Henoch-Schonlein purpura is a common pediatric disease presenting most frequently with skin, gastrointestinal, joint and renal manifestations. But in cases are infrequently only severe gastrointestinal manifestations. It is hard to diagnose promptly and exactly. Clinical manifestations and laboratory findings were observed and analyzed in 20 cases with Henoch-Schonlein purpura which were considered as acute abdomen, hospitalized at Kyung Hee university Hospital during the period from December, 1982 to September, 1992. The following results were obtained; 1) The age distribution of Henoch-Schonlein purpura had a peak incidence between 7 to 9 year old. And male preponderance was observed with male to female ratio of 2.33 to 1. 2) The most prevalent season for the initial presentation of Henoch-Schonlein purpura was in fall: in 10 cases (50%). 3) The frequency of each type of clinical manifestations showed 20 (100%), 20 (100%), 18 (90%), 8(40%) cases for skin, gastrointestinal, joint and renal manifestation respectively in order of frequency. 4) The common previous illness were URI, 40 cases (50%) and allergy, 2 cases (10%). 5) The onset time of skin manifestation from admission were 1 to 4 days (75%0, 5 to 8 days (15%), 9 to 12 days (10%) explolaparotomies were done the last 2 cases. 6) In all cases, X-ray study (100%), abdominal sono (50%), Meckels scan and colon study (5%) respectively were done. 7) Hematologically leukocytosis over 10,000/mm3 was observed in 80% of cases and increase in ESR over 20 mm/hr in 65% of cases. Coagulation studies, immunologic and complement level revealed the result within normal range in most of the cases. 8) Among 8 cases with renal involvement, all cases had both hematuria and proteinuria. 9) Most cases were recovered within 4 weeks but in 4 cases, renal biopsies were done because of relapse. The results were Meadow classification grade I (1 case), II (1 case), IVa (2 cases). After renal biopsy, steroid pulse therapy was started.
Abdomen, Acute* ; Age Distribution ; Biopsy ; Child ; Classification ; Colon ; Complement System Proteins ; Female ; Hematuria ; Humans ; Hypersensitivity ; Incidence ; Joints ; Leukocytosis ; Male ; Proteinuria ; Purpura, Schoenlein-Henoch* ; Recurrence ; Reference Values ; Seasons ; Skin ; Skin Manifestations

This study was undertaken to make current fetal growth curve throughout later part of pregnancy. 5,110 normal singleton deliveries at Il Shin Christian Hospital were included. The 10th, 25th, 50th, 75th, 90th percentiles of birth weight were calculated from 21 to 42 weeks' gestation and the 10th, 50th, 90th percentiles of birth weight compared by fetal sex, maternal parity and height were graphed to know the potency of factors. There was a linear growth pattern between 28 and 38 weeks' gestation. During last month of prgnancy, three factors have significant effect on median birth weight but no significant differences in 10th percentiles. Maternal height & parity significantly affeect on 90th percentiles. So, these factors must be considered when diagnosing large for date.
Birth Weight* ; Female ; Fetal Development ; Gestational Age* ; Parity ; Parturition* ; Pregnancy

Respiratory distress syndrome (RDS) of preterm infants remains a significant cause of morbidity and mortality despite improvements in neonatal intensive care and artificial ventilatory techniques. After identification of the deficiency of pulmonary surfactant is major pathophysiologic basis in RDS, artificial surfactant replacement therapy in RDS was first successfully tested by Fujiwara and co-workers in 1980. therefore, exogenous surfactant replacement produced exellent results in improved clinical and repiratory status during the acute period and decreased incidence of late complications and mortality. According to comparison of administration timing between early (within 6 hours after birth) and late (after 6 hours)group, early replacement therapy is more effective in improving of clinical course and prognosis. Because of that, early, just after birth, recognition and detection of RDS is also important procedure. There are many investigations and methods for the detection of RDS in prenatal or postnatal period. Among then, stable microbubble rating (SMR) test was a simple method and SMR test has a higher diagnostic accuracy. To determine the relation of the SMR and purified natural surfactant (PNS) concentration in vitro, the author conducted each 5 times test of SMR method according to 5 groups of PNS concentration by using modified Pattle's method. The results were as follows: 1) The mean and standard deviation of SMR according to 5 groups of PNS concentration were 119.4 (15.0in 20mug PL (phospholipid)/ml, 452.2 (160.2 in 40mug PL/ml, 879.0 (93.4 in 60mug PL/ml, 1311.8 (274.8in80mug PL/ml, 1710.6(272.3 in 100mug PL/ml. 2) The regression curve of SMR and PNS concentration showed statistically significant relation(p<0.005). In conclusion, the SMR test was a good method in estimation of surfactant concentration in vitro and also in diagnosis of RDS recognized as a surfactant deficiency. In the future, we expected that prophylactic surfactant replacement therapy. immediate after birth, will be more popular in the field of neonatal care of RDS. So, we recommended the use of this method for early detection and serving optimal care of RDS.
Diagnosis ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Microbubbles* ; Mortality ; Parturition ; Prognosis ; Pulmonary Surfactants*

Fracture dislocation or dislocation of the knee can produce a popliteal artery injury that may be difficult to evaluate clinically. Diagnosis of disruption or thrombosis of the popliteal artery is frequently delayed until the opportunity to salvage the extremity is lost. 22 cases of popliteal artery injury were reviewed from July 1978 to December 1983, associated with severe knee trauma at the Orthopaedic department of Kyung Hee University Hospital, of whom average follow-up for about 52 months. The results obtained were as follows; 1. In all 22 cases, 14 cases (63. 6%) were amputated. The amputation rate was correlated with ischemic time after injury. 2. Resection of all injuried vessels with reconstitution of continuity by the use of an interposed saphenous vein graft is often warrented to avoid tension. 3. All 8 patients, which was managed conservatively, were amputated in all cases(100%). In cases of suspicious popliteal artery injury, early aggressive exploration and obvious microvascular reconstruction should be mandatory. 4. Subperiosteal fibulectomy-fasciotomy should be done routinely immediately after vascular injury. 5. Diagnosis of popliteal artery injury was based on the clinical findings but the capillary filling was not contributary. 6. The use of Doppler flowmeter and emergency arteriography was recognizedtobeanexcellent methods in determination of arterial injury.
Amputation ; Angiography ; Capillaries ; Diagnosis ; Dislocations ; Emergencies ; Extremities ; Flowmeters ; Follow-Up Studies ; Humans ; Knee ; Popliteal Artery ; Saphenous Vein ; Thrombosis ; Transplants ; Vascular System Injuries

We performed prospective study evaluating surgically-induced alterations in corneal curvature resulting from filtering surgery using the data obtained by corneal topographic analysis. The operation was performed on 12 eyes of 11patients by one operator with the same method. Preoperatively and 6 times postoperatively, we measured vision, axial length, and intraocular pressure and also performed refraction, keratometry and corneal topography. Keratometry showed against-the-rule astigmatic change by corneal topography, five of twelve eyes developed with-the-rule atigmatism. Three patients including two cases combined with phacoemulsification developed against-the-rule astigmatism. Quantitative descriptors of corneal topography such as SAi(surface asymmetry index), SRI(surface regularity index), and Sim K(simulated keratometry value) indicated increase in corneal stability as time went by. In conclusion, compared with keratometry, corneal topography was more valuable in evaluating corneal change following trabeculectomy in that it correctly indentified the amount of astigmatism and could provide information on peripheral corneal change.
Astigmatism ; Corneal Topography* ; Filtering Surgery ; Humans ; Intraocular Pressure ; Phacoemulsification ; Prospective Studies ; Subject Headings ; Trabeculectomy

PURPOSE: We prospectively determined the value of a non-enhanced spiral CT (NESCT) in the diagnosis of suspected urolithiasis by a comparison with excretory urography (EU). MATERIALS AND METHODS: After giving informed consents, 114 and 103 patients, with suspected urolithiasis, underwent either NESCT or EU, respectively. All the NESCT and EU films were assessed by 2 urologists and 1 radiologist with no knowledge of the clinical histories. The sensitivity, specificity, positive and negative predictive value, diagnostic accuracy and other valuable diagnostics in each group were compared. RESULTS: The sensitivity, specificity and accuracy of NESCT in diagnosing urinary calculi were 96.8, 95.2 and 96.5%, and for EU, were 75.3, 90.9 and 78.6%, respectively. The examinations were performed with an average of less than 5 minutes for the NESCT versus 113+/-31 minutes for the EU, and the times taken to a definitive diagnosis in the two groups were 2.4+/-0.3 and 59+/-5.2 hours, respectively. In the EU group, 24 patients (23.3%) had revisited and 11 (10.6%) were admitted for pain control, prior to the imaging evaluation, only 2 patients (1.7%) revisited, and none were admitted in the NESCT group. In our institution, the cost of a NESCT was more expensive than that of an EU (140,000 vs. 35,790 Won), however the cost-effectiveness is enhanced by the accuracy of NESCT, which lead to fewer ancillary studies. CONCLUSIONS: NESCT is accurate, reliable and safe, and has many advantages over EU, and therefore could be recommended as a first diagnostic modality for the evaluation of patients with suspected urolithiasis.
Diagnosis* ; Humans ; Prospective Studies ; Sensitivity and Specificity ; Tomography, Spiral Computed* ; Urinary Calculi ; Urography ; Urolithiasis*

Animal experiment was carried out to measure the physiologic changes of thoracic or thoracolumbar spine that occurred as a result of electrical stimulation, and to evaluate the usefulness of electrical stimulation as a possible treatment for scoliosis. Unilateral electrical stimulations were applied to the back muscle of immature rabbits.They were subgrouped into medial, intermediate, and lateral muscle stimulated groups in order to observe the effects of various electrode placements. The radiograms were taken every other week to observe the changes of the spinal curvatures for the period of 12 weeks. The histological studies of the muscles, which were obtained from the stimulated(right) and the nonstimulated(left) sides at the same level, also were carried out to determine the response of the muscles to the electrical stimulation. The results were as follows. l. A significant scoliotic curvature was observed two weeks after electrical stimulation, and those curvatures did not change more for the next six weeks in spite of prolonged stimulation. 2. Scoliotic curvature induced by electrical stimulation for eight weeks remained unchanged for another four weeks after stopping stimulation. 3. There were no statistical differences in the induced scoliotic curvature among the three groups stimulated at different sites of the medial, intermediate, and lateral regions respectively. 4. A prolonged unilateral electrical stimulation could induce the scoliosis, and may be used as a method for treatment of scoliosis.
Animal Experimentation ; Back Muscles ; Electric Stimulation ; Electrodes ; Methods ; Muscles ; Scoliosis ; Spinal Curvatures ; Spine

Few reports exists citing a case of a retropharyngeal bronchogenic cysts. In this study, we report a bronchogenic cyst with a cystic appearance observed in the retropharyngeal space.
Bronchogenic Cyst ; Pharyngeal Diseases ; Tomography, X-Ray Computed

PURPOSE: To determine the hemodynamics of the pancreas by investigating the enhancement patterns of pancreaticparenchyma, as seen on spiral CT, after the administration of various amounts of contrast medium, and to determineoptimal scan time by knowing the peak time of normal pancreatic parenchyma. MATERIALS AND METHODS: Between January1995 and April 1997 55 cases of normal abdominal CT with dynamic enhancement study on pancreas, the subject were38 cases(28 persons) with good image, aged 21-65 years, men were twenty-one and women were seven. Non-ioniccontrast medium, 30ml(n=15), 60ml(n=9), 990ml(n=7), and 120ml(n=7) were injected at a rate of 3ml/sec. From 20sec. after the start of injection, 15 images were obtained at 3-sec intervals. Before and after injection, R.O.I.was applied to each image, and for the aorta and pancreatic parenchyma, Hounsfield units(H.U.) were measured; timeof enhancement and maximal H.U. were also measured. RESULTS: After 30, 60, 90, and 120ml of contrast mediuminjection, mean maximal H.U. of pancreatic parenchyma was 36+/-7, 54+/-6, 68V13, and 92+/-8, respectively; mean valueat peak parenchymal enhancement of the pancreas was 27+/-3, 32+/-3, 42+/-3, and 52+/-3, respectively. Time intervalsof maximal enhancement of aorta and pancreatic parenchyma could not be obtained in 30ml injection, but 5,4+/-2.5,4.2+/-1.6, and 6.0+/-2.1sec in 60, 90, and 120ml injection, respectively. CONCLUSION: Maximal H.U. of parenchymalenhancement of the pancreas is directly proportional to the amount of injected contrast medium and the peak timeof parenchymal enhancement was 12sec after the injection of contrast material. Time interval of maximalenhancement of aorta and pancreatic parenchyma was 5.2+/-2.1sec.
Aorta ; Contrast Media ; Female ; Hemodynamics ; Humans ; Male ; Pancreas* ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed

Superficial fungal infections of the face, especially at the beard region, are frequently misdiagnosed. Application of corticosteroids modifies these original clinical manifestations and induces other dermatoses, which may lead to misdiagnosis. We report the case of a patient with fungal folliculitis on the face. The patient had multiple papules and pustules on the perioral area, cheek and periorbital area. Clinically, these lesions looked like lupus miliaris disseminatus faciei or rosacea. At first, we treated the patient with systemic roxithromycin and topical clindamycin, but there was no response to the therapy. Histopathological and mycological examinations revealed that the diagnosis was folliculitis due to Trichophyton mentagrophytes. The lesion was cured by administration of itraconazole for 6 weeks.
Adrenal Cortex Hormones ; Cheek ; Clindamycin ; Diagnosis ; Diagnostic Errors ; Folliculitis* ; Humans ; Itraconazole ; Rosacea ; Roxithromycin ; Skin Diseases ; Trichophyton*