PURPOSE: The purpose of this study was to determine the frequency of CD4+CD25+FoxP3+ regulatory T cells (Treg) in the peripheral blood of patients with childhood chronic immune thrombocytopenic purpura (ITP) exhibiting thrombocytopenia and spontaneous remission. The findings of this study indicate the possibility of predicting spontaneous recovery and pathogenesis of childhood chronic ITP. METHODS: Eleven children with chronic ITP (seven thrombocytopenic and four spontaneous remission cases; mean age, 8.8 years; range, 1.7-14.9 years) were enrolled in this study. Five healthy children and eight healthy adults were included as controls. The frequency of Treg was evaluated by flow cytometry in the peripheral blood. RESULTS: In this study, four patients (36%) achieved spontaneous remission within 2.8 years (mean year; range, 1.0-4.4 years). The frequency of Treg was significantly lower in patients with persisting thrombocytopenia (0.13%+/-0.09%, P<0.05), than that in the patients with spontaneous remission (0.30%+/-0.02%), healthy adults controls (0.55%+/-0.44%), and healthy children controls (0.46%+/-0.26%). A significantly positive correlation was found between the frequency of Treg and the platelet count in children. CONCLUSION: These data suggest that a lower frequency of Treg contributes to the breakdown of self-tolerance, and may form the basis for future development of specific immunomodulatory therapies. Furthermore, Treg frequency has prognostic implication toward the natural course and long-term outcomes of childhood chronic ITP.
Adult ; Child ; Flow Cytometry ; Humans ; Immunomodulation ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic* ; Remission, Spontaneous ; T-Lymphocytes, Regulatory* ; Thrombocytopenia

Background: s: This study was performed to analyze the main key words of newspaper articles related to COVID-19 in 2020 for each category of quarantine measures according to the epidemic period of COVID-19. Methods: We analyzed articles related to COVID-19 in three major newspapers of Korea between February 17 and December 31, 2020. We targeted the front page articles on mondays and thursdays. The analysis of the relationship between the two variables was confirmed through the chi-square test. Results: As a result of analyzing the main key words for each category of quarantine measures, non-pharmaceutical intervention were the most common at 54.3%, followed by 3Ts(test, tracing, treatment and vaccine) at 31.9%. In the category of non-pharmaceutical intervention, social distancing was the most common at 33.9%. In the categories such as 3Ts(test, tracing, treatment) and vaccine, diagnostic tests were the most common at 41.8%. Conclusions It was identified that non-pharmaceutical intervention were the most common, and there was a difference in the reporting of main key words by category of quarantine measures for each epidemic period related to COVID-19 in 2020.

Acute autonomic and sensory neuropathy (AASN) is very rare immune mediated neuropathy characterized by prominent dysautonomia and sensory involvement without motor weakness. Most of AASN patients have a rapid onset reaching its worst within four weeks like Guillain-Barré syndrome. The treatment response is variable. Recently, we experienced a patient diagnosed as AASN with progressive autonomic and sensory symptoms more than 1 year, and showed good response in immunotherapy.

Purpose: This study aimed to identify the effect of warm scarf on xerostomia and sore throat in postoperative colon cancer patients. Methods: A total of 40 participants with colon cancer who underwent colon cancer operation over 2hours were included from C University hospital in Seoul. The number of experimental group and control group is each 20 calculated by G*Power, and they were assigned by using nonequivalent control group no-synchronized design. In the experimental group, a warm scarf was applied to the neck for 120 minutes from entering the recovery room after the colorectal cancer surgery was completed. In the experimental group and the control group, xerostomia and sore throat were measured twice at 60-minute intervals. The degree of xerostomia was measured through the degree of wetness of the absorbent paper in mm, and the degree of sore throat was measured through the NRS (Numeral Rating Scale). Data were collected using self-administered questionnaires from August 2018 to September 2020 and were analyzed using IBM SPSS/WIN 21.0 Descriptive statistics, x2 test, Fisher's exact test, t-test were used to determine the participant's characteristics. The effect of warm scarf on xerostomia and sore throat were separately estimated by Repeated Measures ANOVA. Results: The experimental group showed significant decrease of xerostomia and sore throat as time goes (p<.001). Conclusion Results indicate that warm scarf on xerostomia and sore throat in postoperative colon cancer patients is helpful method for relieving side effect of tracheal intubation.

This review tried to set up an initial diagnostic strategy in patients with functional dyspepsia. Dyspepsia was defined as chronic or recurrent pain, or discomfort centered in the upper abdomen (i.e., epigastrium), excluding heartburn and acute abdominal conditions. We reviewed the available data in order to produce currently applicable recommendations for the diagnosis of dyspepsia in Korea. Two investigators independently conducted an independent literature search of published reports on dyspepsia and diagnosis, including alarm symptoms, Helicobacter pylori (H. pylori) test, empirical pharmacological therapy, and early upper gastrointestinal (GI) endoscopy. The evidence concerning alarm features does not allow clear guideline whether early endoscopy should be performed or not. In Asia, including Korea, the prevalence of H. pylori and gastric cancer are high. Therefore, 'H. pylori test and treatment' strategy is not suitable for the initial diagnostic approach for uninvestigated dyspepsia. Long-term empirical pharmacological therapy is not recommended in Korea because of the possibility of missing or delaying the diagnosis of gastric cancer. There have been a lot of evidences showing that early upper GI endoscopy might be more effective than empirical medication, which is different from Western countries. However, cut-off age for early endoscopy is not clear, especially in case of young age. Further research is necessary to define highrisk age for gastric cancer and for a health economic study in the management of patients with dyspepsia in Korea.
Dyspepsia/*diagnosis ; Endoscopy, Digestive System ; Helicobacter Infections/diagnosis ; Helicobacter pylori ; Humans

This review tried to set up an initial diagnostic strategy in patients with functional dyspepsia. Dyspepsia was defined as chronic or recurrent pain, or discomfort centered in the upper abdomen (i.e., epigastrium), excluding heartburn and acute abdominal conditions. We reviewed the available data in order to produce currently applicable recommendations for the diagnosis of dyspepsia in Korea. Two investigators independently conducted an independent literature search of published reports on dyspepsia and diagnosis, including alarm symptoms, Helicobacter pylori (H. pylori) test, empirical pharmacological therapy, and early upper gastrointestinal (GI) endoscopy. The evidence concerning alarm features does not allow clear guideline whether early endoscopy should be performed or not. In Asia, including Korea, the prevalence of H. pylori and gastric cancer are high. Therefore, 'H. pylori test and treatment' strategy is not suitable for the initial diagnostic approach for uninvestigated dyspepsia. Long-term empirical pharmacological therapy is not recommended in Korea because of the possibility of missing or delaying the diagnosis of gastric cancer. There have been a lot of evidences showing that early upper GI endoscopy might be more effective than empirical medication, which is different from Western countries. However, cut-off age for early endoscopy is not clear, especially in case of young age. Further research is necessary to define highrisk age for gastric cancer and for a health economic study in the management of patients with dyspepsia in Korea.
Dyspepsia/*diagnosis ; Endoscopy, Digestive System ; Helicobacter Infections/diagnosis ; Helicobacter pylori ; Humans

Autoimmune thyroid disease associated with Moyamoya syndrome has mostly been reported as Graves' disease, and not as Hashimoto's thyroiditis. We report a case of a 70-year-old man with right posterior cerebral artery territorial infarction and bilateral distal internal carotid artery occlusion, which suggests Moyamoya syndrome, but who was diagnosed as Hashimoto's thyroiditis.
Aged ; Carotid Artery, Internal ; Graves Disease ; Humans ; Infarction ; Moyamoya Disease ; Posterior Cerebral Artery ; Thyroid Diseases ; Thyroid Gland ; Thyroiditis

PURPOSE: Radiocontrast media are widely used in medical imaging to improve diagnostic accuracy. However, studies on the adverse reactions of radiocontrast media in children are limited. We aimed to describe the characteristics of adverse reactions to radiocontrast media among children who had a computed tomography scan or magnetic resonance imaging in a tertiary university hospital. METHODS: We retrospectively collected data on adverse reactions to radiocontrast media by the reporting system of a tertiary university hospital. We selected data from children under the age of 19 from July 2011 to December 2017 and analyzed their characteristics. We focused mainly on the characteristics of the index case which is defined by the first adverse event of each subject. RESULTS: During the period, a total of 88,050 radiocontrast media-enhanced imaging studies were performed and 184 cases of adverse reactions were reported. A total of 71 were identified as index cases. Forty-nine (69.0%) were male and the mean age was 12.7±3.2 years. The incidence of radiocontrast media-related adverse reactions was 0.09% and severe reactions were 0.002%. The most common clinical feature was skin manifestations (54.9%), followed by gastrointestinal symptoms (40.8%) and neuropsychiatric symptoms (7.4%). CONCLUSION: Adverse reactions to radiocontrast media rarely occur in children and the incidence of severe reactions is low. Most reactions are mild and are related to the skin and gastrointestinal system. This report would provide good evidence for establishing a management strategy in children scheduled for imaging studies using radiocontrast media.
Child* ; Contrast Media* ; Diagnostic Imaging ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Skin ; Skin Manifestations

Jacobsen syndrome is a rare condition associated with the deletion of the long arm of chromosome 11. Though several authors reported prenatal sonographic findings of the Jacobsen syndrome, there are no common disease-specific features. The majority of affected cases were identified postnatally by chromosomal analysis of the dysmorphic or mentally retarded patients. We present a prenatal case of Jacobsen syndrome with a brief review of literature. A routine scanning in a 32-year-old primigravida at 17.3 weeks' gestation showed abnormal ultrasonographic findings consistent with increased nuchal thickening and subtle cardiac abnormalities (levorotated heart axis of greater than 60 degrees and thickened ventricular wall). The patient underwent amniocentesis, and the karyotype showed deletion of the long arm of chromosome 11, 46,XX, del (11) (q23.1q24). The fetal autopsy performed following medical termination confirmed the prenatal findings. The present case represents that the prenatal sonographic detection of the nuchal thickening and subtle cardiac abnormality should warrant a careful assessment of fetal anatomy and prompt cytogenetic analysis looking for chromosomal aberrations.
Adult ; Amniocentesis ; Arm ; Autopsy ; Axis, Cervical Vertebra ; Chromosome Aberrations ; Chromosomes, Human, Pair 11 ; Cytogenetic Analysis ; Heart ; Humans ; Jacobsen Distal 11q Deletion Syndrome* ; Karyotype ; Mentally Disabled Persons ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography

Ovarin hyperstimulation syndrome (OHSS), an iatrogenic complication of ovarian stimulation, shows varying degrees of clinical manifestations. The pathogenesis of OHSS is an increase of vascular permeability resulting in hypovolemia, thromboembolism, ARDS, and death in sometimes. Pleural effusion is also a result of an increase of vascular permedability in the pleura. Thoracentesis is sometimes required to relieve dyspnea. We report a case of OHSS with bilateral exudative pleural effusfion is a 23 year-old female with resting dyspnea. She was received clomi;hen, FSH, and LH for the treatment of irregular menstruation twenty days previously. The ultrasonogram showed severe ascites and bilaterally huge ovary, and chest radiography showed bilateral effusion. Therapeutic thoracentesis and paracentesis were done for relief of the dyspnea. Two weeks later the bilateral effusion and symptoms disappeared spontaneously.
Ascites ; Capillary Permeability ; Dyspnea ; Exudates and Transudates ; Female ; Humans ; Hypovolemia ; Menstruation ; Ovarian Hyperstimulation Syndrome* ; Ovary ; Ovulation Induction ; Paracentesis ; Pleura ; Pleural Effusion* ; Radiography ; Thorax ; Thromboembolism ; Ultrasonography