Three cases of necrotizing vasculitis clinically showing bullous skin lesions and histopathologically confirmed as leukocytoclastic vasculitis are reported. Compared with those of skin -limited non-bullous forms of cutaneous vasculitis, these cases showed relatively frequent abnormalities in urinalysis and required more aggresive corticosteriod therapy. Clinicians should be aware of the possible systemic involvements when the skin lesions are bullous in cutaneous necrotizing vasculitis.
Skin* ; Urinalysis ; Vasculitis*

No abstract available.
Child* ; Humans ; Kidney Transplantation*

Succinylcholine induced hyperkalemia has been reported in many neurologic disorders including subarachnoid hemorrhage. The purpose of this study was to evaluate suceinylcholine induced-hyperkalemia in twenty ruptured cerebral aneuryam patients undergoing general anesthesia for repair of the cerebral aneurysm. Serum potassium levels were measured after induction of anesthesia, but before succinylcholine, and 1, 5 and 10 min after administration of succinylcholine. Serum potassium levels were continuously increased until 10 min after euccinylcholine administration. The increments of serum potassium above 1.0mEq/L were observed in 5 of 9 patients with loss of consciousnesa A relationship between the loss of consciousness and hyperkalemic response after succinylcholine was suggested.
Anesthesia ; Anesthesia, General ; Humans ; Hyperkalemia ; Intracranial Aneurysm* ; Nervous System Diseases ; Potassium* ; Subarachnoid Hemorrhage ; Succinylcholine* ; Unconsciousness

The authors report series of 360 cases of transthoracic fine-needle aspiration cytology (TFNA) from Oct. 1982, through Aug. 1986 at the Seoul National University Hospital. A diagnosis of neoplastic lesion was established in 50.3% of the cases. A non-neop- lastic diagnosis was made in 38.5%, nondiagnostic one in 6.5% and inadequate one in 4.7% of the total. Statistical findings on cytological diagnoses were as follows. Specificity was 100%: sensitivity, 92%; predictive value for positive, 1.0: predictive value for negative, 0.9; concordance rate, 84.2%: diagnostic accuracy in non-neoplastic lesion, 65.4%, and typing accuracy in malignant tumor, 0.77.
Biopsy, Fine-Needle ; Diagnosis ; Glomerulonephritis, IGA* ; Immunoglobulin A* ; Sensitivity and Specificity ; Seoul

Effect of varying hematocrit ratio on the gastric acid production was studied in the heart-stomach preparation of the frog. When the hematocrit ratio was raised by injecting packed red blood cells obtained from the same species of frog, the acid production was increased significantly as compared to the low hematocrit group in which hematocrit ratio was lowered by injecting frog's normal saline. When a small amount of histamine was added to the medium of 25degree C, the acid production was increased in all cases, but the difference in the acid production between the high and the low hematocrit groups was abolished. However, when the temperature of the medium was lowered to 15degree C, the differences in the acid production between the two groups became significant. When a large amount of acetazolamide was added to the medium at 25degree C, the acid production was decreased significantly in both groups without showing a significant difference between the two groups. The reason(s) responsible for the increased acid production in the high hematocrit group was discussed.

OBJECTIVE: The objectives of this study were to obtain information on MIS levels in normal and RDS neonates and to investigate the relationship between the RDS prevalence and MIS level in preterm and term neonates. METHODS: Total 131 male neonates were selected randomly and they were consisted of 50 term normal neonates, 15 term neonates with RDS, 50 prematurely born normal neonates, and 16 prematurely born neonates with RDS. Total 131 female neonates were also selected like male neonates. The venous blood was collected from all subjects and measured the level of MIS using ELISA. The ANCOVA was conducted to evaluate any influence of adjusted value of gestational age and body weight on MIS level between normal neonates and neonates with RDS. RESULTS: 1) The MIS levels of female neonates were significantly lower than those of male neonates with no overlap. 2) The MIS levels of normal female neonates were not significantly different from those of female neonates with RDS. 3) There were significant negative relationships between MIS concentration and gestational age (r=-0.777, p<0.001), and birth weight(r=-0.728, p<0.001) in normal rnale neonates. 4) There were significant negative relationships between MIS concentration and gestational age (r=-0.726, p<0.001), and birth weight(r=-0.725, p<0.001) in male neonates with RDS. 5) After adjusting the value of gestational age, the MIS level of male neonates with RDS was significantly higher than that of normal male neonates(p<0.001). 6) After adjusting the value of body weight, the MIS level of male neonates with RDS was significantly higher than that of normal male neonates(p<0.001). CONCLUSION: Male neonates with RDS had higher MIS levels than normal male neonates of the same body weight or same calculated gestational age. The results of this study suggest that MIS may play a causative or important ancillary role in the sexual dimorphism that characterizes the neonatal RDS and may be used as a predictive marker of RDS in male neonates.
Anti-Mullerian Hormone* ; Body Weight ; Enzyme-Linked Immunosorbent Assay ; Female ; Gestational Age ; Humans ; Infant, Newborn* ; Male ; Parturition ; Prevalence

Renal abscess in childhood is a rare disease, and generally treatment of renal abscesses in childhood follows the guidelines in adults. The guidelines of treatment of renal abscesses in adults include the following:renal abscesses smaller than 3 cm in size can be managed by antibiotics administration, while renal abscesses above 3 cm in size must be considered for percutaneous abscess drainage or open drainage. We experienced a case of a 2 year-old girl with multiple renal abscesses greater than 4 cm in size which resolved by oral antibiotics administration after 2 weeks of intravenous administration. We report this case with literature review.
Abscess* ; Administration, Intravenous ; Adult ; Anti-Bacterial Agents* ; Child, Preschool ; Drainage ; Female ; Humans ; Rare Diseases

PURPOSE: Systemic lupus erythematosus(SLE) is an autoimmune disease with multi-system involvement and renal damage is a major cause of morbidity and mortality in children. Renal involvement is more common and severe in children than in adults. Therefore, renal biopsy plays a crucial role in planning effective therapy. In this study, we investigated the clinical and pathological findings of lupus nephritis in children to aid clinical care of the disease. METHODS: The clinical and pathological data of 40 patients who were diagnosed as SLE with renal involvement in Shinchon Severance Hospital from Jan. 1990 to Sep. 2002 were analyzed retrospectively. RESULTS: The ratio of male to female patients was 1:3 and the median age at diagnosis was 12.1 (2-18) years old. FANA(95.0%), anti-ds DNA antibody (87.5%), malar rash (80.0%) were the most common findings among the classification criteria by ARA. Microscopic hematuria with proteinuria (75.0%), nephrotic syndrome (55.0%), and microscopic hematuria alone (15.0%) were the most common renal presentations in the respective order at diagnosis. There were 27 cases with WHO class IV lupus nephritis confirmed by renal biopsy and 3 cases with pathological changes of WHO class type. Different treatment modalities were carried out : prednisolone only in 5 cases, prednisol-one+azat-hioprine in 9 cases, prednisolone+azathioprine+intravenous cyclophosphamide in 14 cases, prednisolone+cyclosporine A+intravenous cyclophosphamide in 12 cases, plasma exchange in 9 cases and intravenous gamma-globulin in 2 cases. The average follow-up period was 51.8 40.5 months. During 51.8+/-40.5 months. During follow-up, 4 patients expired. The risk factors associated with mortality were male, WHO class IV and acute renal failure at diagnosis. CONCLUSION: Renal involvement was noted in 63.5% of childhood SLE, and 67.5% of renal lesion was WHO class IV lupus nephritis which is known to be associated with a poor prognosis. Therefore aggressive treatment employing immunosuppressant during the early stages of disease could be helpful in improving long-term prognosis. But careful attention should be given to optimize the treatment due to unique problems associated with growth, psychosocial development and gonadal toxicity, especially in children.
Acute Kidney Injury ; Adult ; Autoimmune Diseases ; Biopsy ; Child* ; Classification ; Cyclophosphamide ; Diagnosis ; DNA ; Exanthema ; Female ; Follow-Up Studies ; gamma-Globulins ; Gonads ; Hematuria ; Humans ; Lupus Nephritis* ; Male ; Mortality ; Nephrotic Syndrome ; Plasma Exchange ; Prednisolone ; Prognosis ; Proteinuria ; Retrospective Studies ; Risk Factors ; Treatment Outcome*

No abstract available.
Nephritis, Hereditary*

A case of malignant fibrous histiocytoma(MFH) arising from the pericranium which extend to the calvaria and the dura mater in a 32-year-old man is reported. This tumor presented as scalp induration and headache without any other neurologic abnormalities. Radical excision presented a surgical challenge because of the extensiveness of the lesion. In this case radical excision of pericranial and calvarial lesions were possible, however it is impossible to remove the lesion in the dura mater radically because of its extensiveness. Thus the radiation therapy was necessary after operation. Histologically, pericranial, calvarial and dura mater tumor tissues were same as that of the typical malignant fibrous histiocytoma of the soft tissue. The authors review the literatures of the MFH involving central nerve systems and discuss the management and the radiologic findings of this rare tumor.
Adult ; Dura Mater ; Headache ; Histiocytoma, Malignant Fibrous* ; Humans ; Scalp ; Skull