No abstract available.
Ankle*

We report a case of a 6-month-old female who had had verrucous hemangioma since birth. The lesions were dark red, verrucous surfaced, hyperkeratotic papules on the right sole. A histopathological examination showed hyperkeratosis, papillomatosis, irregular acanthosis, lobular proliferation and dilatation of blood vessels in the deep dermis with a gap devoid of vessel proliferation in the mid dermis.
Blood Vessels ; Dermis ; Dilatation ; Female ; Hemangioma* ; Humans ; Infant ; Papilloma ; Parturition

Clinical observation was performed on 23 children with Guillain-Barre syndrome which were hospitalized at the Pediatric ward of Han Yang University Hospital, from July 1975 through May 1991.@ES The results were as follows: 1) The ratio of male patient to female was 2.8:1 and 47.8% of total GBS patients were between the ages 1 to 5 years. 2) The highest seasonal incidence of GBS was seen in summer and there was no significant variation of GBS annually.3) Preceding illness of GBS was found in 60% of the total patients, and upper respiratory infection was the most common (65%). 4) Muscular paralysis or weakness in extremities was the most common chief complaints on admission, and repiratory difficulty, vomiting, diarrhea, swallowing difficulty and myalgia were followed. 5) The sites of paralysis on admission were upper and lower extremities in 14 GBS patients (60.8%), lower extremities in 7 GBS patints (34.8%) and respiratory muscle in 4 GBS patints (17.3%), respectively. 6) The protein content of cerebrospinal fluid was elevated in 18 GBS patients of total (78.3%) on admission and remnant 5 GBS patients showed increased protein later. 7) There was a tendency that recovery time in 5 GBS patients with muscular fibrillation on E.M.G. was longer than in 4 GBS patients without muscular fibrillation. We thought further studies on critical evaluation and better treatment for GBS were needed.
Cerebrospinal Fluid ; Child* ; Deglutition ; Diarrhea ; Extremities ; Female ; Guillain-Barre Syndrome* ; Humans ; Incidence ; Lower Extremity ; Male ; Myalgia ; Paralysis ; Respiratory Muscles ; Seasons ; Vomiting

BACKGROUND AND OBJECTIVES: Tonsillectomy is a very common surgical procedure in otolaryngology. Steroid is often given to decrease postoperative morbidity from the procedure. This study was designed to determine the intraoperative and postoperative efficacy of the intravenous administration of dexamethasone sodium phosphate, the long-acting steroid, before or after tonsillectomy. MATERIALS AND METHODS: Sixty children aged between 3 to 15 years were divided into three groups. Twenty children received intravenous dexamethasone sodium phosphate (1 mg/kg up to 15 mg) before undergoing sharp dissection tonsillectomy (group I). Another twenty children received it after operation (group II). The third group was control and did not receive the intravenous dexamethasone sodium phosphate (group III). Intraoperatively blood loss, surgical and anesthesia time were checked. After the operation, each child was evaluated for pain, oral intake, vomiting, body temperature, and bleeding. RESULTS: There were no statistically significant differences noted in blood loss, surgical time, anesthesia time, pain score, oral intake, vomiting, and postoperative bleeding among the three groups of patients. CONCLUSION: The results showed that a single dose of the intravenous dexamethasone sodium phosphate did not affect the postoperative morbidity in children undergoing sharp dissection tonsillectomy.
Administration, Intravenous ; Anesthesia ; Blood Loss, Surgical ; Body Temperature ; Child ; Dexamethasone* ; Hemorrhage ; Humans ; Otolaryngology ; Sodium ; Tonsillectomy* ; Vomiting

BACKGROUND: Onychomycosis has become one of the common fungal infection. However, highly reliable and sensitive methods of detecting and identifying causative fungi of onychomycosis are not established yet. Polymerase chain reaction (PCR) analysis of clinical specimens including blood, sputum, urine, and cerebrospinal fluid collected from patient systemically infected fungus is known as a sensitive diagnostic method. But it has been questionable whether PCR analysis is also applicable to onychomycosis. OBJECTIVE: The purpose of this study was to develop a DNA-based diagnostic method to improve the sensitivity and specificity of detection and identification of pathogenic fungi of onychomycosis. METHODS: To detect the fungi in the nail, PCR was performed by using 4 sets of primer (TR1 & TR2, NS5 & NS6, B2F & B4R and CA1 & CA2) designed in conserved sequences of the small ribosomal subunit (185-rRNA) genes and restriction enzyme analysis of amplified product by Hae III was done to identify species. Nail specimens were obtained from 19 cases of onychomycosis confirm by fungus culture. RESULTS: 1. Preparation of nail powder, which is necessary for removal of keratin, and composition of lysis buffer with guanidinium thiocyanate, Tris-HCl, and beta -mercaptoethanol are the most proper modalities for isolation of fungal DNA from fungus-infesting nails. 2. Specific fragments of the 18S-rRNA gene of fungi, 581 bp, 308 bp, 688 bp and 1106 bp were amplified respectively. From sequences of 18S-rRNA gene of fungi by universal primers, dermatophytes (Trichophyton rubrum, Trichophyton mentagrophytes) and yeast (Candida albicans) yielded identical products. 3. Using Hae III endonuclease, digested patterns of fragment of Trichophyton rubrum and Candida albicans resulted in different pattern. CONCLUSION: This method released enough DNA from fungus-infected nails to result in proper amplification and it can be possible to differentiate dermatophytes, yeasts, and molds using Hae III endonuclease. The present study is the first one to demonstrate the feasibility of this molecular biologic approach to identify fungi in the infected nail. Therefore, precise detection and identification of the causative fungi would be of help in investigating distribution of the causative fungi of onychomycosis as well as appropriate treatment of the disease.
Arthrodermataceae ; Candida albicans ; Cerebrospinal Fluid ; Conserved Sequence ; Diagnosis* ; DNA ; DNA, Fungal ; Fungi* ; Guanidine ; Humans ; Onychomycosis* ; Polymerase Chain Reaction* ; Restriction Mapping* ; Ribosome Subunits, Small ; Sensitivity and Specificity ; Sputum ; Trichophyton ; Yeasts

Hirsutoid papillomas of vulvae present as smooth or filiform papules located on the inner surfaces of the labia minora. This disease is usually considered as anatomical variants of the vestibular mucosa. Differentiation from condyloma acuminata is important to avoid unnecessary treatment. Herein we report a case of hirsutoid papillomas of vulvae in a 21-year-old female who complained of pruritic papules on the vulva of one year's duration. Papules were located on the inner surfaces of the left labia minora and vestible of the vulva. Clinically, they were quite similar to condyloma acuminata. Histologically, however, the epithelium was devoid of features of human papillomavirus(HPV) infections such as koilocytosis, double nucleation, and dyskeratosis.
Epithelium ; Female ; Humans ; Mucous Membrane ; Papilloma* ; Vulva* ; Young Adult

The long-term studies of total knee arthroplasty (TKA) have confirmed reliable relief of pain and maintenance of function. However there have been few generalized studies of factors influencing the results of TKA. We evaluated retrospectively 187 TKAs (137 patients) which had been performed between January 1987 and May 1995. The follow-up period was from one year to eight years (mean, 3 years and 8 months). There were 133 knees of osteoarthritis (OA), 43 knees of rheumatoid arthritis (RA) and 11 knees of other causes including septic knee sequelae. We considered the preoperative factors as age, sex, side (right or left), body weight, height, primary disease, flexion contracture (FC), further flexion (FF), range of motion (ROM) of joint, deformity of varus and valgus and pain score, muscle strength score, instability score, total knee score according to the knee rating scale of the Hospital for Special Surgery (HSS). We considered the clinical results as FC, FF, ROM, pain, muscle strength, instability, total knee score according to the knee rating scale of the HSS and the radiological results as Roentgenographic Evaluation and Scoring System of American Knee Society and radiolucent line more than 2mm in width. We evaluated the clinical and radiological results of TKAs followed up more than I year and analyzed the results based on above factors. The results were as follows: 1. The preoperative factors influencing final FC were not the primary disease and FC, but the FF and ROM. The preoperative factors influencing final FF and ROM were the primary disease, the FF and ROM. 2. The pain, muscle power, instability scores were improved but there was no significant factor influencing them. The HSS knee scores were higher in OA group than RA group postoperatively. 3. There was no preoperative factor influencing the complication, revision, the radiological results. The preoperative factors influencing the results of TKA were the FF, ROM and the primary disease.
Arthritis, Rheumatoid ; Arthroplasty* ; Body Weight ; Congenital Abnormalities ; Contracture ; Follow-Up Studies ; Joints ; Knee* ; Muscle Strength ; Myalgia ; Osteoarthritis ; Range of Motion, Articular ; Retrospective Studies

Nineteen revision total knee arthroplasties (TKAs) performed from March 1991 to March 1995 were evaluated to determine the clinical and roentgenographic results and the problems in revision TKA. The mean age was 63 years (range, 23-85 years) and the mean follow-up time was 19 months (range, 12 months-4.4 years). The primary revisions were done in eighteen knees and a re-revision, in one. Four revision TKAs were performed for failed unicompartmental arthroplasty and fifteen, for failed TKA. The mean interval from initial to revision TKA was 4.1 years (range, 3.3 years-5 years) in failed unicompartmental arthroplasty and 5.7 years (range, 4 months-14 years) in failed TKA. The initial diagnosis was degenerative arthritis in 16 knees, tuberculous arthritis in two and rheumatoid arthritis in one. The main cause of revision for both of the failed unicompartmental arthroplasties and failed TKAs was aseptic loosening. The HSS knee score improved from 43+/-14 to 82+/-7 in the failed unicompartmental arthroplasties and from 46+/-16 to 79+/-14 in the failed TKAs. The clinical success rate of revision TKA was 78%. The coronal tibiofemoral angle improved from valgus 0.2degrees to valgus 5.1degrees. At final follow-up, radiolucent line greater than 2mm in width was found around femoral component in one knee. In our series, four complications were occurred. One knee was fused due to mas-sive bone loss and ipsilateral femur shaft fracture. Deep wound infections were developed in two knees and loss of fixation after tibial tuberosity osteotomy in one. In conclusion, significant improvements of clinical and radiological results were achieved in revision TKA but the success rate was relatively low and the complication rate was relatively high compared with primary TKA. So, especially appropriate skillful surgical techniques and postoperative cares were required to overcome the soft tissue problem and infection which was encountered in revision TKA.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty* ; Diagnosis ; Femur ; Follow-Up Studies ; Knee* ; Osteoarthritis ; Osteotomy ; Wound Infection

Severe cough may contribute to serous coplications such as pneumothorax, pneumomediastinum, rib fracture, subconjunctival hemorrhage, subdural hemorrhage and cough syncope. However abdominal wall hematoma is a rare complication. Because it usually presents with abdmoianal pain, abdominal wall hematoma needs to be differentiated from the acute surgical abdomen. A 78-year-old woman was admitted with right lower quadrant abdominal pain and a palpable mass for several days. She experienced abdominal pain after violent coughing associated with an upper respiratory tract in fection. Abdominal computed tomography revealed an approximately 7×4 cm sized, ill-defined, soft tissue density lesion in the right lower posterolateral abdominal wall. An abdominal wall hematoma was diagnosed. After admission, she had persistent right lower abdominal pain and an increasing mass. The mass was surgically removed and she was discharged without complications. In summary, when a patient complains of abdmonial pain after severe coughing, an abdominal wall hematomas as a differential diagnosis must be considered.
Abdomen ; Abdomen, Acute ; Abdominal Pain ; Abdominal Wall* ; Aged ; Cough ; Diagnosis, Differential ; Female ; Hematoma* ; Hematoma, Subdural ; Hemorrhage ; Humans ; Mediastinal Emphysema ; Pneumothorax ; Respiratory System ; Rib Fractures ; Syncope

PURPOSE: Ciliary abnormalities of the respiratory system usually accompany recurrent or persistent respiratory diseases such as paranasal sinusitis, bronchiectasis, rhinitis, and/or otitis media, since they cause certain derangements in ciliary cleaning activities. This disease is usually inherited by autosomal recessive trait, but may also be found to be acquired or transient in rare cases after heavy exposure to pollutants, cigarette smoking or severe infection. We performed this study in children with frequently recurrent or persistent respiratory diseases to clarify if the ciliary abnormalities are preceding factors. METHODS: We enrolled 17 children with suspected respiratory ciliary abnormalities. The indications for evaluation of ciliary ultrastructure were recurrent or persistent respiratory infections. Children with immunologic abnormalities were excluded. From August 2000 to July 2003, we performed a biopsy on nasal mucosa and examined the structure of ciliary status by using an electron microscope. RESULTS: Of the subjects, there were seven males and 10 females, aged 2 to 10 years. Out of the 17 subjects, 12 cases of chronic paranasal sinusitis, nine chronic coughs, nine frequent upper respiratory infections, seven cases of recurrent otitis media, four cases of recurrent pneumonia, and four cases of bronchial asthma were found. Out of the 17 cases on which histologic examinations were conducted, four cases showed pathologic findings, including one case of inner dynein arm defect, one of microtubular transposition, one of supernumerous tubules, and one singlet, respectively. CONCLUSION: It is essential for differential diagnosis and effective treatment to identify the abnormalities of ultrastructure of nasal cilia in children with symptoms of frequently recurrent or persistent respiratory diseases, if immunodeficiency or respiratory allergy could be excluded.
Arm ; Asthma ; Biopsy ; Bronchiectasis ; Child* ; Cilia* ; Cough ; Diagnosis, Differential ; Dyneins ; Female ; Humans ; Hypersensitivity ; Male ; Nasal Mucosa ; Otitis Media ; Pneumonia ; Respiratory System ; Respiratory Tract Infections ; Rhinitis ; Sinusitis ; Smoking