A newborn infant, who was low-birth weight(1,780gm), showed severe degree of jaundice on second day of life and skin color became dark greenish-yellow and moderate hepatosplenomegaly was noted on physical examination. Results of liver function test & radioimmuniassay for hepatitis B antigen of both infant and mother suggested that neonatal hepatitis B seemed to occure transplacentally during pregnancy from infected mother. Pancytopenia was followed, but we could not confirm aplastic anemia due to lack of bone marrow specimen. As mentioned above, we experienced a case of vertically transmitted neonatal hepatitis B with pancytopenia. We present a brief review of related literatures.
Anemia, Aplastic ; Bone Marrow ; Hepatitis B* ; Hepatitis* ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Liver Function Tests ; Mothers ; Pancytopenia* ; Physical Examination ; Pregnancy ; Skin

PURPOSE: To evaluate morphologic characteristics of the microcalcifications on mammography that were confirmed pathologically. MATERIALS AND METHODS: Forty five cases of microcalcifications on mammography (fifteen cases of benign lesion, thirty cases of maiignancy) were retrospectively reviewed. RESULTS: The number of microcalcifications within 1 cm2 were more than 5 in 22 cases (73%) of 30 malignancy and less than 5 in 11 cases (73%) of 15 benignity. The heterogeneity of microcalcifications were seen in 26 cases of malignancy (87%) and the homogeneity of microcaicifications were 11 cases of benignity (73%). The morphologic characteristics of the microcalcifications were linear-V shape in 9 cases (30%), punctate shape in 8 cases (27%), fine stippled shape in 7 cases (23%), and round dot shape in 6 cases (20%) of malignancy and, round dot shape in 11 cases (73%), punctate shape in 2 cases (13%), and linear-V shape in 2 cases (13%) of benignity. CONCLUSION: Numerous irregular microcalcifications that are heterogenous in size and morphology were strong indicators of malignancy.
Mammography ; Population Characteristics ; Retrospective Studies

BACKGROUND: Infection with respiratory virus has been shown to exacerbate asthma in humans. However, the role of a respiratory virus in the pathogenesis of chronic asthma and/or wheezing in young children has not been clearly defined. The objective of this study was to determine whether respiratory virus infections such as RSV, and influenza A virus are related to the productions of IL-11, IFN-gamma, and ECP levels in nasopharyngeal secretions. METHOD: We compared IL-11, IFN-gamma, and ECP levels in nasopharyngeal secretions from 38 non-asthmatic wheezing children with viral infections (RSV in 21 children, influenza A virus in 17 children), and 16 non-asthmatic healthy children who were included as the controls. IL-11, and IFN-gamma levels were analysed by ELISA. ECP concentrations were measured by monoclonal antibody-based fluorometric assay. RESULT: RSV infection in children induced a greater release of IL-11 in nasopharyngeal secretions than in influenza A virus infection, and in the controls. The release of IFN-gamma levels in nasopharyngeal secretions from children with influenza A virus infection was significantly higher than in nasopharyngeal secretions from children with RSV. ECP levels of subjects with viral infection were significantly higher than in control children. CONCLUSION: This study demonstrated that RSV is a potent inducer of IL-11 elaboration in nasal epithelium and that IL-11 is an important mediator in the pathogenesis of RSV infection. Increased IFN-gamma production in response to the influenza A virus infection may be related to effective Th1 responses.
Asthma ; Child* ; Enzyme-Linked Immunosorbent Assay ; Eosinophil Cationic Protein ; Humans ; Influenza A virus* ; Influenza, Human* ; Interferon-gamma ; Interleukin-11* ; Nasal Mucosa ; Respiratory Sounds* ; Respiratory Syncytial Viruses*

We tested the hypothesis that the extent of necrosis at the initial MRI predicts the subsequent risk of collapse of the femoral head in a randomized clinical trial conducted to compare the core decompression to the conservative treatment. After the initial clinical evaluation including plain roentgenography and MRI, 37 hips of early-stage osteonecrosis (ON) in 33 patients were randomly assigned to core decompression group or conservative treatment group. All the patients were regularly followed by clinical evaluation including plain roentgenography and MRI at three-month intervals. The extent of ON was estimated on the basis of the percentage of abnormal signal intensity in the weight-bearing portion of the femoral head as determined on a combination in coronal aod sagittal MR images. The angle of necrotic portion in mid-coronal image (A) and that in mid-sagittal image (B) were used to quantify the extent of necrotic portion by the formula; (A/180) x (B/180) x 100%. A strong association was observed between the percentage of necrotic portion and the development of collapse. We concluded that the extent of necrotic portion is a major risk factor of the collapse and proposed a systematic method of classifying the percentage of necrotic portion, which might be useful as a predictive index for the fate of early-stage ON.
Classification* ; Decompression ; Head* ; Hip ; Humans ; Magnetic Resonance Imaging* ; Necrosis ; Osteonecrosis* ; Radiography ; Risk Factors ; Weight-Bearing

BACKGROUND: Diagnosis of tuberculosis is more complicated because of low sensitivity and time consuming procedures of the conventional diagnostic methods as well as nonspecific clinical features. Recently the serologic diagnosis of tuberculosis has been reported as one of rapid sensitive and specific methods. We evaluated the ability of a rapid ICT Tuberculosis assay(AMRAD/ICT Diagnostics, Syndey, Australia) to detect pulmonary tuberculosis. METHODS: ICT Tuberculosis assay was performed to the sera from 50 patients with pulmonary tuberculosis (24 patients with smear positive, 26 patients with smear negative) and 105 controls (48 patients without tuberculosis, 57 healthy controls). RESULTS: Antibodies were detected in 22 of 24 (92%) smear positive patients and 22 of 26 (85%) smear negative patients who had been clinically diagnosed as having active pulmonary tuberculosis. Two (4.2%) out of 48 patients without tuberculosis and 1 (1.8%) out of 57 healthy controls had a positive antibody response. The overall sensitivity, specificity, and positive and negative predictive value of the ICT Tuberculosis assay were 88%, 97%, 94%, and 94%, respectively. CONCLUSIONS: The ICT Tuberculosis assay was not only sensitive and specific but also rapid and simple. This assay will be useful as a diagnostic method of pulmonary tuberculosis in combination with sputum smear and X-ray.
Antibodies ; Antibody Formation ; Diagnosis* ; Humans ; Sensitivity and Specificity ; Sputum ; Tuberculosis* ; Tuberculosis, Pulmonary*

BACKGROUND: Studies on the incidence and seasonality of respiratory viruses that are the main cause of lower respiratory tract disease in children are insufficient in Korea. In the present study, the epidemiology of respiratory viruses in children was studied during the last 2 years and, the indirect immunofluorescent (IF) method was compared with the direct IF method. METHODS: A total of 814 pediatric inpatients hospitalized for lower respiratory tract infection at Hanyang University Hospital were studied from April, 1996 to July, 1998. Nasopharyngeal aspirates were obtained from these patients and indirect IF (Respiratory Panel I Viral Screening & Identification Kit, Light Diagnostics, Chemicon, Temecula, CA, USA) was performed for the following viruses : respiratory syncytial virus (RSV), parainfluenza virus type I, II and III, influenza virus A, B, and adenovirus. Sixty-nine of these samples were tested by direct IF (IMAGENTM, DAKO, UK) and indirect IF, simultaneously. RESULTS: 1) Viral pathogens were detected in 30.5% of nasopharyngeal aspirates. Among the positive cases, RSV was 60.6%, influenza A 35.3%, adenovirus 5.2%, influenza B 4.0%, and parainfluenza II 0.8%. 2) The occurrence rate of RSV in spring, summer, fall and winter was 7.3%, 13.6%, 31.45%, 33.45%, respectively, and showed a unique pattern in that the incidence rate in the summer of 1997 was 22.2%. A unique pattern was also observed for influenza A, which was continuously detected from December 1997 to July 1998. 3) The positive rate of indirect IF was statistically higher than that of direct IF. Excluding the results of the influenza A, there was no statistically significant difference between the two methods. CONCLUSION: RSV was the most frequently detected virus in viral respiratory infections in children. Infection usually began in the fall and most frequently detected in the winter and lasted until spring. High incidence of RSV in summer 1997 and continuous detection of influenza A till summer 1997 suggest some change of epidemic pattern. The discordance between direct and indirect IF was probably due to the difference in quality of the anti-influenza A reagent rather than a real difference in the two methods.
Adenoviridae ; Child* ; Epidemiologic Studies* ; Epidemiology ; Humans ; Incidence ; Influenza, Human ; Inpatients ; Korea ; Mass Screening ; Orthomyxoviridae ; Paramyxoviridae Infections ; Respiratory Syncytial Viruses ; Respiratory Tract Diseases ; Respiratory Tract Infections ; Seasons

A malignant fibrous histiocytoma of the mesentery is rare, and multifocal involvement as a primary tumor is very rare. In this report, a case of malignant fibrous histiocytoma of the mesentery presenting with two masses and multiple peritoneal seeding in a 48-year-old man is described. A physical examination revealed a large, firm, and non-tender mass in the right lower abdomen of the patient. Computed tomography of the lesion revealed a partially, indistinctly marginated and heterogeneously enhancing mass with irregular peritumoral strands in the mesentery of the right lower abdomen, while sonograms of the lesion revealed an ill-defined low-echoic mass. The final pathology demonstrated the presence of a storiform-pleomorphic malignant fibrous histiocytoma.
Abdomen ; Histiocytoma, Malignant Fibrous* ; Humans ; Mesentery* ; Middle Aged ; Pathology ; Physical Examination ; Ultrasonography

BACKGROUND: Facet joint is an important structure not only contributing to the stability of the lumbar motion segments but also causing low back pain. Hypothetically, the more lumbar lordosis decreases, the more corresponding facet joints orient axially and asymmetrically. Furthermore, the increased incidence of common diseases possessed of low back pain and radiologic findings such as wedging of vertebral body and spondylolisthesis were reported in the patients with asymmetric orientation of the facet joints and loss of lumbar lordosis at the same time. The purpose of our study is to define the relationship of asymmetry of the facet joints and loss of lumbar lordosis. METHODS: The asymmetry and average angle of facet joints with respect to sagittal plane were measured on the magnetic resonance images. The lumbar lordosis was measured on the lateral X-ray. The relevance of lumbar lordosis and facet orientation was analyzed through linear regression. RESULTS: There were no significant relationships between lumbar lordosis and asymmetrical orientation of facet joint. CONCLUSIONS: The loss of lumbar lordosis did not suggest asymmetrical and axial orientation of facet joints. Further investigation into pathology and consideration into individual differences of range of motion, body mass index, age, sex might be needed.
Animals ; Back Pain ; Body Mass Index ; Humans ; Incidence ; Individuality ; Linear Models ; Lordosis* ; Low Back Pain ; Pathology ; Range of Motion, Articular ; Spondylolisthesis ; Zygapophyseal Joint*

PURPOSE: This study investigated the clinical presentations of symptomatic Clostridium difficile infection (CDI) in children. METHODS: We reviewed the medical records of 43 children aged <20 years who showed either positive C. difficile culture or C. difficile toxin test results between June 2010 and April 2014. RESULTS: Of the 43 patients (mean age 6.7 years), 22 were boys. Sixteen patients (37.2%) showed both positive C. difficile culture and toxin test results. Seventeen out of 43 children (39.5%) had preexisting gastrointestinal diseases, and 26 children had other medical conditions that were risk factors for CDI. Twenty-eight children had a history of antibiotic treatment for >3 days, and the most frequently prescribed antibiotic was amoxicillin-clavulanate (35.7%). Twenty-eight patients were diagnosed with CDI despite taking probiotic supplements, most commonly Lactobacillus acidophilus (53.6%). The most common symptom was diarrhea (72.1%) at the time CDI was diagnosed. C. difficile was eradicated in 11 patients (25.6%) after treatment with oral metronidazole for 10-14 days, and in the two patients (4.6%) who required two courses of oral metronidazole. Sixteen patients (37.2%) showed clinical improvement without any treatment. CONCLUSION: This study showed the various clinical characteristics of CDI in children and that preexisting clinical conditions favored the development of CDI. In addition, CDI was found to occur in a number of patients even after probiotic prophylaxis given in conjunction with antibiotic therapy.
Child* ; Clostridium difficile* ; Diarrhea ; Gastrointestinal Diseases ; Humans ; Lactobacillus acidophilus ; Medical Records ; Metronidazole ; Probiotics* ; Risk Factors

Hyperemesis gravidarum is a complication defined as nausea and vomiting during early pregnancy. Wernickes encephalopathy is an illness of acute onset characterized by mental disturbance, paralysis of eye movements, and ataxia of gait cause by thiamine deficiency. We recently experienced a case of Wernickes encephalopalhy due to hyperemesis gravidarum, which is treated by administration of thiamine even though outcome of serious healthy problem to both mother and fetus, and reported it with a brief review of the literature.
Eye Movements ; Female ; Fetus ; Gait Ataxia ; Humans ; Hyperemesis Gravidarum* ; Mothers ; Nausea ; Paralysis ; Pregnancy ; Thiamine ; Thiamine Deficiency ; Vomiting ; Wernicke Encephalopathy*