PURPOSE: The incidence of congenital hypothyroidism (CH) has increased in several countries. Lower cut-off in screening programs have led to an increase in the proportion of transient hypothyroidism (TH) cases diagnosed, leading to debate on the associated clinical and economic impact. This study aimed to identify factors that would allow discrimination between TH and permanent CH (PH) in patients with a eutopic thyroid gland. METHODS: Sixty-six patients with CH from 3 different hospitals were studied: 26 cases of TH, and 40 cases of PH. Laboratory findings and clinical parameters were analysed in 56 patients with eutopic thyroid gland. RESULTS: Initial serum thyroid stimulating hormone levels and L-thyroxine dose at 12 and 24 months of age were significantly higher in PH than TH patients with a eutopic thyroid gland. The area under the curve for the 12-month and 24-month dose for the prediction of TH in eutopic CH was 0.799 (95% confidence interval [CI], 0.678-0.919; P<0.001) and 0.925 (95% CI, 0.837-1.000; P<0.001), respectively. The optimum 12-month and 24-month dose in predicting TH is 3.25 microg/kg (12-month: sensitivity, 87.1%; specificity, 68.0%; 24-month: sensitivity 93.5%, specificity 88%). CONCLUSION: Infants with CH requiring lower L-thyroxine doses (<3.25 microg/kg) are likely to have TH, and thus might be re-evaluated at 12 months or 24 months rather than 3 years of age.
Congenital Hypothyroidism* ; Discrimination (Psychology) ; Humans ; Hydrogen-Ion Concentration ; Hypothyroidism ; Incidence ; Infant ; Mass Screening ; Thyroid Gland ; Thyrotropin ; Thyroxine*

BACKGROUND AND OBJECTIVE: Auro Dex(R) Visual ENS(TM) allergy screening test is a simplified and newly developed method for the detection of allergen-specific IgE in human serum. This system has advantages in several ways compared to the Pharmacia CAP system, such as the need for relatively small amounts of serum, no expensive equipment and rapid detection. The purpose of this study is to evaluate the efficiency of Auro Dex(R) Visual ENS(TM) screening test for the detection of specific IgE compared to the Pharmacia CAP system in atopic patients. METHOD: In 27 atopic patients (M:F = 11:16, age:13-51 years, average 27.9+/-10.2 years) who had positive response on skin prick test, the Pharmacia CAP system for the sensitized allergen and Auro Dex(R) Visual ENS(TM) screening test were performed. For comparison, 5 normal subjects who had negative response on skin prick test were tested for 5 allergens(Dermatophagoides(D) farinae, D. pteronyssinus, cockroach, dog epithelium, cat epithelium) by the Pharmacia CAP system and Auro Dex(R) Visual ENS(TM) screening test. RESULTS: Using skin prick test results as the reference standards, the sensitivity of the Pharmacia CAP system and Auro Dex(R) Visual ENS(TM) screening test was 87.5%, 57.1%, respectively. The specificity of Pharmacia CAP system and Auro Dex(R) Visual ENS(TM) screening test were 100%. There was a significant correlation between the Auro Dex(R) Visual ENS(TM) and CAP system (D.f. r=0.755, D.p. r=0.856) for D. farinae and D.pteronyssinus. CONCLUSION: Auro Dex(R) Visual ENS(TM) screening test showed high specificity for detection of allergen-specific IgE and good correlation with the Pharmacia CAP system. This system may be useful in general practice. However, due to relatively low sensitivity to some antigens compared to skin prick test, further development may be necessary.
Animals ; Cats ; Cockroaches ; Dogs ; Epithelium ; General Practice ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Mass Screening* ; Sensitivity and Specificity ; Skin

PURPOSE: This study reviewed articles related to breast cancer, cognitive function and chemotherapy available in 4 databases. METHODS: The researcher reviewed 32 pieces of literature that were published between January 2001 and November 2011. RESULTS: Within the last decade, several studies have investigated whether adjuvant treatment of breast cancer affects cognitive function. A number of prospective studies have reported inconsistent results regarding whether chemotherapy affects cognitive function. Approximately half of the studies reported subtle cognitive decline in a wide range of domains among some breast cancer patients following chemotherapy, and others did not. CONCLUSION: Breast cancer patients receiving adjuvant chemotherapy showed the most deterioration and the most persistent decline in cognitive function. Since cognitive impairment is subtle, if evident at all, discrepant findings are due to hormonal, physiological, psychological or temporal confounding variables and differences in study design. Especially, that chemotherapy may impair memory, executive function, attention and visuospatial function in women with breast cancer.
Breast ; Breast Neoplasms ; Chemotherapy, Adjuvant ; Cognition ; Confounding Factors (Epidemiology) ; Executive Function ; Female ; Humans ; Memory

PURPOSE: The use of a 12-week steroid regimen (long-term therapy, LT) for the first episode of idiopathic nephrotic syndrome (NS) reportedly induces a more sustained remission and lower relapse rate than previous regimens, including an 8-week steroid regimen (short-term therapy, ST). Here, we assessed the potential for selective application of 2 steroid regimens (LT vs. ST) based on the days to remission (early responders [ER] vs. late responders [LR]) for the first idiopathic NS episode in children. METHODS: Patients were divided into 4 subgroups (ST+ER, ST+LR, LT+ER, and LT+LR) according to the initial steroid regimen used and rapidity of response; the baseline characteristics, relapse rates, and cumulative percentage of children with sustained remission were then compared among the 4 subgroups. RESULTS: Fifty-four children received ST, and the remaining 45 children received LT. As observed in previous studies, children receiving LT showed significantly lower relapse rates during the first year after the first NS episode than those receiving ST. The ST+ER group showed significantly lower relapse rates during the first one year and two years after the first NS episode than the the ST+LR group, whereas there were no significant differences of the relapse rates and duration to the first relapse between the ST+ER and LT+ER groups. CONCLUSION: We suggest that the initial steroid regimen in idiopathic NS patients can be shortened according to the duration to remission i.e., LT in patients achieving remission after the first week of steroid therapy, and ST in those achieving remission within the first week of steroid therapy.
Child ; Humans ; Nephrotic Syndrome* ; Recurrence ; Steroids

Meckel's diverticulum is generally acknowledged to be the most prevalent congenital anomaly of the gastrointestinal tract. The preoperative diagnosis of Meckel's diverticulum is difficult, especially in neonates, because of the lesions ability to masquerade as one of a variety of much more common abdominal pathologies. Recently we experienced a case of perforated Meckel's diverticulum with mild inflammatory reaction, intestinal adhesion, and small bowel obstruction in a previous healthy 9-day-old neonate. The spontaneous perforation of Meckel's diverticulum in neonate is very rare but serious entity. The course was rapid and progressed to sepsis. So despite its varied presentation, Meckel's diverticulum should be kept in mind as a cause of acute abdomen in neonates.
Abdomen, Acute* ; Diagnosis ; Gastrointestinal Tract ; Humans ; Infant, Newborn* ; Intestinal Obstruction ; Meckel Diverticulum* ; Pathology ; Sepsis

The edentulous posterior maxilla generally provides a limited amount of bone height because of atrophy of the ridge and pneumatization of the maxillary sinus. Maxillary sinus augmentation is one of the surgical techniques for reconstruction of the severely resorbed posterior maxilla. The purpose of this study was to evaluate the survival rate of implants and the long-term changes of graft height after maxillary sinus augmentation by lateral window approach. From September 1996 to July 2004, maxillary sinus augmentation with mixed grafts of autograft, allograft, xenograft and alloplast were performed on 45 patients and 100 implants were placed. We evaluated the survival rate of implants and the changes of BL(bone length)/IL(implant length) according to time using panoramic radiographs. The survival rate of implants was 91.0% for follow-up period. The mean reduction of graft heights was 0.34mm(3.0%) for 6 months and 1.22mm(10.66%) for 3 years after augmentation. The total mean BL/IL was 1.34+/-0.21 during 5 year observation period after augmentation and decreased slightly over time. The result means that graft materials were stable above the implant apex. BL/ILs of 1 stage procedure were significantly decreased at 1-2 year, 3-4 year after augmentation and no statistically significant changes were observed in those of 2 stage procedure. The graft materials of both procedures were stable above the implant apex. No statistically significant changes of BL/IL were observed in the grafts combined with low amount of autogenous bone or without autogenous bone. The graft materials of both groups were stable above the implant apex. The results indicated that the placement of dental implants with maxillary sinus augmentation showed predictable clinical results and the grafts combined with low amount of autogenous bone or without autogenous bone had long-term resistance to resorption in maxillary sinus.
Allografts ; Atrophy ; Autografts ; Dental Implants* ; Follow-Up Studies ; Heterografts ; Humans ; Maxilla ; Maxillary Sinus* ; Survival Rate ; Transplants*

BACKGROUND: Rituximab (RTX) can be used as a rescue therapy for steroid-dependent nephrotic syndrome (SDNS). However, the efficacy and safety of long-term, repeated use of RTX are not established. This study was conducted to assess the efficacy and safety of long-term, repeated RTX treatment in children. METHODS: Eighteen consecutive child patients with SDNS who were treated with three or more cycles of RTX for one year or longer were recruited, and their medical records were retrospectively reviewed. RESULTS: The patients were followed for 4.7 ± 1.9 years and received 5.2 ± 2.3 cycles of RTX over 2.8 ± 1.1 years. Approximately 70% of the additional RTX cycles were administered due to recovery of B-cells without relapse. The relapse rate decreased from 3.4 ± 2.0 per year initially to 0.4 ± 0.8 per year at the third year after RTX treatment. Approximately 10% of the RTX infusions were accompanied by mild infusion reactions. Eight patients showed sustained remission without any oral medication after the last cycle of RTX, while 10 patients had one or more episodes of relapse after the last cycle of RTX. The relapse rate in the latter group decreased from 2.8 ± 1.5 per year before RTX treatment to 1.3 ± 0.8 per year after cessation of RTX treatment. No significant differences in clinical parameters were found between the two groups. CONCLUSION: This retrospective study showed that pre-emptive and long-term, repeated RTX treatment is relatively effective and safe in children with SDNS. However, well-designed prospective studies are needed to confirm these findings.
B-Lymphocytes ; Child ; Humans ; Medical Records ; Nephrotic Syndrome* ; Prospective Studies ; Recurrence ; Retrospective Studies ; Rituximab*

While nontuberculous mycobacterium (NTM) infections are recently on the rise, arthritis caused by NTM is hardly reported in Korea. NTM arthritis has no distinctive clinical characteristics from chronic arthritis. Tuberculosis of the joint specifically produces similar clinical and pathologic presentations to NTM arthritis, so it is not easy to distinguish between them. We report a case of Mycobacterium intracellulare in an arthritis patient after trauma and surgical repair of the injury. At the beginning, the patient was diagnosed as tuberculous tenosynovitis through pathology without microbiologic evidence. The final diagnosis was made after subsequent recurrences for several years. The misdiagnosis and delayed diagnosis led to irreversible joint destruction and functional impairment. NTM infection must be included in the differential diagnosis of chronic arthritis at the outset.
Arthritis ; Delayed Diagnosis ; Diagnosis, Differential ; Diagnostic Errors ; Humans ; Joints ; Korea ; Mycobacterium ; Mycobacterium avium Complex ; Mycobacterium avium-intracellulare Infection ; Nontuberculous Mycobacteria ; Recurrence ; Tenosynovitis ; Tuberculosis

BACKGROUND: The serum total cholesterol is supposed to be increased as dietary pattern is Westernized recently in our country. We studied the longitudinal change of serum total cholesterol levels in normal Korean adult male workers and analyzed the influence of age, weight, blood pressure, fasting blood sugar, lifestyle (exercise, smoking, alcohol drinking habits) on change of serum total cholesterol levels. METHODS: The 6279 healthy adult male workers were studied during recent 10 Years (1992 and 2002). Those who suffered from hypertension, diabetes mellitus, ischemic heart disease, nephropathy, thyroid disease were excluded. Those who took antilipidemic drugs were also excluded. Blood sampling for serum total cholesterol and sugar was done after overnight fasting for more than 12 hours. Data on lifestyle were obtained using self administered questionnaires. RESULT: The serum total cholesterol levels had increased by 23.2 +/- 23.60 mg/dL (2.32 mg/dL per year) between 1992 and 2002 surveys. The increment of serum total cholesterol levels was most prominent in twenties (3.30 mg/dL per year) during 10 years and less prominent in thirties (2.80 mg/dL per year), forties (2.19 mg/dL per year) and fifties (1.55 mg/dL per year). The change of body mass index (BMI) was most significantly correlated with that of serum total cholesterol level (r=0.290, p=0.0001) (r2=0.084, p=0.0001). The change of serum total cholesterol levels was also significantly correlated with age, diastolic blood pressure change, fasting blood sugar change, exercise and smoking habits. However, it was not significantly correlated with the alcohol drinking habits among influencing variables. CONCLUSION: The serum total cholesterol levels were increased by 23.2 +/- 23.60 mg/dL (2.32 mg/dL per year) during recent 10 years. The increment of serum total cholesterol levels was most prominent in younger age group. The change of serum total cholesterol levels was most significantly correlated with that of body mass index (BMI) among influencing variables.
Adult* ; Aging ; Alcohol Drinking ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cholesterol* ; Diabetes Mellitus ; Fasting ; Follow-Up Studies* ; Gyeongsangbuk-do* ; Humans ; Hypertension ; Life Style ; Longitudinal Studies ; Male* ; Myocardial Ischemia ; Smoke ; Smoking ; Thyroid Diseases ; Surveys and Questionnaires

Gliotoxin, a fungal metabolite, is one of the epipolythiodioxopiperazine classes and has a variety of effects including imrnunomodulatory and apoptotic agents. This study is designed to evaluate the effect of zinc on gliotoxin-induced death of HL-60 cells. Here, we demonstrated that treatment of gliotoxin decreased cell viability in a dose and time-dependent manner. Gliotoxin-induced cell death was confirtned as apoptosis characterized by chromatin marginafion, fragmentation and ladder-pattern digestion of genomic DNA. Gliotoxin increased the proteolytic activities of caspase 3, 6, 8, and 9. Caspase-3 activation was further confirmed by the degradation of procaspase-3 and PARP in gliotoxin-treated HL-60 cells. Zinc compounds including ZnC12 and ZnSO4 markedly inhibited gliotoxin-induced apoptosis in HL-60 cells (from 30% to 90%). Consistent with anti- apoptotic effects, zinc also suppressed the enzymatic activities of caspase-3 and -9 proteases. In addition, cleavage of both PARP and procaspase 3 in gliotoxin-treated HL-60 cells was inhibited by the addition of zinc compounds. We further demonstrated that expression of Fas ligand by gliotoxin was suppressed by zinc compounds. These data suggest that zinc may prevent gliotoxin- induced apoptosis via inhibition of Fas ligand expression as well as suppression of caspase family cysteine proteases-3 and -9 in HL-60 cells.
Apoptosis* ; Caspase 3 ; Cell Death ; Cell Survival ; Chromatin ; Cysteine ; Digestion ; DNA ; Fas Ligand Protein ; Gliotoxin* ; HL-60 Cells ; Humans ; Peptide Hydrolases ; Zinc Compounds ; Zinc*