We reviewed the clinical features, histrologic patterns and clinical courses of 30 children with lupus nephritis retrospectively, and the results were summerized as follows; 1) The male to female ratio was 1:2.8, and the mean age at the onset was 10 8/12 years. 2) The clinical symptoms were diverse, and malaise, weight loss, anorexia, fever and malar rash were the most frequent findings. 3) Among the immunologic tests, FANA and anti-ds-DNA test revealed the highest sensitivity with positive rates of 97% and 87%, respectively. 4) Clinically, 57% of patients had active nephrotic syndrome at the onset, and 33% showed (?) was the most common findings (70%). 5) During the follow-up period, one children with Class IV lupus nephritis expired. And 8 out of 9 cases with renal insufficiency at the onset showed improvement of renal function after treatment with corticosteroid and cytotoxic agents. In conclusion, the clinical features and histologic findings of lupus nephritis in children were diverse. Early diagnosis and proper treatment can prevent rapid deterioration of renal function and improve long-term survival rate.
Anorexia ; Child* ; Cytotoxins ; Early Diagnosis ; Exanthema ; Female ; Fever ; Follow-Up Studies ; Humans ; Immunologic Tests ; Lupus Nephritis* ; Male ; Nephrotic Syndrome ; Renal Insufficiency ; Retrospective Studies ; Survival Rate ; Weight Loss

PURPOSE: To evaluate changes in the degree of pseudomyopia and prognosis in patients with convergence spasm and acquired pseudomyopia. METHODS: The medical records of patients with convergence spasm and acquired pseudomyopia at the Korea University Medical Center from 2011 to 2014 were identified. We reviewed the patients' gender, age, onset time, visual acuity, refractive error, angle of strabismic deviation and the selected management (cycloplegics, patching, cycloplegics + patching, prism glasses). RESULTS: At the first medical examination, the mean age was 20.08 years. The mean spherical equivalent was -3.75 diopter (D) in the right eye and -4.03 D in the left eye based on manifest refraction and -2.59 D in right eye and -2.85 D in left eye using cycloplegic refraction. Eleven of 12 patients had esodeviation with a mean esodeviation of 10.42 D. The pupil size was 3.63 mm in the right eye and 3.63 mm in the left eye. No patient experienced severe miosis (pupil size <2 mm). Observation (5), patching (3), cycloplegics (2), patching + cycloplegics (1) and prism (1) management were performed in 12 patients. Outcomes included completely cured (3), improvement (7) and no change or recurrence (2). CONCLUSIONS: Active management is necessary for patients with convergence spasm and acquired pseudomyopia.
Academic Medical Centers ; Esotropia ; Humans ; Korea ; Medical Records ; Methods* ; Miosis ; Mydriatics ; Prognosis ; Pupil ; Recurrence ; Refractive Errors ; Spasm* ; Visual Acuity

Treatment of cerebellar medulloblastoma has been much improved with modern surgical technique for gross total tumor removal and adequate radiation therapy for the whole craniospinal axis. Questions have been arosen about the optimal radiation dose for the preventive treatment of whole cranium and whole spinal axis. Recently, many authors have reported their treatment results as comparable to older data, using lower than conventional dose of 3,600cGy-4,000cGy. For 50 patients treated between 1981 and 1950 at the Department of Radiation Therapy of SNUH, retrospective analysis was done for the treatment result, especially the neuraxis control, by radiation dose for the presymptomatic area of the disease. Analysis only by total spinal dose did not give any significant difference. But further analysis by following patient group: 3,600cGy/150cGy (n=S), 3,000cGy/150cGy (n=10), 2,400 cGy/150cGy (n=17) and 2,400cGy/100-120cGy (n=11) showed significant improvement of neuraxis control by decreasing order (p=0.003). There was no significant difference in overall survival between the groups. For the 19 patients who had been confirmed initially as having no neuraxis disease, TDF 30 was the cur-off value that could prevent neuraxis failure (p=0.004). We couldn't define any TDF value that give reasonable control for the patient group with positive CSF study at initial diagnosis.
Axis, Cervical Vertebra ; Diagnosis ; Humans ; Medulloblastoma* ; Retrospective Studies ; Skull

Ki-1 positive anaplastic large cell lymphoma is a newly described high-grade lymphoma and is defined by histopathological and immunologic criteria. We experienced a case of systemically involving Ki-1 positive anaplastic large cell lymphoma in a 44 year- old female which initially manifested as pleural effusion. Abdominopelvic CT scan showed the evidence of marked lymphadenopathy in retroperitoneal and both external and inguinal lymph nodes. On cytologic examination of pleural fluid, tumor cells revealed pleomorphic large isolated cells with prominent nucleoli and abundant cytoplasms. The nuclei were large with irregular profiles including some deep invaginations. Also, occasional multilobed/ multinucleated and binucleated nuclei were seen. Immunohistochemical examination was performed to differentiate from the undifferentiated adenocarcinoma, Hodgkin's disease, non-Hodgkin's lymphoma and malignant histiocytosis. The neoplastic cells were positive for leukocyte common antigen, CD3, CD30(Ki-1) but negative for cytokeratin, epithelial membrane antigen, and CD15. A histologic diagnosis of Ki-1 positive anaplastic lymphoma was made by biopsies of the inguinal lymph node, polypoid lesions of the stomach and cecum.
Adenocarcinoma ; Amyloid ; Antigens, CD45 ; Biopsy ; Cecum ; Child* ; Cytoplasm ; Diagnosis ; Female ; Histiocytic Sarcoma ; Hodgkin Disease ; Humans ; Keratins ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, Non-Hodgkin ; Mucin-1 ; Multiple Myeloma ; Pleural Effusion ; Stomach ; Tomography, X-Ray Computed

The benefits of radio-chemotherapy in HIV-negative primary central nervous system (CNS) lymphomas were analyzed in 40 patients, who received radiotherapy to the brain or craniospinal axis with the total dose of 4460-5940 cGy to the primary tumor. Radiotherapy was followed by systemic chemotherapy, mainly with the cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) regimen, in 16 of the patients. Follow-up ranged from four to 95 months with a median of 15 months. The relapse rate was 72.5%, and 83% of the relapses occurred within the radiation field. Median survival was 19 months and the two-year survival rate was 41%. Survival was significantly influenced by treatment method and radiation dose when measured by univariate analysis; median survival and the two-year survival rate was 29 months and 63% after radio-chemotherapy, while 13.5 month and 29% after radiotherapy alone (p= 0.027), and 22 months and 49% with doses of 50 Gy or more, but 12.5 months and 13% with doses less than 50 Gy (p=0.009). However, statistical significance was lost in multivariate analysis. These results might suggest the short-term efficacy of radio-chemotherapy, however, cautious observation is needed to confirm long-term effects.
Adolescence ; Adult ; Aged ; Antineoplastic Agents, Combined/therapeutic use* ; Antineoplastic Agents, Combined/adverse effects ; Bleomycin/administration & dosage ; Central Nervous System Neoplasms/therapy* ; Central Nervous System Neoplasms/mortality ; Cyclophosphamide/administration & dosage ; Disease-Free Survival ; Doxorubicin/administration & dosage ; Epirubicin/administration & dosage ; Female ; Human ; Lymphoma/therapy* ; Lymphoma/mortality ; Male ; Mechlorethamine/administration & dosage ; Methotrexate/administration & dosage ; Middle Age ; Neoplasm Recurrence, Local ; Prednisolone/administration & dosage ; Procarbazine/administration & dosage ; Radiotherapy Dosage ; Radiotherapy, Adjuvant/adverse effects ; Survival Rate ; Treatment Failure ; Vincristine/administration & dosage

Curschmann's spirals morphologically similar to those seen in sputum were found in cervico-vaginal smears of six patients ranged from 28 to 40 years of age, during 18 months from January. 1985 to June, 1986. The prevalence was 1 in 2147 smears in that period. All of them had gynecologic disorders without systemic effect such as chronic cervictis in three, leiomyoma in one, pelvic inflammatory disorder in one, and primary infertility in one. The Curshmann's spirals in the smear showed varying degrees of maturation from wavy incipient ones to highly coiled mature ones, admixed with thick mucinous back- ground, suggesting of their production in the uterine cervix itself. Also the recent history of undergone cryocautery, electrocautery or parturition suggest its production in the endocervical gland due to mechanical obstruction and/or change in biochemical composition of mucus.
Cervix Uteri ; Diabetes Insipidus* ; Electrocoagulation ; Female ; Humans ; Infertility ; Leiomyoma ; Mucins ; Mucus ; Parturition ; Pedigree* ; Pilomatrixoma ; Prevalence ; Receptors, Vasopressin* ; Sputum ; Vasopressins*

Brain metastasis from primary uterine cervical carcinoma have been described but are extremely rare and usually occur in the presence of widely disseminated diseases. The authors report a case of solitary cerebellar metastasis from uterine cervical carcinoma, which was confirmed by histopathological examination. The patient has shown no evidence of metastatic lesions elsewhere, thus far, but had undergone a radical hysterectomy under the diagnosis of uterine cervical carcinoma 52 months prior to the surgical excision of the cerebellar metastasis.
Brain ; Diagnosis ; Humans ; Hysterectomy ; Neoplasm Metastasis*

PURPOSE: Methicillin-Resistant-Staphylococcus aureus (MRSA) has been increasingly recognized as a cause of nosocomial infection. MRSA is hardly-controllable organism among the pathogen of nosocomial infection, because it is resistant to most antibiotics except vancomycin, and local treatment with most antiseptics are not effective to eradicate MRSA from the infection. The effectiveness of Vacuum-Assisted-Closure(VAC) was reported widely. we tried to modify original VAC. We tried VAC dressing on MRSA infected wound to evaluate whether or not the VAC is effective to eradicate MRSA which existed in the open wound. METHODS: From September 2003 to December 2003, 24 patients admitted to the plastic and reconstructive surgery and orthopedic surgery, were studied. All patients were found to be positive in previous wound. Using clinical randomized study, 24 patients were divided into two groups: VAC dressing group and the Betadine(R) dressing group(control). During treatment, wound culture was done twice a week for evaluation of MRSA infection elimination. RESULTS: The mean period that MRSA become not detected in all case was 17.1 days in VAC dressing group, and 25.8 days in control group, respectively. The p value was 0.013. The result reveals that the VAC dressing group is more effective to MRSA infection control. As a result, the VAC dressing was more effective in MRSA infected wound than conventional dressing. CONCLUSION: Through this study, we found objective result of VAC dressing. We hope that VAC dressing is more widely applied to fresh and infected wound.
Anti-Bacterial Agents ; Anti-Infective Agents, Local ; Bandages ; Cross Infection ; Hope ; Humans ; Infection Control ; Methicillin-Resistant Staphylococcus aureus ; Orthopedics ; Plastics ; Vancomycin ; Wounds and Injuries*

PURPOSE: To determine predictive factors associated with visual outcome after treatment for myopic choroidal neovascularization (mCNV). METHODS: Medical records of the patients who underwent photodynamic therapy (PDT), intravitreal anti-vascular endothelial growth factor (Anti-VEGF) injection, or combination therapy of PDT and Anti-VEGF for myopic CNV, and followed up for more than a year, were reviewed retrospectively. Multiple linear regression analyses were performed to evaluate the predictive factors significantly associated with the visual outcome at 1 year after the treatment. RESULTS: Mean best-corrected visual acuity (BCVA) of 45 eyes of 45 patients showed statistically significant improvement 1 year after the treatment with a mean of 3.5 line improvement (p < 0.01, Wilcoxon signed rank test). Age, 1-month BCVA after treatment and treatment type appeared to be associated with the 1-year visual outcome after treatment for mCNV (p = 0.033, p < 0.001, and p = 0.044, respectively, multivariate linear regression analysis). CONCLUSIONS: Younger age (less than 40 years), better 1-month BCVA after treatment, intravitreal Anti-VEGF monotherapy were associated with improved visual outcome after treatment for mCNV. In particular, 1-month BCVA after treatment is a useful indicator to predict therapeutic response after treatment for mCNV.
Antibodies, Monoclonal, Humanized ; Choroid ; Choroidal Neovascularization ; Endothelial Growth Factors ; Eye ; Humans ; Linear Models ; Medical Records ; Photochemotherapy ; Retrospective Studies ; Triazenes ; Visual Acuity ; Bevacizumab ; Ranibizumab

The authors analysed retrospectively 41 cases of spontaneous IVH(intraventricular hemorrhage) which were treated with EVD(extraventricular drainage). In cases of poor drainage of CSF(cerebrospinal fluid) through the EVD catheter, infusion of urokinase was tried. The most common age groups of IVH patients were the 5th and 6th decades. Sexual incidence was 23 : 18 in male vs. female. The etioligies of the spontaneous IVH in order of frequency were hypertension, aneurysm rupture, AVM. The overall mortality rate was 49%, but a poor outcome was noted in 64% of the cases. The cases of high Graeb score & low GCS(Glasgow coma scale) score on admission showed poor outcome. Incidence of complication was 27%. Ventriculostomy was effective in many cases of IVH, especially in the early stage of stroke.
Aneurysm ; Catheters ; Coma ; Drainage ; Female ; Hemorrhage* ; Humans ; Hypertension ; Incidence ; Male ; Mortality ; Retrospective Studies ; Rupture ; Stroke ; Urokinase-Type Plasminogen Activator ; Ventriculostomy