Idiopathic thrombocytopenic purpura is an uncommon illness but most common form of thrombocytopema in pregnancy. Corticosteroids, splenectomy, immunosuppressive drugs, and immunoglobulin therapy have been recommended for manaaement. The optimal method of delivery is controversial. We have experienced a case of idiopathic thrombocytopenic purpura diagnosed previously and managed with corticosteroid and vincrstine, which was followed by pregnancy, vaginal delivery and postpiirtum splenectomy.
Adrenal Cortex Hormones ; Immunization, Passive ; Pregnancy* ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy

No abstract available.
Female ; Hypertension, Pregnancy-Induced* ; Pregnancy ; Pregnancy* ; Prolactin* ; Umbilical Cord*

Advanced techniques of nasal endoscopy made it possible to approach the optic nerve, pituitary gland, and anterior skull base transnasally. Epidural or brain abscess caused by ascending infection through the defect of the fovea ethmoidalis can be drained with reduced morbidity by endoscopic sinus surgery. Recently we have experienced a brain abscess that was managed by endoscopic transnasal drainage successfully.
Brain Abscess* ; Brain* ; Drainage* ; Endoscopy ; Optic Nerve ; Pituitary Gland ; Skull Base

No abstract available.
Membranes* ; Nipples* ; Pregnancy*

PURPOSE: Anaphylaxis is an acute, life-threatening systemic reaction which should be treated by epinephrine, and patients should be prescribed epinephrine auto-injector after the event. The purpose of this study was to investigate the clinical features of pediatric anaphylaxis, including the rate of using epinephrine at hospital and prescribing epinephrine auto-injector. METHODS: We performed a retrospective study of 68 anaphylactic patients at in-hospital, out-hospital, and Emergency Department of Soonchunhyang University Cheonan Hospital, Cheonan, Korea, who were under 15 years of age, from January 2013 through December 2014. We reviewed their clinical features, doctor's treatment methods, rate of follow-up and prescribing epinephrine auto-injectors. RESULTS: Causes of anaphylaxis were food (76.5%), drug (10.3%), and idiopathic (13.2%). The involved organs were the skin (86.8%), respiratory tract (80.9%), cardiovascular system (23.5%), and gastrointestinal tract (17.7%). Patients were treated with systemic steroids (91.2%), antihistamines (88.2%), and epinephrine (75.0%). Fifty-three patients (77.9%) revisited our pediatric allergy clinic and epinephrine auto-injectors were prescribed for 25 patients (36.8%). CONCLUSION: Physicians should make an effort to use epinephrine as an initial treatment of anaphylaxis, to prescribe epinephrine auto-injectors, and to give proper information about disease.
Anaphylaxis* ; Cardiovascular System ; Child ; Chungcheongnam-do ; Emergency Service, Hospital ; Epinephrine* ; Follow-Up Studies ; Gastrointestinal Tract ; Histamine Antagonists ; Humans ; Hypersensitivity ; Korea ; Respiratory System ; Retrospective Studies ; Skin ; Steroids

The tailgut is a blind extension of the hindgut into the tail fold just distal to the cloacal membrane. Remnants of this structure may form a tailgut cyst. This is prone to infection and chronic fistula formation and has a long-term risk of malignancy. Non-recognition and incomplete treatment leads to morbidity. A twenty one year-old female patient visited our hospital with repeated perianal pain and discharge. Preoperative abdominopelvic MRI and endorectal ultrasonography revealed a retrorectal cyst suggestive of a tailgut cyst. She underwent a complete excision of the retrorectal mass through a presacral approach. She recovered uneventfully. This report includes the case and a brief review of tailgut cysts.
Female ; Fistula ; Humans ; Magnetic Resonance Imaging ; Membranes ; Ultrasonography

OBJECTIVE: Onion and garlic are a commonly consumed food in the Korean population. But these food materials have rarely been studied for their allergenic potentials. We analyzed the sensitization rate of garlic and onion using multiple allergen simultaneous test (MAST)-immunoblot assay. METHODS: From January 2009 to December 2013, we analyzed the results of the MAST immunoblot assay performed in 2,691 allergy patients at Soonchunhyang University Cheonan Hospital, retrospectively. RESULTS: Among 2,691 patients, 1,063 were under 18 years old, and 1,628 were over 18 years old. In the all age groups, 29 patients (1.08%) were positive to garlic, 54 patients (2.01%) were positive to onion and one patient was positive to garlic and onion and others. A total of 84 patients (3.12%) were positive to garlic or onions. In infants under the age of 2 years, garlic was the seventh and onion was the nineteenth common food allergen, and onion was more common than rice. While getting older, the sensitization rate of garlic decreased (P<0.001), but onion increased (P<0.01). CONCLUSION: Using one of the semi-quantitative methods, MAST immunoblot assay, we realized that the sensitization rate of garlic was higher than rice or wheat in infants. We presume further studies on the role of garlic and onion in food allergy are needed.
Chungcheongnam-do ; Food Hypersensitivity ; Garlic* ; Humans ; Hypersensitivity ; Immunoassay ; Infant ; Onions* ; Retrospective Studies ; Triticum

Growth hormone (GH) deficiency is caused by congenital or acquired causes and occurs in childhood or adulthood. GH replacement therapy brings benefits to body composition, exercise capacity, skeletal health, cardiovascular outcomes, and quality of life. Before initiating GH replacement, GH deficiency should be confirmed through proper stimulation tests, and in cases with proven genetic causes or structural lesions, repeated GH stimulation testing is not necessary. The dosing regimen of GH replacement therapy should be individualized, with the goal of minimizing side effects and maximizing clinical improvements. The Korean Endocrine Society and the Korean Society of Pediatric Endocrinology have developed a position statement on the diagnosis and treatment of GH deficiency. This position statement is based on a systematic review of evidence and expert opinions.

BACKGROUND: The ongoing Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) aims to observe the natural course of papillary thyroid microcarcinoma (PTMC), develop a protocol for active surveillance (AS), and compare the long-term prognosis, quality of life, and medical costs between the AS and immediate surgery groups. METHODS: This multicenter prospective cohort study of PTMC started in June 2016. The inclusion criteria were suspicious of malignancy or malignancy based on fine needle aspiration or core needle biopsy, age of ≥18 years, and a maximum diameter of ≤1 cm. If there was no major organ involvement, no lymph node/distant metastasis, and no variants with poor prognosis, the patients were explained of the pros and cons of immediate surgery and AS before selecting AS or immediate surgery. Follow-up visits (physical examination, ultrasonography, thyroid function, and questionnaires) are scheduled every 6 months during the first 2 years, and then every 1 year thereafter. Progression was defined as a maximum diameter increase of ≥3, ≥2 mm in two dimensions, suspected organ involvement, or lymph node/distant metastasis. RESULTS: Among 439 enrolled patients, 290 patients (66.1%) chose AS and 149 patients (33.9%) chose immediate surgery. The median follow-up was 6.7 months (range, 0.2 to 11.9). The immediate surgery group had a larger maximum tumor diameter, compared to the AS group (7.1±1.9 mm vs. 6.6±2.0 mm, respectively; P=0.014). CONCLUSION: The results will be useful for developing an appropriate PTMC treatment policy based on its natural course and risk factors for progression.
Biopsy, Fine-Needle ; Biopsy, Large-Core Needle ; Cohort Studies* ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Prognosis ; Prospective Studies* ; Quality of Life ; Risk Factors ; Thyroid Gland* ; Thyroid Neoplasms ; Ultrasonography

No abstract available.