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

Perinatal atrial flutter is a potentially lethal arrhythmia. Management of this disorder is difficult and controversial. Fetal atrial flutter is a serious and life threatening rhythm disorder particulary when it causes hydrops; it may be associated with fetal death or neurological damage. Although the initial episode of flutter may be difficult to control, recurrence of atrial flutter after successful resolution of the arrhythmia seems highly unlikely and long-term prognosis is excellent. We experienced a case of a atrial flutter diagnosed in utero at 38+6 weeks' gestation by fetal cardiac echocardiography. He was treated with maternal digoxin, but he continued to have atrial flutter until delivery. Restoration of sinus rhythm occured with propafenone therapy in this patient after failure of initial digoxin therapy and direct current cardioversion.
Arrhythmias, Cardiac ; Atrial Flutter* ; Diagnosis* ; Digoxin ; Echocardiography* ; Edema ; Electric Countershock ; Fetal Death ; Humans ; Pregnancy ; Prognosis ; Propafenone* ; Recurrence

The goal of this study was to examine the characteristics of the histo- immunological changes following induction of autoimmune prostatic inflammation achieved by subcutaneous allograft injection of the tissue homogenate of mouse ventral prostate. We also investigated the effect of the administration of androgen upon the development of mouse autoimmune prostatitis. Eight week old male C57BL/6 mice were selected and the presence, location and the degree of inflammation were identified after injection. The extent of infiltrations of the inflammatory cells in the prostate following the administration of the exogenous testosterone, the variation of the CD4/CD8 ratio of splenic lymphocyte and the variations of the interleukin-2 and tumor necrosis factor-alpha secreted by the splenic cells were also examined. The autoimmune prostatitis of the mouse induced by subcutaneous allograft injection of the mouse ventral prostate showed histological findings similar to that of human. The degree of induction was in proportion to the amount of tissues injected and showed organ-specificity. Exogenous administration of testosterone resulted in partial inhibitory effect on the induction of inflammation which was thought to be related to the decrease in the CD8+ T lymphocyte count and the functional inhibitory effect of the splenic T lymphocyte on the production of Interleukin- 2. However, tumor necrosis factor-alpha is presumed to be not closely related to the inhibitory effect of the administration of testosterone. In the future, further studies on the variation of cytokine levels and the value of sex hormones within the prostate and, moreover investigations in related to the humoral immune mechanism should be encouraged.
Allografts ; Animals ; Gonadal Steroid Hormones ; Humans ; Inflammation ; Interleukin-2 ; Lymphocyte Count ; Lymphocytes ; Male ; Mice* ; Prostate ; Prostatitis* ; Testosterone* ; Tumor Necrosis Factor-alpha

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

OBJECTIVE: We examined the difference between IQ(Intelligence Quotient) estimated from computerized Standard Progressive Matrices(SPM) score(SPM IQ) and Korean-Wechsler Adult Intelligence Scale(KWAIS) IQ(KWAIS IQ) in Korean patients with mental disorders in order to test the validity of SPM as a brief nonverbal intelligence test, and to find the groups that need standardization. And, we studied the method to predict KWAIS IQ more precisely from SPM test. METHODS: SPM test in Vienna test system was administered to 166 Korean patients with mental disorders. The degree of consistency and Pearson's correlation coefficient between SPM IQ and KWAIS IQ in total subjects and groups by sex, age, education, and clinical diagnosis were investigated. And, we obtained a regression equation to predict KWAIS IQ from SPM score. RESULTS: In total subjects, Pearson's correlation coefficient between SPM IQ and KWAIS IQ was as high as 0.704, and the percent of patients whose absolute value of difference between SPM IQ and KWAIS IQ is equal to or less than 10 was 54.8%. The degree of consistency between SPM IQ and KWAIS IQ was influenced by age and educational level. SPM IQ were higher than KWAIS IQ in younger age and lower education group. SPM IQ were lower than KWAIS IQ in older age and higher education group. The regression equation from SPM score, age, and education years predicted KWAIS IQ more correctly. CONCLUSION: The Computerized Standard Progressive Matrices test is validated and can be used usefully as a brief nonverbal intelligence test in patients with mental disorders. In order to provide more precise evaluation, standardized data should be prepared for age group 16 to 25 and age group 26 to 35 with lower educational level.
Adult ; Diagnosis ; Education ; Humans ; Intelligence ; Intelligence Tests ; Mental Disorders*

OBJECTIVE: Postoperative brain swelling after resection of olfactory groove meningiomas by bifrontal interhemispheric transbasal approach is a knotty subject. Pathogenesis and predictive factors were investigated to prevent the problem. METHODS: Eighteen patients of olfactory groove meningiomas who had undergone surgery were enrolled and retrospectively analyzed using their clinical and radiological data. Bifrontal interhemispheric transbasal approach was used in all patients. Magnetic resonance imaging and transfemoral cerebral angiography were available for investigation in 18 and 14 patients respectively. Postoperative clinical course, tumor volume, peritumoral edema, tumor supplying vessels, and venous drainage patterns were carefully investigated in relation to postoperative brain swelling. RESULTS: Seven patients (39%) developed clinically overt brain swelling after surgery. Among them, 4 patients had to undergo decompression surgery. In three patients, attempted bone flap removal was done by way of prevention of increased intracranial pressure resulted from intractable brain swelling and two of them eventually developed brain swelling which could be recovered without sequellae. Abnormal frontal base venous channel observed in preoperative angiography was significant predictive factor for postoperative brain swelling (p=0.031). However, tumor volume, peritumoral edema, and existence of pial tumor supplying vessels from anterior cerebral arteries were failed to show statistical significances. CONCLUSION: To prevent postoperative brain swelling in olfactory groove meningioma surgery, unilateral approach to preserve frontal base venous channels or temporary bone flap removal is recommended when it is indicated.
Angiography ; Anterior Cerebral Artery ; Brain Edema* ; Brain* ; Cerebral Angiography ; Cerebral Veins ; Decompression ; Drainage ; Edema ; Humans ; Intracranial Pressure ; Magnetic Resonance Imaging ; Meningioma* ; Postoperative Complications ; Retrospective Studies ; Tumor Burden

Pancreaticopleural fistula is an uncommon complication of chronic pancreatitis. We report a case of pancreaticopleural fistula that was presented with right-sided hemothorax. A 49-year-old male with a history of chronic alcoholism was presented with a month of dyspnea. A chest radiography showed a right-sided massive pleural effusion with old-blood-colored fluids and amylase levels of 1,020 IU/L. On the chest computerized tomography (CT), there was pleural effusion and a well-defined tract from the posterior mediastinum to the pseudocyst in the tail of the pancreas. Even with conservative treatment with closed thoracostomy, octreotide and gabexate mesilate, he developed hemothorax. Abdominal CT revealed an increase of the hemorrhagic pancreatic pseudocyst. Distal pancreatectomy with splenectomy and external drainage of the pancreaticopleural fistula on the posterior mediasternum were performed. The patient had an uneventful course and was discharged on the 27th postoperative day. Management of pancreaticopleural fistula is multimodal included medication, endoscopic stenting and surgery. Surgery in pancreaticopleural fistula might be beneficial in selective cases.
Alcoholism ; Amylases ; Drainage ; Dyspnea ; Fistula ; Gabexate ; Hemothorax ; Humans ; Male ; Mediastinum ; Middle Aged ; Octreotide ; Pancreas ; Pancreatectomy ; Pancreatic Pseudocyst ; Pancreatitis, Chronic ; Pleural Effusion ; Splenectomy ; Stents ; Thoracostomy ; Thorax

A small localized infarction in the dorsal pontine area can cause various eye-movement disturbances, such as abducens palsy, horizontal conjugate gaze palsy, internuclear ophthalmoplegia, and one-and-a-half syndrome. However, complete loss of vertical saccades and pursuit with horizontal gaze palsy has not been reported previously in a patient with a small pontine lesion. We report a 67-year-old man with a small dorsal caudal pontine infarct who exhibited total horizontal gaze palsy as well as loss of vertical saccades and pursuit.
Aged ; Humans ; Infarction* ; Ocular Motility Disorders ; Ophthalmoplegia ; Paralysis* ; Saccades*

A case of traumatic carotid-cavernous fistula treated using Debrun's latex detatchable balloon catheter is reported. The patient was a 33-year-old man, who has complaints of proptosis and chemosis of left eye 2 months after motor vehicle accident. The cerebral angiography showed direct fistula between intracavernous portion of internal carotid artery and cavernous sinus as high flow-high pressure type. After complete radiologic and neurologic examination, the fistulous opening was successfully occluded by Debrun's latex detatchable balloon with transient ischemic attack, was resolved 2 hours after the procedure.
Adult ; Carotid Artery, Internal ; Catheters ; Cavernous Sinus ; Cerebral Angiography ; Exophthalmos ; Fistula ; Humans ; Ischemia ; Ischemic Attack, Transient ; Latex* ; Motor Vehicles ; Neurologic Examination