To analyse the age of onset, etiologic microorganisms, clinical manifestations, managements and genetic variation of chromic granulomatous disease, the authors reviewed four patients who were diagnosed as CGD at Department of Pediatrics, Seoul National Univesity Children's Hospital. They were siblings in relationship-two of them were brothers, the others were brother-sister. @ES The results were as follows; 1) Initial manifestations developed within 1 year old, and lymphadenopathy associated with BCG vaccination was the most common. 2) In culture study of micro-organism, catalase positive microorganisms such as Staphylococcus aureus, Serratia marcescens, Coagulase (-) Staphylococcus, Enterococcus, Proleus vulgaris, Klebsiella pneumoniae, E. coli and fungus such as Candida albicans were isolated. In 2 cases, culture study revealed no growth. 3) Fever, lymphadenopathy, hepatomegaly, suppurative dermatitis and pneumonia were the most common manifestations. In most of cases, antituberculous medications were administered under the impression of tuberculosis without response. 4) Immunologic screening tests including B-cell system, T-cell system, and complement system were within normal limit except NBT test. 5) In spite of severe infections, NBT scores of all the cases were less than those of controls. Liver biopsies of 3 cases showed granuloma formation with characteristic yellow brown pigment-laden macrophages.
Age of Onset ; B-Lymphocytes ; Biopsy ; Candida albicans ; Catalase ; Coagulase ; Complement System Proteins ; Dermatitis ; Enterococcus ; Fever ; Fungi ; Genetic Variation ; Granuloma ; Hepatomegaly ; Humans ; Klebsiella pneumoniae ; Liver ; Lymphatic Diseases ; Macrophages ; Mass Screening ; Mycobacterium bovis ; Pediatrics ; Pneumonia ; Seoul ; Serratia marcescens ; Siblings ; Staphylococcus ; Staphylococcus aureus ; T-Lymphocytes ; Tuberculosis ; Vaccination

Chronic mucocutaneous randidiasis is a clinical syndrome characte ized by chronic and reccurent superficial candidal infection of the skin, mucous membranes, and nails. This syndrome is frequently associated with immune deficiency or endocrinopathy, especially hypopar; thyroidism. We report a case of chrcinic mucocutaneous candidiasis associated with hypoparathyroidism in a 8- year-old girl.
Candidiasis ; Candidiasis, Chronic Mucocutaneous* ; Female ; Humans ; Hypoparathyroidism* ; Mucous Membrane ; Skin ; Thyroid Gland

This study was performed in order to recognize the identifications of the glycoproteins containing oligosaccharides in human gingiva. After made paraffin sections of human gingiva at 4µm, the sections were incubated with 7 lectins (UEA-I, BS-I, SBA, DBA, WGA, PNA, PNA after neuraminidase treated, Con-A). In order to increase specificity of reactions, the sections were applicated with ABC system. And then the sections were incubated with DAB and were counterstained with hematoxylin. Using the same sections, the sections were done H-E and PAS stains. In WGA, DBA and Con-A, plasma membranes of the layers of all epithelium and connective tissue were stained. In BS-I ; In the epithelium of marginal gingiva, plasma membranes of upper layer of the spinous cell layer and granular cell layer were stained. And in epithelium of sulcular gingiva, plasma membranes of the all spinous cell layer and granular cell layer were stained. In SBA ; Plasma membranes of the granular cell layer were stained. In PNA ; In the epithelium of marginal gingiva, plasma membranes of the basal cell layer and lower layer of spinous cell layer were stained. But lectin reactions were not occurred in thc sulcular gingiva. In PNA treated neuraminidase, plasma membranes of the all epithelial layer except basal cell layer membranes especially cytoplasms of upper layer at the sulcular gingiva and connective tissue were reacted. 1. By the above results, authors could know the identification of oligosaccharides existing g1ycoproteins in the human gingiva. 1) All epithelial layer ; α-D-N-Acetyl-Galactosamine, Sialic acid, D-Glucosamine, α-D-Mannose 2) Basal cell layer ; Galactose-β-(1-3)-N-Acetyl-Galactosamine 3) Spinous cell layer ; α-D-Galactose, Galactose-β-(1-3)-N-Acetyl-Galactosamine 4) Granular cell layer ; α-D-Galactose 5) Connective tissue ; α-D-N-Acetyl-Galactosamine, Siallic acid, β-(1-4)-D-Acetyl-Glucosamine, α-D-Glucosamine, α-D-Mannose 2. The Galactose-β-(1-3)-N-Acetyl-Galactosamine was not existed in the basal cell layer and spinous cell layer in the sulcular gingiva.
Cell Membrane ; Classification* ; Coloring Agents ; Connective Tissue ; Cytoplasm ; Dronabinol ; Epithelium ; Gingiva* ; Glycoconjugates ; Glycoproteins ; Hematoxylin ; Humans* ; Lectins ; Membranes ; N-Acetylneuraminic Acid ; Neuraminidase ; Oligosaccharides ; Paraffin ; Periodic Acid-Schiff Reaction* ; Sensitivity and Specificity

No abstract available.
Clone Cells* ; Cloning, Organism* ; DNA* ; Genome* ; Nucleopolyhedrovirus* ; Plasmids*

This is a clinical analysis and review of one-hundred ninety-four patients with periappendiceal abscesses who were treated at the Departmeat of Surgery, Masan Samsung Hospital over a ten year period from January 1985 to December 1994. The following results were obtained. The incidence of periappendiceal abscesses was 7.24% of the total cases of appendicitis operated on during the same period, and most of the patients(43.8%) were over fifty years old. The male to female ratio was 1:1.02. 41.2% of the patients had operations within four days after their symptoms occurred. On admission, the most common physical finding was tenderness on the right lower quadrant of the abdomen (92.9%) and leukocytosis(> OR = 10,000/mm3) was noted on CBC in 82% of the patients. Abdominal sonograms revealed periappendiceal abscesses in 88% of the patients, 83% were revealed with barium enema and 88% with abdominal CT scan. Many patients(75.5%) visited the local clinic and were treated under the diagnosis of gastritis or enteritis instead of appendicitis. One-hundred eighty-three patients(94.3%) had appendectomies with drainages(94.3%), two patients had drainages of abscesses without appendectomy, six patients had ileocecal resections and three patients had right hemicolectomies. Microbiologically, E. coli was the most frequently cultured species(63%) from abscess, and Klebsiella, Enterococcus and Proteus were isolated in some cases. Postoperative complication occurred in seventy-five patients(38.6%) and the most frequent complication was wound infection(28.8%). There was no mortality and the mean hospital stay was fifteen days.
Abdomen ; Abscess* ; Appendectomy ; Appendicitis ; Barium ; Diagnosis ; Enema ; Enteritis ; Enterococcus ; Female ; Gastritis ; Humans ; Incidence ; Klebsiella ; Length of Stay ; Male ; Mortality ; Postoperative Complications ; Proteus ; Tomography, X-Ray Computed ; Wounds and Injuries

Paroxysmal itching is a rare symptom in multiple sclerosis and it was first reported in 1975 by Osterman and Westerberg. It has been suggested that paroxysmal itching may be due to the activation of axons in CNS via abnormal synapses between demyelinated axons. Carbamazepine, phenytoin, and ibuprofen are known to be effective in the treatment of paroxysmal itching. We report a case of paroxysmal itching of 4 months' duration in a 41-year-old female with multiple sclerosis who suffered from severe paroxysmal itching on the left side of her neck and chest. The itching did not respond to carbamazepine, but it was partially controlled with ibuprofen.
Adult ; Axons ; Carbamazepine ; Female ; Humans ; Ibuprofen ; Multiple Sclerosis* ; Neck ; Phenytoin ; Pruritus* ; Synapses ; Thorax

OBJECTIVE: This study was done to evaluate the risk factors associated with recurrence after first-ever stroke. METHOD: We retrospectively studied 256 first-ever stroke patients treated in Dong-Eui hospital from March 1997 to February 1998. Telephone or out-patient interviews were performed with these patients regarding stroke recurrence and treatment for hypertension and diabetes mellitus. These were divided into two groups, those with recurrence and those without. Evaluated risk factors for stroke recurrence were the following: history of diabetes mellitus, hypertension, heart disease, smoking, alcohol drinking, and transient ischemic attack; clinical findings at admission of hypertension, diabetes mellitus, hyperlipidemia, heart disease, type and location of stroke; treatment compliance for diabetes mellitus and hypertension after discharge. RESULTS: The recurrence rate after first-ever stroke was 12.9%. In univariate analysis, significant risk factors for stroke recurrence were history of smoking, clinical findings at admission of diabetes mellitus, atrial fibrillation, ischemic heart disease, and non-compliance with therapy for diabetes mellitus and hypertension after discharge (p<0.05). In multivariate analysis, significant risk factors for stroke recurrence were atrial fibrillation at admission (odds ratio=3.43) and non-compliance with therapy for hypertension after discharge (odds ratio=7.51)(p<0.05). CONCLUSION: History of smoking, clinical findings at admission of diabetes mellitus, atrial fibrillation, ischemic heart disease, and non-compliance with therapy for diabetes mellitus and hypertension after discharge are considered to be important factors for recurrence of stroke. So treatment and education for those factors associated with stroke recurrence are needed during rehabilitation program.
Alcohol Drinking ; Atrial Fibrillation ; Compliance ; Diabetes Mellitus ; Education ; Heart Diseases ; Humans ; Hyperlipidemias ; Hypertension ; Ischemic Attack, Transient ; Multivariate Analysis ; Myocardial Ischemia ; Outpatients ; Recurrence* ; Rehabilitation ; Retrospective Studies ; Risk Factors* ; Smoke ; Smoking ; Stroke* ; Telephone

OBJECTIVE: The purpose of this study is to evaluate the patterns of voiding dysfunction of stroke patients during rehabilitation. METHOD: We evaluated 53 patients with complaints of voiding dysfunction following the strokes. After the comprehensive history and physical examination, all patients underwent cystometric study and males underwent the transrectal ultrasound. RESULTS: The incidences of detrusor hyperreflexia, detrusor areflexia, and normal finding on the cystometry were 50.9%, 32.1%, and 17.0%, respectively (p<0.05). There was a significantly high incidence of detrusor hyperreflexia in the groups of subcortical lesion, large lesion, and the over 3 months after stroke (p<0.05). However, there was no statistical difference on cystometric findings according to the other characteristics of the stroke such as the age, sex, type of stroke, cognition, aphasia, and diabetes mellitus. The incidences of irritative, obstructive, and mixed symptoms according to the presenting voiding complaints were 49.1%, 32.1%, and 18.9%, respectively (p<0.05). There was no significant statistical difference on the cystometric findings according to the 3 voiding symptom groups as well as none of significant statistical difference on prostate enlargement in males in according to the 3 voiding symptom groups. CONCLUSION: Only with the pattern of voiding, we could not predict the cystometric finding or the presence of bladder outlet obstruction. Thus, we recommend the further studies including cystometry and evaluation of the bladder outlet obstruction for the treatment of voiding dysfunction of stroke patients during rehabilitation.
Aphasia ; Cognition ; Diabetes Mellitus ; Humans ; Incidence ; Male ; Physical Examination ; Prostate ; Reflex, Abnormal ; Rehabilitation* ; Stroke* ; Ultrasonography ; Urinary Bladder Neck Obstruction

PURPOSE: This study was performed to describe the clinical manifestations of hospitalized children due to varicella-zoster virus (VZV) infection. METHODS: This study included 40 children who were hospitalized for varicella or herpes zoster at Seoul National University Children's Hospital, 2009-2012. Diagnosis of VZV infection was confirmed by VZV PCR or culture from vesicular fluid. Medical records were reviewed to collect clinical features and outcome, antiviral treatment, history of varicella vaccination, and underlying diseases. RESULTS: Sixteen patients with varicella and 24 patients with herpes zoster were included. Their median age was 10.5 years (16 days-19 years). Thirty-five (87.5%) patients had underlying diseases. Among 24 patients with herpes zoster, 11 patients had previous history of varicella and 1 had herpes zoster. Twenty patients (50%) had a history of varicella vaccination, and 19 immunocompromised patients had VZV infection despite of vaccination. Most (95%) patients were treated by intravenous or oral acyclovir, and no treatment failure of intravenous acyclovir was found. The median duration of fever was 4.4 days (1-10 days), and that of antiviral treatment was 12 days (7-23 days) in immunocompromised patients. Immunocompromised patients received longer duration of antiviral treatment than imunocompetent patients (P=0.014). Eleven (27.5%) immunocompromised patients had postherpetic neuralgia, 2 (5%) had proven co-infection by Streptococcus pyogenes and Klebsiella oxytoca, and 1 (2.5%) complicated with pneumonia. CONCLUSION: Immunocompromised children require longer duration of treatment and are at risk of severe complication associated with VZV infection. Early initiation of antiviral therapy and close monitoring are necessary for those in immunocpompromised conditions.
Acyclovir ; Chickenpox ; Child ; Child, Hospitalized* ; Coinfection ; Diagnosis ; Fever ; Herpes Zoster ; Herpesvirus 3, Human* ; Humans ; Immunocompromised Host ; Klebsiella oxytoca ; Medical Records ; Neuralgia, Postherpetic ; Pneumonia ; Polymerase Chain Reaction ; Seoul ; Streptococcus pyogenes ; Treatment Failure ; Vaccination

No abstract available.
Animals ; Herpes Simplex* ; Mice* ; Simplexvirus* ; Skin* ; Vagina*