PURPOSE: We conducted a study to determine which factors may be useful as predictive markers in identifying Kawasaki disease (KD) patients with a high risk of resistance to intravenous immunoglobulin (IVIG) and developing coronary artery lesions (CAL). METHODS: We enrolled 287 patients in acute phase of KD at a single center. The demographic, clinical and laboratory data were collected retrospectively. RESULTS: There were 34 patients in the IVIG resistant group. The IVIG resistant group had significantly higher serum N-terminal-pro-brain natriuretic protein (NT-proBNP) levels (P<0.01) and polymorphonuclear neutrophil (PMN) percentage (P<0.01) in comparison to the IVIG responders. The results yielded sensitivity (78.8%, 60.6%), specificity (58.2%, 90%) and cutoff value (628.6 pg/mL, 80.3%) of NT-proBNP and PMN respectively, in predicting IVIG resistance. Despite IVIG administration, 13 of the 287 patients developed CAL. The patients in the CAL group had higher NT-proBNP levels (P<0.01) and higher PMN percentage (P<0.01). In these patients, the results yielded sensitivity (73.3%, 56.7%), specificity (67.9%, 88.9%) and cutoff value (853.4 pg/mL, 80.3%) of NT-proBNP and PMN respectively, for predicting CAL. The area under the curve (AUC) for predicting resistance to IVIG was NT-proBNP 0.712, PMN 0.802. The AUC for predicting CAL was NT-proBNP 0.739, and PMN 0.773. CONCLUSION: Serum NT-proBNP levels and PMN percentage were significantly elevated in patients with KD with IVIG resistance and CAL. Thus, they may be useful predicting markers for IVIG resistance and development of CAL in KD patients.
Area Under Curve ; Coronary Vessels* ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Mucocutaneous Lymph Node Syndrome* ; Neutrophils ; Retrospective Studies ; Sensitivity and Specificity

PURPOSE: The aim of this study was to evaluate the clinical manifestations, contact history, and status of tuberculosis contact investigations in school-age children and adolescents with pulmonary tuberculosis (TB) at two centers. METHODS: This study was conducted with 54 patients in the age ranging from 10 to 18 years, who were diagnosed with pulmonary TB at the Pusan National University Hospital and Pusan National University Children's Hospital, January 2008 to December 2012. We retrospectively reviewed the medical records of the patients. RESULTS: The median age of the patients was 16 years old; 11 patients were aged 10 to 14 and 43 patients were aged 15 to 18. Among 54 patients, 19 had history of contact with pulmonary TB, 10 had contact with house members (household), and remaining 9 had contact with classmates (non-household). One out of 10 patients who had household contacts and 6 out of 9 patients who had non-household contacts were evaluated with contact investigation after the exposure to pulmonary TB. Among 7 patients who were evaluated with contact investigation, 3 were diagnosed with active pulmonary TB, 1 had latent tuberculosis infection (LTBI), and 3 had no evidence of TB or LTBI. The median period of diagnosis after the exposure to active pulmonary TB was 2 years in patients with household contacts and 0.23 years in patients with non-household contacts. CONCLUSION: This study suggested that if the contact investigation conducted properly, it would be helpful for early diagnosis and prevention of pulmonary TB.
Adolescent* ; Busan ; Child* ; Diagnosis ; Early Diagnosis ; Family Characteristics ; Humans ; Latent Tuberculosis ; Medical Records ; Retrospective Studies ; Tuberculosis* ; Tuberculosis, Pulmonary*

We herein report a case of occupational contact urticaria syndrome induced by cefotiam di-hydrochloride in a nurse. She had generalized pruritic wheals accompanied by palpitations and tachypnea during the preparation of cefotiam solution. A scratch patch test with cefotiam di-hydrochloride, a major component of cefotiam ingredient showed multiple erythema and wheals within 5 minutes, accompanied by palpitations and tachypnea. No delayed type reaction was observed. Based on her clinical history and scratch test result, we diagnosed her condition as contact urticaria syndrome caused by cefotiam.
Cefotiam* ; Erythema ; Patch Tests ; Tachypnea ; Urticaria*

PURPOSE: The purpose of this study was to identify the effects of structured information provided on self care knowledge, self care performance, and functional status. METHOD: The data were collected using self care knowledge and performance assessment tool, and functional status assessment tool from both group hospitalized patients at D hospital in Busan. RESULTS: There was a significant improvement(p=.032) in self care knowledge in experimental group compared to the control group. But there were not improvement in self care performance and functional status in experimental group compared to the control group. But comparing to pretest and posttest in experimental group, There were significant improvement in self care performance (p=.003) and functional status(p=.013). CONCLUSION: Structured information provided showed increased in the degree of knowledge, self care performance, and functional status. But the effect size of program which had been developed in this study was estimated small, so there is needed to modify this program and to research repeatedly.
Busan ; Humans ; Liver Cirrhosis* ; Liver* ; Self Care*

Purpose: This systematic review aimed to investigate the effects of aromatherapy interventions on depression and anxiety in menopausal women. Methods: This study adhered to PRISMA (preferred reporting items of systemic reviews and meta-analysis) guidelines. Relevant studies published between 1994 and 2002 were searched in PubMed, Embase, Cochrane Library, CINAHL, Google Scholar, DBPIA, KISS, and RISS databases. Search criteria included the mesh terms 'aromatherapy menopause women depression anxiety.' The review included randomized and nonrandomized studies of women who were menopausal or postmenopausal and received aromatherapy intervention for depression and anxiety associated with symptoms of menopause. The extracted literature was evaluated via quality appraisal checklists of ROB 2 (Risk of Bias 2.0) and ROBINS-1 (Risk Of Bias In Non-Randomized Studies - of Interventions) and visualized using a risk-of-bias visualization tool. Results: The review included 6 randomized controlled studies and 2 quasi-experimental studies. The results showed that aromatherapy massage and inhalation therapy were effective in reducing depression and had beneficial effects in reducing anxiety, improving quality of sleep, and menopausal symptoms in menopausal women. Conclusion Interventions using aromatic essential oils to massage the hands, arms, back, and scalp or inhalation of aromatic oils from clothing, necklaces, and bedding might be beneficial for the emotional health of menopausal women. Women health professionals should consider applying aromatherapy to menopausal women to improve emotional health, sleep, and menopausal symptoms.

Acute generalized exanthematous pustulosis (AGEP) is characterized by acute nonfollicular sterile pustules on a background of edematous erythema. Hydroxychloroquine (HCQ), an antimalarial drug, widely used to treat rheumatic and dermatologic diseases. HCQ has been reported to be an uncommon cause of AGEP. We report a 60-year-old woman with rheumatoid arthritis requiring the use of HCQ presented fever and erythematous eruption on the trunk with sterile pustules. Leukocytosis and elevated erythrocyte sedimention rate noted on laboratory examination. On the histopathological examination of the skin biopsy specimen showed neutrophilic infiltration and scattered eosinohpils. The lesions were resolved with removal of HCQ. The clinical course was consistent with the diagnosis of AGEP associated with HCQ. We reported a case of typical AGEP associated with HCQ in a patient with Rheumatoid arthritis. The patient presented resolution from cutaneous lesions with withdrawal of culprit drug, without the need of systemic steroid.
Acute Generalized Exanthematous Pustulosis ; Arthritis, Rheumatoid ; Biopsy ; Erythema ; Erythrocytes ; Female ; Fever ; Humans ; Hydroxychloroquine ; Leukocytosis ; Neutrophils ; Skin

Carcinosarcoma of the salivary gland is an extremely rare tumor that is composed of both malignant epithelial and mesenchymal components. Diagnosing carcinosarcoma with fine-needle aspiration cytology is challenging because of its overlapping cytomorphologic characteristics with other high-grade malignant salivary gland tumors. Among the many features, including pleomorphic oncocytoid epithelial components, necrotic background, and mitoses, recognizing the singly scattered atypical spindle cells is most essential in carcinosarcoma. We present a case of a 66-year-old male patient with characteristic features of carcinosarcoma, who was successfully treated by wide local excision and subsequent radiation therapy.
Aged ; Biopsy, Fine-Needle ; Carcinosarcoma ; Humans ; Male ; Mitosis ; Salivary Glands

Purpose: This study aimed to assess the incidence of and factors associated with major complications, delayed discharge, and emergency room (ER) visits or readmission after percutaneous radiofrequency ablation (RFA) for single hepatocellular carcinoma (HCC) <3 cm in a recent cohort at a tertiary cancer center. Methods: A total of 188 patients with treatment-naïve single HCCs <3 cm who underwent RFA between January 2018 and April 2021 were included in the analysis. Univariable and multivariable logistic regression analyses were performed to identify the factors associated with major complications, delayed discharge, and ER visits or readmission. Local tumor progression (LTP) and overall survival were estimated using the Kaplan-Meier method and Cox proportional-hazards regression analysis. Results: Major complications occurred in 3.2% (6/188) of the patients. The longest diameter of the ablation zone was significantly larger in patients with major complications (P=0.023). Delayed discharge occurred in 5.8% (9/188) of the patients, for which albumin-bilirubin grade 3 was identified as an important determinant. No variables other than major complications were significantly associated with ER visits or readmission, which occurred in 7.0% (13/188) of the patients. Major complications, delayed discharge, and ER visits or readmission were not substantially related to the post-treatment outcomes of LTP and overall survival. Conclusion This study confirmed RFA as a highly safe procedure for single HCCs <3 cm, despite the rapidly changing RFA techniques in the most recent cohort. A large ablation zone and poor liver function were predictors of major complications and delayed discharge, respectively.

This study was performed to investigate the effect of vitamin C and E supplementation on blood pressure, plasma lipids, folate, and homocysteine levels in smokers and non-smokersof college male students in Gyeonggi Area. The nutrient intakes were determined by a 24hr-recall method. The subjects were divided into six groups: vitamin C supplementation group (n: smokers = 10, nonsmokers = 10), vitamin E supplementation group (n: smokers = 10, nonsmokers = 10), vitamin C and E supplementation group (n: smokers = 10, nonsmokers = 10), respectively. There were no significant differences between the smokers and nonsmokers in terms of anthropometric measurements. Systolic and diastolic blood pressure were significantly higher (p < 0.05) in smokers than that of non-smokers. There was no significant difference in energy and other nutrients intakes between smokers and non-smokers. In plasma lipids levels, smokers had higher plasma triglyceride, LDL-cholesterol, VLDL-cholesterol, total cholesterol concentration than that of non-smokers (p < 0.05). HDL-cholesterol level of smokers had a tendency to be lower than that of nonsmokers. In smokers, AI, TPH, LPH were significantly higher than that of non-smokers (p < 0.01). Plasma folate, homocysteine levels were not significantly different between smokers and non-smokers. The effect of antioxidant vitamins supplementation in smokers: In vitamin C supplementation group, HDL-cholesterol level was significantly increased (p < 0.01) and AI, TPH, LPH were significantly decreased (p < 0.01). In vitamin E supplementation group, HDL-cholesterol level was significantly increased (p < 0.05). In vitamin C and E supplementation group, LPH was significantly decreased (p < 0.05). The effect of antioxidant vitamins supplementation in non-smokers: HDL-cholesterol level was significantly increased (p < 0.05) and AI, TPH, LPH were significantly decreased (p < 0.05) by vitamin C supplementation group. Plasma homocysteine level was decreased by vitamin E supplementation group in non-smokers p < 0.01). The results of this study showed that smoking had a tendency to increase plasma lipids levels that factor into the risk of coronary heart disease. It is considered that antioxidant vitamin supplementation in smokers had a tendency to decrease cardiovascular disease than in nonsmokers.
Ascorbic Acid ; Blood Pressure* ; Cardiovascular Diseases ; Cholesterol ; Coronary Disease ; Folic Acid* ; Gyeonggi-do* ; Homocysteine* ; Humans ; Male ; Plasma* ; Smoke ; Smoking ; Triglycerides ; Vitamin E ; Vitamins*

PURPOSE: To evaluate the correlation among hypertropia, inferior oblique overaction (IOOA), and extorsion. METHODS: Thirty-one patients with congenital unilateral superior oblique palsy were evaluated. Visual acuity tests, refraction tests, ocular movement tests, prism cover tests, and fundus photography were performed. The correlations of vertical deviation, IOOA, and extorsion were analyzed. The operation method involved weakening the inferior oblique muscle, and then a comparison was made between measurements 1 month preoperative and 1 month postoperative for vertical deviation, inferior oblique overaction, and extorsion. RESULTS: On average, preoperative hypertropia was 8.84+/-6.88 prism diopters (PD), IOOA was 2.20+/-0.69, and extorsion was 18.06+/-5.83 degrees. The Pearson's correlation of IOOA and extorsion, hypertropia and IOOA, and extorsion and hypertropia were r=0.620, r=0.327, and r=0.126, respectively. Postoperative hypertropia, IOOA, and extorsion were reduced to 1.42+/-3.11PD, 0.42+/-1.11, and 8.63+/-5.09, respectively. CONCLUSIONS: Both extorsion and hypertropia showed significant positive correlations with IOOA, whereas hypertropia and extorsion revealed somewhat weaker positive correlations in congenital monocular superior oblique palsy. In addition, the amount of hypertropia was reduced, and extorsion and IOOA improved after recession of the inferior oblique muscle.
Humans ; Paralysis* ; Photography ; Strabismus* ; Visual Acuity