PURPOSE: Obesity is related to systemic inflammatory processes causing cardiovascular complications. Intercellular adhesion molecule-1 (ICAM-1), CD40 ligand (CD40L), P-selectin are newly described mediators of inflammation and have a significant effect in atherosclerosis. Adiponectin has shown anti-inflammatory effects in adults. The aim of this study was to evaluate the relationship between adiponectin and inflammatory mediators in children and adolescents. METHODS: Fifty children or adolescents, twenty two with a body mass index (BMI) over 95th percentile, and twenty eight with a BMI below 75th percentile were included in the study. Serum soluble ICAM-1 (sICAM-1), P-selectin, CD40L, lipid profiles, aspartate aminotransferase, alanine aminotransferase, glucose and insulin were measured to evaluate associations with adiponectin. Comparison of these variables was performed between the obese and the nonobese group. RESULTS: We found a adiponectin to be significant lower and sICAM-1 significant higher in the obese group compared to the nonobese group, but there were no significant differences in P-selectin and soluble CD40L. Adiponectin was negatively associated with ICAM-1 and P-selectin in the obese group. CONCLUSION: Negative associations of adiponectin with ICAM-1 and P-selectin in obese children and adolescents suggest that serum adiponectin level may represent the inflammatory status.
Adiponectin* ; Adolescent ; Adult ; Alanine Transaminase ; Aspartate Aminotransferases ; Atherosclerosis ; Body Mass Index ; CD40 Ligand ; Child ; Cytokines* ; Glucose ; Humans ; Inflammation Mediators ; Insulin ; Intercellular Adhesion Molecule-1 ; Obesity ; P-Selectin

No abstract available.
Adenocarcinoma* ; Scrotum* ; Stomach Neoplasms*

Neonatal hypocalcemia and congenital heart defects has been known as the first clinical manifestation of the chromosome 22q11.2 deletion syndrome (22q11DS). However, because of its wide clinical spectrum, diagnosis of 22q11DS can be delayed in children without classic symptoms. We report the case of a girl with the history of imperforate anus but without neonatal hypocalcemia or major cardiac anomaly, who was diagnosed for 22q11DS at the age of 11 after the onset of overt hypocalcemia. She was born uneventfully from phenotypically normal Korean parents. Imperforate anus and partial cleft palate were found at birth, which were surgically repaired thereafter. There was no history of neonatal hypocalcemia, and karyotyping by GTG banding was normal. At the age of 11, hypocalcemia (serum calcium, 5.0 mg/dL) and decreased parathyroid hormone level (10.8 pg/mL) was noted when she visited our Emergency Department for fever and vomiting. The 22q11DS was suspected because of her mild mental retardation and velopharyngeal insufficiency, and a microdeletion on chromosome 22q11.2 was confirmed by fluorescence in situ hybridization. The 22q11DS should be considered in the differential diagnosis of hypocalcemia at any age because of its wide clinical spectrum.
22q11 Deletion Syndrome* ; Anal Canal* ; Anus, Imperforate ; Calcium ; Child* ; Cleft Palate ; Delayed Diagnosis* ; Diagnosis ; Diagnosis, Differential ; DiGeorge Syndrome ; Emergency Service, Hospital ; Female* ; Fever ; Fluorescence ; Heart Defects, Congenital ; Humans ; Hypocalcemia* ; Hypoparathyroidism ; In Situ Hybridization ; Intellectual Disability ; Karyotyping ; Parathyroid Hormone ; Parents ; Parturition ; Velopharyngeal Insufficiency ; Vomiting

PURPOSE: A possible involvement of autoimmune mechanism in the pathogenesis of bronchial asthma has been proposed. Recently, alpha-enolase protein was identified as a major autoantigen recognized by circulating IgG autoantibodies in patients with severe asthma. To evaluate a possible pathogenetic significance of these autoantibodies in severe asthma, isotype (IgG, IgA, IgM, and IgE) and IgG subclass (IgG1, IgG2, IgG3, and IgG4) distributions of autoantibodies to recombinant human alpha-enolase protein were analyzed. PATIENTS AND METHODS: We examined serum samples from 10 patients with severe asthma and 7 patients with mild-to-moderate asthma, and 5 healthy controls by immunoblot analysis. Severe asthma was defined as patients having at least 1 severe asthmatic exacerbation requiring an emergency department visit or admission in the last year despite continuous typical therapies. RESULTS: IgG1 was the predominant IgG subclass antibody response to alpha-enolase protein in patients with severe asthma. IgG1 autoantibody to alpha-enolase protein was detected in 7 of 10 patients with severe asthma (70%), 1 of 7 patients with mild-to-moderate asthma (14.3%), and none of 5 healthy controls (0%) (chi-square test; p < 0.05). IgA, IgM, and IgE autoantibodies to alpha-enolase protein could not be detected in patients with severe asthma. CONCLUSION: IgG1 subclass was the predominant type of autoantibody response to alpha-enolase protein in patients with severe asthma, suggests a possibility of IgG1 autoantibody- mediated complement activation in the pathogenesis of severe asthma.
Adult ; Aged ; Asthma/*enzymology/*immunology ; Autoantibodies/*blood/classification ; Autoantigens ; Case-Control Studies ; Complement Activation ; Female ; Humans ; Immunoglobulin G/blood/classification ; Immunoglobulin Isotypes/blood ; Male ; Middle Aged ; Phosphopyruvate Hydratase/*immunology ; Recombinant Proteins/immunology ; Young Adult

Lichen nitidus (LN) is an uncommon, usually asymptomatic cutaneous eruption characterized by the presence of multiple, small, flesh-colored papules. The epidemiologic and pathophysiologic characteristics of LN have not yet been defined. Furthermore, LN has rarely been described in association with other cutaneous diseases. We herein report 3 cases of LN associated with various cutaneous diseases, including lichen striatus, oral lichen planus, and psoriasis vulgaris.
Lichen Nitidus* ; Lichen Planus ; Lichen Planus, Oral ; Lichens ; Mouth ; Psoriasis

PURPOSE: The aim of this study was to investigate the clinical characteristics of primary spontaneous pneumothorax (PSP) in adolescents and identify risk factors for the recurrence of PSP. METHODS: A total of 292 patients diagnosed with PSP from January 1998 to December 2011 were retrospectively studied. Clinical data on demographics, diagnostic imaging, therapies, and risk factors of recurrence were collected and analyzed. RESULTS: The sex ratio of 292 patients was 19.8:1 (male:female), and the average age of the patients was 17.0 years. The average body mass index of the patients was 18.8 kg/m2. The most common presenting symptom was chest pain. There was no seasonal variation in the incidence of PSP. Thirty patients (10.2%) had a history of smoking. The most common location of PSP was the left side. Out of 249 patients, 169 (67.9%) had cysts (blebs/bullae). Fifty-four patients (18.5%) received oxygen therapy, 3 patients (1%) needle aspiration, 119 patients (40.8%) closed tube drainage, and 116 patients (39.7%) surgery. The recurrence rate was 38.6%. Smoking was associated with the size of pneumothorax (P=0.002). Also, the size of pneumothorax and surgery was associated with recurrence (P=0.040 and P=0.004). However, previously reported risk factors for recurrence were not identified in our patients. CONCLUSION: Pediatric PSP occurred mainly in males in late adolescence with normal body mass index. No significant risk factors were related to recurrence of PSP in our study.
Adolescent* ; Body Mass Index ; Chest Pain ; Demography ; Diagnostic Imaging ; Drainage ; Humans ; Incidence ; Male ; Needles ; Oxygen ; Pneumothorax* ; Recurrence* ; Retrospective Studies ; Risk Factors ; Seasons ; Sex Ratio ; Smoke ; Smoking

Fluoroscopy-induced chronic radiation dermatitis (FICRD) is a cutaneous disorder that results from prolonged exposure to ionizing radiation during interventional procedures. With the expanded use of interventional procedures, there is increased fluoroscopic exposure. However, diagnosis and treatment of such disorder remain difficult. Herein, we report on a case of FICRD that occurred in the right subscapular area.
Angioplasty, Balloon, Coronary ; Dermatitis ; Radiation, Ionizing

Balloon cell melanoma, an uncommon histopathological variant of malignant melanoma, was first described by Gardner and Vazquez in 1970. This condition is histopathologically characterized by the presence of balloon cells with varying sizes and atypical nuclei. An 84-year-old woman presented with a solitary, dome-shaped, walnut-sized, brownish nodule on the posterior aspect of the left ear with bleeding, having only detected the nodule 2 weeks prior. Histopathologically, the lobulated tumor mass revealed copious melanin pigment and many balloon cells with clear cytoplasm, atypical nuclei, and variable size. Immunohistochemically, the tumor mass showed positive reaction to S-100 protein and HMB 45 staining. We herein report a typical case of balloon cell melanoma, which developed primarily on the skin.
Aged, 80 and over ; Cytoplasm ; Ear ; Female ; Hemorrhage ; Humans ; Melanins ; Melanoma ; S100 Proteins ; Skin

Zinc deficiency in breast-fed infants is an important disorder. Unlike acrodermatitis enteropathica, it is transient and stops when nursing ends. We report on a case of a breast-fed, full-term male infant who presented with erythematous fine scaly patches and plaques involving the flexural area and trunk at 4 month of age. Clinical impressions of intertrigo, fungal infection or inverse psoriasis were considered. These lesions did not respond to treatment with topical antifungal agents and corticosteroids. The results of laboratory investigations revealed a lowered zinc level in the infant's serum (48.4microg/dl: normal 70~121microg/dl) and in the mother's milk (16microg/dl: normal 48~75microg/dl) and a normal level of zinc in the mother's serum. After the patient's mother was given zinc supplements, the skin lesions were dramatically improved and his serum zinc level became normal. Early recognition of the disorder and introduction of zinc supplementation rapidly reversed the transient zinc deficiency.
Acrodermatitis ; Adrenal Cortex Hormones ; Antifungal Agents ; Humans ; Infant ; Intertrigo ; Male ; Milk ; Mothers ; Psoriasis ; Skin ; Zinc

PURPOSE: We evaluated the effects of the timing of treatment initiation with gonadotropin-releasing hormone agonist (GnRHa) on the change in predicted adult height (PAH) in girls with idiopathic true precocious puberty (TPP). METHODS: Data for this retrospective study were collected on 104 girls with TPP who were treated with GnRHa for 36 months, between January 2002 and March 2012. RESULTS: The PAH SDS differed before and after treatment in all patients (-1.91 +/- 1.47 vs. -1.37 +/- 1.17 after 1 year of treatment, -1.96 +/- 1.58 vs. -0.48 +/- 1.11 after 3 years of treatment) as well as in Group 1 (-2.15 +/- 1.54 vs. -1.51 +/- 1.20 after 1 year of treatment, -2.09 +/- 1.59 vs. -0.55 +/- 1.19 after 3 years of treatment) and Group 2 (-1.57 +/- 1.34 vs. -1.17 +/- 1.12 after 1 year of treatment, -1.50 +/- 1.55 vs. -0.21 +/- 0.74 after 3 years of treatment). This result could be due to improvement in bone age advancement during the treatment. The difference between mid-parental height SDS and PAH SDS was decreased after GnRHa treatment. However, the means of PAH SDS did not surpass the mid-parental height SDS. CONCLUSION: GnRHa treatment can preserve growth potential by slowing bone age progression, resulting in short adult height, but it cannot alter the genetic growth potential.
Adult ; Gonadotropin-Releasing Hormone ; Humans ; Puberty, Precocious ; Retrospective Studies