To know the efficacy of intravenous gammaglobulin(IVGG) treatment and the resulting outcome at 18 months for acute Guillain-Barr syndrome (GBS) in children, clinical courses of 27 GBS patients who had been treated with IVGG in a dose of 1g/kg/day oyer 2 consecutive days were investigated. One died with respiratory failure and 8 patients received assisted ventilatory care with improvement. All consecutively treated patients responded well to IVGG. The mean plateau period in 26 recovered patients was 8.5 days. At the 6th month evaluation, only one failed to reach grade 2 on GBSSG scales. At the 18th month evaluation, minor motor symptoms such as easy fatigability or mild tremor on writing were remained in 9 patients. 9 patients showed mild to moderate febrile response to IVGG infusion, but no significant side effects were noted. IVGG can be chosen as an initial treatment for acute GBS in children because of its rapid effect, relative safety even in unstable patients and convenience of administration.
Child* ; Humans ; Respiratory Insufficiency ; Tremor ; Weights and Measures ; Writing

PURPOSE: To determine the reliability of sonourethrog raphy (SUG) in the evaluation of male anterior urethral strictures. MATERIALS AND METHODS: Both SUG with retrograde saline infusion and retrograde urethrography (RUG) were performed in 5 young normal volunteers and 20 patients with symptoms of impaired urine flow. Those findings were compared with urethroscopic and operative findings in all patients. RESULTS: SUG was more accurate in the evaluation of the stricture length and degree than RUG in 7 patients with anterior urethral strictures, when compared with their subsequent open urethroplasty findings. Only SUG could classify the degree of spongiofibrosis surrounding the strictures in 15 patients. So, SUG was diagnostically as efficacious as or, superior to, RUG in all 20 patients. CONCLUSION: SUG can be used as one of complementary and reliable tools for diagnosis, evaluation and follow-up of anterior urethral strictures.
Constriction, Pathologic ; Diagnosis ; Healthy Volunteers ; Humans ; Male ; Urethral Stricture*

The authors reviewed 17 patients with radial nerve palsy complicating fracture of humerus who were treated at the Department of Orthopedlc Surgery, St. Mary's Hospital Catholic Medical College, for past 3 years from Jan. 1974 to Dec. 1976, and the following results were obtalned. 1. The ratio of male to female in 17 cases with radial nerve palsy was 4 to 1, and In patients within the first decade the ratio was same (1:1). But those in the 3rd and 4th decade showed high incidence of palsy. 2. Among 113 humerus shaft fractures, 17 cases (15.0%) complicated the radial nerve palsy; among 17 cases the middle shaft fractures were 15, lower 2, none in the upper third. 3. The radial nerve was the most vulnerable to injury at the middle third of the humerus, especially when there was comminution of fracture. 4. The incidence of radial nerve palsy in closed fracture (102 cases) was 13.7% (14 cases), and 27.2% (3cases) in open fracture (11 cases). 5. By early surgical exploration the practlcal cause of radial nerve palsy in 9 cases were found; 2 cases by bruise, 2 by interposition, 2 severance of nerve, one stretching, one impaled, and one unknown. 6. There were no signiflcant correlation between the type of nerve damage and the degree of its recovery, and between duration of paralysis since onset and its prognosis. 7. Of the 17 cases with palsy, complete recoveries were obtained 11 cases, 5 incomplete, and no recovery in one.
Contusions ; Female ; Fractures, Closed ; Fractures, Open ; Humans ; Humerus ; Incidence ; Male ; Paralysis ; Prognosis ; Radial Nerve

PURPOSE: Cerebral cortical dysplasias are one of the important causes for epileptic seizures and developmental disabilities in children, particularly in diffuse or bilateral cases. These developmental malformations are generally regarded as a group of neuronal migration disorders, however, the classification system and pathogenetic mechanisms of cortical dysplasias are not yet entirely clear. Even a novel entity, congenital bilateral perisylvian syndrome, characterized by speech delay, pseudobulbar Palsy, intractable seizures, and bilateral perisylvian abnormalities on imaging studies, have rather diverse figures on morphology and symptomatology than initially considered. We have studied the clinical features and correlations of clinical outcomes 3nd magnetic resonance imaging(MRI) findings of bilaterally involved cortical dysplasias. METHODS: 20 cases of bilateral cortical dyspalsias were grouped into three categories on the basis of MRI findings; centroparietal dysplasias(6 cases), diffuse dysplasias with (5) or without white matter lesions(4), and schizencephaly(5). EEGs, motor and language development, epilepsy, and outcomes were reviewed in each groups. RESULTS: Language delay(100%), motor developmental delay(94.7%), motor deficit(65%), epilepsy(40%) were the main reasons for their initial hospital visits. A meaningful word expression was possible at the mean age of 2 years and 2 months(1 to 4 years of age). Hypotonia and spastic motor paralysis were evident in all the cases of diffuse dysplasia with white matter lesions and the schizencephaly groups. All but one case of centroparietal dysplasia showed motor developmental delay. Epilepsies were developed in 8 cases at the mean age of 5 years and 5 months(2 months to 12 years of age) and the seizures were relatively well controlled with anticonvulsants. EEG findings were variable; normal, focal or diffuse abnormalities. High amplitude diffuse fast activities were only noted in the diffuse dysplasia group. CONCLUSION: The severity of neurological deficits and developmental delay had correlated to the size of cortical abnormalities. The epilepsies were relatively well controlled during childhood and the EEG finding of high amplitude diffuse fast activities was specific for the diffuse cortical dysplasias. Bilateral centroparietal dysplasias should be included on consideration of the causes for developmental aphasia.
Anticonvulsants ; Aphasia ; Child ; Classification ; Developmental Disabilities ; Electroencephalography ; Epilepsy ; Humans ; Language Development ; Language Development Disorders ; Magnetic Resonance Imaging* ; Malformations of Cortical Development* ; Muscle Hypotonia ; Muscle Spasticity ; Neuronal Migration Disorders ; Paralysis ; Pseudobulbar Palsy ; Seizures

Hypertensive encephalopathy is characterized by an acute, severe rise in blood pressure associated with headache, nausea, vomiting, altered mental status, and focal neurologic deficits, and rapid improvement after control of blood pressure. An eight-year old boy had been admitted with symptoms of red urine, fever, headache, convulsion, and visual blurring of vision. Blood pressure was 140/90mmHg, and CSF exam revealed WBC 8/mm3, glucose 83mg/dL, protein 106mg/dL. Serum C3 was 8mg/dL, C4 17mg/dL, ASO 1,024 Todd units. Brain CT showed non specific findings, however, MRI revealed symmetric high signal intensity lesions on T2WI over the parieto-occipital areas bilaterally. These lesions had been completely resolved on the following MRI 4 weeks later.
Blood Pressure ; Brain* ; Fever ; Glomerulonephritis* ; Glucose ; Headache ; Humans ; Hypertensive Encephalopathy* ; Magnetic Resonance Imaging* ; Male ; Nausea ; Neurologic Manifestations ; Seizures ; Vomiting

BACKGROUND: Squamous cell caircinoma(SCC) often shows acantholysis as a result of degenerative changes of neoplastic cells. Regurding the acantholytic changes of SCC most textbooks and literature describe the acantholysis-associated tubular or alveolar structures, which are diagnostic features of adenoid SCC. But the acantholytic changes of SCC are not always assaciated with tubular or alveolar structres. The general and detailed histologic features of acantholysis of SCC have not been reported. OBJECTIVE: We analyzed the histologic features of acantholysis of SCC . MEHTODS: Twenty six biopsy specimens from 26 patients with SCC were studied for the distributions and sites of acantholysis such as lefts and tubular or alveolar structurs on routine histologic staining. RESULTS: All 26 biopsy specimens showed acantholysis in their tumors ocal acantholysis was found in 12 cases, and diffuse, widesprcad acantholysis was found in 14 cascs. The foci of acantholysis were in the surface epidermis in 9 cases, in the follicular wall in 5 cases, and in both the surface epidermis and the follicuar wall in 12 cases. The types of acantholytic cells were either dyskeratotic cells or non-dyskeratotic squamous cells. Tuthular or alveolar structures were found in 5 cases. Clefts were found in 12 cases, one in the subcomealarea, the other 11 were within tumor mases, and one of them showed Darier-like feature with papillary projections of neoplastic cells into thc lumens. CONCLUSION: The acantholytic hanges of the SCC are more comrr on y found than expected. The acantholytic changes involve not only dyskeratotic cells but also non-dysL eratotic cells and often show glandular structures and clefts.
Acantholysis* ; Adenoids ; Biopsy ; Carcinoma, Squamous Cell* ; Dronabinol ; Epidermis ; Humans

Pseudoaneurysm due to chronic pancreatitis is uncommon, but it can cause recurrent and massive hemorrhage. Because of high morbidity and mortality associated with the pseudoaneurysm, early detection and treatment is essential. Surgical ligation or resection of the aneurysm has a high mortality and therefore, transcatheter embolization is preferably carried out. We report a case in which gastroduodenal artery pseudoaneurysm caused by chronic pancreatitis was successfully treated by transcatheter embolization using Gelfoam and Gianturco spring coils.
Aneurysm ; Aneurysm, False* ; Arteries* ; Gelatin Sponge, Absorbable ; Hemorrhage ; Ligation ; Mortality ; Pancreatitis, Chronic*

No abstract available.
Femur* ; Osteosarcoma*

No abstract available.
Thyroid Gland* ; Thyroiditis*

In 1978, Bjornberg and Friis reported 32 patients with persistent pusi ulosis(PP) on distal extremities, of whom 13 patients were initially diagnosed as scabies. In 1984, Elpern described 7 patients with infantile acropustulosis(IA), of whom 4 patients had antecedant scabies. We report herein a case of PP, which was found in a 18 month-old mal who was treated for scabies at the age of 5 month and 12 month. The pruritic vesicopustules dev',lo ed 2 months after the second treatment for scabies and relapsed for 4 months. We also discuss the relationship between scabies and PP and also between PP and IA.
Extremities ; Humans ; Infant ; Scabies*