PURPOSE: Moyamoya disease is a primary vascular disease characterized by stenosis that is followed by occlusion of the intracranial portion of the internal carotid artery and other vessels of the circle of Willis. Since there has not been any specific reports about clinical manifestation in children, we plan to study on clinical manifestation through these patients who have moyamoya disease. METHODS: We have reviewed our case of moyamoya disease in patients admitted to Yonsei University College of Medicine and analyzed their age & sex distribution as well as clinical manifestations, together with brain CT and angiographic findings. RESULTS: The results were as follows: 1) Fifty cases of moyamoya disease were encounted during a 10-year period. 2) The male to female ratio was 1:2.3 and mean age was 6.3 years old. 3) The most common chief complaint on admission was hemiparesis followed by convulsion. 4) 42 patients(84%) showed infarction on brain CT and only 5 patients(10%) showed hemorrhage. Most common lesion was frontal lobe. 5) Bilateral occlusion of the internal carotid arteries was most common site of lesions on cerebral angiography.
Brain ; Carotid Artery, Internal ; Cerebral Angiography ; Child ; Circle of Willis ; Constriction, Pathologic ; Female ; Frontal Lobe ; Hemorrhage ; Humans ; Infarction ; Male ; Moyamoya Disease* ; Paresis ; Seizures ; Sex Distribution ; Vascular Diseases

BACKGROUND: Caudal anesthesia is considered a safe and reliable anesthetic technique for many pediatric surgical procedures. It is well known that extradural clonidine produces analgesia in adult. The purpose of this study is to assess its efficacy in children. METHODS: We randomized 45 pediatric patients aged under 10 years, weighted under 25 kg presented for lower abdominal surgery with duration of operation would be shorter than 2 hours, into three groups of 15 each. After sedation with the use of intravenous thiopental sodium, caudal anesthesia was performed with the use of 1 mL/kg of 0.25% bupivacaine. We allocated randomly the patients who received no additional medication in 0.25% bupivacaine (group I), with epinephrine 1/200,000 (group II), and with 1 mcg/kg of clonidine (group III). The degree of postoperative analgesia was evaluated using the Broadman ""Objective Pain/discomfort Scale"" (OPS) at hourly intervals for 24 hours. RESULTS: Duration of sleep in the recovery room was significantly longer in group III than in group I and group II, and statistical significant difference was found between the group I and group II. Duration of analgesia was significantly longer in group III than in group I and group II. Overall hourly OPS scores were lower in group III than in group I and group II. CONCLUSION: Duration of postoperative analgesia with caudal bupivacaine was increased by addition of 1 mcg/kg of clonidine.
Adult ; Analgesia ; Anesthesia, Caudal* ; Bupivacaine ; Child ; Clonidine* ; Epinephrine ; Humans ; Recovery Room ; Thiopental

The fine needle aspiration (FNA) cytologic findings in 16 cases of histologically confirmed thymoma are reported. The aspirates were obtained under fluoroscopic guidance. The cytologic diagnoses were inadequate sample in one case, thymoma in 12 (75%), small cell carcinoma or thymoma in 1, benign mesenchymal tumor in 1, and germ cell tumor in one. The cytologic features were detailed according to the constituent epithelial cell type, and to the ratio of epithelial cells and lymphocytes. Fifteen cases were classified into 4 small epithelial cell type, 6 intermediate epithelial cell type, 1 large epithelial cell type, 1 large pleomorphic epithelial cell type, and 3 spindle-shaped epithelial cell type. Cytologic differential diagnosis was discussed, and the important criteria for the cytologic diagnosis of thymoma were reviewed. This review leads us to think that nonoperative cytologic approaches in the diagnosis of the thymoma are possible, and that correct cytologic diagnosis of thymoma with FNAs can easily be made, if adequate samples are obtained. However, the invasiveness and histologic type could not be predicted by cytological features only. Knowing various cytologic and histologic features of thymoma will be helpful for the diagnosis of thymoma and the differential diagnosis of mediastinal tumors.
Diagnosis, Differential

Ameloblastic fibrosarcoma is an extremely rare variety of odontogenic tumor. It has not previously been reported in Korea. The tumor is composed of benign odontogenic epithelium with a mesenchymal part which exhibits the histologic features of fibrosarcoma. We have reported a case of amloblastic fibrosarcoma of the mandible in a 26-year-old man with swelling of right mandible for 2 weeks. The tumor showed yellowish ill-demarcated ulcerating mass involving right premolar and molar area. Light microscopy revealed irregularly arranged strands and islands of odontogenic epithelium surrounded by abundant mesenchymal tissue with the feature of fibrosarcoma. The fibrosarcoma cells were strong positive on immunostain for vimentin and ameloblastic cells were weakly positive for cytokeratin. S-100 and CEA were negative in both epithelial and sarcoma cells. The sarcoma cells were corresponding to fibroblasts on the electron microscopy with abundancy of RER and mitochondria and covering of basal lamina. Two types of virus like particles were distributed in the cytoplasm and nuclei of sarcoma cells. We treated the patient with surgery and chemotherapy. The recovery was uneventful and the prognosis is under observation.
Male ; Humans

No abstract available.
Humans ; Transplants*

Pre-surgical and post-surgical change in adult clef lip and palate patient following Le Fort I advancement osteotomy combined with bone graft was evaluated clinically and cephalometically. We obtained a successful function and esthetic improvement. The bone graft of alveolo-palatal clefts provides a stable bone support to the adjacent teeth of the cleft area, and well union of adjacent bone tissue, the closure of oronasal fistula and improvement of speech problem. Le Fort I osteotomy following the ostectomy of nasal septum for advancement of the maxilla was obtained relative improvement of esthetics and functional occlusion. 1. The orthodontic correction was required before and after surgery. 2. In this case, there was a limited range of anterior advancement of the Premaxillary-segment due to the scar tissue. 3. After 8 months of operation, we could show the new bone deposition on the cleft sites in dental radiograph and then the prosthetic treatment to the missing teeth was done.
Adult ; Bone and Bones ; Cicatrix ; Esthetics ; Fistula ; Humans ; Lip ; Maxilla ; Nasal Septum ; Osteotomy ; Palate ; Tooth ; Transplants

Serum IgE levels in 48 patients with scabies were measured by enzyme-linked immunosorbent a.ssay(ELISA) to evaluate the relationship between the scabies and serum IgE. A group of 44 healthy persons was taken as a controls. The results were summarized as follows: In children group(p 15 year-old) of the scabies, serum IgE level was 446 3 +267.2 IU/ml and significantly elevated than in controls, 126, 3 175, 4 IU/rnl, In adult group(over 16 year-old), serum IgE levels of the scabies and controls were 506. 4 + 581. 8 IU/ml, 435, 5+ 548, 8 lU/rnl respetively, and there was no significant difference between them. 2) There were no statistical correlations between the serum IgE levels and intensity of pruritus, duration of illness, number of skin lesions or number of circu1ating eosinophils in patients with scabies.
Adult ; Child ; Eosinophils ; Humans ; Immunoglobulin E* ; Pruritus ; Scabies* ; Skin

No abstract available.
Child* ; Edema* ; Humans ; Renal Insufficiency*

A 36 year-old woman immigrated from Nepal showed erythematous plaques on her face, buttock and legs one month after the immigration. Before the correct diagnosis was made, the patient had been erroneously treated as anallergic dermatitis for three months. Clinico-pathologically, her skin lesion was borderline lepromatous type leprosy with bacilli positive. We report the case to keep the high index of suspicion for leprosy when we meet with patients from the countries where leprosy is still epidemic.
Buttocks ; Dermatitis ; Emigrants and Immigrants ; Emigration and Immigration ; Female ; Humans ; Leg ; Leprosy ; Leprosy, Multibacillary ; Nepal ; Skin

No abstract available.
Fetal Blood* ; Umbilical Cord*