The pathogenetic mechanism of focal segmental glomerulosclerosis (FSGS) is not known. Some authors suggest glomerular hypertrophy may precede the development of FSGS in patients with minimal lesion. It was recently reported that the size of nonsclerotic glomeruli in adults with FSGS is significantly larger than that of cases with minimal lesion. It is not clear whether glomerular hypertrophy observed in adults with FSGS is also seen in children with FSGS. Thus, we have analyzed 37 renal biopsies from children with FSGS by morphometry and the data were compared with 37 renal biopsies from age- and sex-matched patients with minimal lesion. The number of glomeruli submitted for morphometric analysis was 22.6+/-14.2 in cases with FSGS and 30.9+/-11.4 in cases with minimal lesion. Mean glomerular volume (MGV) in FSGS group was significantly larger than that of minimal lesion [(13.1+/-3.9) x10(5) microm3 vs. (10.1+/-1.9) x10(5) microm3, p<0.001]. The relative interstitial volume of renal cortex in patients with FSGS was significantly larger than that of minimal lesion [(0.106+/-0.051) microm3/microm3 vs. (0.029+/-0.012) microm3/microm3, p<0.0001]. In FSGS, the percentage of glomeruli with FSGS was significantly correlated with relative interstitial volume of renal cortex (r=0.79, p<0.0001). As is the case for adult FSGS, MGV of children with FSGS is significantly larger than that of minimal lesion. Thus, the presence of glomerular hypertrophy observed in biopsies with minimal lesion nephropathy seems to be an indication that the coexistent FSGS lesions are undetected due to sampling problems.
Child ; Adult ; Male ; Female ; Humans ; Biopsy

Multicystic ovary was first described by Silver in 1958 as a rare case feature of acquired primary hypothyroidism. In 1980, Lindsay reported four girls with hypothyroidism associated with multicystic ovary diagnosed by pelvic ultrasonography. The mechanism of ovarian cyst formation and pseudoprecocious puberty in severe hypothyroidism in childhood are unknown. Increased ovarian sensitivity to GnRH and increased TSH level which acts on FSH receptor is one of the mechanism explained. We report a case of a girl with primary hypothyroidism presented with pseudoprecocious puberty and giant follicular ovarian cyst with torsion.
Adolescent ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Hypothyroidism* ; Ovarian Cysts* ; Ovary ; Puberty ; Receptors, FSH ; Silver ; Ultrasonography

Primary segmental volvulus (PSV) of the ileum in neonate occurs rarely but shows an aggressive clinical course. Thus, early diagnosis is important to prevent necrosis and perforation of the intestine. We report a case of PSV of the ileum in a 2-day-old female neonate whose clinical features and radiologic findings appeared to be meconium plug syndrome.
Early Diagnosis ; Female ; Humans ; Ileum ; Infant, Newborn ; Intestinal Volvulus ; Intestines ; Meconium ; Necrosis

Background: Renin-angiotensin systems (RAS) are involved in the physiology of migraine. Ramipril is an angiotensin-converting enzyme inhibitor. We tested whether ramipril has an effect on migraine. Methods: The study was designed as a prospective open-labeled trial in a single center. All patients were asked to maintain a headache diary. Ramipril was administered at 5mg/day (2.5mg twice a day) and subjects were checked every 4 weeks up to 12 weeks. Results: The mean number of headache days was 19.9 ± 11.2 days per month at baseline, and 12.0 ± 11.5 at 12 weeks (p<0.001 vs. baseline) with a responder rate of 41.9%. Stratified analysis by migraine frequency (15 days a month > vs. <15 days a month) did not show a difference. Mean blood pressure was not altered. Conclusions: Ramipril prevented migraine attacks independently from blood pressure. This result supports a link between renin-angiotensin system and migraine pathophysiology (Clinicaltrials.gov identifier: NCT01402479).

No abstract available.
Anemia, Hypoplastic, Congenital*

In this study, the feasibility of identification and genotypic differentiation of enteroviruses was investigated by using nested reverse transcription-polymerase chain reaction (nested RT-PCR), single-stranded conformation polymorphism (SSCP), and restriction fragment length polymorphism (RFLP) techniques. Two hundred seventy-four clinical samples were assayed by both nested RT-PCR and tube culture method using MRC-5 and MK cells; 58 (86.6%) out of 67 enterovirus culture-positive samples contained enteroviral RNA. In addition, 114 (55.1%) of 207 samples from patients with suspected enteroviral CNS disease with negative viral cultures were positive by the nested RT-PCR. The nested RT-PCR products were genotyped by the SSCP method and the results were compared with serotypes. We could differentiate 6 subtypes, 3 of which are similar to coxsackievirus B3, B5, echovirus 11, plus 3 other subtypes. RFLP cleaved with Sty I, Bgl I, and Xmn I yielded characteristic patterns for each laboratory strains. This study demonstrates the usefulness of the RT-PCR for the rapid diagnosis of enterovirus infection and the potentials of the SSCP method for differentiation of enterovirus strains.
Central Nervous System Diseases ; Diagnosis ; Enterovirus B, Human ; Enterovirus Infections ; Enterovirus* ; Genotype* ; Humans ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single-Stranded Conformational ; RNA

No abstract available in English.
Arthritis, Rheumatoid ; Clinical Study

PURPOSE: The purpose of this study was to investigate factors associated with sexual debut among Korean middle school students. METHODS: From the database of the Eighth Korea Youth Risk Behavior Web-based Survey (KYRBS), the researchers selected 37,297 middle school students aged 12-15 years. Data were analyzed using chi2 test and multiple logistic regression with the SPSS WIN 18.0 program. RESULTS: The proportion of middle school students who had a sexual debut was 2.1% of boys and 1.5% of girls. In multiple regression analysis, economic status, experience of part time work, smoking, drug use and depression were associated with an increased proportion of sexual intercourse for both boys and girls. Living with parents, drinking alcohol and suicidal ideation were associated with sexual debut for boys only. By contrast, formal sexual education was associated with a reduced risk of sexual debut. CONCLUSION: The results of this study show the factors associated with sexual debut among Korean middle school students. Gender-related interventions should be taken into consideration in school sexual education programmes, because of differences in related factors according to gender.
Adolescent ; Coitus ; Depression ; Drinking ; Education ; Female ; Humans ; Korea ; Logistic Models ; Parents ; Risk-Taking ; Smoke ; Smoking ; Suicidal Ideation

BACKGROUND: Quinidine appeared to increase serum digoxin levels when given with quinidine. Therefore elevated serum digoxin concentrations and clinical toxicity have been reported in patient receiving quinidine. Currently, Bayesian method which estimates the most probable parameters of the drug for each patient from population parameters data is useful approach for adjusting digoxin dosage. To increase the accuracy of Bayesian method, it is desirable to use population parameters of Korean. Therefore we evaluated the effect of quinidine on digoxin clearance in Korea. METHOD: Patient's records from 19 adult cardiac disease without CHF having normal renal and liver function from Seoul National University of Hospital respectively wre evaluated. Digoxin pharmacokinetic parameters, CL and Vd, were obtained from serum concentration of digoxin of single and combined therapy at each steady-state by using bayesian method. RESULTS: This study show that quinidine reduced the total body clearance of digoxin from 2.39+/-0.17 to 1.51+/-0.08ml/min/kg(p<0.05) and reduced the digoxin volume of distribution from 8.57+/-0.29 to 4.98+/-0.19L/kg(p<0.05). This results show that digoxin dosage reduced to 40-50% in Korean, if quinidine therapy is initiated.
Adult ; Bayes Theorem ; Digoxin* ; Drug Interactions ; Heart Diseases ; Humans ; Korea ; Liver ; Pharmacokinetics ; Quinidine* ; Seoul

Williams syndrome is a progressive and multisystemic disorder. We experienced one case of Willams syndrome which was characterized by elfin facies, mental retardation, diffuse aortic hypoplasia, mitral regurgitation and chronic nonparoxysmal sinus tachycardia. The tachycardia has been managing with beta-blocker successfully. We presented a case of unusual form of Williams syndrome with a reivew of literatures.
Facies ; Intellectual Disability ; Mitral Valve Insufficiency ; Tachycardia ; Tachycardia, Sinus ; Williams Syndrome*