Henoch-Sh nlein Purpura(HSP) is an immuologically mediated systemic vasculitis of small blood vessels affecting predominantly the skin, gastrointestinal tract, joints, and kidneys. Clinical neurological manifestations such as headaches, behavioral changes, mental changes, seizures, and visual loss are described, but neurological complication are rare during the course of HSP. We experienced a case of an 8 year-old male with HSP who presented with seizures. Magnetic resonance imaging(MRI) showed multiple high signal intensity in both cortical and subcortical areas of frontal and parieto-occipital lobes and magnetic resonance(MR) angiogram showed stenosis of cerebral arteries, compatible with MRI and MR angiogram findings of cerebral vasculitis. We report this case with related literature.
Blood Vessels ; Cerebral Arteries ; Child ; Constriction, Pathologic ; Gastrointestinal Tract ; Headache ; Humans ; Joints ; Kidney ; Magnetic Resonance Imaging ; Male ; Neurologic Manifestations ; Purpura* ; Seizures ; Skin ; Systemic Vasculitis ; Vasculitis, Central Nervous System*

PURPOSE: To report a rare case of an angioleiomyoma involving the orbit. CASE SUMMARY: A 32-year-old male visited our clinic with pain and decreased visual acuity in the left eye, which had developed 1 month prior to admission. Best corrected visual acuity of the left eye had decreased to 0.7, and 3 mm of proptosis was observed. A 1x1 cm sized soft orbital mass was palpated on the lateral area of the left lower eyelid. Funduscopic examination of the left eye revealed multiple horizontal choroidal folds. On magnetic resonance imaging, a well-demarcated tumor was identified that showed hypointense signal intensity on a T1-weighted scan and hyperintense signal intensity on a T2-weighted scan. We performed anterior orbitotomy with an inferior conjunctival forniceal incision. The tumor was well encapsulated and easily dissected and could be completely removed. Histopathologic examination showed many vascular elements and intervascular fibrous stromas composed of spindle cells. The tumor was classified as angioleiomyoma. CONCLUSIONS: Angioleiomyoma should be considered in the differential diagnosis of a well-circumscribed mass lesion involving the orbit.
Adult ; Angiomyoma ; Choroid ; Diagnosis, Differential ; Exophthalmos ; Eye ; Eyelids ; Humans ; Magnetic Resonance Imaging ; Male ; Orbit ; Visual Acuity

PURPOSE: To describe a series of patients with lower eyelid epiblepharon associated with lower eyelid retraction. METHODS: We retrospectively reviewed the medical records of patients who underwent surgery for lower eyelid retraction, epiblepharon, or thyroid-associated ophthalmopathy (TAO) between October 1999 and March 2007. Patients with both lower eyelid retraction and epiblepharon on preoperative examination were included in this study. RESULTS: Twenty-seven eyelids of 20 patients with both lower eyelid retraction and epiblepharon were enrolled. The underlying causes of lower eyelid retraction included congenital retraction (seven eyelids), congenital fibrosis of the extraocular muscles (CFEOM; seven eyelids), TAO (seven eyelids), post-operative cicatricial retraction (five eyelids), and facial nerve palsy (one eyelid). Eight of 27 eyelids were successfully corrected after the repair of retraction without the repair of epiblepharon, regardless of the cause of lower eyelid retraction. Another four eyelids with epiblepharon associated with TAO resolved after only orbital decompression. Cilia-everting sutures were additionally applied for epiblepharon in another 14 eyelids, 12 of which did not require the excision of a skin fold or the orbicularis muscles. Only one eyelid with mild retraction and epiblepharon underwent simple epiblepharon repair. Recurrence of retraction or epiblepharon developed in three eyelids during follow-up. CONCLUSIONS: In cases with both lower eyelid retraction and epiblepharon, the retraction should be repaired first, and then the epiblepharon can be corrected selectively according to the severity of the case.
Adolescent ; Adult ; Child ; Child, Preschool ; Eye Abnormalities/*complications/surgery ; Eyelid Diseases/*complications/surgery ; Eyelids/*abnormalities/surgery ; Graves Ophthalmopathy/surgery ; Humans ; Middle Aged ; Ophthalmologic Surgical Procedures/*methods ; Retrospective Studies ; Young Adult

PURPOSE: To report a rare case of conjunctival myxoma. CASE SUMMARY: A 40-year-old man presented with a nasal bulbar conjunctival mass in his left eye. The mass was a 12 mmx7 mm pinkish movable mass in the subconjunctival space. There was no pain and no tenderness. We diagnosed the case as lymphoma, and we performed excisional biopsy of the mass. Histopathologic examination revealed the tumor to be a myxoma. CONCLUSIONS: When a patient presents with a pinkish, less vessel-appearing, non-pigmented and movable mass of the conjunctiva, conjunctival myxoma should be considered as a possible diagnosis.
Adult ; Biopsy ; Conjunctiva ; Eye ; Humans ; Lymphoma ; Myxoma

PURPOSE: Acute measles encephalitis(ME) is characterized by an abrupt onset of fever and obtundation, frequently accompanied by seizures and multifocal neurological signs. The aim of this study was to clarify the clinical manifestation, progression and the brain SPECT patterns in patients with acute ME. METHODS: This study included 11 children with acute ME admitted to Chonbuk National University Hospital. Ten patients received a first dose of measles vaccine, one patient did not receive a first dose, and no patients received a second dose. ME was diagnosed based on characteristic clinical pictures, measles antibodies by ELISA and abnormal CSF findings. Brain MRI and brain SPECT were performed in 11 patients with acute ME. RESULTS: There were four males and seven females whose ages at onset ranged between 18 months and 14 years(mean : 10.5 years). The main clinical neurologic pictures were loss of consciousness(10) and seizure(five). The titer of IgG and IgM antimeasles antibodies in serum were positive in 10 patients. In CSF, nine patients had IgG antibodies and one patient had IgM antibodies. The concentration of protein(mean : 124+/-60 mg/dL) and WBC counts(mean : 158+/-157/microL) in CSF were elevated in all patients. In electroencephalographic examination, nine patients showed increased slow waves. Seven of 11 patients(63.6%) revealed high signal intensity on the brain MRI. In contrast, all patients showed hypoperfusion in brain SPECT examination. According to brain SPECT, the perfusion deficits were frequently observed in the frontal lobe(nine), temporal (nine), parietal(eight) and thalamus(eight). CONCLUSION: Brain SPECT is more sensitive than MRI for the evaluation of brain damage in early stages of acute ME.
Antibodies ; Brain* ; Child ; Electroencephalography ; Encephalitis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Fever ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Jeollabuk-do ; Magnetic Resonance Imaging ; Male ; Meals* ; Measles ; Measles Vaccine ; Perfusion ; Seizures ; Tomography, Emission-Computed, Single-Photon*

OBJECTIVES: The purpose of this study was to establish normative data for healthy Korean adults by measuring the maximal strength and endurance scores of the tongue, lip, and cheek, and to examine correlations between these measurements. MATERIALS AND METHODS: This study included 120 subjects that were divided into three groups according to age: young (20-39 years), middle-aged (40-59 years), and older (over 60 years); and by gender. Measurements were taken using the Iowa Oral Performance Instrument (IOPI). RESULTS: The mean maximal tongue strengths were as follows: young men (46.7±10.2 kPa) and women (32.1±7.9 kPa), middle-aged men (40.9±9.3 kPa) and women (36.9±8.6 kPa), and older men (35.2±9.0 kPa) and women (34.5±6.9 kPa). The mean tongue endurance scores were: young men (28.8±12.6 seconds) and women (20.8±13.5 seconds), middle-aged men (17.0±8.5 seconds) and women (15.3±5.2 seconds), and older men (15.8±6.7 seconds) and women (17.9±8.1 seconds). The mean maximal lip strengths were: young men (11.6±3.0 kPa) and women (11.4±3.8 kPa), middle-aged men (11.4±4.2 kPa) and women (11.1±5.1 kPa), and older men (14.5±3.9 kPa) and women (11.7±2.6 kPa). The mean lip endurance scores were: young men (41.1±23.9 seconds) and women (22.4±21.7 seconds), middle-aged men (24.3±10.3 seconds) and women (30.5±13.4 seconds), and older men (24.9±11.0 seconds) and women (12.8±7.6 seconds). The mean maximal cheek strengths were: young men (24.5±4.6 kPa) and women (20.5±4.3 kPa), middle-aged men (25.2±6.4 kPa) and women (21.2±5.5 kPa), and older men (22.4±5.3 kPa) and women (18.0±4.8 kPa). The mean cheek endurance scores were: young men (47.8±24.4 seconds) and women (43.9±25.0 seconds), middle-aged men (27.3±11.3 seconds) and women (20.0±14.6 seconds), and older men (21.7±14.5 seconds) and women (17.2±11.4 seconds). CONCLUSION: The data collected in this study will provide an important database of standardized measurements for maximal strength and endurance scores of the tongue, lip and cheek in healthy, normal Koreans.
Adult ; Cheek* ; Female ; Humans ; Iowa ; Lip* ; Male ; Tongue*

PURPOSE: This study was carried out to obtain the vaccination rate and age appropriateness of vaccination in children under five years of age in Jeonbuk province. METHODS: Eight hundred and fifty infants and children were enrolled in this study. Vaccination rate(Number of vaccinees/Number of subjects), places of vaccination, age appropriateness of vacination were examined by either vaccine record review or interview with parents or guardians. RESULTS: The salient features of the findings were as follows : All subjects were aged under five and mostly under two years of age(68.8%). Places of vaccination were health centers or subcenters(50.4%), private clinics(44.3%), and general hospitals(5.3%). Routine vaccinations such as BCG, hepatitis B vaccine(HBV), diphtheria, tetanus, acellular pertussis(DTaP) and Trivalent Oral Polio Vaccine(TOPV), measles, mumps, rubella(MMR), and Japaneses B encephalitis(JBE) were vaccinated mostly in health centers or subcenters, while chickenpox(CHP) and haemophilus influenzae vaccines(Hib), which are not routine in Korea, were vaccinated in private clinics. The vaccination rates of BCG(99.2%), HBV(93.5%) and DTaP(96.1%) were very high. But those of MMR(83.7%), CHP(72.5%), JBE(50.2%), and Hib(15.8%) were lower than expected. Considering the age appropriateness of vaccination, some infants and children were not appropriately vaccinated(vaccination rate/age appropriateness of vaccine; HBV, 93.5%/88.4% : DTaP, 94.6%/73.1% : JBE, 50.2%/ 18.5%). CONCLUSION: The vaccination rate of BCG, HBV, DTaP and TOPV was very high, but MMR, CHP, JBE, and Hib vaccination rate was not high enough to be able to protect against epidemic. We should pay more attention to vaccinating children, and there is a need for a program that will enhance coverage for vaccines.
Child* ; Diphtheria ; Haemophilus influenzae ; Haemophilus influenzae type b ; Hepatitis B ; Humans ; Infant ; Jeollabuk-do* ; Korea ; Measles ; Mumps ; Mycobacterium bovis ; Parents ; Poliomyelitis ; Tetanus ; Vaccination* ; Vaccines

PURPOSE: Acute respiratory distress syndrome(ARDS) is the final course of acute lung injury. It results from various etiological origins and pathophysiologic mechanisms, and has a mortality rate of approximately 60-70%. Although the confirmative incidence of ARDS in children is yet unknown, the increasing incidence of ARDS has been reported in Korea. In the present study, we report ARDS diagnosed at the Clinic for Pediatric Allergy and Respiratory Disease in eleven medical centers nationwide. METHODS: The study was conducted on 42 patients diagnosed with ARDS in Pediatric Allergy and Respiratory Clinics from January, 1995 to August, 1997. We analyzed the clinical course and treatment modalities of the 42 cases of ARDS retrospectively. RESULTS: The total number of patients recruited was 42, including seventeen(40.4%) below 1-year-old. The mean age was 2.0+/-2.3(mean+/-standard deviation) years with a range of 2 months to 10 years, and there was no sex predominance(male/female : 27/15). Twenty-one cases(50.0%) occured during the spring(March, April and May). The major triggering factors of ARDS were viral pneumonia(59.5%) and bacterial pneumonia (19.1%). Mechanical ventilation was used in 37 cases(88.1%). Major complications included pneumothorax, DIC, and gastrointestinal bleeding. The mortality rate was 61.9% of which 16 case (61.5%) occurred before 2 years of age. CONCLUSION: We conducted this study to make a rapid diagnosis and appropriate treatment of ARDS in children, who have major risk factors, to reduce its mortality rate.
Acute Lung Injury ; Child* ; Dacarbazine ; Diagnosis ; Hemorrhage ; Humans ; Hypersensitivity ; Incidence ; Korea ; Mortality ; Pneumonia, Bacterial ; Pneumothorax ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult* ; Retrospective Studies ; Risk Factors

PURPOSE: Acute respiratory distress syndrome(ARDS) is the final course of acute lung injury. It results from various etiological origins and pathophysiologic mechanisms, and has a mortality rate of approximately 60-70%. Although the confirmative incidence of ARDS in children is yet unknown, the increasing incidence of ARDS has been reported in Korea. In the present study, we report ARDS diagnosed at the Clinic for Pediatric Allergy and Respiratory Disease in eleven medical centers nationwide. METHODS: The study was conducted on 42 patients diagnosed with ARDS in Pediatric Allergy and Respiratory Clinics from January, 1995 to August, 1997. We analyzed the clinical course and treatment modalities of the 42 cases of ARDS retrospectively. RESULTS: The total number of patients recruited was 42, including seventeen(40.4%) below 1-year-old. The mean age was 2.0+/-2.3(mean+/-standard deviation) years with a range of 2 months to 10 years, and there was no sex predominance(male/female : 27/15). Twenty-one cases(50.0%) occured during the spring(March, April and May). The major triggering factors of ARDS were viral pneumonia(59.5%) and bacterial pneumonia (19.1%). Mechanical ventilation was used in 37 cases(88.1%). Major complications included pneumothorax, DIC, and gastrointestinal bleeding. The mortality rate was 61.9% of which 16 case (61.5%) occurred before 2 years of age. CONCLUSION: We conducted this study to make a rapid diagnosis and appropriate treatment of ARDS in children, who have major risk factors, to reduce its mortality rate.
Acute Lung Injury ; Child* ; Dacarbazine ; Diagnosis ; Hemorrhage ; Humans ; Hypersensitivity ; Incidence ; Korea ; Mortality ; Pneumonia, Bacterial ; Pneumothorax ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult* ; Retrospective Studies ; Risk Factors

A 35-year old male developed epigastric pain and hematemesis one week before admission. Esophagogastroduodenoscopy was performed and a communication between the esophagus and another opening was discovered. On a follow-up CT and barium esophagogram, a tubular duplication was suspected and the patient was referred to the department of cardio-thoracic surgery. A pathological diagnosis of esophageal duplication (tubular type) was established. The patient was discharged and is currently being followed up. Esophageal duplication is a rare congenital malformation. Moreover, it has not heen reported in Korea that esophageal duplication presents with hematemesis.
Adult ; Barium ; Diagnosis ; Endoscopy, Digestive System ; Esophagus ; Follow-Up Studies ; Hematemesis* ; Humans ; Korea ; Male