Reye syndrome is a rapidly progressive encephalopathy with hepatic dysfunction, which often begins several days after apparent recovery from a viral illness, especially varicella or influenza A or B. Salicylate use was identified as a major precipitating factor for the development of Reye syndrome. With the recommendation to avoid use of salicylates in children, Reye syndrome has virtually disappeared in recent years. We report a case of Reye syndrome in a 5-month-old infant who had been treated with intravenous immunoglobulin and aspirin under the diagnosis of Kawasaki disease, and showed symptoms of sudden onset of irritability, rigidity, decreased activity, vomiting, poor appetite, lethargy, liver dysfunction without jaundice, coagulopathy, and hyperammonemia.
Appetite ; Aspirin ; Chickenpox ; Child ; Humans ; Hyperammonemia ; Immunoglobulins ; Infant ; Influenza, Human ; Jaundice ; Lethargy ; Liver Diseases ; Mucocutaneous Lymph Node Syndrome ; Precipitating Factors ; Reye Syndrome ; Salicylates ; Vomiting

No abstract available.
Candidiasis* ; Humans ; Infant, Newborn ; Infant, Premature*

Intracranial vasculitis is a rare and disastrous complication of tuberculous meningitis if not treated properly. Focal neurologic deficits according to the vessels involved are common manifestation. Here, we report a 29-year-old man who suffered abrupt, bizarre behavioral changes caused by vasculitis complicating tuberculous meningoencephalitis. The diagnosis of tuberculous meningitis is based upon both the CSF findings and a chest X-ray. His systemic symptoms disappeared by after being administered antituberculous medication but various psychotic features such as hypersomnia, hyperphagia and aggressivebehavior continued. A brain MRI showed multiple small parenchymal tuberculous nodules, and the brain MR angiography revealed a narrowing of the proimal middle cerebral arteries and a reduced visualization of the cerebral vessels, suggesting widespread vasculitis. Intravenous dexamethasone successfully ameliorated his behavioral changes. In addition both the follow up brain MRI and angiography showed a normalization of the previous findings.
Adult ; Angiography ; Brain ; Dexamethasone ; Diagnosis ; Disorders of Excessive Somnolence ; Follow-Up Studies ; Humans ; Hyperphagia ; Magnetic Resonance Imaging ; Meningoencephalitis* ; Middle Cerebral Artery ; Neurologic Manifestations ; Thorax ; Tuberculosis ; Tuberculosis, Meningeal ; Vasculitis

Primitive neuroectodermal tumors (PNET) of the ovary are rare tumors with an exclusive or almost exclusive malignant neuroectodermal composition, and are generally regarded as a monodermal expression of an ovarian teratoma. The tumors are basically identical with the lesions of the same name occuring typically in the central nervous system of children. These tumors consist chiefly of undifferentiated small cells resembling neuroblasts. There are also mature, well- differentiated neuroectodermal cells, such as astrocytes and ependymal cells. We report a case of ovarian PNET with glial and neuroblastic differentiation and focal teratomatous foci of non-neural tissue in a 17-year-old female.
Adolescent ; Astrocytes ; Central Nervous System ; Child ; Female ; Humans ; Neural Plate ; Neuroectodermal Tumors, Primitive* ; Ovary* ; Teratoma

This report describes a primary malignant melanoma which developed in the anus, as documented by light microscopy and immunohistochemistry. A 53-year-old woman had a 4 month history of a protruding mass in the anal canal. The mass was located in the squamo-columnar junction of the anal canal, measuring 5.0x4.5 cm. Its cut surface was dark brown and poorly circumscribed. The histologic appearance was characterized by epithelioid or spindle cells with prominant nucleoli and frequent atypical mitosis. Melanin pigments were strongly seen in Fontana-Masson stain. Immunoreactivity revealed that the cytoplasm of tumor cells was strongly positive with antibody directed against S-100 protein, vimentin and it was focally positive with neuron specific enolase.
Female ; Humans

Two cases with umbilical polyp are reported. One was 7-year-old boy who had l. 5cm x l. 6cm protruded urnbilieal growth, the other was 2-year-old baby who had 0. 7crn x 0. 6cm umbilical growth. This uncommon malforrnation arises from remnants of the omphalomesenteric duct and should be clinically discerned from a granuloma pyogenicum or other benign umbilical neoplasms. Histllogically umbilical polyp shows blanching glandular structures lined by intestinaI mucosa in connection with the surface of the skin. When the umbilical polyp is not associated with any other types of underlying abnormalities, it may be treated by a simple surgical excision.
Child ; Child, Preschool ; Granuloma, Pyogenic ; Humans ; Male ; Mucous Membrane ; Polyps* ; Skin ; Vitelline Duct

Hemimegalencephaly is an uncommon sporadic congenital malformation of the central nervous system characterized by enlargement of one cerebral hemisphere with cranial asymmetry, hemiparesis, epilepsy, and mental retardation. This report deals with a 12-month-old girl with intractable seizure and developmental delay, who revealed hemispheric asymmetry and enlarged right cerebral hemisphere. MRI scan revealed asymmetric enlargement of right cerebral hemisphere with lissencephaly and multifocal calcification. She underwent right frontal lobectomy and parietal cortical resection, but died of complication of surgery. Histological features included loss of cortical lamination, large atypical neurons, neuronal heterotopia, and astrocytosis with dystrophic calcification. The heterotopic neurons in the white matter were suggestive of aberrant neuronal migration.
Central Nervous System ; Cerebrum ; Epilepsy ; Female ; Gliosis ; Humans ; Infant ; Intellectual Disability ; Lissencephaly ; Magnetic Resonance Imaging ; Malformations of Cortical Development* ; Neurons ; Paresis ; Rabeprazole ; Seizures

No abstract available.
Cervix Uteri* ; Female ; Hysterectomy*

CD44, an integral membrane glycoprotein expressed by many cell types, serves as the principal transmembrane hyaluronate receptor and may be a determinant of metastatic and invasive behavior in carcinomas. This study was performed to investigate the relationship between CD44 splicing variants v4/5 and v6 expression and histopathologic prognostic factors (depth of tumor invasion, histologic classification, vascular and lymphatic invasion, and lymph node metastasis) in 107 gastric adenocarcinomas. In 107 cases of gastric carcinoma, the immunohistochemical stainining for CD44 v4/5 and CD44 v6 gave the following results. CD44 v4/5 was expressed in 40.2% and CD44 v6 in 67.3% of gastric carcinomas. The expression of CD44 v4/5 was correlated with histologic classification by Lauren (p<0.05), lymphatic invasion (p<0.05), and lymph node metastasis (p<0.004). In contrast, expression of CD44 v6 had no impact on prognostic markers. This study suggests the role of CD44 v4/5 in invasion, metastasis, and its prognostic significance in gastric adenocarcinoma.
Adenocarcinoma* ; Classification ; Immunohistochemistry ; Lymph Nodes ; Membrane Glycoproteins ; Neoplasm Metastasis

The incidence of tinea capitis was the least in the middle of 1970s, and thereafter it has been msrkedly increased along with other superficial mycoses due to Microsporum cania This study was to investigate the recent clinical and mycological trends of tinea capitis among the individuals of both out-patients of dermatologic clinic and orphanage children. These study data were compiled from 47 out-patients, which consisted of 31 patients from St. Pauls Hospital from September, 1980 to August, 1981 and 16 from St. Marys Hospital and Kangnam St. Marys Hospital from February to May in 1981, and from 79 patients of the orphage located in Seoul area in May, 1981. The results were as follows: 1. M. canis was isolated from all 47 out-patients with tinea capitis(male: 21, female 26). In orphanage, from 50 patients(63.3%) among the 79 patients with tinea capitis, 46 strains(92%) of T. ferrugineum from 30 male and 16 female patients, 3(6%) of M. canis from 3 males, and 1(2%) of T. violaceurn from a female were isolated. 2. The incidence of tinea capitis by M. canis in a total 5, 340 out-patients was 0. 58% (0. 62% in male, 0.56% in female) and its monthly distribution was almoat even through the studied period. The male to female ratio was 1:1,24, being more prevalent in female. 3. The age of onset was younger in female with tinea capitis due to M. canis than in male: The median age of onaet was 5 years in female and 7 years in male. In the group below 7 years of age, the maIe to female ratio was 1:1.84 and in the group above 8 years of age, l.74: 1.4. Most lesions of tinea capitis due to M. canis from out-patients showed multiple round grey scaled patches with shrotened hairs or round erythematous scaled alopetic patches. Kerion celsi were found in 4(9%) out of 47 out-patiente. Tinea corporia was combined in 4(9%) out-patients. There were domestic animals shch as kit or dog in 7(29%) among 24 houses of the patients.
Age of Onset ; Animals ; Animals, Domestic ; Child ; Dogs ; Female ; Hair ; Humans ; Incidence ; Male ; Microsporum ; Mycoses ; Orphanages ; Outpatients ; Seoul* ; Tinea ; Tinea Capitis