No Abstract Available.
Hypopigmentation*

Membranous fat necrosis is a variant of fat necrosis characterized by the presence of membranocystic foci which is lined by eosinophilic, homogeneous and crenulated membrane that has pseudopapillary projections. Membranous fat necrosis may be idiopathic or has been associated with many local and systemic diseases. The pathogenesis of membranous fat necrosis is uncertain but trauma may be suspected in our case. We describe a case of lipoma with membranous fat necrosis.
Eosinophils ; Fat Necrosis* ; Lipoma* ; Membranes

Mondor's disease is a superficial thrombophlebitis of anterolateral chest wall. The exact cause is unclear, but it is suggested that Mondor's disease is often associated with recent local trauma, muscular strain, or breast surgery. We report two cases with Mondor's disease who had malignant lymphoma. The coagulation profile was normal in both patients. The nodule involuted with analgesics within several months. The possibility of Mondor's disease associated with hypercoagulable state from malignancy may be suggested.
Analgesics ; Breast ; Humans ; Lymphoma* ; Thoracic Wall ; Thrombophlebitis

BACKGROUND: Exposure to airborne allergens exacerbates symptoms of atopic dermatitis in sensitive patients. OBJECTIVE: We attempted to evaluate the therapeutic effect of Dermatophagoides farinae antigen-autoantibody immune complex therapy in atopic dermatitis. METHODS: Four patients with atopic dermatitis were treated with antigen-autoantibody immune complex therapy using D. farinae antigen for 1 year. The therapeutic effect was evaluated by clinical severity (erythema, excoriations, scale, pruritus, lichenification) and D. farinae specific antibodies, skin test to D. farinae, total IgE, eosinophil count and soluble vascular cell adhesion molecule-1 (VCAM-1). RESULTS: One of four patients had significant improvement in clinical severity and decrease in serum eosinophil count, but three of four patients had no significant improvement in clinical severity, skin test to D. farinae, total IgE, specific antibodies and soluble VCAM-1 after allergenantibody complex therapy except specific IgE to D. farinae. CONCLUSION: The efficacy of allergen-antibody complex therapy may be limited in some atopic dermatitis patients.
Allergens ; Antibodies ; Antigen-Antibody Complex* ; Dermatitis, Atopic* ; Dermatophagoides farinae* ; Eosinophils ; Humans ; Immunoglobulin E ; Pruritus ; Pyroglyphidae* ; Skin Tests ; Vascular Cell Adhesion Molecule-1

PURPOSE: This study was performed to compare the clinical characteristics of 2009 pandemic influenza A(H1N1) [A(H1N1) pdm09] and seasonal influenza A infection in the pediatric cancer patients. METHODS: A retrospective review was performed in the pediatric cancer patients who had confirmed A(H1N1)pdm09 infection at Samsung Medical Center from August 2009 to February 2010. For the comparison, the medical records of pediatric cancer patients with seasonal influenza A from January 2000 to May 2009 were reviewed retrospectively. RESULTS: Eighty-two A(H1N1)pdm09 infections were confirmed in the pediatric cancer patients. Ten patients (12.2%) developed complicated clinical course by lower respiratory infections or extrapulmonary infections; 4 pneumonia, 1 bronchitis, 1 pericarditis with pneumonia, 1 encephalitis with pneumonia, 2 meningitis and 1 pericarditis. Three patients received mechanical ventilator and ICU care. Three pediatric cancer patients (3.7%) died. The risk factors related to complicated A(H1N1)pdm09 infections were date of infection (44-45th week 2009) and nosocomial infection. When comparing with previous seasonal influenza A infections, more prompt and aggressive antiviral therapy was given in A(H1N1)pdm09 infections. CONCLUSION: The A(H1N1)pdm09 infections caused a various clinical manifestations including fatal cases in pediatric cancer patient during pandemic season. There was no significant difference in clinical course between influenza A(H1N1)pdm09 and seasonal influenza A infections except the antiviral treatment strategy.
Bronchitis ; Child ; Cross Infection ; Encephalitis ; Humans ; Influenza, Human ; Medical Records ; Meningitis ; Pandemics ; Pericarditis ; Pneumonia ; Respiratory Tract Infections ; Retrospective Studies ; Risk Factors ; Seasons ; Ventilators, Mechanical

Verruciform xanthoma is a rare benign lesion characterized by verrucous epidermal hyperplasia with aggregates of foam cells in dermal papillae. The pathogenesis is still unknown. Although most verruciform xanthoma tend to occur as isolated lesions, several have been associated with other conditions including squamous cell carcinoma and epidermal atypia. We describe a case of verruciform xanthoma associated with epidermal atypia.
Carcinoma, Squamous Cell ; Foam Cells ; Hyperplasia ; Xanthomatosis*

PURPOSE: Hematopoietic cell transplantation (HCT) recipients are vulnerable to invasive infection by Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae (Sp). This study was performed to evaluate immune responses after Hib and Sp vaccination in Korean pediatric HCT recipients. METHODS: Patients were prospectively enrolled at Samsung Medical Center during 2009-2011. ELISA tests to detect anti-PRP IgG antibody and antibodies to Sp serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F were performed at the Center for Vaccine Evaluation and Study, Ewha Medical Research Institute. RESULTS: Ten patients (two allogeneic, eight autologous recipients) with median age 5.4 years (range 2.7-12.2 years) were enrolled. Before Hib vaccination, 60% of patients' anti-PRP IgG titers were below 0.15 microg/mL. After vaccination, 100% of patients' anti-PRP IgG titers increased above 0.15 microg/mL (cut-off value for detection) and 1.0 microg/mL (cut-off value for seroprotection). For pneumococcus, in 2-5 year-old patients, pre-vaccination geometric mean concentrations (GMCs) of IgG for six serotypes (4, 6B, 9V, 14, 18C, and 23F) were below 0.35 microg/mL and at 5 months post-vaccination GMCs of IgG for all seven serotypes increased to above 0.35 microg/mL. In patients older than 5 years, pre-vaccination GMCs of IgG for four serotypes (4, 9V, 14, and 23F) were below 0.35 microg/mL and at 3 months post-vaccination GMCs of IgG for all seven serotypes increased to above 0.35 microg/mL. CONCLUSION: Most HCT recipients had low or no protective antibodies to Hib and Sp before vaccination, but showed good immune responses to protective levels after vaccination.
Academies and Institutes ; Antibodies ; Antibody Formation* ; Cell Transplantation* ; Enzyme-Linked Immunosorbent Assay ; Haemophilus influenzae type b* ; Humans ; Immunoglobulin G ; Prospective Studies ; Streptococcus pneumoniae* ; Transplants* ; Vaccination*

Staphylococcus epidermidis is a part of the normal skin flora of humans. However, it can cause serious infections in people exposed to foreign bodies or in immunocompromised patients. A 13-year-old boy was hospitalized with fever and myalgia. Painful nodular lesions were detected on the scalp, arms, and legs. Pancytopenia and blasts were present in the peripheral blood. He was diagnosed with acute myeloid leukemia. Magnetic resonance imaging of the whole body showed multiple peripheral rim-enhancing, cyst-like lesions. Ultrasonography showed echogenic nodules inside the cystic lesions in the intramuscular space of the arms and legs. Therefore, cysticercosis was strongly suggested initially. However, an abscess was confirmed on sono-guided biopsy and S. epidermidis was isolated from a microbial culture of the tissue. We report a case of multiple disseminated lesions caused by S. epidermidis in a leukemia patient, initially mistaken for cysticercosis.

PURPOSE: Ventilator-associated pneumonia (VAP) is a serious threat in critically ill pediatric patients. Data regarding Stenotrophomonas maltophilia VAP in pediatric population is limited. We evaluated the clinical data of S. maltophilia associated VAP in critically ill pediatric patients. METHODS: A retrospective chart review was performed in pediatric patients 18 years old or younger who developed S. maltophilia associated VAP at Samsung Medical Center, Seoul Korea from January 2008 to December 2012. RESULTS: A total of 31 patients were identified S. maltophilia associated VAP. Median age was 8 months (range, 0.5 month to 16.6 years) and 13 patients were male (40.6%). Underlying illnesses were cardiologic diseases (n=11, 34.4%), hematologic oncologic malignancies (n=7, 25%), neurologic diseases (n=4, 12.5%), pulmonary diseases (n=3, 9.4%), and others (n=4, 12.5%). The median duration of ventilator use before S. maltophilia VAP diagnosis was 14 days (range, 4-256 days). Overall mortality at 30 days was 12.5% (4/32). CONCLUSIONS: S. maltophilia should be also considered as a possible pathogen for VAP in critically ill pediatric patients. Empiric antibiotic choice should include agents that are active against S. maltophilia in patients who are deteriorating on broad spectrum beta-lactam antimicrobial agents.
Anti-Infective Agents ; Child ; Critical Illness* ; Diagnosis ; Humans ; Korea ; Lung Diseases ; Male ; Mortality ; Pneumonia ; Pneumonia, Ventilator-Associated* ; Retrospective Studies* ; Seoul ; Stenotrophomonas maltophilia* ; Stenotrophomonas* ; Ventilators, Mechanical

PURPOSE: Dengue fever occurs in many popular tourist destinations and is increasingly imported by returning travelers in Korea. Since Korea is not an endemic country for dengue fever, pediatricians do not usually suspect dengue fever in febrile children even with typical presentation and exposure history. This study was performed to describe the international travel experiences and dengue fever in Korean children. METHODS: Travel histories were collected based on questionnaires completed by all patients' guardians who visited the pediatric infectious diseases clinic at Samsung Medical Center from January 2008 to December 2008. For patients who were suspected of dengue fever, a serological test was performed. RESULTS: Five hundred and seventeen children visited the pediatric infectious diseases clinic for the first time during this period. About 30% of patients who responded to the questionnaire (101/339) had experienced international travel within the last 2 years. Four patients were diagnosed with dengue fever by serological test. CONCLUSION: Increasing numbers of Korean children visit dengue endemic areas and they may return home with dengue fever. Dengue fever should be suspected in patients who have a travel history to endemic areas.
Child ; Communicable Diseases ; Dengue ; Humans ; Korea ; Surveys and Questionnaires ; Serologic Tests