No abstract available.
Accidents, Traffic* ; Aggression*

A 6-year-old girl visited us with a 4-week history of inflammatory, pustular, tender patches and plaques on the scalp, and a 3-day history of multiple, erythematous, indurated, tender, subcutaneous nodules on both pretibial areas. A swab was taken from the scalp lesion and colonies of Tiichophyton mentagrophytes grew on culture. The histopathological findings of the leg nodule were consistent with erythema nodosum. The patient was treated with oral itraconazole and deflazacort, combined with topical potassium permanganate solution. Erythema nodosum regressed two weeks later and the kerion of the scalp regressed six weeks after starting the treatment, leaving residual scarring alopecia. The patient was diagnosed as erythema nodosum probably induced by kerion celsi, that has not been reported in the Korean literature.
Alopecia ; Child ; Cicatrix ; Erythema Nodosum* ; Erythema* ; Female ; Humans ; Itraconazole ; Leg ; Potassium Permanganate ; Scalp ; Tinea Capitis*

A 12-year-old girl presented with a 1-week duration of hair loss associated with splitting of the hair ends and whitish dots on the occipital hairs. On microscopic examination, a longitudinal splitting of the hair shaft with reconstitution of the normal hair distal to the fracture, nodular swellings, with the appearance of broomsticks pushed into one another, at the site of whitish swellings, and the flattening and twisting of the hair shaft around the long axis were demonstrated. Minor trauma to injury-prone hair is a common cause of hair shaft defects, however the reports with the combined conditions are insufficient in the literature. We describe a patient with central trichoptilosis associated with localized trichorrhexis nodosa and pili torti.
Axis, Cervical Vertebra ; Child ; Female ; Hair ; Humans

PURPOSE: To evaluate the surgical results of segmental scleral buckling procedures in pseudophakic retinal detachments. METHODS: We retrospectively analyzed the surgical results of 35 patients (35 eyes) undergoing only segmental scleral buckling procedures in pseudophakic retinal detachments, who had been postoperatively followed up 6 months or longer. RESULTS: The average age of patients was 58.4 +/- 14.8 and twenty-five of the 35 patients were male. Posterior capsule was ruptured in 14 eyes, and among the 14, 5 eyes had vitreous prolapse. The primary success rate of segmental scleral buckling procedures was 100% (21/21 eyes) in intact posterior capsules, and 64.3% (9/14 eyes) in ruptured posterior capsules. The causes of failure were proliferative vitreoretinopathy (2 eyes) and failure to close the retinal breaks (3 eyes). CONCLUSIONS: We suggest that segmental scleral buckling procedure may be an effective method for the management of retinal detachments in pseudophakia if without posterior capsule ruptures.
Capsules ; Humans ; Male ; Prolapse ; Pseudophakia ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Retrospective Studies ; Rupture ; Scleral Buckling* ; Vitreoretinopathy, Proliferative

PURPOSE: Recently, vancomycin-resistant enterococci (VRE) have become one of the major nosocomial pathogens in Korea. However, there have been few studies on the epidemiology of VRE colonization among neonates. In this study, we investigated the prevalence of VRE colonization, risk factors for VRE, and how to control the spread of VRE infection in the Neonatal Intensive Care Unit (NICU) of Pusan National University Hospital (PNUH). METHODS: We retrospectively reviewed medical records of 192 neonates who were admitted to the NICU of PNUH from March 2006 to March 2007. Surveillance cultures from rectal swabs for detecting VRE were obtained weekly during the study period. We analyzed the prevalence of VRE and various risk factors. RESULTS: The rate of VRE colonization among NICU patients was 25% (48/192). Thirty five of these VRE colonized patients were transferred to the NICU from other local hospitals. Compared with the non-VRE group, the risk factors associated with VRE colonization were lower birth weight, congenital heart disease, applied mechanical ventilation, use of a central venous catheter, chest tubing, a history of surgery, and use of antibiotics. CONCLUSION: VRE colonization among patients admitted to the NICU is rapidly increasing. Monitoring and managing premature neonates from the beginning of the birth process, avoiding many invasive procedures, avoiding antibiotics such as vancomycin and third generation cephalosporin are important for preventing the emergence and spread of VRE colonization in the NICU.
Anti-Bacterial Agents ; Birth Weight ; Central Venous Catheters ; Colon ; Heart Diseases ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Korea ; Medical Records ; Parturition ; Prevalence ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Thorax ; Vancomycin ; Vancomycin Resistance

BACKGROUND: The HMG-CoA reductase inhibitor is the most powerful cholesterol lowering drug and lovastatin, simvastatin and pravastatin are used clinically. We studied the efficacy and side effects of pravastatin monotherapy in patients with hypercholesterolemia(type IIa or IIb). METHODS: Patients who showed 12-hours fasting serum total cholesterol level more than 240mg% were enrolled to diet therapy. After 4weeks of diet therapy, serum lipid profiles were checked and the drug therapy was considered according to NCEP guidelines. The pravastatin 5mg po bid was administrated and the patients had regular follow-up every 2weeks for 8week. RESULTS: The total study population was 20 patients and the mean age of them was 55 years old (55+/-18, M : F=6 : 14). There were a few side effects in 5% of study patients and no patient discontinued pravastatin due to side effects.The side effect was G-I trouble and there were not other side effects. Serum CK was elevated in only one patient but the elevation was mild(less than 3 times) and transient. The LFT, serum uric acid, BUN and creatinine level did not show any significant changes during therapy. Among lipid profiles, total cholesterol, LDL-cholesterol and apolipoprotein B level showed significant reduction after therapy and the maximum reduction was achieved after 2week of therapy. The mean reduction was 20%, 33% and 23% respectively. HDL-cholesterol and apolipoprotein A1 11% and 17% respectively. The triglyceride level did not show any changes during therapy but in one type IIb patient, the triglyceride level decreased significantly. CONCLUSIONS: The pravastatin is effective and safe in patients with hypercholesterolemia.
Apolipoprotein A-I ; Apolipoproteins ; Cholesterol ; Creatinine ; Diet Therapy ; Drug Therapy ; Fasting ; Follow-Up Studies ; Humans ; Hypercholesterolemia* ; Lovastatin ; Middle Aged ; Oxidoreductases ; Pravastatin* ; Simvastatin ; Triglycerides ; Uric Acid

Mitochondrial DNA (mt DNA) and the non-recombining region of the Y chromosome are passed down, unaltered, from generation to generation, matrilineally and patrilineally, respectively. Therefore, the Y-chromosome DNA and mtDNA are known as lineage markers, and they play important roles in studies based on human migration and evolutionary history. Y-chromosome DNA is used in forensic analysis to identify individuals involved in cases of sexual assault. In this paper, we review the methods of statistical evaluation of lineage markers used in forensic identification. We also review the combined approach of autosomal and lineage marker evidence.
DNA ; DNA, Mitochondrial ; Human Migration ; Y Chromosome

BACKGROUND: Fluid overload prior to continuous renal replacement therapy (CRRT) is an important prognostic factor. Thus, precise evaluation of fluid status is necessary to treat such patients. In this study, we investigated whether fluid assessment using bioelectrical impedance analysis (BIA) can predict outcomes in critically ill patients requiring CRRT. METHODS: A prospective observational study was performed in patients who were admitted to the intensive care unit and who required CRRT. BIA was conducted before CRRT; then, the ratio of extracellular water to total body water (ECW/TBW) was derived to estimate volume status. RESULTS: A total of 31 patients treated with CRRT were included. There were 18 men (58.1%), and the median age was 67 years (interquartile range, 51 to 78 years). Fourteen patients (45.2%) died within 28 days after CRRT initiation. Patients were divided into 16 with ECW/TBW ≥0.41 and 15 with ECW/TBW <0.41. Survival rate within 28 days was different between the two groups (P = 0.044). Cox regression analysis revealed a relationship between ECW/TBW ≥0.41 and 28-day mortality, but it was not statistically significant (hazard ratio, 3.0; 95% confidence interval, 0.9 to 9.8; P = 0.061). Lastly, the area under the curve of ECW/TBW for 28-day mortality was analyzed. The area under the curve of ECW/TBW was 0.73 (95% confidence interval, 0.54 to 0.92), and this was significant (P = 0.037). CONCLUSIONS: Fluid status can be assessed using BIA in critically ill patients requiring CRRT, and BIA can predict mortality. Further large trials are needed to confirm the usefulness of BIA in critically ill patients.
Body Water ; Critical Illness* ; Electric Impedance* ; Humans ; Intensive Care Units ; Male ; Mortality ; Observational Study* ; Prospective Studies* ; Renal Replacement Therapy* ; Survival Rate ; Water

No abstract available.
Lymphangioleiomyomatosis*

PURPOSE: This study was performed to be helpful in early diagnosis and treatment of the children with peptic ulcer disease. METHODS: The authors observed 36 children with peptic ulcer disease who had been admitted to Hanyang University Hospital during the 11 year 4 mont period from January 1981 to April 1992 retrospectively. The diagnosis was established in 33.3% by gastric endoscopy, in 25% by upper gastrointestinal barium study, in 11.7% by gastric endoscopy and upper gastrointestinal barium study simultaneously, and in 30% by emergency operation. RESULTS: 1) Age and sex incidence of chidlren with peptic ulcer disease(3 days to 16 years old) showed that males predominated in a proportion of 8:1 and 83.3% were 7 years of age or older. Under the age of 7, the incidence of gastric ulcer was greater than that of duodenal ulcer and above the age of 7 duodenal ulcer was 2.6 times more frequent than gastric ulcer. 2) The chief comlaints on admission were abdominal pain in 17 patients(47%), hematemesis or melena in 15 patients(25%), vomiting in 6 patients(16%). There was a tendency that abdominal pain also increased as the age increased. 3) Most common blood type among 13 patients with duodenal ulcer was Rh+O type(53.8%). 4) Of the 15 children who had gastrointestinal bleeding, 10(43.3% of duodenal ulcer) were doudenal ulcer and 4(33.3% of gastric ulcer) were gastric ulcer. Severe anemia(Hb<7g/dl) was shown in only 5 patients with duodenal ulcer. 5) According to the region of the ulcer, 20(86.9%) of 23 children with doudenal ulcer had ulcers in doudenal bulb and 8(66.7%) of 12 children with gastric ulcer had ulcers in antrum. 6) 18 children with duodenal ulcer, 7 children with gastric ulcer and 1 child with gastroduodenal ulcer had complications. Of the 26 children, bleeding occured in 10 children, perforation occured in 7 children and obstruction occured in one child. 7) 23 children were treated medically and 13 children were treated surgically. 11 patients received operation due to panperit unitis(perforation), 1 patients(71%) were treated medically, however, under 7 year of age, 5 patients(62%) received surgical treatment. Surgical methods used were primary closure(4 patients), vagotomy with pyloroplasty(1 patients), subtotal gastrectomy with gastrojejunostomy(7 patients) and antrectomy with gastroduodenostomy(1 patients). CONCLUSIONS: We conclude that it is important to diagnose early peptic ulcer disease in children, who have nonspecific symptoms and signs above mentioned, to prevent possible complications including failure to thrive.
Abdominal Pain ; Barium ; Child* ; Diagnosis ; Duodenal Ulcer ; Early Diagnosis ; Emergencies ; Endoscopy ; Failure to Thrive ; Gastrectomy ; Hematemesis ; Hemorrhage ; Humans ; Incidence ; Infant* ; Male ; Melena ; Peptic Ulcer* ; Retrospective Studies ; Stomach Ulcer ; Ulcer ; Vagotomy ; Vomiting