For evaluating the reproductive performances of GTD patients, we found 115 cases of GTD patients, 77 HM and 38 GTT, who became pregnant after the completion of treatments and follow-up period. The results of this study suggest subsequent pregnancies after the completion of treatments may promise normal reproductive outcomes regardless of the chemotherapy.
Drug Therapy ; Follow-Up Studies ; Gestational Trophoblastic Disease* ; Humans ; Pregnancy

KBG syndrome is a very rare genetic disorder characterized by macrodontia of upper central incisors, global developmental delay, distinctive craniofacial features, short stature, and skeletal anomalies. Ankyrin repeat domain 11 gene (ANKRD11) has recently been identified as a causal factor of this syndrome. We describe a 6-yr-old Korean boy with features of KBG syndrome. The patient had a short stature, macrodontia, dysmorphic facial features, speech and motor delay with intellectual disability, and partial seizures as indicated by the electroencephalogram, but he was neither autistic nor had autism spectrum disorders. Using high-resolution oligonucleotide array comparative genomic hybridization, we identified a heterozygous 240-kb deletion at 16q24.3 corresponding to ANKRD11. This patient provided additional evidence on the influence of ANKRD11 in KBG syndrome and suggested that deletion limited to ANKRD11 is unlikely to cause autism.
Abnormalities, Multiple/diagnosis/*genetics ; Asian Continental Ancestry Group/*genetics ; Bone Diseases, Developmental/diagnosis/*genetics ; Child ; Chromosomes, Human, Pair 16 ; Comparative Genomic Hybridization ; Electroencephalography ; Facies ; Gene Deletion ; Heterozygote ; Humans ; Intellectual Disability/diagnosis/*genetics ; Male ; Phenotype ; Repressor Proteins/*genetics ; Republic of Korea ; Tooth Abnormalities/diagnosis/*genetics

BACKGROUND: Secundum atrial septal defect (ASD) is a common congenital heart defect in adults. Patients with ASDs at high risk of cardiovascular complications undergo either surgical repair or percutaneous device closure. CASE REPORT: We report the case of an 85-year-old male with unusual recurrent cerebral infarctions. The patient has undergone repair of secundum ASD 12 years ago. Evaluation by transesophageal echocardiography revealed a mobile mass at the patch repair site in the left atrium. The mass was surgically removed due to recurrent stroke during the anticoagulation. CONCLUSION: This case emphasizes the importance of regular cardiac checkup and the need to consider cardioembolic source as being part of the etiology of stroke recurrence, even if the event occurs many years after intracardiac shunt closures.
Adult ; Aged, 80 and over ; Cerebral Infarction ; Echocardiography, Transesophageal ; Heart Atria ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Humans ; Male ; Recurrence ; Stroke

BACKGROUND: Hyperhomocysteinemia is an independent risk factor for cerebrovascular disease. MTHFR 677TT genotype can induce hyperhomocysteinemia. However, the association between this 677TT genotype and ischemic stroke still remains controversial. This study was undertaken to determine whether MTHFR 677TT genotype was associated with certain subtype of ischemic stroke. METHODS: The case group consisted of 129 patients with ischemic stroke and the control group consisted of 157 healthy individuals. We checked their fasting plasma homocysteine levels and analyzed the C677T mutation in the MTHFR gene. The relative risk of MTHFR 677TT genotype was assessed by odds ratios using multivariate logistic regression. RESULTS: Homocysteine levels in plasma were significantly higher in ischemic stroke patients (10.386.44 mol/L) than in controls (8.002.40) (P<0.05). In small-artery disease (11.366.01), the same result was found (P<0.05). On the other hand, the prevalence of the homozygote mutation was not significantly higher in ischemic stroke patients (20.2%) than in controls (13.4%) (adjusted OR 1.39, 95% CI 0.65 to 2.96). The adjusted OR and 95% CI was 2.59 (1.08 to 6.25) for the TT genotype in patients with small-artery disease compared to controls. The 677TT genotype was increased in small-artery disease compared to large-artery disease (adjusted OR 7.60, 95% CI 1.66 to 34.77). CONCLUSIONS: Our findings suggest that the homozygous C677T mutation in the MTHFR gene is a risk predictor in the subtype of ischemic stroke, such as small-artery disease.
Fasting ; Genotype ; Hand ; Homocysteine ; Homozygote ; Humans ; Hyperhomocysteinemia* ; Logistic Models ; Odds Ratio ; Plasma ; Prevalence ; Risk Factors ; Stroke*

Theophylline has been widely used in the treatment of asthma and chronic obstructive lung disease. To date, there have been very few reports on hepatotoxicity due to theophylline. We diagnosed, through biochemical testing and a liver biopsy, a case of acute cholestatic hepatitis developed after oral consumption of theophylline. A 43 year-old man was admitted to the department of internal medicine due to jaundice and pruritus which developed after ten days administration of oral theophylline (Etheophyl ). Liver function tests showed elevated serum bilirubin at 13.2 mg/dL with AST and ALT of 71 U/L and 194 U/L. Alkaline phosphatase and gamma-GTP were also elevated at 175 U/L and 301 U/L. There was no evidence of viral or autoimmune hepatitis in laboratory tests. The patient's symptoms and liver function tests were improved after conservative treatment. After 9 months oral theophylline was readministered for the control of relapsed asthma. Then, jaundice and pruritus again developed again. A liver biopsy showed a few lymphocytes and eosinophilic inflammatory cell infiltration in portal tract and cholestasis in the lobule. Drug-induced hepatitis was diagnosed with a typical clinical course; the exclusion of all possible causes of acute hepatic dysfunction; and a positive response to accidental readministration of drug. We report this case with a review of the literature.
Adult ; Alkaline Phosphatase ; Asthma ; Bilirubin ; Biopsy ; Cholestasis ; Drug-Induced Liver Injury ; Eosinophils ; Hepatitis* ; Hepatitis, Autoimmune ; Humans ; Internal Medicine ; Jaundice ; Liver ; Liver Function Tests ; Lymphocytes ; Pruritus ; Pulmonary Disease, Chronic Obstructive ; Theophylline

PURPOSE: We undertook this study to evaluate the pertinence of yearly CPR training for three years in hospital. METHODS: We evaluated 106 participants (79 registered nurses, 17 assistant nurses, 10 medical technicians who were not emergency medical technicians). We performed the education once a year for three years. We used color slides and videos for the lecture. We used a CPR training manikin for training in the CPR skills. For the evaluation, we used a list involving 10 items about understanding the CPR scheme and the CPR training program. We divided the 106 participants based on frequency of training, occupation and career. RESULTS: The mean number of points for understanding the CPR scheme was 17.5 points out of 28. The mean number of points for check for breathing, rescue breathing, pulse check, and chest compression were 2.5, 2.3, 1.7, and 1.7, respectively out of 4 points. In CPR skills, appropriate rescue breathing was 37+/-31%, and appropriate chest compression was 62+/-39%. There were no significant statistical differences based on frequency of CPR training or career. There were significant statistical differences based on occupation. CONCLUSION: Our yearly CPR training in the hospital was not pertinent in improving the ability to perform CPR. Different CPR training methods are needed for different occupation. We think that further study are needed to develope effective CPR training methods and to identify the appropriate re-training interval.
Cardiopulmonary Resuscitation* ; Education ; Emergencies ; Manikins ; Nursing* ; Occupations ; Respiration ; Thorax

BACKGROUND: The objects of this study is to compare the clinical aspects and characteristics of the sternal fracture between non-old aged and the old aged. METHODS: This study is based on 105 patients who were diagnosed as a sternal fracture at the emergency center of Chunchon Sacred Heart Hospital from January of 2001 to June of 2007. RESULTS: The overall clinical presentations of sternal fracture of the old aged are similar to that of non-old aged. There were some differences in the patterns of spinal fracture occurred with sternal fracture between non-old aged and the old aged. In non-old aged group, there were 7 patients(8.6%), who had the facture of spine along with sternal fracture, and there were 4 male and 3 females. In the old aged group, there were 4 male and 4 female patients out of 8 patients. There were 2 female patients who had both thoracic and lumbar spinal fractures in the old aged group. CONCLUSION: There were many cases of injury which were accompanied with the sternal fracture. When the two groups are compared, the spinal facture were more often in the old aged group. Especially, the fracture of lumbar spine occurred more frequent in the old aged group.
Emergencies ; Female ; Gangwon-do ; Heart ; Humans ; Male ; Spinal Fractures ; Spine ; Sternum

PURPOSE: The prevalence of allergic diseases has risen over the last few decades. Many factors, including environmental factors such as those related to diet, have been considered. Among dietary factors, intake of antioxidant-related nutrients has been associated with the risk of allergic disease. We investigated the association of antioxidant nutritional status with allergic rhinitis (AR) in Korean schoolchildren aged 6-12 years. METHODS: Subjects were 4,554 children in Seoul, Korea. The risk of allergic disease was measured using the Korean version of the International Study of Asthma and Allergies in Childhood, and dietary intake was measured by a semi-quantitative food frequency questionnaire. Intake of vitamins A (including retinol and beta-carotene), C, and E was used in the analysis. RESULTS: Vitamin C intake was negatively associated with an increased risk of current symptoms (adjusted odds ratio, 0.886; 95% confidence interval, 0.806-0.973). There was no association between AR and intake of vitamin A, retinol, beta-carotene, or vitamin E. Total serum IgE level and sensitization to allergen did not differ according to nutrient intake. CONCLUSIONS: The group of children with increased vitamin C consumption had fewer AR symptoms, despite the lack of a difference in total serum IgE level or allergen sensitization. These findings suggest that nutrient intake, especially that of vitamin C, influences AR symptoms.
Aged ; Antioxidants ; Ascorbic Acid ; Asthma ; beta Carotene ; Child ; Diet ; Humans ; Hypersensitivity ; Immunoglobulin E ; Korea ; Nutritional Status ; Odds Ratio ; Prevalence ; Rhinitis ; Rhinitis, Allergic, Perennial ; Vitamin A ; Vitamin E ; Vitamins ; Surveys and Questionnaires

In order to develop a structured and objective diagnostic instrument, authors completed: (1) the translation and back translation of the Korean version of the Kiddie-Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (K-SADS-PL) and (2) the examination of its validity and reliability of the K-SADS-PL-Korean version (K-SADS- PL) when used with Korean children. A total of 91 study subjects were recruited from child and adolescent psychiatry outpatient clinics. Clinical diagnoses were used as a gold standard for the examination of validity of K-SADS-PL-K. Consensual validity of threshold and sub-threshold diagnoses were good to excellent for attention-deficit/hyperactivity disorder (ADHD), fair for tic and oppositional defiant disorders, and poor to fair for anxiety and depressive disorders. Inter-rater and test-retest reliabilities were fair to excellent for ADHD and tic disorder. The significant correlations between the K-SADS-PL-K and Korean Child Behavior Checklist (K-CBCL) were found, which provided additional support for the concurrent validity of the K-SADS-PL-K. Sensitivities varied according to the diagnostic categories, but specificities remained high over all diagnoses, suggesting that the K-SADS-PL-K is a desirable confirmatory diagnostic tool. The results of this study suggest that the K-SADS-PL-K is an effective instrument for diagnosing major child psychiatric disorders, including ADHD, behavioral disorders and tic disorders in Korean children. Future studies will examine the validity and reliability of the K-SADS-PL-K in larger samples, including adolescents and community samples on a variety of child and adolescent psychiatric disorders.
Adolescent ; Child ; Human ; Korea ; Mood Disorders/*diagnosis ; Predictive Value of Tests ; *Psychiatric Status Rating Scales ; Reproducibility of Results ; Schizophrenia/*diagnosis ; Sensitivity and Specificity ; Support, Non-U.S. Gov't ; Translations

The objective of this study was to investigate clinical and radiographic features and gender differences in Korean patients with adult-onset ankylosing spondylitis. Multicenter cross-sectional studies were conducted in the rheumatology clinics of 13 Korean tertiary referral hospitals. All patients had a confirmed diagnosis of ankylosing spondylitis according to the modified New York criteria. Clinical, laboratory, and radiographic features were evaluated and disease activities were assessed using the Bath ankylosing spondylitis disease activity index. Five hundred and five patients were recruited. The male to female ratio was 6.1:1. Average age at symptom onset was 25.4+/-8.9 yr and average disease duration was 9.6+/-6.8 yr. Males manifested symptoms at a significantly earlier age. HLA-B27 was more frequently positive in males. Hips were more commonly affected in males, and knees in females. When spinal mobility was measured using tragus-to-wall distance and the modified Schober's test, females had significantly better results. Radiographic spinal changes, including bamboo spine and syndesmophytes, were more common in males after adjustment of confounding factors. In conclusion, we observed significant gender differences in radiographic spinal involvement as well as other clinical manifestations among Korea patients with adult-onset ankylosing spondylitis. These findings may influence the timing of the diagnosis and the choice of treatment.
Adult ; Age of Onset ; *Asian Continental Ancestry Group ; Female ; HLA-B27 Antigen/diagnostic use ; Humans ; Joints/pathology ; Male ; Severity of Illness Index ; Spondylitis, Ankylosing/diagnosis/*pathology/*physiopathology/*radiography