BACKGROUND: The value of serum lipid in children after recovery of Kawasaki disease may be important bacause of the predilection of this disease for the coronary artery. METHODS: To determine the alterations in serum total cholesterol(TC) and high density lipoprotein(HDL)-cholesterol levels in Kawasaki disease(KD), we measured serum HDL-cholesterol and TC in 35 patients(mean age 36.8+/-22.0 months, range 6 to 93 months) with Kawasaki disease(KD) during 10 days or less after the onset(group A) and 2 months later after recovery. TC and HDL-cholesterol were also measured in an acute febrile respiratory illness group(group B) and a nonfebrile respiratory illness group(group C) to compare with those of KD. RESULTS: HDL-cholesterol levels in group A were depressed(29.6+/-11.0mg/dl) compared with group B and C(47.3+/-13.3mg/dl and 45.1+/-12.4mg.dl, respectively, p<0.01). TC levels in group A(145.1+/-33.1mg/dl) were not significantly different from those of group B(146.8+/-33.4mg/dl) and C(157.1+/-29.6mg/dl). Also the level of serum HDL-cholesterol in the acute phase of KD was significantly lower when compared with that after recovery(30.2+/-13.2mg/dl vs 50.0+/-10.2mg/dl, p<0.05). In KD patients, TC levels were not significantly different between the acute & recovery phase(145.0+/-26.6mg/dl, 153.4+/-32.6mg/dl). Echo-cardiography confirmed coronary artery aneurysms in 11 patients(31.4%) and otherwise, normal findings(n=24) in the KD group. There were no significant difference in TC level(140.7+/-27.6mg/dl vs. 146.9+/-35.4mg/dl, p=NS) and HDL cholesterol level(30.1+/-12.5mg/dl vs. 29.2+/-10.7mg/dl, p=NS) between patients with and without coronary aneurysms. CONCLUSIONS: HDL-cholesterol levels were significantly depressed only in the acute phase of KD but TC levels did not change significantly. Both levels were not related to coronary artery aneurysm.
Aneurysm ; Child ; Cholesterol, HDL ; Coronary Aneurysm ; Coronary Vessels ; Humans ; Mucocutaneous Lymph Node Syndrome*

Aortopulmonary fistula is an exceedingly rare vascular malformation. It is commonly derived after chest injuly or from complication of chest operation and aortic dissection and congenital aortopulmonary fistula is only several cases combined with Tetralogy of Fallot or aortic stenosis. But a congenital aortopulmonary fistula without any hemodynamic abnormalities was not reported. A 56-year old man with exertional dyspnea was admitted. In an examination on admission, there were no abnomalities. Aortography showed an aortopulmonary fistula that branches from the ascending aorta adjacent to the right coronary artery, running to the main pulmonary artery. Transcatheter coil embolization was performed and he was discharged 7 day after embolization without complication. Exertional dyspnea disappeared and careful follow up has be performed periodically.
Aorta ; Aortic Valve Stenosis ; Aortography ; Coronary Vessels ; Dyspnea* ; Embolization, Therapeutic ; Fistula* ; Follow-Up Studies ; Hemodynamics ; Humans ; Middle Aged ; Pulmonary Artery ; Running ; Tetralogy of Fallot ; Thorax ; Vascular Malformations

PURPOSE: This study was to evaluate the effect of stem cell transplantation into the sub-retinal space in retinitis pigmentosa (RP) patients for improving their visual acuity. RP is a progressive hereditary disease that leads to the blindness, and there is no reliable treatment for recover the disease until now. METHODS: The author transplanted mesenchymal stem cell extracted from umbilical cord blood into the sub-retina of four RP patients recommended by Korea RP association, and checked the changes of their visual acuity and electroretinograms. RESULTS: There was no obvious improvement in their visual acuity and elecroretinograms compared with preoperative state. Two patients, however, experienced slight improvements of their color sense and peripheral visual fields, and slight decrease of photophobia. Although there were no any obvious complications in relation to the stem cell transplantation, surgical procedures developed complications such as vitreous hemorrhage and retinal detachment. CONCLUSIONS: Mesenchymal stem cell derived from umbilical cord blood could not improve visual acuity and electroretinogram of RP patients.
Blindness ; Fetal Blood ; Genetic Diseases, Inborn ; Humans ; Korea ; Mesenchymal Stromal Cells ; Photophobia ; Retinal Detachment ; Retinitis Pigmentosa* ; Retinitis* ; Stem Cell Transplantation* ; Stem Cells* ; Strabismus ; Visual Acuity ; Visual Fields ; Vitreous Hemorrhage

Lesions of the skull vault are often incidentally encountered during in plain radiography, CT, and MR imaging of the brain and benign lesions are more common than primary malignancies. The usefulness of plain skull films is limited, but when combined with CT or MRI, there is a high probability of accurate diagnosis. The aim of this essay is to describe a wide range of cranial lesions and to illustrate their distinguishing features.
Brain ; Diagnosis ; Magnetic Resonance Imaging ; Radiography ; Skull*

Bone Density ; Cone-Beam Computed Tomography ; Dental Implants ; Follow-Up Studies ; Maxilla ; Osseointegration

A 7-year-old boy, diagnosed with an arachnoid cyst and subdural effusion on initial MRI, was admitted with left limb weakness and no history of head trauma. A subsequent follow-up MRI showed different stages of hematoma within multilayered enhancing membranes and in the arachnoid cyst, which was separated by the cerebrospinal fluid cleft. Craniotomy and fenestration of the cyst wall and hematoma removal were performed. The patient was diagnosed as a having a hemorrhagic rupture of an arachnoid cyst into the intradural space, probably via some one-way valve-like defect, based on the MRI and surgical findings. The MRI features and possible mechanism of this rare disease are discussed within the literature review.
Arachnoid* ; Cerebrospinal Fluid ; Child ; Craniocerebral Trauma ; Craniotomy ; Dura Mater ; Extremities ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Humans ; Lymphangioma, Cystic ; Magnetic Resonance Imaging ; Male ; Membranes ; Rare Diseases ; Rupture* ; Subdural Effusion

Rhino-orbito-cerebral muconnycosis is an uncommon fatal fringal infection, almost exclusively seen in diabetic or other itnmunocompromised patients. Recurrent transient ischemic attacks(TIAs) as initial presenting sign of rhino-orbito-cerebral mycormycosis has not been reported to our knowledge. We report a patient with muconnycosis unusually presenting with recurrent TIAs, followed by central retinal artery occlusion, multiple cranial nerve palsies, and then cerebral infarction in the territory of middle cerebral artery.
Cerebral Infarction ; Cranial Nerve Diseases ; Humans ; Middle Cerebral Artery ; Mucormycosis* ; Retinal Artery Occlusion

PURPOSE: The subconjunctival sparganosis is rare tissue helminthiasis which developed frequently in abdominal, urethral, ureteral and vertebral cases. Authors report a case of sparganosis in the subconjunctival mass. METHODS: A 51-year-old man with reddish non painful mass in his left eye on the subconjunctiva that was unresponsive to medications for 6months was evaluated and treated surgically. On surgical exploration, a white thread-like plerocercoid 0.2 x 4.7 cm in size was extracted from the subconjunctival mass and actively motile in the bottle filled with saline. It was confirmed as a typical sparganum under histologic examination. Three months after surgery, the lesion disappeared completely. RESULTS: Although rare, parasitic disease should be suspected in a palpable subconjuntival mass unresponsive to the medical treatment.
Helminthiasis ; Humans ; Middle Aged ; Parasitic Diseases ; Sparganosis* ; Sparganum ; Ureter

PURPOSE: This research is to evaluate the effectiveness of vitrectomy on early vision recovery compared to that of panretinal photocoagulation for the high-risk proliferative diabetic retinopathy (PDR) patients. METHODS: A retrospective chart review of 84 high-risk PDR patients (100 eyes) who had undergone panretinal photocoagulation or vitrectomy under the diagnosis the high-risk PDR and followed up at least 12 months. Authors divided them into two different groups; one with who received PRP, and another with vitrectomy. We investigated both groups' vision change every 3, 6, and 12 months after the treatment. RESULTS: The Vitrectomy group patients showed higher percentage of vision improvement and lower percentage of vision decrease (p< or =0.05) than the PRP group patients in 3rd and 6th month. Macular edema decreased in the Vitrectomy group and increased in the PRP group in the 3rd month. Need for additional surgery due to complication showed 26% in the PRP group, and 12% in the Vitrectomy group. CONCLUSIONS: We conclude the vitrectomy is more efficient method than PRP for high-risk PDR patients who are in need of early vision recovery.
Diabetic Retinopathy ; Diagnosis ; Humans ; Light Coagulation ; Macular Edema ; Retrospective Studies ; Vitrectomy*

OBJECTIVE: Fetal adrenal gland hormone was known to have close association with fetal weight and labor pain in response to fetal stress. Our purpose was to analyze the correlation between cortisol, DHEA-S in cord blood and obstetric status of fetuses. METHODS: We collected cord blood samples from 60 neonates immediately after delivery of baby. Six cases were complicated by intrauterine growth restriction and fourteen patients were complicated by preeclampsia. We measured cortisol, DHEA-S levels by using the RIA commercial Kits for the ELISA. We performed statistic analysis of the data on the SPSS computer program. RESULTS: Cortisol was significantly higher in intrauterine growth restriction (23.4 +/- 16.2 microgram/dL) statistically than control group (13.7 +/- 9.5 microgram/dL) (P=0.022). Cortisol and DHEA-S had negative correlation each other (P=0.025). DHEA-S was significantly lower in intrauterine growth restriction (1202.2 +/- 1005.9 ng/ mL) than control group (1714.8 +/- 978.6 ng/mL) (P=0.01). DHEA-S had increased with advancing gestational age (P=0.03) and fetal weight (P=0). CONCLUSION: Cord blood cortisol level and DHEA-S level has close association with intrauterine growth restriction and negative correlation with each other.
Adrenal Glands* ; Enzyme-Linked Immunosorbent Assay ; Female ; Fetal Blood ; Fetal Weight ; Fetus ; Gestational Age ; Humans ; Hydrocortisone ; Infant, Newborn ; Labor Pain ; Pre-Eclampsia ; Pregnancy*