No abstract available.
Alexander Disease*

No abstract available.
Drainage* ; Prognosis*

A case of transient neonatal diabetes mellitus combined with congenital adrenal hyperplasia(CAH) is described. A female infant was born by cesarean delivery due to fetal distress, she had sunken eyeball and anterior fontanelle, large protruded tongue and thin subcutaneous tissues. She had large clitoris and progressive pigmentation on whole body was observed since 10th day of birth. Hyperglycemia and glycosuria was noted at 3rd day of birth. Level of insulin and C-peptide was 3.0 mU/L and 0.35 ng/mL respectively. Serum ACTH was 870.4 pg/mL and 17-hydroxyprogesterone was increased to 20,000 ng/dL. Serum Na was 124 mEq/L, K 5.6 mEq/L. Abdominal MRI showed no abnormality. Chromosomal study showed 46,XX. Genetic analysis with polymorphic DNA markers for chromosome 6 showed paternal uniparental isodisomy at D6S276, D6S1704 and DNA analysis of CYP 21 gene showed mutation at P435S. She required insulin therapy for 8 months after birth. Hydrocortisone and florinef was needed for the control of CAH.
17-alpha-Hydroxyprogesterone ; Adrenal Hyperplasia, Congenital* ; Adrenocorticotropic Hormone ; C-Peptide ; Chromosomes, Human, Pair 6 ; Clitoris ; Cranial Fontanelles ; Diabetes Mellitus* ; DNA ; Female ; Fetal Distress ; Genetic Markers ; Glycosuria ; Humans ; Hydrocortisone ; Hyperglycemia ; Infant ; Insulin ; Magnetic Resonance Imaging ; Parturition ; Pigmentation ; Subcutaneous Tissue ; Tongue ; Uniparental Disomy

Background: To date, only a few studies have reported the relationship between shift work and subclinical hypothyroidism. Therefore, this study aimed to investigate this relationship. Subclinical hypothyroidism is defined as normal thyroxine (free T4) and thyrotropin (thyroid stimulating hormone, TSH) levels above 10 mU/L. Methods: This study included 12,126 male participants who visited Ulsan University Hospital health promotion center from March 1, 2016 to February 28, 2017. Participants answered a self-administered survey about their marital status, educational level, smoking habits, alcohol intake, and frequency of physical activity. Venous blood sampling was performed after maintaining fasting state for at least 8 hours to test for fasting glucose, hemoglobin A1c, total cholesterol, TSH, and free T4. Results: The TSH level was significantly higher in shift workers than that in the non-shift workers, whereas free T4 level did not show any difference between the two groups. In the shift work group, the odds ratio for subclinical hypothyroidism was significantly higher (odds ratio, 1.99, 95%; confidence interval, 1.16–3.40). This result persisted after adjusting for covariates of age, body mass index, educational level, smoking habits, alcohol intake, and frequency of physical activity. Conclusion The odds of subclinical hypothyroidism were higher in the shift work group. Therefore, clinicians should pay more attention to detect subclinical hypothyroidism in shift workers.

Objective: The number of patients suffering from dysphagia is increasing in line with societal aging. However, preparing dysphagia diets at home or in welfare facilities is challenging due to the lack of commercially specifically designed products. The thickening agents used to prepare dysphagia meals can be difficult due to changes in viscosity and homogenization. Therefore, this study was performed to prepare dysphagia meals using commercially available foods following the classification system outlined by the International Dysphagia Diet Standardization Initiative (IDDSI). Methods: Commercial foods were categorized as main dishes, side dishes, and snacks. Selected foods were ground or minced, and 1-3 g of thickening agent was added. Following the IDDSI framework, fork flowability, spoon tilt, and gravity flow tests were conducted using a syringe, and based on these evaluations, texture-modified foods were classified as general, minced, ground, or liquid foods. Results: Commercial foods used in the experiment could be used in IDDSI Level 2-7 dysphagia diets after adjusting their structures. Food size and viscosities were appropriately controlled, and an usage manual was developed. Conclusion This study successfully demonstrated the easy incorporation of commercial food products into the dysphagia diets for personal care and welfare facilities. By adopting the described approach, dysphagia patients could be provided various meal options with improved service. In addition, this study suggests possibilities for developing and producing diverse products designed specifically for dysphagia patients.

Objective: The number of patients suffering from dysphagia is increasing in line with societal aging. However, preparing dysphagia diets at home or in welfare facilities is challenging due to the lack of commercially specifically designed products. The thickening agents used to prepare dysphagia meals can be difficult due to changes in viscosity and homogenization. Therefore, this study was performed to prepare dysphagia meals using commercially available foods following the classification system outlined by the International Dysphagia Diet Standardization Initiative (IDDSI). Methods: Commercial foods were categorized as main dishes, side dishes, and snacks. Selected foods were ground or minced, and 1-3 g of thickening agent was added. Following the IDDSI framework, fork flowability, spoon tilt, and gravity flow tests were conducted using a syringe, and based on these evaluations, texture-modified foods were classified as general, minced, ground, or liquid foods. Results: Commercial foods used in the experiment could be used in IDDSI Level 2-7 dysphagia diets after adjusting their structures. Food size and viscosities were appropriately controlled, and an usage manual was developed. Conclusion This study successfully demonstrated the easy incorporation of commercial food products into the dysphagia diets for personal care and welfare facilities. By adopting the described approach, dysphagia patients could be provided various meal options with improved service. In addition, this study suggests possibilities for developing and producing diverse products designed specifically for dysphagia patients.

Objective: The number of patients suffering from dysphagia is increasing in line with societal aging. However, preparing dysphagia diets at home or in welfare facilities is challenging due to the lack of commercially specifically designed products. The thickening agents used to prepare dysphagia meals can be difficult due to changes in viscosity and homogenization. Therefore, this study was performed to prepare dysphagia meals using commercially available foods following the classification system outlined by the International Dysphagia Diet Standardization Initiative (IDDSI). Methods: Commercial foods were categorized as main dishes, side dishes, and snacks. Selected foods were ground or minced, and 1-3 g of thickening agent was added. Following the IDDSI framework, fork flowability, spoon tilt, and gravity flow tests were conducted using a syringe, and based on these evaluations, texture-modified foods were classified as general, minced, ground, or liquid foods. Results: Commercial foods used in the experiment could be used in IDDSI Level 2-7 dysphagia diets after adjusting their structures. Food size and viscosities were appropriately controlled, and an usage manual was developed. Conclusion This study successfully demonstrated the easy incorporation of commercial food products into the dysphagia diets for personal care and welfare facilities. By adopting the described approach, dysphagia patients could be provided various meal options with improved service. In addition, this study suggests possibilities for developing and producing diverse products designed specifically for dysphagia patients.

Objective: The number of patients suffering from dysphagia is increasing in line with societal aging. However, preparing dysphagia diets at home or in welfare facilities is challenging due to the lack of commercially specifically designed products. The thickening agents used to prepare dysphagia meals can be difficult due to changes in viscosity and homogenization. Therefore, this study was performed to prepare dysphagia meals using commercially available foods following the classification system outlined by the International Dysphagia Diet Standardization Initiative (IDDSI). Methods: Commercial foods were categorized as main dishes, side dishes, and snacks. Selected foods were ground or minced, and 1-3 g of thickening agent was added. Following the IDDSI framework, fork flowability, spoon tilt, and gravity flow tests were conducted using a syringe, and based on these evaluations, texture-modified foods were classified as general, minced, ground, or liquid foods. Results: Commercial foods used in the experiment could be used in IDDSI Level 2-7 dysphagia diets after adjusting their structures. Food size and viscosities were appropriately controlled, and an usage manual was developed. Conclusion This study successfully demonstrated the easy incorporation of commercial food products into the dysphagia diets for personal care and welfare facilities. By adopting the described approach, dysphagia patients could be provided various meal options with improved service. In addition, this study suggests possibilities for developing and producing diverse products designed specifically for dysphagia patients.

OBJECTIVES: The Korean government in January 2006 instigated an exemption policy for hospitalized children under the age of six years old. This study examines how this policy affected the utilization of medical care in Korea. METHODS: A total of 1,513,797 claim records from the Health Insurance Review Agency were analyzed by complete enumeration methods. The changes of medical utilization were compared from 2005 to 2006. In addition, the changes of medical utilization between 2004 and 2005 were compared as a pseudocontrol group. RESULTS: The admission rate increased 1.14-fold from 15.20% in 2004 to 17.32% in 2005, and this further increased 1.08-fold to 18.65% in 2006. The increase of patients with a common cold (1.2-fold) was higher than that of both the general patients (1.08-fold) and the patients with the top 10 fatal diseases (0.91-fold). The average length of stay per case for clinics showed the highest increase rates (1.06-fold). The rates of patients with the common cold showed a higher increase (1.05-fold) than that of the general patients. The average medical expense per case was increased by 1.10-fold from 2005 to 2006, which was higher than that from 2004 to 2005 (1.04-fold). The increase rate for patients with the common cold was higher at 1.18-fold than that of the general patients. CONCLUSIONS: The cost exemption policy has especially led to an increase in the utilization of clinics and the utilization by patients with a common cold.
Child, Preschool ; Cost Sharing/*legislation & jurisprudence ; *Health Policy ; Health Services/*utilization ; Hospitalization ; Humans ; Insurance Claim Review ; Korea ; Length of Stay

OBJECTIVE: We used nucleated erythrocytes in maternal blood for prenatal determination of the fetal gender as the preliminary experiment for the screening of fetal genetic status and the BclI DNA polymorphism in an attempt to clarify the origin of erythrocytes in maternal blood. METHODS: In seventeen pregnant women, venous blood was withdrawn and the nucleated erythrocytes were recovered by magnetic activated cell sorting (MACS) and immunostaining. After isolation of nucleated erythrocytes by micromanipulation, we performed nested PCR for amelogenin gene to identify the fetal gender and performed BclI DNA polymorphism to clarify the origin of erythrocytes. RESULTS: We could amplify the minute DNA in a single cell by primer extension preamplification and nested PCR of amelogenin gene in 94 (48.7%) cells and could identify the fetal gender by 58.8%. BclI DNA polymorphism revealed that the several cells, which did not reveal the specific band of Y chromosome in spite of the pregnancy of male fetuses, must be the cells from mother. CONCLUSION: Through this study, we could conclude that several nucleated erythrocytes in maternal blood circulation can originate from mother, therefore we must develop the new method to identify the nucleated erythrocyte of fetal origin. Considering that we must apply for the larger number of pregnant women to screen, the procedure was multi-step and complex. Therefore, we must design the new scheme to utilize the nucleated erythrocytes in maternal blood.
Amelogenin ; Blood Circulation ; DNA ; Erythroblasts ; Erythrocytes ; Female ; Fetus ; Humans ; Male ; Mass Screening ; Micromanipulation ; Mothers ; Polymerase Chain Reaction ; Pregnancy ; Pregnant Women ; Y Chromosome