Purpose: Red meat allergy has recently been described as rare food hypersensitivity with unique pathogenesis and clinical relevance of delayed anaphylaxis. The culprits are various mammal meats containing oligosaccharide epitope (galactose-α-1,3-galactose, α-gal). Interestingly, hard tick bites precede the onset of this allergic condition. The clinical characteristics of red meat allergy had never been reported in Korea. Methods: Among patients diagnosed with food hypersensitivity in a hospital located in Jeju, Korea, those with red meat allergy were recruited. Clinical characteristics were retrospectively reviewed and additionally interviewed. Results: Five patients (mean age, 57±4 years; 4 males and 1 female) were diagnosed as having red meat allergy. They suffered from hives, as the most common symptom, followed by shortness of breath from 10 minutes to 6 hours after exposure to the culprits. Four patients visited the emergency department for anaphylaxis. Culprits included beef, pork, dog, ham, goat, and roe deer. Chicken, duck, bacon, or horse did not cause clinical symptoms. In 4 patients, hard tick bites preceded the onset. Detection of specific IgE to α-gal and culprits such as beef and pork facilitated the confirmative diagnosis. They were advised to avoid mammal meats and to receive a prescription for self-injectable epinephrine. Conclusion Red meat allergy is one of the food hypersensitivities, characterized by severe and delayed allergic reactions to various meats. Red meat allergy may be a tick-borne illness in Jeju, Korea.

Differentiating between nocturnal seizures and sleep-related behaviors is challenging; a detailed history and careful examination are imperative. There have been some case reports of patients who were comorbid with nocturnal seizures and obstructive sleep apnea (OSA). Here, we report a case of an overweight 12-year-old boy diagnosed with sleep-related epilepsy and comorbid OSA. We were able to make these two diagnoses by performing polysomnography with full extended electroencephalography on our patient, who complained of recurrent nocturnal choking episodes during sleep. What differentiates our case is that after further evaluation, the cause of our patient’s OSA was ultimately determined to be laryngeal lymphoid hyperplasia.

OBJECTIVES: The purpose of this study was to investigate the characteristics of attention, intellectual functioning and adaptation of girls with attention-deficit hyperactivity disorder (ADHD). METHODS: The scores of the ADHD Diagnostic System (ADS), the Korean Wechsler Intelligence Scale for Children-III (K-WISC-III) and the Korean Personality Inventory for Children (KPI-C) were compared between 26 girls with ADHD and 26 boys with ADHD. RESULTS: 1)There was no significant gender difference in the intellectual functioning, except for the picture completion subscale. 2) Compared to the boys, the girls responded more slowly on the ADS visual task. 3) The girls were rated higher by their parents for the depression and social relationship problems of the KPI-C. CONCLUSIONS: The results suggest that there are noticeable gender differences for the attention problems and social functioning of children with ADHD.
Child ; Depression ; Humans ; Intelligence ; Parents ; Personality Inventory

We present a case of persistent left superior vena cava, anomalous right pulmonary venous connection to the right-sided superior vena cava and sinus venosus atrial septal defect detected by computed tomography (CT) pulmonary angiography and echocardiography. These defects were surgically corrected using a double-patch technique. In fact, CT can provide anatomical information about a complex anomaly in the systemic and pulmonary vasculatures. Though modern imaging techniques are useful for detecting complex cardiovascular disease, careful echocardiographic examination should be performed to diagnose complex cardiac anomalies.
Angiography ; Cardiovascular Diseases ; Echocardiography ; Heart Septal Defects, Atrial ; Vascular Diseases ; Vena Cava, Superior

We present a case of persistent left superior vena cava, anomalous right pulmonary venous connection to the right-sided superior vena cava and sinus venosus atrial septal defect detected by computed tomography (CT) pulmonary angiography and echocardiography. These defects were surgically corrected using a double-patch technique. In fact, CT can provide anatomical information about a complex anomaly in the systemic and pulmonary vasculatures. Though modern imaging techniques are useful for detecting complex cardiovascular disease, careful echocardiographic examination should be performed to diagnose complex cardiac anomalies.
Angiography ; Cardiovascular Diseases ; Echocardiography ; Heart Septal Defects, Atrial ; Vascular Diseases ; Vena Cava, Superior

Background: : Effective communication between doctors and patients is very important not only for diagnosis and treatment but also for building trust. Although teaching communication skills is very important in medical schools, there are limitations such as the number of students and the uncertainty of the patient population. Therefore, this study evaluates the effect of Fishbowl method to teach communication skills to medical students, which involves the medical students communicating with standardized patients in front of a large classroom and being observed by rest of the students. Methods: : This study involves 10 weeks of educating 126 fourth grade medical students and graduates. During this period, total 8 classes were taken by subjects, where each class lasts 2 hours and is conducted by observing treatments of the standardized patients on 14 clinical topics by randomly selected medical students and giving feedback on the communication skills of the selected medical students. The educational effect was evaluated based on the scores of the clinical performance examination before and after the classes. Results: : The scores assessed for medical history taking before and after the training are increased by 2.45 (p<0.001) and the scores for patient-doctor relationship is increased by 7.56 (p<0.001). Conclusions : It is expected to improve the communication skills of medical students by large scale lectures with standardized patients.

Henoch-Schonlein purpura (HSP) is the most common form of systemic vasculitis in children. Palpable purpura, arthralgia, arthritis, abdominal pain and renal involvement are the major clinical manifestations. Gastrointestinal involvement is related with abdominal pain and bleeding. We described a 71 year-old female experienced acute exacerbation of HSP presented with gastrointestinal bleeding. She was hospitalized for hematemesis and diagnosed duodenitis by esophagogastroduonenoscopy (EGD). Duodenitis was improved at EGD checked in 7 days. She still complained of melena and abdominal pain. There were no abnormal findings at sigmoidoscopy. Jejunal ulcer and purpura were diagnosed by capsule endoscopy. Symptoms were relieved after administration of systemic steroid. But she needed renal replacement therapy for 3 months. Small bowel ulcer diagnosed by capsule endoscopy in patients with HSP was rarely described in Korean literature. This case suggests that capsule endoscopy have a role in diagnosis of small bowel ulcer and its severity in HSP with gastrointestinal symptom.
Abdominal Pain ; Arthralgia ; Arthritis ; Capsule Endoscopy ; Child ; Duodenitis ; Female ; Gastrointestinal Hemorrhage ; Hematemesis ; Hemorrhage ; Humans ; Melena ; Purpura ; Purpura, Schoenlein-Henoch ; Renal Replacement Therapy ; Sigmoidoscopy ; Systemic Vasculitis ; Ulcer

MicroRNAs (miRNAs) act as regulators of gene expression by binding to the 3’ untranslated region (UTR) of target genes. They perform important biological functions in the various species. Among many miRNAs, miR-21-3p is known to serve vital functions in development and apoptosis in olive flounder. Using genomic and bioinformatic tools, evolutionary conservation of miR-21-3p was examined in various species, and expression pattern was analyzed in olive flounder. Conserved sequences (5’-CAGUCG-3’) in numerous species were detected through the stem-loop structure of miR-21-3p. Thus, we analyzed target genes of miR-21-3p. Among them, 3’ UTR region of PPIL2 gene indicated the highest binding affinity with miR-21-3p based on the minimum free energy value. The PPIL2 gene showed high expression levels in testis tissue of the olive flounder, whereas miR-21-3p showed rather ubiquitous expression patterns except in testis tissue, indicating that miR-21-3p seems to control the PPIL2 gene expression in a complementary repression manner in various tissues of olive flounder. Taken together, this current study contributes to infer the target gene candidates for the miR-21-3p using bioinformatics tools. Furthermore, our data offers important information on the relationship between miR-21-3p and target gene for further functional study.
Apoptosis ; Computational Biology ; Conserved Sequence ; Flounder* ; Gene Expression ; MicroRNAs ; Olea* ; Repression, Psychology ; Testis ; Untranslated Regions

Intravenous immunoglobulin (IVIg) therapy is being increasingly used in a wide range of neurological conditions. Although IVIg is generally regarded as being safe, there are reports of acute renal failure, aseptic meningitis, and unexplained stroke or thromboembolic events in elderly patients. We report a patient with Guillain-Barre syndrome who developed a cerebral infarction following intravenous immunoglobulin therapy.
Acute Kidney Injury ; Aged ; Cerebral Infarction* ; Guillain-Barre Syndrome* ; Humans ; Immunization, Passive* ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Meningitis, Aseptic ; Stroke

This study was purposed to investigate the effect of onion or beet on plasma and liver lipids, erythrocyte Na efflux channels and platelet aggregation in simvastatin (SIM) treated hypercholesterolemic rats. Forty Sprague Dawley rats were divided into four groups and fed 0.5% cholesterol based diets containing 2 mg/kg BW simvastatin or simvastatin with 5% onion or beet powder. Plasma total cholesterol was significantly increased in SIM group compared with the control (p<0.01), and the elevated plasma total cholesterol of SIM group was significantly decreased in SIM-onion and SIM-beet groups (p<0.05). HDL-cholesterol in SIM-beet group was significantly increased compared with other groups (p<0.05). Platelet aggregation in both the maximum and initial slope was significantly decreased in SIM group compared with SIM-onion group (p<0.05). Na-K ATPase was significantly decreased in SIM group compared with the control, SIM-onion and SIM-beet groups (p<0.05). Na passive leak was significantly increased in all groups treated with SIM compared with the control (p<0.05). The total Na efflux was decreased in SIM group and increased in SIM-onion group and the difference between these two groups was significant (p<0.05). There was no difference in intracellular Na among groups. In present study, simvastatin, a HMG CoA reductase inhibitor at dose of 2mg/kg BW/day rather increased plasma total cholesterol in rats, inferring that the action mechanism of simvastatin on cholesterol metabolism differ between rat and human. Onion and beet play favorable roles in cardiovascular system by restoring the reduced Na efflux through Na-K ATPase and Na-K cotransport in SIM treated rats.
Adenosine Triphosphatases ; Animals ; Beta vulgaris ; Blood Platelets ; Cardiovascular System ; Cholesterol ; Diet ; Erythrocytes ; Humans ; Hydroxymethylglutaryl CoA Reductases ; Liver ; Onions ; Plasma ; Platelet Aggregation ; Rats ; Rats, Sprague-Dawley ; Simvastatin