Spontaneous rupture of subcapsular liver hematoma in pregnancy is rare but potential life threatening complication of preeclampsia. We experienced a case of spontaneous rupture of subcapsular hematoma of liver that was treated with conservative method. So, we present the case with a brief review of literatures as first report in Korea.
Hematoma* ; Korea ; Liver* ; Pre-Eclampsia ; Pregnancy* ; Rupture, Spontaneous

PURPOSE: A significant proportion of patients with cough variant asthma (CVA) eventually develops asthma. The aim of this study was to investigate the relationship between bronchial hyperresponsiveness (BHR) and development of asthma in preschool children with CVA. METHODS: We reviewed the medical records of children aged 5 to 7 years who presented with chronic cough and had regular check-up by the school age. All children had methacholine bronchial challenge test (MBCT) at preschool age with a modified auscultation method. The end-point was defined as the appearance of wheezing and/or oxygen desaturation. Positive BHR was defined as end-point concentration (EPC)< or =8 mg/mL. MBCT was performed at the school age with spirometric method. Positive BHR was defined as PC20< or =8 mg/mL. We collected information on the development of wheezing or dyspnoea from the medical records. RESULTS: Thirty-six children with CVA were analyzed. During follow-up (2.1+/-0.9 years), 9/36 children developed wheezing or dyspnoea (group A), and 27/36 children did not (group B). EPC (geometric mean, 95% confidence interval) was significantly lower in group A than group B (1.59 mg/mL, 0.93 to 2.70 mg/mL vs. 3.43 mg/mL, 2.34 to 5.03 mg/mL; P=0.02, respectively). The prevalence of positive BHR at school age was significantly higher in group A than group B (77.8% vs. 22.2%, P<0.01). CONCLUSION: These results suggest that the increase and the persistence of BHR may have an important role in the development of asthma during the course of CVA in preschool children.
Aged ; Asthma ; Auscultation ; Bronchial Provocation Tests ; Child ; Child, Preschool ; Cough ; Follow-Up Studies ; Humans ; Medical Records ; Methacholine Chloride ; Oxygen ; Phosphorylcholine ; Prevalence ; Respiratory Sounds

Herein, a new left renal vein stenting procedure (expandable metallic stent placement), which provided relief for an 18-year-old man incapacitated by an intermittent gross hematuria, is reported. The placement of an expandable metallic stent is a minimally invasive therapy, and a simpler and more physiological therapy than previous approaches to Nutcracker syndrome.
Adolescent ; Hematuria ; Humans ; Renal Veins ; Stents*

No abstract available.
Cyclosporine ; Peroneal Neuropathies

The authors recently found a mistake in their previously published article.

PURPOSE: It is important to assess the level of control in asthmatic children who were well-controlled and thus discontinued controller medications. Office spirometry has been regarded to provide objective measures. We aimed to see time changes in lung function indices measured by the office spirometry and their relationship to clues for asthma exacerbation after discontinuation of controller medications. METHODS: As a pilot study, a total of 20 well-controlled children with persistent asthma were included. After discontinuing controller medications, each made follow-up visits at the 2nd, 6th, and 12th week. At each visit, spirometric values before and after bronchodilators were evaluated by the office-based spirometer. Time changes and their relationship to clues for asthma exacerbation were assessed. RESULTS: Among 20 children, 13 (65%) were successfully followed-up for 12 weeks with asthma kept stable. They presented similar spirometric values (forced expiratory volume in 1 second [FEV1], peak expiratory flow rate [PEFR], bronchodilator responses [BDRs] based on the FEV1 and PEFR) across all time-points. No differences in spirometric values were found between those who were stable and those who exhibited clues for asthma exacerbation. BDRs calculated from FEV1 values (BDRFEV1) correlated well with those calculated from PEFR values (BDRPEFR). CONCLUSION: When controller medications were discontinued in children with well-controlled asthma, many of them were able to maintain the stable condition. Since the spirometric measures including BDR failed to differentiate clues for asthma exacerbation, the usefulness of office spirometry needs to be reevaluated by the larger population of children with controlled asthma after discontinuing medications.
Asthma ; Bronchodilator Agents ; Child ; Follow-Up Studies ; Humans ; Lung ; Peak Expiratory Flow Rate ; Pilot Projects ; Spirometry

Chondroblastoma is a rare benign cartilaginous neoplasm that accounts for approximately 1% of all bone tumors and characteristically arises in the epiphysis of a long bone, particularly the humerus, tibia, and femur. Chondroblastoma can affect people of all ages. It is, however, most common in children and young adults between the ages of 10 and 20 years. Although most chondroblastomas are cured by limited surgical procedures, occasional lesions behave more aggressively and may even metastasis. In this case a young man with pulmonary metastatic chondroblastoma on spine is presented. Unlike previously published examples of metastatic chondroblastoma, these metastasis developed before any operative manipulation of the primary tumor. And primary tumor site was also unusual. The histologic characteristics of the primary, metastatic tumors were those of a conventional chondroblastoma.
Child ; Chondroblastoma ; Epiphyses ; Femur ; Humans ; Humerus ; Lung ; Neoplasm Metastasis ; Spine ; Tibia ; Young Adult

Cyclooxygenase (COX)-1 and -2 expressions in the incisional wound healing of mouse skin were determined by immunohistochemistry and Western blot analysis. By Western blotting, compared to normal skin, COX-2 activity was increased at days 1, 4, 8, and 12 and was maximal at 4 day after incisional wound of mouse skin whereas COX-1 was barely detectable. In normal skin, COX-1 immunostaining was observed among the basal cells of epidermis whereas COX-2 immunostaining was detected in the more differentiated, suprabasal keratinocytes. At 1~4 days after wound, COX-2 staining was particularly prominent in the inflammatory cells, and at day 8, many macrophage-like cells were stained positively. COX-2 immunoreactive fibroblast, macrophage-like cells, and newly formed vascular endothelial cells were increased in number at 12 days after incision. These data suggest that COX-2 is constitutively expressed, just as is COX-1, in epidermis and is associated with keratinocyte differentiation. In addition, these findings support the well-established role for COX-2, the prostaglandins that they generate, as mediators of inflammatory response.
Animals ; Blotting, Western ; Endothelial Cells ; Epidermis ; Fibroblasts ; Immunohistochemistry ; Isoenzymes* ; Keratinocytes ; Mice* ; Prostaglandin-Endoperoxide Synthases* ; Prostaglandins ; Skin* ; Wound Healing* ; Wounds and Injuries*

A 29-month-old boy presented with fever, dyspnea, and paleness. He was initially diagnosed with pneumonia and severe sepsis. Although he was treated with intravenous antibiotics and high dose methylprednisolone, dyspnea and paleness recurred two times. Under suspicion of pulmonary hemosiderosis, we performed video-assisted thoracoscopic lung biopsy and bronchoalveolar lavage on him and found hemosiderin-laden macrophages in both specimens. Despite thorough history and laboratory examination, we could not find any pathologic or serologic evidence for primary and secondary causes of pulmonary hemosiderosis except for one that indicating Heiner's syndrome. After taking oral prednisolone he showed improvement of anemia and dyspnea, which was maintained by milk avoidance. Based on the history and the existence of immunoglobulin G antibodies against milk components, we are considering it as the case of Heiner's syndrome.
Anemia ; Anti-Bacterial Agents ; Antibodies ; Biopsy ; Bronchoalveolar Lavage ; Dyspnea ; Fever ; Hemosiderosis ; Immunoglobulin G ; Lung ; Lung Diseases ; Macrophages ; Methylprednisolone ; Milk ; Milk Hypersensitivity ; Pneumonia ; Prednisolone ; Sepsis

PURPOSE: Dyspnea is the cardinal symptom of asthma, but it is difficult to quantify clinically. Although modified Borg (mBorg) scale has been successfully used in adult, but there has been some difficulties to apply in children. Recently, Pediatric Dyspnea Scale (PDS) was adequately designed and has been widely used. The aim of this study is to compare 2 evaluating scales of dyspnea provoked by induced-bronchoconstriction in childhood asthma. METHODS: Seventy-three clinically suspected children with asthma were enrolled in this study. Each ‘fractional exhaled nitric oxide (FeNO)’ was documented. Forced expiratory volume in 1 second (FEV₁), mBorg score and PDS score were recorded during methacholine provocation test. RESULTS: Mapping using canonical plot demonstrated global similarity between 2 scales with some distinctive features. Whereas mBorg score showed more diverse categories in low level of dyspnea, PDS score did in medium level of it. A distribution of dyspnea perception score at a 20% decrease in FEV₁ relative to baseline (PS₂₀), a perception score of dyspnea at 20% fall in FEV1 of 2 scales represented similar wide, biphasic feature. Statistical relevance was verified with spearman correlation (R(s)=0.903, P<0.001) and Bland-Altman analysis. PS₂₀ of both scores and FeNO had no statistical relationship. While relationship between PS20 by mBorg score and the concentration of methacholine at 20% fall in FEV₁ (PC₂₀) was not significant (R(s)=0.224, P=0.154), that between PS₂₀ by PDS and PC₂₀ was weak positive (R(s)=0.29, P=0.063). CONCLUSION: PDS had similar pattern to assess the dyspnea with the mBorg scale suggesting adequacy of PDS in evaluating pediatric clinical asthma. We expect these scales to help clinical practice in complementary ways.
Adult ; Asthma* ; Bronchial Provocation Tests ; Bronchoconstriction* ; Child* ; Dyspnea* ; Forced Expiratory Volume ; Humans ; Methacholine Chloride ; Nitric Oxide ; Weights and Measures