BACKGROUND: Acute abdominal pain in children is one of the most common problems encountered in our daily practice. The children often are not able to tell us their exact complain symptoms and differential diagnosis of acute abdominal pain is difficult in its first encounter. When family physicians encounter patients with acute abdominal pain in the ambulatory care settings, they must make an appropriate decision for proper management such as admission, referral, discharge and follow-up without firm diagnosis. If it is possible to predict the course or prognosis of acute abdominal pain by clinical data concerning patient, it will be helpful to make a decision for the management of acute abdominal pain. So we tested for hypothesis that patients with acute intermittent abdominal pain and normal simple abdomen X-ray finding is not serious and shows favorable outcome. METHOD: 82 patients with acute abdominal pain were assessed from Oct. in 1996 to Sep. in 1997 at the emergency department of Kyungju Hospital, Dongkuk University. 69 patients among 82 showed normal simple abdomen X-ray findings. 67 patients were discharged and 2 patients were admitted. 64 patients were contacted by phone call after 1 week and reported their outcome of the previous abdominal pain. RESULTS: Among 64 subjects 36 patients were male and 28 patients female. 57 patients complained of intermittent abdominal pain and 7 patients complained continous abdominal pain. Positive predictive value of intermittent abdominal pain and normal simple abdominal x-ray was 98%. Outcome of patients with intermittent abdominal paln was more favorable than that of continuous pain. CONCLUSIONS: Acute intermittent abdominal pain and normal simple abdomen x-ray findings in children shows favorable outcome and can be managedim ambulatory care settings.
Abdomen ; Abdominal Pain* ; Ambulatory Care ; Child* ; Decision Making* ; Diagnosis ; Diagnosis, Differential ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Gyeongsangbuk-do ; Humans ; Male ; Physicians, Family ; Prognosis ; Referral and Consultation

Hypertensive encephalopathy is characterized by an acute, severe rise in blood pressure associated with headache, nausea, vomiting, altered mental status, and focal neurologic deficits, and rapid improvement after control of blood pressure. An eight-year old boy had been admitted with symptoms of red urine, fever, headache, convulsion, and visual blurring of vision. Blood pressure was 140/90mmHg, and CSF exam revealed WBC 8/mm3, glucose 83mg/dL, protein 106mg/dL. Serum C3 was 8mg/dL, C4 17mg/dL, ASO 1,024 Todd units. Brain CT showed non specific findings, however, MRI revealed symmetric high signal intensity lesions on T2WI over the parieto-occipital areas bilaterally. These lesions had been completely resolved on the following MRI 4 weeks later.
Blood Pressure ; Brain* ; Fever ; Glomerulonephritis* ; Glucose ; Headache ; Humans ; Hypertensive Encephalopathy* ; Magnetic Resonance Imaging* ; Male ; Nausea ; Neurologic Manifestations ; Seizures ; Vomiting

Ovarian tumor in pregnancy is not rare and benign cystic teratoma is most common ovarian tumor in pregnancy. Most ovarian tumor in pregnancy is found at first and second trimester but sometimes found at third trimester and it is difficult to make a decision for management. Moreover physician should consider fetal age and mother's condition, and weigh outcome of operation for complicated ovarian tumor in pregnancy. Torsion of ovarian tumor is not an uncommon complication during first trimester of pregnancy and puerperium but rare occurs during the third trimester of pregnancy. We have experienced a case of torsion of benign cystic teratoma of ovary which occurred at 37 weeks gestation in a 25 year-old woman. So we report this case with a brief review of literature.
Adult ; Female ; Gestational Age ; Humans ; Impetigo* ; Ovary ; Postpartum Period ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnancy* ; Teratoma

No abstract available.
Injections, Intralesional* ; Tuberculosis*

PURPOSE: It has been known that there are several areas of T2 hyperintensities in normal white matter of brain, such as terminal zones of myelination, ependymitis granularis, ones of posterior internal capsule, and perivascular space. The aim of our study is to demonstrate another region of T2 hyperintensities in normal pediatric age group. MATERIALS AND METHODS: We have studied brain MR for 10 normal volunteers and 35 patients without having intracranial lesions in pediatric age group(3-19 years). RESULTS: In 5 among 45 cases, focal T2 hyperintensities were seen in the parietal periventricular white matter beneath the postcentral gyri. They were noted as poorly defined, 5--10mm sized areas of increased signal intensities on T2 weighted axial images. They were also characterized by bilateral, posteromedially oriented, short band-like or oval areas. Interestingly, they were directly continuous with the T2 hyperintensity of posterior internal capsule. In spite of the relatively high frequency in the pediatric population as in our study, this finding has not been reported in the asymptomatic adults. CONCLUSION: The results show that the bilateral anterior parietal hyperintense areas may be another terminal zones of delayed myelination affecting the parietopontine tract. They should be differentiated from pathologic T2 hyperintensities by their characteristic findings.
Adult ; Brain ; Healthy Volunteers ; Humans ; Internal Capsule ; Myelin Sheath ; Rabeprazole*

Paget's disease of the breast occurs almost exclusively in women, and is characterized by a unilateral, sharply defined eczematous skin lesion caused by epidermal metastases from underlying ductal adenocarcinoma of the breast. Paget's disease of the male breast is extremely rare. A 61-year-old patient had a skin lesion on the right nipple for 1 year. The lesion was a well defined, brownish, crusted, and keratotic papule, and was associated with an underlying walnut sized, fixed, hard mass and a palpable ipsilateral axillary lymph node. Histologic findings were consistent with Paget's disease. Results of immunoperoxidase staining technigues for S-100 protein and carcinoembryonic antigen were negative. After a modified radical mastectomy and chemotherapy, the patient has been in remission for 12 months.
Adenocarcinoma ; Breast* ; Carcinoembryonic Antigen ; Drug Therapy ; Female ; Humans ; Juglans ; Lymph Nodes ; Male* ; Mastectomy, Modified Radical ; Middle Aged ; Neoplasm Metastasis ; Nipples ; Paget's Disease, Mammary ; S100 Proteins ; Skin

A case of sporotrichosis misdiagnosed as lupus vulgaris was presented. A 56-year-old woman had been to pea sized, nontender pustules and a hypertrophic-scar-like nodule on the right thigh. She denied any trauma before the lesions developed. Histopathologic findings from the lesion showed tuberculosis-like granulomatous changes. And she was diagnosed as lupus vulgaris. She also had pulmonary tuberculosis and had been treated with antituberculous drugs for 1 year. But skin lesions was not cleared. We suspected the lesions as one of deep mycoses and could confirm sporotrichosis by mycologic studies. They showed characteristic gross colonies and microscopic findings of Sporothrix schenckii..
Female ; Humans ; Lupus Vulgaris* ; Middle Aged ; Mycoses ; Peas ; Skin ; Sporothrix ; Sporotrichosis* ; Thigh ; Tuberculosis, Pulmonary

PURPOSE: Refractory status epilepticus refers to patients who do not respond properly to adequate first-line drug treatment such as diazepam, phenytoin, phenobaribital, lorazepam and show longer than 60 minute seizure. This study was designed to determine the efficacy and safety of midazolam given as a continuous infusion in the treatment of status epilepticus in children. METHODS: Midazolam was infused to twelve children with seizures, for whom two time repeated doses of 0.3mg/kg of diazepam, 20mg/kg of phenobarbital, and 20mg/kg of phenytoin failed to bring the episode under control. All patients received a bolus of midazolam(0.15mg/kg) followed by a continuous infusion at 1microgram/kg/min. The dose was increased every 15 min until the episode of seizure was brought under control. Time required to control seizures, infusion rate, and side-effects were monitored. RESULTS: The mean age of the patient population was 6.06 yrs(range 2 months to 16 yrs; 6 females and 6 males). In 11 patients, seizures were controlled in a mean time of 60.1 min(range 15-180 min). The mean infusion rate was 8.5microgram/kg/min(range 1-20). The total treatment duration was 17.6 days(range 1-54 days). One patient who was confirmed to have cortical dysplasia failed to respond. Two of the patients showed respiratory depression and bradycardia. CONCLUSION: Midazolam is an effective and safe drug to control refractory seizures in children with status epilepticus.
Bradycardia ; Child* ; Diazepam ; Female ; Humans ; Lorazepam ; Malformations of Cortical Development ; Midazolam* ; Phenobarbital ; Phenytoin ; Respiratory Insufficiency ; Seizures ; Status Epilepticus*

No abstract available.
Hand* ; Regional Blood Flow*

No abstract available.