Subcutaneous panniculitic T-cell lymphoma is one of very rare diseases in children, which is presumably derived from various immunocompetent T-cell system components. It is a distinctive clinicopathologic entity, different from other lymphoma group. We report a case of subcutaneous panniculitic T-cell lymphoma in a 14-year-old boy with the complaints of fever and multiple subcutaneous nodule. A brief review of related literatures was also made.
Adolescent ; Child ; Fever ; Humans ; Lymphoma ; Lymphoma, T-Cell* ; Male ; Rare Diseases ; T-Lymphocytes*

In this case study, we investigated the effects of robot-assisted gait training on the plasticity of motor system in a stroke patient using functional MRI. A patient who suffered from the left hemiparesis following the right MCA infarction performed gait training with a robot-assisted gait orthosis. Before and after gait training, motor performances were assessed and functional MRIs were acquired with motor activation task of affected lower limb. After gait training with a robot-assisted orthosis, the patient's motor performances were improved and cortical activities were changed. Activation in the ipsilesional primary sensorimotor cortex was increased and cortical reorganization was induced in a way that nearby regions were recruited for the movement of affected lower limb. The results of this study showed that gait training with a robot-assisted orthosis induced cortical reorganization of the motor network that resulted in enhancement of motor performance of the lower limb.

PURPOSE: Clinically, acute respiratory distress syndrome (ARDS) occurs within 72 hours after acute exposure of risk factors. Because of its high fatality rate once ARDS progresses, early detection and management are essential to reduce the mortality rate. Accordingly, studies on early changes of ARDS were started, and serum ferritin, as well the as injury severity score (ISS), which has been addressed in previous studies, thought to be an early predictive indicator for ARDS METHODS: From March 2003 to March 2005, we investigated 50 trauma patients who were admitted to the intensive care unit in Dongguk University Medical Center, Gyeongju. The patients were characterized according to age, sex, ISS, onset of ARDS, time onset of ARDS, serum ferritin level (posttraumatic 1st & 2nd day), amount of transfused blood, and death. Abdominal computed topography was performed as an early diagnostic tool to evaluate the onset of ARDS according to its diagnostic criteria. The serum ferritin was measured by using a VIDAS(R) Ferritin (bioMeriux, Marcy-1' Etoile, France) kit with an enzyme-linked fluorescent assay method. For statistical analysis, Windows SPSS 13.0 and MedCalc were used to confirm the probability of obtaining a predictive measure from the receiver operating characteristics (ROC) curve. RESULTS: The ISS varied from 14 to 66 (mean: 33.8) whereas the onset of ARDS could be predicted with the score above 30 (sensitivity: 90.0%, specificity: 60.0%, p<0.05). On the posttraumatic 1st day, the serum ferritin levels were measured to be from 31 mg/dL to 1,200 mg/dL (mean: 456 mg/dL), and the onset of ARDS could be predicted when the value was over 340 mg/dL (sensitivity: 80.0%, specificity: 65.0%, p<0.05). On the posttraumatic 2nd day , the serum ferritin levels were measured to be from 73 mg/dL to 1,200 mg/dL (mean: 404 mg/dL), and the onset of ARDS could be predicted when the value was over 627 mg/dL (sensitivity: 60.0%, specificity: 92.5%, p<0.05). The serum ferritin levels and the ISS were significantly higher on the posttraumatic 1st and 2nd day in the ARDS group, suggesting that they are suitable indices predicting the onset of ARDS, however relationship between the serum ferritin levels and the ISS was not statistically significant. CONCLUSION: In this study, we discovered increasing serum ferritin levels in multiple- trauma patients on the posttraumatic 1st & 2nd day and concluded that both the serum ferritin level and the ISS were good predictors of ARDS. Although they do not show statistically significant relationship to each other, they can be used as independent predictive measures for ARDS. Since ARDS causes high mortality, further studies, including the types of surgery and the methods of anesthesia on a large number of patients are essential to predict the chance of ARDS earlier and to reduce the incidence of death.
Academic Medical Centers ; Anesthesia ; Ferritins* ; Gyeongsangbuk-do ; Humans ; Incidence ; Injury Severity Score ; Intensive Care Units ; Mortality ; Multiple Trauma* ; Respiratory Distress Syndrome, Adult* ; Risk Factors ; ROC Curve ; Sensitivity and Specificity

A dieulafoy lesion, which is an unusual cause of gastrointestinal bleeding that can be fatal in children. Dieulafoy lesions are characterized by an abnormally large eroded submucosal artery that is commonly located in the lesser curvature of the proximal stomach. In most cases, permanent hemostasis is achieved by endoscopic epinephrine injection, however, some patients require other endoscopic treatment modalities, embolization or surgery. We report here a case of a Dieulafoy lesion in an 11-year-old boy who had recurrent bleeding from the lesion in the duodenal bulb after endoscopic epinephrine injection and surgical ligation, that was successfully treated using coil embolization.
Arteries ; Child* ; Cytochrome P-450 CYP1A1 ; Embolization, Therapeutic ; Epinephrine ; Hemorrhage ; Hemostasis ; Humans ; Ligation ; Male ; Stomach

A dieulafoy lesion, which is an unusual cause of gastrointestinal bleeding that can be fatal in children. Dieulafoy lesions are characterized by an abnormally large eroded submucosal artery that is commonly located in the lesser curvature of the proximal stomach. In most cases, permanent hemostasis is achieved by endoscopic epinephrine injection, however, some patients require other endoscopic treatment modalities, embolization or surgery. We report here a case of a Dieulafoy lesion in an 11-year-old boy who had recurrent bleeding from the lesion in the duodenal bulb after endoscopic epinephrine injection and surgical ligation, that was successfully treated using coil embolization.
Arteries ; Child* ; Cytochrome P-450 CYP1A1 ; Embolization, Therapeutic ; Epinephrine ; Hemorrhage ; Hemostasis ; Humans ; Ligation ; Male ; Stomach

Leukocytosis and neutrophilia is common during the acute phase of Kawasaki disease whereas leukopenia is not common and severe neutropenia is rare. Severe neutropenia is defined as absolute neutrophil count less than 500/mm3. There are only few publicatons reporting of atypical Kawasaki disease with severe neutropenia. We report a case of atypical Kawasaki disease with severe neutropenia.
Leukocytosis ; Leukopenia ; Mucocutaneous Lymph Node Syndrome* ; Neutropenia* ; Neutrophils

Kikuchi-Fujimoto's disease (KFD) is a rare self-limiting necrotizing lymphadenitis found mainly in young women. Patients typically present with lymphadenopathy and often with a high fever. The etiology of the disease remains unknown, but various infection and autoimmune processes have been postulated to be the cause. We report here on a 22-year-old female with 7-year history of systemic lupus erythematosus presented with high fever and many enlarged cervical lymph nodes. Neck computed tomography scan showed multiple lymphadenopathies and KFD was proven by under sonographic guidance percutaneous needle biopsy.
Biopsy, Needle ; Female ; Fever ; Histiocytic Necrotizing Lymphadenitis* ; Humans ; Lupus Erythematosus, Systemic* ; Lymph Nodes ; Lymphadenitis ; Lymphatic Diseases ; Neck ; Ultrasonography ; Young Adult

PURPOSE: To review the clinical and laboratory features of patients with Wilson disease at diagnosis. METHODS: In this retrospective study, records of all 20 patients, who were diagnosed as having Wilson disease at the Paik hospital in Busan from 1990 to 2000, were reviewed. RESULTS: Out of 20 patients, 12 pateints (60%) have hepatic presentation alone, 2 patients (10%) have neurologic presentation, 4 patients (20%) have hepatic and neuropsychiatric presentation, and one patient (5%) has hematologic presentation at diagnosis. One patient (5%) has neither symptom nor laboratory finding of Wilson disease except very low serum ceruloplasmin level and positive family history. Family screening test revealed 3 cases of Wilson disease. 12 patients were revealed to be combined with liver cirrhosis at diagnosis. CONCLUSION: Early diagnosis and treatment is very important in patients with Wilson disease. Children or adolescents who manifest symptoms of hepatitis, who has prolonged elevation of liver enzymes, and has family history of hapatitis of unknown origin, with mild hematologic or urinary abnormalities must be suspected to have Wilson disease. Also, in adolescents with extrapyramidal symptoms or other neuropsychiatric symptoms, liver function test should be done.
Adolescent ; Busan ; Ceruloplasmin ; Child ; Diagnosis ; Early Diagnosis ; Hepatitis ; Hepatolenticular Degeneration* ; Humans ; Liver ; Liver Cirrhosis ; Liver Function Tests ; Mass Screening ; Retrospective Studies

Primary thyroid lymphoma is a relatively rare thyroid tumor and usually a non-Hodgkin type. Its most common histologic type is the diffuse large B cell lymphoma followed by mucosa-associated lymphoid tissue (MALT). It is known to be frequently associated with autoimmune thyroiditis such as Hashimoto's thyroiditis. We report three cases of thyroid lymphoma at a single institution with a review of the literature.
Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell ; Thyroid Gland ; Thyroiditis ; Thyroiditis, Autoimmune

Coronary embolism is an uncommon cause of myocardial infarction. A 48-year-old male presented with typical chest pain of an MI. There was no definite ST segment change on electrocardiogram (ECG) and no elevation of myocardial enzymes. Coronary angiography (CAG) revealed occlusion of the distal left anterior descending coronary artery (dLAD), the distal left circumflex coronary artery (dLCX), the diagonal branch (D) and the obtuse marginal branch (OM), with a large filling defect in the left main coronary artery (LMA) that caused the myocardial infarction. We considered the possibility that coronary embolization was caused by the migration of a thrombus in the LMA during CAG. We did balloon angioplasty in the dLAD, dLCX, OM and D and treated the patient with glycoprotein IIb/IIIa receptor antagonist. However, thrombi remained in the dLAD, OM, and dLCX. After 3 days of anti-thrombotic treatment, follow-up CAG revealed only slight resolution of thrombi in the LAD. After triple antiplatelet agent medication for 1 year, a follow-up CAG showed a resolution of the thrombi in all coronary arteries.
Angioplasty, Balloon ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Electrocardiography ; Embolism ; Follow-Up Studies ; Glycoproteins ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; Thrombosis