PURPOSE: In addition to regulating calcium and phosphorus homeostasis and bone metabolism, vitamin D is known as an immune modulator. Recently, there has been increased worldwide interest in the association between low levels of vitamin D and allergic diseases. The purpose of this study was to assess the relationship between serum vitamin D levels and allergic/vasomotor rhinitis (AR/VR) in children. METHODS: This study included 164 patients. The sample included 59 patients with AR, 42 patients with VR, and 63 controls. Their ages ranged from 0 to 16 years. We examined the levels of 25-hydroxyvitamin D, Immunoglobulin E, specific IgE, and eosinophil cationic protein; peripheral blood eosinophil count; and the results of a skin prick test. RESULTS: Serum 25-hydroxyvitamin D levels were 19.0+/-8.5 ng/mL in the AR group, 25.5+/-10.9 ng/mL in the VR group, and 26.9+/-10.7 ng/mL in the control group. After adjustment for body mass index and season at the time of blood sampling, vitamin D levels in the AR group were lower than those of the VR group (P=0.003) and control group (P<0.001). Vitamin D levels were inversely correlated with Immunoglobulin E levels (r=-0.317, P<0.001). AR patients with food allergy or atopic dermatitis did not have lower levels of 25-hydroxyvitamin D than AR patients without these diseases. CONCLUSION: This study demonstrates a possible relationship between vitamin D levels and allergic rhinitis in Korean children.
Body Mass Index ; Calcium ; Child* ; Dermatitis, Atopic ; Eosinophil Cationic Protein ; Eosinophils ; Food Hypersensitivity ; Homeostasis ; Humans ; Immunoglobulin E ; Immunoglobulins ; Metabolism ; Phosphorus ; Rhinitis ; Rhinitis, Vasomotor* ; Seasons ; Skin ; Vitamin D* ; Vitamins*

The association between choledochal cysts and pregnancy is unlikely to be etiological, but may rather be an aggravation or precipitation of a preexisting condition. Although choledochal cysts rarely occur in pregnancy, the aim of this study is to elucidate the condition associated with pregnancy because delayed or inappropriate therapy may be catastrophic for both mother and child. Authors reviewed 18 cases of choledochal cyst, of which 2 were aggravated during pregnancy, managed at the Department of Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, during the period from 1990 to 1995. The results were as follows: The ratio of female to male was 2.6:1 which revealed predominance in female and most frequent age group was above sixty years old(33%). In non-pregnant patients, the most common symptoms were abdominal pain(78%) and all pregnant patients had pain, jaundice, nausea and vomiting, and indigestion. Transaminase and bilirubin were elevated in all pregnant patients. In all patients, US(88%, 100%) was the most common preoperative diagnostic study and one case was diagnosed during explo-laparotomy. Pregnant patients have cholecystitis in two cases and nonpregnant patients had cholecystitis(19%), CBD stone(19%), and others. The operative procedures were performed in 9 cases and pregnant patients were operated by cyst excision and Roux-en-Y hepaticojejunostomy in one case, and also Roux-en-Y choledochocystojejunostomy in one case. According to Todani's classification, in non pregnant patients, type I was the most common(63%), in pregnant patients, two cases were type I. Postoperative complications occurred in 3 cases, wound infection(6%) and cholangitis(6%) in non pregnant patients, pleural effusion(6%) in pregnant patients. Two cases of choledochal cyst in pregnancy were 25 years old at 29.4 weeks and 36 years old at 16 weeks into pregnancy.
Adult ; Bilirubin ; Child ; Cholecystitis ; Choledochal Cyst* ; Classification ; Dyspepsia ; Female ; Heart ; Humans ; Jaundice ; Male ; Mothers ; Nausea ; Postoperative Complications ; Preexisting Condition Coverage ; Pregnancy* ; Surgical Procedures, Operative ; Vomiting ; Wounds and Injuries

BACKGROUND: Burns remain a common public problem among children and often cause severe injuries, resulting in physical and mental problems for the patients. Children constitute a risk group because of their natural curiosity, their mode of reaction, their impulsiveness and lack of experience in risk assessment. PURPOSE: The objects of this study were to characterize pediatric burn injuries and to understand their clinical outcomes in Korea. METHODS: we analyzed the records of the 1401 pediatric burn patients (age 0~15 years old) out of the 4423 burn patients, who have been admitted to the Burn Center, Hangang Sacred Heart Hospital, Hallym University for 5 years (1991~1995). RESULTS: Males were more affected than females; 58.1% were males and 41.9% were females. Most thermal injuries in children occur in the age group younger than 5 years (82%); especially 66.9% of pediatric burn patients were under the age of 3. Scalding burns accounted for 72.5%, and flame burns fors 18.1%. Most pediatric burns occurred in urban areas. The most common activities related to pediatic burn injuries were food preparation and food consumption, which accounted for 57.5% of all burn injuries. In 66% of the cases, the extent of the burned surface was under 10%. In 77.8% of the cases, the depth of the burn wound was 2nd degree. In 63.9% of the cases, the duration of hospitalization was 3 weeks or less. The incidence of wound infection was 14.8%, and 50% of the infections were caused by Pseudomonas aerusinosa. The major complications were wound infection (30.9%), hypertrophic scarring (21.4%) and irritant dermatitis (20.3%). The mortality rate in a series of 1,401 pediatric patients was 2.6%. The main causes of death were sepsis, burn shock, ARDS and air way obstruction. When 51~70% of the surface area was burned the mortality was 25%, when over 70% of the surface area was burned the mortality was 81.3%. SPCCULATION: The successful way to prevent pediatric burn is to reduce the risk to children by effective intervention.
Burn Units ; Burns* ; Cause of Death ; Child ; Cicatrix, Hypertrophic ; Dermatitis, Irritant ; Exploratory Behavior ; Female ; Heart ; Hospitalization ; Humans ; Incidence ; Korea ; Male ; Mortality ; Pseudomonas ; Risk Assessment ; Sepsis ; Shock ; Wound Infection ; Wounds and Injuries

OBJECTIVES: This study was conducted to investigate the relationship of insight level with temperament and character pattern in chronic male schizophrenics. In addition, we tried to examine demographic variables and illness-related variables which may affect the level of insight. METHODS: To assess insight level by psychiatrists, Insight and Treatment Attitudes Question-naire(ITAQ), Scale to Assess Unawareness of Mental Disorder(SUMD) were applied. Temperament and character patterns were evaluated by the Korean version of Cloninger's self-rated Temperament and Character Inventory(TCI). The authors investigated the correlations between insight level, and scores of temperament and character dimensions. Data on the demographic and illness-related variabres for the subjects were gathered from hospital records and clinical interviews. A total of 113 patients with schizophrenia according to DSM-IV criteria was analyzed. The insight level was dichotomized into good(median value of 11) and poor insight group(<11). RESULTS: 1) There was a significant difference between good insightgroup and poor insight group in novelty seeking dimension in TCI. 2) There was a significant negative correlation between novelty seeking scores by TCI and insight scores by ITAQ(rs:Spearman correlation coefficient=-0.20, p<0.05). There was a positive correlation between harm avoidance scores by TCI and insight scores by ITAQ(rs=0.22, p<0.05). 3) Significant differences between good and poor insight groups were identified in diverse clinical variables such as age at onset of illness, mode of hospitalization, duration of illness, current length of stay, and dosage of drug. CONCLUSION: The results suggest that high scores in the temperament dimension of novelty seeking and low scores in the temperament dimension of harm avoidance may influence poor insight in patients with chronic male schizophrenia. Therefore it is clinically valuable for us to assess the pattern of temperament at the stage of insight evaluation. The authors suggest that further studies on temperament and character in schizophrenia is needed.
Diagnostic and Statistical Manual of Mental Disorders ; Hospital Records ; Hospitalization ; Humans ; Length of Stay ; Male* ; Psychiatry ; Schizophrenia* ; Temperament*

This paper aims to investigate whether good governance of a recipient country is a necessary condition and what combinations of factors including governance factor are sufficient for low prevalence of HIV/AIDS in HIV/AIDS aid recipient countries during the period of 2002-2010. For this, Fuzzy-set Qualitative Comparative Analysis (QCA) was used. Nine potential attributes for a causal configuration for low HIV/AIDS prevalence were identified through a review of previous studies. For each factor, full membership, full non-membership, and crossover point were specified using both author's knowledge and statistical information of the variables. Calibration and conversion to a fuzzy-set score were conducted using Fs/QCA 2.0 and probabilistic tests for necessary and sufficiency were performed by STATA 11. The result suggested that governance is the necessary condition for low prevalence of HIV/AIDS in a recipient country. From sufficiency test, two pathways were resulted. The low level of governance can lead to low level of HIV/AIDS prevalence when it is combined with other favorable factors, especially, low economic inequality, high economic development and high health expenditure. However, strengthening governance is a more practical measure to keep low prevalence of HIV/AIDS because it is hard to achieve both economic development and economic quality. This study highlights that a comprehensive policy measure is the key for achieving low prevalence of HIV/AIDS in recipient country.
Acquired Immunodeficiency Syndrome/*epidemiology/prevention & control ; Computer Simulation ; Developing Countries/*economics/statistics & numerical data ; Economic Development/statistics & numerical data ; Fraud/economics/*statistics & numerical data ; Fuzzy Logic ; HIV Infections/*epidemiology/prevention & control ; Humans ; Models, Statistical ; Prevalence ; Risk Factors ; Socioeconomic Factors

Adult intussusception is a rare entity. Most adult intussusceptions require surgical intervention because they have a high rate of pathologic leading point. Mandatory laparotomy and en bloc resection is recommended in colonic intussusceptions due to the possibility of malignancy. We report herein 3 cases of adult colonic intussusceptions. The intussusceptions were located in the sigmoid and rectum, which were managed by laparoscopic colectomy. Case 1 was managed by laparoscopic anterior resection and diverting ileostomy combined with perineal reduction. Perineal approach facilitated laparoscopic reduction. In case 2, intraoperative colonoscopy was performed to determine the distal resection margin. Intraoperative colonoscopy showed edematous bowel mucosa as well as leading point after reduction of intussusceptions. Case 3 showed asymptomatic transient rectorectal colonic intussusceptions.
Adult ; Colectomy ; Colon ; Colon, Sigmoid ; Colonoscopy ; Humans ; Ileostomy ; Intussusception ; Laparoscopy ; Laparotomy ; Mucous Membrane ; Rectum

PURPOSE: The purpose of this experiment is to measure the expression of TGF-beta and alpha-SM actin (smooth muscle actin) from fibroblast culture by the duration of culture days and to analyze the inhibition of alpha-SM actin expression in fibroblast by the antibodies for TGF-beta. METHODS: The levels of alpha-SM actin from the paired NIH3T3 cell cultures with TGF-beta 1 containing medium (10 ng/ml) and with the antibody (for TGF-beta) medium (1 or 2 ug/ml) were determined by SDS PAGE for cell lysate protein, Western blot with ECL autoradiography and immuno - slot blot. RESULTS: In NIH3T3 culture, the expression of alpha-SM actin increased at culture days 4, 5, 6. TGF-beta was expressed from 2nd day of culture and increased by day 7. The addition of TGF beta (10 ng/ml) did not increased the expression of alpha-SM actin. But alpha-SM actin expression decreased in the presence of anti-TGF beta antibody. The decrease of expression was proportional to the concentration of antibody and duration of exposure to the antibody. CONCLUSIONS: Endogenous TGF-beta produced by fibroblast cultures is sufficient to express the alpha-SM actin from the myofiboblast. There was no additive expression of alpha-SM actin with exogenous TGF-beta 1. The antibody for TGF- beta inhibits the production of the alpha-SM actin during wound healing and may prevent the wound contracture.
Actins* ; Antibodies ; Autoradiography ; Blotting, Western ; Cell Culture Techniques ; Contracture* ; Electrophoresis, Polyacrylamide Gel ; Fibroblasts* ; Myofibroblasts ; Transforming Growth Factor beta* ; Wound Healing ; Wounds and Injuries*

No abstract available.
Osteoblasts* ; Treponema denticola* ; Treponema*

PURPOSE: This study was aimed to compare the effectiveness and tolerability of topiramate add-on therapy versus lidocaine add-on therapy in children with refractory status epilepticus. METHODS: We performed a retrospective analysis of children with refractory status epilepticus who were hospitalized at Kyungpook National University Hospital during the period 2005 to 2012. We divided them into two groups, Group A (midazolam, MDZ, and Topiramate, TPM:11 patients) and Group B (midazolam and lidocaine, LDC:7 patients). Furthermore, they were sub-categorized according to children's sex, age, seizure duration, and seizure type. To comepare the effectiveness and tolerability between the two groups, we evaluated seizure freedom, >50% seizure reduction, adverse events and mortality rates, respectively. RESULTS: In MDZ/TPM group, average dosage of midazolam infusion was 10.8+/-6.8 mcg/kg/min, seizure freedom was achieved in 1 out of 11 patients (9%) and >50% seizure reduction was in 2 out of 11 patients (18%). On the other hand, in MDC/LDC group, average dosage of midazolam infusion is 11.3+/-5.2 mcg/kg/min, seizure freedom was achieved in 2 out of 7 patients (29%) and >50% seizure reduction was 3 out of 7 patients (43%). Aside from the promising effects, there was no significant difference between the two groups. CONCLUSION: In children with refractory status epilepticus, topiramate or lidocaine add-on therapy seemed to be effective and fairly tolerated and showed no serious adverse effects. Therefore they can be an alternative treatment option. However, further studies are required.
Child* ; Freedom ; Gyeongsangbuk-do ; Hand ; Humans ; Lidocaine* ; Midazolam ; Mortality ; Retrospective Studies ; Seizures ; Status Epilepticus*

Erythema multiforme (EM) is an acute mucocutaneous disorder involving the skin, mouth, eyes, and genital organs. It is classified into EM minor and EM major according to the involvement of the mucosal membrane. Stevens-Johnson syndrome (SJS) and toxic epidermal necrosis (TEN) belong to EM major. Compared to EM minor, SJS presents with more severe and progressive symptoms, and has a higher mortality rate. Corticosteroids are used in the treatment of EM. We report three cases of EM (two cases of EM minor and one case of SJS) that developed during treatment with oral corticosteroid (deflazacort; Calcort(R)) in children with nephrotic syndrome.
Adrenal Cortex Hormones ; Child* ; Erythema Multiforme* ; Genitalia ; Humans ; Membranes ; Mortality ; Mouth ; Necrosis ; Nephrotic Syndrome* ; Skin ; Stevens-Johnson Syndrome