A total of 68 primary melanorna cases diagnosed at Seoul National University Hospital for the past 10 years from 1978 to 1987 were included for this clinico pathological study. Among the 31 primary cutaneous melanomss, 19 cases (61.3%) occurred on hands or feet, especially on the plantar surfaces. The average age of patients with acral melanomas was 49.3 years at the tirne of diagnosis and the male to female ratio of 19 cases was 3.8 to 1. The clinical and histopathologic findings showed that most ecral melanomas, if not all, were the acral lentiginous type. A high incidence of metastasis (73.7%) was recognized in acral melanomas.
Diagnosis ; Female ; Foot ; Hand ; Humans ; Incidence ; Male ; Melanoma* ; Neoplasm Metastasis ; Seoul

No abstract available.
Apocrine Glands ; Hidrocystoma*

PURPOSE: The authors carried out this study to determine the relationship between vigabatrin (VGB) and visual field defect. METHODS: Seventy eight patients older than 8 years who had epilepsy which had developed and been diagnosed, and were receiving add-on therapy, were the subjects of this study. If suspicious results were obtained from the initial test with the Humphrey automatic perimeter, the patient was tested again with the Goldman perimeter. Follow-up examinations were performed on these patients after 6 months. RESULTS: In this study, five of the 78 patients had suspicious primary test results, but upon the second examination they were all found to be normal. Thus there were no patients with visual field defects. CONCLUSIONS: VGB is a drug which may cause visual field defects, but in this study no patients presented with this symptom. Instead of limiting the use of VGB due to the adverse effect of visual field defect in the initial treatment of partial seizure and infantile spasm untreatable with other medication, if used with care it may not cause serious problems. Screening for visual defect is recommended, and in patients taking VGB regular examination is necessary.
Child* ; Epilepsy ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Mass Screening ; Seizures ; Spasms, Infantile ; Vigabatrin* ; Visual Fields*

PURPOSE: To determine the role of Tc-99m HMPAO SPECT imaging in children with intractable seizure by evaluating the interictal period. METHODS: We compared the EEG, CT and MRI medical records with those of Tc-99m HMPAO SPECT in 42 patients with intractable seizure referred to Kyunghee University Hospital, from April 1983 to September 1998, retrospectively. RESULTS: Mean age was 8.3 years and male to female ratio was 2.5 : 1. Multiple surface EEG recordings were performed in 42 patients and EEG findings of all patients showed an epileptogenic focus, with the most common area of abnormal findings being the Lt. sides. Brain CT was performed in 23 out of 42 patients(54.8%), and 15 out of the 23 patients(65.2%) showed abnormal findings and the most common area of abnormal findings were both sides. Brain MRI was performed in 21 out of 42 patients(50.0%), and 14 of the 21 patients(66.6%) showed abnormalities and the most common area of abnormal findings were both sides. In 32 out of the 42 patients (76.2%), SPECT images showed abnormal cerebral perfusion, most common area of hypoperfusion were Lt. sides. In 10 out of 14 cases, there were lateralizing abnormalities on the same side shown in SPECT and EEG, CT or MRI findings. CONCLUSION: We concluded that Tc-99m HMPAO SPECT seemed to be a useful tool in the evaluation of intractable seizure patients.
Brain* ; Child* ; Electroencephalography ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Medical Records ; Perfusion ; Retrospective Studies ; Seizures* ; Technetium Tc 99m Exametazime* ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: To determine the role of Tc-99m HMPAO SPECT imaging in children with intractable seizure by evaluating the interictal period. METHODS: We compared the EEG, CT and MRI medical records with those of Tc-99m HMPAO SPECT in 42 patients with intractable seizure referred to Kyunghee University Hospital, from April 1983 to September 1998, retrospectively. RESULTS: Mean age was 8.3 years and male to female ratio was 2.5 : 1. Multiple surface EEG recordings were performed in 42 patients and EEG findings of all patients showed an epileptogenic focus, with the most common area of abnormal findings being the Lt. sides. Brain CT was performed in 23 out of 42 patients(54.8%), and 15 out of the 23 patients(65.2%) showed abnormal findings and the most common area of abnormal findings were both sides. Brain MRI was performed in 21 out of 42 patients(50.0%), and 14 of the 21 patients(66.6%) showed abnormalities and the most common area of abnormal findings were both sides. In 32 out of the 42 patients (76.2%), SPECT images showed abnormal cerebral perfusion, most common area of hypoperfusion were Lt. sides. In 10 out of 14 cases, there were lateralizing abnormalities on the same side shown in SPECT and EEG, CT or MRI findings. CONCLUSION: We concluded that Tc-99m HMPAO SPECT seemed to be a useful tool in the evaluation of intractable seizure patients.
Brain* ; Child* ; Electroencephalography ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Medical Records ; Perfusion ; Retrospective Studies ; Seizures* ; Technetium Tc 99m Exametazime* ; Tomography, Emission-Computed, Single-Photon*

Although congenital syphilis can be prevented with prenatal screening, the disease remains problematic. Currently, there are no cases that describe hematuria and pneumonia related to congenital syphilis. We report a case of congenital syphilis that involved nephrotic syndrome and pneumonia alba in a 22-day-old male infant whose mother did not receive adequate prenatal care. The congenital syphilis diagnosis was confirmed with a serologic test and the patient recovered with penicillin treatment. Clinical findings may be subtle in neonates and delayed recognition occurs frequently, thus complete prenatal screening is critical for congenital syphilis prevention. Immediate serologic testing should be performed to obtain a differential diagnosis if an infant is delivered by a mother that has not received appropriate prenatal examinations.
Diagnosis ; Diagnosis, Differential ; Exanthema* ; Hematuria* ; Humans ; Infant ; Infant, Newborn ; Male ; Mothers ; Nephrotic Syndrome ; Penicillins ; Pneumonia* ; Prenatal Care ; Prenatal Diagnosis ; Serologic Tests ; Syphilis, Congenital*

PURPOSE: There has been no exact answer to the question of when to discontinue antiepileptic drugs(AEDs) in children with well-controlled epilepsy for a long period. This study is about the risk factors of relapse after withdrawal of AEDs in seizure(Sz)-free patients to show a guideline for discontinuation of AEDs. METHODS: One hundred and sixty-nine children were diagnosed as epileptic at the Pediatric Dept.of Kyung-Hee Univ. between 1993 to 1998, in whom AEDs had been withdrawn after at least two years of Sz-free period. Univariate analysis using Kaplan-Meier survival analysis and multivariate analysis using Cox-proportional hazard model were performed for sixteen risk factors. RESULTS: Forty-nine of the 169 patients(28.9%) had recurrence of Szs. The mean follow-up after withdrawal of AEDs was 4.1 years, mean treatment period was 4.1 years, and the mean Sz-free period was 3.3 years. Factors associated with an increased risk of relapse were young age at onset, symptomatic Sz, Sz type in West and Lennox-Gastaut syndrome, neurologic deficit, longer Sz-controlling period, shorter total treatment period, number of AEDs used(more than one drug), age at withdrawal of AEDs, and Sz-free period less than two years in univariate analysis using Kaplan-Meier mothod. From multivariate analysis, the factors indicating a significantly higher relapse risk were pre-treatment period after first Sz attack, Sz-controlling period, Sz-free period, number of AEDs used, neurologic abnormalities. CONCLUSIONS: For epileptic children who were Sz-free for more than two years, and were more than six-years-old, the discontinuation of AEDs should be considered positively, according to age of onset, Sz type, age at withdrawal of AEDs, total treatment period, Sz-controlling period, number of AEDs used, etiology, neurologic deficit, and the wishes of the patients and the their parents.
Age of Onset ; Anticonvulsants ; Child* ; Drug Therapy* ; Epilepsy* ; Follow-Up Studies* ; Humans ; Multivariate Analysis ; Neurologic Manifestations ; Parents ; Proportional Hazards Models ; Recurrence* ; Risk Factors

OBJECTIVE: Arrhythmogenic right ventricular cardiomyopathy(ARVC) is a progressive cardiac muscle disease characterized as progressive fibrofatty replacement of the right ventricle, severe ventricular arrhythmia, and sudden death. However, there is no report of ARVC as a cause of sudden death in Korea. METHODS and RESULTS: Postmortem studies were done to 115 cases of sudden unexplained death at department of legal medicine, school of medicine, Kyungpook national university in year 1999. We identified 7 cases(6%) of typical ARVC with no other identifiable cause of sudden death. The subjects included 5 males and 2 females, ranging in age from 19 to 41 years (mean 29.7 years). All were found dead at bed (5 cases) or workshop (2 cases). Five cases were fibrofatty types and two cases were fatty types. Right ventricular aneurysm, inflammatory infiltrates and left ventricular involvement were found in 4, 2 and 1 cases, repectively. Two cases had family history of sudden death before age 40. No one was suspected of having cardiovascular disease or ARVC before death. CONCLUSION: These findings indicate that ARVC in Taegu-Kyungpook area may be more frequent than previously thought. ARVC may be a major cause of sudden unexplained death.
Aneurysm ; Arrhythmias, Cardiac ; Arrhythmogenic Right Ventricular Dysplasia* ; Cardiovascular Diseases ; Death, Sudden ; Education ; Female ; Forensic Medicine ; Gyeongsangbuk-do ; Heart Ventricles ; Humans ; Korea ; Male ; Myocardium

Toxic effects of ozone, 4-(N-methyl-N-nitrosamino)-1-(3- pyridyl)-1-butanone (NNK), and/or dibutyl phthalate (DBP) were examined through NF-kappaB, AP-1, Nrf2, and osteopontin (OPN) in lungs and livers of B6C3F1 mice. Electrophoretic mobility shift assay (EMSA) indicated that mice treated with combination of toxicants induced high NF-kappaB activities. Expression levels of p105, p65, and p50 proteins increased in all treated mice, whereas IkB activity was inhibited in NNK-, DBP-, and combination-treated ones. All treated mice except ozone-treated one showed high AP-1 binding activities. Expression levels of c-fos, c-jun, junB, jun D, Nrf2, and OPN proteins increased in all treated mice. Additive interactions were frequently noted from two-toxicant combination mice compared to ozone-treated one. These results indicate treatment of mixture of toxicants increased toxicity through NF-kappaB, AP-1, Nrf2, and OPN. Our data could be applied to the elucidation of mechanism as well as the risk assessment of mixture-induced toxicity.
Animals ; Blotting, Western ; DNA-Binding Proteins/*metabolism ; Dibutyl Phthalate/*toxicity ; Electrophoretic Mobility Shift Assay ; Kidney/*drug effects/metabolism ; Liver/*drug effects/metabolism ; Mice ; Mice, Inbred Strains ; NF-E2-Related Factor 2 ; NF-kappa B/metabolism ; Nitrosamines/*toxicity ; Osteopontin ; Ozone/*toxicity ; Proto-Oncogene Proteins/metabolism ; Risk Assessment ; Sialoglycoproteins/*metabolism ; Trans-Activators/metabolism ; Transcription Factor AP-1/metabolism

Miliary tuberculosis is quite a rare but serious cause of acute respiratory distress syndrome (ARDS). Therefore, the early detection of military tuberculosis as the underlying cause of ARDS is very important for the prognosis and survival of the patient. We report a case of military tuberculosis mimicking ARDS. A female patient was admitted due to repeated fever and dyspnea. The initial chest CT scan showed diffuse ground glass opacity, without a miliary pattern. The case was considered to be ARDS caused by pneumonia. She showed improvement after being treated with levofloxacin. However, she was re-admitted with fever seven days after discharge. The follow up chest CT scan showed micronodules in both lungs. An open lung biopsy confirmed the diagnosis of military tuberculosis.
Biopsy ; Dyspnea ; Female ; Fever ; Follow-Up Studies ; Glass ; Humans ; Injections, Intravenous ; Lung ; Military Personnel ; Ofloxacin ; Pneumonia ; Prognosis ; Respiratory Distress Syndrome, Adult ; Thorax ; Tuberculosis ; Tuberculosis, Miliary