No abstract available.
Purpura, Schoenlein-Henoch* ; Scarlet Fever*

Intraductal papillary neoplasm of the bile duct (biliary IPN) is a rare disease characterized by multicentric proliferation of adenomatous epithelium within the bile ducts. The common clinical manifestations are recurrent abdominal pain, jaundice, and acute cholangitis. We report a case of hemobilia caused by biliary IPN. A 59-year-old man was referred to our hospital because of hemobilia of unknown origin. Computed tomography and magnetic resonance cholangiography revealed dilatation of the S6 segmental duct with an ovoid-shaped intraductal mass. Percutaneous transhepatic cholangioscopy showed multiple papillary masses with bleeding in the S6 segmental duct. The patient underwent a right lobectomy, and the pathology revealed a well differentiated intraductal papillary adenocarcinoma.
Abdominal Pain ; Adenocarcinoma, Papillary ; Bile ; Bile Ducts ; Cholangiography ; Cholangitis ; Dilatation ; Epithelium ; Hemobilia ; Hemorrhage ; Humans ; Jaundice ; Magnetic Resonance Spectroscopy ; Middle Aged ; Rare Diseases

Infected urachal cyst is a rare disorder. While a urachal cyst is usually asymptomatic, the infected cyst may mimic a variety of acute intraabdominal infection. We have experienced a case of infected urachal cyst in a 3 year old boy complaining of high fever and diarrhea. During hospitalization, symptoms and sings of acute peritonitis dominated the clinical feature. Abdominal sonogram, abdominal computerized tomography and cavitogram demonstrated cystic mass posterior to central abdominal wall. Pus was drained from the cystic lesion by ultrasound-guided needle aspiration and indwelling catheter insertion. E.coli was cultured from pus. In the differential diagnosis of acute abdomen ultrasonographic examination of abdomen should be recruited to rule out the infected urachal cyst.
Abdomen ; Abdomen, Acute ; Abdominal Wall ; Catheters, Indwelling ; Child, Preschool ; Diagnosis, Differential ; Diarrhea ; Fever ; Hospitalization ; Humans ; Intraabdominal Infections ; Male ; Needles ; Peritonitis* ; Suppuration ; Urachal Cyst*

Major known causes of neonatal adrenal insufficiency are prolonged maternalsteroid use, adrenal hemorrhage from the perinatal stress and adrenogenital syndrome. Theoretically adrenal aplasia might be a cause of neonatal adrenal insufficiency but it has not been reported yet. We had experienced a case of adrenal aplasia in a 5 day-old male neonate whose chief complaint was hyperpigmentation. His laboratory findings were compatible with adrenal insufficiency and adrenal gland was not detected by the ultrasonography and thin section abdominal CT. We reported a case of adrenal aplasia with a brief review of the related literature.
Adrenal Glands ; Adrenal Insufficiency ; Adrenogenital Syndrome ; Hemorrhage ; Humans ; Hyperpigmentation ; Infant, Newborn ; Male ; Tomography, X-Ray Computed ; Ultrasonography

ARCI syndrome consists of arthrogryposis, renal tubular acidosis, cholestatic jaundice and icthyosis. We experienced an ARCI syndrome case with corpus callosum hypoplasia and atrial septal defect. This case had oral feeding difficulty, multiple joint contracture, renal tubular acidosis and neurogenic muscular atrophy at neonatal period. At two months of age, icthyosis and cholestatic jaundice were diagnosed. The case was hospitalized due to pneumonia at four months of age. Corpus callosum hypoplasia and atrial septal defect were detected. The case was treated with a mechanical ventilator because pneumonia was aggravated and respiratory failure occurred. The patient expired at five months of age.
Acidosis, Renal Tubular ; Arthrogryposis ; Contracture ; Corpus Callosum* ; Heart Septal Defects, Atrial ; Heart* ; Humans ; Jaundice, Obstructive ; Joints ; Muscular Atrophy ; Pneumonia ; Respiratory Insufficiency ; Ventilators, Mechanical

Kikuchi disease (histiocytic necrotizing lymphadenitis) is a rare disorder affecting young women where the presentation is usually with the fever and the self-limiting localized lymphadenopathy. The lymphadenopathy is usually observed in the cervical region, and the involvement of intra-abdominal lymph nodes is quite rare. A 8-year-old boy had been operated under the impression of acute appendicitis at a local clinic due to the acute right lower abdominal pain and tenderness. He was found with a large cecal mass and an intact appendix, and was transferred. Abdominal CT showed the conglomerates of lymph nodes located in the mesenteric area. Mesenteric lymph node excisional biopsies and incidental appendectomy were performed. The biopsy specimen showed many necrotic areas with infiltration of the foamy histiocytes. Laboratory tests revealed increased serum CRP concentration with leukopenia. Serologic tests for viral causes were negative. The postoperative course was accompanied with fever which resolved gradually without a specific treatment. In cases of unclear acute abdomen with a mesentereic lymphadenopathy, an attempt at achieving histological view of a lymph node is desirable in order to realize a rare differential diagnosis such as Kikuchi disease.
Abdomen, Acute ; Abdominal Pain ; Appendectomy ; Appendicitis* ; Appendix ; Biopsy ; Child ; Diagnosis, Differential ; Female ; Fever ; Histiocytes ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Leukopenia ; Lymph Node Excision ; Lymph Nodes* ; Lymphadenitis* ; Lymphatic Diseases ; Male ; Serologic Tests ; Tomography, X-Ray Computed

Food allergy is not uncommon among small children. Cow milk and eggs are most frequently incriminated as the major cause of food allergy. A 4-month-old female infant who did not have a previous history of contact with the egg developed anaphylactic shock when an emulsion of raw egg white was rubbed on the buttock by her mother to relieve erosive diaper dermatitis. She had been fed on breast milk. She had no past medical history of any other allergy and no family history of atopy, asthma or allergic rhinitis. Her IgE PRIST was 29.46 IU/ml and multiple antigen simultaneous testing chemiluminescent assay for food specific IgE antibody showed a level 4 positive value only to egg white.
Anaphylaxis* ; Asthma ; Breast* ; Buttocks ; Child ; Dermatitis ; Egg White* ; Eggs ; Female ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant* ; Luminescent Measurements ; Milk ; Milk, Human ; Mothers ; Ovum* ; Rhinitis ; Skin*

PURPOSE: Recommended dietary allowance of vitamin C was determined on the basis of preventing the scurvy without considerations of the important function of the vitamin C as a first line antioxidant. So we measured the whole blood and plasma vitamin C concentrations of the contemporay healthy elementary school children in Chinju for the establishment of the optimal daily vitamin C requirment in the elementary school children. METHODS: Whole blood and plasma vitamin C concentrations were measured by the 2,4-dinitrophenylhydrazine method in 338 children from the 1st to the 6th grade of one elementary school in Chinju. RESULTS: Whole blood and plasma vitamin C concentrations were 1.36+/-0.34mg/dL and 1.07+/-0.33mg/dL respectively. There existed an close relationship between whole blood and plasma vitamin C concentrations (r=0.77, p=0.0001). Whole blood vitamin C concentration decreased as the age became older (r=-0.22 p=0.0001), but plasma vitamin C concentration did not change. There were no sex differences in the whole blood and plasma vitamin C concentrations except in the 3rd grade (p<0.05). Twenty-three of 338 elementary school children (6.8%) had the plasma vitamin C concentration less than 0.6mg/dL. CONCLUSIONS: We produced the blood and plasma vitamin C concentrations of the contemporay elementary school children in Chinju. These values were not satisfactory in consideration of the importance of the childhood health.
Ascorbic Acid* ; Child* ; Gyeongsangnam-do* ; Humans ; Plasma* ; Recommended Dietary Allowances ; Scurvy ; Sex Characteristics ; Vitamins*

PURPOSE: This study was undertaken to evaluate the gastroduodenal pathology and Helicobacter pylori infection in children with upper gastrointestinal symptoms. METHODS: One hundred and seven pediatric patients with upper gastrointestinal symptoms were undergone endoscopy at the Gyeongsang National University Hospital from June 1990 to April 1991. Histopathologic examination was done by H & E staining of gastric antral biopsy specimen and gastritis was defined according to the Sydney System. Tissue H. pylori status was evaluated with the urease test using Christensen's urea broth and H & E or Warthin-Starry silver staining of gastric antral biopsy specimen. IgG Immunoblotting were also performed to detect specific anti-H. pylori antibody in these patients. RESULTS: The reasons for endoscopy were recurrent abdominal pain, acute abdominal pain, sallow face, hunger pain, and frequent nausea. Variable degrees of gastric mucosal hyperemia were found in most of the patients. Gastric hemorrhagic spots, gastric ulcer, duodenal ulcer, duodenal erosion, and hemorrhagic duodenitis were rare endoscopic findings. Histologic chronic gastritis was found in 88% of 107 patients. Histologic chronic duodenitis was observed in all 99 patients whose tissue were available. Gastric tissue H. pylori was positive in 57% of 107 patients by one of the ureasetest, H & E staining and Warthin-Starry silver staining. However, gastric tissue H. pylori detection rate was lower in the younger age groups. Anti-H. pylori IgG antibodies were detectable in 96% of 107 patients. CONCLUSION: Chronic gastroduodenitis and anti-H. pylori IgG antibody were ubiquitous in children with upper gastrointestinal symptoms.
Abdominal Pain ; Antibodies ; Biopsy ; Child* ; Duodenal Ulcer ; Duodenitis ; Endoscopy ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Hunger ; Hyperemia ; Immunoblotting ; Immunoglobulin G ; Nausea ; Pathology* ; Silver Staining ; Stomach Ulcer ; Urea ; Urease

PURPOSE: To assess patient radiation doses during cerebral angiography and embolization of intracranial aneurysms across multi-centers and propose a diagnostic reference level (DRL). MATERIALS AND METHODS: We studied a sample of 490 diagnostic and 371 therapeutic procedures for intracranial aneurysms, which were performed at 23 hospitals in Korea in 2015. Parameters including dose-area product (DAP), cumulative air kerma (CAK), fluoroscopic time and total angiographic image frames were obtained and analyzed. RESULTS: Total mean DAP, CAK, fluoroscopy time, and total angiographic image frames were 106.2 ± 66.4 Gy-cm2, 697.1 ± 473.7 mGy, 9.7 ± 6.5 minutes, 241.5 ± 116.6 frames for diagnostic procedures, 218.8 ± 164.3 Gy-cm², 3365.7 ± 2205.8 mGy, 51.5 ± 31.1 minutes, 443.5 ± 270.7 frames for therapeutic procedures, respectively. For diagnostic procedure, the third quartiles for DRLs were 144.2 Gy-cm² for DAP, 921.1 mGy for CAK, 12.2 minutes for fluoroscopy times and 286.5 for number of image frames, respectively. For therapeutic procedures, the third quartiles for DRLs were 271.0 Gy-cm² for DAP, 4471.3 mGy for CAK, 64.7 minutes for fluoroscopy times and 567.3 for number of image frames, respectively. On average, rotational angiography was used 1.5 ± 0.7 times/session (range, 0-4; n=490) for diagnostic procedures and 1.6 ± 1.2 times/session (range, 0-4; n=368) for therapeutic procedures, respectively. CONCLUSION: Radiation dose as measured by DAP, fluoroscopy time and image frames were lower in our patients compared to another study regarding cerebral angiography, and DAP was lower with fewer angiographic image frames for therapeutic procedures. Proposed DRLs can be used for quality assurance and patient safety in diagnostic and therapeutic procedures.
Angiography ; Cerebral Angiography ; Fluoroscopy ; Humans ; Intracranial Aneurysm* ; Korea ; Patient Safety ; Radiation Exposure*