In air leak syndrome, a significant portion of the volume delivered during a positive pressure breath can be lost through the leak. HFOV can achieve adequate ventilation at lower peak and/or mean intrapulmonary pressure than conventional mechanical ventilation (CMV) and has been an effective treatment of already established air leak syndrome. We report a 1-day-old male infant with severe respiratory failure from pneumothorax and pneumomediastinum, who was refractory to CMV with chest tube drainage. HFOV was applied to this patient for 114 hours, and improvement of oxygenation and ventilation as well as significant reduction of pneumothorax followed.
Chest Tubes ; Drainage ; Humans ; Infant ; Male ; Mediastinal Emphysema ; Oxygen ; Pneumothorax ; Respiration, Artificial ; Respiratory Insufficiency ; Ventilation*

No abstract available.
Gerbillinae

Neonatal Gaves disease is a relatively rare condition due to transplacental passage of Thyroid-stimulating antibody(TSAb) from a mother with active or inactive Graveses disease or autoimmune thyroiditis. A 11-day-old female newborn was referred to our department of pediatrics from a local clinic because of low level T4(3.55microg/dl) concurrent with high level TSH (501.74uIU/ml) on the 5th day neonatal metabolic screening. But, our repeated laboratory data showed very high serum T4(59.6microg/dl), T3(1,600ng/dl), suppressed TSH(0.43uIU/ml), and the presence of TSH receptor antibody. Her mother was treated with propylthiouracil(PTU) for Graves disease during pregnancy. Therefore, we thought it was a delayed-onset neonatal hyperthyroidism, because the fetal thyroid gland was initially suppressed by antithyroid drug taken during pregnancy. After initiating antithyroid drug therapy for the hyperthyroid nature, TSH levels became elevated again, while thyroid hormone levels decreased. Maternal and infant blood samples at the 23th day after birth were examined for serum autoantibodies directed towards the TSH receptor(Thyrotropin-binding inhibitory immunoglobulin:TBII, Thyroid-stimulating antibody:TSAb, Thyroid-stimulating blocking antibody:TSBAb) and high levels of TBII and TSAb were detected. About 2 months after birth, TBII and TSAb decreased within normal limit, and then we could stop antithyroid medication in safety. We report here a case of neonatal Graveses disease with very high level of T4 and T3, but firstly presented as hypothyroid nature on neonatal screening because of the maternally transferred antithyroid drug, PTU.
Autoantibodies ; Drug Therapy ; Female ; Graves Disease ; Humans ; Hyperthyroidism ; Infant ; Infant, Newborn ; Mass Screening ; Mothers ; Neonatal Screening ; Parturition ; Pediatrics ; Pregnancy ; Receptors, Thyrotropin ; Thyroid Gland ; Thyroiditis, Autoimmune

No abstract available.
Brain* ; Tomography, Emission-Computed, Single-Photon*

Gynecomastia is a proliferation of the glandular component of the male breast. Gynecomastia is the most common variant condition of the male breast and results from the effect of an altered estrogen-androgen balance on breast tissue or from the increased sensitivity of breast tissue to a normal estrogen level. We experienced a case of macrogynecomastia in a 16-year-old boy who had a normal male phenotype and was treated by reduction mammoplasty with breast tissue removal, which was effective and produced good cosmetic and psychologic results.
Adolescent ; Breast ; Estrogens ; Female ; Gynecomastia ; Humans ; Male ; Mammaplasty* ; Phenotype

Pseudofolliculitis is a chronic, inflammatory skin disorder seen mainly in individuals with curly hair. This condition is caused by hairs curling back into the skin and is seen most frequently in black men who shave their beards (pseudofolliculitis barbae), but may also be seen in all races who shave the axillary (pseudofolliculitis axillae) and pubic skin (pseudofolliculitis pubis). We report a case of pseudofolliculitis pubis in a 23-year-old black woman, who presented with multiple, dark, black-colored papules on both inner thighs, on the edge of the bikini line, which she regularly shaved. Histopathologically, foreign-body inflammatory reaction surrounding an ingrown hair was observed. We recommended her to stop shaving pubic hairs and to remove the hairs by laser.
Continental Population Groups ; Female ; Hair ; Humans ; Male ; Skin ; Thigh ; Young Adult

PURPOSE: We surveyed parental knowlege about febrile convulsion in order to reduce unnecessary use of diagnostic method and management, and to use as an educational guideline. METHODS: The survey composed of four items : etiology, diagnosis and treatment, prognosis, and method management at home. The rate of correct answers on the total questionnaire, and each questionnaires was compared to the febrile convulsion group (FCG) and control group (CG), to a group that had one episode of febrile convulsion and two and more episodes. The questionnaire about method management was compared to FCG and CG. RESULTS: Comparisons done on the general profiles between FCG and CG showed no singnificant difference statistically. The rate of correct answers on the total questionnaire is 30.6% in FCG and 21.2% in CG. The rate of correct answers on the total questionnaire is 29.0% in the group that had one episode of febrile convulsion, and 33.0% in two and more episodes. Comparing the method management between FCG and CG, cold massage and acupuncture were higher in FCG, statistically. CONCLUSION: The rate of correct answers showed no significant difference between FCG and CG, and was very low in both groups. There is also no difference in the rate of correct answers. Parental knowledge about proper management before they go to the hospital is insufficient. Therefore, we need to establish an educational program on febrile convulsion in order to reduce the use of unnecessary diagnostic method and inappropriate management.
Acupuncture ; Diagnosis ; Humans ; Massage ; Parents* ; Prognosis ; Surveys and Questionnaires ; Seizures, Febrile*

PURPOSE: The incomplete reduction of the sesamoid has lately been issued as cause for recurrence. In this study, we analysed factors that may influence reduction of sesamoid. MATERIALS AND METHODS: The study consists of 50 cases operated by single surgeon. Eighteen cases were done by proximal chevron osteotomy, and 32 cases were done by scarf osteotomy. Hallux valgus (HV) angle and intermetatarsal (IM) angle were measured before and three months after the surgery. Sesamoid position (SP) was classified according to Hardy and Clapham grade system. RESULTS: After the proximal chevron osteotomy, the correction of the mean HV angle was 19.5degrees, and IM angle was 6.2degrees. SP was changed from 5.6 to 3.4 grade. After the Scarf osteotomy, the correction of the mean HV angle was 25 degree, and IM angle was 9degrees. SP was changed from 5.5 to 2.8 grade. There was difference of sesamoid's correction between two different method of surgery (p=0.127). However, better correction of sesamoid was witnessed with bigger correction angle regardless of method of surgery (p=0.002, 0.001). CONCLUSION: We believe surgical method do not effect sesamoid's correction but more correction angle can result in better correction of sesamoid position.
Hallux ; Hallux Valgus ; Osteotomy ; Recurrence ; Wit and Humor as Topic

PURPOSE: The incomplete reduction of the sesamoid has lately been issued as cause for recurrence. In this study, we analysed factors that may influence reduction of sesamoid. MATERIALS AND METHODS: The study consists of 50 cases operated by single surgeon. Eighteen cases were done by proximal chevron osteotomy, and 32 cases were done by scarf osteotomy. Hallux valgus (HV) angle and intermetatarsal (IM) angle were measured before and three months after the surgery. Sesamoid position (SP) was classified according to Hardy and Clapham grade system. RESULTS: After the proximal chevron osteotomy, the correction of the mean HV angle was 19.5degrees, and IM angle was 6.2degrees. SP was changed from 5.6 to 3.4 grade. After the Scarf osteotomy, the correction of the mean HV angle was 25 degree, and IM angle was 9degrees. SP was changed from 5.5 to 2.8 grade. There was difference of sesamoid's correction between two different method of surgery (p=0.127). However, better correction of sesamoid was witnessed with bigger correction angle regardless of method of surgery (p=0.002, 0.001). CONCLUSION: We believe surgical method do not effect sesamoid's correction but more correction angle can result in better correction of sesamoid position.
Hallux ; Hallux Valgus ; Osteotomy ; Recurrence ; Wit and Humor as Topic

BACKGROUND: According to developments in socioeconomic status and medical science, the population of aged individuals has significantly increased. Therefore, this group needs a fundamental epidemiologic survey of dermatologic diseases. OBJECTIVE: The purpose of this study was to evaluate the prevalence of dermatologic diseases in the elderly and to compare with those of previous studies. METHODS: 729 out-patients over 65 years of age who had visited the Department of Dermatology, Yonsei University Wonju Christian Hospital from January, 2004 to December, 2010 were analyzed retrospectively. RESULTS: The elderly group over 65 years of age accounted for 9.7% of all new patients (729/7,532 cases). The ratio of males to females was 1 to 0.99 (366 cases : 363 cases). Patients between 65 and 69 years of age were the majority (36.2%). They visited the hospital most frequently in the summer (31.8%), especially August (11.0%). The most common disease was herpes zoster (10.5%), followed by fungal infection (10.3%), and allergic contact dermatitis (8.4%). Fungal infection was the most frequent disease in patients between 65 and 69 years old and herpes zoster was the most frequent disease between 70 and 79 years old. Scabies was the most frequent disease in patients over 80 years old. Pruritis was found in 9.7% and xerosis in 7.0%. Eczema was the most common disease group (in 22.0%) and the second mmost common was viral infection (12.3%). CONCLUSION: This study provides useful data on the prevalence and characteristics of dermatologic diseases in elderly Korean patients.
Aged ; Dermatitis, Allergic Contact ; Dermatology ; Eczema ; Female ; Herpes Zoster ; Humans ; Male ; Outpatients ; Prevalence ; Pruritus ; Scabies ; Social Class