A histopathologic study including iramunohistochemical stains was made in 30 patients who were presented with gastrointestinal lymphoma. The occurrence was 13 in the stomach, 8 in the ileocecum, 7 in the small intestine and 2 in the colon. The disease more frequently affected males than females and the average ages were 53 years in the patients of gastric lymphoma and 44 years in the patients of intestinal lymphoma. Gastric lymphomas were usually presented with a single lesion, and the antrum and/or body were the most common sites. But intestinal lymphomas were presented with a single or multiple lesion, and the ileocecum was the most common site. The most common gross type of gastrointestinal lymphomas was the ulceroinfiltrating type and most are of the diffuse large noncleaved cell type of B-cell lymphoma, histologically. There were 2 cases of T-cell lymphoma presented in the intestine as the superficially ulcerative gross pattern and diffuse immunoblastic cell type. The distinct MALToma was seen in only one case of stomach but the feature was partially remained in each two cases of stomach and intestine. Their coexistent findings may suggest that diffuse large of immunoblastic component arises through blastic transformation of the low-grade M ALToma component.
Female ; Male ; Humans

PURPOSE: The purpose of this study was to provide basic data on preventive child abuse program development. METHOD: Data were collected on 105 high-risk families of child abuse intervention was obtained from their main child rearer who raised the child under 18 years, olds during 10 months period from May, 2000 to March 2001. RESULT: The results were as follows : 1. Child abuse occurred in the subject's home, in the case of mild child abuse, 'throwing an object at the child' had the highest percentage 39.1%, in severe child abuse, 'rod, stick, belt, broom beating or using a variety of objects such as' had the highest percentage 49.5%, and in very severe child abuse, 'hospitalized by belting' had the highest percentage 3.8%. 2. The degree of child abuse potential showed high risk child abuse score with a mean of 213.3. The degree of beliefs in corporal punishment showed that subjects perceived corporal punishment of children positively with a mean of 32.2. 3. With respect to the child abuse potential, there were significant correlations with the subjects' age (r=.294, p=.002), education level (r=-.442, p=.000), and family income (r=-.355, p=.000). CONCLUSION: From this study not only child abuse occurrence but also child abuse potential were severely increased in poor livelihood families. Therefore to the high risk group, individual preventive approach must be applied.
Child ; Child Abuse ; Cytisus ; Education ; Humans ; Only Child ; Program Development ; Punishment

No abstract available.
Drainage* ; Prognosis*

A 9-year-old Korean boy with lissencephaly was found dead at home. He had previously been diagnosed with lissencephaly that presented with infantile spasm on the basis of magnetic resonance imaging and electroencephalogram results. Antemortem chromosomal banding revealed a normal karyotype. A legal autopsy was requested to eliminate the possibility of neglect or abuse by his parents. The autopsy findings revealed type I lissencephaly with the associated microcephaly. No external wounds or decubitus ulcers were noted. Postmortem fluorescence in situ hybridization for the LIS1 locus and nucleotide sequence analysis of the whole coding regions of the LIS1 gene did not reveal any deletions. The antemortem and postmortem findings revealed that lissencephaly syndrome was associated with isolated lissencephaly sequence. External causes of death were excluded by the full autopsy and toxicology test results. Because patients with mental retardation are frequently victimized and suffer neglect or abuse, thorough external and internal examinations should be conducted at the time of autopsy.
Autopsy ; Base Sequence ; Cause of Death ; Child ; Child Abuse ; Classical Lissencephalies and Subcortical Band Heterotopias ; Clinical Coding ; Electroencephalography ; Fluorescence ; Forensic Pathology ; Humans ; In Situ Hybridization ; Infant ; Infant, Newborn ; Intellectual Disability ; Karyotype ; Lissencephaly ; Magnetic Resonance Imaging ; Microcephaly ; Parents ; Pressure Ulcer ; Spasms, Infantile ; Toxicology

Long QT syndrome(LQTS) is characterized by prolongation of the QT interval, frequent episodes of syncope, and ventricular tachycardia leading to sudden cardiac death in adolescents and young adults. Early diagnosis and prompt treatment to reduce the risk of life-threatening cardiac events is crucial, however sudden onset convulsive syncope may be misdiagnosed as epilepsy and lead to antiepileptic drug therapy for many years. We experienced a case of six-year-old boy who were having seizure triggered by exercise and being treated with antiepileptic drugs. He had normal EEG and brain MRI but his ECG revealed prolonged QT interval(QTc=477 ms) and treadmill test induced polymorphic ventricular tachycardia. After applying beta-blocker, he had no more seizure attacks. We report a case of long QT syndrome misdiagnosed as epilepsy with a brief review of related literatures.
Adolescent ; Anticonvulsants ; Brain ; Death, Sudden, Cardiac ; Early Diagnosis ; Electrocardiography ; Electroencephalography ; Epilepsy ; Exercise Test ; Humans ; Long QT Syndrome ; Seizures ; Syncope ; Tachycardia, Ventricular ; Young Adult

OBJECTIVE: Since IVF program was first established, various types of media and culture systems have been developed either in-house or commercially. The aim of this study was to compare the efficacy of in-house Maria Research Center (MRC) media to that of commercially available Sydney IVF media in human day 3 embryo transfer cycles. METHODS: Three hundred sixty nine couples were included in this prospective, randomized, and comparative study. All couples undergoing IVF treatment at the Maria Fertility Hospital were randomly assigned to either Sydney IVF (n=178) or MRC (n=191) media. RESULTS: No difference was observed between the MRC media and Sydney IVF media groups with respect to fertilization rate (74.4% vs. 75.5%). The clinical pregnancy and implantation rates of MRC media (47.1% and 20.0%, respectively) were also similar to those of Sydney IVF media (44.4% and 19.4%, respectively). However, the proportion of embryos with good quality on day 3 was significantly higher in the MRC media group than the Sydney IVF media group (50.2% vs. 43.2%) (p<0.05). CONCLUSION: MRC media were as effective as Sydney IVF media for sustaining embryo development and pregnancy rates. The present study implies that MRC media can be a suitable alternative to commercially available media for human IVF-ET program.
Embryo Transfer ; Embryonic Development ; Embryonic Structures ; Family Characteristics ; Female ; Fertility ; Fertilization ; Humans ; Pregnancy ; Pregnancy Rate ; Prospective Studies

BACKGROUND AND OBJECTIVES: This study was intended to test how the inflammation at the Bacille Calmette-Guerin (BCG) inoculation site (BCGitis) can be a useful a diagnostic feature of Kawasaki disease (KD). SUBJECTS AND METHODS: All subjects were infants at the time of admission, and had received BCG vaccination during their neonatal period. There were 54 patients with complete KD (group 1) and 29 patients with incomplete KD (group 2). All 83 patients had BCGitis during the acute phase of illness. Data regarding the coronary artery diameters in 31 age-matched controls were used for comparison. RESULTS: The 2 patient groups did not differ in clinical and laboratory variables. During the acute phase, the median z scores of the left anterior descending coronary artery (LAD) diameter were 0.20, 0.42, and -0.48 in groups 1, 2, and control respectively, and that of right coronary artery (RCA) diameters were -0.15, -0.16, and -1.17 respectively. The z scores in both patient groups were greater than those in controls (p=0.0014 in LAD and p<0.0001 in RCA between group 1 and controls; p=0.0023 in LAD and p<0.0001 in RCA between group 2 and controls). A similar pattern was observed during the subacute and convalescent phases. CONCLUSION: BCGitis is a useful feature in the diagnosis of incomplete KD in infants who received BCG vaccine during neonatal period.
BCG Vaccine ; Coronary Vessels ; Humans ; Infant ; Inflammation ; Mucocutaneous Lymph Node Syndrome ; Mycobacterium bovis ; Vaccination

PURPOSE: The resistance of H. pylori to clarithromycin is one of the major causes of eradication failure. In H. pylori, clarithromycin resistance is due to point mutation in 23S rRNA. The aims of this study were to investigate the mutation of 23S rRNA and to examine the association of cagA, vacA genotype and clarithromycin resistant genes. METHODS: H. pylori DNA was extracted from antral biopsy specimens from 27 children with H. pylori infection. Specific polymerase chain reaction (PCR) assays were used for cagA and vacA. Mutations associated with clarithromycin resistance were detected by using PCR restriction fragment length polymorphism (RFLP) analysis of 23S rRNA gene. RESULTS: A2143G mutation was detected in one case and A2144G in 4, indicating 18.5% were clarithromycin resistant. Among the total of 27, cagA was present in 25 (93%), vacA s1a/m1 in 6 (22%), s1a/m2 in 3 (11%), s1c/m1 in 16 (59%), and s1c/m2 in 1 (4%). All of the 5 clarithromycin resistant strains were cagA (+), among which 2 were s1a/m1 and 2 were s1c/m1. There was no relation between genotypes and clarithromycin resistant genes. CONCLUSION: Detection of H. pylori resistance to clarithromycin using PCR RFLP from biopsy specimens might be useful for the selection of antibiotics. Clarithromycin resistant genes are not associated with genotypes of cagA and vacA.
Anti-Bacterial Agents ; Biopsy ; Child* ; Clarithromycin* ; DNA ; Genes, rRNA ; Genotype ; Helicobacter pylori* ; Helicobacter* ; Humans ; Point Mutation ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length

PURPOSE: Henoch-Schonlein purpura (HSP) is a systemic vasculitis involving the skin, joints, gastrointestinal tract, and kidney. Although the pathogenesis of HSP is still unclear, tumor necrosis factor (TNF-alpha) is regarded as an important cytokine contributing to the disease. The goal of this study was to determine the role of TNF-alpha in the pathogenesis of HSP, and to evaluate the TNF-alpha polymorphism for genetic susceptibility to HSP. METHODS: From March 2004 to November 2005, 40 children with HSP and 32 healthy controls were included. Serum TNF-alpha levels were measured using the ELISA method during the acute and convalescent phase of HSP. The genotypic and allelic frequencies of the TNF-alpha gene polymorphisms at positions -308 and -238 were evaluated in patients and controls. RESULTS: Serum TNF-alpha levels were 23.17+/-11.31 pg/mL in the acute phase of children with HSP and 10.56+/-5.59 pg/mL in the convalescent phase (p=0.000). There was no significant correlation between the serum TNF-alpha levels and the clinical scores of HSP (r=0.310, p=0.070). The genotypic frequency of the TNF-alpha - 308 polymorphism in children with HSP was not significantly different compared to healthy controls (GG 80%, GA 20% vs. GG 93.8%, GA 6.2%; p=0.094). The genotypic frequency of the TNF-alpha -238 polymorphism in children with HSP was not significantly different (GG 97.5%, GA 2.5% vs. GG 93.8%, GA 6.3%; p=0.429). CONCLUSION: TNF-alpha is assumed to be the main cytokine associated with the pathogenesis of HSP during the acute phase. However, the presence of TNF-alpha gene polymorphisms at positions -308 and -238 did not distinguish children with HSP from normal controls.
Child* ; Enzyme-Linked Immunosorbent Assay ; Gastrointestinal Tract ; Genetic Predisposition to Disease ; Humans ; Joints ; Kidney ; Purpura, Schoenlein-Henoch* ; Skin ; Systemic Vasculitis ; Tumor Necrosis Factor-alpha*

PURPOSE: This study was conducted to evaluate the role of adiponectin, leptin, and tumor necrosis factor-alpha (TNF-alpha) in the pathogenesis of non-alcoholic fatty liver disease (NAFLD) in obese children, and to elucidatethe relationship between these adipokines and insulin resistance. METHODS: A total of 61 obese children (M : F=42 : 19, mean age 11.2+/-1.3 years) admitted to our facility between March 2004 and June 2005 were included in this study. Patients were divided into three groups based on their NAFLD status obese children without fatty liver (N=23); obese children with simple steatosis (N=20); and obese children with non-alcoholic steatohepatitis (NASH) (N=18). The serum levels of adiponectin, leptin, and TNF-alpha were measured, and insulin resistance determined by homeostasis model assessment (HOMA-IR) was calculated to estimate insulin resistance. In addition, the VSR (visceral-subcutaneous fat ratio) was estimated using abdominal computed tomography. RESULTS: There was no difference in serum TNF-alpha and leptin levels observed between the 3 groups (22.13+/-6.37 vs. 21.35+/-6.95 vs. 25.17+/-9.30; p=0.342 & 20.29+/-8.57 vs. 16.42+/-6.85 vs. 20.10+/-7.86; p=0.330). However, the serum adiponectin level was significantly lower in children with non-alcoholic steatohepatitis (NASH) than in the other two groups (6.08+/-1.38 in children without steatosis vs. 5.69+/-0.79 in simple steatosis vs. 4.93+/-1.75 in NASH; p=0.026). In addition, the VSR was significantly increased in the NASH group (0.31+/-0.08 vs. 0.32+/-0.11 vs. 0.47+/-0.14; p=0.001), and HOMA-IR revealed a significant difference among the three groups (4.77+/-3.67 vs. 6.89+/-7.05 vs. 10.42+/-6.73; p=0.000). However, there was no significant correlation observed between the adiponectin levels and the HOMA-IR or the VSR (r=-0.117; p=0.450 & r=-0.106; p=0.499). CONCLUSION: Insulin resistance may affect the development of hepatic steatosis and steatohepatitis in children, and the results of this study suggest that, of several adipokines evaluated, adiponectin is important in the progression of steatosis to steatohepatitis in obese children.
Adipokines* ; Adiponectin ; Adipose Tissue* ; Body Fat Distribution* ; Child* ; Fatty Liver* ; Homeostasis ; Humans ; Insulin Resistance* ; Insulin* ; Leptin ; Obesity ; Tumor Necrosis Factor-alpha