PURPOSE: Disseminated intravascular coagulation(DIC) is a confusing disorder from both a diagnostic and therapeutic standpoint. In order to investigate the effectiveness of D-dimer test in disseminated intravascular coagulation associated with sepsis, D-dimer level and other laboratory tests were performed. METHODS: Fifty patients with disseminated intravascular coagulation associated with sepsis, who were admitted to the department of pediatrics, were evaluated by several tests(total WBC, erythrocyte sedimentation rate, C-reactive protein, blood culture test, prothrombin time, partial thromboplastin time, fibrinogen, fibrin degradation product, and D-dimer). If the test showed abnormal, follow-up study was performed. RESULTS: The positive rate of D-dimer in DIC was 72% and FDP 58%. The false positive rate of D-dimer level in normal children was 3.3% and FDP 6.7%. There was a significant linear correlation between D-dimer and FDP. CONCLUSION: D-dimer test was the most effective test for diagnosing disseminated intravascular coagulation.
Blood Sedimentation ; C-Reactive Protein ; Child ; Dacarbazine ; Disseminated Intravascular Coagulation* ; Fibrin ; Fibrinogen ; Follow-Up Studies ; Humans ; Partial Thromboplastin Time ; Pediatrics ; Prothrombin Time ; Sepsis*

Cystic hepatocellular carcinoma is unusal, and visualization of the cystic components within hepatic mass lesion have suggested that the lesions were metastatic tumors, primary cystic tumors such as biliary cystadenocarcinoma or cystic papillary cholangiocarcinoma. Although hepatic lesions can be well characterized by noninvasive imaging modalities, findings are often nonspecific. Even for cystic hepatic lesions a considerable diagnostic differential exists. The diagnosis of cystic hepatocellular carcinoma was difficult before the microscopic examination of the biopsy speciemen because of very rare. Then we report an unusual of cystic hepatocellular carcinoma without liver cirrhosis.
Biopsy ; Carcinoma, Hepatocellular* ; Cholangiocarcinoma ; Cystadenocarcinoma ; Diagnosis ; Liver Cirrhosis

BACKGROUND: Malignant follicular lesion is not differentiated from benign lesions cytologically. The objective of this study was to assess the rate and the risk of malignancy in thyroid nodules which were cytologically diagnosed as follicular neoplasm by fine-needle aspiration (FNA) cytology. METHODS: All the patients who had undergone surgery with cytological diagnosis of follicular neoplasm from January 1996 through December 2001 in Asan Medical Center were studied retrospectively. Patients' and nodule characteristics were analyzed for factors associated with the presence of cancer. Two hundred and fifteen patients (196 females, 19 males) were included and their mean age was 39.4 years (range: 12~76). RESULTS: About half of the patients (102 out of 215, 47.4%) had malignancy with 29 papillary carcinomas, 57 follicular carcinomas, 15 H rthle cell carcinomas and 1 medullary carcinoma. Previously suggested factors associated with risk for malignancy, such as male gender, large tumor size (> 4 cm) or age of patients (> 45 years), were not associated with increased risk. Diagnosis of H rthle cell neoplasia on FNA was also not associated with increased risk. Only the extremes in age of the patients (below 20 or above 60 years) were associated with increased risk for malignancy. CONCLUSION: In our findings, prevalence of carcinoma in thyroid nodule patients with cytological diagnosis of follicular neoplasm was much higher than those reported. Clinical characteristics, such as male gender, age and nodule size, are not useful predictors for the presence of malignancy. Thyroid nodules with cytological diagnosis of follicular neoplasm warrant immediate surgery.
Adenocarcinoma, Follicular/pathology ; Adenoma, Oxyphilic/pathology ; Adolescent ; Adult ; Age Factors ; Aged ; Biopsy, Needle ; Carcinoma, Medullary/pathology ; Carcinoma, Papillary, Follicular/pathology ; Child ; Female ; Human ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Thyroid Neoplasms/*pathology ; Thyroid Nodule/*pathology ; Thyroidectomy ; Thyroiditis, Autoimmune/pathology

OBJECTIVES: Since 2013, the Students' Emotional and Behavioral Screening Test (SEBT) has been conducted annually for 1st grade and 4th grade elementary school students, 1st year middle school students, and 1st year high school students. The SEBT has been considered to have effectiveness and strength for screening high risk students who have a strong possibility of harboring emotional or behavioral problems in school. Therefore, in this study, we conducted an investigation into the awareness of the SEBT based on the rating score of the parents and teachers to determine its future direction and management. METHODS: A total of 731 parents and 149 teachers participated in this study. Each participant completed a self-administered questionnaire on their awareness of the SEBT. RESULTS: 428 (58.5%) parents and 99 (66.4%) teachers rated their overall satisfaction at more than 4 points out of a total of 5 points. The test reliability was rated at more than 4 points out of a total of 5 points by 52.1% of the parents (n=381) and 47.7% of the teachers (n=71). CONCLUSION: Both parents and teachers consider the SEBT to be highly satisfactory and reliable.
Humans ; Mass Screening* ; Mental Health ; Parents* ; Personal Satisfaction ; Problem Behavior ; Student Health Services ; Surveys and Questionnaires

PURPOSE: Many studies showed that the asthmatic children mostly have psychosocial problem such as depression or anxiety. The object of this study is to help the asthmatic children and their family by knowing what is their mothers' biggest concern about their asthmatic children. METHODS: We made up a questionnaire with asked the mothers by telephone. If they though asthma had a certain effect on their asthmatic children's activity, depression, anxiety, positiveness, scholastic achievement, friendship, pleasure, concentration, anger, growth and development. We asked the mothers whose children had visited the pediatric department in st. colomban's hospital from 1990 to 1996 and had been diagnosed and treated as asthma, and whose asthmatic children were between 7 and 21. RESULTS: More than half of the mothers who got a phone-call said that their children had problems in house life, school life, social life due to asthma and frequent asthmatic attack made their children less concentrated, inactive, less scholastic achieved, but there were few who said that asthma seemed to have an effect on their children's friendship, depression, pleasure. CONCLUSIONS: In the psychological aspect, the mothers may concern more if their children cannot keep up with the competitive social tendency closely related to concentration and scholastic achievement than if their children have some emotional disorder or behavial disorder such as depression and anxiety
Anger ; Anxiety ; Asthma ; Child* ; Depression ; Friends ; Growth and Development ; Humans ; Mothers ; Pleasure ; Surveys and Questionnaires ; Telephone

PURPOSE: Many studies showed that the asthmatic children mostly have psychosocial problem such as depression or anxiety. The object of this study is to help the asthmatic children and their family by knowing what is their mothers' biggest concern about their asthmatic children. METHODS: We made up a questionnaire with asked the mothers by telephone. If they though asthma had a certain effect on their asthmatic children's activity, depression, anxiety, positiveness, scholastic achievement, friendship, pleasure, concentration, anger, growth and development. We asked the mothers whose children had visited the pediatric department in st. colomban's hospital from 1990 to 1996 and had been diagnosed and treated as asthma, and whose asthmatic children were between 7 and 21. RESULTS: More than half of the mothers who got a phone-call said that their children had problems in house life, school life, social life due to asthma and frequent asthmatic attack made their children less concentrated, inactive, less scholastic achieved, but there were few who said that asthma seemed to have an effect on their children's friendship, depression, pleasure. CONCLUSIONS: In the psychological aspect, the mothers may concern more if their children cannot keep up with the competitive social tendency closely related to concentration and scholastic achievement than if their children have some emotional disorder or behavial disorder such as depression and anxiety
Anger ; Anxiety ; Asthma ; Child* ; Depression ; Friends ; Growth and Development ; Humans ; Mothers ; Pleasure ; Surveys and Questionnaires ; Telephone

We present a case of a 65-year-old man with psoriasis who developed autoimmune hepatitis (AIH) without receiving immunosuppressive therapy with either anti-tumor necrosis factor-α or methotrexate. The AIH had completely resolved at 2 months after prednisolone and azathioprine therapy. This case confirms the need to consider AIH in psoriasis patients who experience new elevations in liver enzymes. To our knowledge, this is first description of the development of AIH in an immunosuppressant-naïve patient with psoriasis.
Aged ; Azathioprine ; Hepatitis, Autoimmune* ; Humans ; Liver ; Methotrexate ; Necrosis ; Prednisolone ; Psoriasis*

No abstract available.
Sweet Syndrome*

Day-to-day insulin requirements often change due to subtle variations in insulin metabolism in patients with type 2 diabetes undergoing hemodialysis. In such cases, intra-hemodialysis hypoglycemia frequently occurs and is a main factor interfering with the delivery of dialysis. As a result, it reduces the quality of life in patients undergoing hemodialysis. The long-acting insulin analogue glargine provides peakless, continuous release over 24 h that approximates a normal basal insulin pattern. Because it has no peak, its use in patients with diabetes undergoing hemodialysis would hypothetically be useful. Specifically, patients would be able to avoid intra-hemodialysis hypoglycemia without the necessity of skipping insulin administration on the day of hemodialysis and achieving adequate glucose control on other days. We recently experienced six cases that switched from treatment with intermediate-acting insulin to a long-acting insulin analogue, which provided better glycemic control by reducing hypoglycemia risk. Limited data are available in the literature concerning insulin analogue usage in patients with diabetes undergoing hemodialysis. Our experience suggests a large-scale prospective investigation is required on this issue.
Dialysis ; Glucose ; Humans ; Hypoglycemia ; Insulin ; Insulin, Long-Acting ; Kidney Failure, Chronic ; Quality of Life ; Renal Dialysis ; Insulin Glargine

Cytomegalovirus (CMV) infection has been described in immunosuppressed individuals such as patients with AIDS, those receiving chemotherapy, and post-transplantation. CMV can cause severe disease either via reactivation of latent virus or via primary infection. In immunocompetent patients, CMV infection is usually transient and does not exhibit many symptoms. The colon is the site most frequently affected by severe CMV disease in immunocompetent patients. Clinically, CMV colitis commonly presents with diarrhea, fever, and abdominal pain. Although some patients recover spontaneously, others suffer from severe complications, such as bowel perforation, severe gastrointestinal bleeding and, rarely, stricture, and surgery is the choice of treatment in these patients. We report a case of stricture of the proximal transverse colon, presenting as a complication of CMV colitis, in an immunocompetent man with acute respiratory distress syndrome. We performed laparoscopic segmental resection of the proximal transverse colon.
Abdominal Pain ; Colitis ; Colon ; Colon, Transverse ; Constriction, Pathologic ; Cytomegalovirus ; Diarrhea ; Fever ; Hemorrhage ; Humans ; Immunocompetence ; Laparoscopy ; Respiratory Distress Syndrome, Adult ; Viruses