Bone imagings have played important role in early detection of acute osteomyelitis. In acute osteomylitis, bone scan findings precede the appearance of bone change on radiograph. Also, recent studies have reported accuracies of bone scan in diagnosis of osteomyelitis ranging from 84% to 100%. But, in above datas, bone scan reading were only qualitative studies. So we have reviewed Technetium-99m labelled methylen dipho sphonate(99mTc-MDP) scan on 21 patients who had been diagnosed acute osteomyelitis by clinical symptoms, blood culture, pus culture and operative findings from January, 1984 to September, 1985. The purpose of this study is to establish the quantitative study of bone scan using computed pixel counting method. The 21 cases were classified into group I and group II according to initial radiographic findihgs. The group I showed normal radiographic finding or soft tissue swelling without osseous change. The group II showed osseous change. The results obtained were as follows: 1. We obtained positive bone scans in the all cases which were confirmed acute osteomyelitis. 2. We experienced diagnosis of acute osteomyelitis by bone scan which was confirmed as early as 48 hours after onset of clinical symptom. 3, In group I, the average uptake ratio of 99mTc-MDP was 3.22±0.82 ranging from 2.20 to 4.80. 4. In group II, the average uptake ratio of 99mTc-MDT was 6.20±2.27 ranging from 4.00 to 9.40. (p <0.001).
Diagnosis ; Early Diagnosis ; Humans ; Methods ; Osteomyelitis ; Radionuclide Imaging ; Suppuration ; Technetium Tc 99m Medronate

A 26-year-old female presented herself to our clinic due to noduloulcerative lesions of one month duration on her face and trunk with accompaning headache and mild fever. In family history, her husband was reported to have a history of chaner. On physical examinat.ion, rice sized eythematous papules and bean sized nodules with central ulceration were seen on the face and trunk. VDRL was 1:31 positive. A skin biopsy iif a noduloulcerative lesion showed ulceration, vascular dilatation with fibrinoid changes and perivascular inflarnmatory cellu infilt.rations, especially plasma cells. Immunoperoxidase stain showed T. pallidum at the epidermis and papillary dermis. The diagnsis was made asecondary syphilis with unusual clinical presentation as noduloucerative skin lesions. The skin lesions completely disappeared one month after treatment with injection of benzathine pelnicillin G 2.4 million unit intramuscularly weekly for three times.
Adult ; Biopsy ; Dermis ; Dilatation ; Epidermis ; Female ; Fever ; Headache ; Humans ; Plasma Cells ; Skin ; Spouses ; Syphilis* ; Ulcer

OBJECT: Peripheral blood stem cells(PBSC) were collected after remission induction chemotherapy and reinfused after intensified chemotherapy in order to increase the chemotherapeutic efficacy. METHOD: Collection of mononuclear cells(MNC) was started when CD34+ cells above 1% and WBC above 1,000/ul with mononuclear cell percentage above 30%, the collection procedures were done 2-6 times in each patient of total 6 cases. The collected MNCs were stored in -75 degrees C and reinfused after thawing in the water bath at 37 degrees C. RESULTS: Twenty three collection procedures from the 6 cases of acute leukemia had made effective MNC collection in 4 cases and mean collection efficiency was 49.8%(from 39.0% to 74.5%). Hematological changes after the procedure were mean reduction of hemoglobin 1.34g/dl and mean 20.25% of decreased platelet count. There were noticed transient symptoms of discomfort, coughing, chest tightness and dyspnea in association with the infusion of stored cells. CONCLUSION: The basic process for the peripheral blood stem cell transplantation(PBSCT) was accomplished with this supportive care for the consolidation chemotherapy of acute leukemia. Effective PBSCT would be warrented with more qualified process and high dose chemotherapy.
Baths ; Consolidation Chemotherapy ; Cough ; Drug Therapy* ; Dyspnea ; Humans ; Leukemia* ; Platelet Count ; Remission Induction ; Stem Cells* ; Thorax ; Water

Ultrasonograhy, it's excellent ability of differentiating cystic from solid lesion and depicting detailedarchitecture, proved itself useful in the diagnosis of thyroid pathologies. Adanced high resolution equipmentsmade hidden small lesion detected and finer structure clearly seen. They seemed to throw light on the histologicaldiagnosis of thyroid diseases, especially differentiation of benignancy and malignancy. Author reviewed picturesof high-resolution ultrasonography of thyroid disease(24 ases0 and correlated them witn proven pathologicalfindings. The results were as follows: 1. Multiplicity of lesion favors benignancy(4 cases). 2. Well definedmargin favors benignancy(14/17), while ill defined margin favors malignancy(3/4), and lesion of no margin favorsthyroiditis(3/3). 3. Surrounding halo favors benignancy(7 cases). 4. Hypoechogenicity were found in most ofmalignancy and thyroiditis. Cystic components in solid nodule were common findings in bening and malignantlesions. Calcification was not found in malignancy.
Diagnosis ; Pathology ; Thyroid Diseases ; Thyroid Gland ; Thyroid Nodule ; Thyroiditis ; Ultrasonography

Examining the eye with high resolution ultrasonography, authors encountered 34 cases(41 eyeballs) of cataractand found out its characteristic ultrasonographic findings, though cataract is easily recognized by physician oninspection. Ultrasonographic findings of cataract were as follows; 1. Thickening of lens due to edema. 2.Demonstration of lens echo in whole circumference. 3. Multiple internal lens echo.
Cataract ; Edema ; Ultrasonography

BACKGROUND: With respect to the risk of developing diabetic vascular complications, the central purpose of most screening and detection program, is to identify people with diabetes at early stage so they might have advantages of early treatment to prevent complication of the disease. Oral glucose tolerence test(OGTT) is widely used for diagnosis of diabetes and impaired glucose tolerence, bit the performance of a complete OGTT is not only time consuming and expensive but physically demanding on the individual being tested. Determination of HbA1 and more recently of glycosylated total serum proteins(fructosamine) has been proposed as an alternative method of screening and diagnosis. The aim of our cross-sectional study is to compare the values of fructosamine and HbA1, for the ourpose of diabetes diagnosis with the OGTT as reference method. METHODS: In the study, from January 1996 to August 1996, we included 55 consecutive subjects in Kyeungssang Hospital. Blood samples for HbA1 and fructosamone determination were drawn at the same time as a fasting plasma glucose sample, and then all subjects underwent a standard 2-hour OGTT according to the World Health Organization recom-mandations, The subjects were classified according to the American Diabetes Association classification. RESULTS: In our study, we observed fasting plasma glucose of 145.32+/-75.00mg/deciliter, two-hour plasma glucose of 245.83+/-155.22mg/deciliter, HbA1 of 7.06+/-2.77%, and fructosamine of 308.77+/-128.23 micromol/liter. The correlation coefficient between FPG and HbA1 was 0.9098(p<.05), between FPG and fructosamine 0.7953(p Blood Glucose ; Classification ; Cross-Sectional Studies ; Diabetic Angiopathies ; Diagnosis* ; Diagnostic Tests, Routine ; Fasting ; Fructosamine* ; Glucose ; Glucose Tolerance Test ; Hemoglobin A, Glycosylated* ; Mass Screening ; ROC Curve ; World Health Organization

BACKGROUND: To reduce life-threatening complication of childhood acute immune thrombocytopenic purpura (ITP), high-dose intravenous immnuoglobulin G (IVIG) therapy has been used since 1981 by Imbach, et al. Several methods of dose and duration of IVIG therapy have been developed. But total doses were 2 g/kg in most of them. To reduce the total doses, we tried to use IVIG according to the patient's response. This study was conducted to evaluate the effect of low-dose and short-term immunoglobulin therapy for childhood acute ITP according to individual clinical course. METHODS: This study was conducted in 73 childhood acute ITP who was diagnosed at the Department of Pediatrics, Kyungpook National University Hospital from September, 1983 to August, 1993. Until June, 1985, IVIG (400mg/kg/day) was given for 5 days in 9 children regardless of the increment of platelet count, but after then IVIG was not given basically when the platelet count was increased above 100,000/mm3. The time to reach targeted platelet count and the rate of relapse and conversion to chronic ITP were evaluated. RESULTS: The mean age was 5.5 years and male to female ratio was 1.4 : 1 and the median duration of follow up was 2.1 years. Among 47 cases who were followed up over 6 months, 13 cases (17.7%) were chronic. The mean days of IVIG therapy was 2.3 days. the mean platelet count was 15,770+/-13,730/mm3 at diagnosis. The paltelet count began to rise above 50,000/mm3 at 2.3 days, 100,000/mm3 at 2.8 days and 150,000/mm3 at 3.5 days of IVIG therapy. But the platelet count was not increased above 100,000/mm3 in 11 cases among those who were given over 4 days or more IVIG therapy. The relapse and the chronic ITP was less developed in rapid responders at the level of 50,000/mm3 than in slow responders (P<0.05). CONCLUSION: The short-term (less than 4 days) IVIG therapy is desirable for effect and cost in childhood acute ITP.
Child ; Diagnosis ; Female ; Follow-Up Studies ; Gyeongsangbuk-do ; Humans ; Immunization, Passive ; Immunoglobulin G* ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Male ; Pediatrics ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic* ; Recurrence

PURPOSE: Intracranial hemorrhage (ICH) in hemophilia patients is the most common cause of death in Korea. Early suspicion and prompt treatment of ICH is a very important for saving their life and minimizing neurologic sequelae. We investigate the prognosis of the hemophilia patients with ICH who registered in Daegu & Kyungpook area. METHODS: We evaluated the clinical courses, laboratory findings, brain image, effect of treatment and prognosis of ICH. Nine of 161 patients registered in our Department of Pediatrics suffered 16 episodes of ICH from Dec. 1996 to Mar. 2002. RESULTS: All were male hemophilia A patients (severe; 5, moderate; 3 and mild; 1) with median age of 48 (17~312) months at diagnosis of ICH. Two patients who had inhibitor became negative and one patient who had found inhibitor on annual routine follow-up has had inhibitor until now. One had trauma history and seven had family history. The median time interval from first symptom to hospital visit was 7 hours (15 minutes~10 days). Chief complaints were vomiting in 6 patients, headache in 4, seizure in 3 and mental change in 1. All patients except one were initially given factor VIII concentrate, 50 units/kg and then continuous infusion, 2~3 units/kg/hour. One patient who had factor VIII inhibitor was given factor IX concentrates, 100 units/kg with activated prothrombin complex (FEIBA ), 75 units/kg at every 12 hours. All except one with hematoma in cerebellar vermis and the third ventricle are alive without any neurologic sequela. CONCLUSION: ICH in hemophilia patients can be severe with no trauma history, or can be recurred several times with life-threatening event. So, it is desirable to have early treatment, prophylaxis, regular follow-up and patient education about abnormal symptoms to reduce the complications of them.
Brain ; Cause of Death ; Daegu ; Diagnosis ; Factor IX ; Factor VIII ; Follow-Up Studies ; Gyeongsangbuk-do ; Headache ; Hematoma ; Hemophilia A* ; Humans ; Intracranial Hemorrhages* ; Korea ; Male ; Patient Education as Topic ; Pediatrics ; Prognosis ; Prothrombin ; Seizures ; Third Ventricle ; Vomiting

PURPOSE: During the follow-up period of the patient who was diagnosed as rhabdomyosarcoma and treated between 1991 and 1992 in Kyungpook National University Hospital (KNUH), the residual mass lesion on computerizing tomography (CT) was suspected as tumor progress. But, it was diagnosed as necrotic tissue by excisional biopsy and he has survived without recurrence until now. So, we have the necessity of the method that is able to differentiate the remnant tumor with necrotic tissue during or after treatment. The objective of this study was to evaluate prospectively the effectiveness of thallium (Tl-201) scan in detecting the bioavailability of tumor at diagnosis and after treatment. METHODS: CT and/or magnetic resonance imaging (MRI) and Tl-201 scan at diagnosis, during the treatment and after treatment were conducted in 19 solid tumor patients treated for their diseases from December 1996 to June 1998, in Pediatric Department of KNUH. And we evaluated the recurrence of solid tumors following them up to March 2001. RESULTS: In the cases of the presence of solid tumor in CT or MRI at diagnosis, we could also find them on Tl-201 scan in all of them. During the treatment, PNET patient had the mass lesion on MRI and Tl-201 scan, we kept going on the chemotherapy and radiotherapy. And retinoblastoma patient also had continued chemotherapy after confirming the mass lesion on MRI, not Tl-201 scan. Six cases (alveolar soft part sarcoma, medulloblastoma, Ewing sarcoma, Non-Hodgkin's lymphoma, rhabdomyosarcoma, neuroblastoma) in which no mass lesion were found in CT or MRI and Tl-201 scan had their final therapy. After finishing the treatment, high-grade anaplastic astrocytoma patient confirmed the mass lesion on MRI and Tl-201 scan and expired irrespective of retreatment after 19 months of diagnosis. In 2 cases of solid tumor on CT scan, not on Tl-201 scan, germ cell tumor patient has been followed up until now without recurrence with normal alpha-FP level, and NHL patient has survived without recurrence. Four cases (Non-Hodgkin's lymphoma; 2 cases, medulloblastoma; 1 case, ependymoma; 1 case) with negative finding on CT or MRI and Tl-201 scan also has survived without recurrence. CONCLUSION: Although CT or MRI is used commonly in the follow-up period of childhood solid tumor, Tl-201 scan can be the useful method of differentiating viable tumor with necrotic tissue in the view of cost-effectiveness and availability.
Astrocytoma ; Biological Availability ; Biopsy ; Diagnosis ; Drug Therapy ; Ependymoma ; Follow-Up Studies ; Gyeongsangbuk-do ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin ; Magnetic Resonance Imaging ; Medulloblastoma ; Neoplasms, Germ Cell and Embryonal ; Neuroectodermal Tumors, Primitive ; Prospective Studies ; Radiotherapy ; Recurrence* ; Retinoblastoma ; Retreatment ; Rhabdomyosarcoma ; Sarcoma ; Sarcoma, Ewing ; Thallium* ; Tomography, X-Ray Computed

Certain natural anticoagulants are known to play critical roles on the control of hemostasis in addition to the physiologic role of fibrinolysis. Major antiproteases of this group include antithrombin III, protein C, protein S, alpha-2-antiplasmin, alpha-2-macroglobulin, etc. There has been increasing recognition of the importance of the control of coagulation and fibrinolysis, both by certain physiologic processes and by natural inhibitors. Especially, activated protein C (protein Ca) and its cofactor, protein S, now are recognized as significant modulators of fibrinolysis, thrombosis and hemostasis. Children and adults with decreased levels of either protein are at increased risk from thrombosis. We experienced a 5 year-old girl patient with cerebral infarction who initially presented with abnormal movement of left extremities. She had lacunar infarction in the posterior limb of the right internal capsule and hypoplastic left carotid artery on brain MRI and MR angiography. She was diagnosed to have protein S deficiency with the level of 43% in the screening test of hypercoagulable state. She remains clinically well after heparin and warfarin treatment with regular follow-up of prothrombin time. A brief review of the literature ensues with the case report.
Adult ; alpha-2-Antiplasmin ; Angiography ; Anticoagulants ; Antithrombin III ; Brain ; Carotid Arteries ; Cerebral Infarction* ; Child ; Child, Preschool ; Dyskinesias ; Extremities ; Female ; Fibrinolysis ; Follow-Up Studies ; Hemostasis ; Heparin ; Humans ; Internal Capsule ; Magnetic Resonance Imaging ; Mass Screening ; Protease Inhibitors ; Protein C ; Protein S Deficiency* ; Protein S* ; Prothrombin Time ; Stroke, Lacunar ; Thrombosis ; Warfarin