Juvenile dermatomyositis is an uncommon autoimmune disease with classic heliotrope discoloration of eyelids, erythematous skin rash of joints and proximal muscle weakness. Quite different from adults, malignancy is rarely accompanied in juvenile dermatomyositis. However vasculitis, muscle atrophy, calcification and gastrointestinal involvement are often observed in juvenile dermatomyositis. A six year old boy was admitted with chief complaints of general weakness and skin rash. Muscle biopsy was performed which was consistent with dermatomyositis. The patient was treated with intravenous immunoglobulin, steroid, methotrexate and physiotherapy. We report a case of juvenile dermatomyositis.
Adult ; Autoimmune Diseases ; Biopsy ; Dermatomyositis* ; Exanthema ; Eyelids ; Humans ; Immunoglobulins ; Joints ; Male ; Methotrexate ; Muscle Weakness ; Muscular Atrophy ; Vasculitis

No abstract available.
Folliculitis ; Herpes Zoster ; Herpesvirus 3, Human

Background: Lymph node fine-needle aspiration (LN FNA) cytology indicates necrosis in various diseases. Dominant necrotic features make the diagnosis of underlying conditions very difficult. Methods: We retrospectively reviewed 460 patients who underwent cervical LN aspiration cytology that revealed necrotic findings at Keimyung University Dongsan Hospital in Daegu, Korea, from 2003–2017. Each specimen was evaluated and analyzed in association with the clinical findings, biopsy findings, and/or other ancillary tests, including acid-fast bacilli staining and molecular testing for Mycobacterium tuberculosis. Results: When necrotic features were noted upon cervical LN FNA cytology, the most common pathologic LN FNA category was necrosis alone (31.5%). The second most common category was granulomatous inflammation (31.3%), followed by Kikuchi disease (20.0%) and malignant neoplasm (8.7%). In cases where the cervical LN FNA revealed necrosis alone, the most common final diagnosis was tuberculosis. In young patients, Kikuchi disease should be considered as one cervical LN FNA category, while metastatic carcinoma should be suspected in older patients. Conclusions Even when necrosis alone is observed in LN FNA cytology, it is important to determine the cause through further evaluation.

No abstract available.
Skin Neoplasms* ; Skin*

PURPOSE: To identify factors that influence serum zinc concentrations in children with acute gastroenteritis. METHODS: Thirty-two children under 5 years of age (15 boys and 17 girls) were selected randomly among those who visited to an pediatric emergency room of Ehwa Womans University Mokdong Hospital with acute gastroenteritis from May to August 2005. This study estimated the association between serum zinc concentrations and clinical, biochemical variables in patients with acute gastroenteritis. RESULTS: Serum zinc concentration was lower in febrile patients than afebrile patients with acute gastroenteritis (67.0+/-25.3 vs 85.5+/-14.2, p<0.05). It also was lower in patients with positive C-reactive protein (CRP) than those with negative CRP (63.9+/-25.4 vs 86.7+/-13.8, p<0.05). Serum zinc concentration was negatively correlated (r=-0.494, p<0.05) with CRP concentration, whereas positively correlated with hematocrit (r=0.370, p<0.05), total protein (r=0.474, p<0.05), and albumin (r=0.636, p<0.05). Twelve patients (37.5%) showed very low serum zinc concentration (<70 microgram/dL) without clinical symptoms of deficiency or growth retardation. Frequency of febrile illness or positive CRP is significantly greater in group with zinc <70 microgram/dL than the group with zinc > or =70 microgram/dL (91.7% vs 55%, p<0.05; 91.7% vs 40%, p<0.05, respectively). CONCLUSION: In patients with acute gastroenteritis, serum zinc concentration was influenced by various factors such as fever, CRP, and biochemical factors. For evaluating zinc status in the body. factors.
C-Reactive Protein ; Child* ; Emergency Service, Hospital ; Female ; Fever ; Gastroenteritis ; Hematocrit ; Humans ; Zinc*

Diffuse neonatal hemangiomatosis is a fatal disorder characterired by multiple cutaneous and visceral hemangiomas. The organs most commonly affected are the gastrointestinal tract, brain, liver and lung. The complications are high output cardiac failure, gastrointestinal bleeding and hydrocephalus. We present a patient with diHuse neonatal hemangiomatosis associated with massive hepatic involvement and high output cardiac failure, which was successfully treated with high dose corticosteroid.
Brain ; Gastrointestinal Tract ; Heart Failure ; Hemangioma ; Hemorrhage ; Humans ; Hydrocephalus ; Liver ; Lung

BACKGROUND: A history of osteoporotic fractures is strongly associated with the subsequent osteoporotic fractures. To prevent subsequent fractures, the diagnosis and treatment of osteoporosis following osteoporotic fractures are very important. A distal radius fracture (DRF) is the second most common type of osteoporotic fracture in South Korea. We analyzed the rate of osteoporosis diagnosis within 6 months post-DRF.METHODS: We used data from the Korean Health Insurance Review and Assessment Service nationwide claims database from 2010 to 2016. International Classification of Diseases, 10th revision codes and procedures codes were used to identify patients aged over 50 years with newly diagnosed DRFs; the osteoporosis assessments of these patients were then analyzed. We used Cochran-Armitage trend test to examine trends in osteoporosis diagnosis.RESULTS: A search of database identified 77,209 DRFs in patient aged above 50 years of age from 2011 to 2016. Among these patients, only 19,305 (25.0%) underwent diagnostic examination for osteoporosis. The number of osteoporosis examinations increased slightly, but not significantly, every year (P=0.061).CONCLUSIONS: Clinicians who treat DRFs shoulder also evaluated patients for osteoporosis after DRFs.
Diagnosis ; Humans ; Insurance, Health ; International Classification of Diseases ; Korea ; Osteoporosis ; Osteoporotic Fractures ; Radius Fractures ; Radius ; Shoulder

No abstract available.
Intestinal Pseudo-Obstruction*

PURPOSE: Multicystic dysplastic kidney(MCDK) is characterized by the presence of multiple cysts of varying sizes. It is associated with ureteral or pelviureteral atresia, and a non-functioning kidney. The purpose of this study was to examine the clinical feature and the natural history of MCDK. METHODS: A study was performed in 36 children with prenatal diagnosis of MCDK from 1989 to 1999. All patients underwent renal ultrasonography and scintigraphy, and most underwent voidin, cystourethrography after birth. Follow-up renal ultrasonography was performed generally every year. RESULTS: Initial size of ultrasonography showed that MCDK was larger than normal in 27 cases, normal in 5 cases, and smaller than normal in 4 cases. Follow-up was available on 26 children during 12-78 months. In one patient, there was a complete involution of the MCDK. In 15 patients(58%), there was a reduction in size and 9 patients(35N) showed no change. One patient underwent nephrectomy for an enlarged MCDK. Voiding cystourethrography in 23 patients revealed vesicoureteral reflux in 6(26%). Other abnormalities of the contralateral kidney was detected in 3 of 36 children(8%), consisting of hydronephrosis, hydronephrosis and ureterocele, and simple cyst. Hypertrophy of the contralateral kidney was observed in 14% at birth and 50% in follow up. No renal dysfunction, hypertension and urinary tract infection were noted in all patients during follow up. CONCLUSION: The natural history of MCDK demonstrates a low incidence of complications and a high incidence of spontaneous regression. Therefore, uncomplicated MCDK is best managed conservatively. But further long-term follow up study is needed.
Child ; Follow-Up Studies ; Humans ; Hydronephrosis ; Hypertension ; Hypertrophy ; Incidence ; Kidney ; Multicystic Dysplastic Kidney* ; Natural History* ; Nephrectomy ; Parturition ; Prenatal Diagnosis ; Radionuclide Imaging ; Ultrasonography ; Ultrasonography, Prenatal* ; Ureter ; Ureterocele ; Urinary Tract Infections ; Vesico-Ureteral Reflux

BACKGROUND AND PURPOSE: Obsessive-compulsive symptoms (OCS) in people with epilepsy (PWE) have not been studied systematically. We evaluated the severity, predictors, and psychosocial impact of OCS in PWE. METHODS: We recruited PWE who visited our epilepsy clinic and age-, gender-, and education-matched healthy controls. Both PWE and healthy controls completed the Maudsley Obsessional-Compulsive Inventory (MOCI), which measures OCS. PWE also completed the Beck Depression Inventory (BDI) and the Quality of Life in Epilepsy Inventory-31 (QOLIE-31). We examined the severity of OCS in PWE relative to healthy controls. Predictors of OCS and the QOLIE-31 score were measured by regression analyses. A path analysis model was constructed to verify interrelations between the variables. RESULTS: The MOCI total score was significantly higher in PWE than in healthy controls (p=0.002). OCS were found in 20% of eligible patients. The strongest predictor of the MOCI total score was the BDI score (beta=0.417, p<0.001), followed by EEG abnormality (beta=0.194, p<0.001) and etiology (beta=0.107, p=0.031). Epileptic syndrome, the side of the epileptic focus, and action mechanisms of antiepileptic drugs did not affect the MOCI total score. The strongest predictor of the QOLIE-31 overall score was the BDI score (beta=-0.569, p<0.001), followed by seizure control (beta=-0.163, p<0.001) and the MOCI total score (beta=-0.148, p=0.001). The MOCI total score directly affected the QOLIE-31 overall score and also exerted indirect effects on the QOLIE-31 overall score through seizure control and the BDI score. CONCLUSIONS: OCS are more likely to develop in PWE than in healthy people. The development of OCS appears to elicit psychosocial problems directly or indirectly by provoking depression or uncontrolled seizures.
Anticonvulsants ; Depression ; Electroencephalography ; Epilepsy* ; Humans ; Quality of Life ; Seizures