Hydrogen peroxide is commonly used for cleansing superficial wounds, because of its antimicrobial action attributed to oxidizing capacity. The release of oxygen doping oxidation results in effervescence, which promotes a weak mechanical means of removing tissue debris. In the past, hydrogen peroxide was used for the management of meconium ileum and for fecal impaction because liberated oxygen tend to break up impaction and initiate peristaltic reflex. However, the stronger solution has a caustic action. The potential dangers of hydrogen peroxide enema were not so well known until 1950s when Pumphery recognized deleterious effects from such enema. During 1980s, hydrogen peroxide was used for disinfection of endoscope and several authors reported peroxide-induced colitis. We report a case of hydrogen peroxide induced chemical colitis in a 47-year-old man, who complained bloody stools and tenesmus after introducing hydrogen peroxide soaked gauss into the rectum to relieve pruritus am. Colonoscopy demonstrated diffuse erythema, edema and friability of rectal mucosa upto 6-7 cm from anal verge. The proximal margin of the lesion was well demarcated from normal appearing mucosa. Mucosal biopsy revealed histologic findings compatible with ischemic changes. His symptoms improved rapidly with conservative treatment.
Biopsy ; Colitis ; Colonoscopy ; Disinfection ; Edema ; Endoscopes ; Enema ; Erythema ; Fecal Impaction ; Humans ; Hydrogen Peroxide ; Hydrogen* ; Ileum ; Meconium ; Middle Aged ; Mucous Membrane ; Oxygen ; Peroxides* ; Proctitis* ; Pruritus ; Rectum ; Reflex ; Wounds and Injuries

A study on physically and mentally handicaped children was carried out by health commttee of korean pediatric Association on August, 1977. 654 children in 5 special children's Institutes in Seoul area were observed and the results obtained were as follows ; 1. 393 out of 654 cases were males and male to female ratio was 6 : 4. The most Common age group in institutes were over 10 years (45.6%). As the age goes young, the number of cases were decreased. 2. 43.7% of all cases were orphans. 3. The most common handicap was cerebral palsy(33.3%). Poliomyelitis(24.0%) and mental retardation (20.0%) were the next and these 3 handicaps were ranged 78.1% of all handicaps. The other less common handicaps were Cong. Anomaly(8.1%), mongolism(4.3%) Tb spine or hip joint(2.1%) and microcephaly(2.0%) in order of frequency. 4. Handicaps originated from acquired and congenital were 37.5% and 15.9% respectively. But the remains were obscure in origin. Cong. Anomaly, mongolism and microcephaly were common causes of congenital origin and poliomyelitis, cerebral palsy and Tb hip or spine were frequently acquired. 5. Only 64 cases(18.0%) of cerebral palsy and mental retardation had Known Causes. These were caused by birth injury(24cases), prematurity, Kern icterus or meningigis. 6. 65.4% of all cases had mentally retardation. 87.2% of cerebral palsy nd 83.0% of congenital anomaly were mentally retarded and all cases with mongolism, microcephaly, hydrocephalus and spina bifida mental retardation. 7. The most common site of congenital anomaly was extremities or joints(47.1%) and multiple anomalies were 28.5% of all anomalies. 8. Less than 6 months of institution were common in paid cases(24.9%) in spite of 5~10 year in institule were common in orphans (28.3%). Even in paid cases, economic stase were very low level.
Academies and Institutes ; Cerebral Palsy ; Child* ; Child, Orphaned ; Down Syndrome ; Extremities ; Female ; Hip ; Humans ; Hydrocephalus ; Intellectual Disability ; Jaundice ; Male ; Mentally Disabled Persons ; Microcephaly ; Parturition ; Poliomyelitis ; Seoul ; Spinal Dysraphism ; Spine ; Statistics as Topic*

A statistical study on visually handicapped children was performed by The Committee on Health of Korean Pediatric Association from July to October, 1978. 3,930 boys and girls in middle school children(3rd grade; around 15 years of age) were studied and the results were obtained as follows; 1, 788 out of 3,930 children(20.1%) were visually handicapped. There were no sex preponderance. 2. Annual incidence of visual handicap was 2.2% of all children studied. 3. There were no specific age preferance for handicapping and annual incidence of visual retardations among the handicapped children was 13.7%(10~19%). 4. Children wearing corrective glasses were 62.8% of all handicapped children and 69.8% of them were began to wear the glasses after entrance of middle school. 5. Nearly all of the handicapped children were suffered from symptoms related with visual defect and the most common difficulty was learning problems(67.5%). Headache(6.7%) and dizziness(5.5%) were another difficulties. 6. 92.5% of children wearing glasses were improved their symptoms related with poor visions but 79.8% of children wearing glasses were suffered form discomfortness by glasses itself. 7. The reasons wearing no glasses among the visual handicaps were advices by parents and friends due to bad effects of glasses on beauty(321.%), hesitation(30.7%) and shyness(13.3%). 8. High famillial incidence of visual handicaps were noted in visually handicapped children than with normal vision. 9. There were no difference between the children with defective vision and normal children on number of television sets at home, places of telvision set ups(children's room or parent?sroom), hours watching televison per day, presence or absence of children's study rooms and reading postures. 10. Habits of watching television or reading books from too short distance, improper illumination when they read the books at home were much more freqently observed in children with visual handicap than children with no defect.
Child ; Disabled Children* ; Disabled Persons* ; Eyeglasses ; Female ; Friends ; Glass ; Humans ; Incidence ; Learning ; Lighting ; Parents ; Posture ; Statistics as Topic* ; Television

Angiosarcoma is a rare malignant tumor of an endothelial cell derivation and it accounts for less than 2% of all sarcomas. It is a highly aggressive neoplasm with a poor prognosis and most patients die within a short period after presentation. Although angiosarcoma may occur in any location on the body, it rarely arises from major vessels, but has a decided predilection for the skin and superficial soft tissue. A 39-year-old man was referred to our department with an asymptomatic, firm, ulcerative nodule on his scalp that was noticed almost 2 months previously. He had been diagnosed with lung angiosarcoma 9 month earlier. Histopathologically, the skin specimen showed angiosarcoma. The histological findings of the metastatic skin cancer are usually the same as that of the primary cancer. Metastatic cutaneous angiosarcoma is uncommon. Based on these clinical and histopathological findings, our case seems to be skin metastasis at the scalp from the lung angiosarcoma.
Adult ; Endothelial Cells ; Hemangiosarcoma ; Humans ; Lung ; Neoplasm Metastasis ; Prognosis ; Sarcoma ; Scalp ; Skin ; Skin Neoplasms ; Ulcer

Primary cutaneous follicular B cell lymphomas are rare entities of an unknown cause, except for those induced by Epstein-Barr virus (EBV) or Borrelia burgdorferi. Follicular B cell lymphoma has been thought to rarely occur primarily in the skin. The lesions are generally solitary plaques or nodules that are localized on the head and neck. It shows considerable variation in the clinical presentation, the histological features, the immunophenotype and the prognosis. In this case, a 79-year-old man presented with a 3-month history of lesions on his head. Clinical examination revealed two deep-seated subcutaneous tumors with uneven surfaces located on the both sides of the frontoparietal area of the scalp. Biopsy of the skin lesion disclosed a massive dermal lymphocytic infiltrate with a follicular pattern. On immunohistochemical staining, the lymphocytes strongly expressed CD20 and Ki-67, but not Bcl-2. He was diagnosed with primary cutaneous follicular B cell lymphoma. This case illustrates a rarely reported example of primary cutaneous follicular B cell lymphoma that arose on the scalp.
Aged ; Biopsy ; Borrelia burgdorferi ; Head ; Herpesvirus 4, Human ; Humans ; Lymphocytes ; Lymphoma, B-Cell ; Neck ; Prognosis ; Scalp ; Skin

Childhood granulomatous periorificial dermatitis (CGPD), also known as facial Afro-Caribbean childhood eruption (FACE), is a distinctive granulomatous form of perioral dermatitis. It is a condition of unknown etiology, characterized by monomorphous, small, papular eruptions around the mouth, nose and eyes that histopathologically show a granulomatous pattern. It affects prepubescent children of both sexes and typically persists for several months but resolved without scarring. We report a 9 year-old girl with multiple, discrete, monomorphic, papular eruptions of 2-months duration on the perioral and periocular areas. Histopathological examination demonstrated upper dermal and perifollicular granulomatous infiltrate.
Child ; Cicatrix ; Dermatitis ; Dermatitis, Perioral ; Eye ; Humans ; Mouth ; Nose

Primary tumors of the heart are uncommon lesions that can mimic almost any type of cardiac disease. Over 90 per cent of myxoma which are the most common cardiac tumor occur in the atria, with 3 to 4 times as many occuring on the left as on the right. The development of nonivasive echocardiographic technique has made it possible to screen large numbers of patients with atrial myxoma with ease and safe. A 28 year old housewife was admitted because of dyspnea for 5 months. Clinical diagnosis of right atrial myxoma was made by echocardiography and right atrial angiocardiogram. Surgical resection was performed successfully. We presented a case of right atrial myxoma with a review of literatures.
Adult ; Diagnosis ; Dyspnea ; Echocardiography ; Heart ; Heart Diseases ; Heart Neoplasms ; Humans ; Myxoma*

Imatinib mesylate (Gleevec(TM)) is an oral anticancer drug. It works as a selective and competitive inhibitor of tyrosine kinases such as bcr-abl protein, c-kit, and platelet-derived growth factor receptors (PDGFR). Gleevec(TM) is a first-line therapeutic agent for chronic myelogenous leukemia (CML) and gastrointestinal stromal tumors, but causes various adverse cutaneous reactions. We herein report on a case of lichenoid drug eruption induced by Gleevec(TM) in a patient with a malignant gastrointestinal stromal tumor.
Benzamides ; Drug Eruptions ; Gastrointestinal Stromal Tumors ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Mesylates ; Phosphotransferases ; Piperazines ; Pyrimidines ; Receptors, Platelet-Derived Growth Factor ; Tyrosine ; Imatinib Mesylate

Enteroviruses are the most common agents of myocarditis and have been implicates in the pathogenesis of dilated cardiopmyopathy. There are still discrepancies in the association of enterovirus and myocardial disease, partially due to lack of data on detection of virus antigen or viral culture in the tissue. For the treatment of fulminant myocarditis, aggressive hemodynamic support is warranted because of its excellent long-term prognosis. This 16 year-old girl was admitted because of anterior chest pain for a day. She had flu-like symptoms such as fever, sore throat and cough at 2 weeks ago. Electrocardiogram showed sinus tachycardia and ST segment elevations in lead II, III, aVF and V1-V4. Troponin T was positive and creatinine phosphokinase was elevated (1323 IU/L) at emergency room. On emergency echocardiogram, inferior wall motion was decreased and the ejection fraction (EF) was 70%. Coronary angiogram showed no thrombus and no significant stenosis in coronary artery, and spasm was not induced with ergonovine. Conventional treatment for congestive heart failure with digoxin (0.25 mg daily) and furosemide (20 mg t.i.d) was started under the impression of myocarditis. On the first hospital day, pulmonary edema and signs of shock were developed. The whole left ventricular(LV) wall motion were markedly decreased and EF was less than 20% on echocardiogram. Despite of intra-aortic balloon pump (IABP) for 4 hours, shock and pulmonary edema was progressed. Mechanical circulatory support was started with left ventricular assist device (LVAD, Bio-pump, Medtronic Bio-Medicus, USA). At the time of operation, central venous pressure was 24cmH20, systolic blood pressure was 75mmHg, left atrium(LA) and LV was dilated and the whole wall of LV showed almost akinesia , and LA appendage was biopsied. After 126 hours of LVAD, LV wall motion was restored and EF was 79% on echocardiogram. LVAD was removed 10 days after operation and she was discharged on 23 days of hospitalization without any heart failure symptoms. Immunohistochemistry of LA showed enteroviral VP1 capsid protein (primary antibody; NoVo Castra Laboratory, UK) over the entire LA wall. Her serum neutralized coxsackievirus B3 (CVB3, H3 variant of Woodruff strain) in neutralization test using horse anti-CVB3 (Nancy strain) antibody (ATCC, V030-501-560) as a positive control. The titer of neutralization Ab in her serum of 21 days increased more than 4 times than that of 2 days.
Adolescent ; Blood Pressure ; Capsid Proteins ; Cardiomyopathies ; Central Venous Pressure ; Chest Pain ; Constriction, Pathologic ; Coronary Vessels ; Cough ; Creatinine ; Digoxin ; Electrocardiography ; Emergencies ; Emergency Service, Hospital ; Enterovirus ; Ergonovine ; Female ; Fever ; Furosemide ; Heart Failure ; Heart-Assist Devices* ; Hemodynamics ; Horses ; Hospitalization ; Humans ; Immunohistochemistry ; Myocarditis* ; Neutralization Tests ; Pharyngitis ; Prognosis ; Pulmonary Edema ; Shock ; Spasm ; Tachycardia, Sinus ; Thrombosis ; Troponin T

BACKGROUND/AIMS: In the management of choledocholithiasis, T-tube drainage was the most common treatment modality after common bile duct (CBD) exploration. However, the T-tube drainage has several problems and risk of complications such as abdominal discomfort, long duration of drainage, or bile leakage. We evaluated the effectiveness of primary closure of CBD after choledochotomy and the possibility of substitution for T-tube drainage. METHODS: Seventy six patients with choledocholithiasis who had undergone CBD exploration were enrolled in this study from January 1999 to March 2001. 20 patients among them had undergone primary closure of CBD with preoperative endoscopic nasobiliary drainage (ENBD) or percutaneous transhepatic biliary drainage (PTBD) in situ after exploration (primary closure group), 56 patients had undergone T-tube drainage (T-tube group). We compared the clinical characteristics and outcome between two groups. RESULTS: There was no difference in postoperative complication (19.6% vs. 20%), the mean amount of biliary drainage (326 ml/day vs. 320 ml/day) and the duration of hospitalization (11.6 day vs. 9.2 days) between the both groups. The duration of biliary drainage was significantly longer in the T-tube group (45.3 days) than in the primary closure group (9.2 days; p<0.01). The rate of remnant stone was higher in the T-tube group (32.1%) than the primary closure group (20%), there was not statistically significant. CONCLUSION: The primary closure of CBD with the preoperative biliary drainage was relatively safe and resulted in no difference of clinical outcome. Furthermore, this method induced going back early to normal life. These result suggest that the primary closure of CBD may be a feasible technique after choledochotomy when the patients are selected by specialized indications.
Bile ; Choledocholithiasis ; Common Bile Duct* ; Drainage* ; Hospitalization ; Humans ; Postoperative Complications