PURPOSE: The etiology of febrile seizures is not yet ascertained but it is known that genetic factors, cytokines or trace elements are associated with pathogenesis of febrile seizures. Among them, zinc deficiency is known to play some role of pathogenesis of febrile seizures. We purposed to know the relation between recurrence of febrile seizures and serum zinc level. METHODS: The subjects were recurrent febrile seizures group who were admitted to our hospital from June 2003 to July 2005 because of more than 3 times febrile seizures. The other two control groups were simple febrile seizures and acute febrile illness groups admitted to our hospital in same period. Simple febrile seizures group showed no more seizure over 1 year after first onset. We investigated serum zinc level in each group. RESULTS: The number of patient in each group is 33 children. Recurrent febrile seizures group was composed of 20 boys and 13 girls (the ratio of 1.5:1) with an average age 30 months old. The mean serum zinc levels in the recurrent febrile seizures group (123.7+/-9.6 microgram/dL) were not statistically different from those of the simple febrile seizures group(112.5+/-8.9 microgram/dL). Both of the recurrent and simple febrile seizures groups had significantly lower serum zinc levels than the febrile illness group(154.1+/-6.8 microgram/dL). CONCLUSION: We suggested that serum zinc level is not relationship with recurrence of febrile seizures. Nevertheless, the fact remains that serum zinc level was decreased in recurrent and simple febrile seizures groups compared with acute febrile illness group.
Child ; Child, Preschool ; Cytokines ; Female ; Humans ; Recurrence* ; Seizures ; Seizures, Febrile* ; Trace Elements ; Zinc*

Entrapment syndrome of suprascapular nerve by a ganglion has been reported not frequently. We experienced a case of suprascapular nerve entrapment by ganglion which was treated with non-operative treatment, and report it with literature.
Ganglion Cysts* ; Nerve Compression Syndromes*

PURPOSE: Mycoplasma pneumoniae pneumonia is rarely found in children under 3 years old. Nevertheless, infants have been recently and frequently diagnosed with M. pneumoniae pneumonia. Therefore, the clinical characteristics of such children were investigated in this study. METHODS: Subjects were 232 infants (group A: 0 to 11 months, group B: 12 to 23 months, group C: 24 to 35 months) who were diagnosed between January 2004 and December 2009 with M. pneumoniae pneumonia infection at Myongji Hospital. We reviewed their medical records, the early and monthly incidence of infection, clinical manifestations, and laboratory findings. RESULTS: Group A consisted of 28 patients (12.1%), group B 78 (33.6%), and group C 126 (54.3%). The younger patient group in the peak season, 2006, demonstrated a high incidence rate. Wheezing was more often auscultated in group A than in the other groups. Negative findings on chest X-rays were more often observed in group A. Serologically, high titers of mycoplasma-specific antibody (>1:1,280) were observed in lobar pneumonia and correlated with the severity of clinical manifestations. CONCLUSION: The age at which M. pneumoniae infection has been diagnosed has recently decreased and has been found with a particularly high frequency in infants. Despite shorter fever duration before hospitalization and uncertain radiological findings, including M. pneumoniae in the differential diagnosis of pneumonia is recommended for children under 1 year.
Child ; Child, Preschool ; Diagnosis, Differential ; Fever ; Hospitalization ; Humans ; Incidence ; Infant ; Medical Records ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Respiratory Sounds ; Seasons ; Thorax

Background: We aimed to investigate mortality, severity, and risk of hospitalization in coronavirus disease 2019 (COVID-19) patients with cancer. Methods: Data of all patients aged 40–79 years from the Korean Disease Control and Prevention Agency-COVID19-National Health Insurance Service who were diagnosed with COVID-19 between January 1, 2020 and March 31, 2022, in Korea were included. After 1:1 propensity score matching, 397,050 patients with cancer and 397,050 patients without cancer were enrolled in the main analysis. A cancer survivor was defined as a patient who had survived 5 or more years since the diagnosis of cancer. Multiple logistic regression analysis was performed to compare the risk of COVID-19 according to the diagnosis of cancer and time since diagnosis. Results: Cancer, old age, male sex, incomplete vaccination against COVID-19, lower economic status, and a higher Charlson comorbidity index were associated with an increased risk of hospitalization, hospitalization with severe state, and death. Compared to patients without cancer, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for hospitalization, hospitalization with severe state, and death in patients with cancer were 1.09 (1.08–1.11), 1.17 (1.11–1.24), and 1.94 (1.84–2.05), respectively. Compared to patients without cancer, the ORs (95% CIs) for hospitalization in cancer survivors, patients with cancer diagnosed 2–5 years, 1–2 years, and < 1 year ago were 0.96 (0.94–0.98), 1.10 (1.07–1.13), 1.30 (1.25–1.34), and 1.82 (1.77–1.87), respectively; the ORs (95% CIs) for hospitalization for severe disease among these patients were 0.90 (0.85–0.97), 1.22 (1.12–1.32), 1.60 (1.43–1.79), and 2.29 (2.09–2.50), respectively. Conclusion The risks of death, severe state, and hospitalization due to COVID-19 were higher in patients with cancer than in those without; the more recent the diagnosis, the higher the aforementioned risks. Cancer survivors had a lower risk of hospitalization and hospitalization with severe disease than those without cancer.

Holoprosencephaly is a rare CNS developmental defect with midline cleavage of embryonal forebrain during the fourth week of fetal development characterized with s single ventricle. Holoprosencephaly is divided into three types by the degree of the brain cleavage : alobar, semilobar, and lobar. Depending on the degree of defected regions, there exist variable clinical symptoms and signs such as stillbirth, hypotonia, apnea, convulsion, delayed development and visual disturbance. It was frequently associated with the deformity of the brain as well as the midline facial structures. Advances in neuroimaging over the past decades have led us to a better understanding of the pathogenesis and the variability of holoprosencephaly. As a result, a lot of cases of holoprosencephaly with various clinical and pathologic findings have been reported. We experienced a case of isolated interhemisphere fusion of frontal lobes with intact septum pellucidum in a child with febrile status epilepticus. Is it a variant of holoprosencephaly?
Apnea ; Brain ; Child ; Congenital Abnormalities ; Fetal Development ; Frontal Lobe* ; Holoprosencephaly* ; Humans ; Muscle Hypotonia ; Neuroimaging ; Prosencephalon ; Seizures ; Septum Pellucidum* ; Status Epilepticus ; Stillbirth

OBJECTIVES: The objectives of this study were to estimate the continuity of care for all Koreans with diabetes and to identify factors affecting the continuity of care. METHODS: We obtained National Health Insurance claims data for patients with diabetes who visited health-care providers during the year 2004. A total of 1,498,327 patients were included as study subjects. Most Frequent Provider Continuity (MFPC) and Modified, Modified Continuity Index (MMCI) were used as indexes of continuity of care. A multiple linear regression analysis was used to identify factors affecting continuity of care. RESULTS: The average continuity of care in the entire population of 1,498,327 patients was 0.89+/-0.17 as calculated by MFPC and 0.92+/-0.16 by MMCI. In a multiple linear regression analysis, both MFPC and MMCI were lower for females than males, disabled than non-disabled, Medicaid beneficiaries than health insurance beneficiaries, patients with low monthly insurance contributions, patients in rural residential areas, and patients whose most frequently visited provider is the hospital. CONCLUSIONS: The continuity of care for patients with diabetes is high in Korea. However, women, the disabled and people of low socio-economic status have relatively low continuity of care. Therefore, our first priority is to promote a diabetes management program for these patients.
Poverty ; National Health Programs ; Middle Aged ; Medical Assistance ; Male ; Linear Models ; Korea/epidemiology ; Insurance Claim Review ; Humans ; Female ; Diabetes Mellitus/economics/epidemiology/*therapy ; Continuity of Patient Care/economics/*statistics & numerical data ; Aged ; Adult

BACKGROUND: Since the Independence in 1945, the Republic of Korea (ROK) has maintained fundamentally the liberal health care system by the influence of U.S.A. Therefore, as in the case of U.S.A., the primary health care system of ROK has fallen in the chaos. Recently, the new government of ROK seems to retry the introduction of 'Family Doctor Registration System (FDRS)' in spite of the 1996's failure. In order to conduct FDRS efficiently, there should be a thorough investigation on the opinions of doctors and people in the community. This study was conducted with a view to collecting necessary information regarding the implementation of FDRS. METHODS: By mailing, the self-administered questionnaires were collected twice during March 18 to May 12 in 1998. The questionnaire had been prepared through several discussions, pretest, and final correction by five family physicians and two health care policy professors. The subjects consisted of 2,093 family physicians. RESULTS: Though the overall response rate was only 28.2% (591) subjects, age distribution for the study subjects was similar to that of average family physicians. The subjects consisted of 451 males and 138 females. The number of those whose age was less than 40 was 49.9% (195). "The group that agrees with the introduction of FDRS" was 58.5% of all respondents; "the group that objects 14.4%; and the group undetermined" 24.7%. The 73.6% of all respondents had negative opinion on increased administrative work. Only 21.3% expected their net income to increase. On multiple logistic regression analysis, relatively large city rather than metropolitan Seoul, the smaller number of visiting patients a month, regular resident training experience, and male sex resulted in having a significant positive relationship with the introduction of FDRS. Further analyses are called for to identify differences of opinions between family physicians and single specialty medical practitioners. CONCLUSIONS: The results of this survey should be reflected into the health care policy when retrying to implement FDRS in Korea.
Age Distribution ; Surveys and Questionnaires ; Delivery of Health Care ; Female ; Humans ; Korea* ; Logistic Models ; Male ; Physicians, Family ; Postal Service ; Primary Health Care ; Republic of Korea ; Seoul ; Specialization*

OBJECTIVES: With the end of the coronavirus disease 2019 (COVID-19) pandemic, the health outcomes of this disease in Korea must be examined. We aimed to investigate health outcomes and disparities linked to socioeconomic status during the COVID-19 pandemic in Korea and to identify risk factors for hospitalization and mortality. METHODS: This nationwide retrospective study incorporated an analysis of individuals with and without COVID-19 in Korea between January 1, 2020 and December 31, 2022. The study period was divided into 4 stages. Prevalence, hospitalization, mortality, and case-fatality rates were calculated per 100,000 population. Multivariate logistic regression was performed to identify risk factors for COVID-19 hospitalization and mortality. RESULTS: Overall, the incidence rate was 40,601 per 100,000 population, the mortality rate was 105 per 100,000 population, and the case-fatality rate was 259 per 100,000 cases. A total of 12,577,367 new cases (24.5%) were recorded in stage 3 and 8,979,635 cases (17.5%) in stage 4. Medical Aid recipients displayed the lowest 3-year cumulative incidence rate (32,737 per 100,000) but the highest hospitalization (5,663 cases per 100,000), mortality (498 per 100,000), and case-fatality (1,521 per 100,000) rates. Male sex, older age, lower economic status, non-metropolitan area of residence, high Charlson comorbidity index, and disability were associated with higher risk of hospitalization and death. Vaccination was found to reduce mortality risk. CONCLUSIONS As the pandemic progressed, surges were observed in incidence, hospitalization, and mortality, exacerbating disparities associated with economic status and disability. Nevertheless, Korea has maintained a low case-fatality rate across all economic groups.

BACKGROUND/AIMS: To describe the toxicity profile of anti-neoplastic agents from real clinical settings, we analyzed spontaneously reported adverse events (AEs) using data from the adverse drug reaction (ADR) reporting system of the Korean Food and Drug Administration (KFDA). METHODS: Data were extracted from the nationwide spontaneous ADR reporting system of KFDA from July 2009 to December 2010. We extracted and analyzed data related to chemotherapy and identified unlabeled ADR that were not described in the package insert of the products. RESULTS: In total, 5,867 cases of antineoplastic agent-related AE reports were identified after excluding cases for duplication and cases assessed as 'unlikely' and 'unclassifiable', based on expert opinion. Of the patients with AEs, 52.4% were males and the median age was 56 years. In total, 460 AEs (7.8%) from 267 patients were reported as 'serious' AEs. The most common causative anti-cancer drug class was pyrimidine analogs (31.5%), followed by platinum compounds (19.9%), protein kinase inhibitors (10.8%), and taxanes (8.8%). The most common clinical manifestation of AEs was gastrointestinal toxicities (25.5%), followed by skin disorders (25.3%), and generalized reactions (14.3%). In total, 168 cases (2.9%) of unlabeled AEs were identified. Among these, 10 were reported as serious AEs. CONCLUSIONS: The most common causative class of antineoplastic agents was that of pyrimidine analogs. Gastrointestinal and dermatological toxicities were the most common clinical chemotherapy-related adverse events. Further investigation and monitoring to evaluate causality associated with unlabeled AEs identified in this analysis are needed.
Antineoplastic Agents ; Drug Toxicity ; Expert Testimony ; Humans ; Male ; Pharmacovigilance ; Platinum Compounds ; Product Labeling ; Protein Kinase Inhibitors ; Pyrimidines ; Skin ; Statistics as Topic ; Taxoids ; United States Food and Drug Administration

BACKGROUND/AIMS: To describe the toxicity profile of anti-neoplastic agents from real clinical settings, we analyzed spontaneously reported adverse events (AEs) using data from the adverse drug reaction (ADR) reporting system of the Korean Food and Drug Administration (KFDA). METHODS: Data were extracted from the nationwide spontaneous ADR reporting system of KFDA from July 2009 to December 2010. We extracted and analyzed data related to chemotherapy and identified unlabeled ADR that were not described in the package insert of the products. RESULTS: In total, 5,867 cases of antineoplastic agent-related AE reports were identified after excluding cases for duplication and cases assessed as 'unlikely' and 'unclassifiable', based on expert opinion. Of the patients with AEs, 52.4% were males and the median age was 56 years. In total, 460 AEs (7.8%) from 267 patients were reported as 'serious' AEs. The most common causative anti-cancer drug class was pyrimidine analogs (31.5%), followed by platinum compounds (19.9%), protein kinase inhibitors (10.8%), and taxanes (8.8%). The most common clinical manifestation of AEs was gastrointestinal toxicities (25.5%), followed by skin disorders (25.3%), and generalized reactions (14.3%). In total, 168 cases (2.9%) of unlabeled AEs were identified. Among these, 10 were reported as serious AEs. CONCLUSIONS: The most common causative class of antineoplastic agents was that of pyrimidine analogs. Gastrointestinal and dermatological toxicities were the most common clinical chemotherapy-related adverse events. Further investigation and monitoring to evaluate causality associated with unlabeled AEs identified in this analysis are needed.
Antineoplastic Agents ; Drug Toxicity ; Expert Testimony ; Humans ; Male ; Pharmacovigilance ; Platinum Compounds ; Product Labeling ; Protein Kinase Inhibitors ; Pyrimidines ; Skin ; Statistics as Topic ; Taxoids ; United States Food and Drug Administration