A Case of a Human Tail Without Associated Anomalies / 대한소아신경학회지

Human tails or caudal cutaneous appendages are rare congenital anomalies with lesions usually arising from the midline of the lumbosacrococcygeal area. There have been only around 70 cases reported in literature. A 4-month-old male infant born as the 1st child of a dizygotic twin was presented with a penis-shaped mass of 4-cm in the coccygeal area. The mass was entirely covered by skin without any skin defect and was connected to the midline skin of the posterior coccygeal area by a stalk. Magnetic resonance images showed fat density of the mass without any demonstrable communication with the spinal canal nor any underlying central nervous system anomalies. The patient underwent a simple surgical excision of the mass without residual effects and complications. Histopathologic examination of the mass revealed lobules of mature adipose tissue, fibromuscular soft tissue, small vessels and nerves with normal hair follicles on the skin.

Relationship Between Air Pollutants and Prevalence of Allergic Disease/Pulmonary Function in Students in Incheon / 소아알레르기및호흡기학회지

PURPOSE: To investigate the association between concentrations of air pollutants and the prevalence of allergic diseases/pulmonary function among elementary school students. METHODS: There were 1,262 students in the second grade of 11 elementary schools in Incheon. At each school, 5-year mean concentration of carbon monoxide, nitrogen dioxide, ozone, sulfur dioxide and PM10 (particulate matter with diameter < or =10 microm) were calculated via the Geographic Information System through the database of the National Institute of Environmental Research. The association was compared by two ways of grouping. First, the schools were classified into adjacent and nonadjacent schools by whether the school was located within or away 1 km from air pollutant-emitting facilities. Second, the schools were divided into 2 groups: those with relatively high concentrations of air pollutants based on the median level of 5-year mean concentrations and those with low concentrations. RESULTS: The concentrations of air pollutants except ozone were higher in adjacent schools than nonadjacent schools. The students of adjacent schools showed a lower level of forced expiratory volume in one second and peak expiratory flow, and higher prevalence of 'difficulty of speaking due to dyspnea, within the last year' than those of nonadjacent schools. The prevalence of this speaking difficulty was higher in schools with relatively high concentrations of nitrogen dioxide, sulfur dioxide and PM10 groups than in those with low concentrations of them. The relatively high level of PM10 group increased the prevalence of allergic rhinitis than the low level of PM10 group. CONCLUSION: Air pollutants may influence an increase in the prevalence of allergic diseases, especially allergic rhinitis, and a decrease in the pulmonary function in students.

A Case of Intracranial Dermoid Cyst Associated with Scalp Abscess / 대한소아신경학회지

Intracranial dermoid cyst is a rare congenital disease originating in the embryo. Intracranial dermoid cysts are usually detected before five years of age; however, asymptomatic cysts have been discovered after the third decade of life through various complications. Sometimes, there are neurologic symptoms caused by a cystic mass effect and if there is a dermoid sinus, purulent infections can occur. Early diagnosis is important and as such, CT or MR imaging for recognition of the location, size, and characteristics of the cysts are recommended before surgical resection. Extradural dermoid cysts with an intact occipital dermoid sinus are a rare event. We report a case of intracranial dermoid cyst associated with scalp abscess. In this case, a three-year-old boy was presented with scalp abscess and we performed MR imaging, which revealed a cystic region. The prognosis after resection operation was good without any complication.

The Effect of Growth Hormone on TNF-alpha Level in Zymosan: A Induced Multiorgan Failure

The pathogenesis of sepsis is not clearly understood. In animal models, the association of a high plasma TNF-alpha level with the frequent development of adult respiratory distress syndrome in septic conditions suggests that TNF-alpha plays a major role in the pathogenesis of the lung injury. Also, oxygen free radicals are known to participate in the pathogenesis of multiorgan failure. However, the relations between those factors have not been elucidated clearly. In pharmacological dosage, growth hormone (GH) promotes positive nitrogen balance and anabolic metabolism. There have been many studies about the therapeutic effects of GH in sepsis; However, the exact mechanism is not known. The purpose of this study is to evaluate the mechanism of the therapeutic action of GH in sepsis induced by intraperitoneal injection of Zymosan-A in an animal model. The experimental animals were female Sprague-Dawley rats which were devided into three groups: a control group, a group injected intraperitoneally with Zymosan-A, and a group injected intraperitoneally with Zymosan-A and intramurally with growth hormone. After the lapse of time of 6, 12, 24, 48, and 72 hrs., the rats were sacrificed; then the histopathologic findings for the lung tissue were examined, and the levels of malondialdehyde(MDA) in the lung tissue and TNF-alpha in the blood were measured. In the Zymosan-A-injected group, an increment of infiltration by lymphocytes and neutrophils was observed, the MDA levels in the lung tissue were remarkably increased and reached a peak level 24 hrs. after Zymosan-A injection, and the TNF-alpha levels in the plasma were markedly increased. In the Zymosan-A-plus GH-injected group, there were less infiltration of inflammatory cells and less interstitial edema, and significantly suppressed increments of TNF-alpha and MDA. It can be concluded that GH inhibits the production of TNF-alpha and MDA in sepsis and protect against systemic tissue injury. However, the mechanism for the inhibition of the TNF-alpha production was not elucidated by this study. Further experiments are required.

Surgical Treatment of Substernal Goiters

Substernal extension of a goiter into the thoracic inlet endows a generally benign neck mass with morbid potential. The reported incidence varies between 1% and 15% of all thyroidectomies performed. Whether all patients with a substernal goiter should undergo an operation or whether the operation should be performed selectively remains controversial. From May 1989 to March 1996, 10 patients underwent thyroidectomies for substernal goiters, and those cases of resected substernal goiters have been reviewed to access the symptoms and signs that brought patients to surgery: the size and the position of goiter, the preoperative work-up, the risk associated with the operation, and the histopathologic state of the goiter. There were 3 male and 7 female patients, and their ages ranged from 40 to 68 years. The chief complaints were cervical mass (4), dyspnea (2), facial edema (1) and chest pain (1). No symtomatic cases (2) were also found. The average mass size was 8.4 cm (5-14 cm) and the average weight was 109 gm (41-350 gm). Although chest film was the most used, computed tomography was by far the most useful study. Thyroid scans often failed to show the substernal goiter. Fine-needle aspiration was not helpful because of inaccessibility. In the majority of the patients (7 cases), the substernal goiters were removed by a cervical incision. Three cases of goiters located deep to the carina level required a combined cervical and sternotomy approach or thoracotomy. In the cervical incision group, the complications were transient hypocalcemia (1) and unilateral recurrent laryngeal nerve injury (1). In the combined cervical and sternotomy approach or thoracotomy, unilateral recurrent laryngeal nerve injury (1) and bilateral recurrent laryngeal nerve injury (1) and mediastinitis (1) were the complications. An occult papillary carcinoma, which was not identified preoperatively, was found in one case. Removal was almost always accomplished via cervical incision and with low morbidity and no deaths. Also, the substernal goiters revealed unusual symptoms and signs, such as dyspnea, facial edema and chest pain, compared to usual thyoid goiters and were relatively bigger in size. In conclusion, most substernal goiter above the carinal level could be removed by cervical incision with a low rate of complication. The threat of compression, the substantial chance of malignancy, and the safety of resection mean that the presence of a substernal goiter is an indication for surgery.

Parathyroid imaging: comparison of technetium-thallium subtraction scan, ultrasonography and computed tomography / 대한내분비학회지

No abstract available.

A Case of Behcet's disease

The author presents a case of Behcet's disease which was developed in both eyes of a Korean male. Prednisolone and atropine was topically administered. Depomedrol was administered by subconjunctival and intramuscular injection. The visual acuity was not improved and finally decreased to blindness, but lesions in the skin and buccal mucosa were cleared.

Two Cases of Squamous Cell Carcionoma of Upper Eyelid

The authors present 2 cases of squamous cell carcinoma which occurred primarily in the eyelid. One is a 33-year-old Korean female who had the carcinoma in the right upper palpebral Conjunctiva, and the other is a 75 year-old Korean female who had the carcinoma at the margin of the left upper eyelid. These two cases were more likely to be confused with chalasion and were confirmed to be squamous cell carcinoma by the gistopathological examination.