A 4-year-old boy has had a solitary sclerotic depressed plaque on the right anterior chest since birth. The histopathologic findings are consistent with morphea profunda: thickening, hyalinization, and homogenization of collagen bundles in the dermis and subcutaneous tissues, admixture with a prominent lymphocytic and plasma cell infiltrate, and sweat glands en-trapped between the thickened collagen bundles. We report a case of congenital solitary morphea profunda.
Child, Preschool ; Collagen ; Dermis ; Humans ; Hyalin ; Male ; Parturition ; Plasma Cells ; Scleroderma, Localized* ; Subcutaneous Tissue ; Sweat Glands ; Thorax

No abstract available.
Child* ; Humans ; Rheumatic Fever* ; Rheumatic Heart Disease*

PURPOSE:We performed this study to compare correlation between the indices of insulin resistance using fasting insulin and glucose level and body mass index (BMI), and to determine the clinical usefulness of glucose/insulin ratio (G/I ratio), which is easily available in clinical base. METHODS:Total 119 children with simple obesity, whose BMI is over 95th percentile, were evaluated. We calculated G/I ratio, logInsulin, HOMA-IR, logHOMA-IR, and QUICKI and evaluated their relationship to BMI. RESULTS:Children with high-degree obesity had higher insulin resistance than children with mild to moderate-degree obesity (logInsulin, 1.13+/-.23 vs 1.27+/-.29; logHOMA-IR, 0.46+/-.24 vs 0.61+/-.30; QUICKI, 0.33+/-.03, 0.31+/-.03)(P<0.01), and pubertal children had higher insulin resistance than prepubertal children (G/I ratio, 7.39+/-.07 vs 4.85+/-.29; logInsulin, 1.14+/-.27 vs 1.31+/-.22; logHOMA-IR, 0.47+/-.28 vs 0.65+/-.22; QUICKI, 0.33+/-.03 vs 0.31+/-.02) (P<0.001). BMI had correlation coefficient as -0.436 for QUICKI, -0.432 for G/I ratio, 0.430 for logInsulin, and 0.425 for logHOMA-IR (P=0.000). G/I ratio was well correlated with QUICKI (r=0.901, P=0.000), logHOMA-IR (r=-0.865, P=0.000), and logInsulin (r=0.899, P=0.000). The changes of BMI were correlated with changes of G/I ratio (r=-0.547, P<0.01), QUICKI (r=-0.464, P=0.01), and logHOMA-IR (r=0.429, P<0.05). CONCLUSION: This study revealed that the degree of BMI had statistically significant correlation with insulin resistance, which can be reflected by G/I ratio, logHOMA-IR and QUICKI. G/I ratio was well correlated with logHOMA-IR and QUICKI, which suggests that G/I ratio could be used as an bedside index of insulin resistance. The changes of G/I ratio were more correlated with changes of BMI than those of logHOMA-IR and QUICKI.
Body Mass Index ; Child* ; Fasting ; Glucose ; Humans ; Insulin Resistance* ; Insulin* ; Obesity*

No abstract available.

No abstract available.

This study was performed to compare the amount of blood flow from left and right side heart using Doppler echocardiography and Fick method. The pulmonary blood flow (Qp), aortic blood flow (Qs) and Qp/Qs ratio were noninvasively evaluated by two dimensional Doppler echocardiography in 10 patients with ventricular septal defect in children, aged 2 years to 15 years (mean+/-SD=7.1+/-4.9 years). Cardiac catheterization was performed within 2 days after examination of Doppler echocardiography in all patients. Systemic and pulmonary blood flow was calculated by using Fick principle, based on measured oxygen consumption and measured blood oxygen saturation. The Doppler frequency shift was analyzed by computer system combined with Meridian Echocardiography System. Comparison of Qp, Qs and Qp/Qs ratio obtained by invasive methods and by two-dimensional pulsed wave Doppler echocardiography showed a correlation of 0.679 in Qp, 0.710 in Qs and 0.639 in Qp/Qs ratio (p<0.05).
Cardiac Catheterization* ; Cardiac Catheters* ; Child* ; Computer Systems ; Echocardiography ; Echocardiography, Doppler* ; Heart ; Heart Septal Defects, Ventricular* ; Humans ; Oxygen ; Oxygen Consumption

No abstract available.
Granuloma* ; Subphrenic Abscess*

The purposes of this study were to test the negative association between schizophrenia and rheumatoid arthritis(RA) and to clarify the role of prolactin and estrogen as protective factors in this association. The author compared the prevalence rate of RA between 561 patients with schizophrenia and 222 patients with mood disorder. For investigating the role of estrogen and prolactin, the author checked the plasma prolactin and estradiol level in 80 patients with paranoid schizophrenia and 77 patients with RA. The results were as follows. 1) Epidemiological data The prevalence rate of RA in the schizophrenic group was 0/561 and that of RA in the mood disorder group was 2/222. To compare these results between two groups, the author applied the Binomial test using the average prevalence rate of RA(0.8%) in the general population as a reference rate. The prevalence rate of RA in the schizophrenic group was significantly lower than that of RA in the general population. However, the prevalence rate of RA in the mood disorder group was not significantly different to that of RA in the general population. 2) Comparison of plasma prolactin and estradiol level between two groups. The plasma level of prolactin in the schizophrenic group was significantly higher than that of prolactin in th RA group(p=0.000). However, the plasma level of estradiol in the schizophrenic group was significantly lower than that of estradiol in the RA group(p=0.017). These results were not consistent across gender. To contrast with the results in the female group, which were consistent with the results in the total subjects, for the male group, the plasma levels of prolactin and estradiol in the schizophrenic group were significantly higher than those of prolactin and estradiol in th RA group. These results support the results of previous studies which confirm the negative association between schizophrenia and RA. These results also suggest that the elevation of plasma prolactin level in the patient with schizophrenia has a antirheumatic effect while the elevation of plasma estradiol level in the patients with RA has a anti-schizophrenic effect, and that these effects act as a possible mechanism in the negative association between two disorders. However, these results suggest that this association is specific to female patients.
Arthritis, Rheumatoid* ; Epidemiology* ; Estradiol ; Estrogens* ; Female ; Humans ; Male ; Mood Disorders ; Plasma ; Prevalence ; Prolactin* ; Schizophrenia* ; Schizophrenia, Paranoid

Clinical observations of 11 cases of acute pyogenic osteomyelitls and 14 cases of acute pyogenic arthritis in infancy during past 11 years were carried out and following results obtained. 1. The highest age incidence was less than 3 months after birth (70.6%). 2. Average duration of symptoms was 7.8 days. 3. The most important underlying cause was multiple femorai vessel puncture (23.5%). 4. The chief symptom or sign on admission was pseudoparalysis or limitation of motion (82.4%), and local swelling (82.4%). But high fever on admission was present in only 29.4% of cases. 5. The femur was the most common site in acute pyogenic osteomyelitis (36.4%), and the hip joint in acute pyogenic arthritis (42.9%). 6. Leucocyte count was Increased more than 20,000/mm in 60.0% of the cases. Erythrocyte sedimentation rate was increased more than 21 mm/hr in 72.0% of cases. The positive result on bacteriologic culture was 76.0%. Coagulase-positive Staphylococcus aureus was cultured in 4 cases of acute pyogenic osteomyelitis and 5 cases of acute pyogenic arthritls. a-hemolytic Streptococcus was cultured in 2 cases of acute pyogenic osteomyelitls and 1 case of acute pyogenic arthritis. Hemophilus influenzae was cultured in 1 case of acute pyogenic osteomyelitls and 2 cases of acute pyogenic arthritis. 7. 45.5% of acute pyogenic osteomyelitis was combined with acute pyogenic arthritis. 8. The longer the duration of symptoms was, the longer the abnormal hematologic picture lasted. Erythrocyte sedimentation rate was the most accurate index of activity in acute infection of bone and joint. 9. Shortening or deformity due to epiphyseal plate damage occured in 1 case of acute pyogenlc osteo-myelitis, and 3 cases of acute pyogenic arthritis. Those complications could be minimized wlth early diagnosis and treatment.
Arthritis ; Blood Sedimentation ; Congenital Abnormalities ; Early Diagnosis ; Femur ; Fever ; Growth Plate ; Haemophilus influenzae ; Hip Joint ; Incidence ; Joints ; Osteomyelitis ; Parturition ; Punctures ; Staphylococcus aureus ; Streptococcus

Peri-tarsal dislocation occurs rarely and it has a complex joint structure anatomically. So, the injuries of the tarsal joint include many bony and ligament injuries and many complications such as pain on weight bearing and limitation of joint motion. The authors have reviewed a series of 15 cases of Peri-tarsal dislocations and the results obtained are as follows;1. Among the 15 cases of peri-tarsal dislocations, subtalar dislocation were 2 cases, Chop-art dislocation was 1 case, Lisfranc dislocation were 11 cases, and pure ankle dislocation was 1 case. 2. There were 12 cases of associated tarsal bone fractures 6 cases were cuneiform fractures, 4 cases were navicular fractures, and 2 cases were cuboid fractures 3. The clinical and radiological result of treatment was good in 3 cases, fair in 6 cases, and poor in 6 csses. 4. The cause of poor results were open dislocation, associsted tarsal bone fractures, delay of treatment, unstable reduction, and associated long bone fractures. 5. The most common complications after treatment were pain on weight bearing and limitation of joint motion.
Ankle ; Clinical Study ; Dislocations ; Fractures, Bone ; Joints ; Ligaments ; Tarsal Bones ; Tarsal Joints ; Weight-Bearing