556 children(220 boys and 336 girls) of clinical ametropia among 4715 children of a grade school were determined under 5% homatropine cycloplegia. 1) As to the distribution of refractive errors, 60.2% were myopic and 32,7% were hyperopic; 17.8% had astigmatism and 81.1% did not. 2) Refractive errors were numerous around the age of 11. 3) The degree of refraetive errors varied, but in the great majority was less than -3.00 D. 4) As to the type of astigmatism, 52.2% were with the rule and 41.2% were against the rule. 5) Only 12 children were anisometropic.
Astigmatism ; Child* ; Humans ; Refractive Errors*

Transcutaneous electrical nerve stimulation (TENS) has widely been employed as a method of obtaining analgesia in medical practice. The mechanisms of pain relief by TENS are known to be associated with the spinal gate control mechanism or descending pain inhibitory system. However, most of the studies concerning the analgesic effects and their mechanisms for TENS have dealt with somatic pain. Thus, in this experiment, we investigated the analgesic effects of TENS on renal pain as a model of visceral pain, and the characteristics of the dorsal horn cells with renal inputs. The renal pain was induced by acute occlusion of the ureter or renal artery. The main results are summarized as follows: 1) The renal nerve was composed of A beta, A delta and C fiber groups; the thresholds for each group were 400-800 mV, 1.1-1.5 V, and 2.1-5.8 V, respectively. 2) The dorsal horn cells tested received A and/or C afferent fibers from the kidney, and the more C inputs the dorsal horn cells had, the greater was the response to the stimuli that elicited the renal pain. 3) 94.9% of cells with renal input had the concomitant somatic receptive fields on the skin; the high threshold (HT) and wide dynamic range (WDR) cells exhibited a greater responses than low threshold (LT) cells to the renal pain-producing stimuli. 4) TENS reduced the C-responses of dorsal horn cells to 38.9 +/- 8.4% of the control value and the effect lasted for 10 min after the cessation of TENS. 5) By TENS, the responses evoked by acute occlusion of the ureter or renal artery were reduced to 37.5 +/- 9.7% and 46.3 +/- 8.9% of the control value, respectively. This analgesic effects lasted 10 min after TENS. 6) The responses elicited by squeezing the receptive fields of the skin were reduced to 40.7 +/- 7.9% of the control value and the effects lasted 15 min after TENS. These results suggest that most of dorsal horn cells with renal inputs have the concomitant somatic inputs and TENS can alleviate the renal pain as well as somatic pain.
Animal ; Cats ; Female ; Kidney/innervation/*physiopathology ; Male ; Pain/physiopathology/*therapy ; Support, Non-U.S. Gov't ; *Transcutaneous Electric Nerve Stimulation

The authors reviewed 16 cases of spontaneous spinal epidural hematoma(SSEH) described in the Journal of the Korean Neurosurgical Society and one case unpublished case of our own. Attention was focused on sex,age, medical history, position and vertebral level of the hematoma, preoperative neurological condition and operative result. This study comprised 17 patients, 14 males and 3 females, between five and 79 years old. All vertebral segments were affected, though the thoracic area predominated. In 13 patients, sensory and/or motor deficit was incomplete and in four, SSEH resulted in complete preoperative sensory and motor loss. In all patients, the hematomas were removed surgically through total laminectomy. In four, postoperative recovery was total, but in ten, was incomplete, and the neurological condition of three showed no improvement. We concluded that in cases of SSEH, this operation is the treatment of choice.
Aged ; Female ; Hematoma ; Hematoma, Epidural, Spinal* ; Humans ; Laminectomy ; Male

The authors report a case of postoperative supratentorial epidural hematoma as a complication of acoustic neurinoma surgery. The 43-year-old man presented with hearing difficulty on the left side and decreased facial sensation. MR imaging demonstrated a huge, cystic left acoustic neurinoma and the retromastoid suboccipital approach was used for gross-total resection of the tumor. Postoperatively, the patient was drowsy and showed right hemiparesis. Computed tomographic scanning revealed a huge epidural hematoma in the left parietooccipital convexity. The intraoperative course was uneventful. Immediate craniotomy was performed and the epidural hematoma was removed. Bleeding from the superior sagittal sinus occurred, but was completely controlled. Postoperatively, the patient was neurologically normal, except for mild left facial weakness. Remote postoperative intracranial hemorrhage is a rare complication of craniotomy with significant morbidity and mortality. Such hemo-rrhages are likely to develop at or soon after surgery and can be related to the craniotomy site, operative positioning, and nonspecific mechanical factors. In this case, mechanical displacement of the brain secondary to excessive dehydration and CSF drainage was thought to be the cause of postoperative epidural hematoma. Clinical awareness of this rare but potential complication is essential to its early diagnosis and treatment. Difficulty in awakening from anesthesia and the development of new neurological deficits not attributable to the operative site are the most important keys to early diagnosis. Computed tomography is the diagnostic method of choice.
Acoustics* ; Adult ; Anesthesia ; Brain ; Craniotomy ; Dehydration ; Drainage ; Early Diagnosis ; Hearing ; Hematoma* ; Hemorrhage ; Humans ; Intracranial Hemorrhages ; Magnetic Resonance Imaging ; Mortality ; Neuroma, Acoustic* ; Paresis ; Sensation ; Superior Sagittal Sinus

BACKGROUND: Herpes zoster is a common dermatologic disorder. However, there has been no reported study of herpes zoster in children exclusively in the Korean literature. OBJECTIVE: The purpose of this study was to analyze epidemiological features and clinical characteristics of herpes zoster in children. METHODS: A retrospective study was performed by reviewing the medical records of 64 patients who were under 12 years old and who had herpes zoster. We searched for cases occurring during a 10-year-period from January 2000 to December 2009. We analyzed for age, gender, accompanying symptoms, dermatomal distribution, underlying disease, treatment and complications. RESULTS: Children under 12 years old account for 2.48% of all herpes zoster patients. The ratio of males to females is 1:1. The number of enrolled patients was increasing according to age (p=0.0004). The number (p=0.0009) and the proportion (p=0.0187) of pediatric patients has been increasing year by year. Underlying diseases were observed in 17.2%, and included asthma, atopic dermatitis, chronic sinusitis, epilepsy and tic disorder. There was no patient with immunocompression. Lesions of herpes zoster were most frequently found in the trigeminal dermatome (35.9%), followed by the thoracic (34.4%), cervical (14.1%), lumbar (9.4%), and sacral (4.7%) dermatomes, and multiple involvement (1.16%). Pain accompanying herpes zoster was reported in 54.7% and pruritus in 71.9%. Complications were observed in 14.1%; the most common one was eye involvement. CONCLUSION: The incidence of accompanying pain in children with herpes zoster is lower than in adults with this disease. However, the incidence of accompanying pruritus was higher in children than in adults. Postherpetic neuralgia did not developed in children.
Adult ; Asthma ; Child ; Dermatitis, Atopic ; Epilepsy ; Eye ; Female ; Herpes Zoster ; Humans ; Incidence ; Male ; Medical Records ; Neuralgia, Postherpetic ; Pruritus ; Retrospective Studies ; Sinusitis ; Tic Disorders

BACKGROUND: Pyogenic granuloma is a common vascular neoplasm of the skin and mucous membranes. However, few comprehensive studies are available on the clinical and histopathological characteristics of pyogenic granuloma. OBJECTIVE: To analyze the clinical and histopathological characteristics of pyogenic granuloma. METHODS: Patients with pyogenic granuloma diagnosed clinically and histopathologically were reviewed retrospectively. RESULTS: Fifty patients (17 males and 33 females) were enrolled, and the mean age of onset was 33.6 years old. The mean lesion size was 6.7 mm. Forty-eight patients had a solitary lesion, whereas two patients had multiple lesions on the skin and mucosa. The most common area for lesions was the head and neck followed by the hands, trunk, and lower extremities. Patient complained of easy bleeding, pain, tenderness, and pruritus. Dermoscopic findings of nine lesions showed patterns of a reddish homogenous area, white scaly collarette, white rail lines, and a hemorrhagic crust. Histopathological findings of all biopsy cases showed a lobular pattern of angiomatous tissue with numerous congested capillaries, a flattened epidermis, a well-formed epidermal collarette, and CD34-positive endothelial cells. Various treatment modalities including surgery and laser have been used, but lesions recurred following a single laser treatment with a pulsed dye laser or long-pulsed Nd:YAG laser. CONCLUSION: A correlation between clinicopathological and dermoscopic findings was useful for the differential diagnosis of other diseases mimicking pyogenic granuloma and to detect recurrence after treatment. Laser treatments were less invasive therapy, but the recurrence rate was higher than that of other surgical modalities when used alone. Additional prospective studies are needed to determine the effectiveness of the various treatment modalities.
Age of Onset ; Biopsy ; Capillaries ; Dermoscopy ; Diagnosis, Differential ; Endothelial Cells ; Epidermis ; Estrogens, Conjugated (USP) ; Granuloma, Pyogenic ; Hand ; Head ; Hemorrhage ; Humans ; Lasers, Dye ; Lower Extremity ; Male ; Mucous Membrane ; Neck ; Pruritus ; Recurrence ; Skin ; Vascular Neoplasms

BACKGROUND: Generalized lichen nitidus is a rare subtype of lichen nitidus characterized by multiple, flesh-colored, shiny papules occurring over the entire body. OBJECTIVE: We investigated the clinical features of generalized lichen nitidus in patients followed up at our institution. METHODS: The patients with generalized lichen nitidus diagnosed clinically and histopathologically between 1998 and 2007 were reviewed. RESULTS: Twelve patients (9 males and 3 females) were enrolled in this study and the mean age at onset was 10.3 (range: 4~27) years. Of the 12 patients, 5 (41.7%) experienced pruritus and 4 (33.3%) had atopic dermatitis. None of the patients had a family history of lichen nitidus. Nine patients were treated with topical steroids, systemic steroids, oral antihistamines, or narrow-band UVB. We propose that narrow band UVB is an effective treatment modality for generalized lichen nitidus. The mean duration to clearance was 37.7 (range: 7~120) months and the disease was relapsing in 2 patients. The duration to clearance was correlated to the age at onset (p=0.0005) and to the duration at the first visit (p=0.0000), whereas it was not related to the sex of the patient, pruritus or the accompanying atopic dermatitis. CONCLUSION: Generalized lichen nitidus is often associated with varying degrees of pruritus and the clinical course of the disease tends to be chronic. We propose that onset at an early age and the short duration of disease at the first visit are good prognostic factors, and that narrow band UVB is an effective treatment modality for generalized lichen nitidus.
Dermatitis, Atopic ; Histamine Antagonists ; Humans ; Lichen Nitidus ; Lichens ; Male ; Pruritus ; Steroids

Angiomyxolipoma is a rare variant of lipoma and seven cases have been reported in the English literature. The reported cases mostly presented with a well-demarcated, asymptomatic, solitary, subcutaneous mass on the scalp or extremities. Histopathologic features of this tumor are characteristic and consist of the paucicellular myxoid areas and the mature fat tissue, with numerous thin, dilated blood vessels. The important histopathological differential diagnoses include myxoid spindle cell lipoma, myxoid lipoma, angiolipoma, angiomyolipoma, superficial angiomyxoma, myxoid liposarcoma and low-grade myxofibrosarcoma. We describe a 38-year-old man with multiple angiomyxolipoma on the gluteal area and the upper and lower extremities.
Adult ; Angiolipoma ; Angiomyolipoma ; Blood Vessels ; Diagnosis, Differential ; Extremities ; Humans ; Lipoma ; Liposarcoma, Myxoid ; Lower Extremity ; Myxoma ; Scalp

BACKGROUND: Lichen planus is a chronic papulosquamous disease characterized by various clinical manifestations of the skin, mucosa, hair, and nails. Various drugs or physical treatments for lichen planus have been proposed, but the efficacies are often disappointing and controversial. Linear lichen planus is a rare variant of lichen planus, which accounts for 0.2~0.6% of all patients with lichen planus. Systemic corticosteroids remain the most widely used treatment for lichen planus. However, there have been no clinical studies on the effectiveness of this therapy on linear lichen planus despite the fact that linear lichen planus usually lasts for more than 1 year and occasionally results in cosmetic problems. OBJECTIVE: This study evaluated the efficacy and safety of oral methylprednisolone therapy for linear lichen planus. METHODS: Retrospective study was performed by reviewing the medical records and clinical photographs of 12 linear lichen planus patients treated with oral methylprednisolone. The analyses of treatment response to oral methylprednisolone therapy, adverse effects, and recurrence were performed. RESULTS: All the 12 patients who completed the oral methylprednisolone therapy achieved complete response. Most patients showed a marked improvement 1 to 2 weeks after starting oral methylprednisolone therapy. Three of the 12 patients showed recurrence at 9 to 14 weeks after cessation of the treatment. Oral methylprednisolone therapy was generally well-tolerated and no serious adverse effects were observed. CONCLUSION: Oral methylprednisolone therapy is an efficacious, safe, and tolerable treatment modality for linear lichen planus.
Adrenal Cortex Hormones ; Cosmetics ; Hair ; Humans ; Lichen Planus ; Lichens ; Medical Records ; Methylprednisolone ; Mucous Membrane ; Nails ; Recurrence ; Retrospective Studies ; Skin

Acute hemorrhagic edema of childhood or infancy (AHE) is a benign form of leukocytoclastic vasculitis with many similarities to Henoch-schonlein purpura (HSP). It occurs in children younger than 2 years and is characterized by abrupt onset of inflammatory edema and ecchymotic purpura in a target or cockade pattern, that resolve spontaneously within 3 weeks. AHE had been considered by some as a variant of HSP which shares certain clinicopathologic features. But most authors have regarded it as an entity distinct from HSP in view of the younger age of patients, lack of visceral involvement, distinctiveness of cutaneous lesions, absence of perivascular IgA on immunofluorescence, and excellent prognosis. We report a typical case of AHE presenting with a cockade or target-like purpura and edema on the face and acral areas with excellent prognosis in a 13-month-old boy.
Child ; Edema* ; Fluorescent Antibody Technique ; Humans ; Immunoglobulin A ; Infant ; Male ; Prognosis ; Purpura ; Purpura, Schoenlein-Henoch ; Vasculitis