PURPOSE: Although spinal tapping and cerebrospinal fluid analysis is essential for diagnosis of aseptic meningitis, it is equivocal that all patients with headache and vomiting should receive spinal tapping for diagnosis of meningitis during an outbreak of enteroviral meningitis in summer seasons. The purpose of this study was to find clinical indicators that may be useful for differentiation of bacterial meningitis, and also to compare the clinical course between spinal tapping group and non-spinal tapping group confirmed enteroviral infection. METHODS: We retrospectively reviewed medical record of 65 cases of reverse transcription-polymerase chain reaction(RT-PCR) proven enteroviral meningitis, and 30 cases of culture proven bacterial meningitis admitted in Chunchon Sacred Heart Hospital. We compared the difference of clinical factors between bacterial and enteroviral meningitis groups and also clinical course between spinal tapping and non-spinal tapping groups. RESULTS: Children with bacterial meningitis had younger age onset, high incidence of seizure and altered consciousness, increased C-reactive protein(CRP) levels(P<0.05), but no difference in fever degree at admission and white blood cell and platelet count, erythrocyte sedimentation rate(P>0.05). Children with spinal tapping group with enteroviral meningitis had longer hospital stay and duration of fever as compared to children in non-spinal tapping group(P<0.05), but no difference in duration of headache in both groups. CONCLUSION: We recommend children with younger age, altered consciousness, having seizure and increased CRP levels receive spinal tapping for the differentiation of bacterial meningitis during an outbreak of enteroviral meningitis, and introduction of rapid diagnostic technique may reduce unnecessary spinal tapping, hospital stay and antibiotics therapy.
Anti-Bacterial Agents ; Blood Sedimentation ; Child ; Consciousness ; Fever ; Headache ; Heart ; Humans ; Incidence ; Length of Stay ; Leukocytes ; Medical Records ; Meningitis ; Meningitis, Aseptic ; Meningitis, Bacterial ; Platelet Count ; Retrospective Studies ; Seasons ; Seizures ; Spinal Puncture ; Vomiting

PURPOSE: This study was done to identify the level and correlation of knowledge and practice of fever management at home and provide data for the development of an intervention program to improve the fever management ability of mothers of preschool age children. METHODS: Participants were 112 mothers with children between 1 and 6 years of age and attending one of three daycare centers located in J city. The participants had a history of using medication and tepid massage. Data were collected during April, 2016. RESULTS: The mean scores were 27.55 (correct answer rate 70.64%) of 39 for knowledge, and 75.93 of 92 for fever management practice. There were significant differences in scores for knowledge according to the number of children and number of visits to doctors for treatment of a fever. There were no differences in scores for practice. There was a positive correlation between knowledge and practice. CONCLUSION: Results indicate that mothers' knowledge and practice of childhood fever management were insufficient to provide accurate management of childhood fevers. Therefore, to improve the mothers' ability to provide appropriate fever management, educational strategies that focus on increasing knowledge need to be developed.
Child ; Child, Preschool* ; Fever* ; Humans ; Massage ; Mothers*

PURPOSE: This study compared the glaucoma diagnostic abilities of optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). In addition, the possibility of enhancing diagnostic capability by combining the two modalities was investigated. METHODS: A total of 131 healthy eyes and 113 glaucomatous eyes were imaged by both OCT and OCTA. In OCT, glaucoma was defined as when the color of the superior or inferior quadrant of the peripapillary retinal nerve fiber layer thickness map was yellow (borderline, <5%) or red (outside normal limits, <1%). In OCTA, glaucoma was determined using the cut-off value of the superior or inferior peripapillary vessel density, calculated after receiver operating characteristic curve analysis. Sensitivity and specificity were determined by OCT alone, by OCTA alone, or by OCT and OCTA combined. RESULTS: The sensitivity of OCT (86.7%) was better than that of OCTA (74.3%), whereas the specificity of OCTA (87.0%) was better than that of OCT (67.9%). When these two modalities were combined, both sensitivity and specificity were enhanced (90.3% and 92.4%, respectively). Among the 131 eyes, 32 were misdiagnosed as glaucomatous by OCT but accurately diagnosed as normal by OCTA. These eyes were myopic, with a longer axial length and a thinner and temporally displaced peak of peripapillary retinal nerve fiber layer thickness, causing the false positive result in OCT. CONCLUSIONS: When OCTA was combined with OCT, the specificity of glaucoma diagnoses were enhanced. OCTA may compensate for the shortcomings of OCT in the diagnosis of glaucoma.
Angiography ; Diagnosis ; Diagnostic Techniques and Procedures ; Glaucoma ; Nerve Fibers ; Retinaldehyde ; ROC Curve ; Sensitivity and Specificity ; Tomography, Optical Coherence

Unguarded tricuspid regurgitation (TR) due to a flail tricuspid leaflet is a rare condition of newborn cyanosis. A high perinatal mortality has been associated with this fatal condition. But, there are feasible surgical repairs to improve survival. We report the case of a male full-term neonate with intractable hypoxia. He had profound tricuspid insufficiency and leaflet prolapse caused by a ruptured papillary muscle supporting the anterior leaflet of the tricuspid valve. He presented with severe cyanosis and respiratory distress immediately after birth. Despite medical management, the pulmonary vascular resistance was not decreased and a low cardiac output persisted. Initial stabilization was accomplished with nitric oxide and extracorporeal membrane oxygenation. The tricuspid valve repair surgery was successfully performed subsequently. TR resulting from papillary muscle rupture is a potentially lethal condition. Timely diagnosis and proper surgical treatment can be lifesaving.
Anoxia ; Cardiac Output, Low ; Cyanosis ; Diagnosis ; Extracorporeal Membrane Oxygenation ; Female ; Humans ; Infant, Newborn* ; Male ; Nitric Oxide ; Papillary Muscles* ; Parturition ; Perinatal Mortality ; Persistent Fetal Circulation Syndrome* ; Prolapse ; Rupture ; Thoracic Surgery ; Tricuspid Valve Insufficiency ; Tricuspid Valve* ; Vascular Resistance

BACKGROUND/OBJECTIVES: Doenjang, Korean traditional fermented soybean paste has been reported to have an anti-obesity effect. Because adipose tissue is considered a major source of inflammatory signals, we investigated the protective effects of Doenjang and steamed soybean on oxidative stress and inflammation in adipose tissue of diet-induced obese mice. MATERIALS/METHODS: Male C57BL/6J mice were fed a low fat diet (LF), a high-fat diet (HF), or a high-fat containing Doenjang diet (DJ) or a high-fat containing steamed soybean diet (SS) for 11 weeks. RESULTS: Mice fed a DJ diet showed significantly lower body and adipose tissue weights than those in the HF group. Although no significant differences in adipocyte size and number were observed among the HF diet-fed groups, consumption of Doenjang alleviated the incidence of crown-like structures in adipose tissue. Consistently, we observed significantly reduced mRNA levels of oxidative stress markers (heme oxygenase-1 and p40phox), pro-inflammatory adipokines (tumor necrosis factor alpha and macrophage chemoattractant protein-1), macrophage markers (CD68 and CD11c), and a fibrosis marker (transforming growth factor beta 1) by Doenjang consumption. Gene expression of anti-inflammatory adipokine, adiponectin was significantly induced in the DJ group and the SS group compared to the HF group. The anti-oxidative stress and anti-inflammatory effects observed in mice fed an SS diet were not as effective as those in mice fed a DJ diet, suggesting that the bioactive compounds produced during fermentation and aging may be involved in the observed health-beneficial effects of Doenjang. CONCLUSIONS: Doenjang alleviated oxidative stress and restored the dysregulated expression of adipokine genes caused by excess adiposity. Therefore, Doenjang may ameliorate systemic inflammation and oxidative stress in obesity via inhibition of inflammatory signals of adipose tissue.
Adipocytes ; Adipokines ; Adiponectin ; Adipose Tissue* ; Adiposity ; Aging ; Animals ; Diet ; Diet, High-Fat* ; Fermentation ; Fibrosis ; Gene Expression ; Humans ; Incidence ; Inflammation* ; Macrophages ; Male ; Mice* ; Mice, Obese ; Necrosis ; Obesity ; Oxidative Stress* ; RNA, Messenger ; Soybeans* ; Steam ; Weights and Measures

Primary aldosteronism is in most cases due either to a unilateral adrenal adenama or to a bilateral hyperplasia of the adrenal cortex. But, a few of bilateral adrena1 tumors in primary aldosteronism also have been reported. In these cases, it is important to differentiate the bilateral aldosterone producing adenomas from the unilateral aldosteronoma in the presence of a contralateral nonhmctioning adenoma for marking a treatment plan. We report a case of primary aldosteronism due to a unilateral aldosteronoma in the presence of a contralateral nonfunctioning adenoma. Abdominal CT sean revealed bilateral adrenal tumors, of which the functioning one was successfully localized using adrenal scintigraphy and selective adrenal venous sampling.
Adenoma ; Adrenal Cortex ; Aldosterone* ; Hyperaldosteronism* ; Hyperplasia ; Radionuclide Imaging ; Tomography, X-Ray Computed

If cardiac sympathetic activity increases after myocardial injury, a ventricular electrical storm (VES) may occur. The stellate ganglion block is a minimally invasive technique performed to control VES through temporary sympathetic cessation. This case was treated after 3 stellate ganglion blocks in VES developed after non-ST elevation myocardial infarction. This patient underwent prophylactic stellate ganglion block prior to radical nephrectomy for a renal mass found during hospitalization, and the operation was safely completed. Stellate ganglion block is expected to be a safe treatment option for patients with unstable VES.

BACKGROUND: This study was aimed at investigating the relation of P2X7 receptor (P2X7R) expression with the clinicopathological features of papillary thyroid carcinoma (PTC) coexisting with Hashimoto's thyroiditis (HT). METHODS: We examined 170 patients (84, PTC with HT; 86, PTC without HT). P2X7R expression was examined by immunohistochemical methods. The staining intensity and patterns were evaluated and scored using a semi-quantitative method. RESULTS: The PTC with HT group was more likely to contain women and had less extrathyroid extension, lymph node (LN) metastasis, lymphovascular invasion, and recurrence than the PTC without HT group. Patients positive for P2X7R had significantly higher frequencies of lymphovascular invasion, extrathyroid extension, LN metastasis, and absence of HT. As shown by multivariate analysis, the expression of P2X7R was significantly higher if HT was absent and extrathyroid extension was present. In the PTC with HT group, the expression of P2X7R was significantly higher in patients with tumor multifocality, lymphovascular invasion, and extrathyroid extension. In the PTC without HT group, the expression of P2X7R was significantly higher in women and those having tumor multifocality. CONCLUSIONS: Coexistence of PTC with HT is associated with good prognostic factors, and P2X7R expression in PTC was correlated with poor prognostic factors and the absence of HT.
Female ; Hashimoto Disease ; Humans ; Lymph Nodes ; Methods ; Multivariate Analysis ; Neoplasm Metastasis ; Receptors, Purinergic P2X7* ; Recurrence ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroiditis*

BACKGROUND: Complete sequencing, except for intron 1, of the ABO allele in some populations has been reported. However, so far, one report on complete sequencing of the ABO gene in three Korean families with normal ABO phenotypes has been published. This study aimed to establish a reference database of common ABO alleles in Koreans. METHODS: Screening of common ABO alleles, including homozygote form, was performed by direct sequencing of exons 6 and 7 and by real-time PCR using displacing probes in 95 healthy donors. Genomic DNA from the common ABO group (n=8) and some ABO subgroups (n=7) was used in complete sequencing (except for intron 1) of the ABO allele. RESULTS: The sequences of B101/B101 (n=1), O01/O01 (n=1) were identical with the corresponding sequences registered in Genebank. A102 and A105 had a common point mutation, 1142 C>T in intron 4. A102 (n=3/11) and O02 (n=3/3), selected by sequencing of exons 6 and 7, were reclassified into A105 and O65 by whole genomic sequencing, respectively. Analytic results for ABO subgroups were as follows: B3, B101/O01 (n=3) and B101/O02 (n=1); A1B3, A102/B101 (n=1) and A105/B101 (n=1); Ax, A102/O01 (n=1). CONCLUSION: We established a reference database of common ABO alleles in Koreans and found that the molecular basis of introns of ABO alleles in the Korean population differs from that reported in previous studies of other populations.
Alleles ; DNA ; Exons ; Homozygote ; Humans ; Introns ; Mass Screening ; Phenotype ; Point Mutation ; Real-Time Polymerase Chain Reaction ; Tissue Donors

We report on a newborn girl presenting with a 2.0x1.5 cm sized pinkish, doughy lump arising between right labia majora and anus. We performed antenatal sonogram at 33 and 36th weeks gestation. A polypoid mass of 0.8x1.0 cm sized in size was noted on ultrasonography. After birth, we observed a skin-covered protruding mass not to detect other anatomic anomalies-spinal anomalies, anorectal malformations, etc. After 3 months, excision of the perineal mass was done at the Department of Pediatric Surgery of our hospital. Mature fat cells were noted on histopathological exam. To our knowledge, there are few studies in the English literatures about congenital perineal lipoma without combined structural anomalies.
Adipocytes ; Anal Canal ; Humans ; Infant, Newborn ; Lipoma ; Parturition ; Perineum ; Pregnancy