Smooth muscle hamartoma was first described by Stokes in 1923 as the disease characterized by increase of well-defined bundles of smooth muscle fibers in the dermis. It can be either congenital or acquired. Acquired ones are aften in association with Becker's nevus. We present a case of acquired smooth muscle hamartoma that did not show any pigmentation or hair growth.
Dermis ; Hair ; Hamartoma* ; Muscle, Smooth* ; Nevus ; Pigmentation

BACKGROUND: Minerals play important roles in biological processes. They can cause disease through deficiency, imbalance, and toxicity. Many chronic diseases of children may be related to mineral status. But difficulty in sampling enough numbers and amount of body fluid to see long term mineral status for those children have been obstacles for detailed clinical studies. Though measurements of body mineral status are usually done for body fluid, hair mineral analysis method showed potentiality as a useful clinical tool. It could provide a continuous record of nutritional status and exposure history to heavy metal pollutants. Also it has advantages in sampling and observing the profiles of multiple minerals simultaneously. But lack of normal reference values of hair mineral contents focused on Korean children prevented us from conducting further studies. OBJECTIVE: The purposes of this study were to survey reference range of hair mineral concentration of Korean children 2 to 7 years old and analysis its characteristics. METHODS: Mineral concentrations of hair were measured in 78 children 2 to 7 years of age, living in the same area. The contents of fifteen nutritional elements(Ca, Mg, Na, K, Cu, P, Fe, Mn, Cr, Se, B, Co, Mo, S), eight toxic elements(Sb, U, As, Be, Hg, Cd, Pb, Al), and fifteen additional elements(Ge, Ba, Bi, Rb, Li, Ni, Pt, Tl, V, Sr, Sn, Ti, W, Zr) were determined by an inductive coupled plasma mass spectrometry(ICP-MS). Data are analyzed by meticulous statistical approaches. RESULTS: Though direct comparison was impossible in statistical manner, the suggested reference values of normal Korean children were different in K, Cr, Hg, Pb, Sn, Mg, Sb, Zn, Ge, and U content with American reference value. In normal Korean children, the contents of Ca, Mg, Fe, S, Al, Ba, Ni, Sr, U were higher in girls, and Na, Cr, As, V, Bi were higher in boys. Zn and Sr contents were increased with age, Rb, K, Ti, Pb, Mo, Sn, and V contents were decreased with age. CONCLUSION: There are considerable differences in hair mineral contents of normal population by race, age, sex. So it is important to use proper reference values to interpret the hair mineral analysis result correctly. We hope future study conducting for the children living in different geographic regions could verify our suggested reference data as a Korean reference value.
Biological Processes ; Body Fluids ; Child* ; Chronic Disease ; Continental Population Groups ; Female ; Hair* ; Hope ; Humans ; Minerals ; Nutritional Status ; Plasma ; Reference Values

OBJECTIVE: To assess the correlation between the risk categories of diabetic foot screening test by 5.07 Semmes- Weinstein monofilament and the findings of standard nerve conduction studies of upper and lower extremities. METHOD: We studied 74 patients who were consulted to our department to rule out the diabetic neuropathy. We classified the patients to 4 risk groups by foot screening test using 5.07 Sememes-Weinstein monofilament, and performed the standard nerve conduction studies of upper and lower extremities. The risk categories of foot screening tests were compared to the findings of the nerve conduction studies. RESULTS: When the risk category becomes higher, there were more delay in latencies (motor and sensory potentials of median and ulnar nerve, sensory potentials of sural and superficial peroneal nerve, median and peroneal F-wave), slower conduction velocities (median, ulnar, peroneal, posterior tibial nerve) and lower amplitudes (motor and sensory potentials of media and ulnar nerve, peroneal and posterior tibial nerve, sural nerve) (p<0.05). Except for the amplitude of ulnar nerve and the latencies of peroneal and ulnar nerve, there were significant differences in the nerve conduction study data between the risk group 3 and the risk group 0 (p<0.05). CONCLUSION: We confirmed that the risk category of diabetic foot screening test by Semmes-Weinstein monofilament can meaningfully reflect the severity of diabetic neuropathy. We also suggest that it is necessary to pay attention to the nerve conduction study in the patients with history of foot ulcer.
Diabetic Foot* ; Diabetic Neuropathies ; Foot ; Foot Ulcer ; Humans ; Lower Extremity ; Mass Screening* ; Neural Conduction* ; Peroneal Nerve ; Tibial Nerve ; Ulnar Nerve

PURPOSE: To assess the usefulness of amplitude integrated electroencephalography (aEEG), we compared aEEG with electroencephalography (EEG), which is one of the most useful tools for assessment of neonatal seizures in the neonatal intensive care unit. METHODS: We retrospectively studied 24 neonates who had been suspected of seizure activity in the neonatal intensive care unit from January 2009 to February 2010. The 24 neonates had seizure or apnea that did not respond to aminophylline or continuous positive airway pressure. We compared the correlation and efficacy of diagnosis among aEEG, EEG, and neurosonography. RESULTS: We analyzed 24 aEEGs in the neonatal intensive care unit. The aEEGs showed a seizure pattern in 15 (62.6%), burst suppression pattern in 2 (8.3%), flat pattern in 4 (8.3%), and normal in 5 (20.8%). The results of EEGs showed 15 neonatal seizures (62.5%), 2 cerebral dysfunctions (8.3%), and 7 normal findings (29.2%). A correlation between aEEG and EEG was noted (P<0.05). However, there was no correlation between the results of aEEG and echoencephalography. CONCLUSION: There is correlation between aEEG and EEG for seizure detection in the neonatal intensive care unit. We think that aEEG is an useful screening tool for seizure detection in neonates.
Aminophylline ; Apnea ; Continuous Positive Airway Pressure ; Electroencephalography ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Mass Screening ; Retrospective Studies ; Seizures

PURPOSE: To evaluate the CT findings in patients with Langerhans cell histiocytosis (LCH) involving the orbit. MATERIALS AND METHODS: Orbital CT scans of six children with pathologically proven LCH were retrospectively analyzed. Follow-up CT (n = 5) and MR (n = 1) imaging findings were also revi ewed. RESULTS: Initial CT scans revealed varying degree of bone destruction with soft-tissue masses, and on nonenhanced images the mean attenuation value was 44 Hounsfield units(HU). All masses showed mild to moderate enhancement with a mean attenuation value of 74 HU. The bony margins abutting onto soft tissue masses were irregular but clearly demarcated. No evidence of calcification or periosteal reaction was noted. Suprasellar mass and rib involvement was noted in one patient and hepatos-plenomegaly in two. Follow-up CT and MR images showed that the soft tissue masses were almost completely resolve d, with bone remodeling and reossification. CONCLUSION: A soft tissue mass with irregular but clearly demarcated bone destruction is thought to be a characteristic finding of LCH involving the orbit. Follow-up images after treatment showed bone remodeling and reossification.
Bone Remodeling ; Child ; Follow-Up Studies ; Histiocytosis ; Histiocytosis, Langerhans-Cell* ; Humans ; Orbit* ; Retrospective Studies ; Ribs ; Tomography, X-Ray Computed

Lipomas are the most common mesenchymal neoplasms and are characterized by a lobular growth of mature adipocytes with a sharply demarcated border delineated by a thin fibrous capsule. Lipomas usually appear in the adipose tissue but occasionally develop in other mesenchymal tissues and can be classified as either subcutaneous or subfascial tumors. Subfascial lipomas are one of the most uncommon sites for soft-tissue tumors and can be intramuscular, intermuscular, or submuscular. Accordingly subfascial lipomas of the forehead can be differentiated into submuscular and subgaleal lipomas depending on the exact anatomic localization below the frontalis muscle or underneath the galea aponeurotica. The patient, a 33-year-old man, visited our clinic with a complaint of asymptomatic 2x2cm-sized dome-shaped tumor on his forehead. The tumor was surgically excised. During the operation the tumor was found to be located below the frontalis muscle and was revealed histopathologically as lipoma.
Adipocytes ; Adipose Tissue ; Adult ; Forehead* ; Humans ; Lipoma*

The use of caffeine citrate for treatment of apnea in very low birth weight infants showed short-term and long-term benefits. A systematic review and meta-analysis of the literature was undertaken to document the effect providing caffeine early (0-2 days of life) compared to providing caffeine late (> or =3 days of life) in very low birth weight infants on several neonatal outcomes, including bronchopulmonary dysplasia (BPD). We searched MEDLINE, the EMBASE database, the Cochrane Library, and KoreaMed for this meta-analysis. The quality of the included studies was assessed using the Newcastle-Ottawa Scale and Jadad's scale. Studies were included if they examined the effect of the early use of caffeine compared with the late use of caffeine. Two reviewers screened the candidate articles and extracted the data from the full-text of all of the included studies. We included a total of 59,136 participants (range 58,997-59,136; variable in one study) from a total of 5 studies. The risk of death (odds ratio [OR], 0.902; 95% confidence interval [CI], 0.828 to 0.983; P=0.019), bronchopulmonary dysplasia (BPD) (OR, 0.507; 95% CI, 0.396 to 0.648; P<0.001), and BPD or death (OR, 0.526; 95% CI, 0.384 to 0.719; P<0.001) were lower in the early caffeine group. Early caffeine use was not associated with a risk of necrotizing enterocolitis (NEC) and NEC requiring surgery. This meta-analysis suggests that early caffeine use has beneficial effects on neonatal outcomes, including mortality and BPD, without increasing the risk of NEC.
Apnea/*drug therapy ; Bronchopulmonary Dysplasia/drug therapy ; Caffeine/*administration & dosage/adverse effects ; Citrates/*administration & dosage/adverse effects ; Enterocolitis, Necrotizing/etiology ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; Infant, Very Low Birth Weight ; Risk Factors ; Treatment Outcome

Background: This meta-analysis was performed to examine the association between maternal hypertension during pregnancy (HDP) and neonatal bronchopulmonary dysplasia (BPD). Methods: We systematically searched PubMed, EMBASE, the Cochrane Library, and the KoreaMed database for relevant studies. We used the Newcastle-Ottawa Scale for quality assessment of all included studies. The meta-analysis was performed using Comprehensive Meta-Analysis software (version 3.3). Results: We included 35 studies that fulfilled the inclusion criteria; the total number of infants evaluated came to 97,399 through review process. Maternal HDP was not significantly associated with any definition of BPD, i.e., oxygen dependency at 36 weeks of gestation (odds ratio [OR], 1.162; 95% confidence interval [CI], 0.991–1.362; P = 0.064) in pooled analysis of 29 studies or oxygen dependency at 28 days of age (OR, 1.084; 95% CI, 0.660–1.780; P = 0.751) in pooled analysis of 8 studies. Maternal HDP was significantly associated only with severe BPD (OR, 2.341; 95% CI, 1.726–3.174; P < 0.001). BPD was not associated with HDP in the overall analysis (OR, 1.131; 95% CI, 0.977–1.309; P = 0.100) or subgroup analysis according to the definition of HDP. Conclusion Maternal HDP was not associated with neonatal BPD defined by the duration of oxygen dependency (at either 36 weeks of gestation or 28 days of life) but was associated with severe BPD.

Calcification in patients with endstage renal disease on renal replacement therapy can occur in extraskeletal area such as conjunctiva and cornea. Conjunctival and corneal calcification (CCC) has mostly has been reported in adults with endstage renal disease on hemodialysis. CCC seems to be associated with the duration of renal replacement therapy, and high CaxP value. We report a 10-year-old girl who was on peritoneal dialysis for 31 months and presented with CCC on both eyes. Her corneal calcification was resolved after the epithelial debridement and ethylenediaminetetraacetic acid(EDTA) soaking therapy.
Adult ; Child ; Chlormequat ; Conjunctiva ; Cornea ; Debridement ; Eye ; Humans ; Peritoneal Dialysis ; Renal Dialysis ; Renal Replacement Therapy

PURPOSE: The unique nutrient requirements of premature infants necessitate knowledge of the composition of human milk produced by mothers of such infants. We investigated longitudinal changes in iron concentration of preterm human milk and compared to those observed in human milk of mothers of 1-week old term infants to determine optimal iron supplementation guidelines when preterm infants are nourished exclusively by breast feeding. METHODS: Human milk samples were collected at 1, 2, 4, 6, 8 and 12 weeks postpartum from 103 mothers who delivered infants of gestational age <34 weeks or weighing <1,800 g. Term human milk samples were collected at 1 week postpartum from 24 mothers. RESULTS: There were no significant differences in the iron concentrations of preterm human milk obtained at 2 to 8 weeks postpartum (36.3+/-23.1 to 45.8+/-26.0 microg/dL), but these concentrations were higher than those noted at 1 week in preterm (23.1+/-14.6 microg/dL) and term (25.2+/-7.55 microg/dL) infants. The iron concentration in preterm human milk obtained at corrected term age (42.2+/-19.4 microg/dL) was significantly higher than that of mature term human milk (25.2+/-7.55 microg/dL). CONCLUSION: The concentration of iron in preterm human milk was consistently low during the first 3 months of lactation. Supplementation with iron of at least 2 mg/kg/day should be considered for preterm infants who are exclusively breastfed and who have low body iron stores, to meet the minimum enteral iron requirements recommended by AAP-CON (2004).
Breast ; Female ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Iron ; Lactation ; Longitudinal Studies ; Milk, Human ; Mothers ; Postpartum Period ; Premature Birth ; Term Birth