatic fibrosis and even cirrhosis. To date, in Korea, there have been very few reports on hepatotoxicity due to MTX, and no report on biopsy-proven chronic active hapatitis. We report one patient who developed chronic acitve hepatitis while taking long-term daily dose of MTX(10mg per day) for psoriasis for a prolonged period.
Arthritis, Rheumatoid ; Fibrosis ; Hepatitis ; Hepatitis, Chronic* ; Humans ; Korea ; Methotrexate* ; Psoriasis*