BACKGROUND: The purpose of this study was to find the factors associated with becoming obese children during the past 2 years in 6th grade children of elementary school and then to evaluate the high risk groups for childhood obesity. METHODS: The 738 children from May to June, 2001 in 6th grade of 5 elementary schools in Busan were the subjects of this study. The children's height and weight in 4th grade and 6th grade were obtained from school health records. We calculated the body mass index in 4th and 6th grades and classified into 3 weight groups (normal, at risk for obesity, and obese) according to the age and sex-specific BMI established by the Korean Academy of Pediatrics. If children's weight group in 4th grade was changed to heavier weight group in 6th grade, we defined it as increased group. Otherwise, we defined it as non-increased group. The association between the increase in weight group and parental and children's characteristics were analyzed by x2-test, x2-test for the trend, t-test, ANOVA and multiple logistic regression. RESULTS: Among the total, 3.3% of children with normal weight and 16.9% of children at the risk for obesity in 4th grade were transformed to increased group in 6th grade, respectively (P<0.001). Children who had excessive appetite (P<0.001), watched TV greater than or equal to 2 hours per day (P=0.004) or had an obese father (P=0.044) were more likely to become increased group. After adjusting for father's obesity, appetite and TV watching time in children, the odds ratio of transforming to increased group after 2 years in children at risk for obesity or in obese child in 4th grade was 2.5 (95% CI: 1.09~5.55) compared to children with normal weight. Children having excessive appetite were 3.2 times (95% CI: 1.42~7.01) more likely to become the increased group after adjusting for father's obesity, TV watching time and weight in 4th grade. Children watching TV greater than or equal to 2 hours/day was 2.8 times (95% CI: 1.27~6.18) more likely to become increased group after adjusting for father's obesity, appetite and weight in 4th grade. CONCLUSION: The risk of becoming obese was higher in children at risk for obesity or obese children in those with excessive appetite or those who have watched TV> or =2 hours/day for the past two years. These findings suggest promotion of educational plan to prevent childhood obesity.
Appetite ; Body Mass Index ; Busan* ; Child* ; Fathers ; Humans ; Logistic Models ; Obesity ; Odds Ratio ; Parents ; Pediatric Obesity ; Pediatrics ; Risk Factors ; School Health Services

Blood culture-negative infective endocarditis (CNE) can be a diagnostic dilemma. Herein, we report a case of CNE caused by Haemophilus parainfluenzae identified only via 16S rRNA sequence analysis directly from valve tissue. A 17-year-old boy presented with high spiking fever for one month. Pansystolic murmur (Grade III) and vegetation (0.65x0.26 cm and 0.62x0.55 cm) on the anterior mitral valve leaflet via transesophageal echocardiogram suggested the diagnosis of infective endocarditis (IE). However, blood culture performed on admission was negative even after 2 weeks of incubation. Gram stain and culture of a direct tissue specimen failed to identify causative microorganism, while 16S rRNA gene sequences (548 bp) showed 100% identity with those of Haemophilus parainfluenzae (GenBank: FJ939586.1). The 16S rRNA sequence analysis with a direct tissue specimen might be useful in cases of CNE.
Endocarditis ; Fever ; Genes, rRNA ; Haemophilus ; Haemophilus parainfluenzae ; Mitral Valve ; Sequence Analysis

The Korean Society of Otorhinolaryngology-Head and Neck Surgery and Korean Rhinologic Society appointed a guideline development group (GDG) to establish a clinical practice guideline, and the GDG developed a guideline for nasal irrigation for adult patients with chronic rhinosinusitis (CRS). The guideline focuses on knowledge gaps, practice variations, and clinical concerns associated with nasal irrigation. Nasal irrigation has been recommended as the first-line treatment for CRS in various guidelines, and its clinical effectiveness has been demonstrated through a number of studies with robust evidence. However, no guidelines have presented a consistent nasal irrigation method. Several databases, including OVID Medline, Embase, the Cochrane Library, and KoreaMed, were searched to identify all relevant papers using a predefined search strategy. When insufficient evidence was found, the GDG sought expert opinions and attempted to fill the evidence gap. Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. The committee developed 11 evidence-based recommendations. This guideline focuses on the evidence-based quality improvement opportunities deemed the most important by the GDG. Moreover, the guideline addresses whether nasal lavage helps treat CRS, what type of rinsing solution should be used, and the effectiveness of using additional medications to increase the therapeutic effect.

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract, but also occurs at a lower frequency in extra-gastrointestinal regions such as omentum, mesentery, retroperitoneum and undefined abdominal sites. This tumor is called extragastrointestinal stromal tumor (EGIST). EGIST is mostly diagnosed as a cystic mass, but rarely occurs as a disseminated abdominal tumor. We experienced a 70-year-old man with primary EGIST presenting as peritoneal dissemination. Abdominal CT showed diffuse peritoneal thickening with a large amount of ascites, but no definite mass lesion. Laparoscopic biopsy was performed and histologic findings showed tumor composed of epithelioid cells. In the results of immunohistochemical stains, the tumor showed positive reactivity with CD117 (c-kit), CD34, vimentin and actin, but negative reactivity with desmin and S-100 protein. On account of unresectability and histologic parameters of malignant behavior, he was started on imatinib.
Actins/metabolism ; Aged ; Antigens, CD34/metabolism ; Gastrointestinal Stromal Tumors/*diagnosis/pathology ; Humans ; Laparoscopy ; Male ; Peritoneal Neoplasms/*diagnosis/secondary ; Positron-Emission Tomography ; Proto-Oncogene Proteins c-kit/metabolism ; Tomography, X-Ray Computed ; Vimentin/metabolism

Myxoglobulosis is a rare morphologic variant of appendiceal mucocele. We reported herein a case of myxoglobulosis in a 50-year-old man who presented with an appendiceal mass following a several months symptomatic course. Double contrast barium study showed filling defect in cecum. Computed tomograph showed well defined tubular, cystic lesion with slight wall enhancement at the appendiceal area. Laparotomy disclosed a distended appendix, measuring 12.0 4.0 cm, without perforation containing white to pale yellowish globules, reminiscent of parasitic eggs. Microscopically globules are composed of centers of inflamed granulation tissue and amorphous granular necrotic debris, surrounded by rings of inspissated mucous shells. The wall shows devoid of a lining epithelium. We performed ileocecectomy.
Appendix* ; Barium ; Cecum ; Eggs ; Epithelium ; Granulation Tissue ; Humans ; Laparotomy ; Middle Aged ; Mucocele ; Ovum

Xanthogranulomatous inflammation is a rare chronic inflammatory condition that is characterized by aggregation of lipid-laden foamy macrophages (xanthoma cells). Although the precise pathogenesis of xanthogranulomatous inflammation is not well understood, various mechanisms have been proposed, including chronic recurrent infection, the presence of gallstones, immunologic disorders and defective lipid transport. This disease entity is well recognized in the kidney and gallbladder, yet involvement of the gastrointestinal tract is extremely rare and the involvement of both the stomach and colon has never been reported on. A coexisting malignancy rarely has been reported in a patient with xanthogranulomatous inflammation. This might present as an inflammatory mass-like lesion with infiltration to the surrounding tissues, and so this often mimics advanced cancer. Therefore, a surgical operation together with careful pathological evaluation is required for making the precise diagnosis. We herein report on a case of xanthogranulomatous inflammation that presented as a submucosal mass in the stomach which was a huge irregular mass involving transverse colon.
Colon ; Colon, Transverse ; Gallbladder ; Gallstones ; Gastrointestinal Tract ; Humans ; Inflammation ; Kidney ; Macrophages ; Stomach

Aspiration of foreign bodies into tracheobronchial tree is more common in children than in adults. Foreign bodies in airway commonly occur by accident, and in most cases they get removed without delay. Small foreign bodies that lodge in the peripheral airway are often asymptomatic initially and can result in respiratory symptoms several years later. Although foreign body aspiration is frequently suspected in children with acute or recurrent pulmonary symptoms, it is rarely considered in adults, unless a clear history of an aspiration event can be obtained. We have experienced and studied a case of occult aspiration of a shrimp which had been lodged for a long period.
Adult ; Bronchi* ; Bronchoscopy* ; Child ; Foreign Bodies* ; Humans

Objectives: . Due to the rarity of olfactory neuroblastoma (ONB), there is ongoing debate about optimal treatment strategies, especially for early-stage or locally advanced cases. Therefore, our study aimed to explore experiences from multiple centers to identify factors that influence the oncological outcomes of ONB. Methods: . We retrospectively analyzed 195 ONB patients treated at nine tertiary hospitals in South Korea between December 1992 and December 2019. Kaplan-Meier survival analysis was used to evaluate oncological outcomes, and a Cox proportional hazards regression model was employed to analyze prognostic factors for survival outcomes. Furthermore, we conducted 1:1 nearest-neighbor matching to investigate differences in clinical outcomes according to the use of neoadjuvant chemotherapy. Results: . In our cohort, the 5-year overall survival (OS) rate was 78.6%, and the 5-year disease-free survival (DFS) rate was 62.4%. The Cox proportional hazards model revealed that the modified Kadish (mKadish) stage and Dulguerov T status were significantly associated with DFS, while the mKadish stage and Hyams grade were identified as prognostic factors for OS. The subgroup analyses indicated a trend toward improved 5-year DFS with dural resection in mKadish A and B cases, even though the result was statistically insignificant. Induction chemotherapy did not provide a survival benefit in this study after matching for the mKadish stage and nodal status. Conclusion . Clinical staging and pathologic grading are important prognostic factors in ONB. Dural resection in mKadish A and B did not show a significant survival benefit. Similarly, induction chemotherapy also did not show a survival benefit, even after stage matching.