We herein report a 4-year-old boy with infantile digital fibrornatosis developing on the distal & middle phalanx portion of the right index & ring fingers, and the middle phalanx portion of the right middle finger, which started at the age of 5 months after birth. Biopsy specimen taken from the right middle finger showed the proliferating collagen bundles and fibroblasts in the dermis and eosinophilic cytoplasmic inclusions within the fibroblasts. Although we attempted to treat tbe patient with intralesional injection of triamcinolone acetonide suspension and cryotherapy 5 times biweekly, there was no signifit effect.
Biopsy ; Child, Preschool ; Collagen ; Cryotherapy ; Dermis ; Eosinophils ; Fibroblasts ; Fibroma* ; Fingers ; Humans ; Inclusion Bodies ; Injections, Intralesional ; Male ; Parturition ; Triamcinolone Acetonide

We encountered a case of Sweet's syndrome associated with myelodysplastic syndrome in a 60-year-old woman. The clinical presentation strongly suggested Sweet's syndrome. A skin biopsy specimen taken from her skin lesion on the leg showed an infiltration of numerous neutrophils in the subcutis instead of the dermis which is the main area of neutrophilic infiltration in Sweet's syndrome. Among infiltrating cells, many neutrophils(8%) showed nuclear segmentation anomalies, that is, hyposegmentation(pseudo-Pelger-Huet anomaly) or hypersegmentation. Peripheral blood neutrophils had similar anomalies. This subcutaneous variant of Sweet's syndrome, Sweet's panniculitis, is rare and nuclear segmentation anomalies of neutrophils are probably a good clue to underlying myelodysplastic syndrome.
Biopsy ; Dermis ; Female ; Humans ; Leg ; Middle Aged ; Myelodysplastic Syndromes* ; Neutrophils* ; Panniculitis ; Skin ; Sweet Syndrome*

PURPOSE: To determine the enhancing patterns of hepatocellular carcinoma(HCC) and the difference of enhancing patterns according to the tumor size, using spiral CT. MATERIALS & METHODS: We reviewed 213 lesions in 76patients who had been clinically or histopathologically diagnosed as HCC sufferer. The tumors were divided into three groups, according to size(&3 cm, 3-5cm and >5 cm). The enhancing patterns of tumor and capsule in the earlyand delayed phase were analysed. The enhancing patterns of the tumor were divided into five types(high, peripheralhigh, mixed, iso and low attenuation) in the early phase and four types(central high, mixed, iso, and low attenuation) in the delayed phase. The enhancing patterns of the capsule were divided into three types such asiso, low and high attenuation. RESULTS: High attenuating lesions in the early phase were as follows : below 3cm 72% ; 3-5cm., 60% ; above 5cm., 49%. Mixed attenuating lesions in the early phase were as follows : below 3cm., 1%; 3-5cm., 22% ; above 5cm., 36%. Thus, most HCCs were high attenuation type in the early phase, but as the tumorbecame larger, less high attenuation and more mixed attenuation was demonstrated(p<0.01). There was no difference of enhancing patterns according to the tumor size in peripheral high, iso and low-attenuating lesions. In the delayed phase most of the hepatomas appeared as totally hypodense lesions. For capsules, the results were as follows : below 3cm., 20% ; 3-5cm.,58% ; above 5cm., 73%. As the tumors became larger, more capsules were demonstrated(p <0.01). The capsules were visualized as iso or low attenuating rim in the early phase and high attenuating rim in the delayed phase. CONCLUSIONS: To determine the enhancing patterns of HCC using spiral CT is considered to be helpful in the diagnosis of HCC.
Capsules ; Carcinoma, Hepatocellular* ; Diagnosis ; Tomography, Spiral Computed*

The purpose of this study was to identify the factors associated with dietary attitudes and dietary self-efficacy of juvenile delinquents. Out of 110 questionnaires distributed to the juvenile detention home students in Daegu, and 150 questionnaires distributed to the juvenile detention home students in Anyang, 210 were analyzed (80.7% analysis rate). These data were analyzed by SPSS program. The results are summarized as follows. Almost all parents' educational levels showed 'graduation of middle school', and only 43.8% of the juvenile detention students were living with parents. In case of incoming status, average income per month was 2,000,000 won, which was lower than normal one. Diet attitude score was higher in boy students than girl students (p < 0.05). There was a higher score of diet attitude in higher educational levels of father. The average score of dietary self-efficacy was 2.51 +/- 0.86. This value was lower than the normal juvenile. There was a higher diet attitude score in the higher dietary self-efficacy score (p < 0.001). Therefore, proper nutrition education is required to improve their dietary self-efficacy. The results of this study could be useful data to plan and develop nutritional education programs of juvenile delinquents
Diet ; Fathers ; Humans ; Parents

PURPOSE: To describe the two-phase spiral CT findings of acute cholecystitis. MATERIALS AND METHODS: CTscans of nine patients with surgically-proven acute cholecystitis were retrospectively reviewed for wallthickening, enhancement pattern of the wall, attenuation of the liver adjacent to the gallbladder, gallstones,gallbladder distention, gas collection within the gallbladder, pericholecystic fluid and infiltration ofpericholecystic fat. RESULT: In all cases, wall thickening of the gallbladder was seen, though this was moredistinct on delayed images, Using high-low-high attenuation, one layer was seen in five cases, nd three layers infour. On arterial images, eight cases showed transient focal increased attenuation of the liver adjacent to thegall bladder;four of these showed curvilinear attenuation and four showed subsegmental attenuation. One caseshowed curvilinear decreased attenuation between increased attenuation of the liver and the gallbladder, andduring surgery, severe adhesion between the liver and gallbladder was confirmed. Additional CT findings wereinfiltration of pericholecystic fat (n=9), gallstones (n=7), gallbladder distension (n=6), pericholecystic fluid(n=3), and gas collection within the gallbladder (n=2). CONCLUSION: In patients with acute cholecystisis,two-phase spiral CT revealed wall thickening in one or three layers ; on delayed images this was more distint. Inmany cases, arterial images showed transient focal increased attenuation of the liver adjacent to the gallbladder.
Cholecystitis, Acute* ; Gallbladder ; Gallstones ; Humans ; Liver ; Retrospective Studies ; Tomography, Spiral Computed*

Lower Extremities Committee of Korean Academy of Medical Sciences Guideline for Impairment Rating develops new guidelines which are based on McBride method, American Medical Association Guides, Disability evaluation by The Korean Orthopaedic Association, The Korean Neurosurgery Society, and Korean Academy of Rehabilitation Medicine. The committee analyzed and discussed to create an ideal method practical in Korea. Our committee endeavors to develop new methods which are easy to use, but are suitable for professional use and also independent from the examinee's intentions. The lower extremities are evaluated on the basis of anatomic change, functional change, and diagnosis based evaluation. Nine methods are used to assess the lower extremities. Anatomic assessment includes leg length discrepancy, ankylosis, amputation, skin loss, peripheral nerve injury, and vascular disease. In functional assessment, range of motion and muscle strength are included. Diagnosis-based assessments are used to evaluate impairment caused by specific fractures, deformities, ligament instability, meniscectomies, post-traumatic arthritis, fusion of the foot, and lower extremity joint replacements.
Ankylosis/classification/physiopathology ; *Disability Evaluation ; Humans ; Korea ; Lower Extremity/pathology/*physiopathology ; Muscle Weakness/classification/physiopathology ; Program Development ; Severity of Illness Index

OBJECTIVE: The association of obesity, diabetes mellitus, drug compliance, and body image with use of antipsychotic medication has been documented in many studies. We aimed to assess the effects of antipsychotics and sodium valproate combination therapy on glucose, cholesterol level and weight in schizophrenic patients. METHODS: Chronic schizophrenic patients were grouped according to drug combination: risperidone, olanzapine, haloperidol, risperidone+valproic acid (VP), olanzapine+VP, haloperidol+VP. Planned assessment of included glucose and cholesterol, which were collected at baseline and at the end of the 12 weeks later. RESULTS: There were significantly increased glucose and cholesterol level, in olanzapine+VP group, but not in risperidone group. Cholesterol levels were not increased at the end of 12 weeks for haloperidol and risperidone group. Glucose and cholesterol levels had no significant association with weight gain. CONCLUSION: Changes in glucose and cholesterol level, weight, and body mass index associated with antipsychotics including sodium valproate combination were reported in our report. In the future, we need follow up study and various studies about other combination drug and metabolic symptoms.
Antipsychotic Agents* ; Body Image ; Body Mass Index ; Cholesterol* ; Compliance ; Diabetes Mellitus ; Follow-Up Studies ; Glucose* ; Haloperidol ; Humans ; Obesity ; Risperidone ; Valproic Acid* ; Weight Gain

We report 3 cases of multiple myeloma showing ABO discrepancy with missed reaction in serum typing. They showed markedly decreased immunogolobulin level except for monoclonally increased abnormal immunoglobulin. Their blood group was confirmed by saliva test and addition of anti-globulin reagent. As serum immunoglobulin level is raised, the reactivity in serum typing showed improving tendency and ABO discrepancy appeared when immunoglobulin was markedly decreased.
Immunoglobulins ; Multiple Myeloma* ; Saliva

BACKGROUND: To elucidate the mechanism of interaction between depolarizing and nondepolarizing muscle relaxants, train-of-four (TOF) fade during onset of neuromuscular blockade of d-tubocurarine (dTC) with or without decamethonium (C10) was evaluated in a rat phrenic nerve hemidiaphragm preparation. METHODS: Phrenic nerve hemidiaphragm preparations from 250~300 g Sprague Dawley rats (n=20) were suspended in a Krebs solution bubbled with 5% CO2 in O2 at 32oC. Phrenic nerves were stimulated with supramaximal stimuli of 0.2 ms duration at 0.15 Hz single twitch and 2 Hz TOF by a Grass S88 stimulator and the contractions of the hemidiaphragm were detected by a Grass FT03 force transducer then recorded. Estimation of ED50 for the dose response data were performed by a linear regression. The statistical significance of the results was determined by Wilcoxon Rank Sum test. p<0.05 was considered significant. RESULTS: Mean ED50 values of dTC and C10 calculated from the dose response relations were 7.76 microgram/ml and 0.65 microgram/ml respectively. Compared to adminstration of 2xED50 of dTC alone, TOF ratios at 75% and 50% of twitch height were markedly decreased by combination of ED50 of C10 and ED50 of dTC with statistic significance (67 +/- 1.9% vs. 46 +/- 3.1% and 36 +/- 2.5% vs. 7 +/- 2.5%). Conclusion: If fade in response to TOF stimulation represents a prejunctional effect, the results from this study suggests that the presynaptic action of C10 has some role in the mechanism of the interaction between dTC and C10 in the rat.
Animals ; Linear Models ; Neuromuscular Blockade* ; Phrenic Nerve* ; Poaceae ; Rats* ; Rats, Sprague-Dawley ; Transducers ; Tubocurarine*

PURPOSE: To evaluate the incidence and describe radiologic pattern of ankle arthritis following change of mechanical loading axis by total knee arthroplasty. MATERIALS AND METHODS: We reviewed radiographs of 419 cases, 243 patients underwent total knee arthroplasy from January 2002 to October 2006 retrospectively. We described radiologic parameters around the ankle joint and measured the amount of change of knee varus or valgus angle by comparing preoperative and postoperative anteroposterior standing lower extremities AP X-rays. We divided cases into two groups, one with radiologically arthritic change of the ankle joint and the other one without any radiologic change after surgery. We compared two groups in each parameters and analyzed statistically (SPSS v13.0). RESULTS: Three hundred eighty one cases were divided into varus group and 38 cases in valgus group. 125 cases were divided into ankle arthritic change-positive subgroup among the varus group and 251 cases were in negative subgroup. The amount of varus angle correction by total knee arthroplasty showed significant difference between two subgroups. There was no significant difference in each parameters between subgroups within 38 valgus cases. CONCLUSION: Ankle arthritis can be aggravated after total knee arthroplasty because of the change of mechanical loading axis onto the ankle joint. Therefore it may be needed to evaluate symptoms and function of ankle joints before performing total knee arthroplasties especially in patients with huge varus deformities of knee joints.
Ankle Joint* ; Ankle* ; Arthritis ; Arthroplasty* ; Axis, Cervical Vertebra ; Congenital Abnormalities ; Humans ; Incidence ; Knee Joint ; Knee* ; Lower Extremity ; Retrospective Studies