PURPOSE: Acute appendicitis is one of the most common causes of abdominal emergency. Children, under age of 5 years, are unable to give an accurate history, but other nonspecific abdominal pain is more common at this age. Because diagnosis is often delayed and progression of appendicitis is faster, incidence and perforation rate is higher than those of adults. Abdominal US and CT are helpful in diagnosis of acute appendicitis. METHODS: Between July, 1997 and April, 2004, 39 patients below 5-year-old were participated, but 2 (Negative) patients were excluded. This study was done retrospectively based on medical charts. For statistical analysis, Chi-squre test was used. RESULTS: All patients undergone emergency operations, in which male to female ratio was 1.79: 1, with its mean age of 4.05. 19 patients (49%) were perforated and fever developed more frequently in perforating group, but leukocytosis was not significant. Delayed preoperative duration was associated with perforation rate significantly. All complications were occurred in perforating group. CONCLUSION: To decrease perforation rate and complications, early diagnosis and management are necessary to avoid delaying preoperative time.
Abdominal Pain ; Adult ; Appendicitis* ; Child* ; Child, Preschool ; Diagnosis ; Early Diagnosis ; Emergencies ; Female ; Fever ; Humans ; Incidence ; Leukocytosis ; Male ; Retrospective Studies

BACKGROUND: Studies on herpes zoster have been extensively reported in Korea. However, few reports have dealt with herpes zoster in children and adolescents. OBJECTIVE: The purpose of this study was to investigate the epidemiological features and clinical characteristics of herpes zoster in children and adolescents. METHODS: During a 10-year period (2005~2014), 95 herpes zoster patients, aged 18 years and younger, were evaluated in regard to the annual, monthly, and seasonal incidences; the age distribution; and the gender ratio. The children and adolescents with herpes zoster were further assessed on the accompanying symptoms, dermatomal distribution, associated diseases, treatments, and complications. RESULTS: Among all the patients with herpes zoster, 2.41% were children and adolescents. The highest incidence was in summer (35.8%). The age group of 10 to 14 years had the highest incidence (40.0%). The male to female ratio was 1.4:1. The common accompanying symptoms were pain (77.9%) and pruritus (22.1%). The most common dermatomal distribution was the thoracic dermatome (50.5%), followed by the cervical (21.1%), the trigeminal (16.8%), the lumbar (7.4%) and the sacral (4.2%) dermatomes. Associated diseases including atopic dermatitis, bronchial asthma, allergic rhinitis, chronic sinusitis, and epilepsy were observed in 23.2%. There was no case with immunosuppression. The most common complication was secondary bacterial infection (5.2%), followed by herpes zoster ophthalmicus or herpes zoster generalisatus (4.2%), Ramsay Hunt syndrome (2.1%), meningitis and recurrent herpes zoster (1.1%). No patient developed postherpetic neuralgia. CONCLUSION: Herpes zoster is rare and relatively mild in healthy immunocompetent children and adolescents. Pruritus was observed in some pediatric patients, but there was no occurrence of postherpetic neuralgia.
Adolescent* ; Age Distribution ; Asthma ; Bacterial Infections ; Child* ; Dermatitis, Atopic ; Epilepsy ; Female ; Herpes Zoster Ophthalmicus ; Herpes Zoster Oticus ; Herpes Zoster* ; Humans ; Immunosuppression ; Incidence ; Korea ; Male ; Meningitis ; Neuralgia, Postherpetic ; Pruritus ; Retrospective Studies* ; Rhinitis, Allergic ; Seasons ; Sinusitis

Mandible fractures have recently been managed by rigid internal fixation with miniplate and screws more often than by traditional interosseous wiring methods. The purpose of this paper was to compare traditional interosseous wiring with miniplate fixation in open reduction of mandible fracture, especKweonially in operative results and costs. From June of 1989 to June of 1998, there were 142 patients, admitted to the department of Plastic and Reconstructive Surgery, Chun-Cheon Sacred Heart Hospital, Hallym University. Of those, 101 patients were managed by open reduction, and among them, 83 patients were treated with miniplate fixation, but 18 patients had recently been treated with interosseous wiring methods. No significant difference was noted between the two groups in terms of complications, but the overall cost of miniplate and screws was higher than interosseous wiring, while the mean operative time was longer in the group treated with miniplate fiation. The authors recommend interosseous wiring technique for patients with mandible fractures requiring open reduction and fixation, except for absolute indications of rigid internal fixation.
Gangwon-do ; Heart ; Humans ; Mandible* ; Operative Time ; Plastics

PURPOSE: There diagnostic modalities have been commonly used to detect prostate cancer to date: digital rectal examination (DRE), serum prostate specific antigen (PSA) and transrectal ultrasonography(TRUS). We evaluated the diagnostic values of these three modalities in the early detection of prostate cancer. MATERIALS AND METHODS: We analysed 215 patients with low urinary tract symptoms who had pathologic diagnosis for prostatic cancer was possible by biopsy or transurethral resection. Transectal ultrasonography guided sextant biopsies were performed if the PSA level was greater than 4.0 ng/ml or DRE was suspicious, even if TRUS revealed no ateas suspicious for cancer. TURP were performed without TRUS or biopsies if the PSA level was lesser than 4.0 ng/ml and DRE was negative. RESULTS: Of the 215 patients, 36 (16.7%) revealed prostate cancer. Positive predictive value, sensitivity and specificity was 37.0%. 83.3%. 71.5% for DRE, 30.0%, 91.7%, 58.3% for PSA and 27.6% 58.3%. 43.3% for TRUS respectively. Positive findings on serum PSA or DRE or both tests detected significantly more tumors(97.2%, 35of 36 cancers) than only PSA (91.7%, 33 for 36 cancers), DRE (83.3%, 30 of 36 cancers) and TRUS (60.0%, 21 of 35 cancers) alone. CONCLUSIONS: These result shows that DRE is more valuable and cost effective method for detection of prostate cancer than serum PSA and the use of DRE in conjunction with serum PSA enhances prostate cancer detection.
Biopsy ; Diagnosis ; Digital Rectal Examination* ; Humans ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Sensitivity and Specificity ; Transurethral Resection of Prostate ; Ultrasonography* ; Urinary Tract

PURPOSE: Differentiated thyroid cancer is known to be one of cancers which have a favorable prognosis and long-term survival resulting from slow growth of tumor and late distant metastasis. Patients are nearly cured of thyroid cancer after first operation. But, some of those have high risk factors of recurrence. Practically it has been reported that 20% of those have recurrence of cancer and 50~60% of patients died of recurrence. We analyzed factors involving to recurrence after initial treatment, frequency and site of recurrence, disease-free interval, and results of treatment. Based on this information, we investigated therapeutics to decrease the rate of recurrence and prognostic factors to expect death. METHODS: 1803 patients were primarily operated for thyroid cancer in Kyungpook National University Hospital between 1985 and 2003. Among the cases, we reviewed the clinical records of 124 patients (6.9%) who had recurrent thyroid cancer. We analyzed the difference in frequency of recurrence on the basis of sex, age, histologic types, risk groups, and lymph node metastases when they had a first operation. The correlation between these factors and mortality rate was analyzed statistically by using Chi-square test and Fisher's exact probability test. RESULTS: Post-operative recurrence of thyroid cancer was highly observed in over 40 years old at first operation (8.4% vs. 4.9%), men (17.1% vs. 3.9%). Similarly, in the case of medullary or poorly-differentiated thyroid cancers, the groups of patients with high-risk (12.3% vs. 3.9%) or with lymph node metastases (13.5% vs. 3.7%) have high frequency of recurrence. Among the 124 patients, 53.3% cases have regional recurrence sites and 20.1% have local, 17.7% distant metastases, and 1.6% combined locoregional. The number of patients who died of recurrent cancer was 32 of 124 cases. Major cause of the death was distant metastases. In the case of 104 patients who had recurrent differentiated thyroid cancer, significant prognostic indicators of low survival rates are age greater than 45 years, neck dissection at second operation and distant metastases. CONCLUSION: In order to decrease the rate of local and regional recurrence in thyroid cancer, we conclude that complete resections of thyroid tissue and cervical lymph nodes have to be operated specially in the group with high-risk. Although adjacent organs are infiltrated, active treatment should be carried out. The treatment of most medullary or poorly-differentiated thyroid cancers which result in the death of distant metastases still remains to be studied.
Gyeongsangbuk-do ; Humans ; Lymph Nodes ; Male ; Mortality ; Neck Dissection ; Neoplasm Metastasis ; Prognosis* ; Recurrence ; Risk Factors* ; Survival Rate ; Thyroid Gland* ; Thyroid Neoplasms*

A lymphangioma is comparatively rare in the elimentary tract, and is a benign tumor of the lymphatic system. A duodenal lymphangioma is especially rare, and has an obscure etiology. Clinically, and in the laboratory the are non-specific, and are incidentally found by endoscopy, and their treatment is total excision. Recently, the authors experienced a 45 year-old woman, who had a duodenal lymphangioma, but with no symptom. An endoscopic examination revealed a single, about 2 cm, polypoid lesion below the ampulla. The lesion was successfully excised after a duodenotomy.
Duodenum ; Endoscopy ; Female ; Humans ; Lymphangioma* ; Lymphatic System ; Middle Aged

No abstract available.
Mycobacterium*

No abstract available.
Chordoma*

PURPOSE: The malignant conversion of epithelial cells involves alterations in the expression and the function of cell-matrix and cell-cell adhesive systems that enable a switch to a migratory phenotype in tumor invasion and metastasis. Here, the author studies the prevalence and the potential clinical significance of fascin and Matrix metalloproteinase-9 (MMP-9) expression in relation to the progression of colon adenocarcinoma and of tumor cell proliferation as measured by using the topoisomerase II-alpha (Topo II-alpha) index. METHODS: Relatively well-preserved paraffin-embedded tissues of 120 cases of colon adenocarcinomas were immunohistochemically stained for fascin, MMP-9, and Topo II-alpha expression. A reaction was determined as being positive when more than 10% of the cells were positive for fascin, and/or MMP-9. The Topo II-alpha index is defined as the positive number of tumor cells divided by the total number of tumor cells counted times 100. At least 1,000 cells were counted for this analysis. A chi-square test, by using Epi info 2000, for Fascin and/or MMP-9 and a two-sided test for the Topo II-alpha index were employed with a significance of P<0.05. RESULTS: Positive reactions for fascin and MMP-9 in colon adenocarcinomas were 44.2% and 56.7%, respectively. In clinically annotated tumors, fascin immunoreactivity was more common in tumors located in the right colon (P=0.014) and was associated with older age (>65 yr, P=0.028), tumor grading (P=0.009), and lymph node metastases (P=0.005). However, MMP-9 immunoreactivity was not statistically associated with age, gender, tumor stage, or lymph node metastases. Fascin expression was statistically associated with MMP-9 expression, especially for left colon adenocarcinomas (P=0.0032). Although the topo II-alpha proliferating index was associated with lymph node metastasis (P<0.01), this result was not statistically associated with Fascin or MMP-9 expression. CONCLUSION: Fascin expression may be closely linked with tumor grading and lymph node metastasis of more aggressive colon adenocarcinomas and partly associated with MMP-9 expression in tumor invasion. However, further studies of fascin expression as an independent prognostic factor are required for the determination of significant relationships with other clinicopathologic indices.
Adenocarcinoma ; Adhesives ; Carrier Proteins ; Cell Proliferation ; Colon ; Epithelial Cells ; Lymph Nodes ; Matrix Metalloproteinase 9 ; Microfilament Proteins ; Neoplasm Grading ; Neoplasm Metastasis ; Organophosphorus Compounds ; Phenotype ; Prevalence

Onychomycosis is caused by dermatophytes usually, but some species of nondermatophytic molds and yeasts are also associated with invasion of nails. Aspergillus sydowii is a nondermatophytic mold which is opportunistic filamentous fungus in all environments. We report a case of onychomycosis caused by A. sydowii in a 65-year-old male. The patient showed yellowish discoloration with hyperkeratotic change on the distal and lateral portion of both great toenails. Direct microscopic examination of scraping on the potassium hydroxide preparation revealed dichotomous septate hyphae and repeated cultures on Sabouraud dextrose agar showed the same blue green velvety colonies. Biseriate phialides that cover entire vesicle with conidial structure resembling Penicillium were shown in the slide culture. The DNA sequence of internal transcribed spacer (ITS) region of clinical sample was 99% match to that of A. sydowii strain XWSFJJ1 (GenBank accession number FJ461692). We confirmed A. sydowii by KOH mount, colony, light microscopic morphology and DNA sequence analysis. The patient was treated with 250 mg oral terbinafine daily and topical 5% amorolfine nail lacquer for 3 months.
Agar ; Aged ; Arthrodermataceae ; Aspergillus* ; Base Sequence ; Fungi ; Glucose ; Humans ; Hyphae ; Lacquer ; Male ; Nails* ; Onychomycosis* ; Penicillium ; Potassium ; Sequence Analysis, DNA ; Yeasts