The most common cause of obstructive sleep apnea syndrome (OSAS) in childhood is adenotonsillar hypertrophy. Adenotonsillectomy improves the symptoms quite well in most cases. However, some patients could experience the OSAS again after adenotonsillectomy, who might have several risk factors such as incomplete operation, misdiagnosis, combined anatomical malformation, sinusitis or chronic allergic rhinitis, obesity, initial severe OSAS, and early onset OSAS. We report a case of 11-year-old obese boy who presented with snoring for several years. He was obese with body mass index (BMI) of 26.3 kg/m2 and also found to have fatty liver by ultrasonogram. Initial polysomnography (PSG) showed that he met the criteria of severe OSAS with the apnea-hypopnea index (AHI) of 70.5. He underwent adenotonsillectomy and symptoms improved immediately. Four months later symptoms were relieved with AHI of 0, but 1 year after the adenotonsillectomy he started to complain snoring again and the subsequent PSG results showed that OSAS has relapsed with AHI of 43. Paranasal sinus X-ray and physical examination showed sinusitis and re-growth of adenoid. Obesity was proved not to be a contributing factor because his BMI decreased to normal range (23.1 kg/m2) after diet control and regular exercise. Also, liver transaminase was normalized and fatty liver was disappeared on follow-up abdominal ultrasonogram. After treatment of sinusitis, symptoms were relieved with decreased AHI (8.5). This case suggests that simple adenotonsillectomy might not be the end of OSAS treatment in childhood. Patients who had adenotonsillectomy should be followed by subsequent PSG if symptoms recur. It is also important to be aware of risk factors in the recurrent OSAS for the proper intervention according to the cause.
Adenoids ; Body Mass Index ; Child ; Diagnostic Errors ; Diet ; Fatty Liver ; Follow-Up Studies ; Humans ; Hypertrophy ; Liver ; Obesity ; Physical Examination ; Polysomnography ; Reference Values ; Rhinitis ; Rhinitis, Allergic, Perennial ; Risk Factors ; Sinusitis ; Sleep Apnea, Obstructive ; Snoring

Immunoglobulin G4-related disease (IgG4-RD) can involve any organ. The majority of reported cases involve IgG4-RD of the biliary tract or pancreas, while only two cases of pericarditis have been reported. A 58-year-old man visited the outpatient clinic of our institution with a seven-day history of progressive dyspnea. Based on his transthoracic echocardiogram and transesophageal echocardiogram, he was diagnosed with constrictive pericarditis. The histopathology of his pericardiectomy revealed the cause of constrictive pericarditis to be IgG4-RD. Prednisolone (40 mg) was initiated after the pericardiectomy. As the patient's symptoms resolved, he was discharged and followed-up on an outpatient basis. This is the first case report of constrictive pericarditis caused by IgG4-RD in Korea.
Ambulatory Care Facilities ; Biliary Tract ; Dyspnea ; Humans ; Immunoglobulin G ; Immunoglobulins* ; Inflammation ; Korea ; Middle Aged ; Outpatients ; Pancreas ; Pericardiectomy ; Pericarditis ; Pericarditis, Constrictive* ; Prednisolone

PURPOSE: To determine whether primary snoring could be distinguished from obstructive sleep apnea syndrome (OSAS) by clinical evaluation and symptom scores. METHODS: 56 snoring and 20 asymptomatic subjects were recruited and polysomnography was used to confirm that there were 39 OSAS, 17 primary snoring, and 20 control subjects. We evaluated the size of the childrens adenoids and tonsils. Parents completed sleep disordered breathing scale (SDBS) and obstructive sleep apnea 18 (OSA-18) questionnaires for use as symptom scores, as well as an attention deficit hyperactivity disorder rating scale-IV (ADHD RS-IV). RESULTS: There were no differences between primary snoring and OSAS in terms of tonsil and adenoid size, SDBS (9.4+/-4.6 vs 10.8+/-4.5), and OSA-18 score (61.1+/-25.1 vs 71.2+/-8.4). The patients with OSAS (15.8+/-7.9) and PS (22.2+/-9.4) had a higher ADHD RS-IV score than the control subjects (2.9+/-3.3). There was no difference in the ADHD RS-IV scores of patients with primary snoring and OSAS. CONCLUSION: We confirmed that clinical evaluation could not distinguish OSAS and primary snoring. In addition, our study suggests that primary snoring as well as OSAS is associated with attention deficit hyperactivity disorder.
Adenoids ; Attention Deficit Disorder with Hyperactivity ; Child ; Discrimination (Psychology) ; Humans ; Palatine Tonsil ; Parents ; Polysomnography ; Surveys and Questionnaires ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Snoring

The article ‘The biofilm removal effect of MnO2-diatom microbubbler from the dental prosthetic surfaces: In vitro study’ authored by Eun-Hyuk Lee,Yongbeom Seo, Ho-Bum Kwon, Young-Jun Yim, Hyunjoon Kong, Myung-Joo Kim, published in April issue [Vol 58, No 1] of The Journal of KoreanAcademy of Prosthodontics (2020), has an erratum.The author names were mistakenly given as Ho-Bum Kwon, Young-Jun Yim. It should be corrected as Ho‐Beom Kwon, Young‐Jun Lim. The Journal ofKorean Academy of Prosthodontics apologizes to the readers for this error.

OBJECTIVE: A Comparison of QTc prolongation for various antipsychotics and an analysis of QTc prolongation for the various types of serotonin transporter polymorphism were performed. METHOD: EKG was checked, followed by QTc measurement as Bazett's correction, and the serotonin transporter polymorphism was examined in 110 chronic schizophrenia patients were performed EKG before 24 weeks ago. We defiened QTc prolongation as over 450ms. The risk factor of sudden cardiac death were defiend as QTc prolongation and or 60ms in delta value. RESULT: The prevalence of QTc prolongation in this study was 7.3%, and the prevalence of over 60ms was 4.5%. Patients who had the risk factors were 10(9.1%). 6/52 who prescribed atypical antipsychotics and 2/58 who prescribed haloperidol showed QTc prolongation. The prevalence who had the risk factor of sudden cardiac death were 16% in atypical antipsychotics group, 3.4% in haloperidol group. QTc prolongation were observed more frequently in l/l type than s/s type. l allele frequency were 50% in QTc prolongated group, 19% in not prolongated group. l allele had an association with QTc prolongation(p<0.01). CONCLUSION: The prevalence of QTc prolongatin was frequent in chronic schizophrenia patients who were prescribed atypical antipsychotics. It has strong association with l allele of 5-HTTLPR.
Alleles ; Antipsychotic Agents ; Death, Sudden, Cardiac ; Electrocardiography ; Gene Frequency ; Haloperidol ; Humans ; Prevalence ; Risk Factors ; Schizophrenia ; Serotonin Plasma Membrane Transport Proteins

OBJECTIVE: Cognitive dysfunction is common in people with schizophrenia, and language disability is one of the most notable cognitive deficits. This study assessed the use and comprehension ability of the Korean language in patients with schizophrenia and the correlations between language ability and cognitive function. METHODS: Eighty-six patients with schizophrenia and a group of 29 healthy controls were recruited. We assessed both clinical symptoms and cognitive functions including Korean language ability. For clinical symptoms, the Positive and Negative Syndrome Scale, Clinical Global Impression-Schizophrenia Scale, and Social and Occupational Functioning Assessment Scale were used. For the Korean language ability assessment, a portion of the Korean Broadcasting System (KBS) Korean Language Test was used. The Short-form of Korean-Wechsler Adult Intelligence Scale, the Korean version of the University of California San Diego (UCSD) Performance-based Skills Assessment (K-UPSA), and the Wisconsin Card Sorting Test (WCST) were used to assess cognitive functions. RESULTS: Schizophrenic patients had significantly lower scores in the language and cognitive function tests both in the total and subscale scores. Various clinical scores had negative correlations with reading comprehension ability of the KBS Korean Language Test. The WCST and a part of the K-UPSA had positive correlations with multiple domains of the language test. CONCLUSION: A significant difference was found between schizophrenic patients and controls in language ability. Correlations between Korean language ability and several clinical symptoms and cognitive functions were demonstrated in patients with schizophrenia. Tests of cognitive function had positive correlations with different aspects of language ability.
Adult ; California ; Cognition ; Comprehension ; Humans ; Intelligence ; Language Tests ; Language* ; Schizophrenia* ; Wisconsin

The most common causes of acute pancreatitis are microlithiasis and alcohol. In pediatrics, anomalies in pancreaticobiliary system should be considered as possible causes. Among many anomalies, pancreas divisum associated with anomalous pancreaticobiliary ductal union (APBDU) is very rare. APBDU is associated with acute pancreatitis, choledochal cyst, and gallbladder cancer. Pancreas divisum is also a well known cause of acute recurrent pancreatitis. In adult cases with such conditions, the role of endoscopic management including sphincterotomy or stenting through the Santorini duct is well documented. However, it is still controversial to perform endoscopic retrograde cholangiopancreatography in pediatrics. Herein, we experienced a case of 4 year 7 month old female patient suffered from recurrent attacks of acute pancreatitis, which were caused by APBDU and incomplete pancreas divisum. She was treated by endoscopic sphincteretomy of both openings to the Santorini's and Wirsung's ducts. Thus, we report this interesting case with literature review.
Abnormalities, Multiple ; Acute Disease ; Child, Preschool ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct/*abnormalities/surgery ; Female ; Humans ; Pancreas/*abnormalities ; Pancreatic Ducts/*abnormalities/surgery ; Pancreatitis/*diagnosis/etiology/surgery ; Sphincterotomy, Endoscopic ; Tomography, X-Ray Computed

OBJECTIVE: The purpose of this study was to compare air trapping in healthy volunteers with asthmatics using pulmonary function test and quantitative data, such as specific volume change from paired inspiratory CT and registered expiratory CT. MATERIALS AND METHODS: Sixteen healthy volunteers and 9 asthmatics underwent paired inspiratory/expiratory CT. DeltaSV, which represents the ratio of air fraction released after exhalation, was measured with paired inspiratory and anatomically registered expiratory CT scans. Air trapping indexes, DeltaSV0.4 and DeltaSV0.5, were defined as volume fraction of lung below 0.4 and 0.5 DeltaSV, respectively. To assess the gravity effect of air-trapping, DeltaSV values of anterior and posterior lung at three different levels were measured and DeltaSV ratio of anterior lung to posterior lung was calculated. Color-coded DeltaSV map of the whole lung was generated and visually assessed. Mean DeltaSV, DeltaSV0.4, and DeltaSV0.5 were compared between healthy volunteers and asthmatics. In asthmatics, correlation between air trapping indexes and clinical parameters were assessed. RESULTS: Mean DeltaSV, DeltaSV0.4, and DeltaSV0.5 in asthmatics were significantly higher than those in healthy volunteer group (all p < 0.05). DeltaSV values in posterior lung in asthmatics were significantly higher than those in healthy volunteer group (p = 0.049). In asthmatics, air trapping indexes, such as DeltaSV0.5 and DeltaSV0.4, showed negative strong correlation with FEF25-75, FEV1, and FEV1/FVC. DeltaSV map of asthmatics showed abnormal geographic pattern in 5 patients (55.6%) and disappearance of anterior-posterior gradient in 3 patients (33.3%). CONCLUSION: Quantitative assessment of DeltaSV (the ratio of air fraction released after exhalation) shows the difference in extent of air trapping between health volunteers and asthmatics.
Adult ; Aged ; Asthma/*physiopathology ; Exhalation/physiology ; Female ; Healthy Volunteers ; Humans ; Lung/*physiopathology/radiography ; Male ; Middle Aged ; *Respiratory Function Tests ; Tomography, X-Ray Computed/methods

Eruptive vellus hair cysts(EVHCs) are small, red or brown colored cystic papules that usually occur on the chest and proximal extremities of children and adults. Although EVHCs, facial variant, is rare and chracteristic in its location and color, histopathological findings of facial variant are not different from those of typical EVHC. We report a case of EVHC, facial variant which occured on the face of 23-year-old man with asymptomatic, bluish papules. The lesions first appeared at the age of 19 years and had increased in number thereafter.
Adult ; Child ; Extremities ; Hair* ; Humans ; Thorax ; Young Adult

PURPOSE: To determine the relationship between the pulmonary function test (PFT) and the optimal threshold value for the emphysema index at volumetric CT in chronic obstructive lung disease (COPD). MATERIALS AND METHODS: Volumetric CT scans were performed in 53 patients with COPD at inspiration and expiration using the same CT scanner. By using the in-house software, the emphysema index, which included the threshold value between -700 and -990 HU, was calculated automatically. The data were analyzed by calculating the Pearson correlation coefficient between each set of CT data and the forced expiratory volume occurring over 1 second (FEV1), the forced expiratory volume occurring over 1 second over the vital capacity ratio (FEV1/FVC), and the diffusion capacity of carbon monoxide (DLco). RESULTS: The strongest correlation between FEV1 and FEV1/FVC was found to have a threshold of -940 HU at inspiration and -910 HU during an expiration CT scan. The strongest correlation with DLco was observed with a threshold of -970 HU at inspiration and -960 HU at expiration. CONCLUSION: The threshold showing the best correlation with the PFT parameters was variable. As for the inspiration CT scan, the threshold area, showing a relatively good correlation with PFT, occurred over -940 to -970 HU. Hence, it is pertinent that -950 HU or -960 HU was a common benchmark used for threshold of the emphysema index.
Carbon Monoxide ; Cone-Beam Computed Tomography ; Diffusion ; Emphysema ; Forced Expiratory Volume ; Humans ; Pulmonary Disease, Chronic Obstructive ; Respiratory Function Tests ; Tomography, X-Ray Computed ; Vital Capacity