Chronic pancreatitis is a rare problem in childhood and sometimes shows pancreatic calcification. The most common symptom is recurrent upper abdominal pain with or without associated nausea or vomiting. Pancreatic calcifications are virtually pathognomonic of chronic pancreatitis. In our case, however, chronic pancreatitis caused by multiple pancreatic stones in dilated pancreatic duct, which was very rare in childhood. Endoscopic retrograde cholangiopancreaticography (ERCP) is valuable in confirming the diagnosis and decision making process for further medical or surgical management of pancreatic disease. We experienced a case of chronic relapsing pancreatitis with pancreatic stones in 13-year-old girl who presented with recurrent upper abdominal pain. She was investigated with ERCP and treated by endoscopic sphincterotomy of sphincter of Oddi and by some stone removal with endoscopic basket. We report this case and review related literatures briefly.
Abdominal Pain ; Adolescent ; Cholangiopancreatography, Endoscopic Retrograde ; Decision Making ; Diagnosis ; Female ; Humans ; Nausea ; Pancreatic Diseases ; Pancreatic Ducts ; Pancreatitis* ; Pancreatitis, Chronic ; Sphincter of Oddi ; Sphincterotomy, Endoscopic ; Vomiting

The purpose of this study was to assess several indices of diet quality based on nutrient, food and food group intake of Korean adolescents based on several indices on diet quality according to residence area and body size. Using the data from the 1998 National Health and Nutrition Survey, twenty-four-hour-dietary recalls of a total of 1,110 Korean adolescents aged 13-19 years (male 543, female 567) were analyzed for nutrient adequacy ratio (NAR), index of nutritional quality (INQ), the number of foods (Dietary Variety Score, DVS) and food group consumed (Dietary Diversity Score, DDS). In doing that, it was attempted to apply only the minimum amount of solid foods of Kant's without inclusion of liquid foods because of the very limited variety in Korean foods. Based on weight length index, 13.1% of the subjects were categorized as obese, 14.2%, overweight, 44.4%, normal and 28.3%, underweight. Only vitamin B2 intake was higher in the obese group than in the underweight group. There was no meaningful difference in energy, protein and fat intakes according to the grade of the body size. In terms of residence area, intake of fat, niacin, vitamin B6 and folic acid were lower in the rural areas than in the metropolitan city. Only vitamin E intake was higher in the rural areas. Mean value of NARs (MAR) and INQs (mINQ) was also higher in the metropolitan city than in the rural areas, but there was no significant difference of these two values according to body size of the subjects. Mean DVS was 21.02 for total subjects, and has no difference between male and female and between metropolitan city and other medium-small city. But, the rural areas showed the lowest DVS of 19.05. Mean DDS in which five is a maximum score was 3.3 with no significant difference by sex and by residence area in male subjects. However, in female subjects, DDS in the rural areas was the lowest. According to body size of the subjects, there was no meaningful difference in both scores of DVS and DDS. In conclusion, most indices of nutrient intake and food and food group intake were not significantly different by body size of the subjects, while most indices were significantly different by residence areas: higher in the metropolitan city than in the rural area.
Adolescent* ; Body Size* ; Diet* ; Female ; Folic Acid ; Humans ; Male ; Niacin ; Nutrition Surveys ; Nutritive Value ; Overweight ; Riboflavin ; Thinness ; Vitamin B 6 ; Vitamin E ; Vitamins

BACKGROUND: Severe forefoot deformities, particularly those involving the dorsum of the foot, cause inconvenience in daily activities of living including moderate pain on the dorsal aspect of the contracted foot while walking and difficulty in wearing nonsupportive shoes due to toe contractures. This paper presents clinical results of reconstruction of severe forefoot deformity using the anterolateral thigh (ALT) free flap. METHODS: Severe forefoot deformities were reconstructed using ALT flaps in 7 patients (8 cases) between March 2012 and December 2015. The mean contracture duration was 28.6 years. RESULTS: All the flaps survived completely. The size of the flaps ranged from 8 cm × 5 cm to 19 cm × 8 cm. The mean follow-up period was 10 months (range, 7 to 15 months). There was no specific complication at both the recipient and donor sites. There was one case where the toe contracture could not be completely treated after surgery. All of the patients were able to wear shoes and walk without pain. Also, the patients were highly satisfied with cosmetic results. CONCLUSIONS: The ALT flap may be considered ideal for the treatment of severe forefoot deformity.
Congenital Abnormalities ; Contracture* ; Follow-Up Studies ; Foot ; Foot Deformities ; Free Tissue Flaps ; Humans ; Shoes ; Thigh* ; Tissue Donors ; Toes ; Walking

OBJECTIVES: In the unique metal iris method, the developing interfacial gap at the cavity floor resulting from the cavity wall property during polymerizing composite resin might affect the nominal shear bond strength values. The aim of this study is to evaluate that the iris method reduces the cohesive failure in the substrates and the cavity wall property effects on the shear bond strength tests using iris method. MATERIALS AND METHODS: The occlusal dentin of 64 extracted human molars were randomly divided into 4 groups to simulate two different levels of cavity wall property (metal and dentin iris) and two different materials (ONE-STEP(R) and ALL-BOND(R) 2) for each wall property. After positioning the iris on the dentin surface, composite resin was packed and light-cured. After 24 hours the shear bond strength was measured at a crosshead speed of 0.5 mm/min. Fracture analysis was performed using a microscope and SEM. The data was analyzed statistically by a two-way ANOVA and t-test. RESULTS: The shear bond strength with metal iris was significant higher than those with dentin iris (p = 0.034). Using ONE-STEP(R), the shear bond strength with metal iris was significant higher than those with dentin iris (p = 0.005), but not in ALL-BOND(R) 2 (p = 0.774). The incidence of cohesive failure was very lower than other shear bond strength tests that did not use iris method. CONCLUSIONS: The iris method may significantly reduce the cohesive failures in the substrates. According to the bonding agent systems, the shear bond strength was affected by the cavity wall property.
Dentin ; Humans ; Incidence ; Iris* ; Molar ; Polymers

Background: The purpose of this study was to measure several mental health variables according to HbA1c level and examine their relationship among diabetic patients. Methods: Total 89 outpatients who attended diabetes education program at St. Vincent’s Hospital, The Catholic University of Korea College of Medicine, were enrolled this study. The Beck Depression Inventory (BDI), State-Trait Anxiety Inventory, Stress Response Inventory (SRI), abbreviated version of World Health Organization Quality of Life assessment instrument (WHOQOL-BREF), Insomnia Severity Index, and Epworth Sleepiness Scale (ESS) were administered to all patients. Significant differences between groups were assessed by t-test and chi-squared test. Pearson correlation and multiple linear regression analyses were used to identify the variables that affect HbA1c levels. Results: The well-controlled group had a significantly lower BDI score than the poorly controlled group. The wellcontrolled group also showed significantly lower SRI and ESS. HbA1c, BDI, SRI, and ESS were positively correlated. Duration and BDI were the only variables affecting HbA1c levels. Conclusion Emphasis should be given to the identification and management of mental health problems, including especially depressive symptoms in patients with diabetes.

OBJECTIVES: This study investigated the hypothesis that increasing light-curing time would leave the oxygen-inhibited layer (OIL) of the adhesive thinner, and in turn, result in lower shear bond strength (SBS) than those obtained by the routine curing procedures. METHODS: 120 human extracted posterior teeth were randomly divided into three groups for bonding with three adhesives: All Bond 2(R), One Step(R), and Adper Prompt(R). They were subsequently divided into four subgourps with different light-curing time (10, 20, 30 and 60 s). The assigned adhesives were applied on superficial occlusal dentin according to the manufacturer's instructions and cured with one of the four curing times. Composite resin cylinder, 2.35 mm in diameter, were built on the cured adhesive and light-cured for 40 s. SBS were measured after 24 h from the bonding using a universal testing machine (crosshead speed 1.0 mm/min). The relative thickness of the OIL and the degree of conversion (DC) were determined from the adhesive on a slide glass using FT-NIR in an absorbance mode. Data were analysed with One-way ANOVA and Duncan's multiple test (p < 0.05). RESULTS: With increasing cure time, although there were no significant difference in th SBS of One-step and Adper Prompt (p > 0.05), those of All Bond 2 decreased significantly (p < 0.05). The relative thicknesses of the OIL on each adhesive were not affected by the cure time (p > 0.05). Although the DC of All-Bond 2 were statistically not different with increasing cure time (p > 0.05), those of One-Step and Adper Prompt showed an increasing trends with increasing cure time (p < 0.05). CONCLUSIONS: Increasing light-curing time did not affect on the relative thickness of the OIL of the adhesives, and in turn, on the SBS to dentin.
Adhesives* ; Dentin* ; Glass ; Humans ; Tooth

OBJECTIVES: This study investigated the hypothesis that increasing light-curing time would leave the oxygen-inhibited layer (OIL) of the adhesive thinner, and in turn, result in lower shear bond strength (SBS) than those obtained by the routine curing procedures. METHODS: 120 human extracted posterior teeth were randomly divided into three groups for bonding with three adhesives: All Bond 2(R), One Step(R), and Adper Prompt(R). They were subsequently divided into four subgourps with different light-curing time (10, 20, 30 and 60 s). The assigned adhesives were applied on superficial occlusal dentin according to the manufacturer's instructions and cured with one of the four curing times. Composite resin cylinder, 2.35 mm in diameter, were built on the cured adhesive and light-cured for 40 s. SBS were measured after 24 h from the bonding using a universal testing machine (crosshead speed 1.0 mm/min). The relative thickness of the OIL and the degree of conversion (DC) were determined from the adhesive on a slide glass using FT-NIR in an absorbance mode. Data were analysed with One-way ANOVA and Duncan's multiple test (p < 0.05). RESULTS: With increasing cure time, although there were no significant difference in th SBS of One-step and Adper Prompt (p > 0.05), those of All Bond 2 decreased significantly (p < 0.05). The relative thicknesses of the OIL on each adhesive were not affected by the cure time (p > 0.05). Although the DC of All-Bond 2 were statistically not different with increasing cure time (p > 0.05), those of One-Step and Adper Prompt showed an increasing trends with increasing cure time (p < 0.05). CONCLUSIONS: Increasing light-curing time did not affect on the relative thickness of the OIL of the adhesives, and in turn, on the SBS to dentin.
Adhesives* ; Dentin* ; Glass ; Humans ; Tooth

We report four cases of Ganoderma lucidum-induced aplastic anemia involving members of the same family. A 33-year-old man and three family members were admitted to the hospital due to fever and pancytopenia. The illness arose after ingesting herbal wine containing G. lucidum 2 weeks earlier. A bone-marrow biopsy showed hypocellularity in three of the four family members (the exception was the one who died). They were treated with supportive management, including transfusions, granulocyte colony stimulating factor, and empirical antibiotics for neutropenic fever. The pancytopenia improved 4-5 weeks after the symptoms first appeared.
Adult ; Anemia, Aplastic* ; Anti-Bacterial Agents ; Biopsy ; Colony-Stimulating Factors ; Fever ; Ganoderma ; Granulocytes ; Humans ; Pancytopenia ; Plants, Medicinal ; Reishi* ; Wine

A 39-year-old man with a history of hypertension for 10 years and 10 pack-years smoking, was admitted with dyspnea and generalized edema. On admission, renal insufficiency accompanied with nephrotic syndrome was diagnosed. Even on careful examination including history, blood chemistry test, and fundoscopic examination, no clinical evidence of diabetes was found. Renal biopsy findings, which strongly resembled that of diabetic nodular glomerulosclerosis in microscopic features, showed glomerular hypertrophy and nodular mesangeal sclerosis. Additional immunohistochemistry and ultrastructural investigations excluded other possible diseases that should be differentiated; membranoproliferative glomerulonephritis, thrombotic microangiopathy, amyloidosis, monoclonal immunoglobulin deposition disease, fibrillary glomerulonephritis, and immunotactoid glomerulopathy. Idiopathic nodular glomerulosclerosis is histopathologically similar to nodular diabetic glomerulosclerosis but is unusually developed in persons with hypertension and smoking history. Though there were three reports about cases of nodular glomerulosclerosis in the Korean literature, the cases were related to hepatitis B virus or diabetic retinopathy without overt diabetes. We report a rare case of idiopathic nodular glomerulosclerosis that was related to hypertension and smoking without other medical history.
Adult ; Amyloidosis ; Biopsy ; Chemistry ; Diabetic Nephropathies* ; Diabetic Retinopathy ; Dyspnea ; Edema ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative ; Hepatitis B virus ; Humans ; Hypertension* ; Hypertrophy ; Immunoglobulins ; Immunohistochemistry ; Nephrotic Syndrome ; Renal Insufficiency ; Sclerosis ; Smoke* ; Smoking* ; Thrombotic Microangiopathies

OBJECTIVES: We aimed to investigate the discontinuation rate and reasons of doxepin base prescription pattern in insomnia outpatients of psychiatry department of a university hospital. METHODS: 534 patients prescribed doxepin were screened. 201 patients were included and reviewed for their medical records retrospectively. The discontinuation rate and reasons of doxepin after 2 months of prescription were investigated. Patients were divided into three groups according to the prescription patterns. The initial group, prescribed doxepin as the first hypnotic, the add-on group, prescribed doxepin while maintaining existing hypnotics, and the switching group, prescribed doxepin after discontinuation of existing hypnotics. RESULTS: The discontinuation rate after 2 months of prescription of doxepin was 56.2%. There were significant differences in the discontinuation rate among three groups. The initial group had the highest while the add-on group had the lowest (p=0.018). In reasons for discontinuation of doxepin among three groups, lack of efficacy (p < 0.001) and adverse events (p < 0.001) were significantly higher in the add-on group. In the initial group, patient's refusal (p=0.022) and unknown or loss to follow up (p < 0.001) were significantly higher. CONCLUSIONS: The results of this study suggested that add-on is superior than switching method and gradual reduction of existing hypnotics is necessary to maintain doxepin treatment and prevent adverse events. Additional large scale prospective studies are needed to evaluate various factors and risks of discontinuation of doxepin.
Doxepin ; Follow-Up Studies ; Humans ; Hypnotics and Sedatives ; Medical Records ; Methods ; Outpatients ; Prescriptions ; Prospective Studies ; Retrospective Studies ; Sleep Initiation and Maintenance Disorders