Pupose:Recently childhood obesity is increasing and has been accompanied by an increase in the prevalence of type 2 diabetes mellitus(DM) among children and adolescents. We evaluated insulin resistance and impaired glucose tolerance(IGT) in 48 obese children and adolescents. METHODS:All subjects underwent a two-hour oral glucose tolerance test(1.75 g of glucose per kg of body weight) and then glucose and insulin levels were measured. Insulin resistance was estimated by homeostatic model assessment, and betacell function was estimated by calculating the ratio between the changes in the insulin level and glucose level during the first 30 minutes after the ingestion of glucose. RESULTS:IGT was detected in 4.2% of the 24 obese children(4-10 years of age) and 20.8% of the 24 obese adolescents(11 to 18 years of age). Type 2 DM was identified in 8.3% in children and 29.2% in adolescent obesity. Insulin levels were markedly elevated after the glucose tolerance test in subjects with IGT but a little decreased in cases with DM. Those changes of insulin levels were not significant statistically. The insulinogenic index was decreased in IGT and DM group of childhood and adolescent obesity compared to normal glucose tolerance(NGT) but it was not significant statistically. Insulin resistance, which was evaluated with fasting insulin, QUICKI and HOMA-IR, was increased in childhood obesity compared with adolescent obesity and the HOMA-IR of adolescent IGT group was significantly higher compared with NGT group(P<0.05). CONCLUSION: IGT is highly prevalent among children and adolescents with obesity. IGT was associated with insulin resistance and hyperinsulinemia, while beta-cell function was still relatively preserved. Overt type 2 diabetes was linked to insulin resistance and to beta cell failure.
Adolescent* ; Child* ; Eating ; Fasting ; Glucose Tolerance Test ; Glucose* ; Humans ; Hyperinsulinism ; Insulin Resistance* ; Insulin* ; Obesity* ; Pediatric Obesity ; Prevalence*

Pupose:Recently childhood obesity is increasing and has been accompanied by an increase in the prevalence of type 2 diabetes mellitus(DM) among children and adolescents. We evaluated insulin resistance and impaired glucose tolerance(IGT) in 48 obese children and adolescents. METHODS:All subjects underwent a two-hour oral glucose tolerance test(1.75 g of glucose per kg of body weight) and then glucose and insulin levels were measured. Insulin resistance was estimated by homeostatic model assessment, and betacell function was estimated by calculating the ratio between the changes in the insulin level and glucose level during the first 30 minutes after the ingestion of glucose. RESULTS:IGT was detected in 4.2% of the 24 obese children(4-10 years of age) and 20.8% of the 24 obese adolescents(11 to 18 years of age). Type 2 DM was identified in 8.3% in children and 29.2% in adolescent obesity. Insulin levels were markedly elevated after the glucose tolerance test in subjects with IGT but a little decreased in cases with DM. Those changes of insulin levels were not significant statistically. The insulinogenic index was decreased in IGT and DM group of childhood and adolescent obesity compared to normal glucose tolerance(NGT) but it was not significant statistically. Insulin resistance, which was evaluated with fasting insulin, QUICKI and HOMA-IR, was increased in childhood obesity compared with adolescent obesity and the HOMA-IR of adolescent IGT group was significantly higher compared with NGT group(P<0.05). CONCLUSION: IGT is highly prevalent among children and adolescents with obesity. IGT was associated with insulin resistance and hyperinsulinemia, while beta-cell function was still relatively preserved. Overt type 2 diabetes was linked to insulin resistance and to beta cell failure.
Adolescent* ; Child* ; Eating ; Fasting ; Glucose Tolerance Test ; Glucose* ; Humans ; Hyperinsulinism ; Insulin Resistance* ; Insulin* ; Obesity* ; Pediatric Obesity ; Prevalence*

Effectiveness of flubendazole, a newly introduced as an anthelmintic in Korea, was evaluated in 28 ascariasis, 28 whipworm infections and 17 pinworm infections in primary school children. All patients were orally given by flubendazole of 500 mg once. Stools for roundworm and whipworm and anal swabs for pinworm infections were examined both before and 25 days after treatment. After flubendazole treatment, all ascariasis and pinworm infected cases were cured. On the other hand, in whipworm infections, the cure rate was 82.1 percent (23 cured of 28 infected), and the egg reduction rate was 67.1 percent, respectively. Headache (one case), dizziness (2 cases) and abdominal pain (3 cases) were noticed as untoward effects, but they were mild and disappeared within 24 hours. These results demonstrate the excellent effectiveness of flubendazole in treating these helminth infections.
parasitology-helminth-nematoda ; Ascaris lumbricoides ; Trichocephalus trichiurus ; Enterobius vermicularis ; chemotherapy ; flubendazole

The indirect fluorescent antibody(IFA) test was used to detect serum IgG and IgM antibodies to Trichomonas vaginalis in 31 vaginal trichomoniasis, 7 candidiasis and in 20 non-infected healthy wonem with antigen prepared from axenic culture of Trichomonas vaginalis isolated from vulvovaginitis patient. The results were as follows: In 31 vaginal trichomoniasis the positive reactions of IgG antibody were 27 in the 1/8 dilution or higher and 4 in the 1/4 dilution whereas in healthy women the reaction showed signigicantly low as in the 1/4 dilution of below. The sensitivity and specificity of IFA test for IgG antibody to trichomonad antigen in this study were 87.1% and 100%, respectively. No significant difference of IgM antibody levels between vaginal trichomoniasis and healthy women was observed. No relation between the levels of IgG and IgM antibodies to trichomonad antigen by IFA test was observed. No relation between the time lapse and the level of serum IgG antibodies in IFA test of vaginal trichomoniasis was regarded. In conclusion the present study suggests that IFA test in trichomoniasis could be a useful tool for detection of anti-trichomonad IgG antibodies and applicable as an immundiagnostic method.
parasitology-protozoa ; Trichomonas vaginalis ; trichomoniasis ; diagnosis ; IgM ; IgG ; immunology

PURPOSE: It was noted some changes of clinical manifestations of mycoplasma pneumonia. we reviewed and compared these changes and saught any clues causes for proper dignosis and treatment. METHODS: We divided patients with mycoplasma pneumonia into two groups, Group 1 (from Jan. to Dec. 1996) and Group 2 (from Jan. to Dec. 1994), and analyzed clinical, radiologic, and serologic differences. RESULTS: Mean age of onset lowered markedly from was 8.34 +/- 2.56 years to 6.91 +/- 3.28 years (P<0.05). In clinical symptoms, high fever lasted longer and gastrointestinal symptoms were more frequent noted group 1. Serologically, high titers of mycoplasma-specific antibody (>1 : 1280) were more frequently observed in group 1 and correlated with severity of clinical manifestations. In radiologic findings, alveolar consolidation were significantly prominent findings in Group (P<0.05). The mean period of response to Roxithromycin was not difference between two groups but longer lasting fever (> or = 3 days) in spite of medication were more prevalent in Group 1 (P<0.05), suggesting increased cases of diminished responsiveness to treatment. CONCLUSIONS: Recently, there was some clinical changes of mycoplasma pneumonia, lowering of onset age, severe clinical symptoms, and more decreased responsiveness to antibiotic treatment. We suggest that it is to neccessary to make some efforts to prevent antibiotics abuse and to decrease the occurrence of resistant strains by introducing of new method for early diagnosis, selective identification of micro-organism and minute sensitivity test for antibiotics.
Age of Onset ; Anti-Bacterial Agents ; Early Diagnosis ; Fever ; Humans ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Roxithromycin

We have recently experienced a case of prune-belly syndrome, in 119/12-year-old male child with congenital defects of abdominal muscles, cryptorchidism, hydronephrosis, megacystis and spina bifida. Diagnosis was confirmed by EMG, IVP, retrograde cystogram, radiorenogram & renal scanning, and roentgenologic examinations. The patient in this report may be one of the most long-term survival case reported in korean literature.
Abdominal Muscles ; Child ; Congenital Abnormalities ; Cryptorchidism ; Diagnosis ; Humans ; Hydronephrosis ; Male ; Prune Belly Syndrome* ; Spinal Dysraphism

Guillain-Barr syndrome is rarely complicated by hypertension, which has been ascribed to sympathetic nervous system hyperactivity. We report a 11 years old female with Guillain-Barr syndrome complicated by persistent hypertension associated with elevated renin-angiotensin. So we report this case with brief review of related literatures.
Child ; Female ; Humans ; Hypertension* ; Sympathetic Nervous System

The present study was undertaken to demonstrate the surface structure of Paragonimus westermani metacercaria in Korea with special reference to the distribution of sensory papillae. Metacercariae were isolated from crayfish, one of the second intermediate host of P. westermani in Bogil island, Chollanam-do (Province), Korea, where has been known as an endemic area of human paragonimiasis. Isolated metacercariae were excysted and examined with light, scanning and transmission electron microscopes for morphological features. On the surface of metacercariae, three types of sensory papillae were identified. Large domed papillae (3-5 micrometer), which were covered with wrinkled plasma membrane of the worm, were distributed on the oral and ventral suckers only. On the oral sucker, these large domed papillae were 12-13 in number. On the other hand large domed papillae on the ventral sucker were constantly 6 in number and hexagonal in distribution. Small domed papillae (2-3 micrometer), of which surface was more smooth than those of large ones, were distributed symmetrically on the ventral (30-32 pairs) and dorsal surfaces (40-42 pairs). Ciliated papillae (0.8-1.5 micrometer) were observed about 5-6 in number around the oral sucker and 3-5 pairs each on the ventral and dorsal surface of the body. Single pointed spines covered the entire surface of the body except around the excretory pore. Spines on the anterior part of the body were 0.9-2.0 micrometer in length and 45-55/100 square micrometer in number, and were gradually reduced in length (0.4-1.4 micrometer) and in number (12-27/100 square micrometer) toward the posterior part. The body wall of P. westermani metacercariae was consisted with anucleated syncytium layer, fibrous interstitial layer and musclar layer. In the anucleated syncytium, biconcave (0.15-0.55 micrometer) and spherical (0.08-0.16 micrometer) secretory granules, which were transferred from epidermal cells via protoplasmic tubules, mitochondria and ribosomes, were observed. Spines originated around the basement membrane protruded externally. Epidermal cells were consisted with a nucleus and a cytoplasm, and connected to syncytium with protoplasmic tubules. In the cytoplasm many secretory granules, mitochondria, Golgi complex, endoplasmic reticula, ribosomes and lipid droplets were observed.
parasitolgy-helminth-trematoda ; Paragonimus westermani ; electron microscopy

Neonatal ascites is an uncommon problem with many etiologies. The common causes include hematologic diseases, bowel perforation, obstructive uropathy, cardiovascular diseases, chylous ascites, intrauterine infection, and meconium peritonitis. Recently, the wide application of sonography has greatly narrowed the list of differential diagnosis of neonatal ascites. Meconium peritonitis is readily diagnosed if calcification in the abdomen or scrotum can be seen radiologically or sonographically in a neonate with abdominal distension at birth. We report a case of generalized meconium peritonitis without intraabdominal calcification by radiologic and sonographic study and notable meconium hydrocele at birth.
Abdomen ; Ascites ; Cardiovascular Diseases ; Chylous Ascites ; Diagnosis, Differential ; Hematologic Diseases ; Humans ; Infant, Newborn ; Meconium* ; Parturition ; Peritonitis* ; Scrotum ; Ultrasonography

PURPOSE: The clinical findings of early neonatal hypocalcemia are variable and it is difficult to find relationship between the symptoms and hypocalcemia due to complex causes. The purpose of this study is to establish the relationship between early neonatal hypocalcemia and clinical manifestations and to propose a guideline for appropriate treatment of early neonatal hypocalcemia, especially in asymptomatic cases. METHODS: Study subjects were all sick babies admitted to nursery and NICU and randornly selected 43 healthy babies at Sun General Hospital from January 1996 to December 1996. We examined serum calcium level within 72 hours after birth. Then we evaluated prospectively clinical findings according to each disease category in hypocalcemic cases and analysed the relationship of time course of clinical findings with hypocalcemia and compared serum calcium concentration followed by each therapy after 3 days. RESULTS: The results were as follows. 1) The incidence of early neonatal hypocalcernia was high in premature infants, low birth weight infants, infants with neonatal asphyxia, hyaline membrane disease and transient tachypnea. 2) Tremor, seizure, apnea, dyspnea, abdominal distension, cyanosis, and vomiting were frequently presented symptoms in early neonatal hypocalcemia. 3) In the cases of early hypocalcemia with symptoms, these symptoms persisted continuously after norrnalization of serum calcium concentration. 4) Among asymptomatic hypocalcernic group, mean serum calcium levels changed from 6.7 mg/dL to 8.7 mg/dL in 23 cases of no treatment, from 5.4 mg/dL to 10.3 mg/dL in 4 cases of calcium gluconate infusion, and from 6.3 mg/dL to 8.7 mg/dL in 7 cases of feeding low phosphorus containing milk. None persisted in hypocalcemic state irrespective of treatment methods. CONCLUSION: It is difficult to regard these symptoms as a rule to treatment because these symptoms were present after normalizaton of serum calcium concentration. In addition, asymptomatic hypocalcemia was improved shortly without any treatment without any problem. We conclude that for asymptomatic hypocalcemia, withholding dangerous calcium gluconate infusion would be perrnissible.
Apnea ; Asphyxia ; Calcium ; Calcium Gluconate ; Cyanosis ; Dyspnea ; Hospitals, General ; Humans ; Hyaline Membrane Disease ; Hypocalcemia* ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Milk ; Nurseries ; Parturition ; Phosphorus ; Prospective Studies ; Seizures ; Solar System ; Tachypnea ; Tremor ; Vomiting