Herpes zoster (HZ) has been reported in immunocompetent children who received the varicella vaccine. In vaccinated children, HZ can be caused by vaccine-strain or by wild-type varicella-zoster virus (VZV). Like wild-type VZV, varicella vaccine virus can establish latency and reactivate as HZ. We report two cases of HZ in otherwise healthy 16- and 14-month-old boys who received varicella vaccine at 12 months of age. They presented with a vesicular rash on their upper extremities three to four months after varicella vaccination. In one case, a swab was obtained by abrading skin vesicles and VZV was detected in skin specimens by polymerase chain reaction. The VZV open-reading frame 62 was sequenced and single nucleotide polymorphism analysis confirmed that the virus from skin specimen was vaccinestrain. This is the first HZ case following varicella vaccination confirmed to be caused by vaccine-strain VZV in the immunocompetent children in Korea. Pediatricians should be aware of the potential for varicella vaccine virus reactivation in vaccinated young children.

BACKGROUND: Tumor-associated macrophages (TAMs) play a tumorigenic role related to advanced staging and poor prognosis in many human cancers including thyroid cancers. Yet, a functional role of TAMs in papillary thyroid carcinoma (PTC) has not been established. The aim of this study was to investigate TAM expression in human PTC with lymph node (LN) metastasis. METHODS: Thirty-six patients who underwent surgery after being diagnosed with PTC with LN metastasis were included. Primary tumor tissues were immunohistochemically stained with an anti-CD68 antibody and clinical characteristics according to TAM density were evaluated. RESULTS: The TAM densities (CD68+ cells) varied from 5% to 70%, in all tumor areas, while few cells were stained in adjacent normal tissues. TAMs were identified as CD68+ cells with thin, elongated cytoplasmic extensions that formed a canopy structure over tumor cells. Comparing clinicopathologic characteristics between tumors with low (<25%) and high (25% to 70%) TAM densities, primary tumors were larger in the high density group than in the low density group (2.0+/-0.1 vs. 1.5+/-0.1; P=0.009). CONCLUSION: TAMs were identified in primary PTC tumors with LN metastasis and higher TAM densities were related to larger tumor sizes, suggesting a tumorigenic role of TAMs in human PTCs.
Carcinoma ; Cytoplasm ; Factor IX ; Humans ; Lymph Nodes ; Macrophages ; Neoplasm Metastasis ; Prognosis ; Thyroid Gland ; Thyroid Neoplasms

BACKGROUND: Life expectancy is ever increasing due to medical advancements, but cancer death rate is also increased. Quality of life is an important issue in cancer patients. Despite developments of early diagnosis and treatments for cancer, the medical costs is increasing due to exfended sarvival against cancer and the absolute numbers of terminal cancer patients. We assessed the medical costs and quality of life in terminal cancer patients by the types of medical facilities, which would contribute to effective management. METHOD: A total 159 patients(males 70, females 89) with terminal cancer patients who were treated and died in various types of medical facilities(home hospice, charity hospital hospice unit, university hospital hospice unit, university hospital non-hospice unit) between November 1, 1997 and January 31, 1999 were included in the study. After the confirmation that the demographic factors correlated with factors of quality of life, the differences in the medical costs and quality of life(pain, depression, ADLs, family APGAR score) during the last 1 week of life in the various types of medical facilities analyzed by multi-way ANOVA with interaction of the significant demographic factors. RESULTS: The mean cost of types of medical facilities during the last week of patients as 65332.5 won in charity hospital hospice unit, 105165.5 won in home hospice, 702083.4 won in university hospital hospice unit, and 1037358.6 won in university hospital non-hospice unit. The difference between free hospital hospice unit and home hospice in medical costs as not statistically significant, but the difference among charity hospital hospice unit and home hospice, university hospital hospice unit, and university hospital non-hospice unit as significant (p<0.001). The demographical factors of quality of life in terms of pain, depression, ADLs, and family APGAR score were compared among various facilities. The ADL score of home hospice was 8.2 +/- 3.3, which was lower than free hospital hospice unit and university hospital hospice unit(p<0.05). The mean pain scor of home hospice as 1.7+/-1.7 and that of university hospital hospice as 1.2+/-1.2, and pain scores of home hospice were lower than free hospital hospice unit, and pain scores of university hospital hospice were lower than free hospital hospice unit and university hospital non-hospice unit(p<0.05). In depression's categorial scale of home hospice the score was 4.8+/-1.3, which was higher than those of free hospital hospice unit and university hospital non-hospice unit(p<0.05), signifying less depression. The family APGAR score was statistically insignificant among various types of medical facilities. CONCLUSION: The cost of hospice care is less than the non-hospice care. We found that the patients of home hospice experienced less pain and depression even with low ADLs, and increased the quality of life in both psychological and physical aspects.
Activities of Daily Living ; Apgar Score ; Charities ; Demography ; Depression ; Early Diagnosis ; Female ; Hospice Care ; Hospices ; Humans ; Life Expectancy ; Mortality ; Quality of Life*

Typhlitis is a necrotizing colitis that usually occurs in neutropenic patients and develops most often in patients with hematologic malignancies such as leukemia and lymphoma. Typhlitis may proceed to bowel perforation, peritonitis and sepsis, which requires immediate treatment. Irinotecan is a semisynthetic analogue of the natural alkaloid camptothecin which prevents DNA from unwinding by inhibition of topoisomerase I. It is mainly used in colon cancer and small cell lung carcinoma (SCLC), of which the most common adverse effects are gastrointestinal toxicities. To the best of our knowledge, no case of typhlitis after chemotherapy with a standard dose of irinotecan in a solid tumor has been reported in the literature. We, herein, report the first case of typhlitis developed after chemotherapy combining irinotecan and cisplatin in a patient with SCLC.
Camptothecin ; Cisplatin ; Colitis ; Colonic Neoplasms ; DNA ; DNA Topoisomerases, Type I ; Hematologic Neoplasms ; Humans ; Leukemia ; Lymphoma ; Peritonitis ; Sepsis ; Small Cell Lung Carcinoma ; Typhlitis

Fistulas of the fourth branchial pouch have an external opening in the neck and the inner opening at the apex of the pyriform fossa. The tract passes from the left lobe of the thyroid, resulting in acute suppurative thyroiditis in most cases. Actinomycosis is an indolent, slowly progressive infection caused by anaerobic or microaerophilic gram-positive bacteria, primarily of the genus Actinomyces. These bacteria are filamentous with branching and may colonize in the oral cavity. Actinomycosis is a chronic disease characterized by abscess formation, tissue fibrosis, and draining sinuses. We experienced a case of 6-year-old boy who had presented with a left neck mass. Neck sono showed an approximately 3 cm-sized low echoic mass in the left thyroid gland. Thyroid scan was compatible with thyroid hypofunction. Gomori-methenamine silver stain after fine needle aspiration showed colonies of bacteria, are composed of long, thin, filamentous bacteria. Barium esophagogram showed a linear barium-filled track at the left pyriform sinus. Neck excisional biopsy was consistent with the remnant of a fourth branchial cleft fistula. We report a case of actinomycotic thyroiditis in a child with fourth branchial cleft fistula, with a brief review of related literature.
Abscess ; Actinomyces ; Actinomycosis ; Bacteria ; Barium ; Biopsy ; Biopsy, Fine-Needle ; Branchial Region* ; Child* ; Chronic Disease ; Colon ; Fibrosis ; Fistula* ; Gram-Positive Bacteria ; Humans ; Male ; Mouth ; Neck ; Pyriform Sinus ; Silver ; Thyroid Gland* ; Thyroiditis* ; Thyroiditis, Suppurative

Cytomegalovirus is a common virus that is mostly asymptomatic when infected, but rarely causes life-threatening hemolysis especially in immunocompromised children. We report a case of antiglobulin test negative severe hemolytic anemia caused by cytomegalovirus infection developed in an immune competent 9-year-old girl. The patient's hemoglobin level was 4.8 g/dL on the day of admission. The diagnosis was achieved by exclusion of other causes of hemolytic anemia and serological evidence of recent CMV infection. The patient was successfully treated with anti-viral agents and steroids resulting in recovery from anemia. Clinicians should consider cytomegalovirus infection in the differential diagnosis of hemolytic anemia in pediatric patients.
Anemia ; Anemia, Hemolytic* ; Child ; Coombs Test* ; Cytomegalovirus ; Cytomegalovirus Infections ; Diagnosis ; Diagnosis, Differential ; Female ; Hemolysis ; Humans ; Steroids

BACKGROUND: Tyrosine kinase receptor (TKR) is an important protein for normal-development, growth and tumorigenesis in human tissues. The purpose of this study was to evaluate the effect of TKR in the progression of breast cancer. METHODS: The expressions of EphA2, c-met and c-erbB-2 were examined, by using immunohistochemical methods and RT-PCR, in samples of breast tissue that included 111 samples of normal epithelium, 34 samples of ductal carcinoma in situ (DCIS), and 109 samples of invasive ductal carcinomas (IDC). The results were compared with the prognostic parameters of breast cancer including the tumor grade, growth pattern, lymph node metastasis and the expressions of ER, PR, p53 and Ki-67. RESULTS: The protein expressions of the three TKRs were higher in DCIS and IDC than in normal epithelium. The protein expression of EphA2 was correlated with a tumor grade, a labeling index of Ki-67, and the protein expression of c-met. Overexpression of c-erbB-2 was correlated with lymph node metastasis. The mRNA levels of the three TKRs were correlated with each other in normal tissue and IDC. The level of c-met mRNA was higher in the low grade tumors. CONCLUSIONS: The three TKRs may play roles in the tumorigenesis of human breast cancer. The overexpressions of EphA2 and c-erbB-2 may be a poor prognostic parameter in breast cancers.
Breast Neoplasms ; Breast* ; Carcinogenesis ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Epithelium ; Humans* ; Lymph Nodes ; Neoplasm Metastasis ; Protein-Tyrosine Kinases* ; Receptor Protein-Tyrosine Kinases* ; RNA, Messenger ; Tyrosine*

The prevalence of gout is increasing worldwide, and control of serum uric acid level has been regarded as one of the therapeutic methods for gout. Inhibition of xanthine oxidase (XO) activity which can oxidize hypoxanthine to uric acid has been commonly proposed to decrease serum uric acid level. The aim of this study was to demonstrate the hypouricemic effect of ethanol extract of Aster glehni leaves (EAG) by in vitro and in vivo study in potassium oxonate (PO)-induced hyperuricemic rats. EAG possessed 132.5 ± 6.8 mg QE/g of total flavonoid and showed antioxidant activity. EAG showed in vitro and in vivo inhibitory activity against XO and significantly decreased serum uric acid level in PO-induced hyperuricemic rats without liver toxicity. These results show that EAG significantly attenuates hyperuricemia by inhibiting XO activity, which resulted in the decrease of serum uric acid level. Therefore, EAG might possess a potential therapeutic ability for improving gout.
Animals ; Ethanol* ; Gout ; Hyperuricemia ; Hypoxanthine ; In Vitro Techniques ; Liver ; Potassium* ; Prevalence ; Rats* ; Uric Acid ; Xanthine Oxidase

We evaluated the neutralizing activity in serum from three patients >1 year after recovery from Middle East respiratory syndrome (MERS) associated with mild pneumonia treated with antivirals during the MERS outbreak in South Korea at 2015. The neutralizing activity in serum was measured by pseudovirus inhibition assays. Three-fold diluted serum of subjects showed only 9.7%, 10.3%, and 2.2% reductions in relative light units. So, significant neutralizing activity was not demonstrated in any sera of three patients with mild pneumonia >1 year after being successfully treated with antiviral agents and recovering from MERS coronavirus infection.
Antibodies, Neutralizing ; Antiviral Agents* ; Coronavirus Infections ; Humans ; Korea* ; Middle East Respiratory Syndrome Coronavirus ; Pneumonia

PURPOSE: This study was implemented to develop and validate the semi-quantitative food frequency questionnaire (SQ-FFQ) to assess energy, carbohydrates, fat, protein, minerals, and vitamins as well as fatty acids and alcohol in Korean adults. METHODS: The SQ-FFQ consisted of 88 food items, and 12 food groups were selected based on information of frequently consumed foods from the Korean Health and Nutrition Examination survey. Each portion size was categorized as one of three amounts: small (0.5 times), medium (1 time), and large (1.5 times). A total of 111 subjects finished 3-day diet records and the SQ-FFQ. The relative validity of SQ-FFQ was assessed by comparison with the 3-day diet records. RESULTS: The mean nutrient intakes obtained from the SQ-FFQ were estimated to be greater than those of the two 3-day dietary records. Spearman's correlation coefficient between the two methods was the highest for energy (r = 0.583; p < 0.001) and lowest for saturated fatty acid (r = 0.121). Correlation coefficients were energy (r = 0.583; p < 0.001), carbohydrates (r = 0.500; p < 0.001), protein (r = 0.466; p < 0.001), fat (r = 0.411; p < 0.001), dietary fiber (r = 0.467; p < 0.001), alcohol (r = 0.527; p < 0.001), calcium (r = 0.409; p < 0.001), phosphorus (r = 0.499; p < 0.001), potassium (r = 0.418; p < 0.001), magnesium (r = 0.427; p < 0.001), and zinc (r = 0.464; p < 0.001), respectively, for all subjects. CONCLUSION: The developed SQ-FFQ in this study seems to be useful for estimating nutritional status, particularly energy, carbohydrates, protein, fat, dietary fiber, alcohol, calcium, phosphorus, potassium, magnesium, and zinc of Korean adults.
Adult ; Calcium ; Carbohydrates ; Diet Records ; Dietary Fats ; Dietary Fiber ; Fatty Acids ; Humans ; Magnesium ; Minerals ; Miners ; Nutritional Status ; Phosphorus ; Portion Size ; Potassium ; Vitamins ; Zinc