PURPOSE: Many diagnostic modalities have been used for diagnosis of gastroesophageal reflux disease (GERD). Feeding materials during esophageal pH monitoring may interfere the result of examination and esophageal pH monitoring can not diagnose GER in case of alkaline reflux. The purpose of our study is to evaluate whether scintigraphy can substitiute 24 hr pH monitoring in children with GERD. METHODS: From March 2002 to June 2003, 23 patients (12 boys and 11 girls, mean age 27 months) who have been admitted to Hanyang University Hospital presented with GER symptoms (recurrent vomiting, cough, chest pain, irritability) were included in the study. Scintigraphy and 24 hr pH monitoring were performed in all patients. RESULTS: Six out of the 23 patients (26.1%) had evidence of GER on 24 hr pH monitoring, whereas nine of 23 patients (39.2%) exhibited GER by scintigraphy. Two out of the 23 patients could not be tested because of irritability. Three (14.3%) patients had evidence of GER on both 24 hr pH monitoring and scintigraphy, three (14.3%) patients on only 24 hr pH monitoring, six (28.6%) patients on only scintigraphy, and nine (42.9%) patients had no evidence of GER on both methods. No correlation was observed between 24 hr pH monitoring and scintigraphic results by Fisher's exact test (p=0.523) or Kendal's tau (t=0.678). CONCLUSION: The results of this study demonstrated that there was no correlation between 24 hr pH monitoring and scintigraphy. Therefore these modalities could be used as complementary tests to diagnose GERD.
Chest Pain ; Child* ; Cough ; Diagnosis ; Esophageal pH Monitoring ; Female ; Gastroesophageal Reflux* ; Humans ; Hydrogen-Ion Concentration* ; Radionuclide Imaging ; Vomiting

Centronuclear myopathy is a rare congenital myopathy, which is characterized by centrally located nuclei and hypotrophy or predominance of type 1 fibers in muscle pathology. It is classified into three forms according to the clinical features and inheritance pattern: the X-linked recessive, the autosomal recessive, and the autosomal dominant forms. We report a case of a patient with generalized muscle weakness, poor muscle bulk, and dysmorphic features who was diagnosed as centronuclear myopathy.
Humans ; Inheritance Patterns ; Muscle Weakness ; Muscular Diseases ; Myopathies, Structural, Congenital* ; Pathology

Congenital laryngeal atresia is a rare cause of airway obstruction that is almost always lethal within a few minutes after birth. Therefore congenital laryngeal atresia should be diagnosed in the prenatal period. If not, it should be considered in newborn infant with life-threatening symptoms at birth such as cyanosis and dyspnea that need emergent procedures like a tracheotomy. We report a case of congenital laryngeal atresia with single umbilical artery diagnosed in a one-day-old neonate who required a tracheotomy and ventilator care after intubation failure.
Airway Obstruction ; Cyanosis ; Dyspnea ; Humans ; Infant, Newborn ; Intubation ; Parturition ; Single Umbilical Artery* ; Tracheotomy* ; Ventilators, Mechanical

In diabetic patients who were being treated with hemodialysis, coma and other neurological deficits did not occur in spite of extremely elevated serum glucose levels. In this report, we compared diabetic patients with renal failure in severe hyperglycemia with nonketotic hyperosmolar coma patients with normal renal function to know what affect mental changes. Mental changes were not present in diabetic patients with renal failure. These patients with renal failure showed more severe hyperglycemia, but corrected serum sodium concentration and calculated effective serum osmolality were low. So it is suggested that corrected serum sodium concentration and effective serum osmolality are more important factor affecting mental changes than high blood glucose levels in diabetic patients with renal failure, due to absence of osmotic diuresis.
Blood Glucose ; Coma ; Diuresis ; Humans ; Hyperglycemia* ; Osmolar Concentration ; Renal Dialysis ; Renal Insufficiency* ; Sodium

Vascular ectasia is a well-known cause of lower gastrointestinal bleeding in the elderly. Endoscopically, it usually appears as a flat or elevated bright red lesion. We report on an extremely rare case of a large, pedunculated, polypoid vascular ectasia in an asymptomatic patient. A large pedunculated polypoid mass in the sigmoid colon was observed on colonoscopy during a regular health check-up, and a polypectomy was performed using a detachable snare. In histology, vessels with massive dilation were found mainly in the submucosa, which was consistent with vascular ectasia.
Aged ; Colon, Sigmoid ; Colonoscopy ; Dilatation, Pathologic ; Hemorrhage ; Humans ; SNARE Proteins

Dendritic cells (DCs), which are regarded as the most potent antigen-presenting cells, are involved in innate and adaptive immunity. Upon uptake of pathogens, DCs express cell surface markers and secrete cytokines. In this study, we analyzed production of cytokines and found that interleukin (IL)-10 and transforming growth factor (TGF)-beta production significantly increased in bone marrow-derived DCs and a mouse DC line, DC2.4, after treatment with crude antigen (CA) from liver fluke, Clonorchis sinensis. However, expression patterns of several activation molecules did not change. In addition, following treatment of DC2.4 cells with antigen from the lung fluke, Paragonimus westermani, production of IL-10 and TGF-beta significantly increased compared with groups treated with other parasite antigens, Spirometra erinacei plerocercoid CA and Echinococcus granulosus hydatid cystic fluid. We also found that treatment of DC2.4 cells with C. sinensis CA resulted in rapid and significant phosphorylation of extracellular signal-regulated kinase 1/2, a mitogen-activated protein kinase. Following treatment of DC2.4 cells with C. sinensis CA, treatment with an inhibitor specific to an extracellular signal-regulated kinase inhibited production of IL-10 and TGF-beta. Our results suggest that CA from C. sinensis has a role in the anti-inflammatory function of DC cells by inducing IL-10 and TGF-beta through activation of extracellular signal-regulated kinase 1/2.
Animals ; Antigens, Helminth/*pharmacology ; Cells, Cultured ; Clonorchis sinensis/*immunology ; Dendritic Cells/drug effects/*metabolism ; Interleukin-10/genetics/*metabolism ; MAP Kinase Signaling System ; Mice ; Transforming Growth Factor beta/genetics/*metabolism

PURPOSE: Efonidipine, which inhibits both T- and L-type calcium channels, has been shown to be effective in reducing proteinuria and preserve renal function. This study was conducted to compare the effects of efonidipine versus amlodipine on the management of hypertension and proteinuria in patients with chronic kidney disease (CKD) receiving ACE inhibitors or ARB. METHODS: This study included 41 CKD patients who were at stages 2-4 and had a urine spot protein/ creatinine ratio of >0.5. Patients were administered amlodipine (5 mg/day) and efonidipine (40 mg/ day) for 3 months in a cross-over design. Blood pressure and spot urine protein/creatinine ratio were compared before and after the cross-over treatment. RESULTS: There were 24 male patients and 17 female patients. The mean age of the patients was 55.9+/-12.9 years. When the patients' medication was changed to eponidifine, we obtained the following results. First, there were no significant changes in blood pressure and serum creatinine. Second, the urine spot protein/creatinine ratio was significantly decreased (before the cross-over, 2.9+/-2.6; after the cross-over, 2.3+/-1.9 g/g; p=0.02). Finally, the reduction rate of proteinuria was significantly higher in patients with CKD at stages 2-3 than in those with CKD at stage 4 after the cross-over (stage 2, - 26.1%; stage 3, -17%; stage 4, +12.8%; p=0.03). CONCLUSION: It is concluded that efonidipine may significantly decrease proteinuria compared with amlodipine in CKD patients receiving ACE inhibitors or ARB. Further double-blind clinical trials with a larger sample size are needed to confirm our results.
Amlodipine ; Angiotensin-Converting Enzyme Inhibitors ; Blood Pressure ; Calcium Channels, L-Type ; Creatinine ; Cross-Over Studies ; Dihydropyridines ; Female ; Humans ; Hypertension ; Male ; Nitrophenols ; Organophosphorus Compounds ; Proteinuria ; Renal Insufficiency, Chronic ; Sample Size

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the major pathogens of nosocomial infections. Especially in intensive care units (ICUs) and nasal carriage of Staphylococcus aureus has been known as a major risk factor of staphylococcal infections. In Korea, MRSA is the most common pathogen of nosocomial infections in ICUs. We performed this study to investigate the effects of conventional control measures and the additional effect of intranasal fusidic acid in prevention of MRSA nasal carriage and infection in ICUs of one educational hospital in Korea. METHOD: All patients admitted to medical ICU and surgical ICU in Samsung medical center from April to September 1999 were studied prospectively. Surveillance culture was done in all patients and health care workers by nasal swab culture. We tried to control MRSA infection by conventional methods in the first period April-June 1999) and by additional intranasal fusidic acid application in the second period (July-September 1999) RESULTS: Comparing the first with second periods, new nasal MRSA colonization rate among patients was significantly decreased from 14.8% to 1.8% in surgical ICU (P=0.016). Although there was no statistical difference between the first and second periods in medical ICU (14.6% vs 5.9%, P=0.192), the new nasal colonization of the first period was significantly decreased than that of the previous study which was performed in 1996 (14.6% vs 36.2%, P=0.015). And new MRSA infection rate was much more decreased than the previous study, but there was no statistical significance (11.7% vs 2.0%, P=0.066). CONCLUSION: Conventional methods for MRSA control decreased new MRSA nasal colonization of patients in ICUs. Application of intranasal fusidic acid was considered as an additional control measure for reducing MRSA nasal colonization. For evaluating effect of intranasal fusidic acid for preventing of MRSA infection in ICUs, further study with larger scale of study population is warranted.
Colon ; Cross Infection ; Delivery of Health Care ; Furosemide* ; Fusidic Acid* ; Humans ; Intensive Care Units ; Korea ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Prospective Studies ; Risk Factors ; Staphylococcal Infections ; Staphylococcus aureus

Eosinophilic cholecystitis is a rare condition of cholecystitis which was first described by the Albot in 1949. We describe a case of eosinophilic cholecystitis associated with Clonorchis sinensis. A 42-year-old woman presented with a classic history of acute cholecystitis and a peripheral eosinophilia of 56% without an allergic history. An abdominal CT scan showed thickened, edematous gallbladder wall but no cholelithiasis, and an cholecystectomy was performed. Pathological examination revealed diffuse infiltration of eosinophils throughout all gallbladder wall layers and marked eosinophilic infiltration of the liver. Skin test for clonorchis sinensis was strong positive and serologic test for Clonorchis sinensis antibody was high titer. The serum alkaline phosphatase, SGOT, SGPT and eosinophil count normalized within a week after praziquantel medication.
Adult ; Alanine Transaminase ; Alkaline Phosphatase ; Aspartate Aminotransferases ; Cholecystectomy ; Cholecystitis* ; Cholecystitis, Acute ; Cholelithiasis ; Clonorchiasis* ; Clonorchis sinensis ; Eosinophilia ; Eosinophils* ; Female ; Gallbladder ; Hepatitis* ; Humans ; Liver ; Praziquantel ; Serologic Tests ; Skin Tests ; Tomography, X-Ray Computed

Coronavirus disease 2019 vaccinations for healthcare workers (HCWs) have begun in South Korea. To investigate adverse events (AEs) of the first dose of each vaccine, any symptom was collected daily for seven days after vaccination in a tertiary hospital. We found that 1,301 of 1,403 ChAdOx1 nCoV-19 recipients and 38 of 80 BNT162b2 recipients reported AEs respectively (90.9% vs. 52.5%): injection-site pain (77.7% vs. 51.2%), myalgia (60.5% vs.11.2%), fatigue (50.7% vs. 7.5%), headache (47.4% vs. 7.5%), and fever (36.1% vs. 5%; P < 0.001 for all). Young HCWs reported more AEs with ChAdOx1 nCoV-19 than with BNT162b2.No incidences of anaphylaxis were observed. Only one serious AE required hospitalization for serious vomiting, and completely recovered. In conclusion, reported AEs were more common in recipients with ChAdOx1 nCoV-19 than in those with BNT162b2. However, most of the reported AEs were mild to moderate in severity. Sufficient explanation and preparation for expected AEs required to promote widespread vaccination.