This study was designed to evaluate the therapeutic effect between single(A group) and five-day(B group) administration of IV gammaglobulin in the patients with Kawasaki disease from June 1987 to September 1993, who were admitted to the Department of Pediatrcs, Hanyang University College of Medicine. The clinical and echocardiographic results were as follows. 1) Of 90 cases, 40 cases belong to A group, and 50 cases to B group. The ratio of male to female was 2.60 : 1, and 85% of A group and 76% of B group was under the age of 3 years. 2) In 90% of A group and 88% of B group, peak level of platelet count was above 400,000.mm3, and as a whole peak level of platelet in 88.9% above 400,000/mm3. 3) Complications in S group were hepatitis(22.5%), coronary arterial involvement(12.5%), and gall bladder hydrops(7.5%), and in B group hepatitis(26%), gall bladder hydrops(18%), coronary arterial involvement(12%), pericardial effusion(4%), and meningitis(2%). 4) All 5 cases with mild coronary arterial dilatation in a group had improved in follow up echocardiography after 6 months. And in B group, 5 of 6 cases with coronary arterial involvement had improved, but coronary pathology in one case with large coronary aneurysm sustained after 2 years. In conclusion, we could not find the significant difference in reduction of the duration of illness or the coronary arterial disease between two groups, but we recommend single intravenous infusion of gammaglobulin as soon as possible to prevent severe coronary arterial disease.
Blood Platelets ; Coronary Aneurysm ; Dilatation ; Echocardiography ; Female ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Male ; Mucocutaneous Lymph Node Syndrome* ; Pathology ; Platelet Count ; Urinary Bladder

No abstract available.
Adiposity* ; Adult* ; Humans

Diabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes and is diagnosed as the presence of symptoms and/or signs of peripheral nerve dysfunction in people with diabetes. The prevalence of DPN was reported at 33.5% of type 2 diabetes patients by the Korean diabetes neuropathy study group. Early diagnosis is recommended to prevent diabetic foot ulcers, amputation, or disability. A questionnaire asking about symptoms and neurologic examination of feet is commonly used as a screening tool. However, complete diagnostic tests for DPN are not well established because of incomplete understanding of the pathogenetic mechanisms leading to the nerve injury, the various clinical manifestations, and the unclear natural history. Therefore, DPN has not been paid sufficient attention by clinicians. The roles of glycemic control and management of cardiovascular risk factors in the prevention and treatment of neuropathic complications are well known. Pathogenetically oriented or symptomatic agents are other options, though such treatments do not always produce a satisfactory outcome. Therefore, DPN remains a challenge for physicians to screen, diagnose, and treat. There have been recent advances in understanding the mechanisms underlying DPN and in the development of new diagnostic modalities and treatments. In this review, diagnosis and management of DPN will be discussed.
Amputation ; Diabetes Complications ; Diabetic Foot ; Diabetic Neuropathies ; Diagnosis* ; Diagnostic Tests, Routine ; Early Diagnosis ; Foot ; Humans ; Mass Screening ; Natural History ; Neurologic Examination ; Peripheral Nerves ; Peripheral Nervous System Diseases* ; Prevalence ; Risk Factors ; Ulcer

Thirty-six sinus grafts were performed in 34 patients with an alveolar crest bone height in the posterior maxilla of 3 to 5 mm before grafting. The sinuses were grafted using Bio-Oss alone or mixed with fibrin glue. Group 1 was the control group and included 25 patients who received a xenograft mixed in saline. Group 2 comprised 9 patients who received a xenograft and fibrin glue. The study was further subdivided at the time of 9 months. This histologic study evaluated by hematoxylin-eosin (H & E) and histomorphometric analysis whether fibrin glue in combination with Bio-Oss enhances bone regeneration in sinus floor elevation in humans. The new bone formation was better in Group 2 than in Group 1, but the difference was not significant. The absorption of the graft material was faster in Group 2 than in Group 1, in the short term, but better in Group 1 over the long term, although the difference was not significant. Lamellar bone was formed earlier in Group 1 compared to Group 2, but the difference was not significant. Overall, the surgery site stabilized earlier with new bone formation in Group 2 than in Group 1, but the difference was not significant. Combining a fibrin sealant and Bio-Oss could lead to improved scaffolds for bone tissue engineering based on the synergistic effects of the biomaterials. Therefore, Bio-Oss or Bio-Oss plus Tisseel may be used depending on the situation.
Absorption ; Biocompatible Materials ; Bone and Bones ; Bone Regeneration ; Fibrin ; Fibrin Tissue Adhesive ; Floors and Floorcoverings ; Humans ; Maxilla ; Minerals ; Osteogenesis ; Transplantation, Heterologous ; Transplants

BACKGROUND AND OBJECT: Cheiro-oral syndrome (COS) is characterized by a sensory disturbance in the unilateral hand and ipsilateral mouth corner. It is usually due to a lesion in the parietal cortex, thatamocortical projections, thalamus, or rarely brain stem. However, the syndrome is relatively unknown and rarely mentioned in most neurological textbooks. We presented ten cases of COS with a review of the clinical symptoms and signs and the neuroradiological methods used to demonstrate the responsible site. METHODS AND RESULTS: We studied 10 patients with stroke who showed restricted sensory disturbance on the one hand and ispilateral mouth. The study forms consisted of clinical manifestaion, neurological examination, electrophysiological, and neuroradiologic studies. Computed tomography and/or magnetic resonance imaging identified lesion in the thalamus in 5, brain stem in 3, and corona radiata in 1 patient. But, the anatomical responsible site for one case was not founded. Infarction had occurred in nine cases and hemorrhage in one. Seven of the 10 patients showed sensory disturbances restricted to the perioral area, hands, fingers when they were first examined; the remaining patients complained more diffuse sensory disturbances at first, but it had become restricted to perioral and fingers, usually within 2-3 weeks. The durations of symptom varied from 5 days to more than 15 months and these symptoms were improved within 2-3 weeks to 4 months in treated patients. CONCLUSION: When the symptoms and signs of the COS were presented, especially if a history of migraine is lacking, neuroradiological methods such as CT or MRI should be undertaken to localize and diffentiate the nature of lesion.
Brain Stem ; Fingers ; Hand ; Hemorrhage ; Humans ; Infarction ; Magnetic Resonance Imaging ; Migraine Disorders ; Mouth ; Neurologic Examination ; Rabeprazole ; Stroke ; Thalamus

No abstract available.

Hypothyroidism can cause a variety of signs and symptoms of the neuromuscular system. However, ptosis in a patient with hypothyroidism is very rare. We report here on a case of central hypothyroidism that was due to Sheehan's syndrome and it manifested as bilateral ptosis in a 51-yr-old woman. She complained of exertional dyspnea and weakness. About 25-yr ago, she had a history of severe postpartum vaginal bleeding. The laboratory studies demonstrated hypopituitarism with secondary hypothyroidism. The ptosis was improved by replacement of thyroid hormone. Hypothyroidism should be considered in the differential diagnosis of patients who manifest with ptosis and that prompt replacement of hormone can lead to a complete recovery.
Blepharoptosis/complications/*diagnosis/drug therapy ; Electromyography ; Female ; Glucocorticoids/therapeutic use ; Humans ; Hypopituitarism/complications/*diagnosis/drug therapy ; Hypothyroidism/complications ; Magnetic Resonance Imaging ; Middle Aged ; Muscular Diseases/etiology ; Neuromuscular Junction/physiopathology ; Prednisolone/therapeutic use ; Thyroxine/therapeutic use

The authors report a case of cholesterol granuloma in the sphoid sinus in 54-year old woman, which is probably the first report of cholesterol granuloma arising primarily in the sphenoid sinus apart from the petrous bone. The initial clinical presentations were unilateral decreased visual acuity and facial sensory change. The mass was removed totally via transsphenoidal route and the pathological examination revealed cholesterol clefts and chronic granulomatous changes. The differences between the present case and the previous reports are discussed.
Cholesterol* ; Female ; Granuloma* ; Humans ; Middle Aged ; Petrous Bone ; Sphenoid Sinus* ; Visual Acuity

No abstract available.
Mucocele*

The purpose of this study was to evaluate the position of tongue and hyoid bone in relation to vertical facial patterns in the adult and child. Lateral cephalograms taken in adults(63 cases, 11.7 years in average age) and children(69 cases, 22.6 years in average age) were traced and measured about position and posture of tongue and hyoid bone using the horizontal and vertical reference lines. The angle of mandibular plane to SN plane was employed to classify the samples into groups of hypodivergent and hyperdivergent. The comparison of the tongue/hyoid bone measurements between hypodivergent group and hyperdivergent group in the adult and child were statistically executed with Student's t-test. The results were as follows; 1. The tongue height was lower in the hyperdivergent group than in hypodivergent group, and higher in children than in adults. 2. The vertical height of hyoid bone was higher in hypodivergent group than in hyperdivergent group and also higher in children than in adults. 3. The anteroposterior position was of no significant difference in relation to age or vertical facial pattern. 4. The inclination of hyoid bone in relation to cranial base was steeper in children than in adults.
Adult ; Child ; Humans ; Hyoid Bone* ; Malocclusion* ; Posture ; Skull Base ; Tongue*