BACKGROUND AND OBJECTIVES: Respiratory symptoms are often observed in children with Kawasaki disease (KD) during the acute phase. The association of respiratory viruses in children with KD was investigated using multiplex reverse transcriptase-polymerase chain reaction (RT-PCR) and tissue Doppler echocardiography. SUBJECTS AND METHODS: 138 KD patients were included from January 2010 to June 2013. We compared 3 groups (group 1: n=94, KD without respiratory symptoms; group 2: n=44, KD with respiratory symptoms; and group 3: n=50, febrile patients with respiratory symptoms). Laboratory data were obtained from each patient including N-terminal pro-brain natriuretic peptide (NT-proBNP). Echocardiographic measurements were compared between group 1 and group 2. RT-PCR was performed using nasopharyngeal secretion to screen for the presence of 14 viruses in groups 2 and 3. RESULTS: The incidence of KD with respiratory symptoms was 31.8%. The duration of fever was significantly longer, and coronary artery diameter was larger in group 2 than in group 1. Tei index was significantly higher and coronary artery diameter larger in group 2 than group 1. Coronary artery diameter, C-reactive protein levels, platelet count, alanine aminotransferase levels, and NT-pro BNP levels were significantly higher and albumin levels lower in group 2 compared with group 3. CONCLUSION: NT-pro BNP was a valuable diagnostic tool in differentiating KD from other febrile viral respiratory infections. Some viruses were more frequently observed in KD patients than in febrile controls. Tei index using tissue Doppler imaging was increased in KD patients with respiratory symptoms.
Alanine Transaminase ; C-Reactive Protein ; Child ; Coronary Vessels ; Echocardiography ; Echocardiography, Doppler ; Fever ; Humans ; Incidence ; Mucocutaneous Lymph Node Syndrome* ; Natriuretic Peptide, Brain ; Platelet Count ; Respiratory Tract Infections ; Reverse Transcriptase Polymerase Chain Reaction

PURPOSE: Incomplete Kawasaki disease (KD) is frequently associated with delayed diagnosis and treatment. Delayed diagnosis leads to increasing risk of coronary artery aneurysm. Anterior uveitis is an important ocular sign of KD. The purpose of this study was to assess differences in laboratory findings, including echocardiographic measurements, clinical characteristics such as fever duration and treatment responses between KD patients with and those without uveitis. METHODS: We conducted a prospective study with 110 KD patients from January 2008 to June 2013. The study group (n=32, KD with uveitis) was compared with the control group (n=78, KD without uveitis). Laboratory data were obtained from each patient including complete blood count (CBC), erythrocyte sedimentation rate (ESR), platelet count, and level of alanine aminotransferase, aspartate aminotransferase, serum total protein, albumin, C-reactive protein (CRP), and N-terminal probrain natriuretic peptide (NT-pro BNP). Echocardiographic measurements and intravenous immunoglobulin responses were compared between the two groups. RESULTS: The incidence of uveitis was 29.0%. Neutrophil counts and patient age were higher in the uveitis group than in the control group. ESR and CRP level were slightly increased in the uveitis group compared with the control group, but the difference between the two groups was not significant. No significant differences in coronary arterial complication and treatment responses were observed between the two groups. CONCLUSION: Uveitis is an important ocular sign in the diagnosis of incomplete KD. It is significantly associated with patient age and neutrophil count.
Alanine Transaminase ; Aneurysm ; Aspartate Aminotransferases ; Blood Cell Count ; Blood Sedimentation ; C-Reactive Protein ; Coronary Vessels ; Delayed Diagnosis ; Diagnosis ; Early Diagnosis* ; Echocardiography ; Fever ; Humans ; Immunoglobulins ; Incidence ; Mucocutaneous Lymph Node Syndrome* ; Natriuretic Peptide, Brain ; Neutrophils ; Platelet Count ; Prospective Studies ; Uveitis* ; Uveitis, Anterior

No abstract available.

OBJECTIVE: It has been suggested that hysterectomy has a disturbing influence on bowel function, mainly constipation. We performed a prospective study to assess the changes of ano-rectal physiology after hysterectomy. METHODS: Fourteen consecutive patients were assessed before and two months after hysterectomy. A detail questionnaire was devised to allow assessment of bowel function and ano-rectal pressure test and balloon expulsion test were performed before and after hysterectomy. The parameters measured in ano-rectal pressure test included the minimal sensible volume, ano-rectal resting pressure, maximal squeezing pressure, recto-anal inhibitory reflex and balloon expulsion test. Data analysis was carried out by paired t-test. Statistical significance was inferred when the p value was<0.05. RESULTS: Among the fourteen patients, the straining in defecation was found in three patients after operation, other defication habits were not significantly changed after hysterectomy(P>0.05). There were no significant changes in ano-rectal pressure test after hysterectomy. The disturbance of balloon expulsion capacity was increased in four patients after hysterectomy(29%). CONCLUSION: Our results demonstrate that hysterectomy does not cause a decrease in ano-rectal pressure and rectal sensitivity, but has an adverse effect on rectal expulsion capacity in a some of patients.
Constipation ; Defecation ; Humans ; Hysterectomy* ; Physiology ; Prospective Studies ; Surveys and Questionnaire ; Reflex ; Statistics as Topic

BACKGROUND: In recent days, the prevalence of childhood metabolic syndrome (MS) has increased substantially due to the increasing rate of childhood obesity on a global scale. The aims of this study were to detect the important parameters and provide the screening system to prevent cardiovascular disease in adolescents with MS. METHODS: Ninety one male adolescents were divided into two groups based on the presence or absence of MS. Anthropometric measurement and laboratory study were studied. Intimal medial thickness and pulse wave velocity were estimated. Left ventricular mass index (LVMI), ejection fraction, myocardial velocity, strain and strain rate were measured by tissue Doppler imaging and strain rate imaging. RESULTS: The prevalence of MS was 7.7%. Weight, body mass index (BMI), waist circumference (WC), glucose, insulin, homeostasis model assessment of insulin resistance, triglyceride and LVMI were significantly increased in the MS group. High density lipoprotein-cholesterol (HDL-C), peak early diastolic myocardial velocity (e'), systolic myocardial velocity (s') and global longitudinal strain were significantly lower in the MS group. In univariant analysis, LVMI was significantly correlated with BMI, WC, fat %, fat mass, systolic blood pressure, alanine aminotransferase, total cholesterol (TC) and low density lipoprotein-cholesterol. e' was significantly correlated with BMI, fat %, fat mass, and HDL-C. Global circumferential strain had significant correlation with glucose and TC. Basal anterolateral strain rate was significantly correlated with weight, BMI, WC, fat %, and fat mass. CONCLUSION: LVMI, strain and strain rate are practical and accurate parameters for assessment of left ventricular function in adolescents with MS.
Adolescent* ; Alanine Transaminase ; Blood Pressure ; Body Weight ; Cardiovascular Diseases ; Cholesterol ; Glucose ; Homeostasis ; Humans ; Insulin ; Insulin Resistance ; Mass Screening* ; Pediatric Obesity ; Prevalence ; Pulse Wave Analysis ; Triglycerides ; Ventricular Function, Left ; Waist Circumference

BACKGROUND AND OBJECTIVES: Since statins and angiotensin receptor blockers are a frequently prescribed combination in patients with atherosclerotic cardiovascular diseases, we tested the interactive effects of simvastatin and losartan on atherosclerosis in apolipoprotein E (apoE)-/- mice. MATERIALS AND METHODS: Apolipoprotein E-/- mice were fed a high-fat, high-cholesterol (HFHC) diet for 12 weeks, with and without simvastatin (40 mg/kg) and/or losartan (20 mg/kg). The mice were divided into 5 groups and were fed as follows: regular chow (control diet, n=5), HFHC diet (n=6), HFHC diet with losartan (n=6), HFHC diet with simvastatin (n=6), and HFHC diet with both losartan and simvastatin (n=6). RESULTS: Losartan treatment in apoE-/- mice significantly decreased atherosclerotic lesion areas in whole aortic strips stained with Oil Red O. The plaque area measured at the aortic sinus level was reduced significantly by 17% (HFHC; 346830.9+/-52915.8 microm2 vs. HFHC plus losartan; 255965.3+/-74057.7 microm2, p<0.05) in the losartan-treated group. Simvastatin and simvastatin plus losartan treatments reduced macrophage infiltration into lesions by 33% (HFHC; 183575.6+/-43211.2 microm2 vs. HFHC plus simvastatin; 120556.0+/-39282.8 microm2, p<0.05) and 44% (HFHC; 183575.6+/-43211.2 microm2 vs. HFHC plus simvastatin and losartan; 103229.0+/-8473.3 microm2, p<0.001, respectively). In mice fed the HFHC diet alone, the smooth muscle cell layer in the aortic media was almost undetectable. In mice co-treated with losartan and simvastatin, the smooth muscle layer was more than 60% preserved (p<0.05). Given alone, losartan showed a slightly stronger effect than simvastatin; however, treatment with losartan plus simvastatin induced a greater inhibitory effect on atherosclerosis than either drug given alone. Serum lipid profiles did not differ significantly among the groups. CONCLUSION: Losartan displayed anti-atherosclerotic effects in apoE-/- mice that were equivalent to or greater than the effects of simvastatin. Combined treatment with these drugs had greater effect than either drug alone.
Angiotensin Receptor Antagonists ; Animals ; Apolipoproteins ; Atherosclerosis ; Azo Compounds ; Cardiovascular Diseases ; Diet ; Humans ; Losartan ; Macrophages ; Mice ; Mice, Knockout ; Models, Animal ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Simvastatin ; Sinus of Valsalva

The national licensing examination is used to evaluate the medical competency at the time of graduation, however no study has been performed on the validity of traditional Korean medicine license examination yet. The purpose of this study was to develop learning analytics using item response theory (IRT) to examine the validity and academic competency of the mock test of the national licensing exam. Classical test theory and IRT were used to evaluate the validity of test items, and IRT was used for test validity and competency analysis. The correlation between competency score of 12 subjects was analyzed using Pearson’s correlation. The distribution of students’ latent competencies was examined by gender and administrative group using a Kernel density map, Latent Profile Analysis, and χ2. The guessing parameter of 340 items was relatively high, and the information level of 12 subjects were relatively low. Significant correlations (r = 0.49–0.83, p < 0.05) were observed between the competency scores of total and 12 subjects. Two (high and low) latent academic competency groups were identified based on the competency score of 12 subjects. The low academic competency group requiring intensive management has a significantly higher frequency of male students with the experience of academic fail in the seven-year course. This study presented the quantitative learning analytics for the national licensing exam of traditional Korean medicine. The multifaceted item and test validities of the mock license test were provided, and an evidence-based approach to competency-based student management and national licensing exam of traditional Korean medicine was suggested.

Background: This study aimed to investigate the prevalence and management of diabetes mellitus, risk-factor control, and comorbidities among Korean adults. Methods: We conducted a cross-sectional analysis of data from the Korea National Health and Nutrition Examination Survey to assess the prevalence, treatment, risk factors, comorbidities, and self-management behaviors of diabetes mellitus from 2019 to 2020. We also analyzed data from the Korean National Health Insurance Service to evaluate the use of antidiabetic medications in people with diabetes mellitus from 2002 through 2018. Results: Among Korean adults aged 30 years or older, the estimated prevalence of diabetes mellitus was 16.7% in 2020. From 2019 through 2020, 65.8% of adults with diabetes mellitus were aware of the disease and treated with antidiabetic medications. The percentage of adults with diabetes mellitus who achieved glycosylated hemoglobin (HbA1c) <6.5% was 24.5% despite the increased use of new antidiabetic medications. We found that adults with diabetes mellitus who achieved all three goals of HbA1c <6.5%, blood pressure (BP) <140/85 mm Hg, and low-density lipoprotein cholesterol <100 mg/dL were 9.7%. The percentage of self-management behaviors was lower in men than women. Excess energy intake was observed in 16.7% of adults with diabetes mellitus. Conclusion The prevalence of diabetes mellitus among Korean adults remained high. Only 9.7% of adults with diabetes mellitus achieved all glycemic, BP, and lipid controls from 2019 to 2020. Continuous evaluation of national diabetes statistics and a national effort to increase awareness of diabetes mellitus and improve comprehensive diabetes care are needed.

Human placenta synthesizes bioactive corticotropin releasing factor(CRF), a 41 amino acid peptide, which displays identical immunological, biological, and chemical characteristics to hypothalamic CRF. Placental CRF enters the maternal circulation and stimulates release of local placental prostaglandin E2 and F2alpha that have a central role in the mechanisms controlling uterine contractility and cervical softening. A large number of clinical investigators has suggested that placental CRF may be involved in mechanisms leading to labor. As well as CRF`s rises in term pregnancy, maternal serum CRF levels are also elevated in pregnancies complicated by preterm labor. So the clinical use of maternal serum CRF levels as a predictor of preterm labor was proposed. Therefore, we have carried out a prospective study on the efficacy of maternal serum CRF levels in diagnosis of preterm labor. In this study, the subjects consisted of 30 women admitted for the treatment of preterm labor and another 30 women with normal pregnancies between 28 and 36 completed weeks of gestation, and their serum CRF levels were assessed. The results were as follows: 1. In both groups, serum CRF levels were increased as being associated to gestational ages, especially in late pregnancy. 2. In a comparative study between two groups, the serum CRF values of pregnancies complicated by preterm labor were significantly higher than their values of control group(p<0.05). 3. In pregnancies complicated by preterm labor, the serum CRF values of preterm delivery were not significantly elevated comparing with their values of other pregnancies complicated bypreterm labor(p>0.05).
Adrenocorticotropic Hormone* ; Corticotropin-Releasing Hormone* ; Diagnosis* ; Dinoprostone ; Female ; Gestational Age ; Humans ; Obstetric Labor, Premature* ; Placenta ; Pregnancy* ; Prospective Studies ; Research Personnel

OBJECTIVE: To evaluate the efficacy of concurrent chemoradiation (CCRT) using 5-flurouracil (5-FU) and cisplatin for locally advanced cervical cancer. METHODS: We reviewed the medical records of 57 patients with locally advanced cervical cancer (stage IIB-IVA and bulky IB2-IIA tumor) who underwent the CCRT at Dong-A University Hospital from January 1997 to June 2007. The CCRT consisted of 5-FU, cisplatin and pelvic radiation. Every three weeks, 75 mg/m(2) cisplatin was administered on the first day of each cycle and 5-FU was infused at the dose of 1,000 mg/m(2)/d from the second day to the fifth day of each cycle. Radiation was administered to the pelvis at a daily dose of 1.8 Gy for five days per week until a medium accumulated dose reached to 50.4 Gy. If necessary, the radiation field was extended to include paraaortic lymph nodes. Consolidation chemotherapy was performed using 5-FU and cisplatin. RESULTS: Fifty-seven patients were enrolled and the median follow-up duration was 53 months (range 7-120 months). The overall response rate was 91.5% (74% complete response and 17.5% partial response). The 5-year overall survival and 3-year progression free survival rates were 69.4% and 74.9%, respectively. During the follow-up period (median 23 months, range 7-60 months), fourteen patients were diagnosed as recurrent disease. CONCLUSION: CCRT with 5-FU and cisplatin which is the primary treatment for patients with locally advanced cervical cancer was effective and well tolerated.
Cisplatin ; Consolidation Chemotherapy ; Disease-Free Survival ; Fluorouracil ; Follow-Up Studies ; Humans ; Lymph Nodes ; Medical Records ; Pelvis ; Uterine Cervical Neoplasms