The purpose of this study is to present our experience of distraction osteogenesis procedure used to improve the functional and consmetic problems of two patients associated with Pierre-Robin sequence, which is an uncommon congenital disease in combination with micrognathia, glossoptosis, and respiratory obstruction. A female child of 42 months and a male infant of 4 months suffering from pneumonia, difficult breathing, cyanosis and insomnia were admitted. We performed temporary tongue to lip dhesion by modified Routledge method and bilateral mandibular distraction. After the operation, symptoms of insomnia and impaired breathing had improved. We found an extension of the mandibular length. In addition, the posterior airway space and lower face area were expanded in the cephalometric tracing and profilogram. We report that bilateral distraction provedure could be an effective and safe method for improving of impaired breathing and cosmetic problems of patients with Pierre-Robin sequence.
Child ; Cyanosis ; Female ; Humans ; Infant ; Lip ; Male ; Osteogenesis, Distraction ; Pneumonia ; Respiration ; Sleep Initiation and Maintenance Disorders ; Tongue

It was not until 1919 that the treatment of retinal detachment began to plan on rationale line by Jule Gonin, Who was the first to appriciate the pathological significance of retinal break and therapeutic effect of closing these. Since after the first Gonin's suggestion, various surgical techniques for rhegmatogenous retinal detachment was reoprted in the literatures. Recently the authors had been experienced good surgical results of 45 eyes, beililg operated. The authors employed encircling procedurs and segmental buckling procedure with implants. The segmental buckling procedure was modified from the pocket technique, being employed in the case of simple posterior vitreous detachment. The encircling procedure followed the Crock and Galbraith technique modified from Schepens, being employed in the case of to tal posterior vitreous detachment with collapse. 36 eyes out of 45 eyes was much successful, and no postoperative complication was occurred.
Postoperative Complications ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Vitreous Detachment

Multicystic ovary was first described by Silver in 1958 as a rare case feature of acquired primary hypothyroidism. In 1980, Lindsay reported four girls with hypothyroidism associated with multicystic ovary diagnosed by pelvic ultrasonography. The mechanism of ovarian cyst formation and pseudoprecocious puberty in severe hypothyroidism in childhood are unknown. Increased ovarian sensitivity to GnRH and increased TSH level which acts on FSH receptor is one of the mechanism explained. We report a case of a girl with primary hypothyroidism presented with pseudoprecocious puberty and giant follicular ovarian cyst with torsion.
Adolescent ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Hypothyroidism* ; Ovarian Cysts* ; Ovary ; Puberty ; Receptors, FSH ; Silver ; Ultrasonography

Control of tuberculosis is threatened by widesread emergence of drug resistant Mycobacterium tuberculosis. Rifampin is a key component among therapeutic regimens for the tuberculosis; therefore patients in whom resistance to this drug develop have a poor outlook, particularly if rifampin resistance is associated with resistance to other tuberculosis drugs. The purpose of this study was to detect the mutation in rpoB gene of rifampin resistant M. tuberculosis in Korea and to evaluate the usefulness of the method in clinical aspects. A sample of 80 M. tuberculosis was studied, and it included 40 rifampin resistance isolates and 40 rifampin sensitive isolates by conventional methods. The detection method involved the amplification by polymerase chain reaction (PCR) of the Rif' region and the identification of mutations by single-strand DNA conformation polymorphism analysis (SSCP) of the amplification products (157 bp). Mutation were identified in 39 of 40 rifampin resistant isolates, and in 1 of 40 rifampin sensitive isolates.
Humans ; Korea ; Mycobacterium tuberculosis* ; Mycobacterium* ; Nucleic Acid Conformation ; Polymerase Chain Reaction* ; Rifampin ; Tuberculosis

Control of tuberculosis is threatened by widespread emergence of drug resistance in Mycobacterium tuberculosis. Understanding the molecular basis of resistance might lead to development of novel rapid methods for diagnosing drug resistance. Rifampin is a key component among therapeutic regimens for the tuberculosis; therefore, patients who have drug resistance do not convalesce satisfactorily. The molecular mechanism of resistance to rifampin in M. tuberulosis has been elucidated. Substitutions of a limited number of highly conserved amino acids encoded by the rpoB gene are responsible for the ""single-step"" high-level resistance of M. tuberculosis to rifampin. Currently, two genotype-based protocols allow drug test from minimally grown cultured materials: (i)mutation identification by direct sequencing of PCR-amplified material. and (ii)mutation screening by PCR-SSCP. The purpose of this study is to evaluate the usefulness of the both methods. A sample of 75 isolates of M. tuberculosis was studied, and it inculded 36 rifampin-resistant strains and 39 rifampin-sensitive strains by conventional methods. Mutaions were identified in 36 rifampin-resistant isolates but in none of 39 sensitive isolates. All mutations were clustered within a region of 23 amino acids. Both methods allow detection of rifampin resistance in 2 to 3 days and will thus help in the early management of infection by M. tuberculosis.
Amino Acids ; Drug Resistance ; Humans ; Mass Screening ; Mycobacterium tuberculosis* ; Mycobacterium* ; Rifampin ; Tuberculosis

Herpes simplex esophagitis has been recognized with increased frequency as an opportunistic infection in immunosuppressed or debilitated patients. However, it is also documented as self-limited esophagitis in apparently healthy patients. We report two cases of herpetic esophagitis diagnosed by biopsies. One case was noted in an immunocompetent patient having gastric peptic ulcer who had clinical improvement with symptomatic treatment. And the other was noted in an immunosuppressed patient having chemotherapy for gastric carcinoma who had resolution of symptoms with acyclovir therapy. Histologically, esophageal mucosa exhibited erosion and inflammatory cellular exudate with intranuclear eosinophilic inclusions in the epithelial cells. These were confirmed by the PCR and immunohistochemical stain for herpes simplex virus using a biopsy material.
Acyclovir ; Biopsy ; Drug Therapy ; Eosinophils ; Epithelial Cells ; Esophagitis* ; Exudates and Transudates ; Herpes Simplex* ; Humans ; Mucous Membrane ; Opportunistic Infections ; Peptic Ulcer ; Polymerase Chain Reaction ; Simplexvirus

Acute generalized exanthematous pustulosis (AGEP) has symptoms of abrupt onset of a widespread pustular eruption on an erythematous. base. Most cases appear to be related to drug reactions, mainly antibiotics, but viral infections and hypersensitivity to mercury may cause AGEP. The essential features of AGEP include. (1) numerous (several dazen) small((5mm), mostly non follicular pustules arising on a widespread erythema:purpura and target-like lesions may be associated; (2) histology showing intraepidermal or subcorneal pustules associated with one or more of the following.clermal edema, vasculitis, perivascular eosinophils, or focal necrosis of keratinocytes; (3) fever (over 38C); (4) neutrophilia, and (5) acute evolution with spontaneous resulotion of pustules within 15 days. We report a case of AGEP which presented with widespread tiny pustules on the whole body except the face, palms and soles. There were petechia, purpura, and vesiculobullous lesions on the axilla, popliteal fossa and upper abdomen. A biopsy specimen from a pustule showed subcorneal pustules with perivascular polymorphous cellular infiltration, marked dermal edema and necrotic keratinocytes. There was complete resolution of the lesions within 10 days.
Abdomen ; Acute Generalized Exanthematous Pustulosis* ; Amoxicillin ; Anti-Bacterial Agents ; Axilla ; Biopsy ; Drug Eruptions ; Edema ; Eosinophils ; Fever ; Hypersensitivity ; Keratinocytes ; Necrosis ; Purpura ; Vasculitis

BACKGROUND: Passive smoking is an important worldwide public health issue. In many Korean studies, parental smoking has been reported to be associated with reduced pulmonary function in children. But few studies have evaluated the effects of passive smoking on pulmonary function in adults. Therefore, we looked into this association in the study. METHODS: Participants in the study included non-smoking, healthy men (n=46) and women (n=326) from rural Korea enrolled from June to December 2006. Exposure to passive smoking was assessed by a self-administered questionnaire, and standardized pulmonary function tests were performed. RESULTS: There were significant reductions in forced expiratory volume in 1 second (FEV1, % of predicted) and forced mean expiratory flow rate 25-75% (%) among the men exposed to passive smoke compared with those not exposed (55.7 vs 75.8, P=0.010; 33.9 vs 58.6, P=0.029, respectively). There were significant reductions in FEV1 among men exposed at both workplace and home compared with men exposed only at either workplace or home (42.8 vs 49.3, 64.6; P=0.034). No significant difference in pulmonary function was found between women exposed to passive smoke compared those not exposed. There were, however, reductions in FEV1 and FEV1/forced vital capacity among the women exposed at workplace. Regression analysis showed that passive smoking negatively affected lung function, which were not statistically significant. CONCLUSIONS: Exposure to environmental tobacco smoke, particularly at the workplace, adversely affects pulmonary function in adults.
Adult ; Child ; Female ; Forced Expiratory Volume ; Humans ; Korea ; Lung ; Male ; Parents ; Public Health ; Respiratory Function Tests ; Smoke ; Smoking ; Tobacco ; Tobacco Smoke Pollution ; Vital Capacity ; Surveys and Questionnaires

No abstract available.
Diagnosis* ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma*

PURPOSE: Emotional and behavioral disturbances have been reported in severe short stature children. The purpose of this study was to examine psychosocial problems in children with Growth hormone deficiency(GHD), comparing with their normal height siblings. METHODS: Twenty three children with GHD(17 boys and 6 girls, mean age:13.1+/-2.8 yrs) were included. Their normal height siblings(8 boys and 2 girls, mean age:12.3+/-2.9 yrs) were included as control group. Parents of all participating children completed the Child Behavior Checklist. Patients 10 years and older completed the Youth Self Report. RESULTS: 1)Internalizing problem scores(somatic complaints, anxiety, depression, social incompetence) were higher in GHD compared to control group(49.0+/-15.0 vs 43.2+/-6.2, P<0.05). Externalizing problem scores and social competences were not different between GHD and control group. 2) Total problem scores in GHD were not different by sex. 3)Total problem scores were not different between idiopathic GHD and organic GHD. 4)Attention problems(r=0.45, P<0.05), delinquent behavior(r=0.49, P=0.01) and aggressive behavior(r=0.51, P<0.01) increased by age. 5)Height SDS negatively correlated with social problem(r=-0.47, P<0.05) and delinquent behavior(r=-0.61, P<0.01). Height SDS also negatively correlated with somatic complaints(r=-0.75, P<0.01), anxiety and depression(r=-0.66, P=0.01). CONCLUSION: Internalized problems such as somatic complaints, anxiety and depression were higher in GHD than control group. Behavioral problem scores were increased by age and behavioral problem scores were correlated with height deficit. When we treat GHD children, appropriate medical and psychological counseling should be included.
Adolescent ; Anxiety ; Checklist ; Child Behavior ; Child* ; Counseling ; Depression ; Female ; Growth Hormone* ; Humans ; Parents ; Self Report ; Siblings