Toxic epidermal necrolysis(T.E.N.) is a toxic erythema of the skin that undergoes epidermal necrolysis and peding so that it appears to have been scalded. There seem to be two basic form of T.E.N. In children, the deavage of the epidermis that results from an acantholytic-dyskeratotic cytolytic process is in the malpighian or granular layer and is usually induced by a staphylococci toxin. In adult, it is characterized by a full-thicknees cytolytic cleavage of skin above the basal layer and is usually precipitated by a drug. The authors observed a 17 year-old male with T.E.N. He began to notify the erythematous skin lesion with burning sensation on the whole body surface at 12 hours after oral administration of some drugs for common cold and developed the characteristic flaccid bullous and denuded lesions with tenderness within next 20 hours.
Administration, Oral ; Adolescent ; Adult ; Burns ; Child ; Common Cold ; Epidermis ; Erythema ; Humans ; Male ; Sensation ; Skin

We present a case of generalized congenital ichthyosiform dermatosis associated with neurosensory hearing loss, neovascularization of corneas, partial alopecia and abnormalities of nails and teeth on a 26 years old female patient. This case is strictly similar to the previously reported cases. The combination of these abnormalities was stuggested to be a new syndrome by some authors. This case is the first reported case in Korea, although in the literature we could find several cascs with similar patterns of malformations.
Adult ; Alopecia ; Cornea ; Deafness* ; Female ; Hearing Loss ; Humans ; Keratitis* ; Korea ; Skin Diseases* ; Tooth

Nevus Iipomatosus cutaneous superficialis (NLCS) is a very rare skin disease which usually is present at birth. The lesion consists of grouped papules and nodules which on histological examination show the presence of ectopic fatty tissue in the corium. The authors observed a 17year old female with NLCS. She noticed soft papules and nodules on the coccygeal area since 8 years old. We confirmed this case by clinically and histopathological findings which showed the strands or islands of mature fatty tissue within papillay, mid and lower dermis.
Adipose Tissue ; Child ; Dermis ; Female ; Humans ; Islands ; Nevus* ; Parturition ; Skin Diseases

We report a case of metastatic renal cell carcinoma to thyroid. A 56-year-old woman was presented with multiple nodules in the thyroid with the history of left radical nephrectomy 4 years ago due to renal cell carcinoma(stage I). During postnephreectomy follow-up period, no recurrence nor metastasis to other organs were noted. She had euthyroid function and multiple cold nodules in bilateral lobes on thyroid scan. Total thyroidectomy was done, and multiple nodules in the thyroid were bilaterally. The pathology reports showed the findings of metastatic renal cell carcinoma to the thyroid. The postoperative course was uneventual.
Carcinoma, Renal Cell* ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Neoplasm Metastasis ; Nephrectomy ; Pathology ; Recurrence ; Thyroid Gland* ; Thyroidectomy

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

Rapid crestal bone resorption following maxillary tooth loss is further accentuated in the posterior regions because of pneumatization and enlargement of the maxillary sinuses. A treatment rationale that allows preservation and augmentation of vertical available bone at the time of posterior maxillary tooth extraction may offer numerous therapeutic benefits which are more short courses of therapy and no needs of additional surgical augmentation. The present study comprised 3 patients who had 4 posterior maxillary teeth with no evident bone between the tooth apex and sinus floor, as estimated through preoperative radiographic analysis. Sinus floor augmentation at the time of tooth extraction was chosen for the ltreatment of these patients. After the tooth was carefully extracted, the empty alveolus was thoroughly debrided and a trephine approach was performed. Particulated autogenous bone was gently pushed beyond the empty alveolus to elevate the sinus membrane using an osteotome. The distance between bone crest and sinus floor was radiographically estimated 4 months after the first procedure. Another procedure was then carried out to place the implants of 11 mm length without another augmentation procedure. All implant were clinically stable, with no sign of infection. The presented surgical procedure performed at the time of extraction of posterior maxillary teeth in close proximity to the sinus floor allowed placement of implants of proper length.
Bone Resorption ; Humans ; Maxillary Sinus ; Membranes ; Sinus Floor Augmentation* ; Tooth Apex ; Tooth Extraction ; Tooth Loss ; Tooth*

OBJECTIVE: This study had three objectives: 1) to investigate the rehabilitation professionals' way of thinking on physical, psychological and social characteristics of older patients: 2) to assess their actual knowledge level about aging; and, 3) to deduce and analyze the influences that cause these different kinds of perceptions and attitudes. METHOD: Total 239 rehabilitation professionals (including rehabilitation doctors, nurses, physical therapists, occupational therapists, speech therapists, social workers, psychologists, prosthetists & orthotists) responded to our questionnaire were included in this study. Self-addressed questionnaires were composed of two categories: 1) the perception of older patients compared with younger patients: and 2) the actual knowledge level about aging. RESULTS: 1) There were significant (p<0.05) differences by job classification on a speculative disposition with the physical characteristics, motive of treatment, emotional characteristics, and discharge problem of older patients. 2) There were also significant (p<0.05) differences by job classification in the actual knowledge level about aging by job classification. A higher score on the questionnaire correlated with a more optimistic view of the motive of treatment, emotional characteristic and discharge problem. CONCLUSION: Many rehabilitation professionals have a misconceptions about older patients due to insufficient knowledge on aging. Therefore we propose an objective understanding of older patients along with proper education on aging to provide an effective rehabilitation treatment.
Aging* ; Classification ; Education ; Humans ; Physical Therapists ; Psychology ; Surveys and Questionnaires ; Rehabilitation* ; Social Workers ; Sociology ; Thinking

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

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

OBJECTIVE: Minimal data exist regarding non-operative management of suspected pseudarthrosis after pedicle subtraction osteotomy (PSO). This study reports radiographic and clinical outcomes of non-operative management for post-PSO pseudarthrosis at a minimum 5 years post-detection.METHODS: Nineteen consecutive patients with implant breakage indicating probable pseudarthrosis after PSO surgery (13 women/six men; mean age at surgery, 58 years) without severe pain and disability were treated with non-operative management (mean follow-up, 5.8 years; range, 5–10 years). Non-operative management included medication, intermittent brace wearing and avoidance of excessive back strain. Radiographic and clinical outcomes analysis was performed.RESULTS: Sagittal vertical axis (SVA), proximal junctional angle, thoracic kyphosis achieved by a PSO were maintained after detection of pseudarthrosis through ultimate follow-up. Lumbar lordosis and PSO angle decreased at final follow-up. There was no significant change in Oswestry Disability Index (ODI) scores and Scoliosis Research Society (SRS) total score, or subscales of pain, self-image, function, satisfaction and mental health between detection of pseudarthrosis and ultimate follow-up. SVA greater than 11 cm showed poorer ODI and SRS total score, as well as the pain, self-image, and function subscales (p<0.05).CONCLUSION: Non-operative management of implant failure of probable pseudarthrosis after PSO offers acceptable outcomes even at 5 years after detection of implant breakage, provided SVA is maintained. As SVA increased, outcome scores decreased in this patient population.
Animals ; Braces ; Follow-Up Studies ; Humans ; Joint Deformities, Acquired ; Kyphosis ; Lordosis ; Male ; Mental Health ; Osteotomy ; Pseudarthrosis ; Scoliosis ; Spine