Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system that typically follows an infection or vaccination and has a favorable long-term prognosis. We describe the first reported case of ADEM after vaccination against novel influenza A (H1N1). A previously healthy 34-month-old boy who developed ADEM presented with a seizure and left-sided weakness 5 days after vaccination against novel influenza A (H1N1). Cerebrospinal fluid examination revealed elevated cell counts. T2-weighted images and fluid-attenuated inversion recovery images revealed multiple patchy hyperintense lesions in the frontal and parietal subcortical white matter and the left thalamus. After the administration of intravenous corticosteroid, the patient's clinical symptoms improved and he recovered completely without neurologic sequelae.
Cell Count ; Central Nervous System ; Child ; Demyelinating Diseases ; Drug Toxicity ; Encephalomyelitis, Acute Disseminated ; European Continental Ancestry Group ; Humans ; Influenza, Human ; Preschool Child ; Prognosis ; Seizures ; Thalamus ; Vaccination

This is a retrospective study on condylar fracture of mandible. The stucy based on a series of 112 patients who had treated for the fractures of mandibular condyle on Kyunghee Dental Hospital from January, 1989 to August 1997. We studied the age and sex distributions, causes of fractures, location of fractures and so on. The results as follow : 1. The ratio of male : female was 4:1, and the highest frequency of condylar fractures was registered among patients aged to 21 to 30 years. 2. The most common cause of condylar fractures was fall-down(47.7%), followed in incidence by direct-blow(27.9%) and traffic accidents(20.7%). 3. Subcondylar fracture had highest incidence(50%), and followed by condyle head(27.4%) and condylar neck(22.6%). 4. 9.7% of condylar fractures had occurred bilaterally and in cases of bilateral condylar fractures, condylar head fractures(58.33%) was hightest incidence. 5. Mandibular symphysis was most commonly involved in condylar fracture(63.4%), and 27.7% of condylar fractures had not any other mandibular fractures.
Female ; Head ; Humans ; Incidence ; Male ; Mandible* ; Mandibular Condyle ; Mandibular Fractures ; Retrospective Studies ; Sex Distribution ; Statistics as Topic*

Primary melanoma of the vagina is rare, accounting for 2.6-2.8% of all primary malignant tumor of the vagina and 0.4-0.8% of all malignant melanomas in the female. Melanocytes are the presumed precursors of malignant melanoma of the vagina; they are embryologically derived from neural crest cells and can be found in the basal portion of the vaginal epidermis in 3% of normal adult females. Though malignant melanoma may occur anywhere in the vagina, it is most commonly found on the anterior wall and in the distal one-third. Vaginal bleeding is the most common symptom. Histochemical and immunohistochemical procedures confirm the initial diagnosis. Vaginal melanoma is a highly malignant disease; due to the extensive lymphatic invasion and melanoma's propensity for hematogeneous spread, so early metastases are very common. The treatment modalities for the primary management of vaginal melanoma are varied according to the location and extend, individually or in combination, wide local incision, radical surgical extirpation, irradiation, or chemotherapy. Although there have been no consensus as to comprehensive treatment, in the case of upper vaginal melanoma, radical abdominal hysterectomy with bilateral salpingo-oophorectomy with pelvic lymph node dissection is generally advocated. Regardless of primary therapy chosen, result of the treatment of vaginal melanoma has been uniformly poor. We experienced a case of malignant melanoma of the vagina confirmed pathohistologically after radical abdominal hysterectomy with bilateral salpingo-oophorectomy and presented with a brief review of literature.
Adult ; Consensus ; Diagnosis ; Drug Therapy ; Epidermis ; Female ; Humans ; Hysterectomy ; Lymph Node Excision ; Melanocytes ; Melanoma* ; Neoplasm Metastasis ; Neural Crest ; Uterine Hemorrhage ; Vagina*

Pelvic actinomycosis is a chronic, progressive, granulomatous and suppurative disease caused by an anaerobic or microaerobic Gram-positive organism, not fungi. Actinomyces species exhibit branching, filamentous growth and appear in the human skin, oral cavity, gastrointestinal tract. Actinomyces infection in human is relatively rare, however, prolonged use of an intrauterine contraceptive device (IUD) is a well known risk factor of pelvic actinomycosis. Pelvic actinomycosis can mimick pelvic malignancy leading to mutilating surgical excision, and diagnostic problems necessitated a laparotomy in many patients. The pathohistological diagnosis is based on the characteristic microscopic image and specific staining of sulfur granule. Adequate surgical excision and administration of antibiotics show good prognosis. We experienced 2 cases of pelvic actinomycosis with the intestinal obstruction, confirmed patho- histologically after laparotomy.
Actinomyces ; Actinomycosis* ; Anti-Bacterial Agents ; Diagnosis ; Fungi ; Gastrointestinal Tract ; Humans ; Intestinal Obstruction* ; Intrauterine Devices ; Laparotomy ; Mouth ; Prognosis ; Risk Factors ; Skin ; Sulfur

Pelvic actinomycosis is a chronic, progressive, granulomatous and suppurative disease caused by an anaerobic or microaerobic Gram-positive organism, not fungi. Actinomyces species exhibit branching, filamentous growth and appear in the human skin, oral cavity, gastrointestinal tract. Actinomyces infection in human is relatively rare, however, prolonged use of an intrauterine contraceptive device (IUD) is a well known risk factor of pelvic actinomycosis. Pelvic actinomycosis can mimick pelvic malignancy leading to mutilating surgical excision, and diagnostic problems necessitated a laparotomy in many patients. The pathohistological diagnosis is based on the characteristic microscopic image and specific staining of sulfur granule. Adequate surgical excision and administration of antibiotics show good prognosis. We experienced 2 cases of pelvic actinomycosis with the intestinal obstruction, confirmed patho- histologically after laparotomy.
Actinomyces ; Actinomycosis* ; Anti-Bacterial Agents ; Diagnosis ; Fungi ; Gastrointestinal Tract ; Humans ; Intestinal Obstruction* ; Intrauterine Devices ; Laparotomy ; Mouth ; Prognosis ; Risk Factors ; Skin ; Sulfur

Extranodal NK-T cell lymphoma is a subtype of non-Hodgkin's lymphoma (NHL) and this most commonly affects the nasal and paranasal cavities. Primary lymphoma of the gallbladder is extremely rare and solitary relapsed extranodal NK-T cell lymphoma of the gallbladder has not yet been reported in Korea. We experienced a case of a solitary relapsed extranodal NK-T cell lymphoma of the gallbladder. One year earlier, a 55-year-old man was diagnosed with extranodal NK-T cell lymphoma of the anus, and he underwent six cycles of chemotherapy with CHOP (cyclophosphamide, adriamycin, vincristine and prednisone), and he achieved complete remission. The patient was admitted for right upper quadrant pain. Computed tomography (CT) performed on readmission revealed gallbladder wall thickening. Fluorodeoxyglucose-positron emission tomography (FDG-PET) showed hypermetabolic lesions along the gallbladder wall. The specimen obtained at cholecystectomy revealed CD3(+) and CD56(+) lymphoma, which is characteristic of NK-T cell lymphoma.
Anal Canal ; Cholecystectomy ; Doxorubicin ; Gallbladder ; Gallbladder Neoplasms ; Humans ; Korea ; Lymphoma ; Lymphoma, Non-Hodgkin ; Middle Aged ; Vincristine

Myelodysplastic syndrome (MDS) is a heterogeneous group of disorders characterized by ineffective hematopoiesis, morphological dysplasia, peripheral blood cytopenias, and progressive bone marrow failure. The only proven curative treatment for MDS is hematopoietic stem cell transplantation. However, invasive fungal infection following hematopoietic stem cell transplantation has become the leading cause of death from infection. Therefore, transplant candidates with previous invasive fungal infection have often been excluded from the transplant program due to high risk of reactivation and associated death. We report on a case involving an MDS patient with complications from invasive aspergillosis who had shown no response to amphotericin-B. The patient underwent successfully unrelated allogeneic hematopoietic stem cell transplantation.
Aspergillosis ; Bone Marrow ; Cause of Death ; Hematopoiesis ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Myelodysplastic Syndromes ; Transplants

A retrospective study was conducted to determine the incidence of major complications after liver transplantations which had been performed at Asan Medical Center from August 1992 to October 1996. Among the 43 orthotopic liver transplantations(OLTs), 27 were cadaveric donor liver transplantation(CDLT) including one retransplantation, 16 were living donor liver transplantation(LDLT). The over-all incidence of major complication was 52.4%, and there were no statistical difference between CDLT and LDLT. But the one-year cumulative survival was better in LDLT than CDLT(86.2% vs 63.3% : p < 0.1). To reduce the incidence of major complications after OLT, proper management of donors, early transplantation of recipients and shortening of cold ischemic time are mandatory especially in CDLT.
Cadaver ; Chungcheongnam-do ; Cold Ischemia ; Humans ; Incidence ; Liver Transplantation* ; Liver* ; Living Donors ; Retrospective Studies ; Tissue Donors

Purpose: While a carcinoma of the splenic flexure is uncommon, is associated with a high risk of obstruction, and has a dual lymphatic drainage system, A COST study excluded transverse colon cancer, including splenic flexure colon cancer. This study reviews our experience with splenic flexure colon cancer treated laparoscopically and discusses a appropriate, safe laparoscopic surgical procedure. Methods: The authors reviewed the medical records of patients who underwent laparoscopic surgery for splenic flexure colon cancer from January 1995 to June 2006. The splenic flexure colon was defined as 5 cm from the splenic flexure proximally and distally by using radiologic studies. Curative surgery for splenic flexure colon cancer was defined as: primary cancer removal, a safe resected margin, no metastasis, and a complete lymphadenectomy including high ligation of left colic artery and of the left branch of the middle colic artery. Results: A total of 407 patients underwent laparoscopic surgery for colon cancer; among them, 15 patients underwent a laparoscopic left colectomy for splenic flexure colon cancer. The mean age of the patients was 63.8 years, and the male-to-female ratio was 9:6. The mean operation time was 325.3+/-95.1 minutes, and the average hospital stay was 15.8+/-4.9 days. The average number of harvested lymph nodes was 12.3+/-9.7, the average distal resection margin was 15.3+/-7.6 cm, and the average proximal margin was 10.7+/-3.2 cm. One case of chyle discharge and one case of ileus developed, but were treated conservatively. There was no surgical mortality. Conclusions: A laparoscopic left colectomy for splenic flexure colon cancer is a technically feasible and safe procedure with acceptable short-term outcomes in experienced hands.
Female ; Male ; Humans ; Mortality

BACKGROUND AND OBJECTIVES: We performed this study to evaluate the common carotid artery intima-media thickness (CCA IMT), and its correlation with several clinical variables, including the 10 year coronary heart disease (10 Yr CHD) risk in both healthy and hyperlipidemic hypertensive (HH) Koreans. SUBJECTS AND METHODS: This was a multi-centered prospective epidemiological study. The study population consisted of 227 healthy subjects without risk factors, with the exception of age (mean 49 years old, 114 males), and 243 HH subjects (mean 51 years old, 120 males). The carotid IMT and presence of plaques were semi automatically measured in both carotid arteries at a central reading facility. RESULTS: Linear regression analysis of all the subjects revealed that the independent factors of both CCA IMT were age, pulse pressure (PP) and HDL-cholesterol, and that of the right CCA IMT were sex and 10 Yr CHD risk. In healthy subjects, the independent factor of both CCA IMTs was age, and that of the right CCA IMT was body weight. In the HH subjects, age, sex, total cholesterol, HDL-cholesterol and PP were independent factors of both CCA IMTs, but 10 Yr CHD risk was an independent factor of only the right CCA IMT. Carotid plaques were seen in 17% of the healthy subjects and 35% of the HH subjects. An ROC curve analysis showed a right CCA IMT of 0.646 mm and left CCA IMT of 0.656 mm demonstrated 60% sensitivity and specificity in differentiating healthy from HH subjects. CONCLUSION: This result reliably demonstrates the Korean CCA IMT, as well as several other significant pieces of information.
Blood Pressure ; Body Weight ; Carotid Arteries ; Carotid Artery, Common ; Carotid Intima-Media Thickness* ; Cholesterol ; Coronary Disease ; Epidemiologic Studies* ; Humans ; Korea* ; Linear Models ; Middle Aged ; Prospective Studies ; Risk Factors* ; ROC Curve ; Sensitivity and Specificity