No abstract available.
Female ; Ovary* ; Teratoma*

OBJECTIVES: The purpose of this study was to assess the clinical features, microbiologic results, and the efficacy of perineal hygienic care of pediatric vulvovaginitis. METHODS: Forty-two unselected premenarcheal patients with symptoms or signs of vulvovaginitis who were attended the outpatient pediatric and adolescent gynecology clinic at Pundang CHA General Hospital from August 1997, to September 1999 were systematically interviewed and examined using a standardized format, studied microbiologically, and followed the efficacy of perineal hygienic measures prospectively. RESULTS: The median age of the patients was 4.8 years (range 2.9 years to 10.9 years). Vaginal complaints of 42 patients were discharge(79%), genital pain or irritation(31%), odor(17%), pruritus(14%), and vaginal bleeding(7%). On physical examination, vaginal discharge and vulvar erythema were noted in 17(40%) and 22(52%) patients, respectively. Aerobic bacteria or yeast excluding vaginal normal flora were found in 24 of 42 patients(57%). Convincing evidence of specific pathogens was found in 9 of 42 patients(21%) including one case of pinworm infestation. Isolated pathogens were H. influenza(3), S. pyogenes(2), K. pneumonia(2) and N. gonorrhea(1). No patients were found to have chlamydial infection or trichomoniasis. In 14 patients, risk factors were identified such as swimming(14%), bubble bath(5%), sexual abuse(5%), genital trauma(5%) and foreign body(2%). After two weeks instructions of perineal hygienic care, 26(62%) of 42 patients revealed complete resolution of symptoms and signs of vaginitis without antibiotics. Efficacies of perineal hygienic care were 94%(17/18) in the patients with normal flora alone, 60%(9/15) in the patients with organisms suspected for nonspecific infection and 0%(0/9) in the patients with specific pathogens(p<0.05). CONCLUSION: Majority(62%) of the pediatric patients with symptoms or signs of vulvovaginitis were cured with perineal hygienic care alone. And the efficacy of hygienic measure were higher in the patients without specific pathogens(79%, 26/33). Therefore, proper physical examination, microbiologic study and appropriate instructions of perineal hygienic care were more important than empirical antibiotic treatment in initial management of pediatric vulvovaginitis.
Adolescent ; Anti-Bacterial Agents ; Bacteria, Aerobic ; Enterobius ; Erythema ; Gynecology ; Hospitals, General ; Humans ; Outpatients ; Physical Examination ; Prospective Studies ; Risk Factors ; Vaginal Discharge ; Vaginitis ; Vulvovaginitis* ; Yeasts

We report a patient who had been initially diagnosed as a myelodysplastic syndrome in 1998 presenting purpuric patches on the left arm that started to develop about a year prior. The purpuric lesions were diagnosed as leukemia cutis by skin biopsy. Her subsequent bone marrow biopsy showed progression into an atypical chronic myeloid leukemia with increased numbers of leukocytes in the peripheral blood. Leukemia cutis typically is regarded as a sign of progression of disease or a manifestation of recurrent disease in treated patients with an established diagnosis of leukemia. We suggest that the skin lesion in this patient could have been a sign of con-version into atypical chronic myeloid leukemia.
Arm ; Biopsy ; Bone Marrow ; Diagnosis ; Humans ; Leukemia* ; Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative* ; Leukocytes ; Myelodysplastic Syndromes* ; Skin

No abstract available.
Animals ; Brain* ; Rats* ; Serotonergic Neurons*

No abstract available.
Cesarean Section* ; Female ; Pregnancy

Purpose: To report a case of preseptal cellulitis after strabismus surgery in a patient with no previous history of ocular surgery.Case summary: A 33-year-old male visited the ophthalmology clinic with a 4-day history of left eye pain and lid swelling after strabismus surgery. He was a healthy patient with a history of polio resulting in left hemiparalysis and difficulty walking. He was followed up with left medial rectus and lateral rectus muscle resection surgery for secondary sensory esotropia. His best corrected visual acuity was 0.6 in his left eye and physical examination revealed pain, eyelid edema, chemosis, and purulent discharge from the left conjunctival fornix. Computed tomography scanning with contrast enhancement revealed diffuse preseptal periorbital soft tissue swelling and enhanced fat stranding suggesting left preseptal cellulitis. The patient was hospitalized with intravenous broad spectrum antibiotics. Left eye swelling was improved and purulent discharge had decreased after 3 days; he was discharged after a 5-day course of intravenous antibiotic treatment. Oral antibiotics were administrated for 1 week. The patient had no recurrent symptoms during the 3-month follow-up. Conclusions Although rare, preseptal cellulitis after strabismus surgery must be promptly recognized to prevent secondary complications related to infection.

Purpose: To report a case of preseptal cellulitis after strabismus surgery in a patient with no previous history of ocular surgery.Case summary: A 33-year-old male visited the ophthalmology clinic with a 4-day history of left eye pain and lid swelling after strabismus surgery. He was a healthy patient with a history of polio resulting in left hemiparalysis and difficulty walking. He was followed up with left medial rectus and lateral rectus muscle resection surgery for secondary sensory esotropia. His best corrected visual acuity was 0.6 in his left eye and physical examination revealed pain, eyelid edema, chemosis, and purulent discharge from the left conjunctival fornix. Computed tomography scanning with contrast enhancement revealed diffuse preseptal periorbital soft tissue swelling and enhanced fat stranding suggesting left preseptal cellulitis. The patient was hospitalized with intravenous broad spectrum antibiotics. Left eye swelling was improved and purulent discharge had decreased after 3 days; he was discharged after a 5-day course of intravenous antibiotic treatment. Oral antibiotics were administrated for 1 week. The patient had no recurrent symptoms during the 3-month follow-up. Conclusions Although rare, preseptal cellulitis after strabismus surgery must be promptly recognized to prevent secondary complications related to infection.

No abstract available.
Fetus* ; Humans ; Pregnancy, Twin* ; Twins*

No abstract available.
Fetus* ; Humans ; Pregnancy, Twin* ; Twins*

We report a case of a 13-year-old girl who was noted to have combined malformation of complete septate uterus, obstructed hemivagina and ipsilateral renal agenesis with complaints of dysmenorrhea. Hematometrocolpos was developed in the result of retained menstrual blood since menarche. This rare congenital anomaly is supposed to be derived from disorders of mesonephric and M llerian developement in embryogenesis of female genitouinary tract. An accurate preoperative diagnosis of this syndrome is critical because of the difference in therapeutic strategy and prognosis. Simple and definite treatment of the condition is excision of the obstructed vaginal septum with prompt exit of retained blood. We present here a interesting case of M llerian anomaly in attempt to alert gynecologist to the possible occurrence of such a malformation with a brief review of concerned literatures.
Adolescent ; Diagnosis ; Dysmenorrhea ; Embryonic Development ; Female ; Humans ; Menarche ; Pregnancy ; Prognosis ; Uterus*