Erythema nodosum is clinical entity defined easily, but because of the variable histopathologic findings showing involvement of the vessels, septa, and fat lobules, the histopathologic features often are not compatible with the clinical diagnosis, We present the results of clinical and histopathologic findings in 26 patients with erythema nodosum observed at the Department of Dermatology, Seoul National University Hospital, fram January 1973 to August 1976. 1. Clinical Findings Erythema nodosum is characterized by painful erythematous nodose lesion occurring symmetrically(92%) on shins(50%) or shins and calves(50%) of women(M: F==4: 22) between sixteen to twenty five years old of age(58%) chiefly. In laboratory study, leukocytosis(1/17) was rare but increased titers of antistreptolysin(64%) and elevation of E.S.R.(88%) were found frequently. 2. Histopathologic Findings Even though hemorrhage(73%), perivascular(100%) and periadnexal(85%) inflammatory cell infiltration were frequently seen in histopathologic changes of erythema nodosum, these changes were nonspecific. Moreover, granulomatous change (38%), thrombophlehitis(35%) and necrosis of fatty tiasue(38%) were observed not infrequently in erythema nodosum. So we concluded that there were no specific histopathologic findings in erythema nodosum which differentiated from the other erythematous nodose diseases on the legs consisted of panniculitis, thrombophlebitis or granulomatous changes.
Dermatology ; Diagnosis ; Erythema Nodosum* ; Erythema* ; Humans ; Leg ; Necrosis ; Panniculitis ; Seoul ; Thrombophlebitis

A case of familiar benign chronic pemphigus is reported. A 41 years old housewife has recurrent history of developing grouped vesicular eruptions with erythematous erosion on the intertrigenous area since 29 years of her age. The lesions were used to aggrevated in summer and improved in autumn. Familiar history revealed same disease of her grand mother, father, 44 year old elder sister and 39 year old younger sister. All of whom had similar clinical signs and symptoms. Routine physical and Iaboratoryfindings were within normal limits. The histopathological findings, from vesicular eruption of the lateral aspect of neck, showed multilocular suprabasal clefts with acantholsis, villi formation and hyperkeratosis. The lesions were improved hy the local application of corticostcroidoid ointrnent only.
Adult ; Fathers ; Humans ; Mothers ; Neck ; Pemphigus, Benign Familial ; Psoriasis* ; Siblings

Since the classical description of pyoderma gangrenosum by O'Leary, Brunsting and Goecgerman in 1930, a considerable nurnber of reports of this clinical entity has appeared. Pyoderma gangrenosum is a painful, ulcerative disease of the skin. The ulcers are highly characteristic in clinical feature as necrotic pus covered lesions having purple colored and elevated border with red halo. Frequently, the ulcers heal with a cribriform type of scar. Its pathogenesis is not understood clearly. We present a case of pyoderma gangrenosum deveIoped on the leg in a 11-year old boy occurring with rectal poIyp, the association of whicb is very rare in world wide. And this case has the evidence of cell mediated immunity impairment characterized by no response to mumps antigen and purified protein derivatives, and not to be activively sensitized by DNCB.
Child ; Cicatrix ; Dinitrochlorobenzene ; Humans ; Immunity, Cellular ; Leg ; Male ; Mumps ; Polyps* ; Pyoderma Gangrenosum* ; Pyoderma* ; Skin ; Suppuration ; Ulcer

Since the description of Familial Benign Chronic Pemphigus by Hailey-Hailey, several cases of this clinical entity have reported in Korea. Familial Benign Chronic Pemphigus is a rare hereditary acantholytic disorder, transmitted as an irregular autosomal dominant traits, characterized by recurrent eruption of vesicles, bullae and impetiginous lesions mainly on the sides of neck, axillae and groins symmetrically. We presented a case of Familial Benign Chronic Femphigus in a 49 years old woman. She had suffered from these characteristic skin lesions have spread to the axillae, inframammary areas, antecubital fossae, inguinal and perianal area progressively. Moderate itching was associated with skin lesions, which were worse in summer and better in winter. Biopsy findings showed hyperkeratosis, irregular acanthosis, multilocular suprabasal clefts of bullae with extensive acantholysis and villi formation. Two daughtera of the patient has had the same clinical features on the sides of neck since puberty,
Acantholysis ; Adolescent ; Axilla ; Biopsy ; Female ; Groin ; Humans ; Korea ; Middle Aged ; Neck ; Pemphigus, Benign Familial* ; Pruritus ; Puberty ; Skin

Despite the advent of new antimicrobial drugs and mordern imaging techniques, mortality and morbidity of bacterial meningitis remain high. The unfavorable clinical outcomes are due to intracranial complications such as cerebrovascular complications, hydrocephalus, cerebral edema, intracerebral hemorrhage, brain abscess, and convulsion. Prompt identification and treatment of each are essential to mininize unfavorable outcomes. We report two cases of cerebral infarctions complicated by Streptococcus pneumoniae meningitis with a brief review of related literatures.
Brain Abscess ; Brain Edema ; Cerebral Hemorrhage ; Cerebral Infarction* ; Hydrocephalus ; Meningitis, Bacterial ; Meningitis, Pneumococcal* ; Mortality ; Seizures ; Streptococcus pneumoniae* ; Streptococcus* ; Thrombosis

PURPOSE: Iron deficiency anemia (IDA) is the most common nutrient deficient disorder in infants and young children. Iron deficiency at this age group can cause serious effects on mental and psychomotor development. We analyzed the hematologic profiles of infants and young children with IDA, comparing them with control group. METHODS: The feeding practices and the iron batteries investigated in 198 anemic patients aged 5 to 36 months who had been brought to Inha General & University Hospital. Control group were 129 healthy infants and children who visited DongBu Municipal Hospital and the local health center for immunizations. They also had hemoglobin concentration (Hb), hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin and red cell distribution width (RDW) tested by the electron counters. Patients with hemoglobin level <11 g/dL who had serum ferritin <10 ng/mL or transferrin saturation <15% were classified as having IDA. RESULTS: Out of the 198 subjects (M:F=1.6:1) with IDA, 81.8% (n=162) was breast feeding more than 6 months. The main causes which they were brought to the clinic were infectious or inflammatory illness, and only 13.1% with IDA were visited for evaluation of pallor or anemia. Correlation between Hb and MCV was much more in IDA group than control group (r=0.709, r=0.368; P<0.001). CONCLUSION: By combining Hb with MCV and RDW as well as iron batteries in screening for iron deficiency and IDA, the accuracy of diagnosis can be increased. We support the use of appropriately iron-fortified formulas or weaning foods, or the routine iron supplement starting at 6 months of age in exclusively breast-fed infants to prevent the iron deficiency.
Anemia ; Anemia, Iron-Deficiency* ; Breast Feeding ; Child* ; Diagnosis ; Erythrocyte Indices ; Erythrocytes* ; Ferritins ; Hematocrit ; Hospitals, Municipal ; Humans ; Immunization ; Infant* ; Iron* ; Mass Screening ; Pallor ; Transferrin ; Weaning

PURPOSE: Iron deficiency anemia is the most common nutrient deficient disorder in infants and young children. Iron deficiency at this age group can cause seroius effects on mental and psychomotor development. The object of this study is to determine the prevalence of iron deficiency and evaluate its relationship with diet during the weaning period. METHODS: We conducted blood tests on 247 healthy, 5-24 months olds, who visited DongBu Municipal Hospital and the local health center for immunizations. One hundred and fifty-two children also had serum iron, TIBC, transferrin-saturation and serum ferritin tested. Mothers of 129 children answered a questionnaire about feeding practices and their children were divided into 3 groups according to age; groupl (5-11 mon.), groupll (12-17 mon.), grouplll (18-24 mon.). RESULTS: Out of the total number of subjects 7.3% (n=18) was anemic (Hbg<11g/dl) and the highest 9.4% was in groupl (5-11 mon.). Among 152, 32.2% (n=49) were in an iron deficient state (ferritin<10ng/ml). In group lll, 57.5% (23/40) were iron deficient. Transferrin saturation<10% was 13.8% (21/152) and ferritin<10ng/ml and/or TS<10% was 37.5%. Analysis of questionnaires is as follows : Total daily caloric intake was 771.9 +/- 264.0 Cal on average. Average daily iron intake was 5.5 +/- 2.7 mg, about half the recommended dietary allowance of 10mg. CONCLUSION: The prevalence of iron deficiency was high (32.9%) in 5-24 months olds. Because iron deficiency without anemia was 27.0%, we recommend to add serum ferritin to routine Hb indices test for iron deficiency evaluation. As average iron intake in weaning period was much less than recommended, it seems appropriate to emphasize feeding iron rich weaning foods.
Anemia ; Anemia, Iron-Deficiency ; Child* ; Diet ; Energy Intake ; Ferritins ; Hematologic Tests ; Hospitals, Municipal ; Humans ; Immunization ; Infant* ; Iron* ; Mothers ; Prevalence ; Surveys and Questionnaires ; Recommended Dietary Allowances ; Transferrin ; Weaning

PURPOSE: Iron deficiency anemia is the most common nutrient deficient disorder in infants and young children. Iron deficiency at this age group can cause seroius effects on mental and psychomotor development. The object of this study is to determine the prevalence of iron deficiency and evaluate its relationship with diet during the weaning period. METHODS: We conducted blood tests on 247 healthy, 5-24 months olds, who visited DongBu Municipal Hospital and the local health center for immunizations. One hundred and fifty-two children also had serum iron, TIBC, transferrin-saturation and serum ferritin tested. Mothers of 129 children answered a questionnaire about feeding practices and their children were divided into 3 groups according to age; groupl (5-11 mon.), groupll (12-17 mon.), grouplll (18-24 mon.). RESULTS: Out of the total number of subjects 7.3% (n=18) was anemic (Hbg<11g/dl) and the highest 9.4% was in groupl (5-11 mon.). Among 152, 32.2% (n=49) were in an iron deficient state (ferritin<10ng/ml). In group lll, 57.5% (23/40) were iron deficient. Transferrin saturation<10% was 13.8% (21/152) and ferritin<10ng/ml and/or TS<10% was 37.5%. Analysis of questionnaires is as follows : Total daily caloric intake was 771.9 +/- 264.0 Cal on average. Average daily iron intake was 5.5 +/- 2.7 mg, about half the recommended dietary allowance of 10mg. CONCLUSION: The prevalence of iron deficiency was high (32.9%) in 5-24 months olds. Because iron deficiency without anemia was 27.0%, we recommend to add serum ferritin to routine Hb indices test for iron deficiency evaluation. As average iron intake in weaning period was much less than recommended, it seems appropriate to emphasize feeding iron rich weaning foods.
Anemia ; Anemia, Iron-Deficiency ; Child* ; Diet ; Energy Intake ; Ferritins ; Hematologic Tests ; Hospitals, Municipal ; Humans ; Immunization ; Infant* ; Iron* ; Mothers ; Prevalence ; Surveys and Questionnaires ; Recommended Dietary Allowances ; Transferrin ; Weaning

Osteoporosis due to the rheumatoid arthritis and the glucocorticoid therapy predisposes patients to insufficiency fractures. Insufficiency fractures or periprosthetic fractures of the lower extremity in the rheumatoid arthritis have been frequently reported. But those of the upper extremity were rarely reported. We report three cases of the insufficiency fracture of the olecranon after total elbow replacement arthroplasty in patients with the rheumatoid arthritis. All the cases were successfully treated by immobilization for 3 weeks. At the last follow-up, there were no functional impairments or residual symptoms caused by the fractures.
Arthritis, Rheumatoid* ; Arthroplasty* ; Arthroplasty, Replacement, Elbow* ; Follow-Up Studies ; Fractures, Stress* ; Humans ; Immobilization ; Lower Extremity ; Olecranon Process* ; Osteoporosis ; Periprosthetic Fractures ; Upper Extremity

Congenital adrenal hyperplasia, which is caused by the disorder of the enzyme for synthesizingadrenal hormones, results in hypertropy of the clitoris due to overporduction of adrenalandrogen. Diagnosis of the congenital adrenal hyperplasia can be obtained by the study ofsteroid levels in blood and urine. The blood levels of ACTH, testosterone and 17-hydroxyprogesteronewere increased and the concentration of 17-ketosteroid were decreased after the dexamethasonesuppression test. The internal genital organ was normal appearance on the pelvic CTscan. Clitoromegaly due to congenital adrenal byperplasia was corrected previously by the variousoperational procedures in which the clitoris was removed entirely for only physial appearance.However the sensitive function of the clitoris after the operative correction throughpuberty is to be preserved by the method "clitoroplasty" for preserving neurovascular supply tothe clitoris. The writer experienced a case of a 5-year-old girl with congenital adrenalhyperplasia and tried this clitoroplasty for surgical treatment of clitoromegly for preservation ofpostoperative sensitivity of the clitoris.
Adrenal Hyperplasia, Congenital* ; Adrenocorticotropic Hormone ; Child, Preschool ; Clitoris* ; Diagnosis ; Female ; Genitalia ; Humans ; Testosterone