A 53-year-old man had skin-colored linear serpiginous plaque within brownish patch on his left thigh for one year. He habitually drank natural spring water for 3 years. We diagnosed this case as sparganosis infiltrated within dermis by histologic and parasitologic diagnosis. The skin lesion mimicked the cutaneous larva migrans by showing dermal migration of sparganum to pro-duce itchy linear serpiginous plaque. We report an interesting case of sparganosis mimicking cutaneous larva migrans.
Dermis ; Diagnosis ; Humans ; Larva Migrans* ; Middle Aged ; Natural Springs ; Skin ; Sparganosis* ; Sparganum ; Thigh ; Water

OBJECTIVE: The authors present the results of management outcomes for upper basilar artery aneurysms via transclinoidal approach. METHODS: Clinical and angiographic evaluations were performed in twenty two consecutive patients with upper basilar artery aneurysms(three of them had superior cerebellar artery aneurysms) treated by surgery via transclinoidal approach between January, 1990 and April, 2000. RESULTS: Of the 22 patients, fifteen patients had multiple aneurysms including basilar bifurcation aneurysms and basilar-superior cerebellar aneurysms. Seventy seven percent were in good preoperative neurological status(H-H grade I-III), 23% were in poor grade(H-H grade IV). The management outcome was:Glasgow outcome scale(GOS) I 54.5%, GOS II 18%, GOS III 13.6%, GOS IV 4.5% and GOS V(death) 9%. The major causes of morbidity were direct brain damage, perforator occlusion, vasospasm and meningitis. CONCLUSION: The management outcome of upper basilar artery aneurysms treated via clinoidectomy was good(72.5%). Transclinoidal approach is an acceptable alternative for upper basilar artery aneurysms.
Aneurysm ; Arteries ; Basilar Artery* ; Brain ; Humans ; Intracranial Aneurysm* ; Meningitis

PURPOSE: The purpose of the present study is to determine the relation between in vitro resistance to 9 drugs, measured with colorimetric methylthiazol tetrazolium(MTT) assay and prognostic factors. METHODS: Thirty children with leukemia were evaluated at the pediatric department of Dongsan Medical Center. All samples tested with the MTT assay contained 80% or more leukemic cells, which were isolated by Ficoll density gradient centrifugation, and were incubated with 9 drugs for 4 days. The optical density(OD) of the wells was measured with microplate spectrophotometer. Leukemic cell survival(LCS) was calculated by OD treated well/OD control wellsx100(%). LD50 was calculated from the dose-response curve and used as a measure of resistance. RESULTS: Among the 30 children with leukemia, 16 were ALL, 14 were AML. Seventeen boys and thirteen girls ranged in age from 9 months to 16 years. Comparing LD50 values according to leukemic type, AML revealed relatively high LD50 values for all drugs, except VCR. But there were no significant differences between ALL and AML(P>0.05). Male showed high LD50 values for ASP, DET, ARA-C, VP16, ADR and 6TG. Age<2 and >10 years children showed high LD50 values for all drugs, except 6TG. Patients with a leukocyte count>100,000/mm3 at diagnosis showed high LD50 values for VCR, ASP, DET, MTX, ARA-C, ADR, and 6TG. Patients with normal chromosome showed higher LD50 values. CONCLUSION: Our study showed higher LD50 values at AML, male, age<2 and 10>years old, leukocyte count>100,000/mm3, and normal karyotype. The MTT test may contribute to the selection of effective chemotherapeutic agent for children with acute leukemia.
Centrifugation, Density Gradient ; Child ; Cytarabine ; DEET ; Diagnosis ; Etoposide ; Female ; Ficoll ; Humans ; Karyotype ; Lethal Dose 50 ; Leukemia ; Leukocytes ; Male ; Viperidae

The mortality of patients with brain abscess has decreased significaltly. This has been attributed to improved diagnostic imaging, the evolution of neurosurgical techniques and understanding of intracranial pressure pathophysiology, greater critical care understanding, and newer antibiotics. However, the mortality associated with intraventricular rupture of brain abscess remained consistently high at or above 80% once identified. A case of intraventicular rupture of thalamic abscess with good quality of survival is presented based on aggressive 4-component therapeutic plan used. The four components are 1) extraventricular drainage for 6 weeks, 2) lavage of the ventricular system using closed irrigation system, 3) intravenous antibiotics, 4) intraventricular gentamicin and vancomycin, twice and once daily, respectively.
Abscess* ; Anti-Bacterial Agents ; Brain Abscess ; Critical Care ; Diagnostic Imaging ; Drainage ; Gentamicins ; Humans ; Intracranial Pressure ; Mortality ; Rupture* ; Thalamus ; Therapeutic Irrigation ; Vancomycin

No abstract available.
Urinary Incontinence*

A 16-year old male patient visited the hospital complaining of inguinal pain and internal snapping of right hip joint. In physical examination, the patient was presumed to be diagnosed femoroacetabular impingement (FAI) and acetabular labral tear. In radiologic evaluation, FAI and acetabular labral tear were identified and bony tumor associated with internal snapping was found on the posteromedial portion of the femoral neck. Despite of conservative treatment, there was no symptomatic improvement. So arthroscopic labral repair, osteoplasty and resection of bony tumor were performed. The tumor was pathologically diagnosed as osteochondroma through biopsy and all symptoms improved after surgery. There was no recurrence, complication or abnormal finding during 1 year follow up. Osteochondroma located at posteromedial portion of femoral neck can be a cause of internal snapping hip and although technical demands are challenging, arthroscopic resection can be a good treatment option.
Acetabulum ; Arthroscopy ; Biopsy ; Femoracetabular Impingement ; Femur Neck ; Follow-Up Studies ; Hip ; Hip Joint* ; Humans ; Male ; Osteochondroma* ; Physical Examination ; Recurrence

Spinal angiolipomas are distinct but rare benign lesions composed of mature lipocytes admixed with abnormal blood vessels that vary from capillary to sinusoid or from venular to arterial in size. They account of 0.14% to 1.2% of all spinal axial tumors, 2% to 3% of extradural spinal tumors, and 16% to 35% of spinal lipomas. The tumors are mostly extradural and have a predilection site in the midthoracic region. The symptoms are usually due to cord compression. Magnetic resornance imaging is the diagnostic choice and surgery is universally successful in relieving the symptoms. The authors report a case of spinal angiolipoma in a 35-year-old female which was successfully treated by operation. A review of the literature on this lesion is also presented.
Adipocytes ; Adult ; Angiolipoma* ; Blood Vessels ; Capillaries ; Female ; Humans ; Lipoma ; Spinal Cord

No abstract available.
Drug Therapy, Combination* ; Lymphoma, Non-Hodgkin*

The permanent impairment evaluation for children in developmental stage is very difficult and it is even impossible in some cases. The impairment evaluation for developing children has not yet been included in the guideline of the American Medical Association. Due to frequent medical and social demands in Korea, we developed an impairment evaluation guideline for motor impairment, intellectual disability/mental retardation, developmental speech-language disorder and epilepsy caused by pediatric cerebral injuries, or cerebral lesions other than the developmental disorders such as autism. With the help of various literature and foreign institutions, we developed our in order to develop a scientific guideline for pediatric impairment that is suited to Korean cultural background and social condition.
Brain/physiopathology ; Brain Diseases/*complications ; Brain Injuries/complications ; Child ; Developmental Disabilities/classification/*diagnosis/etiology ; *Disability Evaluation ; *Disabled Children ; Humans ; Korea ; Language Development Disorders/classification/diagnosis/etiology ; Mental Disorders/classification/diagnosis/etiology ; Program Development ; Seizures/classification/diagnosis/etiology ; Severity of Illness Index

Hepatoblastoma is a hepatic tumor predominantly occurring in children. The usual site of metastasis is the lung. There are only several reports worldwide on the distant metastasis of hepatoblastoma to the central nervous system in children. Only one reported case showed survival of a patient after multiple resections of a recurrent brain lesion. Involvement of the cardiovascular system has been reported in the medical literature. Lesions almost always involve the right-side of the heart. We report a case of recurrent hepatoblastoma at multiple sites, including brain, left atrium of the heart and lung in a 6-year-old girl who was partially treated in the past at the age of 1.5 years; the patient had been event-free for four and a half years.
Brain* ; Cardiovascular System ; Central Nervous System ; Child ; Female ; Heart Atria ; Heart* ; Hepatoblastoma* ; Humans ; Lung* ; Neoplasm Metastasis*