A case of primary non-clear-cell adenocarcinoma of the vagina is reported occurring in a 65-year-old woman without exposure to diethylstilbestrol (DES) in utero. The adenocarcinoma did not appear to be associated with vaginal adenosis. It lacked clear cell component and interestingly composed of columnar epithelial cells of endocervical-type. Cytologically round to oval nuclei revealed one or more small nucleoli and fine granular chromatin pattern. Cytoplasm was plump, faintly basophilic and homogeneously stained. Histologically well differentiated columnar epithelial cells were arranged in trabecular pattern mainly, and also occasional glandular lumina and small solid sheets were found. Mitoses were hardly found.
Adenocarcinoma ; Aged ; Basophils ; Cellular Structures ; Chromatin ; Cytoplasm ; Diethylstilbestrol ; Epithelial Cells ; Female ; Glomerulonephritis* ; Humans ; Mitosis ; Purpura, Schoenlein-Henoch* ; Vagina

Immunization is the most cost-effective method of preventing many infectious diseases. Recommendations for immunization practices are based on scientific knowledge of vaccine characteristics, the principles of immunization, the epidemiology of specific diseases, host characteristics, and expert opinion of public health officials and specialists in clinical and preventive medicine on vaccine benefit and safety issues. Therefore, recommendations for vaccination practices balance scientific evidence of benefits and risks of immunization programs. Many of the standards for child and adolescent vaccination programs that have been previously published are universal and are applicable to many countries where different public health concerns may exist. However, several updated changes are added to these standards to maximize the benefits from the vaccination services. This report will provide the most recent technical guidance about common vaccination concerns for clinicians who administer vaccines to infants, children, and adolescents.
Adolescent ; Child ; Collodion ; Communicable Diseases ; Expert Testimony ; Humans ; Immunization ; Immunization Programs ; Infant ; Preventive Medicine ; Public Health ; Risk Assessment ; Specialization ; Vaccination ; Vaccines

No abstract available.
Influenza, Human

No abstract available.
Child* ; Humans ; Pneumonia*

Background:Ghrelin is a new endogenous ligand for the growth hormone secretagogue receptor. It activates the release of growth hormone from the pituitary and it also participates in the regualtion of energy homeostasis. The aims of the study were to characterize the changes in plasma ghrelin levels in obese subjects compared with lean control or overweight subjects, and their relationship to various parameters in obese subjects. METHODS:In this study, 121 elementary school children were divided into 3 groups according to their body mass index (BMI). The lean control subjects consisted of 28 children who had less than 85 percentile of BMI. The overweight subjects consisted of 22 children who had 85-95 percentile of BMI. The obese subjects consisted of 71 children who had over 95 percentile of BMI. All subjects in 3 groups were evaluated according to their age, height, weight, obesity index, plasma ghrelin, serum lipid, glucose and insulin levels. Leu72Met mutation of prepro-ghrelin gene was directly detected by digesting the PCR fragments with Bsrl. RESULTS:Among antropometric data, body weight, BMI and obesity index were higher in obesity and overweight subjects than those of lean control subjects (P<0.05). The plasma ghrelin levels were significantly lower in overweight and obese subjects (P<0.05). In addition, serum triglyceride and LDL cholesterol levels were significantly higher in these groups compared to the control subjects (P<0.05). The concentrations of plasma ghrelin were significantly negatively correlated with BMI, obesity index, serum triglyceride, LDL cholesterol and insulin in all the children. However, there was no significant relationship between plasma ghrelin levels and any various parameters in obese subjects. Leu72Met mutation was detected in about 30% of obese children. However, we could not find any differences between lean control and obese children. CONCLUSION: We proved a significantly lower plasma ghrelin levels in overweight and obese subjects. Further studies are now needed to establish the role of ghrelin in the pathogenesis of human obesity.
Body Mass Index ; Body Weight ; Child* ; Cholesterol, LDL ; Ghrelin* ; Glucose ; Growth Hormone ; Homeostasis ; Humans ; Insulin ; Obesity* ; Overweight ; Plasma* ; Polymerase Chain Reaction ; Receptors, Ghrelin ; Triglycerides

PURPOSE: Since National Immunization Program (NIP) was implemented recently in Korea, public attention on vaccine safety is increasing. This study was aimed to investigate perceptions of pediatricians on the vaccine injury compensation program and to acquire their suggestions to improve the program. MATERIALS AND METHODS: Pediatricians working in primary care were surveyed at the sites of the annual Korean Pediatric Society meeting or its regular regional branch meetings during September and October 2012. A questionnaire consisted of 15 items about the Korean National Vaccine Injury Compensation Program (KNVICP) was distributed and collected directly from the pediatricians. RESULTS: A total of 340 responses were collected. While only 16% of responded pediatricians answered they knew the program well, 11% answered they did not. Twenty-six percent answered a need to expand the types of vaccines and its injuries. Most responders (82%) wished the compensation program to cover the injuries of non-NIP vaccines. On the filing procedures for compensation, they preferred reducing the minimum medical cost limit to claim (94%). CONCLUSION: On the basis of this survey, it is suggested to provide more active informative education on KNVICP to primary care pediatricians and to improve the program considering the pediatricians' opinions.
Compensation and Redress ; Data Collection ; Immunization Programs ; Korea ; Pediatrics ; Primary Health Care ; Vaccines ; Surveys and Questionnaires

Duodenal web is a very rare congenital anomaly which usually causes clinical features of intestinal obstruction from early infancy. It shows characteristic findings in the radiologic contrast study or endoscopy. But in the cases with large openings, preoperative diagnosis of web is difficult and often is overlooked until adolescence or adulthood because of delayed onset of symptoms. Duodenal web is usually single near the ampulla of Vater and may be multiple. Only a few cases of double duodenal webs have been reported in the literature. We experienced a case of double duodenal web in a 15 year-old girl who complained of peptic ulcer-associated symptoms including epigastric pain and bloody stool. She had suffered from longstanding abdominal symptoms, malnutrition and iron-deficiency anemia. We propose that duodenal web should be kept in mind for patients with a history of chronic gastrointestinal obstructive symptoms and atypical peptic ulcer.
Adolescent ; Ampulla of Vater ; Anemia, Iron-Deficiency ; Diagnosis ; Endoscopy ; Female ; Humans ; Intestinal Obstruction ; Malnutrition ; Peptic Ulcer*

PURPOSE: Chloramphenicol and tetracycline are not recommended for treating scrub typhus in pediatric patients because of potential side effects, such as aplastic anemia or tooth discoloration. While clarithromycin has recently been used in adults, few reports have been published on its effects in pediatric patients. We report the clinical profiles of pediatric scrub typhus and the effects of clarithromycin on scrub typhus in children. METHODS: We retrospectively analyzed medical records of 56 children with scrub typhus who were admitted between 2004 and 2013 to Chonbuk National University Hospital, Jeonju, Korea. Cases were divided into 3 groups based on thetreatment drug (chloramphenicol, azithromycin, and clarithromycin). We compared their clinical manifestations and laboratory findings. RESULTS: All patients exhibited fever and rash. Other common clinical manifestations were eschars (66%), lymphadenopathy (48%), upper respiratory symptoms (42%), abdominal pain (32%), and hepatosplenomegaly (14%). Elevated levels of C-reactive protein, erythrocyte sedimentation rates, aspartate transaminase, and alanine transaminase were detected in 95%, 96%, 84%, and 77% of patients, respectively. Additionally, decreased platelet and white blood cell levels were observed in 43% and 36% of patients, respectively. There were no statistical differences between the treatment groups in mean age (P=0.114) or sex (P=0.507). However, time to defervescence after the treatments differed significantly, being the shortest in the clarithromycin group (P=0.019). All patients recovered without complications related to the disease or drugs. CONCLUSION: Clarithromycin was as effective as chloramphenicol and azithromycin in pediatric scrub typhus patients and may be used as a first-line treatment drug.
Abdominal Pain ; Adult ; Alanine Transaminase ; Anemia, Aplastic ; Aspartate Aminotransferases ; Azithromycin* ; Blood Platelets ; Blood Sedimentation ; C-Reactive Protein ; Child* ; Chloramphenicol* ; Clarithromycin* ; Exanthema ; Fever ; Humans ; Jeollabuk-do ; Korea ; Leukocytes ; Lymphatic Diseases ; Medical Records ; Retrospective Studies ; Scrub Typhus* ; Tetracycline ; Tooth Discoloration