No abstract available.
Necrosis*

No abstract available.
Colon* ; Diverticulitis* ; Laparoscopy*

Erythema Annulare Centrifugum is characterized by migratory annular, arcuate or polycyclic erythemas with central clearing. Its etiology is not conclusive but there are many reports about the etiology, i.e." due to dermatophytid"," the drugs",' intemal diseases", or" unknown etiology" etc. A case of Erythema Annulare Centrifugum with "unkown etiology" was reported. The patient revealed slightly elevated, migratory annular erythemas with central clearing on the both posterior portions of thighs. Histopathologically, there was no abnormality in the epidermis. In the dermis, cellular infiltrates sbowing fairly well demarcated perivascular coat-sleeve like arrangement and endothelial prolifera01
Dermis ; Epidermis ; Erythema* ; Humans ; Thigh

A case of amelanotic melanoma developed on a 19 years old boy was reported. Since the identification of amelanotic melanoma, there were few reports about the tumor but none in Korea. In this case, the histologic findings showed ulceration of the epidermis and irregular junctional activity, and in the dermis, there showed alveolar formation and nevus cell nest like cell masses. And in the deep dermis, the loss of dermal stroma with numerous bizzare giant cells and variable sized, hyperchromatic, plemorphic, mitotic figures were also seen, Strikingly, there were no melanin pigments in H-E stain as well as in Masson-Fontana stain, which was thought to be a amelanotic melanoma. The patient was treated with B.C.G caccination by intralesional and hypodermic injection, on the lesion and on both, the lesion was markedly improved with only scarformation on previously ulcerated lesion. The patient shall be followed up continuously.
Dermis ; Epidermis ; Giant Cells ; Humans ; Korea ; Male ; Melanins ; Melanoma, Amelanotic* ; Nevus ; Ulcer ; Young Adult

The authors observed 2 cases of poikilcdermatomyositis who were 16 and l0 years old female. The former visited our dept. due to rashes on the anterior portion of right thigh with 3 months duration. The skin lesion revealed mottled skin pigmentation, telangiectasia, atrophy, and cigarrette paper like wrinklings. On the palpation, hardness and tenderness in the lesion were felt. The latter visited our dept. due to weakness of the right lower extremity for 3years. The skin lesion revealed the same feature as the former but more prominent. Histophthologically, P.V.A. patterns are seen in the both skin lesions. The epidermis shows moderate atrophy of St. malphigi and flattening of reteridges. The dermis is edematous, vascular dilatations, and cellular infiltrations, most of lymphocytes, around the blood vessels. The muscle biopsies for the Quardriceps Femoris sbow Dermatomyositis patterns which the muscle bundles are degenerative changes and many cellular infiltrations, chiefly of lymphocytes, are seen between the muscle bundles. Diagnosis was confirmed by the clinical and histological pictures. These patients were markedly improved by the prednisolone therapy.
Atrophy ; Biopsy ; Blood Vessels ; Dermatomyositis ; Dermis ; Diagnosis ; Dilatation ; Epidermis ; Exanthema ; Female ; Hardness ; Humans ; Lower Extremity ; Lymphocytes ; Palpation ; Prednisolone ; Skin ; Skin Pigmentation ; Telangiectasis ; Thigh

Primary pyogenic psoas abscess is rare lesion, and often is not suspected. Reasons for delayed diagnosis are unfamility with the lesion and the fact that symptoms often resemble those of primary disease of the hip. We present a case of primary pyogenic psoas abscess in child, which was diagnosed by MRI, and completely recovered after surgical treatment.
Child ; Delayed Diagnosis ; Hip ; Humans ; Magnetic Resonance Imaging ; Psoas Abscess

A clinical study was made on 12 cases of neonatal Group B beta-hemolytic streptococcal (=GBS) meningitis, who were admitted to the department of pediatrics, Dong-San Hospital, Keimyung University during the period of 3 years from Aug 1989 to Jul 1992. The following results were obtained: 1) GBS was cultured in 12 cases (57.1%) among 21 neonatal meningitis admitted during the same period. 2) Male and female ratio was 1.4:1, and 4 cases had early-onset and 8 cases had late-onset. 3) In 6 (50%) out of 12 cases, obstetric factors were noted, including premature rupture of membrane (2 caes), premature delivery(1 case), asphyxia (1 case), cesarean section (1 case) and maternal toxemia (1case). 4) The clinical manifestations were fever (91.7%), lethargy and poor feeding (83.3%),vomiting and irritability (50%), convulsion and bulging fontanel in order. 5) Associated diseases were GBS sepsis (8 cases), pneumonia (2 cases), hyperbilirubinemia (2 cases), etc. 6) Cerebrospinal fluid findings were increased cells(250-12600/mm3), decreased sugar (1-11), increased protim (220-678mg%) and the CBC differential ratio was less than 1.0 in all cases. 7) Overall survival rate was 83.3% with 75% in early-onset disease, and 87.5% in late-onsetdisease. 8) The acute neurologic complications were noted in 5 cases (45.5%) including subdural hemorrhage, brain swelling and cerebral infarction.
Asphyxia ; Brain Edema ; Cerebral Infarction ; Cerebrospinal Fluid ; Cesarean Section ; Female ; Fever ; Hematoma, Subdural ; Humans ; Hyperbilirubinemia ; Infant, Newborn ; Lethargy ; Male ; Membranes ; Meningitis* ; Pediatrics ; Pneumonia ; Pregnancy ; Rupture ; Seizures ; Sepsis ; Survival Rate ; Toxemia

BACKGROUND: High dose fentanyl for cardiac surgery in neonates, infants and children can cause severe bradycardia and chest wall rigidity that result in decreased cardiac output and oxygen desaturation due to fixed stroke volume in pediatric patients. To ameliorate the effects of fentanyl, it is common to administer neuromuscular blocking drugs with wanted cardiovascular side effects. This study was designed to compare the cardiovascular variables and oxygen saturation among different muscular relaxants in high dose fentanyl anesthesia. METHODS: Thirty pediatric cardiac patients were allocated randomly into three muscle relaxant groups treated with 0.2 mg/kg pancuronium (n=10), 0.2 mg/kg vecuronium (n=10) or 0.2 mg/kg pipecuronium (n=10) after receiving an initial bolus dose of 25 g/kg of fentanyl. Changes of heart rate (HR), mean arterial blood pressure (MAP), rate-pressure-product (RPP) and oxygen saturation (SpO2) were observed. The same cardiovascular variables were also observed 1 and 2 minutes after the second bolus dose of 25 g/kg fentanyl and compared to the results among muscle relaxants. RESULTS: HR, MAP and RPP decreased significantly (p<0.05) 1 and 2 minutes after injection of the 1st fentanyl, which returned to levels above the control value after administration of pancuronium, vecuronium or pipecuronium. Among muscle relaxants, pancuronium caused the most rapid and significantly high level compared to the control value in HR and MAP. Next was pipecuronium and then vecuronium. In clinical setting, SpO2 was decreased after the 1st fentanyl injection and increased after the injection of muscle relaxants, but not significant statistically. CONCLUSION: In view of hemodynamic changes, pancuronium is most efficient and rapid in returning the hemodynamic variables that was decreased after high dose fentanyl anesthesia in neonates, infants and children whose cardiac output was dependent on HR due to relatively fixed stroke volume.
Anesthesia* ; Arterial Pressure ; Bradycardia ; Cardiac Output ; Child* ; Fentanyl* ; Heart Rate ; Hemodynamics ; Humans ; Infant* ; Infant, Newborn* ; Neuromuscular Blockade ; Oxygen ; Pancuronium* ; Pipecuronium* ; Stroke Volume ; Thoracic Surgery ; Thoracic Wall ; Vecuronium Bromide*

To characterize the sympathetic nervous system response to congestive heart failure in infants and children, plasma norepinephrine levels were measured in 29 patients aged 4 months to 15 years undergoing routine cardiac catheterization at Dong San Hospital, Keimyung University during the period of 4 months from November 1990 to February 1991. Plasma norepinephrine levels were significantly higher in patients with heart disease and congestive heart failure than in those without congestive heart failure(P<0.001). A significant association was found between the level of plasma norepinephrine and severity of the symptoms of congestive heart failure. Plasma norepinephrine levels correlated well with size of the shunt (Qp/Qs)(gamma=0.75), degree of pulmonary arterial pressure (gamma=0.79) and degree of right ventricular pressure (gamma=0.82).
Arterial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Child* ; Estrogens, Conjugated (USP)* ; Heart ; Heart Diseases ; Heart Failure* ; Humans ; Infant* ; Norepinephrine* ; Plasma* ; Sympathetic Nervous System ; Ventricular Pressure

Erythromelalgia(Erythermalgia) is a syndrome of red, warm, congested, and burning painful extremities. Presently, there are three distinct clinicopathological entities: erythromelalgia, primary erythermalgia, and secondary erythermalgia. Secondary erythermalgia usually arises at an adult age either in association with a detectable underlying disorder or with the use of vasoactive drugs. Typically, it responds to proper treatment of the underlying disorder or discontinuation of the causative drugs. A seven-year-old boy presented with persisting burning pain, erythema, and warmth on both of his feet and lower legs, along with hypertension. He had had this condition for 20 months. Laboratory studies of the patient revealed increased urinary catecholamines and plasma renin activity. Various treatment modalities including aspirin, captopril, sodium nitroprusside, labetalol, epidural block, and stellate ganglion block yielded unfavorable results. Herein, we report an intractable case of secondary erythermalgia associated with hypertension in a child.
Adult ; Aspirin ; Burns ; Captopril ; Catecholamines ; Child ; Erythema ; Erythromelalgia* ; Estrogens, Conjugated (USP) ; Extremities ; Foot ; Humans ; Hypertension* ; Labetalol ; Leg ; Male ; Nitroprusside ; Plasma ; Renin ; Stellate Ganglion