The clinical syndrome of venoocclusive disease of the liver is one of several manifestations of regimen-related toxicity that can occur after high-dose cytoreductive therapy. Hepatic dysfunction after bone marrow transplantation may result from a number of causes such as pretransplant chemoradiation, graft-versus host disease, drugs for prophylaxis of graft-versus host disease, venoocclusive disease, various infections, and infiltration of recurrent malignancy. The clinical distinction of these causes may be difficult and the treatment of each cause is also quite different. Therefore the diagnosis of veno-occlusive disease is important. Veno-occlusive disease affects zone 3 of the liver acinus and produces a syndrome of jaundice, painful hepatomegaly, and fluid retention. Veno-occlusive disease occurs in up to 50% of the patients who undergo BMT and is usually associated with a high mortality rate. In Korea, there are a few case reports on venoocclusive disease after BMT which were only confirmed by clinical symptoms. This is a first report of two cases of hepatic veno-occlusive disease after allogenic BMT, which were proven by laparoscopic liver biopsy in our country.
Biopsy* ; Bone Marrow Transplantation* ; Bone Marrow* ; Diagnosis ; Hepatic Veno-Occlusive Disease* ; Hepatomegaly ; Humans ; Jaundice ; Korea ; Leukemia ; Liver* ; Mortality

The clinical syndrome of venoocclusive disease of the liver is one of several manifestations of regimen-related toxicity that can occur after high-dose cytoreductive therapy. Hepatic dysfunction after bone marrow transplantation may result from a number of causes such as pretransplant chemoradiation, graft-versus host disease, drugs for prophylaxis of graft-versus host disease, venoocclusive disease, various infections, and infiltration of recurrent malignancy. The clinical distinction of these causes may be difficult and the treatment of each cause is also quite different. Therefore the diagnosis of veno-occlusive disease is important. Veno-occlusive disease affects zone 3 of the liver acinus and produces a syndrome of jaundice, painful hepatomegaly, and fluid retention. Veno-occlusive disease occurs in up to 50% of the patients who undergo BMT and is usually associated with a high mortality rate. In Korea, there are a few case reports on venoocclusive disease after BMT which were only confirmed by clinical symptoms. This is a first report of two cases of hepatic veno-occlusive disease after allogenic BMT, which were proven by laparoscopic liver biopsy in our country.
Biopsy* ; Bone Marrow Transplantation* ; Bone Marrow* ; Diagnosis ; Hepatic Veno-Occlusive Disease* ; Hepatomegaly ; Humans ; Jaundice ; Korea ; Leukemia ; Liver* ; Mortality

Typhoid fever can cause serious complications, such as enterobrosia, meningitis, pneumonia, myocarditis, hepatitis, osteomyelitis, and disseminated intravascular coagulation in 10-15% of the patients. Kidney complications are very rare, and a few cases have been reported in children. We are reporting a case of childhood typhoid fever complicated with acute nephritis present with albuminuria, hypertension, and renal failure.
Albuminuria ; Child ; Disseminated Intravascular Coagulation ; Hepatitis ; Humans ; Hypertension ; Kidney ; Meningitis ; Myocarditis ; Nephritis* ; Osteomyelitis ; Pneumonia ; Renal Insufficiency ; Typhoid Fever*

A 3-month-old asymptomatic infant presented with bilateral extensive consolidation of the lungs, which was diagnosed as pulmonary tuberculosis. Evaluation of the baby for tuberculosis was initiated because of a history of contact with a known tuberculosis patient. This case is interesting because the baby rarely showed symptoms during the whole course of the disease.
Asymptomatic Infections ; Humans ; Infant* ; Lung ; Tuberculosis ; Tuberculosis, Pulmonary*

Myasthenia gravis, a disease characterized by weakness and easy fatigue of skeletal muscles, has been associated with other diseases of presumed autoimmune nature. These include rheumatoid arthritis, systemic lupus erythematosus, thyroid dysfunction, hematologic disease, gammopathy, infection, cancer, inflammatory myopathy, etc. In some cases of myasthenia gravis, an inflammatory myopathy develops and adds to the weakness already caused by the transmission defect. We report a 31-year-old female who had the manifestations of myasthenia gravis and polymyositis with the brief review of literatures.
Adult ; Arthritis, Rheumatoid ; Fatigue ; Female ; Hematologic Diseases ; Humans ; Lupus Erythematosus, Systemic ; Muscle, Skeletal ; Myasthenia Gravis* ; Myositis ; Polymyositis* ; Thyroid Gland

PURPOSE: This study aimed to evaluate the clinical factors that could influence the length of hospital stay (LHS) of infants with acute bronchiolitis using the bronchiolitis severity score (BSS). METHODS: The medical records of 105 infants aged 0–12 months with acute bronchiolitis who were admitted to a tertiary hospital between December 2014 and May 2015 were reviewed. The BSS was composed 5 factors, namely general condition, wheezing, chest retraction, respiration rate, and peripheral oxygen saturation, which were evaluated at admission. In addition, the age of the infants, LHS, body weight, birth history, familial history, laboratory test result, chest X-ray, and treatment modalities were reviewed. Subjects were classified into 3 groups according to their BSS, and logistic regression analysis was used to identify the association of the BSS with longer LHS. RESULTS: Among subjects, 62 were studied. Their mean LHS and age were 5.5±2.0 days and 3.9±2.7 months, respectively. Twelve infants were classified as mild (20.3%), 43 as moderate (68.8%), and 7 as severe (10.9%). Venous blood gas pH value and white blood cell count were the best predictors of disease severity. The LHS was associated with the BSS, age, body weight and pCO2 by venous blood gas analysis (P<0.05). CONCLUSION: The LHS was associated with the BSS, age, body weight, and pCO₂ by venous blood gas analysis at admission. The BSS could be a useful tool to predict disease severity and decide treatment strategies for infants with acute bronchiolitis who have no known risk factors.
Blood Gas Analysis ; Body Weight ; Bronchiolitis* ; Hospitalization ; Humans ; Hydrogen-Ion Concentration ; Infant* ; Length of Stay* ; Leukocyte Count ; Logistic Models ; Medical Records ; Oxygen ; Reproductive History ; Respiratory Rate ; Respiratory Sounds ; Risk Factors ; Tertiary Care Centers ; Thorax

Seasonal influenza is a significant cause of morbidity and mortality of children in Korea. However, few data are available on parental perception and action toward childhood influenza. This study aimed to characterize parental perception and patterns of action in response to influenza and influenza-like illnesses (ILIs), including vaccination and healthcare use. This prospective study involved a random survey of parents whose children were aged 6–59 months. The survey was conducted in October 2014. The study included 638 parents of 824 children younger than 6 years. Most parental information of influenza came from mass media (28.2%) and social media (15.5%). The factor that most often motivated parents to vaccinate their children against influenza was promotion of the government or mass media (36.6%). Negative predictors of immunization included safety concerns about influenza vaccination (28.1%) and mistrust in the vaccine's effectiveness (23.3%). Therefore, correct information about influenza and vaccination from mass media will be one of the cornerstones for implementing a successful childhood immunization program and reducing morbidity and mortality in Korea. Furthermore, to enroll younger children in vaccination programs, and to minimize coverage gaps, public concerns about vaccine safety should be resolved. The demographic data in the present study will be used to provide a deeper insight into a parental perception and will help health care providers increase influenza immunization rate.
Child* ; Delivery of Health Care* ; Health Personnel ; Humans ; Immunization ; Immunization Programs ; Influenza Vaccines ; Influenza, Human ; Korea* ; Mass Media ; Mortality ; Parents* ; Prospective Studies ; Seasons ; Social Media ; Vaccination*

PURPOSE: There are limited population-based data regarding herpes zoster in children. Thus we conducted a multi-institutional epidemiological analysis of herpes zoster in children and comparative analysis according to their immune status. MATERIALS AND METHODS: The study included 126 children under the age of 18 years who were hospitalized for herpes zoster at 8 hospitals in South Korea, between July 2009 and June 2015. The subjects were divided into 2 groups according to their immune status, and medical records were reviewed. RESULTS: There were 61 cases (48.4%) in the immunocompetent group and 65 cases (51.6%) in the immunocompromised group. Median age was older in immunocompromised group (11.4 vs. 8.6) (p<0.001). The mean duration of hospitalization was longer in immunocompromised group (11.0 vs. 6.6) (p<0.001). Patients were treated with oral or intravenous antiviral agents. A total of 12 in immunocompetent group were cured only by oral acyclovir. No treatment failure was found in both groups. Six immunocompromised patients had postherpetic neuralgia and 1 case was in immunocompetent group. In immunocompetent children, herpes zoster was likely caused by early varicella infection. There was no increase in progression of severity in both groups due to appropriate treatment. CONCLUSION: Early initiation of therapy is necessary for those in immunocompromised conditions. And inactivated herpes zoster vaccination may be considered in immunocompromised adolescents in the future.
Acyclovir ; Adolescent ; Antiviral Agents ; Chickenpox ; Child ; Child, Hospitalized ; Herpes Zoster ; Hospitalization ; Humans ; Immunocompromised Host ; Korea ; Medical Records ; Neuralgia, Postherpetic ; Treatment Failure ; Vaccination

BACKGROUND AND AIMS: The major complications of reflux esophagitis are stricture formation and Barrett's esophagus. In Korea, the incidence of these complications is low and most patients with reflux esophagitis undergo a mild clinical course. The purpose of this study was to investigate patterns of acid reflux and esophageal motility in mild reflux esophagitis in Korea. METHODS: Using conventional manometry and 24-hour ambulatory pH monitoring, we were investigated esophageal motility and patterns of gastroesophageal reflux in 41 patients with reflux esophagitis Savary-Miller (S-M) Ib using on endoscopy. The total supine, and upright reflux periods, as well as frequency and duration of reflux episodes were determined from the 24-hour pH monitoring record using standard software. Pathologic reflux was defined when the percentage of the total time with pH less than 4 (acid exposure time) exceeded 4%. RESULTS: Pathologic reflux was observed in 17 patients (41.5%), who were categorized into upright refluxers (70.6%), supine refluxers (11.8%), and combined refluxers (17.6%). Patients with reflux esophagitis did not differ in lower esophageal sphincter pressure from the normal subjects. There were two patients (4.9%) with a lower esophageal pressure > or =10 mmHg and four patients (9.8%) with hiatal hernia. Failed peristalsis was seen in 4 patients (9.8%). CONCLUSIONS: A high proportion of upright reflux and low incidence of esophageal peristaltic dysfunction may contribute to the low incidence of stricture formation and Barrett's esophagus in patients with mild reflux esophagitis in Korea.
Barrett Esophagus ; Constriction, Pathologic ; Endoscopy ; Esophageal pH Monitoring ; Esophageal Sphincter, Lower ; Esophagitis, Peptic* ; Gastroesophageal Reflux* ; Hernia, Hiatal ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Korea ; Manometry ; Peristalsis

Subcutaneous panniculitis-like T cell lymphoma (SPTL) is a distinctive cutaneous lymphoma characterized by an infiltration of subcutaneous tissue by neoplastic T cells, similar to panniculitis. It is well-established that patients who are diagnosed with SPTL usually respond poorly to chemotherapy, showing fatal outcome. As a first line treatment for SPTL, anthracycline-based chemotherapy was most frequently used. For the treatment of SPTL, the efficacy of cyclosporine A has been recently reported in relapsed SPTL after anthracycline-based chemotherapy. However, it is still not clear whether cyclosporine A can be used as a first-line treatment against SPTL. Here, we report a case of SPTL, which achieved complete remission for nine years after first-line cyclosporine A therapy. This study suggests that cyclosporine A can induce a complete long-term remission as a first-line treatment.
Cyclosporine* ; Drug Therapy ; Fatal Outcome ; Humans ; Lymphoma ; Lymphoma, T-Cell* ; Panniculitis ; Subcutaneous Tissue ; T-Lymphocytes