No abstract available.
Child* ; Humans ; Rhabdomyosarcoma*

Neurologic complications of Epstein-Barr virus (EBV) infection are diverse including a number of neurologic diseases such as encephalitis, encephalomyelitis, Guillain-Barre syndrome, optic neuritis, acute disseminated encephalomyelitis, cerebellitis, and Alice-In-Wonderland syndrome. In general encephalitis caused by EBV in children has been considered a self-limited disease with few or no sequelae. Occasionally it leaves a severe neurologic sequela and complications. Therefore administration of high dose acyclovir and steroid in early stages of EBV encephalitis is recommended currently. In this case, the patient of a 8-year-old boy was admitted because of generalized tonic seizure of 2 times. He showed 16% of atypical lymphocytosis in peripheral blood smear and positive findings in VCA-IgM and EA-IgM tests. EBV DNA Antibody, and virus PCR in CSF was not evaluated. He also showed hepatosplenomegaly in abdominal sonography. Brain MRI revealed a bilateral increased signal intensity at lenticular nucleus and caudate nucleus, multiple high signal intensity at cortical layer of both gyrus reti, both frontal, inferior parietal, and dorsal aspect of the right paracentral lobue. As mentioned in serologic and imaging study, he was diagnosed as the EBV- associated encephalitis. Although we administered high dose acyclovir and corticosteroids, he showed clinical deterioration with confusion, delirium, and ataxia. Therefore, we administered additional high dose intravenous immunoglobulin, and finally he was recovered. We report the case of improvement of EBV-associated encephalitis after high-dose Intravenous immunoglobulin therapy.
Acyclovir ; Adrenal Cortex Hormones ; Ataxia ; Brain ; Caudate Nucleus ; Child ; Corpus Striatum ; Delirium ; DNA ; Encephalitis* ; Encephalomyelitis ; Encephalomyelitis, Acute Disseminated ; Guillain-Barre Syndrome ; Herpesvirus 4, Human* ; Humans ; Immunization, Passive* ; Immunoglobulins* ; Lymphocytosis ; Magnetic Resonance Imaging ; Male ; Optic Neuritis ; Polymerase Chain Reaction ; Rabeprazole ; Seizures

Neurologic complications of Epstein-Barr virus (EBV) infection are diverse including a number of neurologic diseases such as encephalitis, encephalomyelitis, Guillain-Barre syndrome, optic neuritis, acute disseminated encephalomyelitis, cerebellitis, and Alice-In-Wonderland syndrome. In general encephalitis caused by EBV in children has been considered a self-limited disease with few or no sequelae. Occasionally it leaves a severe neurologic sequela and complications. Therefore administration of high dose acyclovir and steroid in early stages of EBV encephalitis is recommended currently. In this case, the patient of a 8-year-old boy was admitted because of generalized tonic seizure of 2 times. He showed 16% of atypical lymphocytosis in peripheral blood smear and positive findings in VCA-IgM and EA-IgM tests. EBV DNA Antibody, and virus PCR in CSF was not evaluated. He also showed hepatosplenomegaly in abdominal sonography. Brain MRI revealed a bilateral increased signal intensity at lenticular nucleus and caudate nucleus, multiple high signal intensity at cortical layer of both gyrus reti, both frontal, inferior parietal, and dorsal aspect of the right paracentral lobue. As mentioned in serologic and imaging study, he was diagnosed as the EBV- associated encephalitis. Although we administered high dose acyclovir and corticosteroids, he showed clinical deterioration with confusion, delirium, and ataxia. Therefore, we administered additional high dose intravenous immunoglobulin, and finally he was recovered. We report the case of improvement of EBV-associated encephalitis after high-dose Intravenous immunoglobulin therapy.
Acyclovir ; Adrenal Cortex Hormones ; Ataxia ; Brain ; Caudate Nucleus ; Child ; Corpus Striatum ; Delirium ; DNA ; Encephalitis* ; Encephalomyelitis ; Encephalomyelitis, Acute Disseminated ; Guillain-Barre Syndrome ; Herpesvirus 4, Human* ; Humans ; Immunization, Passive* ; Immunoglobulins* ; Lymphocytosis ; Magnetic Resonance Imaging ; Male ; Optic Neuritis ; Polymerase Chain Reaction ; Rabeprazole ; Seizures

Diagnosing pseudoaneurysms of the popliteal artery is usually straightforward in physical examinations and imaging findings. However, when a pseudoaneurysm shows a soft tissue mass with adjacent osseous change, it can mimic a bone tumor or a soft tissue sarcoma. We present a case of a 65-year-old man who had a pseudoaneurysm of the popliteal artery showing soft tissue mass and insinuating into the intramedullary cavity of the tibia. This presented case emphasizes the importance of considering pseudoaneurysms in the differential diagnosis of an apparent soft tissue mass with pressure erosion in adjacent bone.
Aged ; Aneurysm, False ; Diagnosis, Differential ; Humans ; Hydrazines ; Physical Examination ; Popliteal Artery ; Sarcoma ; Tibia

PURPOSE: The purpose of this study is to evaluate ventricular functional changes in Kawasaki disease using tissue Doppler echocardiographic measures with conventional echocardiographic measures. METHODS: Tissue Doppler imaging and conventional Doppler echocardiography were performed in 69 patients with Kawasaki disease and 39 healthy children. Peak velocities of systolic(Sa) and early(Ea), late(Aa) diastolic motion of mitral annulus were obtained at the lateral and septal side from apical 4 chamber view. RESULTS: Sa(7.7+/-1.8 cm/s vs 8.8+/-2.1 cm/s, P=0.01) and Ea(15.7+/-3.2 cm/s vs 17.2+/-3.3 cm/s, P=0.03) measured at lateral mitral annulus were significantly lower in patients with Kawasaki disease. Aa(7.0+/-2.0cm/s vs 6.2+/-1.3 cm/s, P=0.01) measured at septal mitral annulus were statistically higher in patients with Kawasaki disease. There was no significant difference in coronary arteriopathy patients compared with non-coronary arteriopathy patients in Kawasaki disease. In conventional mitral and pulmonary venous flow velocities, there was significant difference of E in Kawasaki disease patients. The ratio of E/Ea and flow propagation velocity(Vp) demonstrated difference in Kawasaki disease patients. CONCLUSION: Peak mitral annular velocities obtained by tissue Doppler imaging were significantly altered in acute phase of Kawasaki disease. Tissue Doppler imaging with conventional Doppler echocardiography can be a promising method for evaluation of ventricular function in patients with Kawasaki disease.
Child ; Echocardiography ; Echocardiography, Doppler ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Ventricular Function*

This study evaluated the pharmacokinetic profile and therapeutic efficacy of piroxicam (PX), a long acting non-steroidal anti-inflammatory drug for the treatment of arthritis, following intra-articular (IA) injection in comparison to the pharmacokinetic profile and therapeutic efficacy of PX after intramuscular (IM) injection. In the pharmacokinetic study in rats, systemic exposure and pharmacokinetic parameters of PX after a single IA dose were compared with systemic exposure and pharmacokinetic parameters of PX after administration of the same dose IM (0.6 mg/kg). The anti-inflammatory and analgesic effects of IA PX were evaluated simultaneously in a monoiodoacetate-induced osteoarthritis rat model. The plasma PX concentration rapidly rose following IA injection, and it was comparable to the plasma PX concentration following IM injection, suggesting the rapid efflux of the drug molecule from the joint cavity. However, in the efficacy study, the IA PX administration significantly reduced the knee swelling by reducing the level of prostaglandin E2 in the joint, compared to that following administration of IA vehicle and after administration of the IM PX dose. In addition, we found that the anti-inflammatory and anti-nociceptive efficacies of IA PX were synergistically increased upon co-treatment with hyaluronic acid (HA), a potent agent for the treatment of osteoarthritis, at the weight ratio of 1:1 or 1:2, and these effects were more pronounced than those following administration of HA or PX alone. In conclusion, this study demonstrated the efficacy of the IA use of PX alone and/or in combination with HA in osteoarthritis.
Animals ; Arthritis ; Dinoprostone ; Hyaluronic Acid ; Injections, Intra-Articular ; Joints ; Knee ; Models, Animal ; Osteoarthritis ; Pharmacokinetics* ; Piroxicam* ; Plasma ; Rats*

PURPOSE: The estimation of fluid deficit is crucial to the proper management of dehydrated children. Without well-documented serial weights on the same scale, the estimation of any given child's fluid deficit is imprecise and dependent largely on subjective clinical criteria. Despite the abundance of literature on clinical and laboratory evaluation of dehydration, few studies have focused on serum uric acid. So, we examined the usefulness of serum uric acid in gastroenteritis patients with dehydration. METHODS: Medical records of 90 gastroenteritis patients were retrospectively reviewed. By the body weight loss, we classified patients with mild, moderate, and severe dehydration groups. We studied the relevance of laboratory data (BUN, creatinine, serum bicarbonate, glucose, urine specific gravity, and uric acid) with dehydration. RESULTS: 54 children (60%) were dehydrated mildly, 24 (26%) dehydrated moderately, and 12 (14%) dehydrated severely. Statistically significant differences in BUN, creatinine, serum bicarbonate, glucose, and urine specific gravity could not be observed. But there was significant relationship between uric acid and the degree of dehydration. Data analysis suggested that the level of 7.0 mg/dL is the best cut-off value for predicting the development of moderate or severe dehydration. At this cut-off value, the sensitivity and specificity were 66.6% and 87.1%. CONCLUSION: Our study supports that the measurement of serum uric acid with traditional scales is useful for predicting the development of dehydration. But, in order to be used as the indicator for proper treatment at an earlier stage, further validation about serum uric acid is necessary.
Body Weight ; Child ; Creatinine ; Dehydration* ; Gastroenteritis* ; Glucose ; Humans ; Medical Records ; Retrospective Studies ; Sensitivity and Specificity ; Specific Gravity ; Statistics as Topic ; Uric Acid* ; Weights and Measures

Meckel's diverticulum is an embryologic derivative of the omphalomesenteric duct and the most commonly encountered congenital anomaly of the gastrointestinal tract, affecting 1% to 2% of the general population. Although this prevalence is relatively low, Meckel's diverticulum is occasionally encountered as an incidental identification during abdominal exploration and can be associated with several life-threatening disease states, such as massive intestinal bleeding, intestinal obstruction, or on rare occasion, perforation. The management of a Meckel's diverticulum found incidentally on laparotomy is controversial because the rate of complications developing from the diverticulum remains uncertain. The data in this report are based on 18 cases of Meckel's diverticulum which were treated at the Department of Surgery, InJe University Sanggye Paik Hospital, during the 7 years between January 1990 and December 1996. The results are as follows: 1) The overall sex ratio of males to females was 5 : 1 and in the symptomatic group, the ratio was 6 : 1. 2) Ninety percent of the patients were under 40 years of age, and 56% were under 10. 3) The diverticula were located from 20 cm to 100 cm proximal to the ileocecal valve, and the average range was 53 cm from the ileocecal valve. Fifteen cases were located at the antimesenteric border, and 3 cases at the mesenteric border of the ileum. 4) The lengths of the diverticula ranged from 1cm to 6cm, and the diameters ranged from 0.5 cm to 4.5 cm. 5) Appendicitis and intestinal obstruction were the most frequent preoperative diagnoses in the symptomatic group. 6) The common complications were intestinal obstruction and inflammation. 7) Heterotopic tissues were found in three patients and all of them were ectopic gastric mucosa. 8) The treatment was a diverticulectomy or a segmental resection of the involved bowel. 9) Postoperative complications were found in three of the asymptomatic group: two early intestinal obstructions and one wound infection.
Appendicitis ; Choristoma ; Diagnosis ; Diverticulum ; Female ; Gastric Mucosa ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileocecal Valve ; Ileum ; Inflammation ; Intestinal Obstruction ; Laparotomy ; Male ; Meckel Diverticulum* ; Postoperative Complications ; Prevalence ; Sex Ratio ; Vitelline Duct ; Wound Infection

PURPOSE: This randomized clinical trial was conducted to assess the safety and effectiveness of the ErhBMP-2 in alveolar bone regeneration as well as preservation of the beta-TCP bone graft material that contains ErhBMP-2. MATERIALS AND METHODS: This study involved 72 patients at the 3 study centers. The patients, who were divided into 2 groups: the experiment group who had ErhBMP-2 coated TCP/HA and the control group who had TCP/HA graft material alone transplanted immediately after tooth extraction. CT was taken before and 3 months after the transplantation and healing status was compared between the two groups. The efficacy endpoints that were used to measure the degree of bone induction included alveolar bone height and 3 measurements of bone width. The paired t test was used to determine the significance of the changes (P<.05). RESULTS: Changes in alveolar bone height were -1.087 +/- 1.413 mm in the control group and -.059 +/- 0.960 mm in the experimental group (P<.01). At 25% extraction socket length [ESL], the changes were 0.006 +/- 1.149 mm in the control group and 1.279 +/- 1.387 mm in the experimental group. At 50% ESL, the changes were 0.542 +/- 1.157 mm and 1.239 +/- 1.249 mm, respectively (P<.01 for 25% ESL, and P<.05 for 50% ESL). During the experiment, no adverse reactions to the graft material were observed. CONCLUSION: ErhBMP-2 coated beta-TCP/HA were found to be more effective in preserving alveolar bone than conventional beta-TCP/HA alloplastic bone graft materials.
Bone Regeneration ; Calcium Phosphates ; Escherichia ; Humans ; Tooth Extraction ; Transplants

Primary adenosquamous carcinoma arising from the papilla of Vater is an extremely rare tumor. Here we report a case of adenosquamous carcinoma of the duodenal major papilla. The patient was a 56-year-old man presenting with abdominal discomfort and anorexia. A computed tomography (CT) scan showed dilatation of the common bile duct (CBD) and both intrahepatic ducts with a suspicious mass in the distal CBD. Duodenoscopy revealed a mass with an irregular surface at the papilla. The patient underwent Whipple's operation. He was diagnosed as having adenosquamous carcinoma of the papilla of Vater. Eighteen months after pancreaticoduodenectomy, metastatic lymph nodes were noted in a follow-up CT scan.
Ampulla of Vater ; Anorexia ; Carcinoma, Adenosquamous ; Common Bile Duct ; Dilatation ; Duodenoscopy ; Follow-Up Studies ; Humans ; Lymph Nodes ; Middle Aged ; Pancreaticoduodenectomy