Purpura fuIminans is a rare form of nonthrombocytapenic purpura characterized by sudden onset, fever, prostration, anemia and symmetrical massive ecchymoses, usually of the lower extremities, and hypotension associated with disseminated intravascular coagulation (DIC). A 18 years old female patieat with characteristic clinical manifestations of purpura fulminans was seen at the department of Dermatology, St. Pauls Hospital. With intensive systemic corticasteroid and heparin treatmemts, the ecchymoses and necrosis began to heal, leaving multiple, thick esehar formation from 8th day, Although purpura fulminana has been known to attack mainly children, this case was of adolescent age.
Adolescent ; Anemia ; Child ; Dermatology ; Disseminated Intravascular Coagulation ; Ecchymosis ; Female ; Fever ; Heparin ; Humans ; Hypotension ; Lower Extremity ; Necrosis ; Purpura Fulminans* ; Purpura*

The objectives of this study were to conduct preliminary research to investigate full course meals in Korean style restaurants in order: i) to analyze the nutrient contents of full course meals per servings, and ii) by analyzing the above, to examine the amount and the quality of the foods served in the full course meals by two different types of Korean style restaurants. A total of 27 restaurants participated in this study, 7 restaurants from the luxurious hotels in Seoul and 20 restaurants from the City of Changwon. A key finding was that restaurant patrons tended to overconsume nutrients as compared to the Korean Recommended Daily Allowance (RDA), and restaurants generated large amounts of food wastes due to the excess food served. Other findings were as follows: 1) Compared with 1/3 or the Korean RDA, all the nutrients were oversupplied. The average nutrient ratios were about 3.7 times higher than 113 of the Korean RDA in calories, about 9 times higher in proteins, 10 times higher in phosphorus, 7 times higher in Vitamin Bl, and 12 times higher in Vitamin E. 2) Seventy-five percent (n = 20) of the restaurants served within the range of thirty to forty dishes, whereas most of the hotel restaurants (70%) served twenty dishes or fewer. 3) The average carbohydrate: protein: fat (CPF) ratio of caloric nutrients was 40:26:34. This study concluded that: i) Korean style full course meals provide too much food, nutrients, and calories, resulting in an over- or unbalanced nutrient intake, and ii) the Korean style full course meals consisted of a high-protein, high-fat and high-caloric intake, which is similar to a westernized caloric nutrient pattern. Such over -or unbalanced nutrient intake could cause chronic degenerative problems such as cancer and cardiovascular disease. These findings indicate that restaurants serving Korean style full course meals should carefully plan their menus in order to provide their customers with balanced meals. They should also be strongly encouraged to play an active role in improving their customers' nutritional status, as well as reducing the restaurants wastage of food. Lastly, further research should be conducted to improve the quality of the menus in Korean restaurants.
Cardiovascular Diseases ; Gyeongsangnam-do* ; Meals* ; Nutritional Status ; Phosphorus ; Recommended Dietary Allowances ; Restaurants* ; Seoul* ; Vitamin E ; Vitamins

PURPOSE: Bacterial infection with Staphylococcus aureus is a common complication of atopic dermatitis (AD) and involved in the worsening of this disease. Recent studies have revealed an increasing prevalence of community-associated methicillin-resistant S. aureus (MRSA) among patients with AD and the role of vitamin D in the immunopathogenesis of AD. We carried out a study to see whether levels of vitamin D correlate with MRSA skin colonization in AD. METHODS: Total 60 patients with AD aged between 3 months and 6 years old were enrolled. We measured disease severity using the Scoring Atopic Dermatitis (SCORAD) index, serum levels of 25-hydroxyvitamin D (25(OH)D), total immunoglobulin E levels, eosinophil cationic protein and bacterial colonization by skin swab and culture method. RESULTS: S. aureus was cultured in 20 patients of the total (33.3%). MRSA was comprised 35% of the S. aureus-positive group. SCORAD value was significantly higher in S. aureus-positive group. Serum levels (mean+/-standard deviation) of 25(OH)D were lower in MRSA group (22.6+/-11.5 ng/mL) compared with those of methicillin-sensitive S. aureus group (31.3+/-10.2 ng/mL) or S. aureus negative group (34.3+/-15.8 ng/mL). But there was no statistically significant difference. CONCLUSION: Our study shows that the serum levels of 25(OH)D were lower in MRSA group. But there was no statistically significant difference. Therefore further studies including large numbers of cases are necessary.
Aged ; Bacterial Infections ; Colon ; Dermatitis, Atopic ; Eosinophil Cationic Protein ; Humans ; Immunoglobulin E ; Immunoglobulins ; Methicillin ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Prevalence ; Skin ; Staphylococcus ; Staphylococcus aureus ; Vitamin D

Cancer and ischemic stroke (IS) are leading causes of death and disability, worldwide. It is reported that cancer increases IS incidence with various unknown mechanism. We retrospectively reviewed medical records of single tertiary medical center between January 2012 and December 2016. A total of 40,047 patients with cancer were analyzed and 63 patients (0.16%) were diagnosed of IS with underlying cancer. Lung (27.0%), gastric (14.3%) and colorectal (12.7%) cancers were the most frequent types of cancers and adenocarcinoma was the most common histologic type. We compared the clinical variables (demographic data, comorbidities, cancer stage, infarction pattern and severity) between adenocarcinoma and non-adenocarcinoma groups. And the results showed low coexistence of dyslipidemia and smoking history, and higher rate of multiple vascular territory infarct in adenocarcinoma group (p < 0.05). Six-month post stroke mortality rate was 34.6% and systemic metastasis and multi-territorial infarction were significantly relevant with the six-month mortality (p < 0.001). Also, initial National Institute of Health Stroke Scale (p < 0.05) and modified Rankin Scale scores were statistically significantly worse in mortality group (p < 0.05). In conclusion, the most frequent cancer type was lung cancer and adenocarcinoma the most common histologic type. Mortality at 6-month post stroke was high, and it was associated with stage of cancer and initial neurological severity.
Adenocarcinoma ; Cause of Death ; Comorbidity ; Dyslipidemias ; Humans ; Incidence ; Infarction ; Lung ; Lung Neoplasms ; Medical Records ; Mortality ; Neoplasm Metastasis ; Retrospective Studies ; Smoke ; Smoking ; Stroke

PURPOSE: To investigate the applicability of the new three-dimensional overlapped reconstruction MR angiography (3-D ORMRA) technique in patients with hemifacial spasm and to compare the new 3-D reconstruction images with conventional MRA source images. MATERIALS AND METHODS: The study group comprised 27 patients with surgically proven hemifacial spasm. In all patients, conventional MRA source images and 3-D fast imaging employing steady-state acquisition (FIESTA) images were obtained prospectively. After 3-D MR angiographic images were obtained, the 3-D MRA and FIESTA images were overlapped at the workstation by using GE A/W 4.2 add/sub software. We analyzed the relationship between the offending vessels and root exit zone of the facial nerve using both 3-D ORMRA images and conventional MRA source images. RESULTS: In 25 of 27 patients, the offending vessel at the REZ of the facial nerve could be correctly identified on conventional MRA source images. In all patients, the presumed offending vessels depicted by the overlapped 3-D reconstruction MRA image corresponded well with the intraoperative findings. The 3-D reconstruction image showed more clear visualization of the spatial relationship between the offending vessels and the root exit zone of the facial nerve. CONCLUSION: The overlapped 3-D reconstruction MR angiography technique is very useful and informative in patients with hemifacial spasm, as compared with conventional MRA angiography technique.
Angiography ; Facial Nerve ; Hemifacial Spasm* ; Humans ; Prospective Studies

PURPOSE: To evaluate a therapeutic efficacy of probiotics mixture (probiotics) in the treatment of children with mild-to-moderate atopic dermatitis (AD). METHODS: Randomized, double-blind, placebo-controlled, parallel trial with a washout period of 2 weeks and an intervention period for 6 weeks, conducted from November 2010 to October 2011. One hundred children with mild to moderate AD (2-9 years old) were randomly allocated to the probiotics (Lactobacilluss casei, Lactobacillus rhamnosus, Lactobacillus plantarum, and Bifidobacterium lactis) or placebo groups. The assessment of efficacy was based on the change in eczema area severity index (EASI), visual analogue scale for pruritus (VASP), fecal cell counts of each strains (log10[cell counts/g stool]), and serum cytokine levels (Interleukin-4 [IL-4]; IL-10; Tumor necrosis factor alpha, [TNF-alpha]) in weeks 0 and 6. RESULTS: Demographics and baseline characteristics at the week 0 were not significantly different between the 2 groups. The significant increments in fecal-cell counts were observed in the probiotcs group at week 6 (P=0.00), while the cytokine levels between the 2 groups were not significantly different in week 6 (IL-4, P=0.50; IL-10, P=0.58; TNF-alpha, P=0.82). The probiotics significantly improved clinical severity after 6 weeks' intervention of probiotics; however, the placebo group also showed significant improvement (EASI; P=0.00, VASP; P=0.00). CONCLUSIONS: Our findings showed that probiotics successfully colonized in the intestine after 6 weeks' intervention; nevertheless, we could not find an additional therapeutic or immunomodulatory effects on the treatment of AD. Further long-term studies will be necessary to clarify the therapeutic efficacy of probiotics.
Bifidobacterium ; Cell Count ; Child* ; Colon ; Cytokines ; Demography ; Dermatitis, Atopic* ; Eczema ; Humans ; Interleukin-10 ; Intestines ; Lactobacillus plantarum ; Lactobacillus rhamnosus ; Probiotics* ; Pruritus ; Tumor Necrosis Factor-alpha

PURPOSE: To evaluate clinical characteristics of ileal neobladder as orthotopic bladder substitution, we examined the urodynamic characteristics, clinical symptoms and radiologic findings of 11 patients who had undergone ileal nobladder substitution following cystectomy or cystoprostatectomy. MATERIALS AND METHOD: From February 1993 to July 1996, 11 patients underwent lower urinary tract reconstruction with ileal neobladder. Cystectomy or cystoprostatectomy was done, and reservoirs were connected to the proximal urethra or urethrovesical junction. Urodynamic and radiologic studies were performed to evaluate neobladder function and upper tract. Clinical symptoms were evaluated via a detailed patient questionaire. RESULTS: Mean cystometric capacity was 434m1(293-640m1). All patients voided by Valsalva maneuver and achieved good peak flow rates(mean value was 22.6m1/sec). Of the patients 10 emptied bladder to near completion with a mean post-void residual of 30m1, while 1 had post-void residuals of 110m1 The neobladder demonstrated good compliance for the storage of urine Phasic neobladder contractions were present during filling cystometrography. While the number of phasic contractions increased at higher neobladder volumes, the mean length and mean pressure of phasic contractions were not Increased a higher neobladder volumes. Daytime continence was obtained in all patients(100%), while nighttime continence was achieved in 8 patients (73%). Of these 8 nighttime continent patients, 4 patients(50%) had to void at least once a night to keep dry. No difference was found in any urodynamic parameter between nighttime continent and incontinent patients. There was no difference in any important urodynamic parameter between patients who had and had not received post-operative chemotherapy. Renal function, based on serum creatinine levels, had remained stable and no significant electrolyte or acid-base imbalance was found in all patients. Voiding cystourethrograms obtained in 9 patients revealed 3 patients(33%) had grades ll-lll/V reflux IVP in 9 patients revealed hydronephrosis in 1/18(5.5%) of renal units. CONCLUSIONS: Neobladder constructed from detubularized ileum achieves adequate capacity at low pressures with a satisfactory continence rate. We conclude that neobladder may be the best choice of urinary diversion after cystectomy in the aspect of quality of life.
Acid-Base Imbalance ; Compliance ; Creatinine ; Cystectomy ; Drug Therapy ; Humans ; Hydronephrosis ; Ileum ; Quality of Life ; Urethra ; Urinary Bladder ; Urinary Diversion ; Urinary Tract ; Urodynamics ; Valsalva Maneuver

PURPOSE: Gastro-esophageal reflux (GER), particularly non-acid reflux, is common in infants and is a known cause of chronic respiratory symptoms in infancy. Recent guidelines recommended empirical acid suppression therapy and the head-up position in patients with suspected GER. However, the efficacy of the upright position in relieving GER and reflux-related respiratory symptoms in infants is unclear. We conducted this study to investigate the efficacy of the upright position on GER and reflux-related respiratory symptoms in infants with chronic respiratory symptoms. METHODS: Thirty-two infants (21 male; median age, 5 months; range, 0 to 19 months) with unexplained chronic respiratory symptoms underwent multi-channel intraluminal esophageal impedance and pH monitoring. We retrospectively compared the frequencies of GER and reflux-related symptoms according to body position. RESULTS: A mean of 3.30 episodes of reflux per hour was detected. Overall, refluxes were more frequent during the postprandial period than the emptying period (3.77 vs. 2.79 episodes/hour, respectively; P=0.01). Although there was no significant difference in the total refluxes per hour between the upright and recumbent positions (6.12 vs. 3.77 episodes, P=0.10), reflux-related respiratory symptoms per reflux were significantly fewer in infants kept in an upright position than in a recumbent position during the postprandial period (3.07% vs. 14.75%, P=0.016). Non-acid reflux was the predominant type of reflux in infants, regardless of body position or meal time. CONCLUSIONS: The upright position may reduce reflux-related respiratory symptoms, rather than reflux frequency. Thus, it may be a useful non-pharmacological treatment for infantile GER disease resistant to acid suppressants.
Electric Impedance ; Esophageal pH Monitoring ; Gastroesophageal Reflux ; Humans ; Hydrogen-Ion Concentration ; Infant ; Meals ; Postprandial Period ; Retrospective Studies

PURPOSE: The aim of this study was to evaluate the details of the clinical characteristics and food exposure types at the first symptom onset in immediate-type cow's milk allergy (CMA) and egg white allergy (EWA) in Korean children. METHODS: This study included children with immediate-type CMA (n=288) or EWA (n=233) with symptom onset time of 2 hours or less, who visited Samsung Medical Center, Ajou University Hospital, and Soonchunhyang University Seoul Hospital between September 2014 and August 2015. The details of clinical features and food exposure types at the first symptom onset were evaluated by retrospective medical record review using a standardized case report form. RESULTS: The median ages of first symptom onset were 10 months in CMA and 12 months in EWA. The most common types of exposure at the first symptom in CMA were formula milk (29.5%) and milk (29.5%), followed by cheese (17.7%) and yogurt (14.2%). The most common type of exposure in EWA was boiled eggs (35.6%), followed by rice/porridge/soup containing eggs (27.5%), pan-fried eggs (17.6%), and baked goods (9.9%). Cutaneous symptoms were most common in both CMA and EWA, and anaphylaxis was noticed in 36.1% and 30.3%, respectively. Baked goods containing milk or eggs also induced anaphylaxis. The symptom onset time was less than 30 minutes in the majority of patients and the most common place of occurrence was home in both CMA and EWA. CONCLUSION: This study provides comprehensive information on CMA and EWA, and therefore helps clinicians diagnose and guide appropriate food restriction in children with CMA and EWA.
Anaphylaxis ; Cheese ; Child* ; Egg Hypersensitivity ; Egg White* ; Eggs ; Humans ; Hypersensitivity* ; Hypersensitivity, Immediate ; Medical Records ; Milk Hypersensitivity ; Milk* ; Ovum* ; Retrospective Studies ; Seoul ; Yogurt

BACKGROUND/AIMS: The use of unproven complementary/alternative medicine (CAM) to treat allergies is popular in Korea. We conducted a multicenter survey of the current use of CAM other than herbal medication in Korean allergy patients. METHODS: This study enrolled 510 adults with allergic diseases, including asthma, allergic rhinitis, atopic dermatitis, and chronic urticaria, from ten hospitals. They underwent a structured questionnaire interview and clinical assessment of the prevalence, motivation, costs, and subjective assessment of CAM. RESULTS: Of the patients, 16.7% used at least one type of CAM to treat their allergic diseases. Common types of CAM were diet (48.6%), aroma therapy (23.8%), massage (14.3%), breathing exercises (7.6%), baths (5.7%), and mind control (5.7%). The therapeutic effects of CAM included "improved" in patients using mind control (50%), diet (50%), breathing exercises (75%), and baths (33.3%), but "worse" in patients using aroma therapy (28%), and massage (26.7%). About 36.4% of the patients used CAM more than four times per year, and the average cost per CAM user was 370,000 won/year. The main reason for trying CAM was 'hope to improve my constitution'. CONCLUSIONS: CAM is used widely for treating allergic diseases in Korea. Detailed knowledge of CAM and patient education are important. Further studies of the clinical efficacy of CAM are needed.
Adult ; Aromatherapy ; Asthma ; Baths ; Breathing Exercises ; Complementary Therapies ; Dermatitis, Atopic ; Diet ; Humans ; Hypersensitivity ; Korea ; Massage ; Motivation ; Patient Education as Topic ; Prevalence ; Rhinitis ; Rhinitis, Allergic, Perennial ; Urticaria ; Surveys and Questionnaires