Malignant pyoperma is a rare, chronic, progressive, destructive ulcerating skin disease of unknown cause that affects the head and neck region of young adults. The disease is progressive but responds to high doses of systemically administered steroids. We present a case of malignant pyoderma developed on the left retroauricular area in 67 year-old male. The patient died of rapidly progressive, desructive, 15cm x 20 cm sized, phagedenic ulcer on the left retroauricular and neck area despite of various extensive local and systemic treatment. Histopathologic findings of tissue from the edge of the ulcer were non-specific, showing upper dermal necrosis and mixed inflammatory cell infiltrate in the deep dermis.
Aged ; Dermis ; Head ; Humans ; Male ; Neck ; Necrosis ; Pyoderma* ; Skin Diseases ; Steroids ; Ulcer ; Young Adult

Functional gastrointestinal disorders are among the most common medical problems in children. Abdominal pain-related functional gastrointestinal disorders can be categorized as functional dyspepsia, irritable bowel syndrome, abdominal migraine and childhood functional abdominal pain according to the Rome III criteria for pediatric functional gastrointestinal disorders. The aim of this paper was to examine the evidence supporting the use of the range of therapeutic options available for functional gastrointestinal disorders.
Abdominal Pain ; Child ; Dyspepsia ; Gastrointestinal Diseases ; Humans ; Irritable Bowel Syndrome ; Migraine Disorders ; Rome

Functional gastrointestinal disorders are among the most common medical problems in children. Abdominal pain-related functional gastrointestinal disorders can be categorized as functional dyspepsia, irritable bowel syndrome, abdominal migraine and childhood functional abdominal pain according to the Rome III criteria for pediatric functional gastrointestinal disorders. The aim of this paper was to examine the evidence supporting the use of the range of therapeutic options available for functional gastrointestinal disorders.
Abdominal Pain ; Child ; Dyspepsia ; Gastrointestinal Diseases ; Humans ; Irritable Bowel Syndrome ; Migraine Disorders ; Rome

Accessory auricle is a relatively rare congenital anomaly arised from the abnormaI development of the auricular tubercles or from the tissues surrounding the second, third and fourth branchial clefts. Clinically this anomaly is a small akin-colored tag or nodule, soft and globular or cartilaginous consistency on or near the tragus along a line drawn from the tragus to the angle of the mouth or along the anterior margin of the sternomastoid muscle. The lesion is usually solitary and located in the preauricular area but may be multiple and rarely bilateral. We present a typical caae of accessory auricles in 4-day-old female infant. The patient had two skin-colored firm nodules on the left preauricular area and well pedunculated one on the Ieft buccal area near the angle of the rnouth. Histopathologic find.ings showed numerous pilosebaceous units, abundant subcutaneous fat and cartilage tissue in the center of the lesion.
Branchial Region ; Cartilage ; Female ; Humans ; Infant ; Mouth ; Subcutaneous Fat

PURPOSE: The purpose of this study was to examine the clinical courses and long-term outcomes of children with Allagille syndrome in Korea, and to evaluate the prognostic potentials of identified variables. METHODS: We reviewed the clinical manifestations and outcomes of 30 children with Alagille syndrome, investigated from 1984 to 2006 until the end of this study (defined as death or last visit; mean follow-up : 5 years). RESULTS: Cholestasis occurred in 100 percent, cardiovascular abnormalities in 83.3 percent, butterfly vertebrae in 30.0 percent, posterior embryotoxon in 43.3 percent, and a characteristic facial appearance in 100 percent. At study conclusion, of these 30 patients, eight had died (26.7 percent); six related to Alagille syndrome. Five patients died of a liver disease complication. Liver transplantation was carried out in five of the 30 patients (16.7 percent) and one of these died due to hyperacute rejection. At age two, cholestasis improved in 17 of the 30 patients. Those who had severe cholestasis at 2 years of age tended to have a complication, such as liver cirrhosis or liver transplantation, or to have died. CONCLUSION: Hepatic complications account for the most mortalities in patients with Alagille syndrome. Careful and complete assessments should be made in children who have cholestasis at 2 years of age. Further investigations of more cases are required.
Alagille Syndrome* ; Butterflies ; Cardiovascular Abnormalities ; Child ; Cholestasis ; Follow-Up Studies ; Humans ; Korea* ; Liver Cirrhosis ; Liver Diseases ; Liver Transplantation ; Mortality ; Spine

Pulmonary function testing (PFT) is an important and fundamental method in the evaluation and treatment of respiratory diseases. Airway responsiveness assessed using histamine or methacholine by PFT is meaningful for the diagnosis of asthma. Spirometry is simple, and has been the most commonly used technique. However, in younger or uncooperative children, other commercially available tools such as impulse oscillometry (IOS), gas dilution, and plethysmography have been used. IOS is a noninvasive method that allows the measurement of airway mechanics (resistance [R] and reactance [X]) with minimal patient cooperation. Functional residual capacity (FRC) is one of the most important measurements obtained by gas dilution. Plethysmography is a gold standard to measure airway resistance and useful for lung function testing in infants. The purpose of this review is to help pediatric physicians being familiar with PFT techniques used in young children by discussing their principles, clinical applications, limitations, and current accessibility in Korea.
Airway Resistance ; Asthma ; Child* ; Diagnosis ; Functional Residual Capacity ; Histamine ; Humans ; Infant ; Korea ; Lung* ; Mechanics ; Methacholine Chloride ; Oscillometry ; Patient Compliance ; Plethysmography ; Respiratory Function Tests ; Spirometry

This study aimed to analyze changing trends in child injury deaths from 2006 to 2016 and to provide basic data for initiatives to help prevent child injury deaths through improvements in social systems and education. Specific causes of death were analyzed using micro-data of the death statistics of Korea from 2006 to 2016, which were made available by Statistics Korea. Types and place of death were classified according to the KCD-7 (Korean Standard Classification of Diseases and Causes of Death). The data were compared to those of other Organization for Economic Cooperation and Development countries. Changing trends were presented. The number of child deaths by injury was 270 in 2016. The death rate was 8.1 per 100,000 population in 2006, while it was 3.9 in 2016. The death rate of boys was 1.7 times greater than that of girls. Unintentional injury deaths comprised 72.6% of all child injury deaths in 2016, while intentional injury deaths comprised 27.4%. The first leading cause of unintentional injury deaths in infants (less than 1-year-old) was suffocation, while that of children aged 1 to 14 years was transport accidents. The second leading cause of death in infants was transport accidents, that of children aged 1 to 4 was falling, and that of children aged 5 to 14 was drowning. Pedestrian accidents comprised 43.7% of the transport accidents from 2014 to 2016. To prevent child injury deaths by both unintentional and intentional causes, nation-wide policy measures and more specific interventions according to cause are required.
Accidental Falls ; Asphyxia ; Cause of Death ; Child ; Classification ; Drowning ; Education ; Female ; Humans ; Infant ; Korea ; Mortality ; Organisation for Economic Co-Operation and Development ; Republic of Korea ; Self-Injurious Behavior

The nephrotic syndrome is characterized by generalized edema, hypoproteinemia(<2 g/dL), proteinuria(>40 mg/m2/hr), and hypercholesterolemia(>200 mg/dL). It is reported that hypoalbuminemia, which is one of the four diagnostic criteria of the nephrotic syndrome, is associated with gallbladder wall thickening. An explanation for the thickened wall in hypoalbuminemic states is the accumulation of fluid in the subserosal layer of the gallbladder wall which contains the most areolar tissue. This report describes a patient who was initially diagnosed with the nephrotic syndrome at the age of 4 and subsequently developed acute acalculous cholecystitis at the age of 5.8 with an albumin level of 1.3 g/dL. The patient responded to fluid therapy, nasogastric suction, and broad spectrum antibiotics.
Acalculous Cholecystitis* ; Anti-Bacterial Agents ; Edema ; Fluid Therapy ; Gallbladder ; Humans ; Hypoalbuminemia ; Nephrotic Syndrome* ; Suction

Paradoxical response refers to the enlargement of old lesions or unexpected appearance of new lesions after initial improvement following treatment with antitubercular agents. Various types of paradoxical responses have been reported in the world, but they are rarely reported in Korean children. We report the case of a 17-year-old boy who was diagnosed with tuberculous pleurisy and was treated appropriately. Although the tuberculous pleurisy initially responded to medication with resolution of the pleural fluid, a new pulmonary lesion subsequently developed 3 weeks after the initiation of treatment that eventually cleared with continuation of the original drug regimen.
Adolescent ; Antitubercular Agents ; Child ; Humans ; Tuberculosis, Pleural

PURPOSE: Henoch-Shonlein purpura(HSP) is a systemic vasculitis that involves multiple organs, especially the kidney, which is the most important organ in determining the prognosis of the disease. The morbidity of HSP nephritis in adults is low and there have been little research done on its clinical course so far. Therefore, we have compared the clinical course of HSP nephritis in children and adults in Korea. METHODS: We retrospectively analyzed 81 cases of HSP nephritis in children younger than 15 years of age, and 25 cases of adults older than 15 years of age who were admitted to Yonsei University Medical College Severance Hospital from Jan. 1986 to May 2003. RESULTS: The male to female ratio was 1.5:1 in children and 1.3:1 in adults. The incidence of HSP nephritis for both age groups was found to be increased during the autumn and winter. Infection was the predisposing factor in 39 cases(48.1%) of children, 16 cases(64.0%) of adults, and drugs were the predisposing factor in 8 cases(9.9%) of children and 4 cases (16.0%) of adults. All patients initially presented with microscopic hematuria. Thirteen cases (16.0%) of children and 7 cases(28.0%) of adults initially showed proteinuria of nephrotic range. Thirty four cases(42.0%) of children and 4 cases(16.0%) of adults showed normal urinalysis after treatment. Asymptomatic urinary abnormalities were found in 41 cases(50.6%) of children and 18 cases(72.0%) of adults. Complications such as nephrotic syndrome and hypertension were found in 3 cases(3.7%) of children and 2 cases(8.0%) of adults. Three children(3.7%) and 1(4.0%) adult required dialysis or renal transplantation. Follow-up renal biopsies were performed on 21 children, of whom 10 cases(47.6%) did not show any histologic change, 9 cases(42.9%) showed low grade changes, and 2 cases(9.5%) showed high grade changes. Prognosis was gloomy when proteinuria of nephrotic range and high grade of abnormal histology were present at diagnosis, and there was no significant difference between the two groups(P<0.05) CONCLUSION: This study showed that there was no difference in terms of the clinical features and courses between the children and adults with HSP nephritis. Proteinuria of nephrotic range and the severity of abnormal histologic changes at diagnosis were found to be associated with a bad prognosis, therefore we recommend that patients with these features require long term follow-up and management.
Adult* ; Biopsy ; Causality ; Child* ; Diagnosis ; Dialysis ; Female ; Follow-Up Studies ; Hematuria ; Humans ; Hypertension ; Incidence ; Kidney ; Kidney Transplantation ; Korea ; Male ; Nephritis* ; Nephrotic Syndrome ; Prognosis ; Proteinuria ; Purpura, Schoenlein-Henoch* ; Retrospective Studies ; Systemic Vasculitis ; Urinalysis