A 68-year-old female had slightly elevated, dusky erythematous nodules on the right infraorbital and the right temple area. Topical, intralesional corticosteroids and oral antihistamines provided temporary but incomplete improvement. Follow up biopsy, four months after the first visit revealed a tiny gold acupuncture needle lodged at the center of the nodule. Subsequent skull series revealed seven more linear radiopaque densities on the corresponding sites to the skin nodules. A patch test and an intradermal test with gold chloride showed strongly positive reactions. Removal of the embedded needles led to disappearance of the cutaneous nodules and itching sensation in seven days.
Acupuncture* ; Adrenal Cortex Hormones ; Aged ; Biopsy ; Female ; Follow-Up Studies ; Histamine Antagonists ; Humans ; Hypersensitivity* ; Intradermal Tests ; Needles* ; Patch Tests ; Pruritus ; Sensation ; Skin ; Skull

Allogenic peripheral blood stem cell transplantation could be used instead of allogenic bone marrow in treatment of leukemia in children. This 10-year-old female patient with high-risk acute lymphoblastic leukemia received a myeloablative regimen followed by allogenic peripheral blood stem cell transplantation from an HI A-identical sibling donor. Neutrophil recovery to greater than 500/pL occurred at day 11 and platelets recovered to greater than 20,000/pL at day 13. Allogenic peripheral blood stem cell transplantation can be performed safely and may result in a rapid neutrophil and platelet engraftment, without any apparent increased risk of acute graft versus host disease.
Blood Platelets ; Bone Marrow ; Child* ; Female ; Graft vs Host Disease ; Humans ; Leukemia ; Neutrophils ; Peripheral Blood Stem Cell Transplantation* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Siblings ; Tissue Donors

Neonatal Gaves disease is a relatively rare condition due to transplacental passage of Thyroid-stimulating antibody(TSAb) from a mother with active or inactive Graveses disease or autoimmune thyroiditis. A 11-day-old female newborn was referred to our department of pediatrics from a local clinic because of low level T4(3.55microg/dl) concurrent with high level TSH (501.74uIU/ml) on the 5th day neonatal metabolic screening. But, our repeated laboratory data showed very high serum T4(59.6microg/dl), T3(1,600ng/dl), suppressed TSH(0.43uIU/ml), and the presence of TSH receptor antibody. Her mother was treated with propylthiouracil(PTU) for Graves disease during pregnancy. Therefore, we thought it was a delayed-onset neonatal hyperthyroidism, because the fetal thyroid gland was initially suppressed by antithyroid drug taken during pregnancy. After initiating antithyroid drug therapy for the hyperthyroid nature, TSH levels became elevated again, while thyroid hormone levels decreased. Maternal and infant blood samples at the 23th day after birth were examined for serum autoantibodies directed towards the TSH receptor(Thyrotropin-binding inhibitory immunoglobulin:TBII, Thyroid-stimulating antibody:TSAb, Thyroid-stimulating blocking antibody:TSBAb) and high levels of TBII and TSAb were detected. About 2 months after birth, TBII and TSAb decreased within normal limit, and then we could stop antithyroid medication in safety. We report here a case of neonatal Graveses disease with very high level of T4 and T3, but firstly presented as hypothyroid nature on neonatal screening because of the maternally transferred antithyroid drug, PTU.
Autoantibodies ; Drug Therapy ; Female ; Graves Disease ; Humans ; Hyperthyroidism ; Infant ; Infant, Newborn ; Mass Screening ; Mothers ; Neonatal Screening ; Parturition ; Pediatrics ; Pregnancy ; Receptors, Thyrotropin ; Thyroid Gland ; Thyroiditis, Autoimmune

This randomized control pilot study quantified the efficacy of interactive virtual reality golf training on balance performance among community mobile older person. Eight older women were assigned randomly to a conventional mat exercises program group (n = 4, mean age = 51 ± 1.6 years old) or an experimental group that participated in interactive virtual reality golf (n = 4, mean age = 53.5 ± 1.4 years old). Balance assessments of all participants included Multi-Directional Reach Test (MDRT), Step Up Test (SUT), Double Leg Static Balance (DLSB) with eyes open and closed and excursion of centre of pressure (COP) sway quantified with a force plate. One subject dropped out from the experimental group and three subjects from the conventional mat exercise group due to work commitments to complete the once a week study for four weeks. No significant differences in base-line balance abilities were found between groups. The experiment group did not have significant improvements in balance capability compared with control subjects (MDRT p = 0.16-0.66; SUT p = 0.05; COP during DLSB p = 0.18-0.66). However, virtual reality golf intervention improved medial-lateral sway by 57.24% during DLSB compared to 14.99% after floor-mat exercises. The improvement in COP during DLSB after interactive virtual reality golf hints towards improved postural control. Further studies with a larger population should explore using off-the shelf interactive virtual reality sports for balance training. This novel technology can complement rehabilitation programs.

PURPOSE: About 10% of girls with Turner syndrome may have autoimmune thyroid disease(AIT), but the disease's pathophysiology has not yet been elucidated. Accordingly, this study was performed to observe whether the pathogenesis of AIT in children with Turner syndrome and without Turner syndrome correlate with special loci of DQ and chain in HLA. METHODS: Blood samples were drawn from children with and without Turner syndrome. Thyroid antibodies(anti-thyroglobulin and anti-microsomal antibody) were measured from the samples to determine AIT. DNAs were extracted with the DNA extraction kit and processed in PCR reaction for amplification of exon 2 region of HLA-DQA1 and -DQB1, and then eluted again. The eluted PCR products were sequenced directly with an automatic sequencer. The sequences were compared with those of normal control. RESULTS: There was a signficant increase in frequencies of HLA DQA1*0301(P<0.05) and HLA DQB1*0601 but without statistical significance(P=0.06) in normal children with AIT, compared with those in control group. There was signficantly but slightly increased frequency of HLA DQA1*0104, 0105 and DQB1*0202 in the group of children with Turner syndrome who had AIT than in control group. The frequency of the marker chromosome(45,X/46,XX+mar) increased in children with Turner syndrome who had AIT, compared with these in children with Turner syndrome who did not have AIT. Children with Turner syndrome who had spontaneous puberty had higher a incidence rate of AIT than those who did not have spontaneous puberty(P<0.01). CONCLUSION: The results suggest that HLA DQA1*0301 and HLA DQB1*0601 play a role in the pathogenesis of AIT in children without Turner syndrome, but not in children with Turner syndrome. Additionally, there seem to be other factors participating in the pathogenesis of AIT in children with Turner syndrome, such as chromosomal karyotype and spontaneous puberty. Therefore, the factors participitating in the pathogenesis of AIT in children with Turner syndrome remain to be elucidated with further study.
Adolescent ; Child* ; DNA ; Exons ; Female ; Humans ; Incidence ; Karyotype ; Polymerase Chain Reaction ; Puberty ; Thyroid Diseases* ; Thyroid Gland* ; Turner Syndrome*

PURPOSE: We investigated the prevalence rate of benign prostatic hyperplasia (BPH) among Korean males in a rural area through a cross-sectional, community-based epidemiologic survey and analyzed the correlation with epidemiologic factors. MATERIALS AND METHODS: A total of 779 males who lived in Yangpyeong County participated in a prostate examination campaign. Targeting these men, we collected the International Prostate Symptom Score (IPSS), medical history, demographic information, serum prostate-specific antigen, and prostate volume as measured by transrectal ultrasonography. The data for 599 participants were analyzed, excluding 180 men who had a possibility of prostate cancer. BPH was defined as an IPSS of 8 points or higher and a prostate volume of 25 mL or more. RESULTS: The prevalence rate of BPH was 20.0%. The prevalence rate increased with age. There were 2 subjects (4.4%) in the age group of 40-49 years, 18 subjects (10.9%) in the age group of 50-59 years, 44 subjects (22%) in the age group of 60-69 years, and 56 subjects (26.6%) in the age group of over 70 years; this increase with age was statistically significant (p<0.001). In the BPH group, the average IPSS was 14.67+/-5.95, the average prostate volume was 37.04+/-11.71 g, and the average prostate-specific antigen value was 1.56+/-0.88 ng/mL. In the analysis of correlations between the epidemiologic factors and the risk of BPH, smoking was the only statistically significant factor. CONCLUSIONS: The total prevalence rate of BPH in this study was 20.0%, which was a little lower than the rate reported in other cities or rural areas.
Adult ; Age Distribution ; Aged ; Community-Based Participatory Research ; Cross-Sectional Studies ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Prevalence ; Prostate/ultrasonography ; Prostate-Specific Antigen/blood ; Prostatic Hyperplasia/*epidemiology ; Republic of Korea/epidemiology ; Rural Population/statistics & numerical data ; Smoking/adverse effects

Background: The decreased use of cord blood units (CBU) due to improvements in haploidentical transplantation is a financial burden for public cord blood banks. Currently, there is no guidance regarding the length of cryopreservation of CBU in Korean public banks. The relative quality of long-term storage CB (LTCB) and short-term storage CB (STCB) needs to be evaluated to establish a storage policy. Methods: Thirty-four and thirty-one units of CB cryopreserved for less than one year and up to 14∼15.5 years, respectively, in the Busan Gyeongnam Public Cord Blood Bank were assessed. The total nucleated cells (TNCs), CD34+ cell counts, and colony-forming units-granulocyte monocyte (CFU-GM) were examined. The cell viabilities were evaluated by Eosin-Y exclusion staining and 7-aminoactinomycin D flow cytometry. The number of stored Korean public CB units from 2000 to 2016 was determined and categorized according to TNCs. Results: The post-thawing viability of the STCBs measured by flow cytometry was consistently higher than that of the LTCBs (TNCs, 62.5% vs 57.3%; MNCs, 93.1% vs 88.9%; CD34+ cells 95.7% vs 94.0%). The CD34+ cell viability was significantly higher in STCB (P=0.03). The CFU-GM after thawing was higher in STCBs (61.5±23.4 vs 49.9±22.8 [0.95 mm 2 ] P=0.05). Of the 48,161 CB units stored until 2016, Dec, 9,493 (19.7%), which were stored until 2006, had been stored for more than 10 years. Conclusion LTCB with a low number of cells (＜0.7×10 9 cells) should be considered to exclude from storage for therapeutic purposes to improve the storage efficiency.

BACKGROUND AND OBJECTIVES: High-resolution computed tomography provides an excellent method for examination of the middle ear, inner ear anatomy and pathologic changes in the temporal bones. The purpose of this study was to get various measurements of the external auditory canal and temporal bones, and to compare the changes with age and sex. MATERIALS AND METHOD: The various measurements by CT of the external ear canal of normal 50 ears were done. RESULTS: The obtained results were as follows: 1) In both male and female group, the distance from the medial end of EAC to bony-cartilage junction, the distance from medial end of EAC to the lateral end of cartilage, the distance from the superior wall to the inferior wall (coronal EAC isthmus) and the distance from anterior wall to the posterior wall (axial EAC isthmus) increased significantly with age (p<0.05). 2) Compared with the female group, the male group had longer distance from the posterior tympanic plate to the sinus tympani with age (p<0.05). 3) Compared with male group, the female group had longer distance from the posterior EAC wall to the Sigmoid sinus and from the EAC superior wall to the tegmen tympani with age (p<0.05). 4) In both male and female groups, the anterior and inferior angles increased and the posterior and superior angles decreased with age (p<0.05). CONCLUSION: Computed tomographic evaluation can give us to information to operate external ear, middle ear, and inner ear surgery.
Cartilage ; Colon, Sigmoid ; Ear ; Ear Canal* ; Ear, External ; Ear, Inner ; Ear, Middle ; Female ; Humans ; Male ; Temporal Bone*

Anti-phospholipid syndrome is characterized by the occurrence of venous or arterial thrombosis in the presence of anti-phospholipid antibodies and is associated with morbidity during pregnancy. Arterial thromboses are less common than venous thromboses and most frequently manifest with features consistent with ischemia or infarction. Only a few cases of arterial thrombosis with primary anti-phospholipid syndrome have been reported in Korea. We report a 41-year-old man with anti-phospholipid syndrome who had abdominal pain due to a recurrent renal infarction, and we review the literature on anti-phospholipid syndrome.
Abdominal Pain ; Antibodies ; Antiphospholipid Syndrome ; Infarction ; Ischemia ; Kidney ; Korea ; Pregnancy ; Thrombosis ; Venous Thrombosis