We reported a case of subcutaneous mass in a 22-year-old lady having unusual histopathologic findings mixed with both features of pilomatricoma and epidermal cyst and the meanings of these peculiar findings were discussed.
Epidermal Cyst* ; Humans ; Pilomatrixoma* ; Young Adult

PURPOSE: To describe radiologic findings of burn-associated persistent candidemia of the thorax. MATERIALS AND METHODS: This study included 42 patients with major burns in whom blood culture had shown the presence for more than 24 hours of persistent candidemia. The duration of positive culture for candidiasis ranged from two to 67 days(mean, 15 days). Radiographic(n=42) and thin-section CT findings(n=13) were retrospectively analyzed. The onset, pattern, size, distribution and persistence of parenchymal abnormalities as well as the presence or absence of pleural effusions, mediastinal lymphadenopathy and cardiomegaly were assessed. RESULTS: On chest radiographs, positive findings were noticed in 61.9%(26/42) and on thin-section CT, in 76.9%(10/13). The most frequent radiographic finding was pulmonary nodule(s), observed in 14 patients(33.3%). in 13, these were bilateral. Bronchovascular bundle thickening(n=6, 14.3%), consolidation(n=4, 9.5%), cardiomegaly(n=6, 14.3%) and pleural effusion(n=4, 9.5%) were also observed. Those lesions appeared eight to 129 days(mean, 33days) after the burn. Radiographic abnormalities persisted for seven to 115 (mean, 35) days, regardless of the treatment. Thin-section CT showed parenchymal abnormalities in 10/13 patients(76.9%) and subpleural nodules of less than 1cm in diameter and without halo in all patients. Cardiomegaly, pleural effusion and mediastinal adenopathy were observed on CT in 5(38.5%), 4(30.8%) and 2(15.4%) of the 13 patients, respectively. CONCLUSION: In a high proportion of patients with burn-associated candidemia, chest radiograph and thin-section CT findings were positive. The most frequent radiographic parenchymal abnormality was multiple bilateral nodules.
Burns* ; Candidemia* ; Candidiasis ; Cardiomegaly ; Humans ; Lymphatic Diseases ; Pleural Effusion ; Radiography, Thoracic ; Retrospective Studies ; Thorax*

PURPOSE: To determine the incidence, etiology, sex, age, seizure type and prognosis of acute symptomatic seizures in children and evaluate the hypothesis that acute symptomatic status epilepticus(SE) is associated with an increased risk of subsequent unprovoked seizure compared with the risk of acute syrnptomatic seizure without SE. METHODS: Five hundred and sixty-eight convulsive children visited the Pediatric Department of Chungbuk National University Hospital from February 1991 to February 1999. Of these, 109 patients were determined as acute symptomatic seizure, and their medical record were reviewed. RESULTS: One hundred and nine children(59#boys, 50#girls) had acute symptomatic seizures, the ratio of male to female and the ages at the onset of first seizure were 1.18: 1 and 1.58+/-2.53 years, respectively. Causes of acute symptomatic seizure in order of frequency were acute gastroenteritis(33.0%), encephalopathy(31.2%), metabolic/toxic disturbance(19.3%), CNS infection (11.0%), brain trauma(2.8%), cerebrovascular disease(1.8%) and CNS tumor(0.9%). At six months of follow-up, the incidence of a first unprovoked seizure was 28.4% for children with acute symptomatic seizure, 67.6% for those with encephalopathic cause, 44% for those with structural cause, and O% for those with metabolic cause. At six months of follow-up, the risk of a first unprovoked seizure was significantly greater for those with acute symptornatic seizure with SE(100%) than without SE(22%). CONCLUSION: The leading causes of acute syrnptomatic seizures were acute gastroenteritis. Age-specific incidence was highest in the group aged 0-12 rnonths. The incidence of subsequent un-provoked seizure was highest in the group of encephalopathy. The risk for subsequent un-provoked seizure was greater for those with SE than for those without SE and for those with abnormal EEG and abnormal findings of neuroimage.
Brain ; Child* ; Chungcheongbuk-do ; Electroencephalography ; Female ; Follow-Up Studies ; Gastroenteritis ; Humans ; Incidence ; Male ; Medical Records ; Prognosis ; Seizures* ; Status Epilepticus

OBJECTIVES: lschemic acute renal failure(ARF) is characterized by an abrupt and sustained decline in GFR within minutes to days after renal ischemia and not immediately reversed on restoration of renal blood flow. The typical delay of a few days to a few weeks suggests reversible parenchymal damage awaiting cell regeneration for functional recovery. Many potentially cell damaging factors, such as ATP depletion, plasma membrane phospholipid degradatian and superoxide-induced membrane damage, play a central part in ischemic injury. More recently, much attention has been focused on the role of calcium, especially ischemic cell injury and the possible therapeutic role of calcium channel blockers emerged from studies conducted several years ago. In the past, it was thought that activation of renin-angiotensin system plays a role in the pathogenesis of ARF. Now the role of angiotensin in human renal ischemia also appears to be controversial. The following study was done in order to investigate the effect of a calcium channel blocker, nifedipine, on gene expression of renin during acute ischemic renal injury. METHODS: The Sprague-Dawley rats were divided into 4 groups, group I(n=3) as the control, group II (n=3) as the sham operation group, group III(n=15) as the ischemic renal injury group without nifedipine pretreatment, and group IV(n=15) as the ischemic renal injury model by right nephrectomy and left renal artery clamping for 40 minutes with systemic nifedipine pretreatment(10mg/kg), 1n ischemic renal injury model(group III and IV), rats were further divided into three subgroups according to reperfusion time of 1,24,72 hours. The non-ischemic right kidney removed at the time of initial procedure served as paired control. Total renal RNA was extracted by Chomczynskis method and electrophoresis was done in a 1% agarose gel containing 2,2M formaldehyde. Northern was performed at 42degrees C with isotope labeled renin probe for 18 hours, Autoradiographs were obtained and quantitated by a densitometer measured at 530nm. RESULTS: 1) The expression of renin gene was markedly decreased after renal ischemia and slowly recovered to one half of the control level after 72 hours of reperfusion. 2) Renin gene expression pattern of ischemic renal injury with prior nifedipine treatment was similar to the ischemic group without nifedipine pretreatment. CONCLUSION: These findings suggest that the renin gene expression was markedly decreased after renal ischemia and slowly recovered. Systemic nifedipine pretreatment does not have a significant effect on gene expression pattern of renin in ischemic renal injury.
Adenosine Triphosphate ; Angiotensins ; Animals ; Calcium Channel Blockers ; Calcium Channels* ; Calcium* ; Cell Membrane ; Constriction ; Electrophoresis ; Formaldehyde ; Gene Expression* ; Humans ; Ischemia ; Kidney ; Membranes ; Nephrectomy ; Nifedipine ; Rats ; Rats, Sprague-Dawley ; Regeneration ; Renal Artery ; Renal Circulation ; Renin* ; Renin-Angiotensin System ; Reperfusion ; RNA ; Sepharose

In 20 eyes of 10 rabbits, total hyphema were produced by injecting human fresh blood into the anterior chamber after aspirating the aquous humor. six hours later, 10 left eyes of them were treated with injection of urokinase into the anterior chamber. A control group of 5 right eyes were treated with normal saline and the other 5 right eyes were left untreated. The eyes treated with urokinase showed the most rapid rate of absorption of blood clot and clearance of corneal opacity among 3 groups. The comparison between the group treated with normal saline and the untreated group about the absorption rate of blood clot and clearance of corneal opacity were made. The former is slightly rapid than the later, but there was no significant differance between them. The observation of ciliary injection and changes of intraocular pressure had not shown a significant differance among 3 groups.
Absorption ; Anterior Chamber ; Corneal Opacity ; Humans ; Hyphema* ; Intraocular Pressure ; Rabbits* ; Urokinase-Type Plasminogen Activator*

Screw fixation of the tibial component offers advantages in initial fixation in cementless total knee replacement. But the high incidence of screw related osteolysis was reported. The purpose of this study is to evaluate clinical results of cementless total knee replacement and to look for radiographic changes at the screw-bone interface. From January 1988 to December 1991, primary cementless total knee replacements with Miller Galante I (Zimmer, Warsaw. IN) were performed to 53 knees at Kyung Hee university hospital. Among them, 21 cases which could be followed-up for more than 4 years were studied retrospectively about the clinical and radiographic results. The mean follow-up period was 5.5 years(ranged from 4.2 years to 8 years). At the last follow-up period, knee scores of Hospital for Special Surgery were improved from mean 56 points to 90 points and the range of motion from 72 degrees to 110 degrees. In the last follow-up radiographs, osteolysis around screw was classified as linear(type I ), cystic(type II ) and cavitary(type III ) according to the width of the lucency around screws. Among 21 cases, radiographic findings of osteolysis around screw were detected in 10 cases but not in 11 cases. But clinical results were similar between these two groups. Among the total 84 screws(4 screws in each case), 21 screws(25%) showed screw related osteolysis typed as I in 13 screws(15.4%), II in 4 screws(4.8%) and III in 4 screws(4.8%). Among the 13 cases that followed-up more than 6 years, 20 screws(38%) showed screw related osteolysis typed as in 11 screws(21.2%), I in 5 screws(9.6%) and II in 4 screws(7.8%). The most frequently involved site of screw was anteromedial(33.3%). In conclusion, after mean 5.5 year follow-up, the clinical results were satisfactory but the development of osteolysis around screw might be an indicator of the implant failure.
Arthroplasty, Replacement, Knee* ; Follow-Up Studies ; Incidence ; Knee ; Osteolysis* ; Range of Motion, Articular ; Retrospective Studies

No abstract available.
Humans ; Infant* ; Leukemia, Megakaryoblastic, Acute* ; Sarcoma, Myeloid*

Absence of one kidney is an uncommon congenital condition and concomitant genitourinary anomalies are very common. We encountered two cases of ureteral strictures associated with contralateral renal agenesis, which developed acute renal failure and recurrent pyelonephritis in children.
Acute Kidney Injury ; Child ; Constriction, Pathologic* ; Humans ; Kidney ; Pyelonephritis ; Ureter*

PURPOSE: The sinus lift procedure requires detailed knowledge of maxillary sinus anatomy and the possible anatomical variations. This study evaluated the location and prevalence of maxillary sinus septa using computed tomography (CT). METHODS: This study was based on the analysis of CT images for posterior maxilla which were obtained from patients who visited Chonbuk National University Dental Hospital during the period of June 2007 to December 2008. With the exclusion of cases presenting any pathological changes, 236 maxillary sinuses in 204 patients were retrospectively analyzed. The average age of the patients was 50.9. The cases were divided into two groups, an atrophy/edentulous segment and a non-atrophy/dentate segment, and maxillary sinus septa of less than 2.5 mm were not taken in-to consideration. The location of septa was also divided for analysis into 3 regions: the anterior (1st and 2nd premolar), middle (1st and 2nd molar) and posterior (behind 2nd molar) regions. RESULTS: In 54 (20.9%) of the 204 patients there were pathologic findings, and those patients were excluded from the analysis. Sinus septa were present in 58 (24.6%) of the 236 maxillary sinuses and in 55 (27%) of the 204 total patients. In the atrophy/edentulous ridge group (148 maxillary sinuses), 41 cases (27.7%) were found, and 17 cases (19.3%) were found in the non-atrophy/dentulous ridge group (88 maxillary sinuses). In terms of location, septa were found in 18 cases (27.3%) in the anterior, in 33 cases (50%) in the middle and in 15 cases (22.7%) in the posterior regions. CONCLUSIONS: In the posterior maxilla, regardless of type of ridge (atrophy/edentulous or non-atrophy/dentate), the anatomical variation of sinus septa is diverse in its prevalence and location. Thus, accurate information on the maxillary sinus of the patient is essential and should be clearly understood by the surgeon to prevent possible complications during sinus lifting.
Dental Implants ; Humans ; Lifting ; Maxilla ; Maxillary Sinus ; Prevalence ; Retrospective Studies

STUDY DESIGN: This is a retrospective study evaluating the efficacy of new surgical technique for treatment of fixed lumbosacral kyphosis. OBJECTIVES: To report a new method of vertebral column resection and to determine its efficacy in the treatment of fixed lumbosacral kyphosis. SUMMARY OF BACKGROUND DATA: The treatment of fixed severe spinal deformity is very difficult and only a few surgical methods are reported. The vertebral column resection from anterior and posterior is a radical method to treat the severe deformity but it has many problems with anterior and posterior approachs. MATERIALS AND METHODS: A new surgical method of vertebral column resection from posterior approach only(PVCR) was carried out in 5 patients of fixed lumbosacral Tb kyphosis from October 1997 to March 1998. The mean age was 43.4 years(range 35-61 years), and four were female and one male. The average postoperative follow-up period was 5.5 months(ranged from 2 months to 12 months). An average of 2.6 vertebrae was resected. The degree of sagittal curves was measured using the Cobb technique preoperatively and postoperatively. the rejional lumbosacral kyphotic angle and compensatory thoracic curvature from 74 to 712. The sagittal imbalance was measured by distance from C7 plumb line to postero-superior corner of 51 using 14 x 36 inch standing lateral radiograph. RESULTS: The sagittal deformities were corrected from an average of kyphosis 37.4 to lodosis 8.4 at lumbosacral level and from an average of lodosis 31.6 to lodosis 8.2 at thoracic level. The sagittal imbalance was improved from an average of +11.7cm to +2.2cm, for a posterior immigration of 9.5cm. The mean operating time was 334 minutes and with an average blood loss of 4338m1. Complication comprised of motor weakness with deep wound infection in one case and superficial wound infection in another case. The transient hip flexor weakness was seen in all the patients. The hip flexor power recovered in 3-4 weeks. The patient of motor weakness and deep infection showed partial motor improvement and complete wound healing at last 2 month follow-up. CONCLUSION: one-stage posterior vertebral column resection is a promising technique for treatment of the severe fixed lumbosacral kyphosis.
Congenital Abnormalities ; Emigration and Immigration ; Female ; Follow-Up Studies ; Hip ; Humans ; Kyphosis* ; Male ; Retrospective Studies ; Spine* ; Wound Healing ; Wound Infection