PURPOSE: The incidence of clinical nephritis is much higher especially in younger ages and in about one half of the cases, it also shows nephrotic syndrome. Thus, we examine the clinical and pathologic consideration of children with lupus nephritis and their treatment modality to improve the prognosis. MATERIAL AND METHOD: Among 67 cases of children under eighteen who were diagnosed SLE, 50 patients with hematuria and proteinuria from Jan. 1980 to Dec. 1996 were selected for the review. RESULTS: The ratio of the male to female patient was 1:3.5 and the average age at the diagnosis was 11.85+/-3.2 years old. Most common clinical manifestations at the time of the diagnosis were fever and skin rashes and the common laboratory results were proteinuria, hematuria, Out of 50 cases, 33 cases had renal biopsy. The results were 17 cases of Class IV, 7 cases of Class lll, 5 cases of Class lll, 3 cases of Class V and 1 case of Class l. Different treatment modalities were carried out; Corticosteroid only 21 cases, Corticosteroid+Azathioprine 25 cases, Corticosteroid+Cyclophosphamide 3 cases, and Corticosteroid+Cyclosporine A 1 case. However, there were no significant difference in the recurrence and complete remission rate of lupus nephritis in between each treatment groups. Average follow-up period was 37+/-23 months. Of all the follow-ups, 7 patients were dead. CONCLUSION: Early diagnosis should be carried out with renal biopsy, and should be considered for vigorous therapy, which currently includes high doses of corticosteroids and immunosuppressive drugs. Among these immunosuppressive agents, azathioprine has a lower incidence of long-term complications and low costs might be recommended. In addition, regular check-up for anti-DNA antibody, serum complement concentration and appropriate moniroting and management for the adverse effects of the treatment should enable to reach the continuous remission.
Adrenal Cortex Hormones ; Azathioprine* ; Biopsy ; Child* ; Complement System Proteins ; Diagnosis ; Early Diagnosis ; Exanthema ; Female ; Fever ; Follow-Up Studies ; Hematuria ; Humans ; Immunosuppressive Agents ; Incidence ; Lupus Nephritis* ; Male ; Nephritis ; Nephrotic Syndrome ; Prognosis ; Proteinuria ; Recurrence

OBJECTIVES: Differential diagnosis based on descriptive psychopathology between bipolar and unipolar depression in the clinical setting is a still huge challenge. Projective psychological tests might provide additional clues. This study aimed to find distinct Rorschach test characteristics of bipolar depression in comparison with unipolar depression. METHODS: Medical records and raw data of the Rorschach Inkblot test applied using standardized procedure for the Exner Comprehensive System were retrospectively reviewed for patients with bipolar disorder or unipolar depression. Individual variables of the Rorchach test were compared among three groups, i.e., (hypo) mania (n=59), bipolar depression (n=56) and unipolar depression (n=25). RESULTS: Bipolar depression group, in accordance with (hypo) manic group, showed more color reponses (WSumC), more extroverted and intuitive decision-making (EBright), and higher emotional expression (CF+C) and instability (ebright), compared to unipolar deperssion group. On the contrary, the (hypo) mania group displayed more cognitive errors (Sum6, WSum6) compared to both depression groups. CONCLUSION: This study suggests that Rorchach test might provide valuable markers for differential diagnosis between bipolar and unipolar depression, and that some of those markers could be regarded as trait markers of bipolar disorder.
Bipolar Disorder ; Depression ; Depressive Disorder ; Diagnosis, Differential ; Humans ; Medical Records ; Psychological Tests ; Psychopathology ; Retrospective Studies ; Rorschach Test

Eighty cases of malignant effusion were cytologically studied to elucidate the incidence of primary tumor site and cytologic characteristics of each tumor types. Eighty fluid specimens were composed of 43 ascitic, 35 pleural, and 2 pericardial effusion and primary tumor site had been confirmed by histology. The frequent primary sites were stomach (22 cases, 28%), lung (21 cases, 26%), ovary (11 cases, 14%), liver (7 cases, 9%), and breast (4 cases, 5%). The principal malignant tumors were adenocarcinoma (56 cases, 70%), squamous cell carcinoma (7 cases, 9%), liver cell carcinoma (7 cases, 9%), small cell carcinoma (4 cases, 5%), and non-Hodgkin's lymphoma (4 cases, 5%). The distinctive cytologic findings according to primary tumor types were as follows; the gastric adenocarcinomas were mainly characterized by isolated cells and irregular clusters sometimes with signet ring cells. Papillary serous cystadenocarcinoma of ovary showed frequently papillary clusters and occasional psammoma bodies. Breast carcinoma of ductal type showed cell balls with smooth margins. Colonic adenocarcinoma showed rather irregular clusters o palisading pattern of cylindrical cells. Metastatic squamous cell carcinoma, liver cell carcinoma, small cell carcinoma, and non-Hodgkin's lymphoma showed also characteristic features. These findings indicate that the cytological features observed in the great majority of malignant effusion are similar to those of primary tumor types, which are very helpful to indentify the primary tumor site.
Adenocarcinoma ; Breast ; Breast Neoplasms ; Carcinoma, Hepatocellular ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Child* ; Colon ; Cystadenocarcinoma, Serous ; Diagnostic Errors ; Female ; Granuloma, Plasma Cell ; Humans ; Iliac Artery* ; Incidence ; Liver ; Lung ; Lymphoma, Non-Hodgkin ; Nephrosis, Lipoid* ; Ovary ; Pericardial Effusion ; Stomach

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

PURPOSE: Kissing contusion between the posterolateral tibial plateau and lateral femoral condyle is frequently found in association with a tear of the anterior cruciate liagment (ACL). The purpose of this study was to determine which ligamentous and meniscal tears are associated with kissing contusion. MATERIALS AND METHODS: We retrospectively reviewed the findings depicted by 323 consecutive MR images of the knee and confirmed at arthroscopy. For the diagnosis of disruption, ligaments, medial menisci (MM) and lateral menisci (LM) were evaluated using accepted criteria. We compared the prevalence and location of meniscal and ligamentous tears between group I (44 knees with kissing contusion) and group II (279 knees without kissing contusion). For statistical analysis the chi-square test was used. RESULTS: ACLs were torn in all 44 knees (100%) with kissing contusion, and 78 (28%) of 279 without kissing contusion. There were ten medial collateral ligament (MCL) tears (23%) in group I, and 17 MCL tears (6%), five lateral collateral ligament (LCL) tears (2%) and ten posterior cruciate ligament (PCL) tears (4%) in group II. In group I, meniscal tears were found in 22 MM (50%) and in 19 LM (43%), while in group II, they occurred in 128 MM (46%) and 128 LM (46%). In group I, 17 (77%) of 22 MM tears and 13 (68%) of 19 LM tears were located in the posterior horn, while in group II, the corresponding figures were 97/128 (76%) and 60 of 128 (47%). The differing prevalence of ACL and MCL tears between the groups was statistically significant (p<0.05), but differences in the prevalence and location of meniscal tears were not (p>0.05). CONCLUSION: Although kissing contusion was a highly specific sign of ACL tears, its presence was also significant among MCL tears. There was no signifficant difference in meniscal tears with or without kissing contusion.
Animals ; Arthroscopy ; Collateral Ligaments ; Contusions* ; Diagnosis ; Horns ; Knee ; Lateral Ligament, Ankle ; Ligaments* ; Menisci, Tibial ; Posterior Cruciate Ligament ; Prevalence ; Retrospective Studies

Pancreatic islet cell adenoma is a benign tumor of pancreatic beta-cell and a rare cause of hyperinsulinemic hypoglycemia in children. The authors experienced a case of pancreatic islet cell adenoma(Insulinoma)in a 11 year and 8 month old male who had frequent loss of consciousness and seizure. Enucleation was done after localization of tumor by selective celiac artery angiography and abdominal computed tomography. Diagnosis was confirmed by histologic findings as pancreatic-adenoma, gyriform growth pattern. A brief review of related literature was made.
Adenoma* ; Angiography ; Celiac Artery ; Child ; Diagnosis ; Humans ; Hyperinsulinism ; Hypoglycemia ; Infant ; Islets of Langerhans ; Male ; Seizures ; Unconsciousness

Epstein's syndrome is a rare disease whish is characterized by the association of thrombocytopenia, macrothrombocytopathia, nephritis and deafness. We experienced a case of Epstein's syndrome in a 12 years old male patient who was presented with a life long history of bleeding, usually as epistaxis, bilateral sensorineural deafness and hematuria with proteinuria starting in late childhood. Hematologic studies showed thrombocytopenia with giant platelets and anemia. A bone marrow aspirate revealed the megakaryocytes to be adequate in number and many giant size platelets. Platelet do not respond to addition of A and epinephrine; collagen and ristocetin induced agglutination response is decreased. It is difficult to be certain the association of thrombocytopenia with giant platelets, nephritis and deafness constitutes a new hereditary disease with a distinct pathogenesis or if it is an expansion of the well recognized Alport's syndrome of hereditary nephritis deafness. We report a case of Epstein's syndrome syndrome with brief review of related literatures.
Agglutination ; Anemia ; Blood Platelets ; Bone Marrow ; Child ; Collagen ; Deafness ; Epinephrine ; Epistaxis ; Genetic Diseases, Inborn ; Hematuria ; Hemorrhage ; Humans ; Male ; Megakaryocytes ; Nephritis ; Nephritis, Hereditary ; Proteinuria ; Rare Diseases ; Ristocetin ; Thrombocytopenia

No abstract available.
Prevalence* ; Seoul*

No abstract available.
Prevalence* ; Seoul*

Bart's syndrome was initially described as a genodermatosis characterized by congenital localized absence of the skin with blistering and nail deformities 1-3. However, it is considered as any type of epidermolysis bullosa(EB) with localized congenital absence of the skin on the extremities. A 33-day-old fbmale baby was presented with congenital absence of the skin over the left shin and dorsa of both feet which were covered with the thin, translucent, and brown-red glistening membranes. Blistering of the right calf and left great toe nail deformity were also noted. She was diagnosed as a recessive dystrophic EB by the histopathological, ultra- structural and immunomapping studies.
Blister ; Congenital Abnormalities ; Extremities ; Foot ; Membranes ; Skin ; Toes