PURPOSE: It is well known that duodenal ulcer disease does not relapse if H. pylori is cleared from the gastric mucosa. Little is known about the recurrence of duodenal ulcer in children. The purpose of this study was to evaluate the effect of the eradication of H. pylori in duodenal ulcer in children upon the duodenal ulcer recurrence. METHODS: 105 patients (M : F=78 : 27) diagnosed as duodenal ulcer by endoscopy in 1987~1995 were reviewed clinically, and were parted into two groups. The two treatment groups were ranitidine/antacid (RAN/ANT) and ranitidine/amoxicillin/denol (RAN/AMX/D). The latter was for H. pylori-positive children with duodenal ulcer who were diagnosed by serology and/or antral biopsies for histology, culture, and urease testing. The recurrence rates were compared between the two groups. RESULTS: 1) 30 patients with primary duodenal ulcer underwent endoscopy for H. pylori and 27 (90.0%) of them were positive for H. pylori. 2) 27 of H. pylori-positive children received RAN/AMX/D. 23(85.2%) of them showed cure of duodenal ulcer and eradication of H. pylori. 3) The duodenal ulcer recurrence rate in RAN/ANT group was 65.3% and the rate in RAN/AMX/D was 4.3% by a year. CONCLUSIONS: There is a strong correlation between the duodenal ulceration and H. pylori infection in children, and the eradication of H. pylori in duodenal ulcer patients reduces the recurrence of the ulcer. Because of the low incidence of duodenal ulcers in children, a multicenter prospective study is required to determine the effect of treating H. pylori infetion on the long term natural history of duodenal ulcer disease.
Biopsy ; Child* ; Duodenal Ulcer* ; Endoscopy ; Gastric Mucosa ; Helicobacter pylori* ; Helicobacter* ; Humans ; Incidence ; Natural History ; Recurrence* ; Ulcer ; Urease

Factor Vll deficiency has an estimated incidence of 1/500,000 in the general population and autosomal recessive pattern of inheritance. Factor Vll deficiency is characterized by prolonged prothrombin time (PT), and normal activated partial thromboplastin time (aPTT) and bleeding time (BT). Definite diagnosis of this condition requires a specific Factor Vll assay. The clinical features are variable and do not always correlate with the Factor Vll level. We experienced a case of Factor Vll deficiency presenting as hemarthroses in a 2-years-old girl, whose chief complaint was pain, swelling of right knee joint and limping gait. The laboratory findings were prolonged PT and prominent deficiency of factor Vll. So, we report a case of Factor Vll deficiency with a brief review of the related literature.
Bleeding Time ; Diagnosis ; Female ; Gait ; Hemarthrosis* ; Humans ; Incidence ; Knee Joint ; Partial Thromboplastin Time ; Prothrombin Time ; Wills

Factor Vll deficiency has an estimated incidence of 1/500,000 in the general population and autosomal recessive pattern of inheritance. Factor Vll deficiency is characterized by prolonged prothrombin time (PT), and normal activated partial thromboplastin time (aPTT) and bleeding time (BT). Definite diagnosis of this condition requires a specific Factor Vll assay. The clinical features are variable and do not always correlate with the Factor Vll level. We experienced a case of Factor Vll deficiency presenting as hemarthroses in a 2-years-old girl, whose chief complaint was pain, swelling of right knee joint and limping gait. The laboratory findings were prolonged PT and prominent deficiency of factor Vll. So, we report a case of Factor Vll deficiency with a brief review of the related literature.
Bleeding Time ; Diagnosis ; Female ; Gait ; Hemarthrosis* ; Humans ; Incidence ; Knee Joint ; Partial Thromboplastin Time ; Prothrombin Time ; Wills

No abstract available.
Arthritis* ; Immunoblastic Lymphadenopathy*

Dysgerminoma developed in a 21-year-old phenotypic female patient with 46,XY pure gonadal dysgenesis, Swyer syndrome. This patient presented with pelvic mass associated with abdominal pain and primay amenorrhea. Clinical characteristics showed a typical stigmata of gonadal dysgenesis: primary amenorrhea, sexual infantilism, a small uterus and left streak gonad. A 46,XY karyotype was made by lymphocyte culture. The patient was counseled to undergo operation, chemotherapy and hormon therapy. She underwent bilateral gonadectomy with total hysterectomy, partial omentectomy and multiple pelvic wall random biopsy. Histological examination revealed dysgenetic gonads with dysgerminoma. After surgery, the patient received chemotherapy and also was started on hormone replacement therapy. She is currently alive with no evidence of disease after 19 months from surgery.
Abdominal Pain ; Amenorrhea ; Biopsy ; Christianity ; Drug Therapy ; Dysgerminoma* ; Female ; Gonadal Dysgenesis ; Gonadal Dysgenesis, 46,XY* ; Gonads ; Hormone Replacement Therapy ; Humans ; Hysterectomy ; Karyotype ; Lymphocytes ; Sexual Infantilism ; Uterus ; Young Adult

A 33-year-old woman who was diagnosed as medullary carcinoma by fine needle aspiration of thyroid mass is presented. The smear revealed dispersed pattern and small clusters of cells without follicular or papillary structures. The nuclei were round, oval or spindle shaped and eccentrically located. The cytoplasm was abundant and showed red-stained cytoplasmic granulation and tail-like projection with indistinct border. Clumps of amorphous, light-green material were intermingled with tumor cells.
Adult ; Biopsy, Fine-Needle ; Carcinoma, Medullary ; Child* ; Cytoplasm ; Female ; Granular Cell Tumor ; Humans ; Hypercalciuria* ; Mass Screening* ; Thigh ; Thyroid Gland

Subacute thyroiditis is a frequent benign thyroid disease associated with previous viral upper respiratory tract infection. Known complications of this disease are long-standing subclinical hypothyroidism, persistent anterior neck pain and rarely Graves disease. In general, thyroid abscess is an uncommon disease because of anatomic isolation of the gland and its rich system of drainage for blood and lymph. Especially, development of thyroid abscess in subacute thyroiditis is extremely rare phenomenan, but significant bad outcomes can be resulted. Its clinical BACKGROUND containes immune-suppressed state, anatomic defect, presence of underlying other thyroid disease and of non-thyroidal infectious foci. We experienced a case of subacute thyroiditis complicated with streptococcal thyroid abscess during glucocorticoid therapy. The patient was a 19-year-old female who was admitted due to anterior neck pain for 1 month. Typical subacute thyroiditis was suggested from initial laboratory findings including CBC, erythrocyte sedimentation rate, serum T3, T4, TSH levels, thyroid scan & thyroid uptake. But during oral prednisolone therapy, unexpected bacterial thyroid abscess was developed. We report this unusual case with review of literatures.
Abscess ; Blood Sedimentation ; Drainage ; Female ; Graves Disease ; Humans ; Hypothyroidism ; Neck Pain ; Prednisolone ; Respiratory Tract Infections ; Thyroid Diseases ; Thyroid Gland* ; Thyroiditis, Subacute* ; Young Adult

No abstract available.
Adult* ; Humans ; Intussusception* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence*

Patients with nonfunctioning bladders, such as found in anuric renal failure, are prone to a severe form of urinary tract infection called pyocystis. Pyocystis is the accumulation of pus in the bladder. Anuric patients are often believed to be incapable of acquiring a urinary pathogen; thus, the urinary tract may be mistakenly discounted as a possible source of sepsis and bladder rupture. Although bladder rupture is normally associated with trauma, spontaneous bladder rupture may occur, especially in patients with mental disabilities, alcohol abuse and urinary tract infection. We report a rare case of a spontaneous intraperitoneal bladder rupture, probably precipitated by pyocystis. Symptoms and signs were atypical and included pain and vomiting with fever, abdominal distension and ascites. An abdominal CT and retrograde cystography showed a large quantity of intraperitoneal fluid and tearing in the dome of the bladder. Repair of the rupture site of the bladder after laparotomy was performed. However,, the patient expired due to peritonitis and pulmonary infection.
Alcoholism ; Anuria* ; Ascites ; Fever ; Humans ; Kidney Failure, Chronic* ; Laparotomy ; Peritonitis* ; Renal Insufficiency ; Rupture ; Rupture, Spontaneous* ; Sepsis ; Suppuration ; Tomography, X-Ray Computed ; Urinary Bladder* ; Urinary Tract ; Urinary Tract Infections ; Vomiting

BACKGROUND: Increased WBC counts have been associated with different components of metabolic syndrome (MS), accompanied by clustering of a number of risk factors for CHD. Because most individuals have one or more of the risk factors for CHD or a cluster of MS symptoms, it may not be appropriate to look only at isolated components. Therefore, the aim of the present study was to examine the association of WBC counts with clustered features of MS in Korean adults. METHODS: The subject of this study included 593 adults (males 344, females 249) aged 20 years or older. Among the subjects, we excluded those who did not have records of physical parameters and blood test results and those who did not complete the questionnaire. We also excluded acutely ill patients. Logistic regression analyses were used to evaluate the association between WBC counts and features of the MS, with an adjustment for age, smoking and alcohol consumption. RESULTS: The relative risks for obesity, hypertension, hypercholesterolemia, low HDL cholesterol levels, hypertriglyceridemia, high fasting plasma glucose levels and hyperuricemia compared with WBC counts <5.2 x 10(3) cells/microliter, increased as WBC counts increased. The relative risks for the presence of > or =1, > or = 2, > or = 3, > or = 4 features of the MS also increased as WBC counts increased. CONCLUSION: An increased, albeit normal, WBC counts associates with the cluster of MS of the so-called "insulin resistance syndrome" and suggest that an increased WBC counts may be yet another feature of this syndrome.
Adult ; Alcohol Drinking ; Blood Glucose ; Cholesterol, HDL ; Cluster Analysis ; Fasting ; Female ; Hematologic Tests ; Humans ; Hypercholesterolemia ; Hypertension ; Hypertriglyceridemia ; Hyperuricemia ; Leukocyte Count* ; Logistic Models ; Obesity ; Risk Factors ; Smoke ; Smoking