PURPOSE: Kawasaki disease(KD) may be linked to primary infection by certain common viruses. KD concurrent with Epstein-Barr virus(EBV) suggests the possibility of an etiologic agent related to the KD rather than to the EBV infection itself, but, the influence on coronary complication is unclear. To establish whether infection with EBV contributed to the outcome of coronary artery lesions in patients with KD is the purpose of this study. METHODS: Retrospective studies were performed on 96 cases(age 2.48+/-1.94 years) of KD evaluated with serologic studies of EBV(EBV EA IgM, EBV EA IgG, EBNA IgG) at admission. We evaluated the clinical features and coronary outcome between a control group with KD and an EBV associated group with KD. RESULTS: On serologic studies of EBV, 62 patients(64.6%) with one more than positive results were in the EBV associated group with KD, in 30 patients with recent EBV infection, and in 32 patients with previous EBV infection. There were no significant differences between the control group and the EBV associated group in age, sex, and other clinical findings. Eighten patients (18.7%) had abnormal baseline echocardiogram, 13 patients(21.0%) among them were in the EBV associated group and 5 patients(14.7%) were in the control group; there was no significant difference between the two groups. Significantly 11 of 13 patients(84.6%) with coronary lesions had positive result of EBNA IgG, suggesting previous infection. There were no significant differences in retreatment and recurrence incidence. After retreatment, in 3 of 6 cases with the EBV associated group, and in no cases with the control group, cardiac complications were observed. CONCLUSION: Previous or chronic EBV infection may influence the occurrence of coronary lesion in patients with KD, even though patients with cardiac complication improved later.
Coronary Vessels* ; Epstein-Barr Virus Infections ; Herpesvirus 4, Human* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Mucocutaneous Lymph Node Syndrome* ; Recurrence ; Retreatment ; Retrospective Studies

Physeal distraction is used for limb lengthening or correction of deformities in skeletally immature patients. But the effect of distraction on the physis is uncertain. The young rabbits were arranged into five groups according to the slow distraction rates: Group I (no distraction), Group II (distraction rate of 0.25mm per day), Group III (distraction rate of 0.5mm per day), Group IV (distraction rate of 0.75 mm per day), Group V (distraction rate of 1mm per day). The tibial length, size of proliferating zone, microscopic findings of physis immunostained with bromodeoxyuridine, and physeal response to physeal distraction on each group were studied. The results were as follows. 1. There was an increase in bone length on the distracted side (1.8 to 4.2mm). 2. There was an irregular increase in the thickness of the distracted physis. 3. There was an abnormal accumulation of hypertrophic chondrocytes in hypertrophic zone in distracted physis. 4. There was no evidence of anomalous cell proliferation, in the resting, proliferating and hypertrophic zones. These results conclude that the physeal distraction does not stimulate cell proliferation in the physis, even when it is seen to be thickened after the chondrodiatasis.
Bromodeoxyuridine ; Cell Proliferation ; Chondrocytes ; Congenital Abnormalities ; Extremities ; Humans ; Rabbits*

Many patients assume that allergic reactions against foods are responsible for triggering or worsening their allergic symptoms. Therefore, it is important to identify patients who would benefit from an elimination diet, while avoiding unnecessary dietary restrictions. The diagnosis of food allergy depends on the thorough review of the patients's medical history, results of supplemented trials of dietary elimination, and in vivo and in vitro tests for measuring specific IgE levels. However, in some cases the reliability of such procedures is suboptimal. Oral food challenges are procedures employed for making an accurate diagnosis of immediate and occasionally delayed adverse reactions to foods. The timing and type of the challenge, preparation of patients, foods to be tested, and dosing schedule should be determined on the basis of the patient's history, age, and experience. Although double-blind, placebo-controlled food challenges(DBPCFC) are used to establish definitively if a food is the cause of adverse reactions, they are time-consuming, expensive and troublesome for physician and patients. In practice, An open challenge controlled by trained personnel is sufficient especially in infants and young children. The interpretation of the results and follow-up after a challenge are also important. Since theses challenges are relatively safe and informative, controlled oral food challenges could become the measure of choice in children.
Appointments and Schedules ; Child ; Diet ; Follow-Up Studies ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant

PURPOSE: In spite of medical advances, empyema is a serious complication of pneumonia in children. Vaccination practices and antibiotic prescribing practices promote the change of clinical manifestations of empyema and causative organisms. So we made a nationwide clinical observation of 122 cases of empyema in children from 32 hospitals during the 5 year period from September 1999 to August 2004. METHODS: Demographic data, and clinical information on the course and management of empyema patients were collected retrospectively from medical records in secondary and tertiary hospitals in Korea. RESULTS: One hundred twenty two patients were enrolled from 35 hospitals. The most frequent age group was 1-3 years, accounting for 48 percent of all cases. The male to female sex ratio was 1.2:1. The main symptoms were cough, fever, respiratory difficulty, lethargy and chest pain in order of frequency. Hematologic findings on admission revealed decreased hemoglobin levels (10.4+/-1.6 g/dL) and increased leukocyte counts (16,234.3+/-10,601.8/microliter). Pleural fluid obtained from patients showed high leukocyte counts (30,365.8+/-64,073.0/microliter), high protein levels (522.3+/-1582.3 g/dL), and low glucose levels (88.1+/-523.5 mg/dL). Findings from pleural fluid cultures were positive in 80 cases(65.6 percent). The most common causative agent was Streptococcus pneumoniae. The majority of patients were treated with antibiotics and closed drainage. Some patients needed open drainage (16.4 percent) or decortication (3.3 percent). The mean duration of hospitalization was 28.6+/-15.3 days. CONCLUSION: We analyzed childhood empyema patients during a period of 5 years in Korean children. The most frequent age group was 1-3 years and the most common causative agent was Streptococcus pneumoniaeiae. The majority of patients were treated with antibiotics and close drainage.
Anti-Bacterial Agents ; Chest Pain ; Child ; Cough ; Drainage ; Empyema* ; Female ; Fever ; Glucose ; Hospitalization ; Humans ; Korea* ; Lethargy ; Leukocyte Count ; Male ; Medical Records ; Pneumonia ; Retrospective Studies ; Sex Ratio ; Streptococcus ; Streptococcus pneumoniae ; Tertiary Care Centers ; Vaccination

OBJECTIVES: Previous studies have suggested an association of pregnancy-induced hypertension(PIH) with several genes involved in cardiovascular control. The objectives of this study were to evaluate the association between PIH and angiotensinogen(AGT) M235T gene and also to study the association between PIH and angiotensin-converting- enzyme(ACE). METHODS: DNA was extracted from whole blood, cheek swabs, and blood spot cards of 39 PIH patients and 54 controls. Controls consisted of women who had undergone at least two term pregnancies unaffected by PIH. All samples were genotyped for all the polymorphism using PCR of known alleic variants. Results were ananlyzed with a kappa2 contingency table. RESULTS: Four of 13 women with mild PIH(30.8%) and thirteen of 26 women with severe PIH(50.0%) were heterozygous for AGT M235T mutation compared with 26 of 54 controls(48.1%). Two of 13 women with mild PIH(15.4%) and two of 26 women with severe PIH(7.7%) were homozygous for AGT M235T mutation compared with 10 of 54 controls(18.6%). Six of 7 women with mild PIH(85.7%) and ten of 21 women with severe PIH(47.6%) were ID type for ACE gene compared with 31 of 56 controls(55.4%). One of 7 women with mild PIH(14.3%) and seven of 21 women with severe PIH(33.4%) were DD type for ACE gene compared with 15 of 56 controls(26.7%). There was no significance between mild, severe PIH patients and controls for AGT M235T mutation and ACE gene polymorphism. CONCLUSION: In Korean population, AGT M235T mutation and ACE gene are not associated with an increased risk for PIH.
Angiotensinogen* ; Cheek ; DNA ; Female ; Humans ; Hypertension, Pregnancy-Induced* ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Pregnancy

Purpose: Immune checkpoint inhibitors (ICIs) have been shown significant oncological improvements in several cancers.However, ICIs are still in their infancy in hepatocellular carcinoma (HCC). Programmed cell death-ligand 1 (PD-L1), tumorinfiltrating lymphocytes (TILs), and epithelial-mesenchymal transition (EMT) have been known as prognostic factors in HCC. Therefore, we have focused on identifying the molecular mechanisms between each marker to evaluate a predictive role. Methods: Formalin-fixed paraffin-embedded samples were obtained from 166 patients with HCC who underwent surgery. The expression of PD-L1 and TILs and EMT marker were evaluated by immunohistochemical analysis. Results: The multivariate analysis showed that TIL expression (hazard ratio [HR], 0.483; 95% confidence interval [CI], 0.269–0.866; P = 0.015) were independent prognostic factors for overall survival. The prognostic factors for disease-free survival were EMT marker expression (HR, 1.565; 95% CI, 1.019–2.403; P = 0.005). Patients with high expression of TILs had significantly better survival compared to patients with low expression (P = 0.023). Patients who were TIL+/EMT– showed a significantly better prognosis than those who were TIL–/EMT+ (P = 0.049). Conclusion This study demonstrates that PD-L1 expression of TILs is closely associated with EMT marker expression in HCC. Clinical investigations using anti–PD-1/PD-L1 inhibitors in patients with EMT-associated PD-L1 upregulation are warranted.

No abstract available.
Humans ; Multiple Myeloma ; Plasma Cells ; Plasma ; Precursor Cell Lymphoblastic Leukemia-Lymphoma

Food allergy has emerged as an important public health problem affecting people of all ages in many countries. The prevalence varies according to age, geographic regions, and ethnicity. For several years, many studies have suggested that the prevalence of food allergy is increasing at an alarming rate, for unclear reasons. Conversely, some studies have also provided findings that sensitization to common food allergens did not increase. Increased recognition rather than an actual increase in patients with IgE-mediated food allergy might lead to the increases in the prevalence of self-reported or physician-diagnosed food allergy. It is also noted that the prevalence of food allergy differs even in the same region according to the study design, i.e., hospital-based or community-based studies. Despite these limitations, epidemiologic data are important because they provide useful information on diagnosis, treatment, and prevention of food allergy. This review focuses on advances in the epidemiology of food allergy in Korean children.
Allergens ; Child ; Diagnosis ; Epidemiology ; Food Hypersensitivity ; Humans ; Prevalence ; Public Health

With increasing need to prevent serious food allergy reactions, Korean food allergen labeling regulation has been revised repeatedly. This paper aims to summarize current statuses of food allergen labeling in Korea and foreign countries and to analyze the issue of food allergen labeling regulation. Korean food labeling regulation currently requires 19 items and 22 foods to be reported on labels (eggs, milk, buckwheat, peanut, soybean, wheat, mackerel, crab, shrimp, pork, peach, tomato, sulfite, walnut, chicken, beef, squid, shellfish, and pine nut). However, some common food triggers (for example, almond, cashew nut, and kiwi fruit) are not included in the current labeling regulation. Another issue is that the Korean labeling regulation has not yet been fully implemented for nonprepacked foods; thus, consumers still have difficulty in correctly identifying allergenic ingredients in food. It should be assessed whether warning statements for cross-contamination are reasonable. To prevent the occurrence of serious reactions from accidental ingestion, efforts must be made to solve recently raised issues including the items required to be listed on food labels, the system of standards for labeling and display methods.
Anacardium ; Arachis ; Chickens ; Decapodiformes ; Eating ; Fagopyrum ; Food Hypersensitivity ; Food Labeling ; Hypersensitivity ; Juglans ; Korea ; Lycopersicon esculentum ; Milk ; Nuts ; Perciformes ; Prunus dulcis ; Prunus persica ; Red Meat ; Shellfish ; Soybeans ; Triticum

Actinomycosis is a rare chronic suppurative disease caused by actinomyces species, which are normal flora in the oral cavity and gastrointestinal tract, and characterized by formation of sulfur granule. Actinomyces can affect cervicofacial, pulmonary, abdominal and pelvic area. However, abdominal and pelvic inflammations are less frequently observed. Most of abdominal actinomycosis develop after abdominal operation, trauma, inflammatory bowel disease or use of intrauterine devices. The definitive diagnosis was made after histopathological study of the tissues. Treatment is long-term antibiotic therapy. Herein, we report a case of a 69-year-old woman with an unusual form of abdominal actinomycosis after total gastrectomy.
Actinomyces ; Actinomycosis* ; Aged ; Diagnosis ; Female ; Gastrectomy ; Gastrointestinal Tract ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Intrauterine Devices ; Mouth ; Sulfur ; Upper Gastrointestinal Tract*