PURPOSE: Asthma is characterized clinically not only by episodic wheeze and reversible airway obstruction but also by excessive airway secretion. Oppenshaw- Warwick found that 77% of asthmatic subjects reported sputum production as a prominent symptom. Invasive assessment for the airway inflammation in children has been frequently limited. Induced sputum by inhalation of hypertonic saline allows monitoring of airway inflammation in children with asthma in a non-invasive way. METHODS: Thirty subjects with asthma were selected by asthma questionares and divided two groups as 14 current symptomatic asthmatics (FEV(1)<85%: PD15) and 16 stable non-symptomatic asthmatics with 4.5% hypertonic saline challenge test, and 14 normal controls were selected. They all inhaled 4.5% hypertonic saline for 10 minutes by ultrasonic nebulizer. The expectorated sputum and saliva were collected from all subjects and collected 3 hours after corticosteroid (Beclomethasone diproprionate 200microgramX2) inhalation for asthmatics and were reduced by dithiotreitol. Total cell counts and differentials were determined. RESULTS: Sputum from current asthmatics contained a significantly higher proportion of eosinophil than stable asthmatics or normal controls (7.9+/-6.0 vs. 3.8+/-4.5% vs. 0.8+/-1.4%, P<0.05). The induced sputum after corticosteroid inhalation showed significant decrease in total cell count, eosinophil proportion in current asthma and stable asthma. CONCLUSION: The cellular analysis of induced sputum was a useful non-invasive and safe study for the diagnosis of childhood asthma and assessment for the direct effects of inhaled corticosteroid on airway inflammation in children with asthma.
Airway Obstruction ; Asthma* ; Cell Count ; Child* ; Diagnosis ; Eosinophils ; Humans ; Inflammation ; Inhalation ; Nebulizers and Vaporizers ; Saliva ; Sputum* ; Ultrasonics

OBJECTIVES: The aim of this study was to investigate Korean Wechsler Intelligence profiles and specific abilities related to attention problem of children with attention-deficit hyperactivity disorder (ADHD). METHODS: The Korean Wechsler Intelligence Scale for Children-fourth edition (K-WISC-IV) and Advanced Test of Attention (ATA) were administered to 91 children and adolescents (age 8.5+/-2.6 years, 73 boys) with ADHD. Pearson correlation and independent t-tests were used. RESULTS: The means of Working Memory Index (WMI) and Processing Speed Index (PSI) showed a score of low average in K-WISC-IV. WMI scores for the K-WISC-IV showed clinically significant correlations with omission errors, commission errors, and response time variability on auditory ATA. PSI scores also showed significant correlations with response time and variability on visual ATA. In addition, significantly lower digit span backward scores were observed in hyperactive-impulsive/combined subtypes compared to inattentive subtype (t=3.60, p<.001). CONCLUSION: Children with ADHD showed significantly lower scores in WMI and PSI which were clinically correlated with ATA scores, and hyperactive-impulsive/combined subtypes showed poorer working memory functions in WMI. Follow-up studies are proposed.
Adolescent* ; Child* ; Follow-Up Studies ; Humans ; Intelligence* ; Memory, Short-Term ; Reaction Time ; Retrospective Studies*

This study was conducted to evaluate the effect of antenatal ambroxol administration to the mothers who were imminent preterm delivery on preventing the neonatal respiratory distress syndrome. Forty-two preterm newborn infants who were delivered at Yeungnam University Hospital from January 1996 to December 1997 were divided into two groups, twenty-one ambroxol-treated group and twenty-one control group. Six cases of respiratory distress syndromes developed from 21 ambroxol-treated infants. but thirteen cases of RDS developed from 21 control infants. It indicated significant reduction of occurrence of RDS by antenatal administration of ambroxol (p<0.05). There were no differences in the occurrence of adverse effects of ambroxol in mothers between two groups, ambroxol-treated and control groups. There was also no difference between pre- and post-treatment hematologic and biochemical parameters in ambroxol-treated group. In conclusion, when premature delivery is expected, administration of ambroxol before delivery enhances lung maturation in premature newborn infants and prevents the occurrence of respiratory distress syndromes without significant adverse effects.
Ambroxol* ; Humans ; Infant ; Infant, Newborn ; Lung ; Mothers ; Respiratory Distress Syndrome, Newborn*

Medullary carcinoma of the thyroid gland(MTC) constitutes approximatesly 3% to 10% of all malignant thyroid tumors. It appears in both familial and sporadic forms. Metastases are frequently present at diagnosis and are resistant to chemotherapy and radiotherapy. Surgical resection of the primary tumor and the metastases is the mainstay of treatment. Although MTC can be detected by elevated serum calcitonin, localization of residual or metastatic foci may be difficult. Many scintigraphic methods have been used for identification of the residual tumor or metastasis. However, most of them have either low sensitivity or low specificity. MTC frequently secretes somatostatin and may express somatostatin receptors. Recently, somatostatin-receptor imaging has been known to be useful for the detection of residual and recurrent medullary thyroid carcinoma. A 25 year-old woman who was dignosed as medullary carcinoma by biopsy of thyroid mass is presented. Thirteen years ago, she underwent left thyroidectomy due to thyroid cancer(MTC). Laboratory tests revealed an increase in the levels in serum CEA(CEA=557.6 ng/ml) and calcitonin(calcitonin= 720 pg/ml). The second patient, a 30 year-old female, complained of a palpable mass in the left anterior neck. Ten years ago, she underwent a right lobectomy of thyroid gland due to adenomatous goiter. Laboratory tests revealed an increase in the levels in serum CEA(CEA=617 ng/ml) and Calcitonin (Calcitonin=2,300 pg/ml). In both cases, pre- and postoperative In-111 pentetreotide scintigraphy were done and compared with "'I scintigraphy. In-111 pentetreotide scan may be useful for the localization of residual or metastatic medullary thyroid carcinoma. Further study is warranted to define the sensitivity and specificity of the technique.
Biopsy ; Calcitonin ; Carcinoma, Medullary ; Diagnosis ; Drug Therapy ; Female ; Goiter ; Humans ; Neck ; Neoplasm Metastasis ; Neoplasm, Residual ; Radionuclide Imaging ; Radiotherapy ; Receptors, Somatostatin ; Sensitivity and Specificity ; Somatostatin ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

BACKGROUND: Fibroblast growth factor 21 (FGF21) was originally identified as a paroxysm proliferator activated receptor-alpha target gene product and is a hormone involved in metabolic regulation. The purpose of this study was to investigate the diurnal variation of serum FGF21 concentration in obese and non-obese healthy volunteers. METHODS: Blood samples were collected from five non-obese (body mass index [BMI] < or =23 kg/m2) and five obese (BMI > or =25 kg/m2) healthy young men every 30 to 60 minutes over 24 hours. Serum FGF21 concentrations were determined by radioimmunoassay. Anthropometric parameters, glucose, free fatty acid, insulin, leptin, and cortisol concentrations were also measured. RESULTS: The serum FGF21 concentrations displayed various individual oscillation patterns. The oscillation frequency ranged between 6 and 12 times per day. The average duration of oscillation was 2.52 hours (range, 1.9 to 3.0 hours). The peaks and troughs of FGF21 oscillation showed no circadian rhythm. However, the oscillation frequency had a diurnal variation and was lower during the light-off period than during the light-on period (2.4 vs. 7.3 times, P<0.001). There was no difference in the total frequency or duration of oscillations between non-obese and obese subjects, but obese individuals had increased numbers of larger oscillations (amplitude > or =0.19 ng/mL). CONCLUSION: Various oscillation patterns in serum FGF21 concentration were observed, and reduced oscillation frequencies were seen during sleep. The oscillation patterns of serum FGF21 concentration suggest that FGF21 may be secreted into systemic circulation in a pulsatile manner. Obesity appeared to affect the amplitude of oscillations of serum FGF21.
Circadian Rhythm ; Fibroblast Growth Factors ; Fibroblasts ; Glucose ; Humans ; Hydrocortisone ; Insulin ; Leptin ; Male ; Obesity ; Radioimmunoassay

We report a case of galactorrhea with acromegaly from the mixed prolactin and GH secreting pituitary microadenoma managed with a successful surgical complete removal. A 31-year-old woman visited our hospital complaining galactorrhea for more than 6 months after delivery. The physical findings of the patient were a prominent galactorrhea and mild acromegalic features of face and extremities. The laboratory findings of hematology and blood chemistry were normal. In addition, the basal levels of prolactin and GH were slightly elevated. The thyroid is in euthyroid state. The results of the combined anterior pituitary hormone-stimulation tests were that the prolactin and GH responses were stimulated exaggeratedly and the other hormonal ones were normal responses. The oral glucose loading test for acromegaly revealed non-responder results. The sellar MRI showed the 6 X 5 mm-sized pituitary microadenoma. She was operated for surgical removal of the lesions of which the immunohistochemistry findings were consistent with the positive findings for both prolactin and GH. She discharged without post-operative complication and has done well with normalized hormonal levels at outpatient department.
Acromegaly ; Adult ; Chemistry ; Extremities ; Female ; Galactorrhea* ; Glucose ; Hematology ; Humans ; Immunohistochemistry ; Magnetic Resonance Imaging ; Outpatients ; Pituitary Neoplasms ; Pregnancy ; Prolactin* ; Thyroid Gland

PURPOSE: Our study aimed to examine psychometric properties and cross-cultural utility of the Behavior Assessment System for Children-2, Parent Rating Scale-Child (BASC-2 PRS-C) in Korean children. MATERIALS AND METHODS: Two study populations were recruited: a general population sample (n=2115) of 1st to 6th graders from 16 elementary schools and a clinical population (n=219) of 6–12 years old from 5 child psychiatric clinics and an epidemiological sample of autism spectrum disorder. We assessed the validity and reliability of the Korean version of BASC-2 PRS-C (K-BASC-2 PRS-C) and compared subscales with those used for US populations. RESULTS: Our results indicate that the K-BASC-2 PRS-C is a valuable instrument with reliability and validity for measuring developmental psychopathology that is comparable to those in Western population. However, there were some differences noted in the mean scores of BASC-2 PRS-C between Korean and US populations. CONCLUSION: K-BASC-2 PRS-C is an effective and useful instrument with psychometric properties that permits measurement of general developmental psychopathology. Observed Korean-US differences in patterns of parental reports of children's behaviors indicate the importance of the validation, standardization and cultural adaptation for tools assessing psychopathology especially when used in populations different from those for which the instrument was originally created.
Autism Spectrum Disorder ; Behavior Rating Scale ; Child* ; Cross-Cultural Comparison ; Humans ; Parents* ; Psychometrics ; Psychopathology ; Reproducibility of Results

PURPOSE: There are three types of bile duct cancer, intrahepatic cholangiocarcinoma (ICC), hilar cholangiocarcinoma (HC), and extrahepatic cholangiocarcinoma (EHC). Despite different clinical presentation, the same protocol has been used in treatment of patients with these cancers. We analyzed clinicopathologic findings and protein expression in order to investigate the difference and the specific prognostic factors among these three types of cancers. MATERIALS AND METHODS: We conducted a retrospective review of 104 patients diagnosed with bile duct cancer at Seoul St. Mary's Hospital between January 1994 and May 2004. We performed immunohistochemical staining for p53, cyclin D1, thymidine phosphorylase, survivin, and excision repair cross-complementing group 1 (ERCC1). RESULTS: Of the 104 patients, EHC was most common (44.2%). In pathologic findings, perineural invasion was significantly less common in ICC. Overall survival was similar among the three types of cancer. Lymph node invasion, lymphatic, and venous invasion showed a significant association with survival outcome in ICC, however, the differentiation of histologic grade had prognostic significance in HC and EHC. No difference in protein expression was observed among these types of cancer, however, ERCC1 showed a significant association with survival outcome in HC and EHC, not in ICC. CONCLUSION: Based on our data, ICC showed different characteristics and prognostic factors, separate from the other two types of bile duct cancer. Conduct of further studies with a large sample size is required in order to confirm these data.
Bile Duct Neoplasms ; Bile Ducts, Extrahepatic ; Cholangiocarcinoma ; Cyclin D1 ; DNA Repair ; Humans ; Liver Neoplasms ; Lymph Nodes ; Prognosis ; Retrospective Studies ; Sample Size ; Thymidine Phosphorylase ; Cholangiocarcinoma

OBJECTIVE: To determine the relation between postvoid residual (PVR) and the occurrence of urinary tract infection (UTI) in stroke patients. METHOD: One hundred and eighty-eight stroke patients who were admitted to an inpatient rehabilitation unit and who did not have UTI on admission (105 males, 83 females, mean age 67.1 years) were included in this study. The PVR was measured 3 times within 72 hours after admission. Mean PVR, demographic variables, K-MMSE (Korean Mini-Mental State Examination), initial K-MBI (Korean Modified Barthel Index), Foley catheter indwelling time and stroke type were defined and the relation to the occurrence of UTI was analyzed. RESULTS: UTI occurred in 74 patients (39.4%) during admission to the rehabilitation unit. There were significant differences between the UTI and non-UTI groups in K-MMSE, K-MBI, Foley catheter indwelling time (p<0.01). However, age, gender, stroke location and type were not associated. The occurrence of UTI was 4.87 times higher in the patients with a mean PVR over 100 ml than in those with a mean PVR <100 ml. The mean PVR was 106.5 ml in the UTI group, while it was 62.7 ml in the non-UTI group (p<0.01). PVR was not associated with age. CONCLUSION: The UTI rate is higher when the mean PVR is over 100 ml irrespective of gender and age. Close monitoring of PVR and appropriate intervention is needed to reduce the occurrence of UTI in stroke patients.
Catheters ; Female ; Humans ; Inpatients ; Male ; Stroke ; Urinary Tract ; Urinary Tract Infections

BACKGROUND: Influenza causes morbidity and mortality, resulting in the medical and socioeconomic costs. We aimed to analyse whether socioeconomic and medical factors may affect influenza vaccination status divided into 2 groups; one aged 19 to 64 years old and the other aged 65 or over who are eligible for free vaccination. METHODS: The study included 1,412 individuals aged 19 and over who responded to influenza vaccination survey, based on 2013 National Health and Nutrition Examination Survey. Related factors were categorized into socioeconomic factors and medical factors. Univariate analyses were conducted to examine the correlations between vaccination rate and each variables. Multivariate analysis was obtained after adjusting variables which were statistcally significant. RESULTS: Influenza vaccination rate was significantly different in the population aged 19 to 64 (24.9%) and the population aged 65 or over (80.5%). In the former population, high vaccination rate was associated with healthcare usage (odds ratio [OR]=1.37, 95% confidence interval [CI]=1.03-1.83), underlying chronic diseases (OR=2.21, 95% CI=1.43-3.40), and public assistance recipient households (OR=2.21, 95% CI=1.03-4.78), while low vaccination rate was correlated with no use of medical check up (OR=0.70, 95% CI=0.52-0.94) and heavy alcoholics (OR=0.41, 95% CI=0.24-0.70). In the latter population aged 65 or over, high vaccination rate was associated with healthcare usage (OR=1.82, 95% CI=1.28-2.59), and underlying malignancies (OR=4.79, 95% CI=1.07-21.54), whereas low vaccination rate was associated with public assistance recipient households (OR=0.33, 95% CI=0.14-0.76), and no use of medical check up (OR=0.37, 95% CI=0.19-0.73). CONCLUSIONS: In the population below 65 years old, vaccination rate would be expected to rise by the recommendation of medical care providers and expanding the coverage of free vaccination. In elderly, individualized care for those who have less access to medical care and high susceptibility is highly recommended.
Adult* ; Aged ; Alcoholics ; Chronic Disease ; Delivery of Health Care ; Family Characteristics ; Humans ; Influenza Vaccines ; Influenza, Human* ; Mortality ; Multivariate Analysis ; Nutrition Surveys ; Public Assistance ; Socioeconomic Factors ; Vaccination*