PURPOSE: Routine screening for toxoplasmosis, rubella, cytomegalovirus (CMV), and herpes simplex virus (TORCH) in intrauterine growth restriction (IUGR) and small for gestational age (SGA) neonates has become a common practice. However, the incidence of TORCH varies across countries, and the cost of TORCH testing may be disadvantageous compared to disease-specific screening. To evaluate the efficacy of TORCH screening, the medical charts of IUGR or SGA neonates born in a single institution in Bucheon, Korea from 2011 to 2015 were reviewed. METHODS: The clinical data of the 126 IUGR or SGA neonates were gathered, including gestational age, Apgar scores, neonatal sonographic findings, chromosome study, morbidities, developmental follow-up, and growth catch-up. Maternal factors including underlying maternal disease and fetal sonography were collected, and placental findings were recorded when available. TORCH screening was done using serum IgM, CMV urine culture, quantification of CMV DNA with real-time polymerase chain reaction, and rapid plasma reagin qualitative test for syphilis. Tests were repeated only for those with positive results. RESULTS: Of the 119 TORCH screenings, only one was positive for toxoplasmosis IgM. This result was deemed false positive due to negative IgM on repeated testing and the absence of clinical symptoms. CONCLUSION: Considering the incidence and risk of TORCH in Korea, the financial burden of TORCH screening, and the single positive TORCH finding in our study, we suggest disease-specific screening based on maternal history and the clinical symptoms of the neonate. Regarding CMV, which may present asymptomatically, universal screening may be appropriate upon cost-benefit analysis.
Cost-Benefit Analysis ; Cytomegalovirus* ; DNA ; Fetal Growth Retardation ; Follow-Up Studies ; Gestational Age* ; Gyeonggi-do ; Herpes Simplex* ; Humans ; Immunoglobulin M ; Incidence ; Infant, Newborn* ; Korea* ; Mass Screening* ; Plasma ; Real-Time Polymerase Chain Reaction ; Rubella* ; Simplexvirus ; Syphilis ; Toxoplasmosis ; Ultrasonography

No abstract available.
Brain* ; Child* ; Humans ; Magnetic Resonance Imaging*

The incidence of Australia antigen (HAA, HBsAg), a known market for hepatitis B virus (HBV), is expected to e high, esp. in the subclinial type. It is well known that the incidence of HAA positivity among the patients with specific diseases and group of blood donors is relatively high in adult age group. But since there is less research for the incidence of HAA in Pediatric age group, the necessecity of investigation of its incidence is required properly. Thirteen from 306 children (4.58%) who were selected randomly among hospitalized patients from Feb., 1975 to April, 1977, were positive for HAA in their serum sample tested by the apgar gel diffusion method. The incidence of HAA was higher (6.54%) in male than in female(0.99%) patients and a trend toward increments was noted with age.
Adult ; Australia* ; Blood Donors ; Child* ; Diffusion ; Hepatitis B Surface Antigens* ; Hepatitis B virus ; Humans ; Incidence ; Male ; Prevalence*

PURPOSE: Obesity and headache are two highly prevalent diseases both in childhood and adolescent. In this study, we assessed the prevalence of obesity in pediatric headaches patients in a single institution in Korea, and differences according to age, sex, headache type, frequency, intensity, and disability. METHODS: We retrospectively reviewed the medical records of 340 subjects (6–18 years of age) who visited the Pediatric Headache Clinic of Bucheon St. Mary's Hospital during the period from January 2015 through March 2018. Data on age, sex, height and weight, as well as headache type, frequency, intensity and disability, were collected. Body Mass Index (BMI) percentile was calculated based on the 2017 Korean Children Adolescence Growth Chart. RESULTS: 17.6% of the pediatric headache patients were obese. The prevalence of obesity in male patients was higher than females (Male 23.8% VS Female 11.6%, P=0.002). There were no significant differences in obesity rate according to age, headache type, frequency, intensity, and disability. CONCLUSION: The prevalence of obesity in the pediatric headache population was 17.6% which is higher than 10.1% in general population (Korea National Health and Nutrition Examination Survey, KNHANES, 2013).
Adolescent ; Body Mass Index ; Child ; Female ; Growth Charts ; Gyeonggi-do ; Headache* ; Humans ; Korea ; Male ; Medical Records ; Migraine Disorders ; Nutrition Surveys ; Obesity* ; Prevalence* ; Retrospective Studies ; Tension-Type Headache

We performed this study to assess the correlation of residual pulmonary hypertension in the immediate postoperative period with that in the late follow-up period, to assess the histologic changes of pulmonary arteries (PA) at the time of repair for patients with congenital heart disease consisting of left-to-right shunt, and to clarify the role of lung biopsy in determining the operability and reversibility of pulmonary vascular changes. Lung biopsy was performed during repair in 38 patients, with a wide range of age, who had congenital left to right shunt and pulmonary hypertension. All were Heath-Edward grade III or less. Morphometric study included measurement of medial wall thickness (MWT) and decrease rate of pulmonary arterial concentration (PAC). Mean PA pressure in the immediate postoperative period was measured in all 38 patients. Follow-up cardiac catheterization was performed in 15 patients (average 3.8 years after repair). At operation, 5 patients of this late follow-up group were under 2 years of age and the other 10 were 2 or more. During catheterization, pulmonary hemodynamic reaction was observed both under room air inhalation and after inhalation of hypoxic gas FiO2 0.15. Mean PA pressure and pulmonary vascular resistance (PVR) in the immediate postoperative period had a significant correlation with PA pressure and PVR values before the operation, but not with morphometry, Heath-Edward grade, or with pulmonary hemodynamics in late follow-up. During the late follow-up study, 5 of the 15 patients had pulmonary hypertension (defined as mean PA pressure > or = 15 mmHg) under room air inhalation, and PA hypertension was induced in 4 additional patients after hypoxic gas inhalation. There was no incidence of PA pressure or PVR values registering above the preoperative level. The degree of PA hypertension showed a correlation with the rate of PAC decrease and also with patients' age-at-operation. Multiple regression analysis showed that both the rate of PAC decrease and the age-at-operation contributed significantly to the degree of PA hypertension. Some of the patients over age 2 had a decreased rate of PAC above the regression line, which none of the patients under age 2 experienced. In patients with Heath-Edward grade III or less, residual pulmonary hypertension in the immediate postoperative period was not correlated with histology, but in late follow-up, it was with PAC and the age-at-operation. Therefore, a decrease of PAC is assumed to be a totally or partially irreversible pulmonary vascular change depending on the patient's age-at-operation, while medial hypertrophy is thought to be a reversible pulmonary vascular change. Lung biopsy could play an important role in determining the reversibility of pulmonary vascular obstruction, particularly in patients older than 2 years. Ed- re highlights above: such hyphenation is optional, but if used then it should be applied consistently throughout the paper. As 3 of the 4 entries in the abstract use it, I have maintained it consistently below.
Adolescent ; Adult ; Biopsy ; Child ; Child, Preschool ; Follow-Up Studies ; Heart Defects, Congenital/*pathology/physiopathology/surgery ; Hemodynamics ; Human ; Pulmonary Artery/*pathology/physiopathology

This study was performed to compare the sensitivity of flow cytometry crossmatch(FCXM) with conventional lymphocytotoxic crossmatch(CXM), and its clinical impact. Total 174 pair of sera from potential living renal transplant donors and recipients were tested from Jan. 5, 1995 to April 3, 1996 with conventional CXM and FCXM at Kangnam St. Mary's hospital. Of 174 potential living donor/ recipient pairs, two (1.1%) had positive warm T (TW)/CXM, 3(1.7%) positive warm B(BW)/CXM, and 5(2.9%) positive warm TandB/CXM. Of 164 potential CXM-negative living donor/recipient pairs evaluated with FCXM, ten (6%) had positive T/ FCXM, and thirty one (19%) positive B/FCXM. Of 45 living donor renal transplantation with negative TW/CXM, one (2.2%) had a positive BW/CXM, 11 (24.4%) positive B/FCXM, and 2 (4.4%) positive T/ FCXM. They had been followed up over 3 months. Acute rejection episodes were observed in 8 patients. Of these patients, two had positive B/FCXM and one had a positive T/FCXM. In conclusion, FCXM is more sensitive than conventional CXM. Further follow-up study is necessary to know whether this higher sensitivity leads to fewer graft rejection.
Flow Cytometry* ; Follow-Up Studies ; Graft Rejection ; Humans ; Kidney Transplantation* ; Living Donors* ; Tissue Donors

BACKGROUND: The incidence of renal cell carcinoma (RCC) in patients receiving long-term hemodialysis or peritoneal dialysis patients is 100-fold higher than that in general population. But the clinical study about RCC in dialysis patients is not reported in Korea yet. This study was performed to evaluate the clinical characteristics of RCC in dialysis patients. METHODS: We retrospectively investigated medical records of dialysis patients who were diagnosed with RCC between patients January, 1993 and December, 2002. RCC diagnosed before first dialysis was excluded. Diagnosis of RCC was made by both radiologic and pathologic examinations. RESULTS: A total of 7 patients was diagnosed with RCC. Mean age was 46+/-9 years. Primary renal disease consisted of chronic glomerulonephritis (n=3), autosomal dominant polycystic kidney disease (n=3), and hypertensive nephropathy (n=1). Five patients were on hemodialysis, 2 were on peritoneal dialysis. Mean duration of dialysis was 82+/-46 months. The presenting symptoms were asymptomatic in 2 patients, sudden onset of flank pain due to spontaneous renal cyst rupture in 3, palpable abdominal mass in 2. Mean tumor size was 3.1+/-1.9 cm and multiple renal cysts were noted in all patients. According to the TNM classification for RCC, 6 patients had stage I and 1 patients had stage IV. Six patients with stage I were treated with nephrectomy. With a mean follow-up of 45+/-35 months after the operation, there has been no recurrence. CONCLUSION: Six patients out of total 7 patients had early stage tumor and all these patients were treated with nephrectomy and the prognosis was good. All RCC were associated with inherited or acquired multiple renal cysts.
Carcinoma, Renal Cell* ; Classification ; Diagnosis ; Dialysis* ; Flank Pain ; Follow-Up Studies ; Glomerulonephritis ; Humans ; Incidence ; Kidney Failure, Chronic ; Korea ; Medical Records ; Nephrectomy ; Peritoneal Dialysis ; Polycystic Kidney, Autosomal Dominant ; Prognosis ; Recurrence ; Renal Dialysis ; Retrospective Studies ; Rupture

In order to assess the effects of radiofrequency-induced local hyperthermia on the normal liver, histopathologic findings and biochemical changes after localized hyperthemia in canine liver were studied. Hyperthermia was externally administered using the Thermotron RF-8 (Yamamoto Vinyter Co., Japan; Capacitive type heating machine) with parallel opposed electrodes. Thirteen dogs were used and allocated into one control group (N=3) and two treatment groups according to the treatment temperature. GroupI(N=5) was heated with 42.5+/-0.5degree C for 30 minutes, and GroupII(N=5) was heated with 45+/-0.5degree C for 15-30 minutes. Samples of liver tissue were obtained through a needle biopsy immediately afterhyperthermia and 7, 14 and 28 days after treatment and examined for SGOT, SGPT and alkaline phosphatase. Although SGOT and SGPT were elevated after hyperthermia in both groups (three of five in each group), there was no liver cell necrosis or hyperthermia related mortality in GroupI. A hydropic swelling of hepatocytes was prominent histologic finding. Hyperthermia with 45degree C for 30 minutes was fatal and showed extensive liver cell necrosis. In conclusion, liver damage day heat of 42.5+/-0.5degree C for 30 minutes is reversible, and liver damage by heat of 45+/-0.5degree C for 30 minutes can be fatal or irreversible. However, these results cannot be applied directly to human trial. Therefore, in order to apply hyperthermic treatment on human liver tumor safely, close observation of temperature with proper thermometry is mandatory. Hyperthermic treatment should be confined to the tumor area while sparing a normal liver as much as possible.
Alanine Transaminase ; Alkaline Phosphatase ; Animals ; Aspartate Aminotransferases ; Biopsy, Needle ; Dogs ; Electrodes ; Fever ; Heating ; Hepatocytes ; Hot Temperature ; Humans ; Hyperthermia, Induced* ; Japan ; Liver* ; Mortality ; Necrosis ; Thermometry

Hashimoto encephalopathy shares common clinical features with Creutzfeldt-Jakob disease and must be regarded as a differential diagnosis because of its good prognosis. We report a case of Hashimoto encephalopathy, which had not been recognized before the diagnosis of Creutzfeldt-Jakob disease. The electroclinical findings were compatible with probable Creutzfeldt-Jakob disease and coexistence of Hashimoto thyroiditis was supported by high titers of anti-thyroid microsomal antibody and cytopathologic findings. Hashimoto encephalopathy was not improved, which was most likely due to the coexistence of Creutzfeldt-Jakob disease.
Creutzfeldt-Jakob Syndrome* ; Diagnosis ; Diagnosis, Differential ; Hashimoto Disease ; Prognosis

PURPOSE: To demonstrate the usefulness of diffusion-weighted MR imaging(DWI) in patients with small acuteinfarction by comparing it with fast spin-echo T2-weighted MR imaging(FSE T2WI). MATERIAL AND METHOD: Weretrospectively analyzed the results of FSE T2WI in 26 consecutive patients who on DWI showed small discretehyperintensities of less than 1.5cm and whose final clinical diagnosis, within one week of clinical attack, wasacute inforction. Lacunar infarcts accounted for 24 cases and 2 small cortical infarcts for two. The onset ofsymptoms occurred within 12 hours (hyperacute stage) in two patients, within 24 hours in seven, within 3 days innine, and within one week in eight. Infarcts as seen on FSE T2WI were categorized as follows : (-) for cases ofimpossible localization with non-visualization ; (+/-) for cases of equivocal localization with faint visualizationand/or poor differentiation from combined chronic infarcts and chronic ischemic changes, or from subarachnoid CSFin cases of cortical infarction ; and (+) for cases of adequate localization with clear visualization andmoderately good differentiation from the associated brain changes, or from subarachnoid CSF in cases of corticalinfarction. These infarcts were analyzed according to the time of onset of symptoms. RESULT: For the localizationof small acute infarctions, DWI was markedly superior to the category(-), moderately superior to the category(+/-).With regard to the onset of symptoms, DWI was markedly or moderately superior to FSE T2WI in 2/2 (100%) ofhyperacute stage diagnosed within 12 hour of clinical attack, in 4/7(57%) diagnosed within 24 hours, in 5/9 (56%)diagnosed within 3 days, and in 1/8 (13%) diagnosed within 1 week(p<0.05). In 12/26 cases(46%), small acuteinfarcts were localized by DWI better than by FSE T2WI. CONCLUSION: Because the signal was unchanged or itsintensity was poor, small infarcts at the acute stage were frequently difficult to localize by FSE T2WI. Inaddition, differentiation of these from combined chronic infarcts and chronic ischemic change was poor. DWI canlocalize small acute infarcts even when the results of FSE T2WI are negative or inconclusive.
Brain ; Cerebral Infarction* ; Diagnosis ; Humans ; Infarction ; Magnetic Resonance Imaging* ; Stroke, Lacunar