This report presents a case of a 17-year-old-girl who developed a, Kaposis varicelliforrn eruption(eczema herpeticum) during oral prednisolone therapy in order to control pemphigus foliaceus. Diagnosis was made by the history, clinical feature and histologic examination. Within 24 hours after the initiation of therapy with ribavirin(Viramid), new lesions had ceased to develop.
Diagnosis ; Kaposi Varicelliform Eruption* ; Pemphigus* ; Prednisolone

The aspergillus tracheobronchitis is distinctive manifestation of invasive aspergillosis, in which infection is limited completely or predominantly to the tracheobronchial tree. It accounts for about 7 to 10 percent of cases of invasive disease. Grossly, such disease may take the mucosal exudate and obstruct partially the airway lumen or completely the occlusive mucous/fungus plugs. Microscopically, the superficial portion of the airway wall is acutely inflamed and contain fungal hyphae. However, infection is often limited to the mucosa. We report a case of aspergillus tracheobrochits in a 54 year-old man who presented cough, progressive dyspnea with wheezing, and mucus plug. Bronchoscopy showed mucosal exudate and plug.Bronchoscopic biopsy showed aspergillus hyphae and inflammation in the mucosa. He was successfully treated with itraconazole.
Aspergillosis ; Aspergillus* ; Biopsy ; Bronchoscopy ; Cough ; Dyspnea ; Exudates and Transudates ; Humans ; Hyphae ; Inflammation ; Itraconazole ; Mucous Membrane ; Mucus ; Respiratory Sounds ; Trees

PURPOSE: Myasthenia gravis(MG) is relatively rare in childhood and shows some distinct epidemiologic and clinical features according to ages and races. The role of immunosuppressive therapy such as steroid treatment is not well established. The objective of this study is to characterize clinical features of childhood MG and to evaluate the outcomes of steroid treatment. METHODS: We studied 23 MG patients(7 male and 16 females) with symptom onsets from 1 to 14 years of age(mean 4.1 years). RESULTS: Fifteen patients were ocular type and 6 patients were generalized type. Sero-positivity to acetylcholine receptor antibodies was found in 85% of the patients. Two patients who showed initial ocular manifestations experienced secondary generalization without steroid treatment. Alopecia totalis and moyamoya disease were associated with systemic MG in two cases. Eighteen patients were treated with both anticholine esterase and steroid while 2 patients were treated with steroid only. Complete remission was observed in 6 patients(30%) while 11 patients(55%) had one or more recurrences and only partial responses were acquired in 4 patients(20%). CONCLUSION: We found some different epidemiologic features from western countries including a relatively high proportion of ocular MG and earlier onset age especially in ocular MG. Further long-term follow up study on responses to steroid treatment will be necessary to evaluate clinical benefits in the disease progression.
Acetylcholine ; Age of Onset ; Alopecia ; Antibodies ; Continental Population Groups ; Disease Progression ; Follow-Up Studies ; Generalization (Psychology) ; Humans ; Male ; Moyamoya Disease ; Myasthenia Gravis* ; Recurrence

MR finding of melanoma shows peculiar signal intensity based on paramagnetic effect of melanin or intratumoral hemorrhage, which displays decreased T1 and T2 relaxation times in many cases. Authors report MR findings in two cases of intracranial metastatic melanoma, which is pathologically confirmed by operation.
Hemorrhage ; Magnetic Resonance Imaging* ; Melanins ; Melanoma* ; Relaxation

OBJECTIVE: As an electronic health record system is implementing in Korean health care sectors, concerns about key functionalities of electronic health record systems are increasing. The purpose of this study was to identify core functions and set the priority in electronic health record systems under the Korean contexts in order to assure and improve the quality of the systems. METHODS: A survey was conducted using questionnaire developed by the study team based on literature review. The subjects were medical record administrators working at medical record department in general hospitals. RESULTS: The response rate was 59.8%(55/92). The functions which more than ninety percent of subjects responded as necessary right now and/or in near future related to 'drug alert', 'clinical guideline', 'chronic disease management', 'automated real-time surveillance', 'coded data', 'result reporting', 'de-identifying data', 'disease registry', and 'provider-provider communication and connectivity'. CONCLUSION: The results showed the high prioritized functions were decision support and health information/data management.
Electronic Health Records* ; Health Care Sector ; Hospitals, General* ; Humans ; Medical Record Administrators ; Medical Records ; Needs Assessment* ; Surveys and Questionnaires

Limb salvage operations for osteosarcoma of the extremity usually consist of wide excision and skeletal reconstruction. Most osteosarcoma patients are anemic prior to the surgery as majority of them undergo preoperative neo-adjuvant chemotherapy; thus, it is necessary to treat anemia before and after the surgery since limb salvage operation tends to accompany significant blood loss. Despite the fact that blood transfusion has bad influence on prognosis, complication, and postoperative outcome of cancer patients, it is still considered as a standard management to fix anemia for limb salvage operations. We would like to present a case report in which the authors succeeded in performing limb salvage operations on patients with distal femur osteosarcoma without transfusion.
Anemia ; Blood Transfusion* ; Drug Therapy ; Extremities ; Femur* ; Humans ; Limb Salvage* ; Osteosarcoma* ; Prognosis

Bronchopulmonary dysplasia associated with lung injury is an important morbidity in extremely low birth weight infants. Lung injury during mechanical ventilation is associated with high tidal volume and high end-inspiratory lung volume. Lung injury and bronchopulmonary dysplasia may be prevented with ventilatory strategies using optimal gas exchange such as permissive hypercapnia. This article will review the pathophysiologic background of lung injury and the current therapeutic ventilatory strategies such as permissive hypercapnia to reduce lung injury in preterm infants.
Bronchopulmonary Dysplasia ; Humans ; Hypercapnia* ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature* ; Lung ; Lung Injury ; Pulmonary Ventilation ; Respiration, Artificial ; Tidal Volume

Virus associated hemophagocytic syndrome, class ll histiocytoses, characterized by high fever, severe constitutional symptoms, abnormal liver function and coagulation, perigheral blood pancytopenia and histiocytic hyperplasis with prominent hemophagocytosis in bone marrow and lymph nodes has been reported and associated with active viral infection. It is non-malignant and reversible. It must be differentiated from histiocytic medullary reticulosis because of the inappopriateness of immunosuppressive of cytotozic therapy which is the therapeutic method for HMR, but is contraindicated in the treatment of VAHS. This paper describes two patients whose clinicopathology was compatible with the diagnosis of virus associated hemophagocytic syndrome.
Bone Marrow ; Diagnosis ; Fever ; Histiocytosis ; Humans ; Liver ; Lymph Nodes ; Lymphohistiocytosis, Hemophagocytic* ; Pancytopenia

This is a retrospective clinical analysis of 156 patient with colorectal cancer who were surgically treated from January 1988 to June 1996 at the Department of Surgery, Seoul Adventist Hospital. The results are as follows: 1) The peak age incidence was in the 7th decade (31.4% of the cases), and the sex ratio of males to females was 1.03 : 1. 2) The most common location of the tumor was the rectum in 77 cases (49.4%); next were the sigmoid colon in 25 cases (16.0%) and the ascending colon in 25 cases (16.0%). 3) In the right colon, the most frequent symptoms and signs were abdominal pain, a palpable mass, weight loss; in the left colon and rectum, bloody tarry stool and bowel- habit change were the most common symptoms and signs. 4) The duration of the symptoms and signs prior to admission was most commonly less than 3 month (46.8% of the cases). 5) The diagnostic methods were digital rectal examination, sigmoidoscopy, colonofiberoscopy, barium enema, and abdominal CT. In two cases,an exploratory laparotomy was done. Also, 2.8 studies were done per patient. 6) The operations performed included an abdominoperineal resection in 36 cases (24.0%) and a right hemicolectomy (18.7%). The operability was 96.2%, and the total resectability was 79.5%. 7) The staging of the tumor was performed during the initial operation according to the Aster Coller classification and the TNM classification. Stages C2 (33.8%) and B2 (29.1%) and T3N0M0 were the most frequent stages in both classification. 8) The most common histologic type was an adenocarcinoma (96.8%). 9) The most common macroscopic finding was of the annular type (59.6%) 10) The most common distant metastasis sites were the pelvic organs and the liver. 11) The most frequent postoperative complication was wound infection (14.7%). The complication rate and perioperative mortality were 32.7% and 2%, respectively.
Abdominal Pain ; Adenocarcinoma ; Barium ; Classification ; Colon ; Colon, Ascending ; Colon, Sigmoid ; Colonic Neoplasms ; Colorectal Neoplasms* ; Digital Rectal Examination ; Enema ; Female ; Humans ; Incidence ; Laparotomy ; Liver ; Male ; Mortality ; Neoplasm Metastasis ; Postoperative Complications ; Rectal Neoplasms ; Rectum ; Retrospective Studies ; Seoul ; Sex Ratio ; Sigmoidoscopy ; Tomography, X-Ray Computed ; Weight Loss ; Wound Infection

We report a case of metastatic carcinoma of the skin in 62-year-old male who showed multiple nodules on the anterior chest, scalp, face and left axilla for 2 months duration. He suffered from lower abdominal discomfortness for 6 months. Histopathologic findings revealed atypical cell nests and some tubular or glandular formation in the dermis and subcutaneous fat tissue. Material in the lumen showed diastase resistant and PAS positive, and alcian blue positive at pH 2.4, but negative pH 0.4. So it represented sialomucin. We did not find primary site of malignant tumor. In view of clinical and histopathological findings, it was considered to be originated from the large intestine.
Alcian Blue ; Amylases ; Axilla ; Dermis ; Humans ; Hydrogen-Ion Concentration ; Intestine, Large ; Male ; Middle Aged ; Scalp ; Sialomucins ; Skin* ; Subcutaneous Fat ; Thorax