l6-year-old male and 48-year-old female with systemic lupus erythematosus (SLE) and renal disease presented with vesiculobullous eruptions during severe attack of the disease. They showed hypocomplementernia, and high ANA titers. Histopathologic findings revealed subepidermal blister and leukocytoclastic vasculitis, Direct immunofluorescence demonstratedlinear deposits of IgG, IgA and lgM at the dermoepidermal junction. The vesiculobullous eruption of SLE may be an important marker reflecting disease activity and prognosis.
Blister ; Female ; Fluorescent Antibody Technique, Direct ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Lupus Erythematosus, Systemic* ; Male ; Middle Aged ; Prognosis ; Vasculitis

We report herein a case of eosinophilic pustular follicultis in a 20-year-old man. The patient showed typical clinical picture with specific laboratory and histopathological findings of eosinophilic pustular folliculitis. The patient responded well to systemic administration of corticosteroid and dapsone.
Dapsone ; Eosinophils* ; Folliculitis* ; Humans ; Young Adult

Median raphe cyst is not a cornmon disease and represents a defect in the embryologic development of male genitalia. It occurs most commonly near the glans penis, but may occur anywhere from the urethral meatus to the anus, and is lined by entodermal or ectodermal epithelium. Surgical excision is the treatment of choice. Recently we observed a 29-year-old male patient who had had a typical median raphe cyst since childhood on the ventral aspect of the glans penis. On histological examination, the cyst was lined by stratified columnar epithelium varied from four to eight cells in thickness.
Adult ; Anal Canal ; Ectoderm ; Epithelium ; Genitalia, Male ; Humans ; Male ; Penis*

PURPOSE: To obtain preliminary data for understanding the central auditory neural pathway by means of functional MR imaging (fMRI) of the cerebral auditory cortex during linguistic and non-linguistic auditory stimulation. MATERIALS AND METHODS: In three right-handed volunteers we conducted fMRI of auditory cortex stimulation at 1.5 T using a conventional gradient-echo technique (TR/TE/flip angle: 80/60/40 degree). Using a pulsed tone of 1000 Hz and speech as non-linguistic and linguistic auditory stimuli, respectively, images-including those of the superior temporal gyrus of both hemispheres-were obtained in sagittal plases. Both stimuli were separately delivered biaurally or monoaurally through a plastic earphone. Images were activated by processing with homemade software. In order to analyze patterns of auditory cortex activation according to type of stimulus and which side of the ear was stimulated, the number and extent of activated pixels were compared between both temporal lobes. RESULTS: Biaural stimulation led to bilateral activation of the superior temporal gyrus, while monoaural stimulation led to more activation in the contralateral temporal lobe than in the ipsilateral. A trend toward slight activation of the left (dominant) temporal lobe in ipsilateral stimulation, particularly with a linguistic stimulus, was observed. During both biaural and monoaural stimulation, a linguistic stimulus produced more widespread activation than did a non-linguistic one. CONCLUSION: The superior temporal gyri of both temporal lobes are associated with acoustic-phonetic analysis, and the left (dominant) superior temporal gyrus is likely to play a dominant role in this processing. For better understanding of physiological and pathological central auditory pathways, further investigation is needed.
Acoustic Stimulation ; Auditory Cortex* ; Auditory Pathways ; Ear ; Linguistics* ; Magnetic Resonance Imaging* ; Neural Pathways ; Plastics ; Temporal Lobe ; Volunteers

No abstract available.
Brachial Plexus* ; Golf*

BACKGROUND: The testes are one of the most common extramedullary sites of relapse in boys with acute lymphoblastic leukemia(ALL). The reported incidence of isolated testicular relapse varies from 3 to 40%. If these patients are treated exclusively with testicular irradialion, a systemic relapse occurs within a few months. Recently, the use of intensive chemotherapy and testicular irradiation improved the survival rate for boys with testicular leukemia. So, we performed this study to identify clinical manifestations, disease free survival and prognostic factors of testicular leukemia in children. METHODS: We reviewed 33 patients of testicular leukemia among total 410 boys with ALL diagnosed at the Department of Pediatrics, Seoul National University Children's Hospital from Jan. 1970 to Aug. 1996. Testicular leukemia was confirmed by testicular biopsy in all 33 patients. These patients were treated with combined local testicular irradiation(2,400~2,500 cGy/8~12fractions) and systemic chemotherapy. Two patients, in whom testicular relapse was diagnosed before 1979, unilateral orchiectomy of the involved site and testicular irradiation of the opposite site were performed. Probability estimates of disease free survival (DFS) were calculated by the method of Kaplan and Meier, and the relationship of prognostic factors to DFS was compared using the chi-square test in survival analysis. RESULTS: In 410 boys with ALL, testicular leukemia occurred in 33 patients(8%). Of 33 patients, 6 patients presented with testicular involvement at initial diagnosis, 16 patients had testicular relapse while still receiving chemotherapy and 11 patients had testicular relapse 3 to 57 months(median : 15 months) after cessation of chemotherapy. The median age of 33 patients was 7.4 yrs(9 months~18 yrs) and median WBC count 7,600/ L(2,700~270,000/L). All patients presented with painless testicular enlargement and testicular leukemia was confirmed by testicular biopsy. Among 33 patients, 2 had prior CNS relapse and 11 had concomitant bone marrow and/or CNS relapse. Twenty nine patients were treated with combined local testicular irradiation and systemic chemotherapy. Eleven had second relapse(6 bone marrow, 3 CNS, 2 opposite testis). Seventeen have been followed until now: 6 patients on chemotherapy and 11 patients(37.9%) in complete remission for 48.5+/-22.3 months(19~86 months). The 3 year DFS for 29 patients was 55.3%+/-10.1%. The following prognostic factors showed no significant association with DFS in testicular relapse : age and WBC count at initial diagnosis, age at testicular relapse, and concomitant relapse. Whether testicular relapse occurred on initial therapy or off initial therapy has prognostic value in predicting DFS. The 3 year DFS for boys with testicular relapse on and off initial therapy were 40.0%+/-12.9% and 78.8%+/-13.4%, respectively(P: 0.046). CONCLUSION: With the use of chemotherapy and testicular irradiation, prolonged second re mission can be achieved in many patients with testicular leukemia. The patients with testicular relapse off initial therapy fared significantly better than patients on therapy. So, to improve the DFS for boys with testicular leukemia, a better understanding of its biology and prognostic factors is needed.
Biology ; Biopsy ; Bone Marrow ; Child ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Humans ; Incidence ; Leukemia ; Missions and Missionaries ; Orchiectomy ; Pediatrics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; Seoul ; Survival Rate ; Testis

PURPOSE: We evaluated changes in the cornea and anterior chamber after LASEK using Pentacam to search for signs of subclinical keratectasia occurrence. METHODS: Seventy-one eyes of 36 patients who had received LASEK were enrolled in this study. All eyes were examined for asphericity of the anterior and posterior cornea (Q-value), anterior and posterior corneal displacement, central corneal thickness, anterior chamber depth, angle, and volume using Pentacam before surgery and again one month after the operation. RESULTS: The postoperative changes in the asphericity of the posterior cornea and posterior corneal displacement were not statistically significant(p=0.668, p=0.101). The anterior chamber depth, angle, and volume decreased by 0.088 mm, 0.983degrees, 7.21 mm3 after LASEK, respectively. (p=0.000) The postoperative changes in asphericity of the anterior cornea, anterior corneal displacement, and central corneal thickness were statistically significant(p=0.000). CONCLUSIONS: In this study, we compared changes in the anterior chamber and cornea after LASEK using Pentacam. Changes in the anterior cornea were significant; however, the posterior cornea did not change significantly. The anterior chamber depth, anterior chamber angle, and volume were decreased one month after the operation, although further long-term follow-ups will be necessary to verify these findings.
Anterior Chamber ; Cornea ; Displacement (Psychology) ; Eye ; Follow-Up Studies ; Humans ; Keratectomy, Subepithelial, Laser-Assisted

PURPOSE: This study was performed to compare the efficacy and adverse reactions of low dose intravenous immunoglobulin (IVIG) with those of high dose IVIG in childhood acute idiopathic thrombocytopenic purpura (ITP). METHODS: Thirty children who were diagnosed as acute ITP in Seoul National University Children's Hospital from June 2000 to Jan. 2003 were enrolled. IVIG (I.V Globulin S, Green Cross Ltd, Korea) were administered 1 g/kg in low dose group (n=15) and 2 g/kg (400 mg/kg for 5 day or 1 g/kg for 2 days) in high dose group (n=15). RESULTS: 1) The median age of the patients was 4 years (range, 2 months to 13 years) and male to female ratio was 0.5: 1. The median duration of follow-up was 6 months (range, 1 month to 2 year 9 months). 2) The median days to recover the platelet count over 50, 000/muL, 100, 000/muL, 150, 000/muL after IVIG administration were 4, 6, and 7 days in the low dose group and 3, 5, and 5 days in the high dose group. After the initial response, the platelet count decreased below 50, 000/muL in 5 out of 13 patients in the low dose group (the median day, 13) and 6 out of 13 patients in the high dose group (the median day, 21). In 25 patients who were followed over 6 months, 3 out of 13 patients (23.1%) in the low dose group and 4 out of 12 patients (33.3%) in the high dose group were remained as chronic ITP. 3) Adverse reactions related to IVIG administration were observed in 4 out of 15 patients (26.7%) in the low dose group and 5 out of 15 patients (33.3%) in the high dose group. They were fever, headache, nausea and vomiting, and most of them were subsided spontaneously. CONCLUSION: There were no significant difference in the response rate, the relapse rate and the incidence of adverse reactions between the low dose group and the high dose group in childhood acute ITP after IVIG therapy. In respect of the cost and the duration of hospitalization, the low dose IVIG might have some advantages.
Child ; Female ; Fever ; Follow-Up Studies ; Headache ; Hospitalization ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Incidence ; Male ; Nausea ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; Recurrence ; Seoul ; Vomiting

PURPOSE: For separation of RBC from cord blood, it is important to minimize RBC contamination without significant loss of nucleated cells using sedimentation agent that is safe for human use. This study was performed to investigate the possibility of replacing 6% hydroxyethylstarch (HES) with 10% pentastarch (PS) which is a lower molecular weight hetastarch-analog that is cleared from the circulation rapidly. METHODS: After dilution of cord blood till hematocrit 25%, PS or HES were added by the ratio of 7:1 and 5:1 respectively. Sedimentation was performed for 2 hours by gravity. RESULTS: PS was used in 14 cases with volume of 72.4+/-22.3 mL (45~126 mL) and HES in 8 cases with volume of 58.4+/-8.0 mL (50~70 mL). Sedimentation rate has reached at plateau by 90 minutes in PS group and it was slightly faster than in HES group. Recovery rate of nucleated cells and residual RBC were 82.9+/-10.7%, 7.6+/-5.4% in PS group, and 84.0+/-4.7%, 10.7+/-2.3% in HES group. There were no significant differences between the two groups (P=0.657, 0.219). Cell viabilities were high in both groups; 92+/-3% before separation and 97+/-2% in PS group and 98+/-3% in HES group. CD34+ cells were 0.75+/-0.28% before separation and 0.64+/-0.21% in PS group and 0.60+/-0.30% in HES group (P=0.690). CFU-GM after 2 week culture were 27.4+/-20.0 per 1 105 mononuclear cells in PS group and 22.9+/-8.6 in HES group (P=0.856). CONCLUSION: These results demonstrated that PS has similar efficacy to HES for separation of RBC from umbilical cord blood. Considering its rapid clearance and faster sedimentation rate, PS can replace HES for RBC separation in cord blood banking.
Cell Survival ; Fetal Blood* ; Granulocyte-Macrophage Progenitor Cells ; Gravitation ; Hematocrit ; Humans ; Hydroxyethyl Starch Derivatives* ; Molecular Weight

Heat-treated autogenous bone graft has been utilized in the cases with large hone defects associated with tumors, chronic osteomyelitis, and trauma. Conventional autoclaved autogenous bone grafting, however, has inherent disadvantages that included decreased biomechanical strength, and loss of osteogenesity. In contrast, despite devitalizing the tumor cells, low heat-treatment can render autogenous hone grafts to retain better biomechanical strength as well as to preserve osteogenesity by avoiding destruction of hone morphogenetic protein. To investigate biomechanical strength and osteogenesity of heat-treated autogenous bone grafts, rahbits were classified into three groups: groupl, in-situ implantation of autogenous graft in the diaphyseal defect of the tibia without any heat treatment; group 2, reimplantation of graft after low heattreatment; group 3, reimplantation of graft after autoclaving. Radiological, histological, and scintigraphic examination were performed postoperativeIy at 2nd, 4th, 6th, 9th, 12th weeks. And biomechanical test was performed postoperatively at 6th, 9th, 12th weeks. Biomechanical test revealed that there were no statistical differences among three groups at 6th week and 9th week. However, at 12th week postoperatively, there were significant differences between group 2 and group 3, and between group 1 and group 3. Radiological and histological examinations showed that new bone formation started earlier in groups l and 2, compared to group 3. Also bone remodeling was advanced in group I and 2, com- pored to group 3. Scintigraphically, the increase of 99mTc-MDP uptake was delayed in group3, compared to group l and 2. Based upon above findings, it was concluded that low heat-treated autogenous bone grafting was hetter than autoclaved autogenous bone grafting in promoting bone healing with retained biomechanical strength.
Bone Remodeling ; Bone Transplantation* ; Hot Temperature* ; Osteogenesis ; Osteomyelitis ; Replantation ; Technetium Tc 99m Medronate ; Tibia ; Transplants