Immune thrombocytopenia is the most common diagnosis of isolated thrombocytopenia. The dilemma encountered by paediatricians is missing diagnosis of acute leukaemia in children with isolated thrombocytopenia. We demonstrated childhood ITP could be diagnosed using a four point clinical criteria without missing a diagnosis of acute leukaemia. Hence, bone marrow examination is not necessary in children with typical features compatible with ITP prior to steroid therapy. This can encourage paediatricians to choose steroid therapy, which is cheaper and non-blood product, as first line platelet elevating therapy in children with significant haemorrhage.
Thrombocytopenic

Clinical manifestations of chronic exposure to organic mercury usually have a gradual onset. As the primary target is the nervous system, chronic mercury exposure can cause symptoms such as fatigue, weakness, headache, and poor recall and concentration. In severe cases chronic exposure leads to intellectual deterioration and neurologic abnormality. Recent outbreaks of bovine spongiform encephalopathy and pathogenic avian influenza have increased fish consumption in Korea. Methyl-mercury, a type of organic mercury, is present in higher than normal ranges in the general Korean population. When we examine a patient with chronic fatigue, we assess his/her methyl-mercury concentrations in the body if environmental exposure such as excessive fish consumption is suspected. In the current case, we learned the patient had consumed many slices of raw tuna and was initially diagnosed with chronic fatigue syndrome. Therefore, we suspected that he was exposured to methyl-mercury and that the mercury concentration in his hair would be below the poisoning level identified by World Health Organization but above the normal range according to hair toxic mineral assay. Our patient's toxic chronic fatigue symptoms improved after he was given mercury removal therapy, indicating that he was correctly diagnosed with chronic exposure to organic mercury.
Animals ; Cattle ; Disease Outbreaks ; Encephalopathy, Bovine Spongiform ; Environmental Exposure ; Fatigue ; Fatigue Syndrome, Chronic ; Hair ; Headache ; Humans ; Influenza in Birds ; Korea ; Nervous System ; Reference Values ; Tuna ; World Health Organization

Background: Many studies have been conducted to validate fatty liver index (FLI) as a marker for non-alcoholic fatty liver disease (NAFLD). However, there are insufficient data in Korea to verify the usefulness of FLI, and the results of these studies are contradictory. This study aimed to validate FLI as a marker for NAFLD in Korea. For better accuracy, computed tomography (CT) scan was used instead of ultrasound scan. Methods: A cross-sectional analysis was performed in 785 subjects who participated in a health examination. The participants were divided according to presence of NAFLD, which was determined by abdominal CT. Frequency analysis was performed on all results. The chi-square test and independent t-test were used to compare the differences between the non-NAFLD group and the NAFLD group in terms of general characteristics and blood tests. The ability of the FLI to detect (nonalcoholic) fatty liver was assessed using area under the receiver operator characteristic (AUROC) curve analysis. Results: FLI was significantly higher in the NAFLD group (42.48±27.63) than in the non-NAFLD group (22.59±20.05) (P<0.0001). The algorithm for FLI had a better AUROC of 0.696 (95% confidence interval, 0.649-0.742) than any other variable in the prediction of NAFLD. Conclusions FLI is a marker that can be used as a simple and cost-effective tool to screen for NAFLD.

BACKGROUND: While the correlation between metabolic syndrome (MS) and serum uric acid (sUA) levels has already been identified, the correlation between MS and the sUA/creatinine ratio has not been studied in Korea. Accordingly, the present study examined the correlation between MS and the sUA/creatinine ratio using data from the seventh Korea National Health and Nutrition Examination Survey (2016). METHODS: The study population consisted of healthy adults aged 19 years or older medical diseases. The five components of MS and the presence of MS were used as independent variables, while the sUA/creatinine ratio was selected as the dependent variable. After adjusting for confounding variables, a complex samples logistic regression test was performed to analyze the correlations between the sUA/creatinine ratio and MS and its components. RESULTS: The following variables showed positive correlation with the sUA/creatinine ratio: systolic blood pressure (BP) (95% confidence interval [CI], 1.051–1.243; P=0.002), diastolic BP 1.144 (95% CI, 1.054–1.241; P=0.001), fasting blood sugar level 1.166 (95% CI, 1.070–1.271; P < 0.001), triglyceride level 1.340 (95% CI, 1.259–1.427; P < 0.001), high density lipoprotein level 1.163 (95% CI, 1.100–1.230; P < 0.001), waist circumference 1.342 (95% CI, 1.239–1.455; P < 0.001), and the presence of MS 1.041 (95% CI, 1.034–1.049; P≤0.001). CONCLUSIONS The findings of the present study demonstrated a statistically significant correlation between the sUA/creatinine ratio and the presence of MS as well as with each component of MS. The significance of the present study is that it is the first study to investigate Koreans.

Background: Many studies have been conducted to validate fatty liver index (FLI) as a marker for non-alcoholic fatty liver disease (NAFLD). However, there are insufficient data in Korea to verify the usefulness of FLI, and the results of these studies are contradictory. This study aimed to validate FLI as a marker for NAFLD in Korea. For better accuracy, computed tomography (CT) scan was used instead of ultrasound scan. Methods: A cross-sectional analysis was performed in 785 subjects who participated in a health examination. The participants were divided according to presence of NAFLD, which was determined by abdominal CT. Frequency analysis was performed on all results. The chi-square test and independent t-test were used to compare the differences between the non-NAFLD group and the NAFLD group in terms of general characteristics and blood tests. The ability of the FLI to detect (nonalcoholic) fatty liver was assessed using area under the receiver operator characteristic (AUROC) curve analysis. Results: FLI was significantly higher in the NAFLD group (42.48±27.63) than in the non-NAFLD group (22.59±20.05) (P<0.0001). The algorithm for FLI had a better AUROC of 0.696 (95% confidence interval, 0.649-0.742) than any other variable in the prediction of NAFLD. Conclusions FLI is a marker that can be used as a simple and cost-effective tool to screen for NAFLD.

BACKGROUND: While the correlation between metabolic syndrome (MS) and serum uric acid (sUA) levels has already been identified, the correlation between MS and the sUA/creatinine ratio has not been studied in Korea. Accordingly, the present study examined the correlation between MS and the sUA/creatinine ratio using data from the seventh Korea National Health and Nutrition Examination Survey (2016). METHODS: The study population consisted of healthy adults aged 19 years or older medical diseases. The five components of MS and the presence of MS were used as independent variables, while the sUA/creatinine ratio was selected as the dependent variable. After adjusting for confounding variables, a complex samples logistic regression test was performed to analyze the correlations between the sUA/creatinine ratio and MS and its components. RESULTS: The following variables showed positive correlation with the sUA/creatinine ratio: systolic blood pressure (BP) (95% confidence interval [CI], 1.051–1.243; P=0.002), diastolic BP 1.144 (95% CI, 1.054–1.241; P=0.001), fasting blood sugar level 1.166 (95% CI, 1.070–1.271; P < 0.001), triglyceride level 1.340 (95% CI, 1.259–1.427; P < 0.001), high density lipoprotein level 1.163 (95% CI, 1.100–1.230; P < 0.001), waist circumference 1.342 (95% CI, 1.239–1.455; P < 0.001), and the presence of MS 1.041 (95% CI, 1.034–1.049; P≤0.001). CONCLUSIONS: The findings of the present study demonstrated a statistically significant correlation between the sUA/creatinine ratio and the presence of MS as well as with each component of MS. The significance of the present study is that it is the first study to investigate Koreans.
Adult ; Blood Glucose ; Blood Pressure ; Confounding Factors (Epidemiology) ; Creatinine ; Fasting ; Humans ; Korea ; Lipoproteins ; Logistic Models ; Nutrition Surveys ; Triglycerides ; Uric Acid ; Waist Circumference

No abstract available.
Adiposity ; Adult ; Humans ; Risk Factors ; Vitamin D

PURPOSE: Metabolic syndrome causes diabetes and increases the risk of cardiovascular disease. This study examined the correlation between metabolic syndrome, nutrition intake, and triglyceride (TG)/high-density lipoprotein (HDL) cholesterol ratio. METHODS: Using the data from the 7th KNHANES (2016), this study was conducted on healthy adults aged 19 and older. The components and existence of metabolic syndrome and nutrition intake were independent variables and the TG/HDLcholesterol ratio was a dependent variable. A complex sample logistic progress test was used with age, sex, smoking, and drinking frequency corrected. RESULTS: The TG/HDLcholesterol ratio of people with metabolic syndrome was as high as 1.314 on average, compared to people without metabolic syndrome (p < 0.0001). Among each component of metabolic syndrome, the TG/HDL cholesterol ratio had a significant association with fasting blood glucose, TG, HDL cholesterol, and waist circumference (p < 0.05). Only energy and carbohydrate intake were significantly related to the TG/HDLcholesterol ratio (p < 0.05). CONCLUSION: The TG/HDLcholesterol ratio is associated with each component of metabolic syndrome, but in particular, it is positively correlated with the presence of metabolic syndrome. Lower energy intakehad a positive correlation with the TG/HDLcholesterol ratio. These results show that metabolic syndrome can be predicted using the TG/HDLcholesterol ratio, and a diet strategy through nutrition and health education is necessary to prevent metabolic syndrome.
Adult ; Blood Glucose ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Diet ; Drinking ; Fasting ; Health Education ; Humans ; Lipoproteins ; Nutrition Surveys ; Smoke ; Smoking ; Triglycerides ; Waist Circumference

BACKGROUND: The glycemic index (GI) indicates the rise in blood glucose caused by carbohydrate-containing foods. In Korea, there have been few studies on the understanding adults have of GI. Thus, this study investigated differences GI knowledge among the korean adults. METHODS: A questionnaire on the perspective of GI and experience in GI education, participational intent to learn, general knowledge level, and dietary practice was conducted among those living in agricultural areas. Respondents were visitors to the health promotion center of a university hospital. RESULTS: When asked about the GI familiarity, the standard of education, the relationships between diseases and GI, the diabetes group was better able to answer correctly than the other groups. However, the diabetes group showed either no difference or less correct responses for general knowledge of GI. With respect to their usual consideration and low GI dietary practice, the diabetes group provided higher responses than the other groups. On the whole, the diabetes group was better than the other groups for GI relative factor but none of the groups showed high levels for perspective, education, dietary practice of GI. CONCLUSIONS: The groups other than the diabetes group had a low perspective of GI, a lack of correct knowledge of GI, and did not follow a proper diet without considering GI. Even in the diabetes group the perspective, knowledge, and proper dietary practices were not adequate. Accordingly, further education of GI is necessary for diabetic patients, patients with chronic diseases and also people without diseases.
Adult* ; Blood Glucose ; Cardiovascular Diseases ; Chronic Disease* ; Diet* ; Education ; Glycemic Index* ; Health Promotion ; Humans ; Korea ; Recognition (Psychology) ; Surveys and Questionnaires

BACKGROUND: There are many studies on lifestyle management of diabetic patients, but few provide sufficient data comparing a diabetic group with an abnormal fasting glucose group and a normal, non-diabetic group. In this study, we compare the lifestyle management of diabetic patients with those of others groups. METHODS: Among patients visiting the health promotion center of a single university hospital, we retrospectively collected medical records and survey responses regarding patient information. RESULTS: No difference was found in smoking status or smoking intake among the three groups. Alcohol consumption was high in the diabetes group, followed by the abnormal fasting glucose group and the normal group. The diabetes group reported a higher frequency of exercise per week than the normal group. With regard to systolic BP, both the diabetes and abnormal fasting glucose groups were higher than the normal group, with a level greater than the therapeutic goal of 130 mmHg. Both the diabetes group and the abnormal fasting glucose group had a higher triglyceride level than the normal group, with a measure greater than the therapeutic goal of 150 mg/d. The diabetes group had a higher highly sensitive C-reactive protein level than other two groups, with a level greater than 1 mg/dL. CONCLUSION: Management of smoking and alcohol consumption is not sufficient in diabetes patients, suggesting the need for tighter control of BP and triglyceride level in such individuals. For these patients, follow-up of highly sensitive C-reactive protein level should also be considered.
Alcohol Drinking ; C-Reactive Protein ; Fasting ; Glucose ; Health Promotion ; Humans ; Life Style* ; Medical Records ; Retrospective Studies ; Smoke ; Smoking ; Triglycerides