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*

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*

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

Down's syndrome (trisomy 21) has been frequently associated with thyroid disease, mainly subclinical hypothyroidism (12.5-32.5%). The occurrence of Downs syndrome in conjunction with hyperthyroidism is rare (0.6-2.5%). The mechanism that Down's syndrome was frequently associated with autoimmune thyroid disease is not clear, but T cell maturation defects and overexpression of chromosome 21 products in Down's syndrome have been suggested. A 19-year-old female was transferred because of generalized weakness. She was born to a 42-year-old mother, She had been suffered from heat intolerance, weight loss, palpitation, dyspnea on exertion and neck swelling and had intermittently taken some medication since her age 9. She had mental retardation (IQ 41) and underdeveloprnent. Exophthalmos, upward-outward slant of palpabral fissures, epicanthal folds, lowset ears, and large, protruding, fissured tongue were identified. Short fifth middle phalanges, clinodactyly and small-sized interventricular septal defect were also detected. Thyroid gland was diffusely enlarged four times the normal size, firm in consistency and had a bruit. Serum T concentration was 7.8ug/dL, T2 306ng/dL, and TSH 0.01ulU/mL. She was positive for thyroid autoantibodies (antimicosomal antibody 1,867 IU/mL, antithyroglobulin antibody 106 IU/mL, and TBII 79.6%). Twenty-four hours radioactive iodine uptake was 64%. Chromosomal analysis with T cell culture stimulated by phytohemagglutinin revealed 47XX, 21 trisomy. Pituitary hormones except TSH were fully stimulated by combined pituitary stimulation. She was finally diagnosed as Down's syndrome with Graves' disease and controlled with use of methimazole.
Adult ; Autoantibodies ; Cell Culture Techniques ; Chromosomes, Human, Pair 21 ; Down Syndrome* ; Dyspnea ; Ear ; Exophthalmos ; Female ; Graves Disease* ; Hot Temperature ; Humans ; Hyperthyroidism ; Hypothyroidism ; Intellectual Disability ; Iodine ; Methimazole ; Mothers ; Neck ; Pituitary Hormones ; Thyroid Diseases ; Thyroid Gland ; Tongue, Fissured ; Trisomy ; Weight Loss ; Young Adult

BACKGROUND: Overt hypothyroidism is well-known cause of secondary hyperlipidemia and atherosclerosis. However, there have been dissenting reports of abnormalities in serum lipid concentrations in patients with subclinical hypothyroidism (SH). Recently, it has been reported that serum Lp (a) concentration, an independent risk factor of atherosclerosis, was increased in patients with SH. Therefore, we analyzed serum Lp (a) and other lipid concentrations to investigate whether they are increased in patients with SH and the correlation between serum Lp (a) and TSH concentrations. METHODS: We undertook this study in 53 patients with SH (TSH > 6 uiU/ml) and 197 age-and sex-matched healthy control subjects, They had no abnormalities in liver function, BUN, creatinine, fasting blood glucose, urinalysis, and past medical histories. Serum T3, T4, and TSH concentrations were measured by RIA using commercial kits. Serum concentrations of Lp (a), total cholesterol, triglyceride (TG), and HDL cholesterol (HDL-C) were measured by rate nephelometry and enzyme assay, respectively. RESULTS: There were no significant differences of serum Lp (a), total cholesterol, LDL cholesterol, TG, and HDL-C concentrations in 53 patients with SH and 197 control subjects (25.6+-3.8mg/dL vs. 25.4+-1.5mg/dL ; 204.0+-4.2mg/dL vs. 204.0+-2.4mg/dL ; 127.0+-3.9mg/dL vs. 125.0+-2.3 mg/dL ; 133.0+-8.5mg/dL vs. 130.0+-6.0mg/dL ; 50.0+-1.5mg/dL vs. 53.0+-0.9mg/dL). There was no correlation between Lp (a) and TSH concentrations in SH (r=0.12, p>0.05). CONCLUSION: Serum Lp (a) concentration as well as total cholesterol, LDL cholesterol, and TG was not increased in patients with SH. There was no correlation between serum Lp (a) and TSH levels in subclinical hypothyroidism.
Atherosclerosis ; Blood Glucose ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Creatinine ; Dissent and Disputes ; Enzyme Assays ; Fasting ; Humans ; Hyperlipidemias ; Hypothyroidism* ; Lipoprotein(a)* ; Lipoproteins* ; Liver ; Nephelometry and Turbidimetry ; Risk Factors ; Triglycerides ; Urinalysis

OBJECTIVE: To investigate the clinical characteristics of dysphagic elderly Korean patients diagnosed with aspiration pneumonia as well as to examine the necessity of performing a videofluoroscopic swallowing study (VFSS) in order to confirm the presence of dysphagia in such patients. METHOD: The medical records of dysphagic elderly Korean subjects diagnosed with aspiration pneumonia were retrospectively reviewed for demographic and clinical characteristics as well as for VFSS findings. RESULTS: In total, medical records of 105 elderly patients (81 men and 24 women) were reviewed in this study. Of the 105 patients, 82.9% (n=87) were admitted via the emergency department, and 41.0% (n=43) were confined to a bed. Eighty percent (n=84) of the 105 patients were diagnosed with brain disorders, and 68.6% (n=72) involved more than one systemic disease, such as diabetes mellitus, cancers, chronic cardiopulmonary disorders, chronic renal disorders, and chronic liver disorders. Only 66.7% (n=70) of the 105 patients underwent VFSS, all of which showed abnormal findings during the oral or pharyngeal phase, or both. CONCLUSION: In this study, among 105 dysphagic elderly patients with aspiration pneumonia, only 66.7% (n=70) underwent VFSS in order to confirm the presence of dysphagia. As observed in this study, the evaluation of dysphagia is essential in order to consider elderly patients with aspiration pneumonia, particularly in patients with poor functional status, brain disorders, or more than one systemic disease. A greater awareness of dysphagia in the elderly, as well as the diagnostic procedures thereof, particularly VFSS, is needed among medical professionals in Korea.
Aged ; Brain Diseases ; Deglutition ; Deglutition Disorders ; Diabetes Mellitus ; Emergencies ; Humans ; Korea ; Liver ; Male ; Medical Records ; Pneumonia, Aspiration ; Retrospective Studies

OBJECTIVE: To examine the usefulness of the Scale for the Assessment and Rating of Ataxia (SARA) in ataxic stroke patients. METHOD: This was a retrospective study of 54 patients following their first ataxic stroke. The data used in the analysis comprised ambulation status on admission and scores on the SARA, the Korean version of the Modified Barthel Index (K-MBI) and the Berg Balance Scale (BBS). The subjects were divided into four groups by gait status and into five groups by level of dependency in activities of daily living (ADLs) based on their K-MBI scores. Data were subjected to a ROC curve analysis to obtain cutoff values on the SARA for individual gait status and levels of activity dependency. The correlations between the SARA, K-MBI and BBS scores were also computed. RESULTS: There was significant correlation between the SARA and the K-MBI scores (p<0.001), and this correlation (r=-0.792) was higher than that found between the BBS and the K-MBI scores (r=0.710). The SARA scores of upper extremity ataxia categories were significantly related to the K-MBI scores of upper extremity related function (p<0.001). The SARA scores were also significantly correlated negatively with ambulation status (p<0.001) and positively with ADL dependency (p<0.001). In the ROC analysis, patients with less than 5.5 points on the SARA had minimal dependency in ADL, while those with more than 23 points showed total dependency. CONCLUSION: SARA corresponds well with gait status and ADL dependency in ataxic stroke patients and is considered to be a useful functional measure in that patient group.
Activities of Daily Living ; Ataxia ; Dependency (Psychology) ; Gait ; Humans ; Retrospective Studies ; ROC Curve ; Stroke ; Upper Extremity ; Walking

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