We report a case of neuroblastoma with multiple skin metastases as a chief complaint in a 2-month-old girl. the skin lesions were rnultiple, pea-sized, bluish, nontender, moable subcutaneous nodules on abdomen, back and scalp. Histopathology showed small round or poly gonal tumor cells which have deeply stained, basophilic, hyperchromatic nuclei with some mitoses. Th.se tumor cells showed clumping tendency which is one of early menifestations of rosette formation. Immunohistochemically positive reaction was demonstrated by anti-NSE(neuron specific enolase) antilody but negative reaction by anti-NFP (neurofilament proteiin ) antibody. She has been succesfully treated with combined chemotherapy for 10 months without relapse.
Abdomen ; Basophils ; Drug Therapy ; Female ; Humans ; Infant ; Mitosis ; Neoplasm Metastasis* ; Neuroblastoma* ; Phosphopyruvate Hydratase ; Recurrence ; Rosette Formation ; Scalp ; Skin*

PURPOSE: Attention Deficit Hyperactivity Disorder (ADHD) is known to be more common in children with epilepsy than in the general population. Thirty one to forty percent of ADHD is accompanied with epilepsy. Few studies regarding this matter have been reported in Korea. This study was aimed to evaluate the comorbidity of ADHD in children with epilepsy. METHODS: This is a two center based, retrospective and controlled study. Thirty four ADHD children with epilepsy from Chungbuk National University hospital and 38 ADHD children without epilepsy from Cheonju St. Mary's hospital were recruited from January 2005 to June 2010. RESULTS: In ADHD children with epilepsy, twelve (35.2%) had partial seizures, 11 (32.2%) did generalized seizures and 11 (32.2%) were unclassified. EEG abnormalities were found in the frontal lobe (15 cases), in the central lobe (7 cases), in the temporal lobe (6 cases), and in the occipital lobe (3 cases). In ADHD children with epilepsy, the combined type was major (76.4%) and in ADHD children without epilepsy, the inattentive type was major (50.5%) (P=0.004). Learning disability was mor common in ADHD with epilepsy than in ADHD without epilepsy (P=0.01). CONCLUSION: This study showed that ADHD children with epilepsy are more likely to have combined type (76.4%) and learning disability as compared with ADHD without epilepsy.
Attention Deficit Disorder with Hyperactivity ; Child ; Comorbidity ; Electroencephalography ; Epilepsy ; Frontal Lobe ; Humans ; Korea ; Learning Disorders ; Occipital Lobe ; Retrospective Studies ; Seizures ; Temporal Lobe

PURPOSE: To assess the usefulness of amplitude integrated electroencephalography (aEEG), we compared aEEG with electroencephalography (EEG), which is one of the most useful tools for assessment of neonatal seizures in the neonatal intensive care unit. METHODS: We retrospectively studied 24 neonates who had been suspected of seizure activity in the neonatal intensive care unit from January 2009 to February 2010. The 24 neonates had seizure or apnea that did not respond to aminophylline or continuous positive airway pressure. We compared the correlation and efficacy of diagnosis among aEEG, EEG, and neurosonography. RESULTS: We analyzed 24 aEEGs in the neonatal intensive care unit. The aEEGs showed a seizure pattern in 15 (62.6%), burst suppression pattern in 2 (8.3%), flat pattern in 4 (8.3%), and normal in 5 (20.8%). The results of EEGs showed 15 neonatal seizures (62.5%), 2 cerebral dysfunctions (8.3%), and 7 normal findings (29.2%). A correlation between aEEG and EEG was noted (P<0.05). However, there was no correlation between the results of aEEG and echoencephalography. CONCLUSION: There is correlation between aEEG and EEG for seizure detection in the neonatal intensive care unit. We think that aEEG is an useful screening tool for seizure detection in neonates.
Aminophylline ; Apnea ; Continuous Positive Airway Pressure ; Electroencephalography ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Mass Screening ; Retrospective Studies ; Seizures

Nimodipine the potent, centrally active, clacium channel blocker, is known to increase cerebral and spinal blood flow. In the present study, the authors investigated the effect on Nimodipine on injured spinal cord. The experiment was a randomized blind study in which four groups of five cats received Nimodipine(0.05mg/kg) intravenously, and control groups of five cats received only Diluent. As a step in the investigation of the possible effect of spinal cord trauma on biochemical and ultrastructural changes in the injured cord, activities of lipid peroxidation were measured in the frozened-dried sample of the spinal cord and fine structure of the mylinated nerve fiber in the white matter were observed. An increase of lipid peroxidation level was found as early as 1 hour after the injury and the highest concentration was reached at 5 hours after the injury(P<0.01). Fine structures of the myelinated nerve fibers were changed progressively with the lapse of time after the injury. The effect of Nimodipine on lipid peroxidation and fine ultrastructural changes of myelinated nerve fibers were studied, and the result of this study revealed that Nimodipine groups showed a lower level of lipid peroxidation with statistical significance(P<0.05) and preservation of ultrastructural myelinated nerve fiber was prominent.
Animals ; Cats ; Lipid Peroxidation ; Nerve Fibers ; Nerve Fibers, Myelinated ; Nimodipine* ; Spinal Cord Injuries* ; Spinal Cord*

PURPOSE: Retrospective study was performed to evaluate the survivals, remission rate and complications of induction chemotherapy using N(4)-behenoyl-1-beta-D-arabinofuranosylcytosine (BH-AC), idarubicin and 6-thioguanine (6-TG) in newly diagnosed childhood acute myelogenous leukemia. METHODS: From July 1994 to March 2000, 40 children (male 30, female 10) were enrolled in the study. From day 0 to 6 of induction, BH-AC 300 mg/m(2)/day was administered intravenously over 3 hours and from day 7 to 9, dosage was adjusted according to residual leukemic blasts in day 7 bone marrow aspirates. Idarubicin 10 mg/m(2)/day was administered intravenously over 15 minutes from day 0 to 2 and 6-TG 100 mg/m(2)/ day orally divided in two from day 0 to 6. Median age at diagnosis was 4.4 years (1 month~14.9 years) with a distribution according to the FAB classification of 1 M1, 10 M2, 13 M4, 5 M4E, 7 M5a, 3 M6 and 1 M7. RESULTS: Complete remission (CR) rate was 82.5% (33/40) with one cycle of induction chemotherapy and 90.0% (36/40) with additional cycle (BH-AC and idarubicin). One patient achieved partial remission with one cycle and was lost to follow-up, and 3 died of septic shock with disseminated intravascular coagulopathy during induction. Median time to CR from diagnosis was 28 days (25~68) and recovery from neutropenia (ANC> 1,000/muL) was achieved on median day 24 (21~44). All 40 patients had a fever during neutropenic period. Toxicities such as diarrhea, mucositis, nausea and vomiting were observed over half of the patients but tolerable and transient. Five-year overall, relapse- free and event-free survivals were 54.0%, 51.1% and 46.7%, respectively. CONCLUSION: These data show that this regimen is superior to others with high remission rate and well tolerated.
Bone Marrow ; Child ; Classification ; Diagnosis ; Diarrhea ; Disease-Free Survival ; Female ; Fever ; Humans ; Idarubicin* ; Induction Chemotherapy* ; Leukemia, Myeloid, Acute* ; Lost to Follow-Up ; Mucositis ; Nausea ; Neutropenia ; Retrospective Studies ; Shock, Septic ; Thioguanine* ; Vomiting

Gestational trophoblastic disease comprises a spectrum of interrelated conditions originating from the placenta. Malignant gestational trophoblastic disease refers to lesions that have the potential for local invasion and metastasis. This compromises many histological entities including hydatidiform moles, invasive moles, gestational choriocarcinomas, and placental site trophoblastic tumors. Before the advent of sensitive assays for human chorionic gonadotropin (hCG) and efficacious chemotherapy, the morbidity and mortality from gestational trophoblastic disease were substantial. Currently, with sensitive quantitative assays for beta-hCG and current approaches to chemotherapy, most women with malignant trophoblastic disease can be cured. We present a case of malignant gestational trophobalstic tumor with serum beta-hCG concentration over 1million IU/L that metastaze to the lungs and have a hyperthyroidism, but negative urine hCG testing. We report a case with a brief review of literatures.
Choriocarcinoma ; Chorionic Gonadotropin ; Drug Therapy ; Female ; Gestational Trophoblastic Disease ; Humans ; Hydatidiform Mole, Invasive ; Hyperthyroidism ; Lung ; Mortality ; Neoplasm Metastasis ; Placenta ; Pregnancy ; Trophoblastic Tumor, Placental Site ; Trophoblasts

Cronkhite-Cadana syndrome is a rare non-familial disease. This syndrome is characterized by multiple hamartomatous polyps on the entire gastrointestinal tract except esophagus, nail dystrophy, alopecia and hyperpigmentation. Taste disturbance, abdominal pain, diarrhea and weight loss are common symptoms of it. The pathogenesis and causes of Cronkhite-Canada syndrome remain unknown until now. Although various treatment strategies including steroid therapy have been tried, their prognosis is poor. We report a 68 years old man who were diagnosed Cronkhite-Canada syndrome with esophageal candidiasis. After using combination of steroids and anti-fungal drugs, both Cronkhite-Canada syndrome and esophageal candidiasis were cured.
Abdominal Pain ; Alopecia ; Candidiasis ; Diarrhea ; Esophagus ; Gastrointestinal Tract ; Hyperpigmentation ; Intestinal Polyposis ; Nails ; Polyps ; Prognosis ; Steroids ; Weight Loss

PURPOSE: This study aimed to evaluate the effects of fibronectin and oxysterol immobilized on machined-surface dental implants for the enhancement of cell attachment and osteogenic differentiation, on peri-implant bone healing in the early healing phase using an experimental model in dogs. METHODS: Five types of dental implants were installed at a healed alveolar ridge in five dogs: a machined-surface implant (MI), apatite-coated MI (AMI), fibronectin-loaded AMI (FAMI), oxysterol-loaded AMI (OAMI), and sand-blasted, large-grit, acid-etched surface implant (SLAI). A randomly selected unilateral ridge was observed for 2 weeks, and the contralateral ridge for a 4-week period. Histologic and histometric analyses were performed for the bone-to-implant contact proportion (BIC) and bone density around the dental implant surface. RESULTS: Different bone healing patterns were observed according to the type of implant surface 2 weeks after installation; newly formed bone continuously lined the entire surfaces in specimens of the FAMI and SLAI groups, whereas bony trabecula from adjacent bone tissue appeared with minimal new bone lining onto the surface in the MI, AMI, and OAMI groups. Histometric results revealed a significant reduction in the BIC in MI, AMI, and OAMI compared to SLAI, but FAMI demonstrated a comparable BIC with SLAI. Although both the BIC and bone density increased from a 2- to 4-week healing period, bone density showed no significant difference among any of the experimental and control groups. CONCLUSIONS: A fibronectin-coated implant surface designed for cell adhesion could increase contact osteogenesis in the early bone healing phase, but an oxysterol-coated implant surface designed for osteoinductivity could not modify early bone healing around implants in normal bone physiology.
Alveolar Process ; Animals ; Bone and Bones ; Bone Density ; Cell Adhesion ; Dental Implants ; Dogs* ; Fibronectins ; Models, Theoretical ; Osteogenesis ; Physiology ; Surface Properties ; Titanium

PURPOSE: Despite the high prevalence of headaches in students, their lifestyles have not been well examined. We examined correlation between lifestyle and headache in Korean students. METHODS: We conducted a cross-sectional, school-based study from a randomized and proportional sample of 5,360 male and female students. The questionnaires include demographic data, lifestyle, in addition to specific questions about headache according to International Classification of Headache Disorder II (ICHD-II) criteria. Valid questionnaires were returned by 94.1% (5,039, boys 2,405, girls 2,634) of the sample. Modified criteria changed the item 'duration' in migraine (>1 hour instead of 4 hours). We analyzed the data in terms of exercise, regular eating, sleep time, fluid intake, and caffeine intake. RESULTS: Students on regular exercise have less headache (P=0.03). Students who eat regularly have less recurrent headache (P<0.0001, odds ratio=0.5). Students sleep more have less headache (P<0.0001). Students take more fluid have less headache (P=0.0002). Students take more caffeine have more headache (P=0.0001). CONCLUSION: There seem to be a significant relationship between life style and headache in school children in South Korea. We suggest that changing the lifestyles or habits should be considered to manage and prevent headaches in school children.
Caffeine ; Child ; Eating ; Female ; Headache ; Headache Disorders ; Humans ; Life Style ; Male ; Migraine Disorders ; Prevalence ; Surveys and Questionnaires ; Republic of Korea

Tibolone (Livial, NV Organon, Oss, Netherlands) is a synthetic steroid which exhibits estrogenic, progestogenic and androgenic activity. In the endometrium, tibolone dose not have estrogenic activity, but dose have intrinsic progestogenic activity. Therefore, it dose not stimulate the endometrial tissue which usually undergoes atrophy. Tibolone has been associated with a relatively low incidence of vaginal bleeding and endometrial hyperplasia. Recently. a few reports have been published even less frequently describing invasive endometrial cancer during tibolone therapy. We report a case of histologically diagnosed adenocarcinoma of the endometrium in women using tibolone. Although we do not suggest causability between the use of tibolone and the development of endometrial malignancy, but we should alert physicians to thorough investigation in patients presenting with vaginal bleeding and the increase of endometrial thickness by sonogram while on tibolone.
Adenocarcinoma* ; Atrophy ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Endometrium ; Estrogens ; Female ; Humans ; Incidence ; Uterine Hemorrhage