Subepidermal calcified nodule, a form of calcinosis cutis, usually occurs as a solitary lesion and develops in early childhood. We report a 20-month-old boy with an unusual form of subepidermal calcified nodules on both palms and soles which were multiple and present at birth. Interestingly, his uncle had similar lesions during infancy which had shown spontaneous remission.
Calcinosis ; Humans ; Infant ; Male ; Parturition ; Remission, Spontaneous

Painful ophthalmoplegia due to idiopathic granulomatous inflammation of the cavernous sinus or superior orbital fissure has been termed Tolosa-Hunt syndrome. We have experienced a case of Tolosa-Hunt syndrome in an 11 year old boy who has diagnosed with several clinical signs and symptoms such as severe ocular pain, headache, ptosis, proptosis, slight limitation of eyeball motion, nausea and vomiting, and the brain and orbital C-T scan which shows the right ethmoid and sphenoid sinusitis and inflammatory thickening of dura an the planum spenoidale.
Brain ; Cavernous Sinus ; Child ; Exophthalmos ; Headache ; Humans ; Inflammation ; Male ; Nausea ; Ophthalmoplegia ; Orbit ; Sphenoid Sinus ; Sphenoid Sinusitis ; Temazepam ; Tolosa-Hunt Syndrome* ; Vomiting

The goals of hip arthroplasty have been to eliminate pain, decrease deformity, increase morbility and obtain stabiIity. Currently total hip replacement is the best avaliable procedure to accomplish these goals. A prospective study of total hip arthroplasty was begun at the orthopedic dept of Kyung Hee Medical College in 1974. Between May, 1974 and June, 1977. 69 total hip replacements of the Charnley type, the Trapesoidal-28 type and the Muller type were peformed by the authors. Of the 60 Patients involved in this study, 9 had bilateral operations. The Charnley type Prosthetic device was used in 56 cases, the Trapesoidal-28 type in 7 cases and the Muller type in 6 cases. Complications included wire breakage, dislocation, loosening, femur shaft perforation, nonunion of greater-trochanter, acetabular protrusion, transient femoral nerve palsy, femur shaft fracture, infection, socket lateralization, ectopic bone formation and death. In 59 patients of the 60 patients, 53 patients felt that they were definitely improved, 5 patients felt their condition was unchanged and 1 patient felt her condition was worse.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Clinical Study ; Congenital Abnormalities ; Dislocations ; Femoral Nerve ; Femur ; Hip Prosthesis ; Hip ; Humans ; Orthopedics ; Osteogenesis ; Paralysis ; Prospective Studies

Kirschner-wires and pins are used for the intenal fixation of the acromioclavicular joint. Many surgeons are aware of the tendency of these appliances to migrate, however, few reports of this complication have appeared in literature. This report concerns two instances of migration K-wires from the acromioclavicular joint into the neck, The potential for K-wires to migrate must be recogniged, and more frequent postoperative radiographic studies performed after the insertion of such pins to permit earlier detection of bony resorption and migration. Thereby permitting earlier removal. In cases of young adult, the wires must be removed as soon as the desired theurapeutic results have been obtained.
Acromioclavicular Joint ; Humans ; Neck ; Surgeons ; Young Adult

Paraquat (1, 1'-dimethy-14, 4' dipyridium chloride: Gramoxon(r)) was first discovered in England in 1955. It has been widely distributed for use in Korea since 1970 as a pesticide and also often the cause of accidental intoxications. The authors would like to report the following case of paraquat intoxicatio in a 13 year old female child admitted via emergency room with complaints of epigastric pain, vomiting and hematuria of four days duration. On admission the data of laboratory evaluation were as follows: BUN/Cr 126/11.6 mg/dl; sGOT/sGPT 641/641 IU/L; total bilirubin/direct bilirubin 3.9/2.4 mg/dl; alkaline phosphatase 396.1 U/L; fecal occult blood test-positive; pH 7.428, pCO2 26.2 mmHg, pO2 131.4 mmHg, base excess -5.0 mmol/L on arterial blood gas analysis (ABGA). Gastroendoscopy revealed esophageal ulcers, and as symptoms of renal failure could not be relieved by hemodialysis, kidney biopsy was performed on the otherwise previously healthy child to establish the cause of renal failure. The result of biopsy revealed tubular necrosis with eosinophilic infiltrations. A more detailed retrograde probe of the child's past medical history evoked that the patient had ingested paraquat in a suicidal attempt. Supportive therapy and hemodialysis were continued thereafter, but the symptoms of renal failure could not be reversed, and the patient eventually died due to acute respiratory distress syndrome.
Adolescent ; Alkaline Phosphatase ; Bilirubin ; Biopsy ; Blood Gas Analysis ; Child ; Emergency Service, Hospital ; England ; Eosinophils ; Female ; Hematuria ; Humans ; Hydrogen-Ion Concentration ; Kidney ; Korea ; Necrosis* ; Occult Blood ; Paraquat* ; Renal Dialysis ; Renal Insufficiency ; Respiratory Distress Syndrome, Adult ; Ulcer ; Vomiting

Conjunctival aspergillosis refers to the infectious process of conjunctiva caused by one of the numerous members of the genus Aspergillus. A 4 year old Korean boy was brought to our hospital due to localized injection and edema of the left temporal bulbar conjunctiva which did not respond to the systemic and topical antibiotics for about 2 weeks. Clusters of the Aspergillus element was identified by the conjunctival biopsy and the diagnosis was made.
Anti-Bacterial Agents ; Aspergillosis* ; Aspergillus ; Biopsy ; Child, Preschool ; Conjunctiva ; Diagnosis ; Edema ; Humans ; Male

PURPOSE: To evaluation the accuracy of the IOL power calculation formulae measured by IOL Master(R) and applanation ultrasonography for the Tecnis ZCB00 IOL. METHODS: We performed a retrospective study of 170 eyes in 121 patients who underwent cataract surgery in our hospital with AMO Tecnis ZCB00 IOL.s. The SRK/T formula was used to predict the patient's implanted IOL power. Differences in the predicted refractive errors between IOL Master(R) and ultrasonography were analyzed and factors attributed to the differences were also analyzed. Three months after cataract surgery, mean numeric error and mean absolute error were analyzed. RESULTS: SRK/II and SRK/T formulas calculated using ultrasonography showed differences compared to the same formulas calculated using IOL Master(R), in which hyperopic shift was also demonstrated. No definite factor was attributed to the differences between the 2 methods. Although the 3 formulas of IOL Master(R) showed no significant difference in refractive errors, the SRK/T formula calculated using IOL Master(R) showed the least mean absolute and numeric errors. CONCLUSIONS: IOL Master(R) is considered more suitable when determining proper AMO Tecnis ZCB00 IOL power in cataract surgery. The hyperopic shift should be considered when calculating the IOL power using only ultrasonography.
Cataract ; Ultrasonography* ; Humans ; Lenses, Intraocular* ; Refractive Errors ; Retrospective Studies ; Ultrasonography

BACKGROUND AND OBJECTIVES: The myocardial protective effect of ischemic preconditioning is well known. However, the mechanism is remains unclear. The purpose of this study is to determine the role of adenosine, protein kinase C, KATP channel and the change of monophasic action potential duration on cardioprotective effect of ischemic preconditioning in cat. Materials AND METHODS: In this experiment, 66 cats were allocated into 7 groups:control (n=10), ischemic preconditioning (n=10), adenosine pre-treated (n=10), SPT (8-p-sulfophenyl theophylline) pre-treated (n=9), polymyxin B pre-treated (n=9), glibenclamide pre-treated (n=9) and nicorandil pre-treated (n=9) groups. Ischemic preconditioning was performed in ischemic preconditioning, SPT pre-treated, polymyxin B pre-treated and glibenclamide pre-treated groups by 3 episodes of 5 minutes ischemia and 10 minutes reperfusion. All animals were subjected to 40 minutes of ischemia and 40 minutes reperfusion. Monophasic action potential duration at 50% repolarization (MAP50) was measured in the ischemic and non-ischemic area respectively by epicardial probe throughout the experiment. The effect of ischemic preconditioning was determined by infarct size (% area at risk). RESULTS: Ischemic preconditioning, adenosine pre-treatment and nicorandil pre-treatment groups demonstrated a significant reduction in infarct size (26+/-4%, 25+/-4% and 34+/-8% infarction of the risk zone, respectively, p<0.01, p<0.01 and p<0.05 vs. control) with respect to control (41+/-8% infarction of the risk zone). However, pretreatment with SPT, polymyxin B or glibenclamide abolished the effect of ischemic preconditioning. Ischemic preconditioning group exhibited a significant reduction of MAP50 duration in the ischemic area during preconditioning;at the first preconditioning 128+/-11 msec vs. 144+/-10 msec control, at the second preconditioning 110+/-10 msec vs.147+/-10 msec control (p<0.01), at the third preconditioning 114+/-10 msec vs. 145+/-11 msec control (p<0.05). But, pretreatment with SPT, polymyxin B and glibenclamide prevented the reduction of MAP50 in the ischemic area during ischemic preconditioning. During 40 minutes ischemia, the shortening of MAP50 was more pronounced in the preconditioned group than in control group;at 5 minutes 112+/-13 msec vs. 124+/-10 msec control, at 10 minutes 89+/-12 msec vs. 133+/-11 msec control (p<0.05 ), at 20 minutes 93+/-12 msec vs. 136+/-11 msec control (p<0.05), and at 30 minutes 107+/-19 msec vs. 144+/-14 msec control (p<0.05). In adenosine pre-treated group, the MAP50 was significantly shortened than control group throughout 40 minutes occlusion period;at 5 minutes 90+/-8 msec (p<0.05), at 10 minutes 77+/-9 msec (p<0.05), at 20 minutes 92+/-8 msec (p<0.05), and at 30 minutes 103+/-8 msec (p<0.05). Nicorandil pretreatment pronounced the ischemic shortening of MAP50 in ischemic area and the effect was significant during early ischemic period;at 10 minutes 98+/-22 msec (p<0.05 vs. control). In pretreatment groups with SPT, polymyxin B or glibenclamide, the ischemic preconditioning of MAP50 measured in non-ischemic area was not significantly different compared with control group. MAP50 measured in ischemic area during reperfusion was not significantly different between groups. CONCLUSION: Based on this study, adenosine receptor-protein kinase C-KATP channel activation and monophasic action potential duration shortening during ischemia play an important role in myocardial protection during ischemic injury.
Action Potentials* ; Adenosine* ; Animals ; Cats* ; Glyburide ; Infarction ; Ischemia ; Ischemic Preconditioning* ; Nicorandil ; Phosphotransferases ; Polymyxin B ; Protein Kinase C* ; Protein Kinases* ; Receptors, Purinergic P1* ; Reperfusion

BACKGROUND AND OBJECTIVE: TDI is known to be the most prevalent cause of occupational asthma ( OA ) in Korea. However, the pathogenesis of TDI - induced occupational asthma still remains to be further clarified. So, we evaluated clinical significance of serum specific IgG and IgE antibodies to TDI - HSA conjugate in TDI - induced occupational asthma. Subjects and METHODS: Serum specific IgG and IgE antibodies to TDI - HSA conjugate were measured by enzyme linked immunosorbent assay. Serum was collected from 50 TDI- induced OA patients ( classified as group I ), and was compared with that from 13 asthmatic subjects with negative TDI - bronchoprovocation test ( BPT, group II ), allergic asthmatics ( group III ), and unexposed healthy controls ( group IV ). RESULTS: The prevalence of specific IgG was significantly higher in group I than in group II (p = 0.01) or group III (p <0.01). No significant difference was noted between group II and group III (p> 0.05). However, the prevalence of specific IgE was not different between group I and group II (p> 0.05 ) or group II and group III( p> 0.05 ). There was no significant difference in prevalence of specific IgG according to the asthmatic response during TDI bronchoprovocation test ( p> 0.05 ). No statistical significance was noted between specific IgG and IgE antibodies in group I subjects ( p> 0.05 ). CONCLUSION: These findings demonstrate that presence of specific IgG to TDI - HSA conjugate is closely related to TDI - BPT results and it may contribute to the development of TDI - induced asthma.
Antibodies* ; Asthma ; Asthma, Occupational* ; Enzyme-Linked Immunosorbent Assay ; Humans* ; Immunoglobulin E* ; Immunoglobulin G* ; Korea ; Prevalence ; Serum Albumin* ; Toluene 2,4-Diisocyanate* ; Toluene*

Ischemic colitis is the most common form of gastrointestinal ischemia. Factors that can contribute to the development of ischemic colitis include atherosclerosis, congestive heart failure, sustained hypovolemia, vasculitis, and mechanical colonic obstruction. Also, pharmacologic agents, including diuretics, pseudoephedrine, non-steroidal anti-inflammatory drugs, and oral contraceptives may be the cause of colonic ischemia. Oral sulfate-free polyethylene glycol (SF-PEG, Colyte-F(R)) has frequently been used as a cleaning agent in bowel preparation for colonoscopy. Some cases of ischemic colitis produced by oral hyperosmotic laxatives have been reported; however, no case has been reported regarding ischemic colitis caused by SF-PEG. Herein we report a rare case of ischemic colitis caused by oral sulfate-free polyethylene glycol, which was given for bowel preparation before colonoscopy in a 70-year-old man with chronic constipation.
Aged ; Atherosclerosis ; Colitis, Ischemic ; Colon ; Colonoscopy ; Constipation ; Contraceptives, Oral ; Diuretics ; Heart Failure ; Humans ; Hypovolemia ; Ischemia ; Laxatives ; Polyethylene Glycols ; Pseudoephedrine ; Vasculitis