No abstract available.
Infant, Newborn ; Jaundice, Neonatal* ; Radionuclide Imaging* ; Technetium Tc 99m Disofenin*

No abstract available.
Child* ; Gait* ; Humans

BACKGROUND: A virus-associated hemophagocytic syndrome(VAHS) is a non-neoplastic, generalized histiocytic proliferation with prominent hemophagocytosis associated with a systemic viral infection. Although VAHS is generally a benign process, Epstein-Barr virus- associated hemophagocytic syndrome(EBV-AHS) is often fatal and has a high mortality rate. Therefore, clinical and laboratory findings, virology studies, treatment and prognosis in EBV- AHS are reviewed. METHODS: We retrospectively analyzed various clinical datas of 7 patients who were diagnosed as EBV-AHS by EBV panel test, mRNA in situ hybridization(1 case) and diagnostic guidelines of Histiocyte Society and followed up to the Department of Pediatrics, Severance Hospital, Yonsei University Medical College from January 1990 to December 1997. RESULTS: The mean age at diagnosis was 2.8 years(range; 0.8~5.4). EBV-AHS was caused by reactivation of EBV in 6 cases and primary infection in 1 case. Persistent fever and hepatosplenomegaly were observed in all cases. Hyperferritinemia was detected in 5 cases. Hypertriglyceridemia was noted in 4 cases among 5 cases tested and hypofibrinogenemia was detected in 5 cases among 5 cases tested. Benign histiocytic infiltration(at least above 5% of all nucleated marrow cells), hemophagocytosis and normocellularity in bone marrow were observed in all cases. The mortality rate was 57%, the main causes of death were bleeding and sepsis. In analysis of prognostic factors associated with death, there was a correlation between hypofibrinogenemia, hepatomegaly, hypoalbuminemia and death, although insignificant statistically. CONCLUSION: In our study, EBV-AHS was caused by reactivation of EBV in most cases. The mortality rate was 57% and the main causes of death were bleeding and sepsis. In analysis of prognostic factors associated with death, there was a correlation between hypofibrinogenemia, hepatomegaly and hypoalbuminemia to a certain degree. But, further study of larger numbers of patients and longer follow-up is needed to clarify the prognostic factors.
Bone Marrow ; Cause of Death ; Diagnosis ; Fever ; Follow-Up Studies ; Hemorrhage ; Hepatomegaly ; Herpesvirus 4, Human ; Histiocytes ; Humans ; Hypertriglyceridemia ; Hypoalbuminemia ; Lymphohistiocytosis, Hemophagocytic* ; Mortality ; Pediatrics ; Prognosis ; Retrospective Studies ; RNA, Messenger ; Sepsis ; Virology

PURPOSE: To present a case of a single isolated cotton-wool spot in a healthy patient. CASE SUMMARY: A 43-year-old woman with no systemic disease complained of sudden inferior field defect of the right eye. On fundoscopic examination of the right eye, a single soft white spot was observed in the superotemporal vascular arcade. An elevated hyper-reflective area in the inner retina corresponding to a white spot was observed on optical coherence tomography. Automated perimetry revealed an arcuate field defect which was wider than the cotton-wool spot. A complete workup for systemic diseases was within normal range except a positive rheumatoid factor. At the 2-week follow-up, the patient's subjective symptom improved and the white spot decreased. After 6 months, the cotton-wool spot disappeared and slit-like retinal nerve fiber layer (RNFL) defects corresponding to the location of the cotton-wool spot was noticed. One year later, disc and RNFL defect were unchanged but the previous field defect disappeared. CONCLUSIONS: Isolated cotton-wool spots can occur without serious systemic diseases in healthy patients. A single isolated cotton-wool spot in the present case disappeared spontaneously leaving permanent structural damage on the retina over time.
Adult ; Dental Caries ; Eye ; Female ; Follow-Up Studies ; Humans ; Nerve Fibers ; Reference Values ; Retina ; Retinaldehyde ; Rheumatoid Factor ; Tomography, Optical Coherence ; Visual Field Tests

PURPOSE: To present a case of a single isolated cotton-wool spot in a healthy patient. CASE SUMMARY: A 43-year-old woman with no systemic disease complained of sudden inferior field defect of the right eye. On fundoscopic examination of the right eye, a single soft white spot was observed in the superotemporal vascular arcade. An elevated hyper-reflective area in the inner retina corresponding to a white spot was observed on optical coherence tomography. Automated perimetry revealed an arcuate field defect which was wider than the cotton-wool spot. A complete workup for systemic diseases was within normal range except a positive rheumatoid factor. At the 2-week follow-up, the patient's subjective symptom improved and the white spot decreased. After 6 months, the cotton-wool spot disappeared and slit-like retinal nerve fiber layer (RNFL) defects corresponding to the location of the cotton-wool spot was noticed. One year later, disc and RNFL defect were unchanged but the previous field defect disappeared. CONCLUSIONS: Isolated cotton-wool spots can occur without serious systemic diseases in healthy patients. A single isolated cotton-wool spot in the present case disappeared spontaneously leaving permanent structural damage on the retina over time.
Adult ; Dental Caries ; Eye ; Female ; Follow-Up Studies ; Humans ; Nerve Fibers ; Reference Values ; Retina ; Retinaldehyde ; Rheumatoid Factor ; Tomography, Optical Coherence ; Visual Field Tests

The Eustachian tube is a passage that connects the middle ear to the nasopharynx and regulates the pressure within the middle ear. If there is persistent inflammation in the mucosa due to infection or allergic reactions, the opening of the Eustachian tube may not function properly, leading to obstructive Eustachian tube dysfunction. If symptoms persist even after three months of conservative treatment, balloon Eustachian tuboplasty may be considered. Although rare, severe complications such as subcutaneous emphysema, pneumomediastinum, and pneumothorax can occur, but there have been no reported cases of such complications in the Republic of Korea so far. Here, we present a case of a 52-year-old male who developed subcutaneous emphysema and pneumomediastinum after undergoing balloon Eustachian tuboplasty and discuss prevention and treatment for possible complications following the procedure.

No abstract available.
Animals ; Heart* ; Rats*

OBJECTIVE: The introduction and development of the embolic protecting device (EPD) has resulted in a decreased rate of stroke after carotid artery stenting (CAS). The authors performed a retrospective study to investigate the risk factors for developing large emboli after CAS which can lead to ischemic events. METHODS: A total of 35 consecutive patients who underwent CAS between January 2009 and March 2012 were included in this study. Patients were divided into two groups including those with small emboli (group A; grade 1, 2) and those with large emboli (group B; grade 3, 4). The size and number of emboli were assigned one of four grades (1=no clots, 2=1 or 2 small clots, 3=more than 3 small clots, 4=large clots) by microscopic observation of the EPD after CAS. We compared demographic characteristics, medical history, and angiographic findings of each group. RESULTS: Thirty-five patients underwent CAS, and technical success was achieved in all cases. Twenty-three patients were included in group A and 12 patients in group B. Our results demonstrated that advanced age [odds ratio (OR) 1.24; 95% confidence interval (CI) 1.01-1.52; p=0.044] and smoking (OR 42.06; CI 2.828-625.65, p=0.006) were independent risk factors for developing large emboli after CAS. CONCLUSION: In patients with carotid artery stenosis treated with CAS, advanced age and smoking increased the number and size of emboli. Although use of an EPD is controversial, it may be useful in CAS in patients with risk factors for large emboli in order to reduce the risk of ischemic events.
Carotid Arteries ; Carotid Stenosis ; Embolic Protection Devices ; Humans ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Stents ; Stroke

Intradiploic cyst, non-neoplastic process simulating neoplasm, is rare in skull. The pathogenesis of this lesion remains obscure. But, results of the hemorrhage into the diploic space after trauma in newborn and young children may attribute as one of the major cause to form a intradiploic cyst. A case of intradiploic cyst in a 7 months-old male, which involved right parietal vertex, is presented with reviews of the literatures. Diagnosis was made with the plain skull X-rays, Brain CT, surgical and pathological findings.
Brain ; Child ; Diagnosis ; Hemorrhage ; Humans ; Infant ; Infant, Newborn ; Male ; Rabeprazole ; Skull

PURPOSE: The prognostic factors in acute lymphoblastic leukemia was patient's age at diagnosis, sex, hepatosplenomegaly, initial WBC & platelet count. Recently immunophenotype has being studied as guidance for several treatment protocol. We performed a retrospective study to evaluate the significance of immunophenotype on clinical course & long-term survival in children with acute lymphoblastic leukemia. METHODS: One hundred two children with acute lymphoblastic leukemia were admitted to the Department of Pediatrics, Yonsei University College of Medicine from Jan.1991 to Dec. 1995, and bone marrow aspiration biopsies and immunophenotyping were performed. The prognostic significance of immunophenotype was evaluated base on the median event free survival and probability of survival at the end of follow-up. RESULTS: 1) In 102 children comprised 14 cases under 2 years old, 71 cases from 2 to 10 years of age and 17 cases above 10 year old. The ratio of male to female was 6 : 4. 2) By CCG risk grouping, standard risk in 21 cases, intermediate risk in 35 cases, high risk in 46 cases. 3) By cytologic classification of FAB, Ll in 65 cases, L2 in 31 cases, L3 in 2 cases 4) Remission induction rate in early pre-B ALL was 100% (39/39), among those recurrence rate 20% (8/39). 5) Remission induction rate in pre-B ALL was 90% (26/29), among those recurrence rate 54% (14/26). 6) Remission induction rate in B-cell ALL was 33%(113), and all cases was expired during follow-up. 7) Remission induction rate in T-cell ALL was 100% (12/12)), among those recurrence rate 41% (5/12). 8) Remission induction rate in T-B mixed ALL was 71%(517), among those recurrence rate 0% (0/5), but non-remission cases was expired during follow-up. 9) Remission induction rate in Myeloid Ag(+) ALL was 83%(516), among those recurrence rate 80% (415). CONCLUSIONS: These results suggest that better result on long-term survival was observed in early pre-B ALL than in T-cell, 7-B mixed, or Myeloid antigen positive ALL and immunophenotype have prognostic impact in acute Iymphoblastic leukemia.
B-Lymphocytes ; Biopsy, Needle ; Bone Marrow ; Child* ; Child, Preschool ; Classification ; Clinical Protocols ; Diagnosis ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Immunophenotyping ; Leukemia ; Male ; Pediatrics ; Platelet Count ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prognosis ; Recurrence ; Remission Induction ; Retrospective Studies ; T-Lymphocytes