We reviewed the 43 medical records of patients with cellulitis or erysipelas who had been admitted at the depar1ment of dermatology of Seoul National University Hospital and followed them up for mean 21.6 months. The results were as follows. 1. The sex ratio of patients with cellulitis was 1:1.4 and the average age was 49 years. 2. The lower extremity as the most frequently invloved site of cellulitis with the frequency of 58.1% (25 cases), with the head and neck being involved in 16 cases(37.2%) and trunk and upper extremity in 1 case each(2.3% ). 3. The portals of infecticin were suspected in 33 cases(76% ), where tinea pedis was detect,ed in 18 cases(41.9%), previous skin infeection 10 cases(23.3%) and trauma in 9 cases(20.9%). 4. Initial systemic symptoms were fever(76.7%), chill(65.1%) and headache(37.2%). Erythema(100%), local heating(90,7%), tenderness(88.4%), swelling(86.0%), ulcer(16.3%), bulla(14.0%), lymphangitis(9.2%) and lymphadenit,is(9.2%) were found in the skin lesions. 5. The laboratory findings revealed leukocytosis in 35.7%, elevaed ESR in 86.8% positive 6. ASO titer in 63.0% and positive CRP in 80%, Microorganism. were detected in only 1 of 15 blood cultures, in 2 of 4 bulla fluid cultures and in 7 of 9 bus cultures. There was no growth of causative microorganisms in 3 tissue cultures and 9 saline needle aspiration cultures. Penicillin was used as primary antibiotics in 19 cases, which changed to another antibiotics due to lack of improvement in 3 cases and cefazolin was used in 21 cases, which changed in 2 cases due to the same reason. 7. Average admission priod was 11 days(range from 3 to 20 days) and 30.2% of patients wit.h cellulitis experienced recurrence, but 48% on low extrernity in contrast with 6.7% on head and neck.
Anti-Bacterial Agents ; Cefazolin ; Cellulitis* ; Dermatology ; Erysipelas ; Head ; Humans ; Leukocytosis ; Lower Extremity ; Medical Records ; Neck ; Needles ; Penicillins ; Recurrence ; Seoul ; Sex Ratio ; Skin ; Tinea Pedis ; Upper Extremity

The diagnosis of acute pancreatitis occurred in CAPD patients is quite difficult due to its clinical similarity with acute peritonitis. Delayed diagnosis and treatment of acute pancreatitis in CAPD patients may result in fatal complication. We experienced a case of acute pancreatitis in a CAPD patient. A 62 years old female visited the hospital with acute abdominal pain and cloudy effluent for 3 days. She has been on CAPD for 3 years and had two episodes of peritonitis at 6 months and 1 year before the admission. The causative organism was Streptococcus viridans in each episode. The peritonitis symptoms and peritoneal leukocyte count incresed despite of using Vancomycin(R) and Netilmicin(R). Causative organism was not isolated from dialysis. Serum amylase concentrations increased from 105mg/dL at the admission to 1,052mg/dL on day 10 of admission. Abdominal ultrasonography and abdominal computerized tomogram revealed fat infiltration, focal necrosis and multiple cyst formation at pancreas area. Computerized tomogram guided aspiration cytology revealed acute inflammation and necrosis. Bacteria were not found in the aspirate. Clinical symptoms were improved after discontinuation of CAPD and intraperitoneal use of antibiotics. The patient restarted CAPD on the day 18 and remained without complications. We report this case with a brief review of literatures.
Abdominal Pain ; Amylases ; Anti-Bacterial Agents ; Bacteria ; Delayed Diagnosis ; Diagnosis ; Dialysis ; Female ; Humans ; Inflammation ; Leukocyte Count ; Middle Aged ; Necrosis ; Pancreas ; Pancreatitis* ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Renal Dialysis ; Ultrasonography ; Viridans Streptococci

Rhabdomyosarcoma is the most common soft tissue sarcoma in childhood, representing 4 to 8% of all malignant tumors in children below 15 years old, but rhabdomyosarcoma of the paratesticular region is rare. The paratesticular rhabdomyosarcoma is a highly malignant lesion with early invasion and metastasis, which has retroperitoneal metastases in about half of the patients at time of diagnosis. However, the survival rates have been improved greatly by using multimodal therapy. We are submitting a case of paratesticular rhabdomyosarcoma with retroperitoneal lymph node metastasis with review of literatures.
Adolescent ; Child ; Diagnosis ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Rhabdomyosarcoma* ; Sarcoma ; Survival Rate ; Testis

Pediatric infection with Helicobacter pylori may occur early in childhood and persist lifelong. Global pediatric clinical studies have reported a decreasing tendency in the overall rate of H. pylori eradication. In pediatric patients with H. pylori infection, pediatric patients with peptic ulcer, and the first-degree relatives of patients with a history of gastric cancer, it is commonly recommended that H. pylori strains be eradicated. Antibiotic drug resistance to H. pylori, which has been reported to vary widely between geographic regions, is mainly associated with treatment failure in these patients. It is therefore imperative that the antibiotic resistance rates of H. pylori in children and adolescents be meticulously monitored across countries and throughout geographic regions. This paper particularly focuses on the antibiotic drug resistance of H. pylori and the thearpy of pediatric H. pylori infection cases.
Adolescent ; Anti-Bacterial Agents* ; Child* ; Drug Resistance ; Drug Resistance, Microbial ; Helicobacter pylori* ; Helicobacter* ; Humans ; Peptic Ulcer ; Stomach Neoplasms ; Treatment Failure

OBJECTIVE: The purpose of this study was to analyze the stress distribution and the displacement pattern of mandibular anterior teeth under various intrusive force vectors according to the position of orthodontic miniscrews and hooks, using three-dimensional finite element analysis. METHODS: A three-dimensional finite element model was constructed to simulate mandibular teeth, periodontal ligament, and alveolar bone. The displacement of individual tooth on three-dimensional planes and the von Mises stress distribution were compared when various intrusion force vectors were applied. RESULTS: Intrusive forces applied to 4 mandibular anterior teeth largely resulted in remarkable labial tipping of the segment according to the miniscrew position. All 6 mandibular anterior teeth were labially tipped and the stress concentrated on the labiogingival area by intrusive force from miniscrews placed mesial to the canine. The distointrusive force vector led to pure intrusion and the stress was evenly distributed in the whole periodontal ligament when the hook was placed between the central and lateral incisors and the miniscrew was placed distal to the canine. CONCLUSIONS: Within the limits of this study, it can be concluded that predictable pure intrusion of the 6 anterior teeth segment may be accomplished using miniscrews placed distal to the canine and hooks located between the central and lateral incisors.
Displacement (Psychology) ; Incisor ; Periodontal Ligament ; Tooth

BACKGROUND: Soon Chun Hyang University Hospital emergency laboratory introduced Cobas(R) 6000 (Roche Diagnostics, Switzerland) to improve the turnaround time of emergency chemistry tests at peak time period. METHODS: For the designated period, before and after introduction of Cobas(R) 6000 the numbers of tests and test time were compared and we analyzed the process of the tests using Workflow simulator (Roche Diagnostics). RESULTS: The numbers of tests of 8 days (every Monday and Thursday) in June, 2007 and 2008 were 22,902 and 27,384. The mean test time of the 8 days in June, 2007 and 2008 were 13 min 41 sec and 12 min 22 sec. In 2007, increased mean test time was due to prolongation of waiting times in rotor within equipment for tests at peak time period. CONCLUSIONS: Using Cobas(R) 6000, the numbers of tests were increased at peak time period but mean test time was reduced, which made physicians and laboratory all satisfied.
Emergencies ; Workflow

PURPOSE: Neonatal late-onset hypocalcemia is defined as hypocalcemia developed after postnatal 3 days and associated with hypoparathyroidism, high phosphate diets and vitamin D deficiency. We experienced the increment of neonatal late onset hypocalcemia over 1 year. We tried to evaluate the relationship between late onset hypocalcemia and maternal hypovitaminosis D. METHODS: The medical records in the neonates with late-onset hypocalcemia during January 2007 to July 2008 were retrospectively reviewed. Among those patients, 17 paired sera of mothers and neonates had collected. The levels of 25-OH vitamin D (25OHD) and intact parathyroid hormone (iPTH) were measured and were compared with neonate and the mother. RESULTS: The mean gestational age was 38+1 weeks, and the mean body weight was 2,980 g. The onset time of hypocalcemia was 5.9 days of age. Most of them (88.2%) were feeding with formula and no one was only breast milk feeding. Of the 17 patients, 13 were born in spring or in winter. The median levels of calcium, phosphorus, alkaline phosphatase, iPTH and 25OHD were 7.0 mg/dL, 8.6 mg/dL, 191.0 U/L, 57.2 pg/mL and 24.0 ng/mL in neonates. The levels of 25OHD of 6 neonates were <20 ng/mL. A total of 16 mothers were considered vitamin D-deficient (<20 ng/mL), and vitamin D insufficient (20<25OHD<30 ng/mL). CONCLUSION: Neonatal late-onset hypocalcemia in our study seems to be influenced by maternal vitamin D deficiency and insufficiency. Sun tanning and vitamin D supplements from winter to spring would be helpful to prevent maternal vitamin D deficiency, one of the causes of neonatal late-onset hypocalcemia.
Alkaline Phosphatase ; Body Weight ; Calcium ; Diet ; Gestational Age ; Humans ; Hypocalcemia* ; Hypoparathyroidism ; Infant, Newborn ; Medical Records ; Milk, Human ; Mothers ; Parathyroid Hormone ; Phosphorus ; Retrospective Studies ; Solar System ; Tanning ; Triacetoneamine-N-Oxyl ; Vitamin D ; Vitamin D Deficiency ; Vitamins

Kimura disease is rare chronic inflammatory disorder of an unknown etiology and it has a predilection for males of Asian descent. It typically presents with non-tender subcutaneous swellings in the head and neck region, peripheral eosinophilia and an elevated immunoglobulin E level. We present here the case of 8-year-old boy with a past history of food allergy, and he developed swelling of the left neck and incidental eosinophilia. Kimura disease was diagnosed on the basis of the clinical and histological findings. The serum IgG titer of cysticercosis was twice the normal level. After surgical excision of the subcutaneous lesion, the patients eosinophilia was dramatically decreased. We suggest that allergy and remote parasite infection may be the causality or a triggering factor for Kimura disease.
Angiolymphoid Hyperplasia with Eosinophilia* ; Asian Continental Ancestry Group ; Child ; Cysticercosis ; Eosinophilia ; Food Hypersensitivity ; Head ; Humans ; Hypersensitivity* ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulins ; Male ; Neck ; Parasites*

Kawasaki disease (KD) is an acute febrile illness that is the predominant cause of pediatric acquired heart disease in infants and young children. Because the diagnosis of KD depends on clinical manifestations, incomplete cases are difficult to diagnose, especially in infants younger than 1 year. Incomplete clinical manifestations in infants are related with the development of KD-associated coronary artery abnormalities. Because the diagnosis of infantile KD is difficult and complications are numerous, early suspicion and evaluation are necessary.
Child ; Coronary Vessels ; Heart Diseases ; Humans ; Infant ; Mucocutaneous Lymph Node Syndrome

PURPOSE: The objective of this study was to ascertain the incidence of congenital heart disease in the western part of Gyeongnam Province in Korea. METHODS: We enrolled 849 children (M:F=390:459) who were diagnosed with congenital heart disease (CHD) and received echocardiography during January 1997 to December 2005 in Gyeongsang National University Hospital. The subjects were limited to patients born from 1997 to 2004. The CHDs were classified into acyanotic types and cyanotic type. Further, acyanotic type CHDs were divided into shunt type and valvular types. RESULTS: Numbers of initially diagnosed patients from 1997 to 2004 were as follows: 113, 128, 116, 104, 129, 97, 84, and 78. The median age of initially diagnosed CHD patients was 1 month in the acyanotic type and 0.5 months in cyanotic type. Also, an annual frequency among CHD types and gender ratio were no significant difference in every year. Incidences of CHD from 2000 to 2004 in the western part of Gyeongnam Province were 8.9, 12.7, 10.9, 10.0, and 9.7 per 1,000 live births, respectively. CONCLUSION: From 1997 to 2001, 100-130, and from 2002 to 2004, less than 100 patients were diagnosed with CHD. This showed a decrease in the numbers of CHD patients in the last three years. However, the Incidence of CHD was 0.89-1.24% during the last five years. Therefore, the decrease in the annual frequency of CHD was due to the recent decline in birth rate in Korea.
Birth Rate ; Child ; Echocardiography ; Heart ; Heart Diseases ; Humans ; Incidence ; Korea ; Live Birth