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

PURPOSE: Syncope in a common condition that is typically benign but is occasionally associated with mortality. We conducted a retrospective validation of the San Francisco Syncope Rule (SFSR) for use in identifying emergency department (ED) syncope patients with short-term serious outcomes. METHODS: We studied 131 syncope patients who were admitted to or visited the out-patient department within 1 month of an ED visit related to syncope from January to December 2010. Patients meeting the inclusion criteria as defined in the SFSR derivation were evaluated for 5 previously derived predictor variables: abnormal electrocardiography (ECG), shortness of breath, hematocrit <30%, triage systolic blood pressure <90 mm Hg, and a history of congestive heart failure. Predetermined outcome measures as defined by the SFSR included death, myocardial infarction, arrhythmia, pulmonary embolism, stroke, subarachnoid hemorrhage, significant hemorrhage, or any condition causing or likely to cause a return ED visit and hospitalization, or related event. RESULTS: The patient group consisted of 63 males and 68 females with an average age of 56 years. 35(26.7%) patients met the predetermined criteria for serious outcome. 10 of 35(28.6%) patients with a serious outcome were not identified as high risk using the rule. The rule performance for predicting serious outcomes included a sensitivity of 71.4% (95% confidence interval (CI), 56% to 86%), specificity of 69.8% (95% confidence interval (CI), 69% to 70%) and positive predictive value of 47.3%. CONCLUSION: In this retrospective validation study in Korea, the SFSR performed with comparable specificity but with significantly lower sensitivity than reported in the original study. Implementing the rule would significantly increase admission rates.
Arrhythmias, Cardiac ; Blood Pressure ; Dyspnea ; Electrocardiography ; Emergencies ; Female ; Heart Failure ; Hematocrit ; Hemorrhage ; Hospitalization ; Humans ; Korea ; Male ; Myocardial Infarction ; Outcome Assessment (Health Care) ; Outpatients ; Pulmonary Embolism ; Retrospective Studies ; San Francisco ; Sensitivity and Specificity ; Stroke ; Subarachnoid Hemorrhage ; Syncope ; Triage

The purpose of this study was to investigate risk factors that are associated with heterotopic pregnancy (HP) following in vitro fertilization (IVF)-embryo transfer (ET) and to demonstrate the outcomes of HP after the surgical treatment of ectopic pregnancies. Forty-eight patients from a single center, who were diagnosed with HP between 1998 and 2012 were included. All of the patients had received infertility treatments, such as Clomid with timed coitus (n = 1, 2.1%), superovulation with intrauterine insemination (n = 7, 14.6%), fresh non-donor IVF-ET (n = 33, 68.8%), and frozen-thawed cycles (n = 7, 14.6%). Eighty-four additional patients were randomly selected as controls from the IVF registry database. HP was diagnosed at 7.5 ± 1.2 weeks (range 5.4-10.3) gestational age. In six cases (12.5%), the diagnosis was made three weeks after the patients underwent treatment for abortion. There were significant differences in the history of ectopic pregnancy (22.5% vs. 3.6%, P = 0.002). There were no significant differences in either group between the rates of first trimester intrauterine fetal loss (15.0% vs. 13.1%) or live birth (80.0% vs. 84.1%) after the surgical treatment for ectopic pregnancy. The risk factors for HP include a history of ectopic pregnancy (OR 7.191 [1.591-32.513], P = 0.010), abortion (OR 3.948 [1.574-9.902], P = 0.003), and ovarian hyperstimulation syndrome (OHSS) (OR 10.773 [2.415-48.060], P = 0.002). In patients undergoing IVF-ET, history of ectopic pregnancy, abortion, and OHSS may be risk factors for HP as compared to the control group of other IVF patients. The surgical treatment of HP does not appear to affect the rates of first trimester fetal loss or live birth.
Abortion, Induced ; Adult ; Databases, Factual ; Embryo Transfer ; Female ; Fertilization in Vitro ; Gestational Age ; Humans ; Live Birth ; Odds Ratio ; Pregnancy ; Pregnancy Outcome ; Pregnancy, Heterotopic/*diagnosis/surgery ; Risk Factors

OBJECTIVE: This study was performed to evaluate the efficacy and the toxicity of paclitaxel and platinum in patients with recurrent cervical carcinoma. METHODS: Twenty nine patients were treated with paclitaxel 135-175 mg/m2 and cisplatin 50-75 mg/m2 or carboplatin at AUC 5 every 3 weeks for a maximum of six courses from January 2001 to January 2004. RESULTS: A total 134 cycles with paclitaxel and platinum were administered. Ten patients (34.2%) achieved an objective response, including four complete responses (13.6%) and six partial responses (20.6%). Overall survival was 13.2 months, and the response and non-response group were 23.2 and 8.1 months, respectively (p=0.01). Clinical response according to recurrent site was significantly different (p=0.048) but, survival was not (p=0.22). Grade 3 or 4 granulocytopenia in 75.9% of patients was developed and one expired due to neutropenic sepsis after first cycle chemotherapy. CONCLUSION: The combination of paclitaxel and platinum seems relatively well tolerated and has 34.2% response rate in patients with recurrent cervical cancer. Further study for this combination chemotherapy and prognostic factor should be needed.
Agranulocytosis ; Area Under Curve ; Carboplatin ; Cervix Uteri* ; Cisplatin ; Drug Therapy ; Drug Therapy, Combination ; Female ; Humans ; Paclitaxel* ; Platinum* ; Sepsis ; Uterine Cervical Neoplasms