We report two cases of midline granuloma of the face which occurred in 60-year-old man and 28-year old man. The former who wa.s suffered from nasal stuffness on the right nasal cavity for 10 months had yellow-brownish colored crusted erythema tous plaque on the right naris. The latter had painful erythematous swelling on the left lower eyelid and ulceration on the hard palate. Both shows polyrnorphous infiltration of atypical mononuclear cells with an admixture of normal inflammatory cells histopathologically.
Adult ; Erythema ; Eyelids ; Granuloma* ; Humans ; Middle Aged ; Nasal Cavity ; Palate, Hard ; Ulcer

No abstract available.
Korea*

PURPOSE: Febrile seizure, the most common seizure disorder in children between 6 months and 5 years of age, is mostly caused by viral infections, except severe CNS infection. It can also be caused by disorders in organic acid metabolism, especially accompanied by fever. Therefore we decided to investigate the relationship between children with febrile seizures and disorders in organic acid metabolism. METHODS: We examined 54 children with febrile seizure who visited Chunchon Sacred Heart Hospital Emergency Department from February 2002 to January 2004. We conducted urine organic acid analysis, CBC, urine analysis, serum ammonia and gas analysis. RESULTS: Thirteen(24.1%) patients showed ketonuria, eight(14.8%) patients showed lactic aciduria and ketonuria, two(3.7%) patients showed pyruvic aciduria, and one(1.8%) showed mandelic aciduria. CONCLUSION: Twenty four of 54(44.4%) showed abnormal findings in urine organic acid analysis. Most results are ketonuria or lactic aciduria with ketonuria. They may show in fasting, severe infection or ketolytic defect(ex, 3-ketothiolase deficiency). Patients with 3-ketothiolase deficiency, can develop seizures during fever, and fasting state. Therefore further evaluation is necessary.
Acetyl-CoA C-Acyltransferase ; Ammonia ; Child ; Emergency Service, Hospital ; Epilepsy ; Fasting ; Fever ; Gangwon-do ; Heart ; Humans ; Ketosis ; Lactic Acid ; Metabolism ; Seizures ; Seizures, Febrile*

Cyclosporine A is the most frequently used immunosuppressive agent for prevention of graft versus host disease (GVHD) and treatment of frequently relapsing nephrotic syndrome in childhood. Some adverse effects such as hepatic and renal toxicity, have been frequently encountered. But central nervous system toxicity caused by cyclosporine A is rare, and the incidence of encephalopathy among patients recieving cyclosporine A is unknown. Brain magnetic resonance imaging is an essential tool for diagnosis of cyclosporine A neurotoxicity. It typically demonstrates nonenhancing symmetric subcortical, and sometimes deep white matter changes resembling edema with posterior hemisphere predominance. We report a child with nephrotic syndrome who developed encephalopathy during cyclosporine A therapy. Based on this study, we emphasize that careful follow up of patient's neurological finding is very important to prevent serious life-threatening complications.
Brain ; Central Nervous System ; Child* ; Cyclosporine* ; Diagnosis ; Edema ; Follow-Up Studies ; Graft vs Host Disease ; Humans ; Incidence ; Magnetic Resonance Imaging ; Nephrotic Syndrome*

PURPOSE: This study was performed to investigate the change of weight and body composition, and lipid profiles in the idiopathic epileptic children treated with valproate. METHODS: We measured the weight, height, left arm circumference, left triceps skinfold thickness of 30 idiopathic epileptic children treated with valproate before, at 1 month and 4 months of treatment. We also analyzed the serum lipid profiles of the patients before and at 4 months of treatment. We analyzed the change of Body Mass Index (BMI), Arm Muscle Area(AMA), Arm Fat Area(AFA), and the serum lipid profiles. Two-way analysis of variance, chi-square test and paired-t test were used for statistical analysis. RESULTS: There was no statistically significant change in BMI, AFA, AMA of the patients. But the weight of 13(44.3%) children increased greater than 10% with valproate treatment. AMA were not changed, but AFA were significantly increased, 791.2+/-209.6 mm2 before treatment, 858.1+/-246.6 mm2 at 1 month, 1051.7+/-393.2 mm2 at 4 months, in 13 patients, whose weight gain were greater than 10%(P<0.05). There was no change in cholesterols, low density lipoproteins, high density lipoproteins of the 30 children. CONCLUSION: The increase of the weight in the children treated with valproate resulted from the increase body fat. So the weight gain may be a risk factor of obesity
Adipose Tissue ; Arm ; Body Composition ; Body Mass Index ; Child* ; Cholesterol ; Humans ; Lipoproteins, HDL ; Lipoproteins, LDL ; Obesity ; Risk Factors ; Skinfold Thickness ; Valproic Acid* ; Weight Gain*

PURPOSE: The locoregional failure rate remain high in advanced cervical carcinoma. Chemotherpy(CT) was added to radiotherapy(RT) in order to improve therapeutic result. We performed this study to evaluate the response rate, toxicities and survival benefit of neoadjuvant chemotherapy and to investigate potential role of neoadjuvant chemotherapy in treatment of cervical cancer. METHODS AND MATERIALS: The patients(68 cases of cervical cancer) were divided into two groups ; The one group was neoadjuvant chemotherapy followed by radiotherapy(n=30) and the other was the radiotherapy(n=38) group. The patients were maintained by regular follow-up and evaluated with regards to treatment related toxicity and effectiveness by response using World Health Organization criteria and 5-year survival rate. RESULTS: 30 patients were assigned to receive neoadjuvant chemotherapy. After chemotherpy, the overall clinical response rate was 46.7%. The response rate of neoadjuvant chemotherapy followed radiotherapy was higher than that of the radiotherapy in cervical cancer (100% vs 84.2%). The 5-year survival rate of patients was not different between two groups(p>0.05). Toxicities of chemotherapy were generally tolerable and usually well resolved with conservative treatment. CONCLUSION: Neoadjuvant chemotherapy followed radiotherapy help to improve response rate but did not affect survival benefit in the cervical cancer in this study. However, well controlled long-term prospective study will be need to get firm conclusion.
Drug Therapy* ; Follow-Up Studies ; Humans ; Radiotherapy* ; Survival Rate ; Uterine Cervical Neoplasms* ; World Health Organization

OBJECTIVES: This study aims to investigate the variables predicting violent behavior in schizophrenic patients. METHODS: Subjects were 65 schizophrenic patients diagnosed according to DSM-IV. Schizophrenic symptom and the insight of patients were evaluated with the Postive and Negative Syndrome Scale (PANSS) and the Scale of Unawareness of Mental Disorder (SUMD). Violent behaviors were evaluated with the Modified Overt Aggression Scale (MOAS). The State Trait Anger Expression Inventory (STAXI) and the Symptom Checklist-90-Reversion (SCL-90-R) self-reported measures were used for the evaluation of anger state & trait, and general psychopathology. Statistic method used in analized variables were stepwise multiple regression and discriminant analysis as well as t-test. RESULTS: Anger out style, hostility and trait anger variables were extracted as the significant predictors in stepwise multiple regression (37%). Emotion and attitude factors related to anger were more powerful predictor than symptom factors. These three variables could discriminate between violent group and nonviolent group in 72.4%. CONCLUSION: Violent behavior of schizophrenic patients could be predicted more accurately by stable factors such as attitude and emotion related to anger than by symptom factors.
Aggression ; Anger ; Diagnostic and Statistical Manual of Mental Disorders ; Factor VII ; Hostility ; Humans ; Mental Disorders ; Psychopathology ; Schizophrenia

PURPOSE: Since 1997, the quantification of organic acids in urine has become possible in Korea. This helped to diagnose a great variety of inborn errors of metabolism. However, we still don't know the normal value of organic acids in amniotic fluid, therefore it is impossible for doctors to make a correct diagnosis of inborn errors of metabolism in prenatal care. We tried to confirm the normal value of organic acid in amniotic fluid. METHODS: From Jan. 1998 to Dec. 2001, we carried out amniocentesis and were able to obtain 43 samples of amniotic fluid from between 16 and 20 weeks of gestation, and quantified 82 organic acids to come up with a normal value. Organic acid concentrations were quantified with gas chromatography, and the individual acids were identified with mass spectrometry. To isolate organic acids from amniotic fluid, we used a solvent extraction method with ethylacetate. Derivatization was done with MSTFA(N-methy-N-trimethylsilylfluoroacetamide). RESULTS: The results of this study showed that when organic acid concentrations in amniotic fluid were compared with those in urine, TCA cycle intermediates(lactate, pyruvate, malate, 2-ketoglutarate, citrate etc) and ketone body(3-hydroxybutyric acid, acetoacetate etc) were found at significantly higher levels. CONCLUSION: Because TCA cycle intermediate in amniotic fluid is found at high concentrations, we could expect that diagnosis of mitochondria disorder is difficult. Organic acids other than TCA cycle intermediates were undetectable in amniotic fluid. Therefore, prenatal diagnosis of organic acidemias is possible. In our study, the prenatal diagnosis of methylmalonic acidemia could be made by using the measurement of methylmalonic acid in the amniotic fluid taken at high risk pregnancy with a family history of methylmalonic acidemia.
Amniocentesis ; Amniotic Fluid* ; Chromatography, Gas ; Citric Acid ; Diagnosis ; Female ; Humans ; Korea ; Mass Spectrometry ; Metabolism, Inborn Errors ; Methylmalonic Acid ; Mitochondria ; Pregnancy ; Pregnancy, High-Risk ; Prenatal Care ; Prenatal Diagnosis* ; Pyruvic Acid ; Reference Values

Intussusception is a frequent cause of bowel obstruction in the first five years of life and it is one of the most common surgical emergencies in infancy and early childhood. The age of five months child was administered in Department of Pediatrics of Chunchon Sacred Heart Hospital. His main symptoms were vomiting and high fever for three days. Abdominal sonography, air reduction and abdominal computerized tomography (CT) were performed and the conclusion of these study was intussusception due to cyst mass lesion; duplication cyst, mesenteric cyst or Meckel's diverticulum. He was transferred for operation. We had performed laparotomy for reduction of the intussusception. Operative findings revealed ileocolic type of intussusception due to cystic tumor on ileocecal valve that was invaginated into the cecum, and hyperplasia of the Peyer's patch were seen. But we failed manual reduction because of the tumor in the ileocecal area. So we had performed partial resection of the ileocecum. Diverticulum of the ileum was confirmed by pathologic examination. We experienced unusual cause of the intussusception. So we report this case with a review of the literatures.
Cecum ; Child ; Diverticulum* ; Emergencies ; Fever ; Gangwon-do ; Heart ; Humans ; Hyperplasia ; Ileocecal Valve ; Ileum ; Intussusception* ; Laparotomy ; Meckel Diverticulum ; Mesenteric Cyst ; Pediatrics ; Vomiting

The Rh blood group D antigen is the most immunogenic of all antigens, next to ABO antigens. Anti-D immunization is clinically important since it may cause clinical problems, such as severe hemolytic transfusion reactions and hemolytic disease of the newborn. DEL is an extremely weak D variant that cannot be detected by basic serologic typing and is typed as D-negative without the absorption-elution techniques and RHD genotyping. Of the DEL phenotype, RHD (c.1227G>A) allelic variant is the most common in Korea. The DEL phenotype has been considered to carry only a few D antigens to induce anti-D immunization, but a few cases have reported that this allelic variant is capable of inducing anti-D immunization in a D-negative recipient, for which it is clinical significant. Herein, we present a case of primary anti-D alloimmunization in a RhD negative patient after receiving RHD (c.1227G>A) DEL red cell transfusion identified by serological and molecular tests, including RHD genotyping.
Erythrocyte Transfusion* ; Erythrocytes* ; Humans ; Immunization ; Infant, Newborn ; Korea ; Phenotype ; Transfusion Reaction