We analysed 58 patients who were admitted to the Department of Pediatrics, Yonsei University College of Medicine due to infectious mononucleosis from January 1986 to August 1992. Of 58 patients who had responses to IgM to EBV viral capsid antigen and/or heterophil antibody, 35 patients had hapatitis. Of 35 hepatitis patients, group I consisted of 22 patients who had only EBV infection and group II consisted of 13 patients who had hepatitis B markers or cytomegaloviral markers. The results were as follows: 1) Sex distribution revealed males to females to be 1.1:1. In the age distribution, the proportion of patients with 1 to 3 years of age occupied 40.9% for group I and 30.8% for group II. In non-hepatitis group, 73.9% of patients were in 2 months to 3 years of age. 2) The common presenting symptoms and signs of hepatitis group included hepatomegaly in 24 cases (68.6%), fever in 19 (54.3%), anorexia in 17 (48.6%), throat injection in 16 (45.7%), splenomegaly in 5 (42.9%), and cervical lymphadenopathy in 10 cases (28.6%) etc. 3) In group I, complications or combined diseases included pneumonia in 4 case, disseminated intravascular coagulation in 2 and 1 case in acute pancreatitis. Group II included 1 case of iron deficiency anemia, acute renal failure, peritonitis and pulmonary hemorrhage respectively. 4) Anemia (Hb: <10g/dl) was found in 3 cases (13.6%) for group I, and in 2 cases (15.4%) for group II. Leukocytosis above 10,000/mm3 was demonstrated in 15 cases (68.2%)for group I and in 3 cases (23.1%)for group II. The higher percentage (>15%)of atypical lymphocytes were found in 3 cases (13.6%)for group I and in 1 case(7.7%) for group II. Thrombocytopenia (platelet: <100,000/mm3) was detected in 1 case (4.5%) for group I and in 3 cases (23.1%)for group II. Total bilirubin above 1.0mg/dl was found in 6 cases (27.3%)for group I and in 5 cases(58.1%)for group II. 5) AST level of 100~500IU/L was found in 10 cases(45.4%)for group I, and in 5 cases (38.5%) for group II. AST level above 500IU/L was demonstrated in 1 case (4.5%) and in 3 cases (23.1%) respectively. The mean values of AST level were 253.4 455.3IU/L and 316.7 102.4 IU/L, respectively. 6) Elevated ALT level of 100~500 IU/L was found in 9 cases (40.9%)for group I and in 9 cases(69.2%)for group II. ALT level above 500IU/L was detected in 5 cases (22.7%)for group I and in 3 cases (15.4%)for group II. The mean values of ALT level were 356.9 561.2IU/L and 308.3 259.1IU/L, respectively. 7) Elevated ALT levels returned to normal values within 3 weeks in 14 cases (82.4%) for group I and in 6 cases (66.7%)for group II. The mean duration of normalization of ALT level were 17.3 14.1 days for group I and 19.9 14.8 days for group II. Our results suggest that it AST/ALT levels are elevated and hepatitis A, B, C markers are negative, or if sudden elevated AST/ALT levels are noted in hepatitis B carriers or a patient with cytomegaloviral hepatitis, Epstein-Barr virus infection should be suspected.
Acute Kidney Injury ; Age Distribution ; Anemia ; Anemia, Iron-Deficiency ; Anorexia ; Bilirubin ; Capsid ; Disseminated Intravascular Coagulation ; Epstein-Barr Virus Infections ; Female ; Fever ; Hemorrhage ; Hepatitis A ; Hepatitis B ; Hepatitis* ; Hepatomegaly ; Herpesvirus 4, Human ; Humans ; Immunoglobulin M ; Infectious Mononucleosis ; Leukocytosis ; Lymphatic Diseases ; Lymphocytes ; Male ; Pancreatitis ; Pediatrics ; Peritonitis ; Pharynx ; Pneumonia ; Reference Values ; Sex Distribution ; Splenomegaly ; Thrombocytopenia

No abstract available.
Orbit*

No abstract available.
Child* ; Humans ; Neurons*

A clinica1 study was carried ou on the 98 cases of purpura who were admitted to the Han Gang Sung Shim Hospital during the period of 3 years from Sept., 1975 to Aug., 1978. The results were as follows: 1. The most common cause of purpura was allergic purpura (35.7%). 2. The highest incidence was under 10 years of age group(63.3%), and males were more frequently affected tban fomal with the ratio of 1.3: l. 3. The saonal incidence of purpura was high during the period of 5 months fror Jan. to Klay. Especially in the allergic purpura high incidence was seen in April, May and October. 4. The preclilection site of purpura was on the lower extremities (87.5%) Especially in allergic purpura, the purpura lesions were occured on the lower extremities in all cases. 5, Platelet count in allergic purpura was normal, and that of L.T.P., leukemia, menigococcemia, aplastic anemia and sepsis was decreased in mostly all cases. 6. Bleeding; time was normal in allergic purpura, hut prolonged in ahout 50% of otber diseases. Coagulation time was normal in all cases. 7. Occuit blood was positive in 40% of all cases. 8. Renal rnan!festations occured in 37 cases(37.8%). The most common among them was proteinuria(89.2%)
Anemia, Aplastic ; Hemorrhage ; Humans ; Incidence ; Leukemia ; Lower Extremity ; Male ; Platelet Count ; Purpura* ; Purpura, Schoenlein-Henoch ; Sepsis

Computerized Tomography can make accurate diagnosis in most of the mediastinal tumors and cysts by assessingtheir location, shape and internal architecture. Authors analysed and present CT findings of 89 surgically provenmediastinal tumpors and cysts that were studied and treated in Seoul National University Hospital during recent 5years. The results are as follows; 1. The most common tumor was teratoma(25 cases). Neurogenic tumor (20 cases),thymic tumor or cyst (16 cases), lymphoma(7 cases), bronchogenic cyst (6 cases), intrathoracic goiter (6 cases),pericardial cyst(3 cases) and cystic hygroma(2 cases) were next in order of frequency. 2. The most constant findings of teratoma was thick walled cystic area(100%), while pathognomonic fat and calcified density were seenonly in 52% and 48% of cases, respectively. 22 cases were located in anterior mediastinum, 2 cases were inposterior mediastinum and a case is in middle mediastinum. 3. There were 20 cases of neurogenic tumor consiting of6 neurilemmomas, 7 ganglioneuromas, 4 neurofibromas, 1 ganglioneuroblastoma, 1 neuroblastoma and 1 malignantschwannoma. Most of them were located in posterior mediastinum with exception of 2 neurilemmomas arising from leftvagus nerve and left recurrent laryngeal nerve in middle mediastinum. Cystic change was seen in 2 cases ofneurilemmoma and in a case of ganglioneuroma. Calcification was seen in 3 cases, of neuroblastoma, aneurilemmoma,and a ganglioneuroma. 4. There were 11 cases of thymoma showing homogeneous solid mass with speckeldcalcification in 4 cases and irregular cystic change in 3 cases. 2 cases were invasive thymoma and myastheniagravis was present in 4 cases. A case of thymolipoma and a case of thymic cyst were included. 5. Lymphoma(2Hodgkin's and 4 non-Hodgkin's) appeared as lobulated, matted mass in anterior mediastinum especially inprevascular area expnading bilaterally. 6. Intrathoracic goiter appeared as slingtly high density mass within termingled calcification and cystic area in 5 cases of secondary goiter and homogeneous high densitymass(100-110 H.U. in precontrast scan) in a case of primary goiter. 7. Among the 6 bronchogenic cysts, 3 werelocated in subcarinal area, 2 were above carina and one was in left hilar area. 3 cases showed high CT number morethan 70 H.U. and others showed water density. 8. 3 cases of pericardial cyst were located in right cardiophrenicangle and all of them showed water density. 9. 2 cases of cystic hygroma were located in superior mediastinum,with extension to lower neck and all of them showed water density.
Bronchogenic Cyst ; Diagnosis ; Ganglioneuroblastoma ; Ganglioneuroma ; Goiter ; Goiter, Substernal ; Granuloma ; Lymphangioma, Cystic ; Mediastinal Cyst ; Mediastinum ; Neck ; Neurilemmoma ; Neuroblastoma ; Neurofibroma ; Recurrent Laryngeal Nerve ; Seoul ; Teratoma ; Thymoma ; Water

We presented a case of Reiters syndrome consisting of conjunctivitis, arthritis, and skin lesions, occurring in 20-year-o1d male. He had neither an episode of dysentery nor a history of sexual exposure before onset of syndrome. The skin lesions had begun with erythernatous scaly patches on the inguinal region and scalp, and later followed by generalized pustular, psoriasiform and/or hyperkeratotic crusted lesions on the erythematous base. Yellowish discoloration and onycholysis of nails and shallow ulcer of glans penis were observed. Arthritis of the knee and shoulder joints were developed, accompanied by pain, swelling, limited motion, wasting and weakness of both lower extremities. In laboratory investigation, urinalysis, stool examination for parasites and occult blood, renal function test, blood VDRL, and X-ray of chest, both knee. joints, shoulder joint and thoracolumbar spine were within normal limit or negative except for leukocytosis(24, 500/mm), increased ESR(90 mm/hr) and hypoalbuminemia(2.6 g/dl), and he was associated with HLA-A3, A 9, B5, and Rw 49 Histopathologically skin biopsy specimen showed extensive hyperkeratosis, paralceratosis, elongated rete ridges, spongiform macropustule of Kogoj. He was treated effectively with antibiotics, corticosteroid, and methotrexate for two months without recurrence till now.
Anti-Bacterial Agents ; Arthritis ; Biopsy ; Conjunctivitis ; Dysentery ; Hematologic Tests ; HLA-A3 Antigen ; Humans ; Joints ; Knee ; Lower Extremity ; Male ; Methotrexate ; Occult Blood ; Onycholysis ; Parasites ; Penis ; Recurrence ; Scalp ; Shoulder Joint ; Skin ; Spine ; Thorax ; Ulcer ; Urinalysis

No abstract available.
Adhesives*

Congenial mitral stenosis may be defined as a develpment abnormality of the mitral valve leaflets,commissures, interchordal spaces, papillary muscle,s annulus or immediate supravalvular area producing obstructionto left ventricular filling. Authors had experience of nine cases of congenital mitral stenosis confirmed by twodimenstional echocardiography, angiocardiography and surgery in recent 5 years since 1979, and analyzed them withemphasis on the angiographic findings. The results are as follows; 1. Among 9 cases, 6 patients were male and 3 were female. Age distribution was from 4 months to 11 years. 2. The types of congenital mitral stenosis were 1typical congenital mitral stenosis, 5 cases of parachute mitral valve and 3 cases of supramitral ring. 3. Angiographically typical congenital mitral stenosis showed narrowing of mitral valvular opening, parachute mitralvalve displayed single large papillary muscle with narrowed valvular opening and supramitral ring disclosedsemilunar shaped filling defect between left atrium and ventricle. 4. Associated cardiac and extracardiacanomalies of congenital mitral stenosis, as frequency wise, were ventricular septal defect, patent ductusarteriosus, coarctation of aorta, supra and subvalvular aortic stenosis, mitral regurgitation and double outletright ventricle. 5. Cardiac angiography is essential to diagnose congenital mitral stenosis, but the need of two dimensional echocardiography cannot be ignored.
Age Distribution ; Angiocardiography ; Angiography ; Aortic Coarctation ; Aortic Stenosis, Subvalvular ; Echocardiography ; Female ; Heart Atria ; Heart Septal Defects, Ventricular ; Humans ; Male ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Papillary Muscles

Routine use of commercially available antisera against hepatitis B core antigen(HBcAg) has permitted a reevaluation of the histochemical distribution of the antigen in liver tissue. HBcAg, classically described almost exclusively in the nucleus, was found with a very high frequency in the cytoplasm of liver cells as well. To elucidate the biologic significance of HBcAg expression and its relation to the natural course of hepatitis B virus(HBV) infection, the patterns of activity in 33 needle liver biopsies of HBsAg carriers were analysed. A good correlation of liver HBcAg with disease activity was demonstrated. HBcAg was present in the hepatocyte nuclei(nHBcAg) or cytoplasm(cHBcAg), or in both(mixed). Pure nHBcAg was seen mainly in non-aggressive reactive liver tissue and cHBcAg was predominantly associated with chronic active hepatitis(95%). The results suggest that expression of HBcAg correlates with the liver pathology and the possibility of HBcAg to be an immunological target for T cell mediated hepatocyte damage.
Biopsy

Only several stages of conventional operation have been able to treat the open fracture of the limb with extensive bone and soft tissue loss. So we, authors, reviewed 25 cases of vascularized osteocutaneous fibulat transfer which were performed to the extensive bone defect of the limb and associated soft tissue injury(from May 13, 1982 to September 30, 1988). In 25 cases, one case was a chronic osteomyelitis combined pseudocarcinomatous epithelial hyperplasia of surrounding soft tissue, the other(24 cases) were the open comminuted fractures with the extensive bone and soft tissue loss of the limbs. The average size of the skin flap was 12.33 × 5.83cm, the average length of vascularized fibula was 16.5cm in length. The complications were fractures of grafted fibula, partial necrosis of both ends of the skin flap and uncontrolled infection of proximal end of grafted fibula. During postoperative period, the patency of the anastomoses were monitored by observing the color of the skin of buoy skin flap. The average amounts hypertrophied fibula at 12 months after operation were 20.6cm. And the following remarkable result were obtained. 1. With the uncontrolled bone infection, the vascularized osteocutaneous fibular transfer was able to be performed. 2. During the follow up period, the grafted fibula had been hypertrophied. 3. In roentgenogram, as compared with conventional bone graft, grafted bone was not resorbed and early united. 4. In adult, free fibula can be obtained and grafted as 23cm as long and the skin flap with fibula can be obtained and grafted as 21 × 7cm as large in or experience. 5. In the vascularized osteocutaneous fibula transfer, the patency of anastomoses was monitored indirectly by confirming skin flap. 6. The fractured fibula was united early by cast immobilization, and it was hypertrophied at the fracture site. 7. The vascularized osteocutaneous fibula transfer is also useful in application of the other long bones.
Adult ; Extremities ; Fibula ; Follow-Up Studies ; Fractures, Comminuted ; Fractures, Open ; Humans ; Hyperplasia ; Immobilization ; Microsurgery ; Necrosis ; Osteomyelitis ; Postoperative Period ; Skin ; Transplants