BACKGROUND: The value of serum lipid in children after recovery of Kawasaki disease may be important bacause of the predilection of this disease for the coronary artery. METHODS: To determine the alterations in serum total cholesterol(TC) and high density lipoprotein(HDL)-cholesterol levels in Kawasaki disease(KD), we measured serum HDL-cholesterol and TC in 35 patients(mean age 36.8+/-22.0 months, range 6 to 93 months) with Kawasaki disease(KD) during 10 days or less after the onset(group A) and 2 months later after recovery. TC and HDL-cholesterol were also measured in an acute febrile respiratory illness group(group B) and a nonfebrile respiratory illness group(group C) to compare with those of KD. RESULTS: HDL-cholesterol levels in group A were depressed(29.6+/-11.0mg/dl) compared with group B and C(47.3+/-13.3mg/dl and 45.1+/-12.4mg.dl, respectively, p<0.01). TC levels in group A(145.1+/-33.1mg/dl) were not significantly different from those of group B(146.8+/-33.4mg/dl) and C(157.1+/-29.6mg/dl). Also the level of serum HDL-cholesterol in the acute phase of KD was significantly lower when compared with that after recovery(30.2+/-13.2mg/dl vs 50.0+/-10.2mg/dl, p<0.05). In KD patients, TC levels were not significantly different between the acute & recovery phase(145.0+/-26.6mg/dl, 153.4+/-32.6mg/dl). Echo-cardiography confirmed coronary artery aneurysms in 11 patients(31.4%) and otherwise, normal findings(n=24) in the KD group. There were no significant difference in TC level(140.7+/-27.6mg/dl vs. 146.9+/-35.4mg/dl, p=NS) and HDL cholesterol level(30.1+/-12.5mg/dl vs. 29.2+/-10.7mg/dl, p=NS) between patients with and without coronary aneurysms. CONCLUSIONS: HDL-cholesterol levels were significantly depressed only in the acute phase of KD but TC levels did not change significantly. Both levels were not related to coronary artery aneurysm.
Aneurysm ; Child ; Cholesterol, HDL ; Coronary Aneurysm ; Coronary Vessels ; Humans ; Mucocutaneous Lymph Node Syndrome*

Red blood cells that agglutinate with most normal adult sera but never with own sera are termed polyagglutinable and can be separated by patterns of lectin reactivity into various types. Among these polyagglutination, activation of the T cryptantigen occurs when carbohydrate structures on glycophorins A and B lose sialic acid and express the disaccharide Gal beta-l-3 GalNac which reacts with the peanut agglutinin, a lectin from Arachis hypogaea. T activation is a temporary condition due to exposure of the membrane antigen to the action of microbial neuraminidase. In T activated red cells, the following hazards, which are theoretically possible, are spontaneous polyagglutination of red cells in vitro, in vivo and severe blood transfusion reactions. We experienced a case of T activation in 6 month old girl with bacterial meningitis caused by Streptococcus pneumoniae. The reactivity to lectins indicated the patient's red cells were T activated. We report a case of T activation in an infant with the review of literature.
Adult ; Arachis ; Blood Transfusion ; Erythrocytes ; Female ; Glycophorin ; Humans ; Infant ; Lectins ; Membranes ; Meningitis, Bacterial ; N-Acetylneuraminic Acid ; Neuraminidase ; Peanut Agglutinin ; Streptococcus pneumoniae

Enchondromas generally occur in the hand and uncommonly in the long bones. Because enchondromas are usually asymptomatic, most are discovered during diagnostic radiology for another disease. Here, we describe a case of enchondroma in the right humerus in a 79-year-old female patient with concomitant rotator cuff tear arthropathy. The patient was initially hospitalized for prolonged pain and pseudoparalysis of the right shoulder. The condition, which was histologically confirmed as an enchondroma in the proximal humerus, was treated with curettage and reverse total shoulder arthroplasty. In this case report, we present a rare case of an enchondroma with combined rotator cuff tear arthropathy.

BACKGROUND: The oncogene, c-fos, is a useful marker of nociceptive neurons activated by various types of pain.However, the relationship between c-fos and acute pain induced by surgical incision has not been studied.The purpose of this study was to describe the expression of spinal c-fos in a rat model of postoperative pain. METHODS: Sprague-Dawley rats were used to enumerate spinal fos-like immunoreactive (fos-LI)-positive neurons after making sham, skin, or skin-muscle incisions on the plantar surface of the rat hindpaw. The spinal cords were divided into the following 4 segments for immunohistochemical detection of fos-LI at 3 time points after the incision (4 hours, POD1, and POD3):thoracic, upper lumbar, lower lumbar, and sacral.For analysis of the laminar distribution of fos-LI, the dorsal horn was divided into three regions (I-II, III-IV, and V-VI). RESULTS: The number of fos-LI was increased in the ipsilateral spinal dorsal horn in the lower lumbar segment 4 hours post-incision and was significantly greater in rats with skin-muscle incisions than in rats with skin-alone incisions.In the skin-muscle group, laminae I-II and V-VI had a greater number of fos-LI neurons than laminae III-IV.The increase in number of spinal fos-LI neurons normalized by POD1 and POD3. CONCLUSIONS: c-fos expression is confined to neurons of the spinal dorsal horn known to be activated by nociceptive stimulation. The larger the injury elicited, the greater the expression of c-fos, suggesting that the expression of c-fos can serve as a useful marker of activated nociceptive neurons caused by acute pain following surgical incision.Further study is required to elucidate why the degree of tissue injury affects the laminar distribution of c-fos expression.
Acute Pain ; Animals ; Horns ; Neurons ; Nociceptors ; Oncogenes ; Pain, Postoperative ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; Skin ; Spinal Cord

Congenital adrenal hyperplasia is inherited disorder of adrenal steroidogenesis. 21-hydroxylase deficiency is the most commone enzymatic defect and is divided into classic and late-onset or nonclassic forms. Both classic non-classic 21-hydrozylase deficiencies are inherited in a recessive manner as allelic variants. But it is rare that happened in twin infants. Chief complaints of affected twins in our case were ambiguous genitalia, hyperpigmentation and dehydrations. They were revealed into hyponatremia, hyperkalemia and increased amount of serum progesterone, 17-hydroxyprogesterone and urinary 17-ketosteroid excretion and were administered with DOCA, 9alpha-fluorohydrocortisone, hydrocortisone to control the electrolyte imbalance. And now, both of them are going to normal ratio of weight gain and body growth.
17-alpha-Hydroxyprogesterone ; Adrenal Hyperplasia, Congenital* ; Desoxycorticosterone Acetate ; Disorders of Sex Development ; Humans ; Hydrocortisone ; Hyperkalemia ; Hyperpigmentation ; Hyponatremia ; Infant ; Progesterone ; Steroid 21-Hydroxylase* ; Twins* ; Weight Gain

The status of renal replacement therapy in Korea as follows ; 1) The response rate to questionaire was 57.9% of the 226 hemodialysis centers in Korea and data file was sent in the 62.4% of responder. 2) The number of dialysis center was 226 and the number of hemodialysis machine was 3,507 and annual increasing rate were 8,7%, 14.0%, respectively. 3) The total number of ESRD patients was 20,244 and prevalance and incidence of ESRD were 431.9 and 101.1 patients per million population(ppm). 4) The proportion of renal replacement therapy was hemodialysis(HD) 53.3%, peritoneal dialysis(PD) 17.196, renal transplants(KT) 29.5%. 5) The proportion of long-term and elderly patients was markedly increased comparing 1985 (long term dialysis 20% vs. 2%, over 60 year old patients 26.2% vs. 13.8%. 6) The primary cause of renal disease was diabetic nephropathy 34.09o, chronic glomerulone-phritis 20.8%, hypertensive nephropathy 15.7%. 7) The mean BMI(body mass index,' kg/M)in over 18 year old patients was 20.7+/-2.7 kg/M in the HD and 22.23.0 kg/M in the PD. 71.9M of HD patients and 73.2% of PD were in the normal range (18.5-24.9). 8) The fistula survival rate was 6 month 93.4%, 1 yr 91.7%, 3 yr 87.6%, 5 yr 84.7%. 9) The cause of death were cardiac disease 31.8%, miscellaneous 23.5%, vascular disease 17.2%, infection 14.2%, liver disease 1.2%, social cause 5.9%.
Adolescent ; Aged ; Automatic Data Processing ; Cause of Death ; Diabetic Nephropathies ; Dialysis ; Fistula ; Heart Diseases ; Humans ; Incidence ; Kidney Failure, Chronic ; Korea* ; Liver Diseases ; Middle Aged ; Reference Values ; Renal Dialysis ; Renal Replacement Therapy* ; Survival Rate ; Vascular Diseases

No abstract available.
Diethylstilbestrol* ; Female ; Humans ; Lymphocytes* ; Siblings* ; Sister Chromatid Exchange*

Os subfibulare is a accessory bone arround the lateral maleolus, but it is different from many other accessory bones in foot and ankle in its development related to trauma and frequent symptoms of ankle instability. Accessory bone is a developmental anomaly which fails to unite to main secondary ossification center and usually asymptomatic. But os subfibulare is developed by recurrent ankle sprains in younger age or non-union of avulsion fracture of anterior talofibular ligament and causes instability of ankle. We experienced two cases of symptomatic os subfibulare in adolecents and report them with review of literatures.
Ankle ; Ankle Injuries ; Foot ; Ligaments

No abstract available.
Hyperlipidemias* ; Kidney* ; Transplantation*

PURPOSE: The value of serum lipid in children after recovery of Kawasaki disease may be important because of the predilection of this disease for the coronary artery. METHODS: We measured serum high density lipoprotein (HDL)-cholesterol, total cholesterol, triglycerides in 22 patients (mean age 38months, range 6 to 93 months) with Kawasaki disease during 10 days or less after onset and 2 months later after recovery. RESULTS: The level of serum HDL-cholesterol was depressed in the acute stage compaired with the level after recovery (33.6+/-15.2mg/dl vs. 54.8+/-8.3mg/dl, mean+/-S.D., p<0.05). Total cholesterol, triglycerides were normal during the acute stage (125.3+/-46.1mg/dl, 142.1+/-32.2mg/dl, respectively) and after recovery (147.4+/-35.5mg/dl, 130.6+/-74.9mg/dl, respectively). Echocardiography confirmed coronary aneurysm in 7 patients (31.8%) and otherwise, normal coronary figures (n=15). In the patients with coronary aneurysm, the level of serum total cholesterol, HDL-cholesterol were 134.0+/-34.1mg/dl, 34.5+/-14.9mg/dl, respectively and in the patients without coronary aneurysm 147.7+/-36.7mg/dl, 29.5+/-12.8mg/dl, respectively. They showed no significant differences between two groups (p=0.5, p=0.43, respectively). CONCLUSIONS: Significantly reduced HDL-cholesterol level, which is considered a risk factor for coronary atherosclerosis, is transient finding in the acute stage of Kawasaki disease and not associated with the incidence of coronary aneurysm. Further basic research is needed to elucidate the pathophysiology by which this abnormality is produced.
Child ; Cholesterol ; Cholesterol, HDL ; Coronary Aneurysm* ; Coronary Artery Disease ; Coronary Vessels ; Echocardiography ; Humans ; Incidence ; Lipoproteins ; Mucocutaneous Lymph Node Syndrome* ; Risk Factors ; Triglycerides